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Generate impression based on findings. | 11-year-old male status post reduction of radial and ulnar fractures.VIEWS: Left forearm PA, lateral (two views) 3/17/15 2308, 2309 Overlying cast material obscures fine bone detail. Again seen is fracture of both bones of the forearm. The radius is mildly medially displaced. The ulna is mildly dorsally displaced. No residual angulation is present. | Interval casting of both bone fracture of the forearm. |
Generate impression based on findings. | Pain. Evaluate for fracture. AP view of the pelvis shows no acute fracture or malalignment. Moderate to severe osteoarthritis affects the right hip. Mild osteoarthritis affects the left hip. Focus of sclerosis within the bilateral proximal femurs is of unknown etiology but likely benign. | No acute fracture is evident. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat left MLO view 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. Benign calcification in the left breast. | 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. | 25 years, Female, Reason: Celiac artery compression History: Abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy. No intrahepatic or extrahepatic 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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedVASCULAR: High-grade narrowing and kinking of the proximal celiac axis on exhalation is compatible with median arcuate ligament compression. No significant compression is identified on inspiration. | Median arcuate ligament compression of the celiac axis. Status post cholecystectomy. |
Generate impression based on findings. | 30 years, Female. Reason: History of Crohn's colitis. Possible C.Diff. Also has CMV colitis. Evaluate for megacolon. History: Abdominal distention and cramping. Nonobstructive bowel gas pattern. Hepatosplenomegaly. Central venous catheter tip projects over the cavoatrial junction. | Nonobstructive bowel gas pattern. Hepatosplenomegaly. |
Generate impression based on findings. | 54-year-old male with cough, x-ray with possible pneumonia, supposed to have surgery tomorrow. Evaluate for pneumonia. LUNGS AND PLEURA: No focal consolidation, pleural effusion, or suspicious nodules. Mild basilar scarring/atelectasis.MEDIASTINUM AND HILA: Heart size normal with no pericardial effusion. No coronary calcifications identified. Right IJ catheter tip terminates at the superior cavoatrial junction. Low-density cardiac blood pool is typical of anemia. Minimal aortic atherosclerotic calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No suspicious focal osseous lesion. Subcutaneous emphysema presumably related to recent catheter placement. Small axillary lymph nodes.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Numerous liver cysts, unchanged in size and number and bilateral, markedly enlarged, dysmorphic polycystic kidneys with innumerable cysts of varying sizes, compatible with known polycystic kidney disease. Small amount of ascites has mildly decreased. | No evidence of pneumonia. |
Generate impression based on findings. | Female 11 days old Reason: Eval lung fields History: Intubated with elevated WBCVIEW: Chest abdomen AP (two view) 3/17/15 at 2302 hrs. ET tube terminates below the thoracic inlet. Proximal side-port of T. NG tube is above GE junction. Right upper extremity PCVC terminates at the lower IVC. Interval removal of umbilical venous line.Cardiac silhouette size is top normal. Bilateral diffuse lung haziness with no focal opacities, effusions or pneumothorax.Normal abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Interval removal of umbilical line.Persistent diffuse lung haziness with no focal opacities. |
Generate impression based on findings. | Headache and vomiting No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. There is asymmetric hyperdensity involving the right caudate head and putamenThe visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. No evidence of intracranial hemorrhage or mass effect.2. Asymmetric hyperdensity involving the right caudate head and putamen, finding which can be seen with metabolic entities such as hyperglycemia. |
Generate impression based on findings. | Stab wound to hand. Pain to MCP joint area. Question of fracture. Three views of the right hand show no acute fracture or malalignment. | No acute fracture is evident. |
Generate impression based on findings. | 76-year-old female with pain status post fall. Evaluation of the pelvis is limited by the inability to position the patient. The bones appear slightly demineralized. Given these limitations, we see no evidence of fracture. Mild osteoarthritis affects the hips. Degenerative disk disease affects the lower lumber spine. A large calcified fibroid is present within the pelvis.Four views of the right knee demonstrate mild medial compartment joint space narrowing, osteophytosis as well as mild sharpening of the tibial spines, consistent with mild osteoarthritis. A small joint effusion is present. There is no evidence of fracture or malalignment.Four views of the left knee demonstrate mild medial compartment joint space narrowing, osteophytosis as well as mild sharpening of the tibial spines, consistent with mild osteoarthritis. A small joint effusion is present. There is no evidence of fracture or malalignment. | Degenerative arthritic changes as described above, without evidence of fracture. |
Generate impression based on findings. | Jumped on yesterday and hurt right elbow. Most pain on lateral posterior aspect. Question of fracture. Four views of the right elbow show no acute fracture or malalignment. No joint effusion is identified. | No acute fracture is evident. |
Generate impression based on findings. | 77 years, Female. Reason: stool burden, bowel distension History: diarrhea/constipation. Nonobstructive bowel gas pattern with average stool burden. | Average stool burden. |
Generate impression based on findings. | Reason: Evaluate for left CN III ptosis, concern for L PCOM aneurysm although pt does not have L blown pupil. At least suspected partial L CN III palsy HEAD: No evidence of acute intracranial hemorrhage. Hypoattenuation of the periventricular and subcortical white matter compatible with age indeterminant small vessel ischemic disease. No evidence of hydrocephalus. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are unremarkable. Right cerebellar enhancing lesion presumably representing metastasis is better seen on prior MRI and not appreciated on current study. CTA HEAD: There are scattered calcification along the right cavernous carotid artery without significant narrowing. Normal contrast opacification is present through anterior circulation and distal intracranial vasculature. There is tortuous course of the right vertebral artery and the basilar artery. Focal calcification of the intracranial right vertebral artery without significant narrowing. Anterior communicating artery is patent. Right posterior communicating artery is patent. Left posterior communicating artery is not well seen on this study. There is no evidence of occlusive thrombus, dissection, or aneurysm. Venous drainage is grossly patent.CTA NECK:The aortic arch origins of the right brachiocephalic, left common carotid, and left subclavian arteries demonstrate mild atherosclerotic changes but are patent. There is calcification at right carotid bifurcation with approximately 50% narrowing. There is also calcification at left carotid bifurcation with less than 50% narrowing by NASCET criteria. There is moderate left vertebral artery origin narrowing with good flow distally. Vertebral arteries in the neck are otherwise patent.Partially imaged right apical bullae and left apical consolidation. There is also left pleural effusion which is partially visualized. Moderate degenerative disease of the lower cervical spine. Partially imaged right chest wall port. | 1.No evidence of intracranial aneurysm.2.Intracranial and extracranial atherosclerotic disease without high grade stenosis. There is moderate left vertebral artery origin narrowing with good flow distally. If there is suspicion for acute infarct, consider MRI for further evaluation.3.Right cerebellar enhancing lesion presumably representing metastasis is better seen on prior MRI and not appreciated on current study. Follow-up MRI can be obtained for better assessment of intracranial metastatic disease.4.Partially imaged left apical consolidation and pleural effusion. |
Generate impression based on findings. | 54 year old 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable right upper breast asymmetry. | 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. | Pain in thigh and groin. Evaluate for fracture. Two views of the right hip and AP view of the pelvis show scattered lucent lesions throughout the visualized osseous structures. No acute fracture is evident. Degenerative changes affect the lower lumbar spine. | Scattered lucent lesions throughout the osseous structures compatible with the patient's history of multiple myeloma. No acute fracture is evident. |
Generate impression based on findings. | The images are degraded by patient motion.HEAD: There is a diffuse right subgaleal fluid collection that measures up to 12 mm in thickness, as well as diffuse subcutaneous fat stranding. There is no discernible evidence of underlying calvarial fracture. There is no evidence of acute intracranial hemorrhage. There is patchy subcortical white matter hypoattenuation suggesting small vessel ischemic disease. The ventricles and sulci are mildly prominent indicating cerebral volume loss. The middle ears and ethmoid air cells appear to be clear. There is mild opacification of the bilateral maxillary sinuses, sphenoid sinuses, and ethmoid air cells with fluid. The right lens is replaced.MAXILLOFACIAL: This examination is limited by motion. There is soft tissue swelling over the left zygomatic arch and cheek, as well as in the right parotid space. There are bone islands in the left mandibular body and right mandibular ramus, but there is no discernible fracture. The patient is edentulous.CERVICAL SPINE: There is diffuse stranding of the subcutaneous tissues and more focal asymmetric thickening of the right sternocleidomastoid muscle and surrounding tissues. There is also a diffuse retropharyngeal effusion. There is multilevel degenerative spondylosis with spinal canal and neural foramen narrowing. The alignment of the cervical spine is otherwise within normal limits. There is no discernible evidence of fracture. There is a partially-imaged right lung effusion and probable left apical scarring. There are multiple partially calcified thyroid nodules, the largest of which measures up to 15 mm. There are bilateral carotid bifurcation calcifications. | The images are degraded by patient motion.1.Right subgaleal fluid collection and bilateral facial contusions, but no evidence of acute intracranial hemorrhage or skull fracture.2.Nonspecific fluid within the paranasal sinuses, but no discernible maxillofacial fractures.3.Right neck contusions and multilevel degenerative changes in the cervical spine, but no discernible fractures.4.Diffuse subcutaneous stranding, a retropharyngeal effusion, and a partially-imaged right pleural effusion may represent anasarca related to congestive heart failure, for example. 5.Multiple partially calcified thyroid nodules, the largest of which measures up to 15 mm. Thyroid ultrasound and tissue sampling may be useful for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two maternal cousins. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Areas of focal asymmetry in each upper outer breast are unchanged, and more similar to the older comparison study from 2011. Stable normal appearing lymph nodes project in each axilla. | 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. | 25-year-old female with left ankle pain and swelling status post fall 3 days prior. Three views of the left foot and 3 views of the left ankle demonstrate a comminuted fracture through the proximal tuberosity of the fifth metatarsal base, with fracture fragments in near-anatomic alignment. There is soft tissue swelling, particularly along the dorsum of the foot and along the lateral aspect of the ankle. No additional fractures are evident. | Fracture through the base of the fifth metatarsal as described above. |
