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Generate impression based on findings. | 47 year old female who has a complaint of palpable left breast area. History of benign right breast biopsy. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts, a laterally exaggerated left CC view, and 2 spot compression views of the left 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. There is a partially circumscribed mass within the upper outer, far posterior left breast, which persists on spot compression views. Stable calcifications are present in the upper outer left breast. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. There is partial visualization of a prominent lymph node within the left axilla. ULTRASOUND: On physical examination, there is a 3 cm firm palpable mass at the 2 o'clock position of the left breast. No axillary mass is identified.A targeted left ultrasound was performed for the palpable and mammographic areas of concern. At the 2 o'clock position of the left breast, 6 cm from the nipple there is a lobulated, hypoechoic mass with echogenic halo measuring 2.8 x 2.1 x 3.0 cm with increased vascularity. Targeted ultrasound of the left axilla was also performed. There is a single enlarged lymph node within the deep axilla measuring up to 2.2 cm, with non-hilar cortical flow. A single benign morphology lymph node is visualized adjacent to the abnormal, enlarged node. | 1. Hypoechoic, lobulated mass measuring 3.0 cm at the 2:00 position of the left breast. Ultrasound guided biopsy is recommended.2. Enlarged left axillary lymph node with non-hilar cortical flow. Ultrasound guided biopsy is also recommended for this lesion. BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | SCC of the lip post induction. CHEST:LUNGS AND PLEURA: No significant change in 3-mm micronodule right lower lobe (6/33). No suspicious lesions.MEDIASTINUM AND HILA: Mild coronary artery calcifications. No lymphadenopathy.CHEST WALL: Unchanged lucent lesion in T5 with sclerotic rim. 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: Probable cyst left kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube.BONES, SOFT TISSUES: Nonspecific lucent lesions in the pelvis unchanged. Small area of sclerosis left iliac wing (6/138) unchanged.OTHER: No significant abnormality noted. | No signs of pulmonary or upper abdominal metastases. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in two paternal aunts and ovarian cancer diagnosed in one paternal 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. Circular skin markers were placed over both breasts. Bilateral subcentimeter benign masses are stable or smaller. Bilateral benign calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: h/o esophageal HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Biapical scarring likely related to radiation. Diffuse bronchial wall thickening compatible with post radiation change. Calcified left apical nodule is unchanged. Scattered nonspecific micronodules are unchanged since the prior exam. Mild centrilobular emphysema. No suspicious nodules or masses. Central airways are patent.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No visible coronary artery calcification.Mildly prominent right hilar lymph nodes are not significantly changed since the prior exam.Paramediastinal fibrosis is again noted, with unchanged mild thickening of the trachea, esophagus and tracheoesophageal recess.CHEST WALL: No significant axillary, or cardiophrenic, or retrocrural lymphadenopathy. No suspicious osseous lesions.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypodense segment 4 subcentimeter lesion is unchanged since the prior exam.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted. KIDNEYS, URETERS: Bilateral hypodense lesions are unchanged since prior exam.PANCREAS: No significant abnormality noted. RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta without evidence of aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Presumed ventriculoperitoneal shunt catheter enters the abdomen on the right with tip coursing below the last image.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No conclusive evidence of metastatic disease.2.Unchanged right hilar lymph nodes and upper mediastinal soft tissue stranding. |
Generate impression based on findings. | Female 52 years old; Reason: presumed peripheral T cell lymphoma History: enlarged lymph nodes CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are nonspecific. For example (series 4, image 42). These are unchanged compared to prior study.MEDIASTINUM AND HILA: Right hilar lymph node measures 1.3 x 0.9 Cm (series 3, image 40), previously 1.4 x 0.7 cm. Small mildly prominent left hilar lymph nodes.CHEST WALL: Multiple enlarged axillary lymph nodes. A reference left axillary node measures 1.4 x 1.0 (series 3, image 11), previously 1.3 x 1.2 cm. Enlarged intramammary lymph nodes. A right breast lesion is significantly smaller than on prior study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypoattenuating renal lesions are too small to characterize.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal and common iliac chain lymph nodes do not meet CT criteria for enlargement.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Hypoattenuating lesion within the uterine body may represent underlying fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: Left external iliac lymph node measures 1.8 x 1.2 cm (series 3, image 173), previously 1.8 x 1.1 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Multistation mild lymph node enlargement is not significantly changed compared to prior study.2. Previously identified right breast lesion has decreased in size. |
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. Examination is slightly limited due to patient mental status. The breast parenchyma is composed of scattered fibroglandular density. Mild arterial calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 68 years old male with a history of HNC presents with a new lung nodule. Please compare to CTs and evaluate for metastatic disease.RADIOPHARMACEUTICAL: 14.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion grossly demonstrates an irregular nodule in the right upper lobe. There are multiple calcified gallstones in the gallbladder. The prostate is enlarged.Today's PET examination demonstrates two foci of intense FDG uptake in the irregular nodule in the right upper lobe with SUV Max of 6.8. A large area of increased activity seen in the right apical lung, corresponding to the nodular and patchy opacities seen on CT. There is a micronodule in the left upper lobe with increased activity and SUV Max of 1.8.Minimal FDG uptake is seen in the right upper lobe pleural based nodule with SUV Max of 1.1.Multiple foci of increased activity are seen in the bilateral axillary regions, mediastinum, and both lung hila are nonspecific.There is a focus of increased activity in the rectosigmoid junction with SUV Max of 7.6.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Hypermetabolic irregular right upper lobe nodule with increased activity, highly suspicious for malignant tumor.2.Hypermetabolic foci in the rectosigmoid junction, which can be due to tumor. Suggest further evaluation with colonoscopy.3.Micronodule in the left upper lobe, which can be due to tumor or inflammatory change.4.Right apical opacity with increased activity is most likely due to post-therapy change.5.Right upper lobe pleural based nodule with minimal FDG uptake is most likely benign.6.Gallstones in the gallbladder. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast benign biopsy in 2009. Family history of breast cancer diagnosed in daughter at age 32 and sister at age 54. 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. A biopsy clip is noted in the right lower inner breast, anterior depth. Benign intramammary lymph nodes are present in the left upper outer quadrant. 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. | Pain over left patella. Assess for fracture.VIEWS: Left knee AP/lateral/oblique/merchant (4 views) 03/16/15 A joint effusion is not present. The bones are normal in appearance. No fracture is identified. | Normal examination. |
