instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | 25-year-old female with history of Ewing sarcoma and pulmonary metastasis post resection. LUNGS AND PLEURA: Small left apical pneumothorax which appears smaller than on the most recent chest radiograph. Postsurgical changes and nonspecific soft tissue thickening in the resection site measuring 3.3 x 1.9 cm (series 4, image 24). This is favored to represent scarring, however follow up is recommended. Inferior to the resection site in the left upper lobe is a linear density likely representing scarring (series 4, image 36). No new suspicious pulmonary nodules or masses. No pleural effusion. Mild linear atelectasis in the lingula.MEDIASTINUM AND HILA: Heart size is normal with trace pericardial effusion. No mediastinal, internal mammary, cardiophrenic, or retrocrural lymphadenopathy. No significant axillary lymphadenopathy.CHEST WALL: Chest port with tip in SVC.UPPER ABDOMEN: The adrenal glands are normal in appearance. Partially visualized hypodensity along the falciform ligament is unchanged in size and known to be FNH. | 1.Improved small left apical pneumothorax.2.Postsurgical changes and nonspecific soft tissue thickening at the site of resection of previously seen metastasis is favored to represent scarring, however interval follow-up imaging is recommended to ensure stability and/or resolution. |
Generate impression based on findings. | Brain: There is no evidence for intracranial hemorrhage. No evidence of intracranial mass, mass-effect, or hydrocephalus. No evidence of fracture. There are no extraaxial fluid collections. Right sphenoid sinus mucous retention cyst. Otherwise visualized portions of the paranasal sinuses and mastoid air cells are clear. Mild proptosis again noted. Cervical Spine: Examination of the lower cervical spine is slightly limited by motion artifact and patient's body habitus. No evidence of acute fracture or subluxation. Vertebral body heights are preserved. There is straightening of the cervical spine which may be positional. Alignment is anatomical. There are mild multilevel degenerative changes without high grade spinal canal or neural foraminal stenosis. No paraspinal soft tissue swelling. There is right apical scarring. | 1. No evidence of intracranial hemorrhage or mass effect. If there is suspicion for acute ischemia, MRI can be considered.2. No evidence of calvarial fracture. No evidence of fracture or subluxation in the cervical spine. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Prior benign left breast biopsies. 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. Small focal asymmetries adjacent to the left breast biopsy clips are unchanged. Bilateral benign calcifications and other areas of asymmetry are also stable. Normal size bilateral axillary and left intramammary lymph nodes are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Nasopharynx cancer status post SBRT to lung. CHEST:LUNGS AND PLEURA: Areas of wedge resection in the right lung.Left upper lobe nodule remains 3-mm (5/24), but has decreased in density. Left upper lobe subsegmental atelectasis or scarring occurs in the region of the nodule, new from previous. Probable subpleural/intrapulmonary lymph nodes on the right, but no new suspicious lesions.MEDIASTINUM AND HILA: No significant abnormality noted. No visible coronary calcification on this non-gated study.CHEST WALL: Degenerative changes described previously.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Interval development of a heterogeneous attenuation pattern within the right hepatic lobe posteriorly. The right hepatic vein is unopacified, suspicious for occlusion, Dr. Haraf verbally notified at 1:20 p.m. on 3/18/2015. Previously seen poorly defined hypoattenuating lesions in the right lobe are unchanged. Assessment for metastatic lesions in this lobe is difficult, and new areas of hypoattenuation measuring up to 2-cm are indeterminate. Cholecystectomy. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Nonvisualization of the right hepatic vein with abnormal attenuation pattern in the right lobe suspicious for right hepatic vein thrombosis. Correlation with duplex ultrasound liver recommended. Dr. Haraf verbally notified.2. Decrease in density of the index left upper lobe micronodule. . No new pulmonary lesions are identified.3. Hepatic perfusion abnormality limits assessment for metastatic lesions, areas of hypoattenuation are indeterminate and could be vascular however underlying metastases cannot be effectively excluded at this time. |
Generate impression based on findings. | Reason: Sarcoidosis with hilar adenopathy on CXR, mild dyspnea, evaluate for parenchymal involvement History: dyspnea. LUNGS AND PLEURA: No focal consolidation, pleural effusion or suspicious nodules. Few scattered calcified micronodules.MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. No coronary calcifications identified. There is extensive bilateral mediastinal and hilar lymphadenopathy in all compartments. A right paratracheal lymph node (3/38) measures up to 2.9 cm. A right hilar node measures to 2.8 cm. A left hilar node measures 1.3 cm. Multiple cardiophrenic nodes are also prominent, measuring up to 1.2 cm.The brachiocephalic veins near the midline are slightly compressed. Superior vena cava is collapsed due to extrinsic compression from lymphadenopathy, measuring 5-mm in AP dimension (3/38).CHEST WALL: No suspicious focal osseous lesion.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Multiple prominent to mildly enlarged lymph nodes are seen in the upper abdomen, especially in the gastrohepatic ligament. Known hepatic parenchymal lesions are not clearly visible in the absence of intravenous contrast. | 1.Mediastinal, bilateral hilar, and upper abdominal lymphadenopathy, distribution is most compatible with sarcoidosis. If there is no tissue diagnosis on this patient however posterior compartment involvement may be also seen in entities such as lymphoma.2.No evidence of pulmonary parenchymal involvement.3.If the patient wishes to return for a expiratory phase scan, an addendum to this report will be issued.4.Central venous compression due to lymphadenopathy, correlate for physical signs of SVC syndrome. |
Generate impression based on findings. | Female 5 years old Reason: eval cardiac anatomy History: PA/VSD s/p Fontan. Two pacer leads and multiple surgical clips are noted.Left Ventricle: Large left ventricle with neo-cardial wall thickness about 1 cm up to 13 mm.Right Ventricle: Hypoplastic right ventricle noted. Left Atrium: The left atrium is enlarged. There are four distinct pulmonary veins which drain normally into the left atrium.Right Atrium: The right atrium is slightly small likely filled from the pulmonary venous return. Great Vessels: No significant collateral circulation was observed. Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 26.5 mm Ascending: 23.9 mm Arch: 20 mm Descending: 12 mmPulmonary Artery: Right pulmonary artery is filled directly by the right subclavian/innominate vein (Status post Fontan). The conduit in between the right pulmonary artery and IVC was identified, however was not filled with contrast, likely due to the timing of the scan , therefore patency cannot be assessed. The left pulmonary artery is visualized and of normal caliber, but not filled with contrast as well, and probably again, because of the timing of the CT and preferential flow.Vena Cavae: Due to lack of contrast the IVC cannot be evaluated.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.LM: The left main coronary artery arises from the left sinus of Valsalva in a slight clockwise, posterior rotation making a sharp angle in between the aorta and the RVOT, downstream , branches normally. RCA: Arises from the anterior sinus of Valsalva. Extracardiac findings: Upper thoracic levocurvature and knee thoracic dextrocurvature are, either pulsation or true scoliosis. No focal lung opacities, effusions or pneumothorax. | 1. Patent Fontan procedure with preferential circulation to the right lung. 2. Aortic root dilatation, likely postsurgical.3. Right ventricular hypoplasia and small right atrium.4. Left ventricular enlargement/hypertrophy.5. No significant collateral circulation (either Venovenous or intrapulmonary) was observed. Dr. Peter Varga was present during the elaboration of this report and agrees with the findings. |