Generate impression based on findings. | 52-year-old male. Abdominal pain, weight loss, nausea and vomiting. ABDOMEN:LUNG BASES: Lingular calcified nodule consistent with prior infection. Small area of pleural scarring in the right lung base.LIVER, 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: The stomach is distended with oral contrast, this may be due to a bolus of oral contrast that the patient drank or delayed gastric emptying due to gastroparesis or partial gastric outlet obstruction (no obvious obstructing lesion is evident).No small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See above. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Distended stomach, which may be due to the patient drinking a bolus of oral contrast versus delayed gastric emptying from partial gastric outlet obstruction or gastroparesis. Further evaluation with a fluoroscopic study or nuclear gastric emptying study may be useful if clinically warranted. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Central venous catheter projects within the axillary region on one of the right MLO views. Her pattern suggests mild underlying symmetric edema in the breasts, which may relate to volume status/end-stage renal disease.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. | 24 year old female with right hand and forearm lacerations status post punching through glass. Three views of the right hand demonstrate a 2-mm linear density in the soft tissues overlying the thenar eminence on the lateral view, compatible with a foreign body. No fracture is evident. A defect in the soft tissues along the first metacarpal presumably represents a laceration.Two views of the right forearm demonstrate irregularity of the soft tissues along the dorsal and ulnar margin of the proximal forearm, containing bandage material. Otherwise, no radiopaque foreign body or fracture is identified. | Foreign body overlying the thenar eminence, as described above. |
Generate impression based on findings. | Male 48 years old; Reason: Evaluate for abdominal pathology History: LUQ pain s/p liver transplant ABDOMEN:LUNGS BASES: Hypoattenuating intracardiac blood pool consistent with anemia. Mild cardiomegaly. Incompletely imaged gynecomastia.LIVER, BILIARY TRACT: Status post hepatic transplant with multiple associated surgical clips. Evaluation of liver parenchyma suboptimal on this noncontrast study but there appears to be interval improvement in the heterogeneous hypoattenuation involving the posterosuperior right liver lobe. Decreased size of posteriorly located presumed hematoma, measuring 8.6 x 2.1 cm, previously measured 8.6 x 3.1 cm. Additional sites of hypoattenuation in liver parenchyma anteriorly and in subcapsular left hepatic lobe also not as well visualized. New small pneumobilia, primarily in left hepatic lobe.SPLEEN: Splenomegaly, spleen measures 18.6 cm. Splenic/left upper quadrant varices.PANCREAS: Evaluation for acute pancreatitis suboptimal on this noncontrast exam and in setting of diffuse mesenteric edema/stranding. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right-sided nonobstructing nephrolithiasis, measuring up to 6 mm. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Percutaneous gastrostomy seen located in gastric body. Mildly prominent small bowel, measuring up to 2.6 cm, ingested contrast did not reach colon, may be secondary in part to timing of IV contrast bolus, findings may be related to ileus. Diffuse mesenteric edema. Moderate periceliac and periSMA stranding. Moderate colonic wall thickening, involving hepatic flexure and transverse as well as descending colon, while findings may reflect components of portal colopathy and reactive thickening in setting of ascites, acute colitis a consideration and correlation with patient's clinical history and laboratory values recommended.Improvement in additional hematoma seen at level of lesser sac, no measurable component seen. Decreased size of additional hematoma seen along greater curvature of stomach, measuring 3.8 x 1.6 cm, coronal image 76, previously measured 10.4 x 2.3 cm.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Collapsed bladder, making assessment suboptimal.BONES, SOFT TISSUES: Interval closure of previously visualized right ventral abdominal defect. Interval removal of previously visualized percutaneous drainage catheters. Ventral abdominal postsurgical sequela including multiple surgical clips. Small loculated fluid and gaseous foci seen in ventral abdominal subcutaneous soft tissues. Elongated fluid containing collection measuring 8.3 x 1.5 cm with surrounding enhancement noted. Fluid and gas containing collection seen in right lateral ventral abdomen measuring approximately 4.9 x 1.5 cm. Additional ventral abdominal soft tissue nodularity in subcutaneous soft tissues may reflect sequela of prior injections. Improvement in previously visualized scrotal edema. Small ascites. | 1. Moderate colonic wall thickening, involving hepatic flexure and transverse as well as descending colon, while findings may reflect components of portal colopathy and reactive thickening in setting of ascites, acute colitis a consideration and correlation with patient's clinical history and laboratory values recommended.2. Improvement in multiple postoperative hematomas as above, improvement in liver parenchymal heterogeneity. New small left-sided pneumobilia. Improving ascites. 3. Interval closure of previously visualized right ventral abdominal wall defect and previously visualized percutaneous drainage catheters removed. Ventral abdominal postsurgical sequela including multiple surgical clips. Small loculated fluid and gaseous foci seen in ventral abdominal subcutaneous soft tissues, including elongated fluid containing collection measuring 8.3 x 1.5 cm with surrounding curvilinear hyperdensity noted, may reflect mesh itself and correlation with patient's clinical history recommended. Fluid and gas containing collection seen in right lateral ventral abdomen measuring approximately 4.9 x 1.5 cm. On call radiology resident discussed these findings with the clinical service and reportedly no evidence of abdominal wall soft tissue infection on physical exam and thus findings may be postprocedural in etiology but continued follow up recommended.4. Improving ascites. Diffuse mesenteric edema/stranding. 5. Splenomegaly and varices.6. Persistent right greater than left pleural effusions. |
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. New focal asymmetry in the left central upper breast. No suspicious microcalcifications or areas of architectural distortion are present. | New left focal asymmetry for which further evaluation with spot compression and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 24 year old female s/p removal of glass from right hand laceration. Three views of the right hand following attempted removal of foreign body redemonstrate the 2-mm linear density overlying the thenar eminence, similar in appearance to prior exam. No fracture is evident. Overlying bandage material is noted. | Foreign body as above. |
Generate impression based on findings. | Male 55 years old Reason: Evaluate for progression of metastatic disease. Compare to previous scan 1. Radical cystectomy. 2. Prostatectomy. 3. Removal of the proximal urethra to the perineal urethrostomy. 4. Bilateral pelvic lymph node dissection. 5. Indiana pouch continent urinary diversion. 6. Resection of the enlarging left iliac femoral schwannoma. CHEST:LUNGS AND PLEURA: New pulmonary metastases. For reference purposes, a nodule at the right lung apex (separate from the previously described 3-mm nodule) measures 1.0 x 1.0 cm (image 27; series 5). 3-mm right apical nodule is stable compared to prior study. New left lower lobe nodule also noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: There is a unchanged 5.2 x 6.4 cm soft tissue mass in the right axilla (series 3, image 18), presumably representing a schwannoma.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: 9-mm hyperattenuating focus at the inferior aspect of the spleen is stable.PANCREAS: Hypoattenuating soft tissue lesion in the pancreatic uncinate process measuring 1.7 x 1.6 cm (series 3, image 126), stable. There is no pancreatic duct dilatation. The previously described second lesion is not clearly visualized.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is mild bilateral pelvocaliectasis, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS | Overall interval progression of disease with enlarging tumor in the pelvis and new lung metastases. Reference measurements are given above. |
Generate impression based on findings. | 29-year-old male status post reduction of right shoulder dislocation. Three views of the right shoulder demonstrate normal alignment of the glenohumeral joint. Flattening of the lateral aspect of the humeral head on the AP view is suggestive of a Hill-Sachs deformity. We see no evidence of Bankart fracture. | The glenohumeral joint is within normal limits. Probable Hill-Sachs deformity. |
Generate impression based on findings. | 75-year-old female. Abdominal pain, nausea. Endoscopic submucosal dissection of a 25-mm flat lesion. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Calcified hepatic granulomas. No biliary ductal dilatation. No suspicious hepatic mass.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal scarring.RETROPERITONEUM, LYMPH NODES: Mild increased size of mildly enlarged and calcified gastrohepatic ligament lymph nodes, including the reference node that is 1.7 x 1 cm (series 3, image 22), previously 1.4 x 1.1 cm. Reference perigastric lymph node is 1.2 x 2 cm (series 3, image 31), previously 1.1 x 1.6 cm. Calcified atherosclerotic disease of the aorta without aneurysm.BOWEL, MESENTERY: Gastric wall thickening extending from site of previously seen gastric wall/mucosal lesion. No evidence of perforation or fluid collection.BONES, SOFT TISSUES: Right lateral abdominal wall hernia, one of which contains nonobstructed ascending colon.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Atrophic or surgically removed.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 | Gastric wall thickening extending from biopsy site without evidence of perforation. Mild increased size of regional lymphadenopathy. |
Generate impression based on findings. | Clinical question: Alteration mental status the signs and symptoms: Alteration of mental status and delirium. Nonenhanced head CT:No acute intracranial finding. CT however is insensitive fir the early detection of acute nonhemorrhagic ischemic strokes.Periventricular callosal cortical and right basal ganglia foci of parenchymal attenuation likely representing age indeterminate small less ischemic strokes considering patient's age of moderate degree is noted. There is resultant mild ex vacuo dilatation of lateral ventricles with maintained midline.Unremarkable study cortex and the cortical sulci. Unremarkable barium, scalp, orbits, paranasal sinuses and mastoid air cells | 1.No acute intracranial findings.2.Moderate age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Distal radius fracture, need to evaluate multiple fragments. Pain. There is a comminuted, slightly impacted fracture of the distal radial metaphysis. There is slight volar angulation of the distal fracture fragment. The articular surface is intact with normal positioning of the radiocarpal joint and distal radioulnar joint. The ulna and carpal bones appear normal. | Slightly impacted, comminuted fracture of the distal radial metaphysis without intraarticular extension. |