Generate impression based on findings. | Lung CA restaging. CHEST:LUNGS AND PLEURA: Exam limited by artifact from patient's ICD as well as motion; assessment for subcentimeter lesions is limited. Scattered micronodules, too small to actually characterize. Spherical ground glass opacity nodule in the right upper lobe abutting the fissure measures 12 x 10 mm, difficult to compare to the most recent prior study due to artifact on the outside examination, but not significantly changed from that time. However it may have slightly increased from the exam of 2/3/2014 where it measured approximately 10 x 9 mm and it was not present on a prior CT of 2003.Subpleural opacity in the right costophrenic angle may reflect rounded atelectasis but should be followed. Postsurgical changes of right middle lobectomy.Scattered subcentimeter nodular opacities, some of which are clustered such as in the left upper lobe (8/65-61), suggestive of postinfectious or postinflammatory lesions of the should continue to be followed given patient's history of malignancyMEDIASTINUM AND HILA: No enlarged mediastinal or hilar lymph nodes. Left subclavian ICD. Severe atherosclerotic calcifications of the aorta and its branches, including the coronary arteries.CHEST WALL: Surgical clips in the right breastABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland nodule measures 47 HU on the postcontrast examination, but appeared to be of water density on the outside study. For reference, this measures 24 x 21 mm (axial series image 82, not appreciably changed compared to exams from the 2014 but not present on the 2003 study.KIDNEYS, URETERS: Right renal lesion is probably a cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Limited examination. Indeterminate sub-solid right upper lobe nodule which may represent a new primary tumor such as a low grade adenocarcinoma. Given limitations of today's study, a short-term 3-month follow-up is suggested. No enlarged lymph nodes, please refer to PET scan report. Left adrenal nodule unchanged, also please refer to PET scan report as it is atypical for an adenoma. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in daughter age 45. Patient reports history of being shot in 1952. 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. Extensive metallic bullet fragments in the right axillary tail are again noted. Arterial 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: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Possible left superior canal dehiscence: hyperacusis and vertigo. Right: There is mild deficiency of bone overlying the superior semicircular canal. The inner ear structures are otherwise unremarkable. The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The facial nerve describes a normal course, but appears to be dehiscent along the tympanic segment. The jugular bulb and carotid canal are intact. Left: There is substantial deficiency of bone overlying the superior semicircular canal. The inner ear structures are otherwise unremarkable. The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The facial nerve describes a normal course, but appears to be dehiscent along the tympanic segment. The jugular bulb and carotid canal are intact. | 1. Extensive left and mild right superior semicircular canal dehiscence.2. Dehiscence of the bilateral facial nerve canal tympanic segments. |
Generate impression based on findings. | Status partial wrist fusion. Evaluate status of carpal fusion. Again seen are orthopedic screws affixing the capitolunate and triquetrohamate articulations. I see no hardware complications. Portions of the capitolunate articulation are slightly indistinct, which may reflect early fusion, but appears similar to that seen on the prior study. Ossific densities are again noted within the soft tissues along the dorsum of the carpus, presumably representing bone graft material. There is diffuse soft tissue swelling. There has been resection of the scaphoid. Mild osteoarthritis affects the basilar joint. | Postoperative changes of partial wrist fusion as described above appearing similar to those seen on the prior study. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy in 3/2007. Family history of breast cancer diagnosed in maternal aunt at age 70. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered bilateral benign dermal 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: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 70-year-old female history of right breast cancer on neoadjuvant therapy. LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: There is aberrant right subclavian artery, a normal variant. The heart size is normal without pericardial effusion. Mild coronary artery calcifications. Tortuous aorta. No significant mediastinal or hilar lymphadenopathy. Scattered thyroid hypodensities are stable.CHEST WALL: Right breast mass measures 9mm in the sagittal plane, previously 12mm. There does not appear to be any subjacent chest wall invasion. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Stable hepatic dome and renal hypodensities. | Slight decrease in size of right breast mass without evidence of metastatic disease. |
Generate impression based on findings. | The study is partially degraded secondary to motion artifact. Given this caveat:The lowermost level containing ribs is presumed to be T12. With this numbering nomenclature, there is transitional anatomy with sacralization of L5, a rudimentary L5/S1 disc, and bilateral pseudoarthroses. If an interventional procedure is contemplated, verification with levels by CT or x-ray is recommended.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 throughout sparing the L5/S1 rudimentary disc.T12/L1: UnremarkableL1/2: Diffuse annular disc bulge without significant stenosis.L2/3: Asymmetric bulge to the right and mild bilateral facet hypertrophy. There is mild right neural foraminal stenosis.L3/4: Trace anterolisthesis L3 on L4, asymmetric bulge to the right, ligamentum flavum thickening, moderate left facet hypertrophy, severe right facet hypertrophy, and a right facet effusion. There is moderate central, moderate bilateral lateral recess, mild left neural foraminal, and moderate right neural foraminal stenosis.L4/5: Trace anterolisthesis L4 and L5, asymmetric bulge to the left, ligamentum flavum thickening, and severe bilateral facet hypertrophy. There is mild left lateral recess, moderate left neural foraminal, and mild right neural foraminal stenosis. L5/S1: Unremarkable rudimentary disc. | 1.The study is partially degraded secondary to motion artifact. 2.The lowermost level containing ribs is presumed to be T12. With this numbering nomenclature, there is transitional anatomy with sacralization of L5, a rudimentary L5/S1 disc, and bilateral pseudoarthroses. If an interventional procedure is contemplated, verification with levels by CT or x-ray is recommended.3.L2/3: Mild right neural foraminal stenosis.4.L3/4: Trace anterolisthesis L3 on L4, moderate left facet hypertrophy, severe right facet hypertrophy, and a right facet effusion. There is moderate central, moderate bilateral lateral recess, mild left neural foraminal, and moderate right neural foraminal stenosis.5.L4/5: Trace anterolisthesis L4 and L5 and severe bilateral facet hypertrophy. There is mild left lateral recess, moderate left neural foraminal, and mild right neural foraminal stenosis. |
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. 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. | 47 year old female with hydronephrosis noted on recent ultrasound. Evaluate etiology. ABDOMEN: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: No significant hydronephrosis bilaterally. No nephroureterolithiasis. No focal renal parenchymal is evident. No urothelial lesion is identified on the delayed images.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple enlarged and tortuous left gonadal veins raise the possibility of pelvic congestion syndrome.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No nephroureterolithiasis, hydronephrosis, or renal parenchymal abnormality.2.Multiple enlarged tortuous left gonadal veins raise the possibility of pelvic congestion syndrome. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are 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. | 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. 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. | Esophageal cancer. Evaluate for metastatic disease. Characterize pleural effusion. Look for obstruction. CHEST:LUNGS AND PLEURA: New 1.8 x 4 cm heterogeneous enhancing pleural thickening between the right 7th and 8th ribs, suspicious for metastatic disease (series 3, image 56). Small loculated right pleural effusion, decreased from prior.Large left pleural effusion with adjacent atelectasis, not significantly changed.Increased bilateral paramediastinal ground-glass opacities with associated architectural distortion and mild bronchiectasis, significantly greater on the right, suggestive of post-radiation change.MEDIASTINUM AND HILA: Reference high right tracheoesophageal lymph node is 5 mm, previously 2 mm (series 3, image 11). Other scattered small mediastinal lymph nodes are also mildly increased in size, nonspecific.Severe coronary artery calcification. Small pericardial effusion.Left chest port tip in the SVC.Post-surgical findings of esophagogastrectomy. CHEST WALL: Mild periosteal reaction of the ribs and small erosion of the scapular tip adjacent to the aforementioned pleural thickening at the right 7th and 8th intercostal space (series 3, image 60).Immediately inferior to this pleural thickening, there is extrathoracic soft tissue density obliterating normal muscle fat planes leading to a rim enhancing hypodensity (series 3, images 68 and 75), suspicious for extrathoracic metastases. ABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating hepatic foci, likely cysts, not significantly changed. Cholelithiasis. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Renal cysts. Subcentimeter hypoattenuating renal foci, too small to characterize, unchanged and likely cysts..RETROPERITONEUM, LYMPH NODES: No significant abnormality noted..BOWEL, MESENTERY: Post surgical findings of esophagogastrectomy with enteric tube that terminates in the jejunum. No bowel obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. New heterogenously enhancing pleural thickening at the right 7th and 8th intercostal space, suspicious for a metastases with possible extrathoracic extension. Correlation with tissue biopsy as clinically warranted.2. Small loculated right pleural effusion, decreased from prior. Large left pleural effusion, not significantly changed.3. Mild increased size of scattered small mediastinal lymph nodes, nonspecific. |