Generate impression based on findings. | Follow-up for impending fracture noted on bone scan. History of prostate cancer. There is a sclerotic lesion in the humeral head compatible with metastatic prostate cancer. I see no destruction of the overlying cortical bone. Additional metastatic foci are noted within the visualized right ribs. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. Mineralization between the humeral head and acromion process likely represents calcific tendinopathy of the rotator cuff. | Metastatic prostate cancer and other findings as above. |
Generate impression based on findings. | 78 years, Female. Reason: evaluate for constipation History: evaluate for constipation Gastrostomy tube in place with gastrojejunostomy extender tip terminating in the proximal jejunum beyond the ligament of Treitz. There is a nonobstructive bowel gas pattern. Below average stool burden. Orthopedic rod and screw fixation of the right hip. Levoscoliosis of the lumbar spine. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female, 15 years old. Reason: Evaluate for etiology of lymphedema LIVER: The liver measures 14.8 cm, has normal echotexture, without focal lesion.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance. No gallbladder wall thickening.The common bile duct measures 0.3 cm.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: The spleen measures 8.8 cm, without significant abnormality noted.KIDNEYS: The right kidney measures 9.9 cm. The left kidney measures 10.9 cm. normal bilateral renal echotexture, without significant pelvicaliceal dilation.ABDOMINAL AORTA: Normal in caliber, with normal flow.INFERIOR VENA CAVA: Normal in caliber, with normal flow.OTHER: The ovaries are mildly prominent bilaterally and symmetric in size, with physiologic follicular cysts and normal vascular flow. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Previous benign MRI guided biopsy of the left breast. Family history of breast cancer in her mother and sister. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable position of the left breast biopsy clip. A few scattered benign calcifications are again noted. | 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. | 56 years, Female. Reason: Assess for obstructive signs History: Hx of renal transplant, abd distension and pain There is a nonobstructive bowel gas pattern. Surgical clips project over the right iliac fossa. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Left knee pain status post fall for one week. Swelling. Fracture? I see no fracture, malalignment, or large joint effusion. I see no specific findings to account for the patient's pain. | No fracture or other specific findings to account for the patient's pain are evident. |
Generate impression based on findings. | 68-year-old female with left hip pain status post ground level fall. Single view of the pelvis demonstrates minimal osteoarthritis of the bilateral hip joints. No fracture or malalignment is evident. The remainder of the pelvis is unremarkable. | Minimal hip osteoarthritis, otherwise normal exam. |
Generate impression based on findings. | Male; 35 years old. Reason: eval for cancer recurrence History: prior h/o early stage colorectal cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Scattered subcentimeter hypoattenuating foci in the right lobe of the liver are too small to characterize but stable since prior study and most likely due to benign cysts.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: Postsurgical change from extended right hemicolectomy with ileocolic anastomosis. No evidence of residual or recurrent 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: Status post extended right hemicolectomy with ileocolic anastomosis. No evidence of residual recurrent disease.BONES, SOFT TISSUES: Chronic-appearing mild superior endplate compression deformity of L2 vertebral body, though new since prior study. A normal variant lumbosacral transitional vertebra is present ("L6").OTHER: No significant abnormality noted | 1. Postsurgical change from extended right hemicolectomy with ileocolic anastomosis. No evidence of residual or recurrent disease.2. No evidence of metastatic disease in the abdomen and pelvis.3. Chronic-appearing mild compression deformity of the L2 vertebral body, though new since prior study. |
Generate impression based on findings. | Status post fracture Again seen is a plate and screw device affixing a fracture of the distal clavicular diaphysis in near-anatomic alignment. Portions of the fracture are slightly less distinct on the current study than on the prior study, suggesting some interval healing. I see no hardware complications. | Orthopedic fixation of healing clavicle fracture as above. |
Generate impression based on findings. | Reason: eval for malignancy. new diagnosis of metastatic prostate cancer History: metastatic prostate cancer to the skull base A large area of uptake in the left skull base corresponds with the patient's biopsy proven metastasis. Additionally, there are areas of radiotracer uptake in the right para-symphyseal pelvic bone with extension into the right inferior pubic ramus and right acetabulum correlating with permeative lesions seen on CT. | Multiple osseous metastases in the left skull base and right pelvis. |
Generate impression based on findings. | Status post allograft placement. Osteosarcoma. No symptoms currently. Two views of the left tibia/fibula again show plate and screw devices affixing allograft between the native proximal tibial epiphysis and proximal tibial diaphysis in near anatomic alignment. I see no hardware complications. The proximal osteotomy margin is indistinct suggesting healing. There has been progression of bridging bone across the distal osteotomy. Overall, the bones appear demineralized. | Orthopedic fixation of healing allograft as described above. |