Generate impression based on findings. | Malignant neoplasm of the cecum. Status post craniotomy for tumor resection. There are postoperative findings related to a left suboccipital craniotomy for left cerebellar hemisphere tumor resection. There is pneumocephalus and a small amount of hyperattenuation within the resection cavity. There is patchy hypoattenuation in the left cerebellar hemisphere, compatible with vasogenic edema. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is trace mucosal thickening in the right maxillary sinus. The remaining imaged paranasal sinuses and mastoid air cells are clear. There is mild scalp swelling overlying the craniotomy. | Postoperative findings related to a left posterior craniotomy for tumor resection with a small amount of hemorrhage in resection cavity and surrounding vasogenic edema. However, evaluation for residual tumor is limited on non-contrast CT.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her sister at age 47. 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. Bilateral benign calcifications are again noted. Intramammary lymph node in the right upper outer breast is stable. | 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. | Female, 16 years old. Evaluate for PE. History: tachypnea PULMONARY ARTERIES: Technically adequate exam, without evidence of pulmonary embolism.LUNGS AND PLEURA: Basilar atelectasis, likely dependent. No focal consolidation to suggest pneumonia. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Cardiac size is normal. No pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | No evidence of pulmonary embolism or other acute abnormality. |
Generate impression based on findings. | 81 years, Male. Reason: assess for ileus History: poor po tolerance Again seen are dilated loops of small bowel compatible with ileus, slightly less dilated when compared to the prior exam. Right upper quadrant surgical clips compatible with cholecystectomy. Interval removal of NG tube. Note is made of a right sided JP drain. | Again seen are dilated loops of small bowel compatible with ileus, slightly less dilated when compared to the prior exam. |
Generate impression based on findings. | 73-year-old male with shortness of breath, evaluate for pulmonary embolism PULMONARY ARTERIES: Technically inadequate examination without evidence of pulmonary embolus. Main pulmonary artery is borderline enlarged measuring 3.0 cm, suggestive of pulmonary artery hypertension.LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema. Peripheral fibrosis prominent at the lung bases raises the question of combined pulmonary fibrosis and emphysema (CPFE). These findings have significantly worsened since prior exam and 2013. There is increased bronchial thickening and traction bronchiectasis.No focal pulmonary consolidation. No suspicious nodules or masses. Scattered nonspecific micronodules. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Scattered, mildly prominent, subcentimeter mediastinal lymph nodes appears slightly more prominent compared to the prior exam. No significant hilar lymphadenopathy. The heart size is normal. No pericardial effusion. Severe coronary artery calcification.CHEST WALL: No axillary, cardiophrenic, or retrocrural lymphadenopathy. Mild gynecomastia.No suspicious osseous lesions.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia. Diffuse low attenuation of the liver is suggestive of fatty infiltration. Atherosclerotic calcification of the aorta and its branch vessels. | No evidence of pulmonary embolism.Interval worsening of severe centrilobular and paraseptal emphysema with basilar predominant fibrosis raising the question of combined pulmonary fibrosis and emphysema (CPFE). Increased bronchial wall thickening may reflect acute COPD exacerbation.Severe coronary artery calcification.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female; 70 years old. Reason: Neutropenic stem cell transplant patient with first neutropenic fever complaining of upper and lower abdominal pain History: abdominal pain, + rebound tenderness, TTP The following observations are made given the limitations of an unenhanced study.CHEST:LUNGS AND PLEURA: Stable pulmonary micronodules. Reference right lower lobe nodule measures 5 mm, unchanged (series 5/62).MEDIASTINUM AND HILA: Stable subcentimeter mediastinal lymph nodes.CHEST WALL: Stable right chest port catheter tip at the superior cavoatrial junction. New left jugular central venous catheter tip in SVC.ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic cysts, unchanged. Mild hepatomegaly. Cholelithiasis with contracted gallbladder, similar to prior study. Prominence of the central intrahepatic and common bile ducts, stable to slightly increased since prior exams.SPLEEN: No significant abnormality noted.PANCREAS: Prominence of the pancreatic duct, not significantly changed when compared to prior exam on 7/22/14.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Mild fatty infiltration of the base of the mesentery, slightly increased.BONES, SOFT TISSUES: Multiple presumed injection sites in the subcutaneous soft tissues of the inferior anterior abdominal wall.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Mild fatty infiltration of the base of the mesentery, slightly increased. This is nonspecific and may be due to acute on chronic panniculitis.2. Prominence of the biliary tree and pancreatic duct without evidence of obstructing lesion, though MRI would be more sensitive if clinically indicated. |
Generate impression based on findings. | Clinical question: Revaluate ventricular size. Signs and symptoms:Gait instability, ?NPH. Nonenhanced head CT:No evidence of acute intracranial process. CT however is insensitive for the detection of acute nonhemorrhagic ischemic strokes.There are moderate periventricular and subcortical low attenuation of white matter as was noted on prior MRI exam and consistent with extensive age indeterminate small muscle ischemic strokes. There is resultant ex vacuo dilatation of supratentorial ventricular system without convincing evidence of interval change since prior exam and with maintained midline. Cortical sulci remain widely patent and unremarkable similar to prior study. Images two posterior fossa are again normal and the normal size of the fourth ventricle. | 1.No acute intracranial process.2.Findings suggestive of extensive age indeterminate small vessel ischemic strokes.3.Stable enlarged supratentorial ventricular system since prior study. |
Generate impression based on findings. | 24-year-old male. Resolving retroperitoneal hematoma. Lack of intravenous contrast limits evaluation for solid organ pathology.ABDOMEN:LUNG BASES: Large right and small left pleural effusions with adjacent atelectasis, not significantly changed.LIVER, BILIARY TRACT: No significant abnormality noted. Ventriculocholecystic shunt terminates in the gallbladder.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Unchanged nonspecific nodularity of left adrenal gland.KIDNEYS, URETERS: Postsurgical findings of left nephrectomy. Embolization coils in the right kidney with several foci of milk of calcium. Right renal cysts and additional poorly defined areas of hypoattenuation in the renal parenchyma, unchanged.RETROPERITONEUM, LYMPH NODES: Left retroperitoneal collection is 8.2 x 3.6 cm (series 3, image 51), stable to mildly increased in size. Interval removal of pigtail drain from this collection.BOWEL, MESENTERY: Gastrostomy tube, unchanged. Large ventral hernia containing multiple dilated small and large bowel consistent with chronic ileus. Mild nonspecific wall thickening of left upper quadrant small bowel.BONES, SOFT TISSUES: Bilateral hip dysplasia and multilevel fusions of the thoracolumbar spine. Anasarca.OTHER: Trace abdominopelvic ascites. IVC filter.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Dilated small large bowel consistent with a chronic ileus.BONES, SOFT TISSUES: Bilateral hip dysplasia and multilevel fusions of the thoracolumbar spine. Anasarca. Multiple sacral decubitus ulcers without extension to bone, unchanged.OTHER: Trace abdominopelvic ascites. Bilateral femoral vascular catheters, unchanged. | 1. Left retroperitoneal hematoma is stable to mildly increased in size. Pigtail drainage catheter has been removed. 2. Diffusely dilated bowel loops consistent with chronic ileus, similar to prior. 3. Bilateral pleural effusions with overlying atelectasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history breast cancer in her sister at age 63. 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. Mild motion artifact on the right MLO view is not a significant limitation. 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. | There is a large mildly heterogeneous enhancing oval soft tissue structure within the right neck, caudal to the right parotid gland. This measures 2.4 x 2.2 cm in greatest axial dimensions, by 2.6 cm CC, and most likely represents a nodal conglomerate. The margins are ill-defined, with surrounding inflammatory changes and soft tissue edema. There are minimal central areas of hypoenhancement which could represent developing suppurative portions of the node. There is mass effect upon the right internal jugular vein although this remains patent, with a slitlike appearance at the level of the enlarged lymph nodes. The right parapharyngeal fat remains preserved. The right submandibular gland is slightly anteriorly displaced, with mass effect upon the posterior margin. Additional smaller enhancing right level IIa and IIb lymph nodes are also seen. There is an enlarged right supraclavicular lymph node which measures 12 mm in length. Mildly enlarged right level 1a lymph node is also seen.Enlarged nodes of Rouviere bilaterally are also suggested although not well delineated. On the left, there are additional mildly enlarged left level Ib and IIa/IIb lymph nodes although these are difficult to delineate due to the paucity of fat. There is significant prominence of soft tissues along the posterior nasopharynx, likely relating to reactive lymphoid tissue within the adenoids in a patient of this age, although correlation with physical exam is recommended. This measures up to 14 mm in greatest thickness, with moderate narrowing of the nasopharyngeal airway. There is also diffuse thickening of the soft palate enlargement of the palatine tonsils, consistent with further enlarged Waldeyer's ring structures.PHARYNX/LARYNX: The oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postcontrast appearance of the salivary glands is unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable.OTHER: There is patchy opacification of the right maxillary sinus, with mild mucosal thickening in the left. | 1. Extensive right much greater than left cervical lymphadenopathy with possible early suppurative change, and extensive surrounding right-sided neck inflammatory changes as well as mild localized mass effect. Findings most likely represent reactive lymphadenopathy, with lymphoma and cat scratch disease/other atypical infections felt to be less likely.2. Significant enlargement of Waldeyer's ring likely also reactive in etiology, with moderate narrowing of the nasopharynx. Close observation of the airway is recommended. |
Generate impression based on findings. | 11-year-old male with history of trauma, concern for fractureVIEWS: Left elbow: AP and lateral; left wrist: PA and oblique; left forearm: PA and lateral (6 views) 3/17/15 at 8:23 p.m. Elbow: No fracture or malalignment of the elbow. Mild soft tissue swelling is noted. Left wrist: No fracture or malalignment. No significant soft tissue swelling.Left forearm: Both bones forearm fracture of the mid diaphysis of the radius and ulna. There is minimal medial displacement of the distal fracture fragments with posterior angulation. | Both bones fracture of the mid forearm. |