Generate impression based on findings. | Pain. Again seen is intramedullary rod and screw device affixing an osteotomy of the distal radius with alignment appearing similar to that seen on the prior study. The osteotomy remains visible, although slightly less distinct on the current study than on the prior study, with maturation of adjacent callus, indicating some interval healing. Also again seen is an ununited ulnar styloid fracture fragment. | Orthopedic fixation of healing distal radial osteotomy as above. |
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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. 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: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female, 58 days old, twin unexplained acute rib fractures. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The osseous structures of skull are intact. No fractures are suspected. The major cranial sutures are patent. Intra-sutural bones are evident within the lambdoid sutures, an occasional anatomic variant. A small area of scalp swelling is present along the right frontal bone. | 1.No acute intracranial abnormality. 2.No evidence of skull fracture.3.Right frontal scalp injury. |
Generate impression based on findings. | Female 45 years old Reason: 45F w/ recent chole complicated by postop cystic artery bleeding now with acutely dropping hgb, eval cystic artery bleeding or other source History: new postop anemia ABDOMEN:LUNG BASES: Bibasal atelectasis. Small bilateral pleural effusions.LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: CT angiogram: Patent origins of the celiac, main hepatic and splenic arteries.Patent origins of the superior mesenteric artery.Patent origins of bilateral renal arteries and inferior mesenteric artery. Bilateral common iliac arteries are patent without significant stenosis.No definite focus of active extravasation is identified.BOWEL, MESENTERY: Relatively hyperdense material is again noted in Morrison's pouch and extending above the right kidney. This measures approximately 5.8 x 3.9 cm, previously 5.9 x 4.1 cm (series 9, image 59) and is essentially stable allowing for differences in imaging technique. The previously described central abdominal lesion, likely hematoma measures 5.1 x 3.7 cm (series 9, image 97), previously 5.2 x 4.1 cm and again is essentially stable allowing for differences in imaging technique. Large-volume abdominopelvic ascites, substantially increased from prior study, and with layering high density material suggestive of blood contents. Right abdominal approach drainage catheter with tip in the left abdomen. Stable small hematoma at site of catheter entry.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small free locules of air, likely related to recent surgery.PELVIS:UTERUS, ADNEXA: Intrauterine device in situ.BLADDER: No significant abnormality notedLYMPH NODES: Multiple nonspecific prominent inguinal and external iliac chain lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Multiple mid abdominal skin staples are again noted and postsurgical changes within the ventral abdominal subcutaneous tissues. Stable probable hematoma beneath the right-sided skin staples.OTHER: No significant abnormality noted | Large volume abdominal ascites with layering blood products, substantially increased from prior study and consistent with intra-abdominal hemorrhage. No site of active extravasation is identified to suggest the source of bleeding. Abdominal hematomas as detailed above are not significantly changed compared to prior study. |
Generate impression based on findings. | Reason: followup of "ifi " History: pulmonary infiltrates see old cts LUNGS AND PLEURA: Scattered nonspecific micronodules. One new micronodule in the left lower lobe (series 7, image 29). Reference left apical nodule measures 3 mm (series 6, image 48), previously 3 mm. reference left lower lobe nodule is not clearly seen.No pleural effusion or pneumothorax. Right lower lobe irregular air space opacity containing an internal air ground bronchograms and adjacent ground glass opacity is very difficult to measure given its proximity to the diaphragm, but overall does not appear conclusively changed in size [viewed on the axial, sagittal and coronal reconstruction series (coronal image 53)] . There is possible internal lipid content versus volume averaging with subpleural fat above the diaphragm (source images series 3 image 189).MEDIASTINUM AND HILA: Prominent subcarinal lymph node measuring 14 mm (series 3, image 144). Coarse calcifications within bilateral hilar lymph nodes suggestive of prior granulomatous disease.The heart size is normal. No pericardial effusion.Severe coronary artery calcification.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy. Subchondral cysts at the right glenohumeral joint. Multiple healed left rib fractures.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Atherosclerotic calcification of the abdominal aorta and its branch vessels. Punctate splenic calcifications are again noted. | 1.Unchanged left upper lobe pulmonary nodule. Reference left lower lobe pulmonary nodule is not identified.2.Indeterminate right lower lobe nodular opacity abutting the right hemidiaphragm containing both irregular solid component and surrounding groundglass opacity, very difficult to reproducibly measure due to curvature of the adjacent diaphragm. Although this possibly may contain internal lipid attenuation and may represent chronic exogenous lipoid pneumonia, and remains indeterminate for indolent malignancy and continued annual follow-up is recommended. |
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. Approximately 12 mm ovoid mass in the left upper outer breast, anterior depth. No microcalcifications or areas of architectural distortion are present. | 12 mm ovoid mass in left upper outer quadrant, for additional views including spot compression view and probable ultrasound are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Pain in knee for two weeks. Assess for effusion/arthritis. Four views of the right knee are provided. Moderate osteoarthritis affects the knee, particularly the medial tibiofemoral compartment. There is a small joint effusion.Moderate osteoarthritis also affects the left knee, to a slightly lesser degree, as seen on the frontal view. | Osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, additional right CC view, and 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. Scattered benign calcifications in both breasts 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: NSC - Screening Mammogram. |
Generate impression based on findings. | Pain. Rule-out fracture.VIEWS: Left elbow AP/lateral/oblique (3 views) 03/16/15 A joint effusion is not present. The bones are normal in appearance. No fracture is identified. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are 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: NSB - Screening Mammogram. |
Generate impression based on findings. | Pain. Rule-out fracture.VIEWS: Left shoulder internal/external rotation (two views) 03/16/15 No fracture is present. The bones are normal in appearance. The humeral head epiphysis is normally positioned with respect to the glenoid. | Normal examination. |
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. Stable bilateral circumscribed subcentimeter masses.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, 12 years old, with orbital cellulitis, abscess and periodontal abscess status post drainage. Please assess for persistence of fluid collection. Since the prior examination, a subperiosteal fluid collection along the external surface of the left anterior maxillary wall has diminished, now measuring only 2 mm in thickness, previously up to 5 mm in thickness. The portion of this fluid collection which was previously seen to extend up and back into the left orbit seems to have resolved. There remains mild extraconal inflammation along the inferior left orbit. Previously seen extensive preseptal periorbital inflammation persists.Opacification of the left maxillary sinus with heterogeneous material has progressed since the prior examination. Opacification of the left ethmoid air cells, the left frontoethoidal recess, the right maxillary sinus and to a lesser degree the right ethmoid air cells, has also progressed.The expansile periodontal cyst in the left paramedian maxilla is again seen. The cyst is completely opacified with the exception of a small bubble of gas which may have been introduced during instrumentation or via communication with the nasal cavity. Since the prior examination, progressive demineralization of both the anterior and posterior bony walls of this cyst has occurred. | 1.Decreasing size of a subperiosteal fluid collection along the external aspect of the left anterior maxillary wall. The component of this collection which had previously tracked up and back into the left orbit has resolved. There remains evidence of extraconal intraorbital and periorbital inflammation.2.A periodontal cystic lesion within the left paramedian maxilla is redemonstrated with progressive demineralization of the the anterior and posterior bony walls. Findings could reflect progressive infectious erosion.3.Progressive paranasal sinus opacification is also seen as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in paternal cousin at age 30. Two standard digital views of both breasts, one additional right MLO, and two additional left MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