Generate impression based on findings. | Reason: lung ca @ 2008. S/p resection and adjuvant therapy. Pls c/w previous study and evaluate dz status. History: lung ca. CHEST:LUNGS AND PLEURA: Postsurgical findings of right upper lobectomy redemonstrated. Few scattered bilateral nonspecific pulmonary micronodules are stable. No suspicious pulmonary nodules identified. Mild left upper lobe bronchial thickening redemonstrated.MEDIASTINUM AND HILA: Heart size normal. No pericardial effusion. No coronary calcifications detected. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. No suspicious focal osseous lesion. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: High attenuation lesion at the hepatic dome is unchanged, remains compatible with hemangioma. Focal fat deposition noted adjacent to the gallbladder.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: The kidneys enhance symmetrically. Multiple areas of scarring and other subcentimeter hypodensities are noted, too small to further characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate calcifications of the abdominal aorta and its branches. No significant intraperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.The bowel is normal in caliber without evidence of obstruction or ileus.BONES, SOFT TISSUES: Mild degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Head and neck tonsillar cancer status post chemoradiation. New thoracic and cerebellar abnormalities on CT. Restaging exam.RADIOPHARMACEUTICAL: 13.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 113 mg/dL. Today's CT portion grossly demonstrates medium to large bilateral pleural effusions. Small pericardial effusion. Scattered pulmonary parenchymal opacities are noted, more confluently at the bases. Several enlarged celiac and borderline retroperitoneal lymph nodes are present.Today's PET examination demonstrates at least two new hypermetabolic intracranial lesions, most notably involving the left cerebellum (SUV max = 19.4), consistent with new brain metastases. In addition, a significantly hypermetabolic pituitary lesion is present but has been fairly stable over several previous exams and may reflect any synchronous primary pituitary lesion such as an adenoma versus additional metastatic disease.There is new widespread markedly hypermetabolic thoracic activity consistent with additional tumor progression. Abnormal activity studs bilateral pleural surfaces including along the diaphragms bilaterally as well as involving bilateral pulmonary parenchymal lesions and numerous mediastinal, bilateral hilar, and bilateral supraclavicular lymph nodes (SUV max = 13.8).Multiple new hypermetabolic abdominal lymph nodes are seen within the celiac axis and retroperitoneum (SUV max = 8.3) indicating additional tumor progression. Additional more subtle but abnormal hypermetabolic intramuscular activity in the left abdomen and left pelvis indicates additional metastatic progression.A new medium-sized markedly hypermetabolic osseous focus within the left acetabulum (SUV max = 8.4) as well as a second suspected osseous focus at the superior aspect of L4 for vertebral body indicate new bone metastases. | Marked interval tumor progression with widespread new hypermetabolic metastatic disease from the head through pelvis involving brain, osseous, pulmonary, intramuscular, and lymph node metastases. |
Generate impression based on findings. | 66 years, Male. Reason: please check dobhoff placement History: above There is a Dobbhoff tube with its tip projecting over the body of the stomach. There is a nonobstructive bowel gas pattern. Chest tubes and mediastinal drains in place. Epicardial pacer leads project over the lower mediastinum. | Dobbhoff tube the tip projecting over the body of the stomach |
Generate impression based on findings. | Back pain for years prolonged morning stiffness. Evaluate for inflammatory back pain. Three views of the sacroiliac joints are provided. Mild degenerative arthritic changes affect the sacroiliac joints, but I can see no radiographic findings to suggest inflammatory sacroiliitis. Vacuum phenomenon within the joints argues against synovitis and/or effusion.Five views of the lumbar spine are provided. Severe degenerative disk disease affects L5/S1. Mild degenerative disk disease affects L4/5. Alignment is within normal limits. Vertebral body heights are preserved. Mild degenerative arthritic changes affect the visualized lower thoracic spine. | Degenerative arthritic changes of the sacroiliac joints and lumbar spine as above. |
Generate impression based on findings. | 73-year-old male with new leukemia, evaluate lung disease prior to treatment and bronchoscopy. LUNGS AND PLEURA: Small left pleural effusion with adjacent atelectasis. Interlobular and intralobular septal thickening with groundglass and focally consolidative opacities predominantly in the upper lobes and superior segment of the lower lobes. Bronchial wall thickening and mild bronchiectasis is also noted in the effected areas.MEDIASTINUM AND HILA: Impression a subtle and hilar lymph nodes measuring up to 16 mm, in a right peribronchial/subcarinal lymph node (series 4, image 61). The ascending aorta is dilated measuring 3.9 cm. Mild cardiomegaly. No pericardial effusion. Severe coronary artery calcification. Decreased attenuation of the blood pool relative to the cardiac muscle is suggestive of anemia.CHEST WALL: Left chest wall ICD with leads in the right atrium and right ventricle. No axillary, cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Small hiatal hernia. Partially visualized hypodense, simple fluid attenuation, structure inferior to the liver presumably represents a benign renal cyst. | Dependent ground glass opacity predominantly in the lung apices with interstitial septal thickening, bronchial wall thickening, and bronchiectasis is in an atypical distribution for pulmonary edema, hemorrhage, or drug toxicity. Differential diagnosis includes aspiration pneumonitis. Pattern is also atypical for PCP infection. |
Generate impression based on findings. | Female, 5 years old. Reason: Adenoid Hypertrophy History: nasal congestion, rhinorrheaVIEWS: Soft tissue neck lateral(one view) 3/18/2015, 1243 Enlargement of the adenoids, with associated complete obstruction of the nasopharynx.The palatine tonsils are not significantly enlarged.The epiglottis is normal.The visualized osseous structures are normal. | Adenoid hypertrophy with associated nasopharyngeal obstruction. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in her mother. Two standard digital views of both breasts with repeat bilateral MLO views 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. Bilateral axillary and intramammary lymph nodes are present and of normal size. | 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. | 34 years, Female. Reason: 34yoF neuroblastoma s/p ASCT with abd distention History: as above Surgical clips project over the right upper quadrant. There is a Dobbhoff tube with its tip projecting over the fundus of the stomach. There is a nonobstructive bowel gas pattern. IUD in place. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Pain. Preop. Three views of the right knee show severe tricompartmental osteoarthritis with near-bone-on-bone apposition of the lateral tibiofemoral and patellofemoral compartments. Components of a left total knee arthroplasty are situated in near anatomic alignment as seen on the frontal view.Mechanical axis radiograph of the right lower extremity reveals the aforementioned osteoarthritis of the knee. There is approximately 14 degrees of valgus alignment of the knee with respect to the neutral mechanical axis. | Osteoarthritis and valgus deformity of the knee as above. |
Generate impression based on findings. | 53y/o female with breast cancer; post chemo; surgery 3/18/15 Left breast wire loc partial mastectomy and Left axillary SNBx RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.45 mCi Tc-99m filtered sulfur colloid was injected in four peri-lesional sites. A faint focus of increased activity is noted in the left axilla, representing the sentinel node. This focus may be faint due to attenuation of overlying tissue or a low degree of lymph node uptake. This region was marked with an indelible marker. | Sentinel node identified in the left axilla. |