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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable focal asymmetry in the right breast near 12 o'clock, shown to represent an underlying cyst on last years ultrasound. Normal sized lymph nodes are seen in each axilla. | 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. | Study is slightly limited by motion artifact. No intracranial hemorrhage is identified on the current study. No evidence of mass effect or hydrocephalus. Gray-white differentiation is maintained. Subgaleal hematoma overlying the right parietal bone with nondisplaced, nondepressed fracture involving the right parietal bone extending anteriorly to the coronal suture. The imaged mastoid air cells are clear. The imaged orbits are intact. | 1.No intracranial hemorrhage is identified on the current study. No intracranial mass effect.2.Linear nondisplaced, non depressed fracture involving the right parietal bone which extends anteriorly to the right coronal suture.3.Right parietal subgaleal hematoma. |
Generate impression based on findings. | There is no significant interval change in the extensive area of white matter hypoattenuation involving the right frontal, parietal, and temporal lobes with relative sparing of the overlying cortex. This is associated with very mild effacement of the overlying sulci and underlying right lateral ventricle effacement. There is additional hypoattenuation in the periventricular white matter on the left. There is negligible midline shift to the left. There are also foci of encephalomalacia in the right cerebellar hemisphere and left internal capsule that likely represent chronic infarcts. There is no evidence of acute intracranial hemorrhage. There are calcifications in the distal internal carotid arteries. The lenses are replaced bilaterally. The patient is intubated, has a nasoenteric tube, and a right frontal burr hole. There is rightward nasal septal deviation. There is persistent mild mucosal thickening of the sphenoid sinuses. | No significant interval change in the extensive encephalitis predominantly involving the right cerebral hemisphere, although the abnormality has progressed since the initial scan on 3/5/15.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 20 year-old female with left foot pain. Three views of the left foot demonstrate a 3-mm linear density on the AP view in the soft tissues, immediately lateral to the calcaneocuboid joint. On the lateral view, a 3-mm linear density projects dorsally to the distal margin of the navicular. These findings may represent a small avulsion fracture (it is conceivable that the densities seen on the two views represent the same fragment). There is soft tissue swelling along the lateral aspect of the foot. | Small avulsion fracture(s), as described above. |
Generate impression based on findings. | Female; 81 years old. Reason: Patient with history of abd/pelvis admitted with leukocytosis, AKI, and failure to thrive. Evaluate for intraabdominal infection and hydronephrosis. Please administer PO contrast. History: As above ABDOMEN:LUNG BASES: Interval resolution of small bilateral pleural effusions. Minimal bibasilar dependent subsegmental atelectasis. Small hiatal hernia.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postsurgical changes from right lower quadrant ileal conduit. Bilateral hydroureteronephrosis appears similar to prior exam. New left ureter stent.RETROPERITONEUM, LYMPH NODES: Stable infrarenal IVC filter.BOWEL, MESENTERY: Interval removal of surgical drain with tip near the ureteric anastomosis of the ileal conduit in the right lower quadrant. Ill-defined density (41 Hounsfield units) at the right lateral aspect of the ureteric anastomosis has increased and measures up to approximately 7 x 8.7 cm (series 4/114). This was the site of prior contrast extravasation seen on IR study dated 12/17/14.BONES, SOFT TISSUES: No significant and amounted notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Increased ill-defined density adjacent to the ureteric anastomosis of the ileal conduit in the right lower quadrant status post removal of surgical drain. This may represent a urine leak with phlegmonous change, given that this was a site of contrast extravasation seen on IR study dated 12/17/14. Hematoma is another consideration. No well-formed abscess is evident. |
Generate impression based on findings. | 25 year-old female with right hand pain. Three views of the right hand demonstrate normal alignment. There is no evidence of acute fracture. No significant soft tissue swelling. | There is no acute fracture or malalignment. |
Generate impression based on findings. | 72-year-old female. Has a new lung mass. Evaluate for metastatic disease. ABDOMEN:LUNG BASES: Refer to separately dictated CT chest report.LIVER, BILIARY TRACT: Homogeneously hyperenhancing 8 mm focus in the liver is incompletely characterized, may be a flash filling hemangioma (series 8, image 21). Punctate hypoattenuating focus in the left hepatic lobe is too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: 0.8 x 1.1 cm left adrenal nodule (series 8, image 37) is indeterminate.KIDNEYS, URETERS: Nonobstructive bilateral renal stones and parapelvic cysts. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: No lymphadenopathy. Calcified atherosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.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 notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Homogeneously hyperenhancing 8 mm focus in the liver is incompletely characterized, may be a flash filling hemangioma, which can be confirmed with dedicated CT or MRI liver imaging. 2. Indeterminate small left adrenal nodule. |
Generate impression based on findings. | Cough and left-sided crackles.VIEWS: Chest AP and lateral 3/17/15 (2 view/s) Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Right lower lobe, ill-defined opacity , better visualized in AP view, is concerning for atelectasis or pneumonia. No effusions or pneumothorax. | Right lung base opacity as described. |
Generate impression based on findings. | Chronic sinusitis. There is mild scattered opacification of the anterior ethmoid sinuses and mild mucosal thickening in the right maxillary sinus. The other paranasal sinuses are clear. The nasal cavity is clear. There is mild S-shaped deviation of the nasal septum. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. There is a left maxillary mesiodens. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There is minimal opacification of the left mastoid air cells and probable cerumen in the left external auditory canal. There is degenerative spondylosis in the imaged portions of the cervical spine. | Mild scattered opacification of the anterior ethmoid sinuses and mild mucosal thickening in the right maxillary sinus without evidence of fluid levels. |
Generate impression based on findings. | 67-year-old female with generalized right hip pain, denies fall/trauma. Two views of the right hip demonstrates mild osteoarthritis. Chronic linear heterotopic mineralization is present in the right buttocks, which has been present since at least 2012. We see no evidence of fracture.Single view of the pelvis demonstrates slight demineralization of the bones. Mild osteoarthritis affects the hips and sacroiliac joints. We see no evidence of fracture. Degenerative disk disease affects the lower lumbar spine. Residual contrast is present in the appendix, descending colon, and rectum with numerous diverticula in the descending colon. | Osteoarthritis, as described above, without evidence of fracture. |
Generate impression based on findings. | Male 39 years old; Reason: kidney stone History: right flank pain with hematuria ABDOMEN:LUNGS BASES: Calcified left micronodules and incompletely imaged calcified hilar adenopathy, likely reflecting sequela of prior granulomatous disease. 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: Punctate nonobstructing left midpole intrarenal stone, coronal image 56. No hydronephrosis. No perinephric fluid or stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix. PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Right iliac sclerosis, image 71 series 3, nonspecific but may be related to degenerative disease or bone island formation. | 1.No hydronephrosis. Punctate nonobstructing left intrarenal stone. 2.Unremarkable exam. |
Generate impression based on findings. | Female, 7 years old. Evaluate stool burden. History of imperforate anus and severe constipation requiring disimpactionsVIEW: Abdomen AP (one view) 3/18/2015, 0844 Large stool burden, predominantly in the descending colon, sigmoid, and rectum.No evidence of obstruction. | Large stool burden. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. There is focal hypoattenuation involving the left insular cortex, compatible with prior infarct. There is hypoattenuation of the subcortical and periventricular white matter compatible with age indeterminant small vessel ischemic disease. Right maxillary mucous retention cyst. Mucosal thickening of left maxillary sinus. Scattered ethmoid air cell opacification. The imaged mastoid air cells are clear. The imaged orbits are intact. The osseous structures are unremarkable. | 1.No evidence for acute intracranial abnormality. 2.Small vessel ischemic changes. Focal hypoattenuation involving the left insular cortex compatible with prior infarct.3.Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia. If high clinical suspicion of acute CVA persists, consider MRI. |
Generate impression based on findings. | 57-year-old male with left wrist pain. Two views of the left wrist demonstrate mild basilar joint osteoarthritis, as well as osteoarthritis affecting the trapezioscaphoid and the radioscaphoid articulations. A tiny ossicle adjacent to the fifth carpometacarpal joint is likely of no clinical significance. | Osteoarthritis as described above. |
Generate impression based on findings. | 82-year-old female with swollen, painful left wrist. Three views of the left wrist demonstrate mild soft tissue swelling. The bones appear demineralized, suggestive of osteopenia. Mild osteoarthritis affects the basilar joint as well as the trapezioscaphoid articulation. Calcification of the lunotriquetral interval may represent chondrocalcinosis. Scapholunate widening and adjacent cysts/erosions are better seen on prior study. | Soft tissue swelling and arthritic changes as described above, including possible chondrocalcinosis of the lunotriquetral interval. No fracture evident. The possibility of "pseudogout" could be considered in the correct clinical context. |
Generate impression based on findings. | Female 64 years old; Reason: pancreatitis s/p stem cell transplant History: abdominal pain and tenderness on exam CHEST:LUNGS AND PLEURA: Biapical pleural nodularity/scarring. Basilar atelectasis/linear scarring. Nonspecific 2 mm right upper lobe lung nodule, image 31 series 4. Left lower lobe 5 mm nodule, image 89 series 4, may represent focus of nodular scarring but continued follow-up recommended. Calcified left lower lobe micronodules, likely reflecting sequela of prior granulomatous disease. No pleural effusion. Visualized central airways patent. MEDIASTINUM AND HILA: Right central venous catheter seen with tip near cavoatrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Right hepatic calcifications, may reflect sequela of prior infection or granulomatous disease. Subcentimeter hepatic hypoattenuating lesion in hepatic segment 4, not able to be definitely characterized on this noncontrast nondedicated study. Mildly prominent gallbladder, measuring 4 cm on transaxial imaging. No radiopaque cholelithiasis. No secondary signs of acute cholecystitis delineated on this noncontrast study, no gallbladder wall thickening, pericholecystic fluid or stranding.SPLEEN: No significant abnormality noted.PANCREAS: Mild retroperitoneal, periceliac and periSMA fat stranding, nonspecific. No CT findings specific for acute pancreatitis otherwise.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing left intrarenal stone measuring 3 mm.RETROPERITONEUM, LYMPH NODES: Mild retroperitoneal, periceliac and periSMA fat stranding, nonspecific. BOWEL, MESENTERY: Mild gastric distention with stomach containing ingested contrast and fluid. Underdistended colon, making assessment for wall thickening suboptimal. Normal appendix.PELVIS:UTERUS, ADNEXA: Lobulated contour of uterus, may reflect underlying leiomyomatous disease.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of spine. Decreased osseous mineralization. Heterogeneous appearance of pelvic bones. L5 vertebral body hemangioma. | 1. Mild retroperitoneal, periceliac and periSMA fat stranding, nonspecific. No CT findings specific for acute pancreatitis otherwise. Please note that early pancreatitis may be clinically suspected or present with a normal CT appearance of the pancreas, correlation with patient's clinical history and lipase and amylase laboratory values recommended. 2. Biapical pleural scarring/nodularity and bilateral micronodules, see above. |