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. Circular skin marker was placed of the right axilla. Stable focal symmetry in the left upper outer breast, mid depth.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 57 years old Reason: eval for cause of cyclic vomiting History: chronic vomiting Double contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The gastric mucosal surface was normal.The duodenal bulb and sweep were within normal limits. TOTAL FLUOROSCOPY TIME: 9:52 minutes. | Normal examination of the esophagus, stomach, and duodenum. |
Generate impression based on findings. | T3N0 supraglottic laryngeal cancer status post CRT. There is decreased stranding of the subcutaneous fat superior to the tracheostomy stoma and in the lower face. There is extensive dental disease, including dental caries and associated periodontal lucencies. There is a left mandibular plate and screws, which produces artifact that obscures the surrounding anatomy. There is persistent supraglottic pharyngeal mucosal edema, without discernible underlying tumor. There is no significant cervical lymphadenopathy. There is a tracheostomy tube in position and the airway inferior to the tube appears to be patent. The remaining portions of the thyroid gland and salivary glands appear unchanged. The right internal jugular vein is tenuous. There is a retropharyngeal course of the right common carotid artery. There is mild multilevel degenerative cervical spondylosis. There is a retrosomatic cleft in the right C1 vertebra. There is mild mucosal thickening within the maxillary sinuses. The imaged portions of the intracranial structures are grossly unremarkable. There is an unchanged a 5 mm right apical calcified granuloma. | 1. No convincing evidence of locoregional tumor recurrence amidst post-treatment effects.2. Interval subsidence of inflammatory changes in the region of the tracheostomy stoma and in the lower face. 3. Extensive dental disease. |
Generate impression based on findings. | Female 49 years old Reason: appendicitis, intraabdominal abscess History: h/o HIV p/w abdominal pain ABDOMEN: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: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Marked wall thickening and inflammation involving the terminal ileum and cecum. There is an additional area of questionable wall thickening in the colonic splenic flexure. The appendix is air-filled within normal limits. No evidence of appendicitis. Uncomplicated colonic diverticulosis in the rectosigmoid colon.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enlarged heterogeneous uterus compatible with underlying fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Terminal ileum and cecal wall thickening and adjacent inflammation as described. Additional area of questionable wall thickening at the splenic flexure. Findings are compatible with enteritis, either infectious or inflammatory bowel disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional MLO and CC views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Circular skin marker was placed over the right breast. Stable benign intramammary lymph node in the right upper outer quadrant. Stable benign calcifications in 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.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Fracture.VIEWS: Right hand PA/lateral/oblique (3 views) 03/16/15 Boxer's fracture of the index finger is again seen. Periosteal reaction and callus formation have increased in the interval. | Further healing of fracture of index finger metacarpal. |
Generate impression based on findings. | 65 years old Female. Reason: A left upper lobe subpleural nodule measures up to 12 x 9 mm (series 10, image 60), increased from the prior exam dated 05/2012. History: cough. RADIOPHARMACEUTICAL: 10.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates low-attenuation lymph nodes in the superior mediastinum, and subpleural nodule in the left upper lobe. Emphysematous changes are seen in the lungs. Patchy opacities are seen in the right middle lobe. A low-attenuation lesion is seen in the periphery of the right lobe of liver. A low-attenuation lesion is seen in the left kidney. Multiple soft tissue densities are seen in the abdominal wall subcutaneous tissue. There is IVC filter.Today's PET examination demonstrates no evidence of increased metabolic activity in the left upper lobe subpleural nodule. Several foci of increased activity are seen in the subcutaneous soft tissue densities in the anterior abdominal wall, which are most likely due to inflammatory change.Multiple foci of mild FDG uptake in the mediastinum and in the lung hila without definite CT correlation, which are nonspecific. Minimal FDG uptake is seen in the low-attenuation lymph nodes in the superior mediastinum.No abnormal FDG uptake in the low-attenuation lesions in the right lobe of liver and left kidney, suggestive of cysts.Physiological activity is seen in the myocardium, liver, spleen, kidneys, intestines and ureters. | 1.No definite abnormal FDG uptake in the subpleural nodule in the left upper lobe, which is most likely benign. Suggest follow-up with CT. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy 6/2013. Patient complains of bilateral breast pain for two weeks. 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. And X-shaped biopsy clip at the 12 o'clock position is unchanged in position. Stable scattered clusters of calcifications. Additional benign calcifications in both breasts are stable.No suspicious masses 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: NSC - Screening Mammogram. |
Generate impression based on findings. | 55 years, Female. Reason: assess for sitz marker History: constipation. 5 sitz markers project over the transverse colon. One sitz marker projects over the right descending colon. The majority, approximately 16, sitz markers project over the rectosigmoid colon. There is an above average stool burden. | Sitz markers locations as described above with the majority projecting over the rectosigmoid colon. |
Generate impression based on findings. | Pain There are minimal chronic-appearing enthesopathic changes along the greater tuberosity at the expected site of insertion of the rotator cuff. I see no acute fracture or malalignment. On the AP view, a small density overlies the anterior aspect of the glenoid; I am uncertain of its etiology, but I believe it was present on a chest radiograph from November 2013, and is therefore chronic and unchanged. Vascular stents overlie the axilla. | Minimal chronic-appearing enthesopathic changes along the greater tuberosity, and small density overlying the glenoid as described above. Otherwise I see no specific findings to account for the patient's shoulder pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy in 1970. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. A few benign intramammary lymph nodes in the upper outer quadrants of both breasts are stable. Arterial 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. | 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. Coarse benign calcification in the right upper outer 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: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 57 years, Female. Reason: evaluate intergrity of leads, connectors...sudden increase in shock lead impedanc History: increase in shock lead impedance Please refer to concomitant chest radiograph for ICD evaluation and report. Nonobstructive gas pattern. | Please refer to concomitant chest radiograph for ICD evaluation and report. Nonobstructive gas pattern. |