Generate impression based on findings. | Reason: prostate cancer History: prostate cancer Focal radiotracer uptake along the left pubic symphysis is somewhat increased in size compared to the prior study. Overlying activity is noted in the patient's right lower quadrant urostomy bag. No new discrete metastatic lesions are identified. Scattered areas of degenerative radiotracer uptake in the lower lumbar spine, left lower SI joint, and cervical spine are unchanged. | Increased size of left pubic metastasis. No additional osseous metastatic lesions identified. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. There is opacification of the visualized left maxillary and bilateral ethmoid sinuses. The visualized portions of the mastoids/middle ears are grossly clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Status post total hip arthroplasty. Postop prosthetic assessment. Two views of the right hip show components of a total hip arthroplasty device situated in near anatomic alignment without radiographic evidence of hardware complication. A suture anchor overlies the acetabulum.Three views of the pelvis reveal the aforementioned right total hip arthroplasty. Mild osteoarthritis affects the left hip. Phleboliths are noted within the pelvis. | Total hip arthroplasty as above. |
Generate impression based on findings. | Female, 6 years old. Increased work of breathing. Evaluate for pneumonia.VIEW: Chest AP (one view) 3/18/2015, 1324 Tracheostomy tube tip below the level of the thoracic inlet. Gastrostomy tube in place.Postoperative changes in the ribs are again seen.The lateral two thirds of the right hemithorax remain opacified, with mediastinum shifted to this location, and the left lung herniating across the midline, mildly increased in volume from prior.No focal opacity in the left lung.No pneumothorax.Leftward thoracic curvature associated with balanced hemivertebra at the T10 level. | Hypoplastic right lung. Left lung without focal opacity, and with increased volume compared to the prior exam, which may be related to bronchiolitis or airway compression. |
Generate impression based on findings. | Reason: restaging lung ca History: restaging. CHEST:LUNGS AND PLEURA: Interval resolution of left lower lobe inflammation/infection. Large loculated right pleural effusion appears similar. Diffuse nodular pleural thickening in the right hemithorax compatible with tumor is not significantly changed. Reference measurements are as follows (series 3):3 o'clock position at the level of the aortic arch: 2.4 cm (image 35), previously 2.6 cm.4 o'clock position at the subcarinal level: 6.8 cm cm (image 47), from previously 7.2 cm.12 o'clock position at the level of the left atrium: 2.7 cm (image 60), previously 2.9 cm.MEDIASTINUM AND HILA: There is lateral mediastinal and hilar lymphadenopathy is redemonstrated. Reference subcarinal lymph node measures 2.1 cm (series 3, image 49), previously 2.4 cm. Right internal mammary chain lymphadenopathy again noted. Severe coronary calcifications.CHEST WALL: Redemonstrated is extension of tumor in through the second and third rib spaces anteriorly, stable.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No focal hepatic lesion is identified. The gallbladder is unremarkable.SPLEEN: Spleen is unremarkable.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: Kidneys enhance symmetrically without focal lesion.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.There appears to be diffuse mesenteric edema.BONES, SOFT TISSUES: The right hemidiaphragm is infiltrated with tumor..OTHER: No significant abnormality noted. | No significant interval change in extensive pleural tumor in the right hemithorax and mediastinal lymphadenopathy.Resolution of left upper lobe inflammation/infection.Assessment of the upper abdomen is limited; a baseline CT of the abdomen and pelvis may be considered with oral and IV contrast. |
Generate impression based on findings. | Bilateral shoulder pain for 7 to 8 months Three views of the left shoulder are provided. The shoulder appears normal with no specific findings to account for the patient's pain.Three views of the right shoulder are provided. There is an os acromiale, a normal variant. The shoulder otherwise appears normal without findings to account for the patient's pain.Mild degenerative arthritic changes affect the visualized thoracic spine. | No specific findings to account for the patient's shoulder pain. There is an os acromiale on the right, a normal variant that can occasionally be associated with rotator cuff impingement. If further imaging evaluation of the rotator cuff is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 30 year-old female with right foot and ankle pain. Three views of the right ankle demonstrate normal anatomic alignment, without evidence of acute fracture. There is no significant soft tissue swelling. No joint effusion is evident.Three views of the right foot are unremarkable. | No evidence of fracture or malalignment. |
Generate impression based on findings. | Headache, rule-out shunt malfunction Ventricular system is decompressed and significantly decreased in size compared to remote CT dated 4/23/2009. No recent comparison study is available. Again seen is a right transfrontal ventriculostomy catheter with tip in unchanged position at the foramen of Monro. Again seen is a separate catheter fragment with tip near the planum sphenoidale.No intracranial hemorrhage, extra-axial collections, or mass effect. Gray-white differentiation is maintained. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. Ventricular system is decompressed and significantly decreased in size compared to remote CT dated 4/23/2009. No recent comparison study is available.2. No intracranial hemorrhage or mass effect. |
Generate impression based on findings. | There is redemonstration of an extensive encephalomalacia changes in the right ACA and MCA territories with mild ex vacuo dilatation of the right lateral ventricle, consistent with prior areas of infarct. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift. There is no intracranial hemorrhage. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with mild age-indeterminate small vessel ischemic changes, especially in the left parietal lobe. There is focal prominence of CSF density in the midline along the posterior fossa which may represent a retrocerebellar cyst versus mega cisterna magna, with mild mass effect upon the cerebellar hemispheres. There is no pathologic extraaxial fluid collection. There is a small mucosal retention cyst in the right maxillary sinus. There is patchy opacification of ethmoid air cells bilaterally. The remainder of the visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. Filling defects within the external auditory canals likely represent cerumen. | 1. No acute intracranial hemorrhage.2. Chronic right MCA and ACA territory infarcts with extensive encephalomalacia. Mild age-indeterminate small vessel ischemic changes especially the left parietal white matter. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended.3. Incidental retrocerebellar cyst versus mega cisterna magna. |
Generate impression based on findings. | Female; 67 years old. Reason: months of epigastric pain and pt reports possible mass from outside hospital studies History: epigastric pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: 2.3 x 2.2 cm indeterminate left adrenal nodule (series 4/34).KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Ill-defined soft tissue density with infiltrative appearance within the mesenteric fat at the base of the mesentery, particularly surrounding the proximal superior mesenteric artery and its branch vessels. This area measures approximately 2.5 x 4 x 4.5 cm (AP by transverse by craniocaudal, series 4/50 and coronal series 80340/63). There are a few prominent mesenteric lymph nodes immediately inferior to this area (e.g. series 4/57). There is slight attenuation of the SMV and SMA as they traverse through this area, but both vessels are patent.BOWEL, MESENTERY: Large colonic stool burden.BONES, SOFT TISSUES: Degenerative arthritic changes of the lumbar spine greatest at L4-5. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Soft tissue density with adjacent coarse calcification (e.g. series 4/99), most compatible with atrophic fibroid uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Large colonic stool burden.BONES, SOFT TISSUES: Degenerative arthritic changes of the lumbar spine greatest at L4-5.OTHER: No significant abnormality noted | 1. Nonspecific ill-defined soft tissue density within the mesenteric fat at the base of the mesentery as detailed above. Overall, the findings are nonspecific and may be related to inflammation such as acute panniculitis, though tumor (e.g. lymphoma) cannot be excluded. The appearance would be atypical for inflammation related to pancreatitis. Clinical correlation and follow-up to resolution is recommended.2. Indeterminate left adrenal nodule, for which dedicated adrenal imaging can be obtained for further characterization. |