Generate impression based on findings. | 44 year old female. Hematuria, pelvic pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Punctate hypoattenuating focus in the left hepatic lobe is too small to characterize. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No renal or ureteral stones. Contrast completely opacifies the bilateral collecting systems on delayed sequences with no focal mass. No hydronephrosis. 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: 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 | No specific findings to explain the patient's hematuria. |
Generate impression based on findings. | There are post-treatment findings including left base of tongue and floor of mouth resection with myocutaneous flap reconstruction and denervation left hemitongue atrophy and mandibulotomy with hardware. There is no significant interval change in the extensive multifocal areas of tumor recurrence in the neck. For example, a right level 2B lymph node measures 12 x 16 mm, previously 11 x 17 mm, a nodule in the left lower neck paraspinal muscles measures 23 x 20 mm, previously 22 x 20 mm, and a left posterior lower neck subcutaneous nodule measures 10 x 12 mm, previously 12 x 10 mm. There are multiple unchanged hypoattenuating lesions in the thyroid gland. There is a right internal jugular venous catheter. The left internal jugular vein remains occluded. There is extensive partially imaged right pleural nodularity and bilateral pulmonary nodules and a left pleural effusion. There is partial opacification of the left sphenoid sinus. Subcentimeter sclerotic foci in the C5 and T1 vertebral bodies appear to be unchanged and may represent enostoses. | 1.Post-treatment findings in the neck without significant interval change in the extensive tumor recurrence in the neck since February 2015.2.Partially imaged right pleural nodules and pulmonary nodules may also represent metastatic disease. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Right lower quadrant abdominal pain for greater than two weeks relieved with bowel movements. No triggers. LIVER: The liver measures 16.2 cm in length and is heterogeneous in echotexture. There is a 1.2-cm hypoechoic nodule along the liver capsule in the right lobe which was present on a prior CT from 2007 indicating it likely represents a benign hemangioma.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 10.5 centers in length and the left kidney measures 9.1 cm in length. There is a 6-mm hypoechoic nodule at the upper pole of the right kidney which is indeterminate due to small size but could represent a benign angiomyolipoma. This was probably present in retrospect on the prior CT examination (image 39; series 3; 1/8/2007 study).OTHER: No significant abnormalities noted. Scanning of the right lower quadrant reveal no focal abnormalities. This area is difficult to evaluate with ultrasound and could be better visualized using cross-sectional imaging such as CT | No definite etiology for the patient's right lower quadrant abdominal pain. Possible hemangioma in the liver and right renal angiomyolipoma as described above. Consider CT exam for further evaluation if clinically indicated. |
Generate impression based on findings. | There is minimal mucosal thickening of the frontoethmoidal recesses. There is a left maxillary sinus septation. The other paranasal sinuses are clear. The nasal cavity is also clear. There is mild undulating nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | 1. No significant paranasal sinus disease.2. Mild nasal septal deviation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 66-year-old male with history of laminoplasty presents status post fall, bilateral knee pain, right wrist pain. Four views of the cervical spine demonstrate postoperative changes related to multilevel laminoplasty, with anterior plate and screws entering the C5, C6, and C7 vertebral bodies. We see no evidence of hardware complications. Intervertebral spacers are present at C5-6 and C6-7, with fusion of these vertebral bodies. Moderate to severe degenerative disk disease affects C4-5. There is approximately 4 mm of anterolisthesis of C4, which increases to 6 mm on flexion imaging. Multilevel facet joint osteoarthritis is also present. We see no evidence of fracture.Three views of the right wrist demonstrate severe basilar joint osteoarthritis, with osteophytosis and lateral subluxation of the first metacarpal relative to the trapezium. A round lucency with sclerotic margins within the scaphoid likely represents a degenerative cyst. A similar-appearing lucency in the distal ulna may represent a cyst although could conceivably represent a chronic erosion. Additional cysts/chronic erosions are noted in the second MCP and IP joint of the thumb.Four views of the right knee demonstrate moderate osteoarthritis, which appears to have progressed compared to the prior study. There is a questionable small joint effusion.Four views of the left knee demonstrates severe osteoarthritis, which appears slightly worse than previous exam. There is slight lateral translation of the tibia with respect to the long axis of the femur. A small joint effusion is present. | 1.Postoperative changes of the spine and degenerative disk disease, as described above.2.Degenerative arthritis of the right wrist and knees, as described above. |
Generate impression based on findings. | There is redemonstration of postoperative changes related to resection of the right posterior lateral pharyngeal wall, tonsillar pillar, and parapharyngeal space from the level of the soft palate down to the level of C4. The surgical defect is bridged with a fatty soft tissue graft, which is unchanged in appearance from the prior exam. There further surgical changes related to tracheostomy, voice prosthesis and prior right-sided neck dissection.However, cranial to the graft, near the level of the most cranial surgical clip at the expected level of the right piriform sinus, there has been interval development of a large area of abnormal enhancing soft tissue which measures 2.0 x 2.8 cm in greatest axial dimensions on 6/15, with effacement of adjacent fat planes. There is more caudal extension of such tissue with encroachment upon the right parapharyngeal fat which is now obscured. The area of abnormality measures approximately 3.0 cm CC on 80486/52. A curvilinear enhancing vessel posterior to the right lateral pterygoid plate is minimally anterolaterally displaced the mass. There may be mild extension of soft tissue laterally beyond the internal margin of the stylomandibular canal seen on 6/24. There is no extension into the adjacent buccal space. There may be some involvement of posterior margins of the right pterygoid muscles. There is effacement of the right piriform sinus and diminished caliber of the right fossa of Rosenmueller.On the delayed postcontrast angle images, the enhancing mass is much more conspicuous near the skull base, with a more peripherally enhancing appearance of soft tissue and central lower density along the remaining lower positioned surgical clips which may represent postoperative changes rather than extension of the new mass.There has been progressive narrowing of the distal right internal artery in the proximal right internal jugular vein at and near the level of prior surgery. For example, the distal right internal carotid artery lumen measures 4 x 2 mm and 6/17, while measuring 6 x 6 mm on the contralateral side at the same level. GLANDS: The postcontrast appearance of the remaining salivary glands is unremarkable. The thyroid gland is surgically absentORAL CAVITY: The oral tongue and floor of mouth are otherwise unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: There is persistent left carotid bulb atherosclerotic calcification. There is redemonstration of multilevel degenerative disease of the cervical spine and postoperative changes from prior C4 to C6 laminectomy and anterior fusion of C5-C6. There is prominent posterior disk osteophyte formation and associated central spinal stenosis, particularly at C3-4 and C4-C5. Cord caliber appears diminished, likely due to chronic atrophy and myelomalacia. There are fibrotic apical pleural postradiation changes, without masses or nodules. | 1. Interval development of large area of abnormal soft tissue caudal to the reconstructive flap, extending from the skull base down to the most cranial surgical clip with localized mass effect. Associated progressive narrowing of the proximal right internal jugular vein and distal right internal carotid artery, which remain patent. This is most concerning for tumor recurrence. Questioned slight extension just lateral to the right stylomandibular canal.2. No cervical lymphadenopathy identified. |
Generate impression based on findings. | Reason: Evaluate for large vessel occlusion History: Sudden R face, arm, and leg weakness with R leg hypoesthesia HEAD: No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. There is focal hypoattenuation of the left insular cortex, compatible with prior infarct. There is hypoattenuation of the subcortical and periventricular white matter compatible with age indeterminant small vessel ischemic disease. Right maxillary mucous retention cyst. Mucosal thickening of left maxillary sinus. Scattered ethmoid air cell opacification. The imaged mastoid air cells are clear. The imaged orbits are intact. The osseous structures are unremarkable. Carious teeth with multiple periapical lucencies noted. Lytic changes involving the left posterior maxillary alveolus is likely related to odontogenic disease.CTA HEAD:Normal contrast opacification is present through anterior circulation, posterior circulation, and distal intracranial vasculature. Normal contrast opacification is present through a complete circle-of-Willis with a patent anterior communicating artery and bilateral posterior communicating arteries. Major venous drainages are grossly patent with hypoplastic right transverse sinus.CTA NECK: The aortic arch origins of the right brachiocephalic, left common carotid, and left subclavian arteries demonstrate minimal atherosclerotic changes. The bilateral vertebral artery origins also have minimal atherosclerotic changes. Minimal bilateral carotid bifurcation plaque without significant narrowing. There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. Scattered calcified pulmonary granulomas. | Minimal atherosclerotic changes with no significant intracranial or extracranial stenosis in the head and neck. |