Generate impression based on findings. | Male, 70 years old. RFO trigger for case length. No unexpected radiopaque foreign body is identified. Nasogastric tube tip projects over the proximal body of the stomach. Right sided surgical drain is noted. Right upper quadrant small amount of pneumoperitoneum is likely post-operative in nature. | No unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Kevin Roggin, the attending surgeon, on 3/16/2015 at 1613. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in maternal uncle. 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. Circular skin marker was placed over the 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: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Patient had fall on 3/6/2013 with loss of consciousness and has low back pain. For the purposes of the study, we have five lumbar type vertebrae and one transitional lumbosacral type vertebra "T". No acute fracture is evident. There is severe degenerative disease at L5/T. Mild facet joint osteoarthritis affects the lower lumbar spine as well as the articulation of the hypertrophied left transverse process of the transitional vertebra. Mild degenerative disease is also noted at L1/L2. | Degenerative disk disease appearing similar to the prior study. We see no acute fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast surgery approximately 25 years ago and left breast aspiration in 1986. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. A circular skin marker was placed over the right breast. A linear skin marker was placed over the left breast. Coarse calcification in the left breast is 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. The sensitivity of mammography for detecting breast cancer is decreased in patients with dense breasts such as this patient. Physical exam assumes a more important role. Additional screening with automated whole breast ultrasound can also be considered based on her mammographically dense breasts.BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | Right hip pain Two views of the right hip reveal some slight narrowing of the superior aspect of the hip joint. There is some subchondral sclerosis. These findings represent moderate osteoarthritis. | Moderate osteoarthritis |
Generate impression based on findings. | Female; 53 years old. Reason: 53yoF w/ hx of severe aortic stenosis, anemia, renal transplant, CHF with current pulmonary Rhizopus infection. Please assess Rhizopus infection and any possible bleeding. History: Dyspnea, anemia CHEST:LUNGS AND PLEURA: Increased left basilar atelectasis/consolidation; underlying infection cannot be excluded. Area of mass-like consolidation in the left lower lobe persists but cannot be reliably measured on the current examination due to increased surrounding opacities. Patchy and streaky opacities in both upper lobes are similar to prior study. Small right and moderate left pleural effusions, increased since prior study. MEDIASTINUM AND HILA: Aortic valve prosthesis noted. Severe coronary artery and aortic arch calcifications. No pericardial effusion. No significant lymphadenopathy. Low density of the cardiac blood pool, suggestive of anemia.CHEST WALL: Status post right mastectomy. Median sternotomy hardware is noted. There are multilevel degenerative changes of the thoracic spine. The bone density appears high suggestive of renal osteodystrophy.ABDOMEN:LIVER, BILIARY TRACT: High density material within the gallbladder dependently, most compatible with biliary sludge and/or stones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nonspecific adrenal thickening, left greater than right. No focal adrenal lesion.KIDNEYS, URETERS: Atrophic native kidneys. Right iliac fossa transplant kidney without hydronephrosis.RETROPERITONEUM, LYMPH NODES: No retroperitoneal hematoma.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There are multilevel degenerative changes of the lumbar spine. The bone density appears high suggestive of renal osteodystrophy.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: There are multilevel degenerative changes of the lumbar spine. The bone density appears high suggestive of renal osteodystrophy.OTHER: Small amount of pelvic ascites. | 1. Increased nonspecific left basilar atelectasis/consolidation obscuring the previously described mass-like area of consolidation in the left lower lobe. Underlying infection cannot be excluded. Follow-up to resolution is recommended.2. Small to moderate pleural effusions, increased since prior study.3. No hematoma is seen. |
Generate impression based on findings. | History of multinodular goiter with early compressive findings. Thyroid FNA revealed a colloid nodule. There is no significant interval change in the enlarged and heterogeneous thyroid gland with nodular components in the isthmus and left lobe. For example, the left thyroid nodule exophytic into the tracheoesophageal groove measures 21 x 33 mm, previously 21 x 32 mm. There is minimal narrowing of the trachea, which measures a minimum of 17 mm in width. There is unchanged asymmetric prominence of the left piriform sinus and mild medial deviation of the left vocal cord. There is no evidence of significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The major cervical vessels are patent. There is multilevel degenerative cervical spondylosis. The imaged intracranial structures are unremarkable. There is unchanged left apical pulmonary scarring. There is mild pulmonary emphysema. | No significant interval change in the multinodular goiter with minimal narrowing of the trachea and possible left vocal cord paralysis. |
Generate impression based on findings. | 72-year-old male with diffuse abdominal pain, night sweats, known prostate cancer. Rule-out malignancy. ABDOMEN:LUNG BASES: Severe coronary artery calcifications again seen. No other abnormalities.LIVER, BILIARY TRACT: No significant abnormality seen. Small subcentimeter hypodense lesions again seen unchanged most consistent with benign cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign renal cysts unchanged. No other abnormality seen.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes in the aorta with with the distal lumbar aortic aneurysm measuring 3.2 x 3.1 cm, compared to 2.9 cm previously.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Radiation seeds noted in the prostate bed. No other significant abnormality seen.BLADDER: No significant abnormality notedLYMPH NODES: No adenopathy or other mass seen. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted and no discrete potential metastatic lesions seen, however nuclear medicine bone scan is more sensitive indicator for activity of metastatic skeletal disease.OTHER: No significant abnormality noted | 1. No evidence for metastatic prostate disease seen, however nuclear medicine bone scintigraphy for more accurate estimator of activity of skeletal metastatic disease. 2. Small distal lumbar aortic aneurysm with minimal change since 2013 examination. 3. No other significant abnormality seen. |
Generate impression based on findings. | There are scattered foci of susceptibility abnormality within sulci, the left lateral ventricle, the fourth ventricle, and within folia. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for acute cerebral, brainstem or cerebellar infarction. Myelination is appropriate. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The mastoid air cells are clear. | Scattered foci of subarachnoid and intraventricular hemorrhage. |
Generate impression based on findings. | Female 59 years old Reason: rule out infection, obstruction, ischemia History: abdominal pain ABDOMEN:LUNG BASES: Basilar dependent subsegmental atelectasis/scarring.LIVER, BILIARY TRACT: No focal parenchymal lesion or biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is not clearly visualized, however there are no pericecal inflammatory change to suggest appendicitis. No bowel dilatation to indicate obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is atrophic or surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No appendicitis or other findings to account for the patient's abdominal pain. |
Generate impression based on findings. | 9-year-old female with right lower quadrant pain, fever, concern for appendicitis ABDOMEN:LUNG BASES: Mild left lower lobe atelectasis. 3-mm right lower lobe nodular density is present.LIVER, BILIARY TRACT: Postsurgical changes in the liver transplant are present. The portal vein is mildly prominent and patent. No focal liver lesions.SPLEEN: Multiple accessory spleens are present.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is not identified. Inflammatory changes are present within the right lower quadrant without evidence of a fluid collection or abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is not identified. Inflammatory changes are present within the right lower quadrant without evidence of a fluid collection or abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Mild inflammatory changes within the right lower quadrant. The appendix is not discretely identified and appendicitis cannot be excluded. No abscess or enhancing fluid collection is present. |