Generate impression based on findings. | Follow-up from surgery The previously seen orthopedic screws affixing the Lisfranc articulation have been removed. Two screws now affix the 1st tarsometatarsal joint. Plate and screw devices affix the second and third tarsometatarsal joints. Alignment is grossly anatomic, with slight abduction of the forefoot relative to the midfoot. I see no hardware complications. Bones are demineralized. | Orthopedic fixation of the tarsometatarsal joint as above. |
Generate impression based on findings. | 64-year-old female with pain status post injury. Single view of the pelvis demonstrates a slightly demineralized appearance of the bones, consistent with osteopenia. Mild osteoarthritis affects the bilateral hip joints. Degenerative arthritic changes also affect the lower lumbar spine. The sacroiliac joints are unremarkable. No fracture is identified. Surgical material is noted in the pelvis.Two views of the right hip demonstrate the aforementioned mild osteoarthritis including osteophytosis and joint space narrowing. There is no evidence of acute fracture or malalignment.Three views of the left knee demonstrate total knee arthroplasty in near-anatomic alignment. Skin staples are present anteriorly. Swelling of the anterior soft tissues and a small joint effusion limits evaluation of the extensor mechanism; however, we see no fracture. | Postop changes of total knee arthroplasty and degenerative arthritic changes of the hips and lower lumbar spine, without acute fracture. |
Generate impression based on findings. | Male; 44 years old. Reason: 44 M with metastatic renal medullary carcinoma, on chemotherapy holiday, please evaluate for interval change since prior CHEST:LUNGS AND PLEURA: Stable mild bibasilar ground glass opacities consistent with scarring. Previously seen right upper lobe nodule has resolved, likely post infectious or inflammatory. Nonspecific right lower lobe nodular opacity with ill-defined margin measuring 12 x 7 mm (series 5/52), which in retrospect was present on prior study and measured approximately 4 x 5 mm.New nonspecific left upper lobe nodular opacity with ill-defined margins measuring 13 x 8 mm (5/22).MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable hypoattenuating lesion in the superior pole of the right kidney, presumably a high attenuating cyst.RETROPERITONEUM, LYMPH NODES: Reference right retrocrural lymph node measures 1.4 x 0.9 cm, previously 1.4 x 0.7 cm (series 3/78), slightly increased. Reference left retrocrural lymph node measures 1 x 0.7 cm, previously 0.9 x 0.6 cm (series 3/81), slightly increased.Reference retroperitoneal lymph node measures 1.4 x 1 cm, previously 1.6 x 0.9 cm (series 3/97), not significantly changed.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Small bilateral nodular opacities as described above are nonspecific, and attention at follow-up is recommended.2.Slightly increased size of retrocrural lymphadenopathy. |
Generate impression based on findings. | 82-year-old female with new lung nodule LUNGS AND PLEURA: Severe centrilobular emphysema. Left upper lobe granuloma. No new pulmonary nodules or masses. No pleural effusion or pneumothorax.Right lower lobe bronchiectasis and consolidation consistent with radiation fibrosis. Cluster of nodules in the right costophrenic angle is unchanged since the prior exam.Previously identified nodular density in the posterior basal segment of the right lower lobe (series 5, image 61) is smaller in size, now measuring 5 mm, previously 6 mm. This is favored to be postinflammatory in etiology.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Severe coronary artery calcification. Aortic annulus calcification.Reference precarinal lymph node measures 11 mm, previously 10 mm. Additional prominent mediastinal and hilar lymph nodes appear similar in size when compared to the prior exam. Calcified mediastinal and hilar lymph nodes suggestive of prior granulomatous disease.CHEST WALL: Unchanged T9 vertebral body compression fracture. No suspicious osseous lesions are identified.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Segment 5 hypodensity is unchanged since prior exam. Calcified granulomata in the spleen. Nonspecific thickening of the left adrenal gland, unchanged. | 1.Interval decrease in right lower lobe nodule likely post-inflammatory or -infectious in etiology. 2.No significant change in lymphadenopathy. |
Generate impression based on findings. | Headache, rule-out bleed No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Clinical question: Brain cyst reported. Signs and symptoms: stuttering. Enhanced head CT:There are no prior exams for comparison. If such a studies are available and provided to radiology department and an addendum to this report MIBI submitted review and comparison.Examination demonstrates no evidence of abnormal parenchymal or leptomeningeal enhancement.There is a tiny focus of low-attenuation overlapping the anterior limb of left internal capsule which is a nonspecific finding however it could represent an age indeterminate lacunar infarct. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination otherwise. There is anatomical variation of partially empty sella.There is no detectable cyst on this exam as is mentioned on provided clinical information. Unremarkable images through the orbits. Well pneumatized paranasal sinuses, mastoid air cells and middle ear cavity. Tiny left maxillary retention cyst however is identified. | 1.No acute intracranial process and no evidence of a cyst. 2.Tiny focus of low-attenuation overlapping the left anterior limb of internal capsule which could represent an age indeterminate lacunar infarct.3.Unremarkable enhanced head CT otherwise. |
Generate impression based on findings. | 11 year old female with history of craniosynostosis and VP shunt. There is a left parietal approach ventriculostomy catheter terminating within the left atrium. The ventricles are decreased in size since 11/18/2013 and are similar in appearance to the exam dated 10/15/2012. There is an unchanged pineal region cyst or cavum velum interpositum. There is new 8 mm discontinuity of the extracranial portion of the catheter below the valve. There is apparent callosal dysgenesis with thinning of the posterior body and splenium. There is also unchanged downward herniation of the cerebellar tonsils, mild tectal beaking, and a small posterior fossa. Known subependymal gray matter heterotopia it is difficult to delineate on this noncontrast CT exam. There is a dysmorphic and brachycephalic appearance of skull as well as postoperative findings related to prior craniosynostosis repair. There are also postoperative findings within the right globe. There is a somewhat dysmorphic appearance of the brain that is also unchanged. There is no evidence of acute intracranial hemorrhage. The imaged paranasal sinuses and mastoid air cells are clear. | 1.Interval fracture of the shunt catheter below the valve with 8 mm discontinuity. 2.Interval decrease in size of the ventricles. 3.Multiple congenital intracranial abnormalities again seen, better delineated on prior MRI.4.Dysmorphic and brachycephalic appearance of the skull, with post-operative findings involving the skull and face. These findings were called by Dr. Michael Rozenfeld to Paula Zakrzewski at 2:00pm on 3/18/15. |