Generate impression based on findings. | Female; 87 years old. Reason: Hx of Crohn's dz w/ previous partial colonic resection with primary anastomosis and diverting end-loop ileostomy. Now with abd pain and blood per rectum and ileostomy. History: Blood per rectum ABDOMEN:LUNG BASES: Minimal bibasilar dependent subsegmental atelectasis. Mild cardiomegaly. Small hiatal hernia. Contrast in the distal esophagus, suggestive of esophageal reflux.LIVER, BILIARY TRACT: No focal liver lesions. Stable prominence of the central intrahepatic bile ducts. Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No focal pancreatic lesions. Stable prominence of the pancreatic duct.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable renal cysts.RETROPERITONEUM, LYMPH NODES: Mild atherosclerosis of the abdominal aorta and its branch vessels.BOWEL, MESENTERY: Post operative changes from partial colectomy with primary anastomosis and right-sided diverting end loop ileostomy. Though contrast opacifies small bowel loops through the ileostomy, there are some loops of small bowel in the right upper quadrant which are dilated measuring up to 3-cm with a transition point seen proximal to the ileostomy along the the anterior peritoneum (series 3/92). Together, the findings are most suggestive of low-grade partial small bowel obstruction due to adhesive disease.Mild to moderate diffuse circumferential bowel wall thickening of the fluid-filled colon with mucosal hyperenhancement, compatible with colitis and most likely due to active inflammatory bowel disease given the patient's history of Crohn's disease.Stable contour deformity of the colon at the junction of the descending and sigmoid colon, which may be due to scarring.Perineal induration with subcentimeter hypoattenuating focus at the right lateral aspect of the anus. The findings may be due to small perineal fistula and/or perianal abscess.PELVIS:UTERUS, ADNEXA: Stable appearance of the left ovary with cystic lesion and dystrophic calcification. Stable appearance of the right ovary with dystrophic calcification. Status post hysterectomy.BLADDER: Bladder is distended.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative arthritic changes of the lumbar spine. | 1. Findings suggestive of low-grade partial small bowel obstruction due to adhesive disease.2. Diffuse colitis, most likely due to active inflammatory bowel disease.3. Possible perineal fistula and/or perianal abscess. Recommend correlation with physical examination. MRI would be helpful for further characterization if clinically indicated. |
Generate impression based on findings. | 54-year-old female with rising white count, concern for infection. Tachypnea, shortness of breath. LUNGS AND PLEURA: Extensive right pleural thickening, large loculated right effusion with chest tube unchanged. Associated atelectasis and superimposed right lung extensive consolidation are slightly increased. Mild right-sided edema redemonstrated. Small to moderate left pleural effusion has increased.MEDIASTINUM AND HILA: Small pericardial effusion stable to slightly increased. Pericardial nodularity is redemonstrated. Right chest wall port catheter tip at the superior cavoatrial junction. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Innumerable subcutaneous and muscular soft tissue nodular metastases in the chest and abdominal walls are redemonstrated.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Numerous hepatic metastases redemonstrated. Splenic hypodensities again seen. Sclerotic and lytic bone lesions again noted. | 1.Right lung consolidation slightly increased.2.Small to moderate left pleural effusion has increased.3.Mild right pulmonary edema, large loculated right pleural effusion, and diffuse right pleural thickening and widespread metastatic disease redemonstrated. |
Generate impression based on findings. | 13-day-old male with PIE concern for pulmonary hemorrhage, former 24 week twin gestation.VIEWS: Chest and abdomen AP (two views) 3/18/15 at 0626 Endotracheal tube is at the thoracic inlet. OG tube tip near the GE junction with proximal sidehole above the GE junction. Left upper extremity PICC with tip in the SVC. Left lower quadrant Penrose drain has been inserted.The cardiac silhouette is normal. Improved aeration of the left lung. Persistent bilateral coarse lung opacities with a PIE pattern. No focal pulmonary opacity. Left costophrenic angle is persistently blunted. Large lung volumes. Diffuse soft tissue swelling is present.Almost no bowel gas is present. No pneumatosis, portal venous gas, or free air. | Continued PIE pattern. Improved atelectasis. Continued abnormal bowel gas pattern. |
Generate impression based on findings. | Patient fell with symptoms down arms. Evaluate cervical laminoplasty. There is extensive quantum mottle in the lower neck, which limits assessment of the lower cervical spine. There is evidence of prior anterior fusion at C5-C7 with a plate and screw fixation along with intervertebral cage devices. The C5-C6 and C6-C7 endplates appear to be at least partly fused.There is evidence of open door laminoplasty spanning from C3 through C7 with laminotomies on the left, laminectomies on the right and resection of the spinous processes through this region. There has been interval partial fusion of the bone graft material at the right-sided laminectomy defects at C4 and C6. There is interval increase in anterolisthesis of C4 on C5, measuring 4 mm. There is also increase in size of a lucency in the anteroinferior endplate of C4, as well as loss of disc height at C4-C5. The paravertebral soft tissues are unremarkable.C2-C3: Disc bulge with right uncinate spur and facet arthropathy, contributing to moderate right foraminal stenosis. No significant spinal canal or left foraminal stenosis.C3-C4: Posterior disc osteophyte complex with bilateral uncinate spurs, thickening of the ligamentum flavum and facet arthropathy, contributing to moderate left and mild right foraminal stenosis and mild spinal canal stenosis.C4-C5: Posterior disc osteophyte complex with bilateral uncinate spurs and facet arthropathy, contributing to moderate to severe bilateral foraminal stenosis and mild spinal canal stenosis.C5-C6: Bilateral uncinate spurs and facet arthropathy and central posterior disc-osteophyte complex with moderate bilateral foraminal stenosis and spinal canal stenosis.C6-C7: Small central posterior disc-osteophyte complex , but no significant neural foramen or spinal canal stenosis.C7-T1: No discernible significant disc bulge, spinal canal or foraminal stenosis. | 1. Status post remote anterior spinal fusion at C5-C7 and C3-C7 open door laminoplasty with at least partial fusion of bone graft materials. 2. Interval increased anterolisthesis at C4-5 with progression of endplate degenerative changes. 3. Multilevel degenerative spondylosis with variable degrees of neural foramen and spinal canal stenosis, as described in the findings section.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 73-year-old female with new lung mass LUNGS AND PLEURA: A large peripherally enhancing, centrally hypoattenuating mass in the right upper lobe adjacent to the pleura measures 4.6 x 7.3 cm (series 6, image 41). Extension into the chest wall in between the 5th and 6th intercostal spaces without convincing evidence of osseous involvement.A solid, pleural adjacent nodule in the right apex measures 1.6 x 1.3 (series 6, image 20). Nonspecific opacity in the right middle lobe adjacent to the minor fissure.Nodule in the left upper lobe apex measures 8 x 8 mm (series 6, image 17).Part cystic and solid nodule in the left upper lobe measures 11 x 8 mm (series 6, image 20). Nodule in the left lower lobe (series 6, image 48). Additional groundglass opacities in the left upper lobe and right upper lobe are nonspecific and may represent atypical adenomatous hypoplasia.No pleural effusion or pneumothorax. Background lung parenchyma with mild centrilobular emphysema.MEDIASTINUM AND HILA: Mildly prominent mediastinal and hilar lymph nodes are noted; for reference, a right hilar lymph node measures 10 mm (series 5, image 36). The heart size is normal. No pericardial effusion. Mild coronary artery calcification.CHEST WALL: No significant axillary, retrocrural, or cardiophrenic lymphadenopathy. No suspicious osseous lesions. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Scattered subcentimeter hypodense lesions in the liver are too small to further characterize. Hypodense lesion in the left kidney likely represents a benign cyst. Additional scattered subcentimeter hypodensities bilaterally are too small to further characterize but are likely of benign etiology.Indeterminate left adrenal nodule. No significant lymphadenopathy. | Large mass in the left upper lobe as described above is suspicious for a primary malignancy. Additional solid nodules in the left upper lobe and right upper lobe may represent satellite lesions. Additional nodules are nonspecific may represent additional satellite lesions or be post inflammatory. |
Generate impression based on findings. | 54-year-old male with HCG Evaluate for hepatocellular carcinoma. LIVER: Liver parenchyma is mildly echogenic consistent with fatty infiltration. No focal hepatic abnormality is identified. Portal vein is patent with flow towards the liver on color Doppler imaging.BILIARY TRACT: No significant abnormalities noted.PANCREAS: The head and body are normal. The tail is not well seen.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. The left kidney is lobulated contour which was present on prior CT and ultrasound examination and is probably a normal variant rather than a true mass. This is poorly characterized on ultrasound.OTHER: No significant abnormalities noted. | Mild fatty liver. No evidence for hepatic mass. Lobulated left kidney contour probably represents a normal variant as was present on prior CT and ultrasound exams. |
Generate impression based on findings. | 62 year-old female with history of psoriatic arthritis, evaluate for changes. Three views of the left hand again show erosive changes of the wrist, appearing similar to prior study; although there appears to been further resorption of the distal pole of the scaphoid, which now has a sclerotic margin. There is narrowing and deformity of the proximal interphalangeal joint of the ring finger, which may be related to old trauma. Mild narrowing of the remaining interphalangeal joints is also noted, and unchanged from prior exam.Three views of the right hand demonstrate severe osteoarthritis of the basilar joint, as well as mild narrowing of the remainder of the interphalangeal joints. A small lucency in the head of the proximal phalanx of the middle finger may represent a degenerative cyst or small erosion, and is unchanged from prior study.Three views of the left foot demonstrate moderate hallux valgus deformity and mild osteoarthritis of the first metatarsophalangeal joint. Mild deformity of the distal interphalangeal joint of the third toe may reflect old trauma, and is unchanged. No specific radiographic features of psoriatic arthritis.Three views of the right foot demonstrate moderate hallux valgus deformity and mild osteoarthritis of the first metatarsophalangeal joint. There is crossing of the second and third toes, which is unchanged. No specific radiographic features of psoriatic arthritis. | Left wrist erosions and additional arthritic changes, as described above, appear similar to prior exam. There appears to have been further interval resorption of the distal pole of the left scaphoid, which now has a sclerotic margin; otherwise, no evidence of disease progression. |
Generate impression based on findings. | Female 86 years old; Reason: Evaluate for progression of known pancreatic cancer/lung cancer History: severe left shoulder pain CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change. Emphysematous disease. Again seen is unchanged right perihilar groundglass opacity near right mainstem bronchus distally, measuring 2.6 x 1.7 cm. Stable right paramediastinal nodular focus, measuring 1.4 x 1.2 cm, image 27 series 4, unchanged accounting for differences in technique, previously measured 1.4 x 1.1 cm. Multiple bilateral calcified granulomas.MEDIASTINUM AND HILA: Calcified and noncalcified small mediastinal and hilar lymph nodes. Severe calcified coronary artery disease. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter nodularity at level of gallbladder fundus on image 108 series 3, nonspecific.SPLEEN: Splenic calcified granulomata. PANCREAS: Stable to mild interval increase in size of patient's known pancreatic tail adenocarcinoma, stable to slightly increased in size, 2.6 x 1.7 x 1.4 cm, image 82 series 3, previously measured 2.4 x 1.6 x 1.3 cm. Marked atrophy of the remainder of the pancreas.ADRENAL GLANDS: Left greater than right bilateral adrenal nodularity. KIDNEYS, URETERS: Exophytic left renal cyst. Additional smaller renal hypoattenuating lesions too small to characterize but cysts favored.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease. Scattered subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: Tiny hiatal hernia. Scattered sigmoid colonic diverticula.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Ventral abdominal subcutaneous emphysema. | 1. Stable to mildly increased size of patient's known pancreatic tail adenocarcinoma.2. Stable pulmonary nodularity/ground glass opacity as above. |