Generate impression based on findings. | T3N2b supraglottic laryngeal squamous cell carcinoma, completed chemoradiation therapy on 12/21/2012. There are post-treatment findings related to partial supraglottic laryngectomy with interval decrease in regional mucosal edema. No mass lesion is identified to suggest tumor recurrence. There is no significant cervical lymphadenopathy. The salivary glands appear unchanged. The thyroid gland appears unremarkable. The airways are grossly patent. The carotid and vertebral vasculature appears intact. There is unchanged multilevel degenerative spondylosis of the cervical spine, right temporomandibular joint degeneration, and bilateral acromioclavicular joint degeneration. The imaged portions of the paranasal sinuses are clear. The imaged portions of the lungs demonstrate biapical emphysematous disease and nonspecific micronodules. | Post-treatment findings in the region of the larynx without evidence of measurable locoregional tumor. |
Generate impression based on findings. | Evaluate for occult fractures History: Twin sibling has unexplained rib fracturesEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (24 views) 3/16/15 There is a soft tissue prominence to the right parietal region. No calvarial fractures noted. The axial and appendicular skeletal structures demonstrate no acute fracture. There is symmetrical periosteal reaction along the medial aspect of the tibial bilaterally likely representing physiologic periosteal reaction. Cardiothymic silhouette normal. No focal lung opacity. Disorganized nonobstructive bowel gas pattern. | Right parietal soft tissue swelling as described above. Bilateral symmetrical periosteal reaction along the medial aspect of the tibia bilaterally likely representing physiologic periosteal reaction. No acute fracture noted. |
Generate impression based on findings. | Postop. Prosthetic assessment. Two views of the right hip show components of a longstem total hip arthroplasty device in near anatomic alignment. Previously seen presumed osteotomy distal to the distal cerclage wire is less distinct on this examination compatible with healing. However, there is a horizontally oriented lucency through the lateral cortex of the proximal femur above the proximal cerclage wire, which was not present on the prior study and could represent a stress fracture. The bones appear demineralized suggesting osteopenia/osteoporosis. Mild osteoarthritis affects the left hip. Severe degenerative disk disease affects the lower lumbar spine. Surgical clips overlie the right hip region. | Right total hip arthroplasty device with findings suggestive of a new incomplete stress fracture of the proximal cortex of the femur. |
Generate impression based on findings. | Presumed peripheral T cell lymphoma. A few right supraclavicular and cervical lymph nodes appear to be slightly larger than in 2010, but are otherwise not significantly enlarged. For example, a right level 2B lymph node measures 6 mm in short axis. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is multilevel degenerative cervical spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | A few right supraclavicular and cervical lymph nodes appear to be slightly larger than in 2010, but are otherwise not significantly enlarged and are therefore nonspecific. |
Generate impression based on findings. | Pain and swelling x 1 month Three views of the left ankle reveal diffuse soft tissue swelling. No bone abnormalities. No fractures | Diffuse soft tissue swelling. Otherwise negative |
Generate impression based on findings. | History of rhabdomyosarcoma painVIEWS: Left tibia and fibula AP and lateral No acute fracture or dislocation. No evidence of bony destruction. | Normal examination. |
Generate impression based on findings. | Abdominal pain and Crohn's disease.EXAMINATION: MR enterography without and with IV contrast 03/16/15 ABDOMEN:LIVER, BILIARY TRACT: Normal in appearance.SPLEEN: Normal in size.PANCREAS: Normal in appearance.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant pelvicaliceal dilation is present. The kidneys are symmetric.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY:No significant abnormality noted..BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No free fluid is identified.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Incompletely distended and normal in appearance.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The terminal ileum is abnormal in appearance extending at least 8 cm. This area is narrowed and on some of the sequences there appears to be some saccular dilation. The wall is thickened and it enhances abnormally. Bowel is dilated proximal to this abnormal segment.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Abnormal terminal ileum, probably worsened in the interval. |
Generate impression based on findings. | Distal radius fracture Three views of the right wrist reveal lung a comminuted impacted distal radius fracture. This results in positive ulnar variance. No change in position from the previous exam. | Fracture of the distal radius unchanged in position |
Generate impression based on findings. | Pain, prior fracture. Three views of the left ankle are provided. Evaluation of fine bone detail is limited due to overlying splint material. A fracture through the base of the fifth metatarsal base, seen best on the AP view, is not well visualized due to the overlying splint. An ossicle distal to the medial malleolus is likely chronic in etiology. | Limited study due to overlying splint; the fracture of the fifth metatarsal base is better seen on prior foot radiographs. |
Generate impression based on findings. | History of rhabdomyosarcoma painVIEWS: Right tibia and fibula AP and lateral No acute fracture or dislocation. No evidence of bony destruction. | Normal examination. |
Generate impression based on findings. | Patient s/p blunt trauma, landing w/ full weight on right heel while playing ultimate frisbee, point ttp right medial heel. Persistent x 2.5 weeks. Evaluating for fracture. Two views of the right heel show no calcaneal fracture. An ossicle situated proximal to the navicular tuberosity probably represents a normal variant accessory navicular bone, but would be better evaluated with dedicated foot radiographs. | No evidence of an acute fracture. An ossicle adjacent to the navicular tuberosity may represent a normal variant accessory ossicle, but would be better evaluated with dedicated foot radiographs. |
Generate impression based on findings. | 13-year-old female evaluate PICC placementVIEW: Chest AP (one view) 3/16/15 Interval placement of left PICC with tip in the SVC. The cardiac silhouette is normal. No pleural effusion or pneumothorax. Mild left lower lobe atelectasis. | Interval placement of left PICC with tip in SVC. |
Generate impression based on findings. | Metacarpal fractureVIEWS: Right hand AP, oblique and lateral There is an acute fracture involving the neck of the fifth metacarpal with volar angulation of the distal fracture fragment. There is associated soft tissue swelling. The remainder of the examination is normal. | Acute fracture neck of the fifth metacarpal as described above. |
Generate impression based on findings. | Trauma. Evaluate for fracture Three views left fifth toe are unremarkable. No fractures. | No fractures. |
Generate impression based on findings. | Status post distal femur replacement for metastatic thyroid cancer. Evaluate for progression/hardware failure. Again seen is reconstruction of the distal femur with a long stem distal femoral endoprosthesis. We see no evidence of hardware complication. Again seen is reticulation of the soft tissues of the thigh/knee, particularly along the medial aspect, appearing similar to the prior study; cannot exclude calciphylaxis in the correct clinical context. | Distal femoral reconstruction, appearing similar to the prior study. |
Generate impression based on findings. | History of rhabdomyosarcoma. Cough congestion LUNGS AND PLEURA: Post-surgical changes in the right upper lobe with associated right-sided volume loss and mediastinal shift. Extensive perihilar consolidations with air bronchograms are not significantly change. The previously described anterior mediastinum soft tissue density is not significantly changed and may represent the thymic tissue.Right-sided pleural thickening appears similar to prior. Scattered, non-specific pulmonary micronodules appear similar to prior. MEDIASTINUM AND HILA: The heart is normal in size. No pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No focal osseous lesion. No axillary lymphadenopathy. UPPER ABDOMEN: Small accessory splenule. | Marked posttreatment changes in the right hemithorax not significantly changed. No evidence of active pneumonia. |
Generate impression based on findings. | Male 56 years old Reason: S/P LVAD. Hx of pancreatitis and Gastric bypass ( Roux-en Y) ; Eval for fluid collection History: Andominal pain ABDOMEN:LUNG BASES: LVAD device in expected position. Streak artifact limits evaluation of the left upper quadrant. No pulmonary parenchymal abnormality or pleural effusion.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No peripancreatic inflammatory changes or fluid collections.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys bilaterally. Punctate nonobstructing right renal calculus.RETROPERITONEUM, LYMPH NODES: Minimal atherosclerotic calcification affects the abdominal aorta.BOWEL, MESENTERY: Post surgical changes affect the stomach. No evidence of bowel obstructionBONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine without suspicious lytic or blastic lesion.OTHER: No intra-abdominal or subcutaneous fluid collections to indicate abscess.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postoperative changes as described without evidence of obstruction. The appendix is within normal limits. Uncomplicated diverticulosis. BONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality noted | Post-operative changes as described. No driveline associated or intra-abdominal fluid collections to indicate an abscess. No CT evidence of acute pancreatitis or peripancreatic fluid collection. |