Generate impression based on findings. | Pain Minimal osteoarthritis affects scattered interphalangeal joints. There may also be mild osteoarthritis of the first metacarpophalangeal joint. The bones appear slightly demineralized. I otherwise see no specific findings to account for the patient's pain. | Minimal osteoarthritis. |
Generate impression based on findings. | There is mild soft tissue thickening in the surgical bed in the left premalar region, which is slightly decreased from the prior examinations. The parapharyngeal soft tissues appear normal. The bilateral parotid and submandibular glands are normal. There is no significant cervical lymphadenopathy. The partially imaged paranasal sinuses and mastoid air cells are clear. There are scattered areas of atherosclerotic calcification in the aortic arch, bilateral carotid bifurcations, and the right vertebral artery which appear stable from the prior examination. The lateral ventricles are asymmetric but stable and can be better assessed with dedicated head CT. Volume loss in the left temporal lobe partially visualized.There is degenerative disease in the cervical spine including large ventral osteophytes from C3 to T1. The thyroid gland appears normal. The lung apices are clear. Please refer to separate report for findings in the chest. Median sternotomy suture noted. Bilateral intraocular lens replacement. | 1. Continued evolution of postoperative findings in the left cheek without evidence of local recurrence or lymphadenopathy.2. Partially imaged enlargement of the left lateral ventricle and left temporal lobe volume loss. Dedicated brain imaging may be useful for further characterization, if clinically warranted. |
Generate impression based on findings. | 70-year-old male with a history of fall two weeks ago; persistent pain and swelling of the left lateral foot. Three views of the left foot and 3 views of the left ankle are provided. There is soft tissue swelling about the lateral aspect of the ankle as well as the lateral mid- and hindfoot, without underlying fracture identified. Osteoarthritis affects the midfoot as well as the first metatarsophalangeal joint. Note is made of an os peroneum, a normal variant. | Soft tissue swelling and osteoarthritis as detailed above, without acute fracture. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The right anterior ethmoid air cells are clear. There is minimal opacification of a left anterior ethmoid air cell, which are otherwise clear.Maxillary sinuses: There is a linear septation and mucus retention cyst in the right maxillary sinus. Maxillary sinuses are otherwise clear. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is mild leftward nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. | Minimal paranasal sinus disease with mild opacification of the left anterior ethmoid air cell and small right maxillary mucous retention cyst. Paranasal sinuses are otherwise clear. |
Generate impression based on findings. | 46-year-old female status post partial thyroidectomy. History of nodules. RIGHT LOBE MEASUREMENTS: 5.3 x 1.7 x 1.5 cm, unchanged.LEFT LOBE MEASUREMENTS: 5.3 x 1.5 x 1.4 cm, slightly larger.ISTHMUS MEASUREMENTS: ResectedRIGHT LOBE: Normal parenchymal echotexture. No nodules identified.LEFT LOBE: Normal parenchymal echotexture. 4-mm hypoechoic nodule, probably present in retrospect and unchanged.ISTHMUS: Surgically resected.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal appearing bilateral level 2 lymph nodes are observed.OTHER: No significant abnormality noted. | No substantial interval change. 4-mm hypoechoic nodule, probably present in retrospect and unchanged. |
Generate impression based on findings. | 66-year-old female with history of left breast cyst. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Multiple small masses in the left upper outer quadrant are unchanged. Scattered benign calcifications are also stable.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the right axilla.LEFT SONOGRAPHIC | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 71-year-old male with left knee pain, preop evaluation. Three views of the left knee demonstrate severe osteoarthritis, with near bone-on-bone apposition of the medial tibiofemoral compartment. Chondrocalcinosis is present in the articular cartilage. A right total knee arthroplasty in near-anatomic alignment is seen on the frontal view.Mechanical axis radiographs reveals the aforementioned severe left knee osteoarthritis. There is approximately 7 degrees of varus alignment of the knee with respect to the neutral mechanical axis. | Osteoarthritis and varus deformity as detailed above. |
Generate impression based on findings. | Known breast cancer on neoadjuvant chemotherapy presents for research core biopsy. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 12 mm at the 3 o’clock position with increased vascularity, 5 cm from the nipple. The lesion was readily visible, though decreased in size compared to the prior study. Also well seen is the biopsy clip that was placed at the outside institution which is located just medial to the mass.PROCEDURE: The procedure and its risks, including bleeding, infection, and removal of biopsy clip, and expected research benefits of ultrasound-guided core biopsy 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 side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a inferior to superior approach, six 12-gauge core needle (Suros) specimens were obtained of the lesion. Targeting was judged excellent. Specimen quality was judged excellent. Samples were radiographed proving no clip was within the specimens. Postbiopsy ultrasound also confirm that the clip was in place. The samples were placed on the Petri dish for retrieval by the research staff.Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Schacht. Dr. Schacht was present during the procedure at all times. | Successful ultrasound-guided core biopsy of the right breast lesion for research purposes.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 90 year-old female with neck pain, concern for malalignment/fracture, bilateral hip pain. Two views of the cervical spine demonstrate severe disk space narrowing at C3-4 and grade 1 retrolisthesis of C3 on C4, as well as mild/moderate disk space narrowing at C4-5 and C5-6, with small anterior and posterior vertebral body osteophytes at these levels. Note is also made of mild multilevel facet joint osteoarthritis. No fracture is evident.Two views of the right hip demonstrate moderate osteoarthritis as well as moderate osteoarthritis affecting the right sacroiliac joint. Severe degenerative disk disease affects the lower lumbar spine. Surgical clips are seen in the pelvis.Two views of the left hip demonstrate moderate osteoarthritis and mild osteoarthritis affecting the left sacroiliac joint. | Degenerative disk disease and osteoarthritis as described above. No fracture is evident. |