Generate impression based on findings. | Reason: evaluate for bronchiectasis History: recurrent asthma exacerbations, SOB LUNGS AND PLEURA: No pleural effusion or pneumothorax.No focal consolidation. Diffuse bronchial wall thickening is again noted with mild bronchiectasis. Minimal peribronchial tree in bud opacities and centrilobular opacities suggestive of bronchiolitis.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy.Heart size is. No pericardial effusion.No visible coronary artery calcification.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy.No suspicious osseous lesions. The osseous structure within normal limits.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hypodense lesions in segment 5 and 7 of the liver likely represents benign cysts. Probable splenule is noted. | Diffuse bronchial wall thickening with mild bronchiectasis with tree-in-bud and centrilobular opacities suggestive of reactive airways disease and bronchiolitis. |
Generate impression based on findings. | 13-day-old male with history of PIEVIEWS: Chest and abdomen AP (two views) 3/17/15, 1932 Endotracheal tube is at level of the thoracic inlet. Left upper extremity PICC with tip in SVC. OG tube tip at the GE junction and proximal sidehole above the GE junction. Interval removal of UAC. Penrose drain in the left lower quadrant.The cardiothymic silhouette is unable to be assessed. Significant interval improvement in aeration of left lung. Persistent coarse opacities in the PIE pattern. Improved blunting of the left costophrenic angle. Large lung volumes No pneumothorax. Diffuse soft tissue swelling.Overall paucity of bowel gas. No pneumatosis, free air, or portal venous gas. | Persistent complications of surfactant deficiency. Persistent abnormal bowel gas pattern. |
Generate impression based on findings. | T3N0 HPV(+) squamous cell carcinoma of the base of tongue, for staging. Neck: There is an infiltrative, partly exophhytic mass centered in the left tongue base with epiglottic and left tonsillar fossa extension and extension across the midline. Overall, the mass measures up to approximately 4 cm. There is narrowing of the oropharyngeal airway. There is no significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is mild degenerative spondylosis of the cervical spine. The imaged portions of the lungs are clear.Head: There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There are left maxillary sinus retention cysts. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. An infiltrative mass centered in the left tongue base that traverses the midline, as well as epiglottic and left tonsillar fossa extension that measures up to approximately 4 cm is compatible with squamous cell carcinoma. 2. No evidence of significant cervical lymphadenopathy based on size criteria.3. No evidence of intracranial metastases. |
Generate impression based on findings. | 53 year old female with left breast cancer (IDC and DCIS); status post chemotherapy, for partial mastectomy and left axillary sentinel node biopsy. On review of the prior studies, 2/23/2015. Target pleomorphic calcifications morphology and top hat clip are located in the left breast in the upper outer quadrant region located in mid-breast and posteriorly 1 o’clock. The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The left breast was placed in an alphanumeric grid using lateral to medial approach. When the targets were positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 7 cm Kopans needle was placed, posteriorly, adjacent to the posterior extent of calcifications. Using coordinates from the grid, a 9 cm Kopans needle was placed, mid depth adjacent to the top hat biopsy clip. Using coordinates from the grid, a 7 cm Kopans needle was placed, anteriorly, adjacent to the anterior extent of calcifications. On orthogonal mammography, adequate positioning of the needles was confirmed after adjusting depth so the needle tip was approximately 2 cm deep to the center of the targets. Spring wires were then deployed. Repeat two view orthogonal mammograms reveal the spring wires to be in good position. The mammogram was annotated and reviewed with Dr. Jaskowiak prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Lai performed the procedure under direct supervision of Dr. Kulkarni, who was present during the procedure at all times.Orthogonal digital specimen radiographs revealed the calcifications and clip and 3 spring wires to be within the specimen. Calcifications were noted adjacent to the lateral margin. Additional lateral tissue revealed calcifications reaching upto the margin. | Successful needle localization of the left breast anterior and posterior extent of calcifications and top hat biopsy clip.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Right abdominal bloating for 3 months. Renal or hepatic mass? Bulky adenopathy? LIVER: No focal liver masses. No intrahepatic biliary ductal dilatation. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. Common duct measures 7 mm in diameter which is slightly enlarged.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: There is a 1.5-cm nodule at the upper pole the right kidney which is near anechoic with posterior acoustic enhancement. This probably represents a cyst. A similar appearing nodule is present on the prior CT examination from 2010. No hydronephrosis of either kidney.OTHER: No significant abnormalities noted. Spleen measures 7.1 cm in length; calcified granulomas noted.. | No evidence of hepatic mass. Probable right renal cyst. If clinical suspicion remains high, correlation with cross-sectional imaging could be performed. |
Generate impression based on findings. | 65-year-old now with nodule on chest x-ray. Shortness of breath. LUNGS AND PLEURA: Evaluation is mildly limited by respiratory motion artifact. No focal consolidation or pleural effusion. Right postero-apical pleural thickening is noted. There is basilar bronchiectasis and questionable interstitial changes, possibly related to chronic aspiration (comparison with prior imaging would be helpful if available). Minimal basilar atelectasis/scarring. No superimposed acute process.MEDIASTINUM AND HILA: Moderate cardiomegaly. No pericardial effusion. Severe coronary and aortic valve calcifications. Prominent mediastinal lymph nodes; a right paratracheal lymph node measures 14 mm (series 4, image 33).CHEST WALL: 19-mm right anterior chest wall subcutaneous nodule abutting/involving the skin surface. Clinical correlation is recommended.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Small to moderate volume of upper abdominal ascites. Left adrenal nodule, meeting criteria for benign adenoma. | 1.No suspicious pulmonary nodules.2.Subcutaneous right chest nodule abutting/involving the skin; clinical correlation is recommended to ensure benignity. |
Generate impression based on findings. | 62 year-old female with history of SLE/scleroderma with Achilles' tendon pain and midfoot pain. Three views of the right foot demonstrate mild diffuse soft tissue swelling about the ankle. The distal Achilles' tendon appears slightly thickened with mineralized foci within its insertional fibers, suggesting chronic tendinosis. Tiny midfoot osteophytes suggest mild midfoot osteoarthritis. An ossicle along the lateral aspect of the base of the proximal phalanx of the great toe may reflect old trauma. The bones appear slightly demineralized, suggesting osteopenia. The proximal phalanx of the right third toe appears hypoplastic.Three views of the left foot demonstrate diffuse soft tissue swelling about the ankle. Ossific foci in the distal Achilles' tendon is suggestive of chronic Achilles tendinosis. Midfoot osteophytosis is indicative of mild osteoarthritis. Moderate osteoarthritis affects the first metatarsophalangeal joint. There is mild hypoplasia of the third and fourth proximal phalanges. | Findings suggestive of chronic Achilles insertional tendinosis bilaterally and osteoarthritis, as described above. |
Generate impression based on findings. | 63-year-old male with left breast palpable lump for two months especially tender presents for bilateral diagnostic mammogram. Mammogram: Three standard views of both breasts and two spot compression views of 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, left more than right. Triangular marker denoting palpable abnormality identified in the left retroareolar region. No suspicious mass identified on spot compression views.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla.Ultrasound: Targeted left retroareolar ultrasound was performed corresponding to the palpable abnormality. On physical examination, no discrete palpable mass noted Normal dense glandular tissue is identified. No suspicious masses noted. | Bilateral gynecomastia, left more than right corresponding to patient's palpable abnormality in the left breast. Clinical correlation is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Male; 22 years old. Reason: r/o obstruction History: nausea and vomiting, abdominal pain ABDOMEN:Lack of intravenous contrast limits sensitivity for solid organ pathology.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: Contrast opacifies small bowel loops through the ileostomy. There is mild dilation of distal small bowel loops measuring up to 2.9 cm, improved since prior study. There is a point of transition just proximal to the ostomy site along the anterior peritoneum (series 3/24), suggesting low-grade partial small bowel obstruction due to adhesive disease. 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: See above discussion.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Findings suggestive of low-grade partial small bowel obstruction due to adhesive disease with transition point proximal to the ostomy site. |
Generate impression based on findings. | 79-year-old male with right knee pain. Three views of the right knee demonstrate moderate to severe osteoarthritis, particularly affecting the medial compartment, with near bone-on-bone apposition. Chondrocalcinosis affects the lateral meniscus and articular cartilage. A moderate joint effusion is present. Moderate osteoarthritis also affects the left knee, with chondrocalcinosis of the lateral meniscus and articular cartilage on the left. | Osteoarthritis and chondrocalcinosis, as detailed above. |
Generate impression based on findings. | 5-year-old male with nausea, vomiting, fever, and one episode of diarrhea treated with ImodiumVIEWS: Abdomen upright and supine AP (two views) 3/17/15 A large amount of gas is present within the colon and there are air fluid levels within the colon. Nonobstructive bowel gas pattern. No pneumatosis, free air, or portal venous gas. Femoral heads are well seated in the acetabula. | Gastroenteritis pattern. |
Generate impression based on findings. | 24-year-old male with left anterior rib pain. Markers are noted along the lateral aspect of the left lower rib cage. No evidence of fracture. | No evidence of fracture or other findings to account for patient's pain. |