Generate impression based on findings. | Rheumatoid arthritis. Evaluate for disease progression. Three views of the left hand again show findings of rheumatoid arthritis, as described previously, affecting the wrists, MCP joints, and PIP joints. There is no evidence of disease progression accounting for slight technical/positional differences.Three views of the right hand again show findings of rheumatoid arthritis, as described previously, affecting the wrists, MCP joints, and PIP joints. There is no evidence of disease progression accounting for slight technical/positional differences.Three views of the left foot are provided. The bones are severely demineralized. The are combined features of rheumatoid arthritis and osteoarthritis, appearing similar to the prior study, when accounting for positional differences. We see no evidence of disease progression.Three views of the right foot are provided. The bones are severely demineralized. The are combined features of rheumatoid arthritis and osteoarthritis, appearing similar to the prior study, when accounting for positional differences. We see no evidence of disease progression. | Findings compatible with rheumatoid arthritis as described above without evidence of disease progression. |
Generate impression based on findings. | Reason: r/o chronic thromboembolic disease History: edema The comparison chest radiograph demonstrates no airspace opacities or pleural effusions. There is mild basilar scarring. The ventilation portion of the exam demonstrates symmetric activity on wash-in images. There is minimal retention of radiotracer during the wash-out phase. The perfusion portion of the exam shows minimal subsegmental perfusion defects, but no moderate or large mismatched segmental defects. | Low probability of pulmonary embolism. |
Generate impression based on findings. | 7-year-old male with sternal chondrosarcoma resection. LUNGS AND PLEURA: Unchanged 3-mm nodule in the minor fissure (series 5, image 46). No suspicious pulmonary nodules or masses. No pleural effusion or pneumothorax. No consolidation.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No significant mediastinal, internal mammary, cardiophrenic, or retrocrural lymphadenopathy.CHEST WALL: Interval resection of previously noted exostosis of the manubrium, and portions of the manubrium. Soft tissue is present at the resection site without ossification, which is nonspecific on this noncontrast exam and may represent postsurgical changes, however local soft tissue recurrence cannot be excluded. No axillary lymphadenopathy by CT size criteria. No new osseous lesion.UPPER ABDOMEN: The adrenal glands are normal. The remaining partially visualized noncontrast abdominal parenchyma is normal. | 1.Interval resection of manubrial exostosis. Nonspecific soft tissue without ossification at the site of resection is nonspecific on this noncontrast exam and represent postsurgical changes, however local recurrence cannot be excluded.2.Unchanged 3-mm soft tissue nodule in the minor fissure. |
Generate impression based on findings. | Arthrogryposis history Hands:The left hand demonstrates mild improved appearance with moderate contractures in the 1st, 2nd and 3rd digits, largely the PIP joints. The right hand is diffusely involved involving most articulations and progressed from December. Forearms: marked flexure of the wrists, greater on the left. See elbows for more proximal changesElbows: Bilateral similar elbows with suspected dislocations posteriorly. | Pronounced extensive changes compatible with patients known diagnosis, see detail provided. |
Generate impression based on findings. | TraumaVIEWS: Left wrist AP, oblique and lateral, left hand AP, oblique and lateral There is acute buckle fractures involving the metaphysis of the distal radius and ulna in near anatomic alignment. There is associated soft tissue swelling about the wrist joint. | Buckle fractures distal radius and ulna as described above. |
Generate impression based on findings. | Reason: stem cell transplant patient with Hx of + coronavirus and human metapneumovirus. 2/11 CT showed progression of alveloar opacities with RLL consolidation. Want follow up CT. History: hypoxia, tachypnea, tachycardia LUNGS AND PLEURA: Diffuse patchy ground glass and air space opacity, compatible with infection has considerably improved since the previous scan. Slightly increased subsegmental atelectasis is present in the lateral segment of the right middle lobe.Marked motion artifact is present at the lung bases which degrades diagnostic detail.No pleural effusions.MEDIASTINUM AND HILA: No significant lymphadenopathy. Calcified lymph nodes in the left hilum compatible with previous infection.No visible coronary artery calcifications.No pericardial effusion.CHEST WALL: Partial collapse of multiple lower thoracic vertebrae, unchanged, but with interval development of a vacuum disk phenomenon at several levels.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. Splenic calcifications compatible with previous infection. | Marked interval improvement in bilateral pulmonary opacities compatible with infection. |
Generate impression based on findings. | Abdominal painVIEW: Abdomen AP Disorganized nonobstructive bowel gas pattern. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum. There are orthopedic screws in the right and left proximal femur bilaterally. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Reason: mets lung cancer, on MPDL3280A, pls c/w previous study and evaluate tx response. s/p chest RT. History: lung cancer LUNGS AND PLEURA: Posterior right upper lobe mass (series 8/35) measuring 5 x 7 cm, not definitively changed though with some increased distal atelectasis.An adjacent smaller mass that was measured on the previous scan is now obscured by surrounding consolidation and not accurately measurable.Right lower lobe mass and associated atelectasis, is not accurately measurable but not appreciably changed.Multiple small nodules in the left lung compatible with metastases have increased in size. For instance (series 8/40) and anterior left upper lobe nodule measures 8 mm, increased from 6 mm previously. A left lower lobe nodule on the same section measures 5 mm, increased from 4 mm previously. Other small nodules have comparably increased.New small right pleural effusion.Dense perihilar airspace opacity compatible with radiation reaction, generally unchanged.MEDIASTINUM AND HILA: Enlarged high right paratracheal lymph node measuring 17 mm (series 6/18) increased from 12 mm previously. Multiple other mediastinal lymph nodes have comparably increased.Severe coronary artery calcification.No pericardial effusion.Small sliding hiatal hernia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Please see the report for the CT of the abdomen and pelvis, reported separately. | Progression of disease in the lungs and mediastinum. |
Generate impression based on findings. | 40 year-old female with suprapubic pain, back pain, hematuria. Urge to defecate. Rule-out appendicitis, kidney stone. Within the limits of a non-IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs vascular structures, the following observations can be made:ABDOMEN: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: Both kidneys are of normal size and morphology. No abnormal calcifications. No hydronephrosis or hydroureter. No calcifications in the expected course of the ureter. No perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality seen in the stomach, small bowel or colon. The appendix appears normal. No periappendiceal inflammatory changes seen. No evidence of diverticulitis. Small amount of free pelvic dependent mesenteric fluid consistent with physiologic changes and similar to seen on 2014 CT examination.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality seen in the stomach, small bowel or colon. The appendix appears normal. No periappendiceal inflammatory changes seen. No evidence of diverticulitis. Small amount of free pelvic dependent mesenteric fluid consistent with physiologic changes and similar to seen on 2014 CT examination.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination with no change in abdomen or pelvis since 2014 CT examination. No CT findings seen to account for patient's symptomatology. |
Generate impression based on findings. | Pain in shoulder. Evaluate fracture Two view of the right clavicle reveal midclavicular deformity secondary to an old healed fracture. No acute abnormalities. Four views of right shoulder reveal no additional abnormalities. | Deformity of right mid clavicle secondary to previous fracture. |
Generate impression based on findings. | Male, 9 years old. Evaluate PICC tip location VIEW: Chest AP (one view) 3/16/2015, 1717 New right arm PICC, tip at the cavoatrial junction.The cardiothymic silhouette is normal.Low lung volumes. No focal pulmonary opacities, pleural effusions, or pneumothorax. | Right PICC tip at the cavoatrial junction. |
Generate impression based on findings. | Stubbed toe during soccer match Foot and toe: Minimal right 1st toe osteoarthritis with mild narrowing, sclerosis and small osteophytes. Alignment otherwise preserved. Remaining foot otherwise within limits other than a small possible effusion involving the 1st IP articulation. No distinct fracture. The small osseous punctate calcific density may be in the articular capsule. | Mild OA without definite acute findings, see detail above and correlate with physical exam |
Generate impression based on findings. | Neck pain Bullet projects in the left neck unchanged. Underlying osseous structures appear similar in the this limited evaluation. | Unchanged left bullet in the posterior soft tissues. |
Generate impression based on findings. | Patient fell The right wrist again demonstrates no acute fracture or dislocation. Unchanged moderate osteoarthritic changes affect the carpal bones and the metacarpophalangeal joints. | No acute fracture or dislocation. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered micronodules compatible with previous infection, unchanged.No suspicious nodules or pleural effusions.MEDIASTINUM AND HILA: Small amount of residual thymic tissue in the anterior mediastinum.No significant lymphadenopathy.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: Multiple hypodensities compatible with cysts and hemangiomas, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Circumaortic left renal vein, normal anatomic variant.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 and no change. |
Generate impression based on findings. | Reason: evaluate for ILD History: crackles at lung bases abnormal PFT LUNGS AND PLEURA: Biapical scarring.Very mild basilar groundglass opacity with a small airspace component at the right base compatible with dependent atelectasis and possibly mild aspiration.No specific evidence of interstitial lung disease.MEDIASTINUM AND HILA: Patulous esophagus with an air-fluid level.Mild coronary artery calcification.No significant lymphadenopathy.Minimal pericardial effusion.CHEST WALL: Moderate dextroscoliosis with associated degenerative abnormalities.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. | 1.No specific evidence of diffuse interstitial lung disease. 2.Very mild groundglass opacity with a focal airspace component at the right base, likely related to aspiration. 3. Patulous esophagus with an air-fluid level. |
Generate impression based on findings. | Bipolar hemiarthroplasty AP view of the pelvis reveals a bipolar hemiarthroplasty on the right. Evidence is seen in any fractures or dislocations. There are surgical drains in the soft tissues.. An additional view of the hip reveals a distal end of the prosthesis. Again no fractures or dislocations. | Bipolar hemiarthroplasty in anatomic alignment |
Generate impression based on findings. | Reason: hx TIA last week History: L hemiparesis, confusion 1hr pta 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 demonstrate right maxillary sinus partial opacification. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Reason: Pt had fall on 3/6/15 with LOC and has HA, n/v, and neck pain since History: n/v since head trauma with LOC 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 mastoid air cells are clear. The visualized portions of the orbits are intact.There is partial opacification of the nasal cavity and minor opacities in the paranasal sinuses. Nasal cavity opacification is less prominent when compared to the prior exam and currently mainly involves the left middle concha.CT cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a facet hypertrophy on the right side associated with an irregular facet joint and osteophyte formation as well as subchondral cysts.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina. At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is loss of disk space height associated with endplate and uncovertebral osteophytes as well as mild narrowing of the right neural foramen. This is stable compared to the prior exam.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is loss of disk space height associated with endplate and uncovertebral osteophytes with a mild encroachment of the left neural foramen at this level. This is stable compared to the prior exam.At C7-T1 there is no significant compromise to the spinal canal or neural foramina. | 1.No evidence for cervical spine fracture2.No evidence for acute intracranial hemorrhage mass effect or edema.3.There are degenerative changes present in the cervical spine without significant compromise of spinal canal or exiting nerve roots.4.There is partial opacification of the nasal cavity which as been previously present but is currently less impressive. The possibility of nasal polyposis cannot be excluded. Please correlate with patient's clinical history and symptoms. |
Generate impression based on findings. | Reason: r/o pe History: acute hypoxemia, tachycardia, history of DVT PULMONARY ARTERIES: Technically adequate examination for the evaluation of pulmonary embolism. No pulmonary embolus is present. The main pulmonary artery is mild to moderately dilated.LUNGS AND PLEURA: Bilateral small pleural effusions.Extensive perihilar ground glass with foci of consolidation, new from prior study. The airways are clear. Considerations include acute edema. Hemorrhage and drug toxicity may have a similar appearance.MEDIASTINUM AND HILA: Small pericardial effusion. Heart size is within limits of normal. Limited visualization of the coronary arteries. No mediastinal or hilar lymphadenopathy.Patulous esophagus containing ingested material to the cervical level.CHEST WALL: Extensive degenerative changes of the thoracic or lumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified and atrophic pancreas from prior pancreatitis. Calcification within the left hepatic lobe unchanged. | No evidence of pulmonary embolism.Interval appearance of coarse perihilar ground glass with patchy consolidation and small pleural effusions. This may represent acute edema. Pulmonary hemorrhage and drug toxicity are also in the differential.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: evaluate for PE History: intermittent chest pain PULMONARY ARTERIES: Technically adequate evaluation for pulmonary embolism. No pulmonary embolus is present.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal or hilar lymphadenopathy. No significant coronary artery calcification identified. Mild, diffuse thickening of the esophagus which may be accentuated in its collapsed state.CHEST WALL: Subsegmental atelectasis involving bilateral lower lobes. No pleural effusion. Calcified granuloma left posterior costophrenic angle. Anterior osteophyte formation of the lower thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. There has been prior cholecystectomy. | No pulmonary embolism.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: PE History: Chest Pain acute onset with radiation to back. Sinus Tachycardia 110s. PULMONARY ARTERIES: Quality this examination is good for the assessment of pulmonary embolism, somewhat limited due to timing of the contrast bolus. No pulmonary embolus is noted to the segmental level.LUNGS AND PLEURA: Apical interstitial thickening with bronchiolectasis and paraseptal emphysema. Finding suggestive of early fibrosis. Diffuse bronchial wall thickening. No significant ground glass or pleural effusion. Calcified right upper lobe granuloma.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion is present. The coronary arteries are blurred; assessment for potential calcifications it is extremely limited.Right hilar lymph node upper limits of normal 10 mm short axis. No left hilar or mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. Bilateral Bochdalek hernias. | No pulmonary embolism. Nonspecific, predominantly apical interstitial thickening, paraseptal emphysema and bronchiolectasis suggestive of early fibrosis. Diffuse bronchial wall thickening.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Clinical question: Syncope. Signs and symptoms: Syncope Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Zoster encephalitis; lesion? Signs and symptoms: Headache. Nonenhanced head CT:There is no detectable two intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus.Prominent subarachnoid space posterior to the cerebellum in the midline consistent with cisterna magna.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white gray differentiation.Unremarkable calvarium and soft tissues of the scalp. Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
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