Generate impression based on findings. | 79 years, Male. Reason: hypotension recent colectomy History: hypotension Gastrostomy tube in place, position unchanged. Right upper quadrant staple line is present. There is a percutaneous common bile duct stent in place (T-type). There is a nonobstructive bowel gas pattern. | Postsurgical changes as described above without evidence of bowel obstruction. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No intra- or extra-axial fluid collections. Nonspecific periventricular white matter hypoattenuation is again seen, along with encephalomalacia of the inferior left temporal lobe.Generalized cerebral volume loss with ex vacuo dilatation of the ventricles. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are intact. Right frontal burr hole. Otherwise osseous structures are unremarkable. | 1. No evidence of intracranial hemorrhage or intracranial mass effect. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia and if there is high clinical suspicion consider MRI.2. Global parenchymal volume loss, which is advanced for age.3. Redemonstration of nonspecific white matter hypoattenuation which may reflect age indeterminate microvascular ischemic disease, as well as presumed chronic cortical infarct of the inferior left temporal lobe. |
Generate impression based on findings. | Status post right knee fusion for osteomyelitis. Again seen is intramedullary rod affixing the distal femur and proximal tibia in near-anatomic alignment. The bones are fused. There has been interval development of arterial calcifications within the posterior soft tissues of the knee. I see no findings to suggest an acute infection. | Right knee arthrodesis as above. |
Generate impression based on findings. | 65 years, Male, Reason: 65M s/p open right hemicolectomy with incisional hernia History: incisional hernia. The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted. Previously described enhancing nodule cannot be assessed on today's exam due to lack of intravenous contrast.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Cyst in the left midpole. Right upper pole hypodensity is too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small ventral fat-containing hernia measuring 4.8 cm in diameter (image 85; series 3). No evidence of obstruction. Postoperative changes of partial colectomy with ileocolonic anastomosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: Prostatic enlargement.PROSTATE, SEMINAL VESICLES: Enlarged prostate.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 | Small ventral fat-containing hernia as described. No substantial interval change compared to prior. |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is right maxillary sinus opacification. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. CTA HEAD | 1. No acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. No intracranial stenosis or aneurysm.3. No flow limiting stenosis of the bilateral internal carotid arteries.4. Mild emphysematous changes of the partially imaged lung apices, as well as non-specific micronodules.5. Multiple dental caries. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 79-year-old female with history of bilateral benign breast biopsies. Three standard views of both breasts and additional left CC and ML spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear scar markers were placed over both breasts. Circular skin marker was placed over the left upper outer breast. Biopsy clip in the left 2 o'clock position from prior cyst aspiration. Immediately posterior and medial to the clip, there is a new circumscribed round mass measuring 13 mm that persists on spot compression views. Benign appearing calcifications are present in both breasts.No suspicious microcalcifications or areas of architectural distortion in either breast. LEFT SONOGRAPHIC | New mass with indistinct margins on ultrasound adjacent to patient's biopsy clip from prior cyst aspiration, likely represents cyst recurrence, although due to sonographic appearance, ultrasound guided biopsy/aspiration is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Postop. Rule out fracture. Osteoarthritis. Components of a left total knee arthroplasty device are situated in near atomic alignment without evidence of complication. There is swelling of the anterior soft tissues and a joint effusion. I see no fracture. | Total knee arthroplasty as above. |
Generate impression based on findings. | Status post left total hip arthroplasty, 6 weeks postop Three views of the left hip show components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of hardware complication.Three views of pelvis show the aforementioned left total hip arthroplasty. Moderate osteoarthritis affects the right hip. Degenerative arthritic changes also affect the visualized lower lumbar spine. There is chondrocalcinosis and capsular calcification involving the pubic symphysis. | Total hip arthroplasty and other findings as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two sisters. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral benign calcifications are again noted. Normal-sized lymph nodes are seen in each axillary region. | 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. | Postop prosthetic assessment Three views of the right hip show components of a total hip arthroplasty device situated in near-anatomic alignment without evidence of hardware complication.Three views of the pelvis show the aforementioned right total hip arthroplasty. Moderate osteoarthritis affects the left hip. The remainder of the pelvis appears normal for age. | Total hip arthroplasty. |
Generate impression based on findings. | Post operative changes are again seen from previous left posterior temporal and parietal craniotomy, with interval expected evolution. There is only very minimal residual smooth dural thickening and enhancement underlying the craniotomy flap, with decreased adjacent parenchymal susceptibility likely relating to postoperative hemosiderin deposition. There is very minimal irregular enhancement remaining within the surgical bed as seen on 1301/125 along the peripheral left parietal region. This is most likely postoperative in nature. There is an area of evolving encephalomalacia in the left posterior temporal occipital region relating to previous infarct. There is also minimal irregular enhancement in this area on 1301/102. There is progressive ex vacuo dilatation of the adjacent left atrium and occipital horn.The ventricles and sulci are prominent, consistent with moderate age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is redemonstration of diffuse abnormal low signal involving the odontoid process as well as areas of abnormal signal in the visualized C3 and C4 vertebral bodies, consistent with metastases. These demonstrate mild enhancement on postcontrast images. Diffuse abnormal signal with thickening and irregularity involving the left parietal temporal calvarium consistent with known osseous metastatic disease. | 1. Expected evolution of previously seen postoperative changes, with minimal smooth dural enhancement underlying the craniotomy flap and minimal areas of irregular enhancement which are favored to be postoperative in etiology, but continued follow-up is recommended to exclude tumor recurrence.2. Expected evolution of left posterior temporal occipital infarct with ex vacuo dilatation of the adjacent left lateral ventricle. Small amount of associated irregular enhancement.3. Redemonstration of diffuse thickening and irregularity of the left parietal temporal calvarium, with abnormal signal in the visualized cervical vertebrae, consistent with known osseous metastatic disease.4. Stable mild chronic small vessel ischemic changes. |
Generate impression based on findings. | Pain Four views of the right knee show severe osteoarthritis particularly affecting the medial and patellofemoral compartments.Four views of the left knee show moderate to severe osteoarthritis, with near bone-on-bone apposition of the medial compartment particularly on the skiers view. | Osteoarthritis. |
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. Normal-sized lymph nodes project in each axilla. A few benign calcifications are noted in the left breast. | 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. | Asymptomatic female presents for routine screening mammography. Known left breast cyst. 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. Numerous bilateral benign calcifications are again seen. Benign morphology mass in the left upper inner breast is stable to decreased in size, shown to be a cyst on ultrasound previously. Asymmetry in the right outer breast is also unchanged. Normal-sized lymph nodes project in each axilla. | 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. | 17 day old former 32 week gestational age patient with concern for NEC.VIEWS: Chest and abdomen AP (two views) 03/18/15, 0516 Feeding tube tip is at GE junction. Left upper extremity PICC has been removed.Cardiothymic silhouette is normal. Minimal hazy lung opacities are present. Lung volumes are small.Bowel gas pattern is abnormal. Multiple dilated, tubular loops are present. No pneumatosis intestinalis, portal venous gas, or free peritoneal air is present. | No focal lung opacity. Abnormal bowel gas pattern. |
Generate impression based on findings. | Fever and more secretions. 2-year-old former 24 week gestational age patient.VIEW: Chest AP (one view) 03/18/15, 0549 Left upper extremity PICC tip is in superior vena cava. Gastrostomy tube is again seen. Surgical clips are noted around the GE junction.Cardiothymic silhouette is normal. Air space disease persists in right upper and left lower lobes. Hazy opacities are noted bilaterally. Cardiothymic silhouette is normal. | Right upper and left lower lobe pneumonia. |
Generate impression based on findings. | Male 66 years old; Reason: History of ileo-cecal mass, suspicious for cancer. Pre-op staging History: History of ileo-cecal mass, suspicious for cancer. Pre-op staging CHEST:LUNGS AND PLEURA: Severe upper lobe predominant emphysematous disease.MEDIASTINUM AND HILA: Normal variant with the left vertebral artery originating directly from aortic arch. Coronary artery disease including mild to moderate calcifications. Small calcified hilar lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Subcentimeter splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing nephrolithiasis, measuring up to 7 mm in left kidney. Multiple simple and mildly complex bilateral renal cysts, the lateral suboptimally characterized on this nondedicated exam. RETROPERITONEUM, LYMPH NODES: Mild calcified aortobiiliac atherosclerotic disease. Retroperitoneal/left paraaortic calcified lymph nodes, measuring up to 9 mm in maximum short axis dimension. BOWEL, MESENTERY: Ileocecal mass present, measuring 6.3 x 4.5 x 5.7 cm in craniocaudal dimension. No proximal small bowel dilatation seen to suggest associated obstruction. Contrast did not traverse beyond aforementioned mass and into colon, this may be secondary to timing of IV contrast bolus. Mildly prominent adjacent right lower quadrant lymph node, measuring 1.2 x 0.6 cm, image 137 series 3. Minimal haziness around sigmoid colon diverticulosis, image 153 series 3, nonspecific. Moderate to large stool burden. Small bowel containing left inguinal hernia, measuring 3.7 cm, image 187 series 3. Smaller right inguinal small bowel containing hernia, measuring 2.9 cm. Tiny hiatal hernia.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate gland, measuring 5.2 cm. BLADDER: Collapsed bladder, making evaluation suboptimal.BONES, SOFT TISSUES: Multilevel degenerative changes of spine. Bilateral hip degenerative disease. | 1. Ileocecal mass with adjacent lymph node, latter nonspecific but may be metastatic. Additional calcified retroperitoneal lymph nodes. Contrast did not traverse beyond aforementioned mass and into colon, this may be secondary to timing of IV contrast bolus. 2. Sigmoid colon diverticulosis with mild paracolic fat stranding, may reflect chronic sequela but may also be seen in setting of mild acute diverticulitis, correlation with patient's clinical history recommended.3. Left larger than right small bowel containing inguinal hernias. No associated small bowel obstruction.4. Bilateral renal cystic lesions as above. 5. Prostatomegaly. 6. Severe emphysematous disease. |
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