Generate impression based on findings. | Reason: elevated psa, prostate cancer. There is a single faint focus of radiotracer uptake in the right para-symphyseal region which correlates on CT with an approximately 1 cm nonspecific posterior cortically based sclerotic focus. Left lower facet radiotracer uptake correlates with benign degenerative changes seen on CT. | Single faint focus of radiotracer uptake in the right para-symphyseal region correlates with a nonspecific cortically based sclerotic focus on CT. Given its overall appearance it is favored to be most likely benign, but a single osseous metastasis cannot be entirely excluded. Attention to this region on subsequent examinations can be made. |
Generate impression based on findings. | 47-year-old male with history of pilon chest Two views of the tibia/fibula and 3 views of the right ankle again show an external fixation device with screws entering the distal tibial diaphysis, calcaneus, and forefoot. We see no evidence of hardware complication. Again seen is a comminuted intra-articular fracture of the distal tibia, with fracture fragments in near anatomic alignment. Although the fracture lines remain visible, they appear slightly less distinct, suggestive of early healing.Again seen is a comminuted, predominately transverse, fracture of the distal fibula, with slight lateral displacement of the distal fracture fragments, appearing similar to prior study. Serpentine calcifications within the proximal and distal tibia, consistent with bone infarctions, appear similar to prior exams. | Distal tibial and fibular fractures with orthopedic fixation as described above. |
Generate impression based on findings. | 66-year-old male h/o BOT ca, s/p induction chemo, eval response. CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema. No suspicious pulmonary nodules/masses. No focal consolidation or pleural effusion. Scattered opacities in the right lung, suggestive of aspirate.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. Heart size normal. No pericardial effusion. Mild coronary calcifications. Right chest wall port catheter tip in the right atrium.CHEST WALL: Mild degenerative changes affect the visualized spine. L3 lucency again noted, likely a Schmorl's node.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: The liver enhance homogeneously without focal lesion identified. Gallbladder is contracted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No adrenal nodularity or thickening. KIDNEYS, URETERS: The kidneys enhance symmetrically without focal lesion identified.PANCREAS: Mildly atrophic.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy. Moderate calcifications affect the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Bowel is normal in caliber without evidence of destruction or ileus.BONES, SOFT TISSUES: No suspicious focal osseous lesion is identified.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Male 71 years old; Reason: 71 year old male with pancreatic cancer s/p resection. Baseline prior to adjuvant chemotherapy. CHEST:LUNGS AND PLEURA: Trace right pleural fluid, similar to prior study. Apical pleural scarring/nodularity. Sites of right-sided linear scarring and volume loss. Small secretion/debris in distal trachea. MEDIASTINUM AND HILA: Mild mediastinal adenopathy. A paraesophageal lymph node is submitted for reference and measures 1.4 x 1 cm, image 67 series 3, previously measured 0.9 x 0.7 cm. Subcentimeter juxtaphrenic lymph nodes.CHEST WALL: Post sternotomy hardware.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Patent portal veins, splenic vein and SMV. Stable small pneumobilia. Subcapsular anteriorly located subcentimeter hypoattenuating liver lesion, too small to characterize. Focal fatty infiltration suggested near gallbladder fossaSPLEEN: No significant abnormality noted.PANCREAS: Residual pancreatic parenchyma atrophic. No pancreatic duct dilatation seen.ADRENAL GLANDS: Stable left adrenal nodule, measuring 10 x 8 mm, image 105 series 3.KIDNEYS, URETERS: Bilateral nonobstructing/renovascular calcifications. Right lower pole 3.8 cm renal cyst, stable bilateral subcentimeter hypoattenuating lesion lesions, too small to characterize.RETROPERITONEUM, LYMPH NODES: Previously visualized enlarged anterior pancreaticoduodenal lymph node not well seen on current study. Subcentimeter upper abdominal and retroperitoneal lymph nodes.BOWEL, MESENTERY: Upper abdominal postsurgical sequela. Mildly distended stomach containing ingested material and debris, may be related to timing of imaging exam but nonspecific. Mild jejunal prominence seen in upper abdomen with gradual luminal tapering noted, no bowel obstruction. Scattered sigmoid colonic diverticula without evidence of acute diverticulitis. New from prior study is mild mesenteric stranding in upper and ventral abdomen and in right upper quadrant in periportal regions, likely postprocedural in etiology. Small hiatal hernia.PELVIS:PROSTATE, SEMINAL VESICLES: Calcification containing prostate.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Decreased osseous station and spinal degenerative disease. | 1. Mild mediastinal adenopathy with mild interval increase in size of a paraesophageal lymph node, nonspecific. 2. Postsurgical sequela as described. Residual pancreatic parenchyma atrophic. No pancreatic duct dilatation seen. Mildly distended stomach containing ingested material and debris, may be related to timing of imaging exam but nonspecific. Scattered sigmoid colonic diverticula without evidence of acute diverticulitis. New from prior study is mild mesenteric stranding in upper and ventral abdomen and in right upper quadrant in periportal regions, likely postprocedural in etiology but attention on follow up recommended.3. Stable indeterminate left adrenal nodule.4. Trace right pleural fluid, similar to prior study. Apical pleural scarring/nodularity. Sites of right-sided linear scarring and volume loss. Small secretion/debris in distal trachea. |
Generate impression based on findings. | 7 year old female POD #2 status post re-exploration of occipital encephalocele, dissection of encephalocele defect and reconstruction with pericranial reinforcement of pseudo dura, and harvesting of cranial bone for cranioplasty graft repair, and excision of th left maxillary cyst. There postoperative findings related to recent repair of a midline occipital defect with scattered bone graft material in the defect. Heterogeneous material that is presumably post-operative is seen subjacent to the defect measuring 22 mm in thickness. There is a soft tissue drain in place. There is no evidence of acute intracranial hemorrhage.There is a left parietal approach ventriculostomy catheter terminating within left atrium. The ventricles are slightly decreased in size with the lateral ventricles measuring 60 mm in transverse dimension, previously 63 mm, and the third ventricle measuring 11 mm in transverse dimension, previously 13 mm. There also postoperative findings related to recent excision of a left anterior maxillary cyst. There is mild paranasal sinus mucosal thickening. There is a mildly congenitally narrow spinal canal and craniocervical junction. There are unchanged dysmorphic features within the posterior fossa suggestive of tecto-cerebellar dysraphism and a supernumerary midline cerebellar hemisphere laying along the posterior fossa floor with an enlarged retrocerebellar CSF space communicating with the fourth ventricle. | 1.Interval repair of the midline occipital defect and excision of the maxillary cyst without evidence of acute intracranial hemorrhage.2.Slight decrease in size of the shunted ventricles.3.Dysmorphic posterior fossa suggestive of tecto-cerebellar dysraphism with a supernumerary cerebellar hemisphere. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in paternal aunt. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral benign calcifications are present, and bilateral focal asymmetries are stable to less prominent on this exam. | 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. | 46 year old female presents for routine screening mammography. Family history of breast cancer in her mother at 25, ovarian cancer history in her sister at 23. Multiple additional relatives with cancer. 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. 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.Given her family history, please consider referral to cancer risk clinic, as the patient may benefit from additional testing such as genetic testing and screening breast MRI.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 50 year-old male with history of left wrist fracture, status post fixation. Three views of the left wrist demonstrate a plate and screws affixing a comminuted intra-articular fracture of the distal radius, in near-anatomic alignment. We see no hardware complication. The fracture line remains visible, appearing similar to prior exam. An ununited, mildly displaced ulnar styloid fracture fragment is again seen.Four views of the left elbow demonstrate interval resolution of the soft tissue swelling seen on prior exam. A tiny linear density along the proximal aspect of the olecranon process may conceivably represent a small avulsion fracture fragment, but this is equivocal. No discrete fracture line is evident. Alignment is within normal limits. | Orthopedic fixation of distal radius fracture and other findings as described above. |
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 almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is a new obscured mass in the right upper outer quadrant. Elsewhere, scattered asymmetries and benign morphology masses are stable. No suspicious microcalcifications or areas of architectural distortion are present. | New obscured mass in the right upper outer quadrant for which further evaluation with spot compression and ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 67-year-old female bilateral call backs from screening mammography. Family reports a remote history of nipple discharge. Family history of breast cancer diagnosed in two sisters at ages 46 and 50. ML views of both breasts, right CC and ML spot compression views, and two left CC and one 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. Right upper outer quadrant 13 mm slightly lobulated mass persists with spot compression and demonstrates circumscribed margins. Multiple small masses persist in the left central lateral breast with partially obscured margins. The largest measures 12 mm. No suspicious microcalcifications or areas of architectural distortion in either breast. | 1.Right breast mass 10 o'clock position, for which ultrasound guided biopsy is recommended to rule out fibroadenoma vs IDC.2.Left breast duct ectasia with three adjacent intraductal masses from the 3-4 o'clock positions, for which ultrasound guided biopsy is recommended for the two more lateral suspicious masses (labeled 2 and 3) are recommended.3.Left breast 2:30 suspicious mass. 4.Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: evaluation post operatively LUL History: evaluation post operatively LUL LUNGS AND PLEURA: Postsurgical scarring and volume loss consistent with left upper lobectomy.Interval resolution of paramediastinal focal consolidation consistent with contusion.Small calcified nodules bilaterally consistent with previous granulomatous infection.Mild upper zone emphysema.No pleural effusion.MEDIASTINUM AND HILA: Marked interval decrease in mediastinal lymphadenopathy.Reference lower right paratracheal lymph node (series 3/36) measures 10 mm, decreased from 20 mm previously.Enlarged main pulmonary artery measuring 36 mm, suggestive of pulmonary hypertension.Severe coronary artery calcification. No pericardial effusion.ICD leads extending to the area of the right atrial appendage and right ventricular apex.CHEST WALL: Status post median sternotomy with sternal fusion.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Multiple small calcifications throughout the liver and spleen consistent with previous infection.Moderate vascular calcification. | No evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | 13-year-old female with history of sickle cell disease and arm painVIEWS: Left forearm: Lateral and AP; left elbow, AP, lateral, oblique; humerus: AP, lateral (7 views) 3/18/15 The bones of the forearm and humerus are normal. No lucent or sclerotic lesion to suggest infarction. No fracture or malalignment. No soft tissue swelling or elbow joint effusion. | Normal examination. |
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 almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable normal-sized low left axillary lymph node noted. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Male; 75 years old. Reason: Pt with acute onset epigastric pain with family history of ruptured AAA History: central chest and epigastric pain CHEST:LUNGS AND PLEURA: Minimal bibasilar dependent subsegmental atelectasis. Cardiomegaly.MEDIASTINUM AND HILA: Enlarged left lobe of the thyroid with substernal extension, unchanged. New mild mediastinal and bilateral hilar lymphadenopathy, as well as new increasing anterior mediastinal soft tissue attenuation, most suspicious for lymphoma recurrence. For future reference, a right paratracheal lymph node measures 12 x 13 mm (series 4/32) and a left hilar lymph node measures 14 x 10 mm (series 12/50).CHEST WALL: No significant abnormality noted.CT angiogram: Normal caliber of the thoracic aorta. Minimal atherosclerotic calcifications of the thoracic aorta and its branch vessels, including the coronary arteries.ABDOMEN:LIVER, BILIARY TRACT: New mild dilation of the central intrahepatic bile ducts and common bile duct, which measures up to 9 mm, previously 5 mm. Subtle hyperdensity within the common bile duct near the ampulla (series 12/121-122), suspicious for obstructing stone(s). M.R.C.P. can be obtained for further characterization as clinically indicated.SPLEEN: No significant abnormality noted.PANCREAS: Subcentimeter cystic lesions in the pancreas are unchanged. New prominence of the pancreatic duct, likely due to the above-described obstruction at the level of the ampulla.ADRENAL GLANDS: Small left adrenal adenoma, unchanged.KIDNEYS, URETERS: Stable renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.CT angiogram: Normal caliber of the abdominal aorta with mild atherosclerotic calcifications. No evidence of dissection or rupture. Patent SMA, celiac artery, and IMA. Bilateral renal arteries are patent with two small accessory renal arteries supplying the right kidney superior pole.PELVIS:PROSTATE, SEMINAL VESICLES: Stable prostatomegaly with heterogeneous appearance.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.CT angiogram: Normal caliber of the distal abdominal aorta and iliac arteries. No evidence of dissection or rupture. | 1. Normal caliber aorta without evidence of dissection or rupture.2. New mild pancreaticobiliary tree dilation likely due to choledocholithiasis at the level of the ampulla. 3. New mediastinal and hilar lymphadenopathy, as well as new anterior mediastinal soft tissue, most suspicious for lymphoma recurrence.4. Stable enlarged, heterogeneous prostate gland, for which correlation with PSA is recommended. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. There is small left supraorbital scalp soft tissue contusion. There is also mild thickening of posterior subgaleal soft tissue compatible with edema. Gray-white matter differentiation is preserved. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are intact. The osseous structures are unremarkable. | 1.No evidence of intracranial hemorrhage. 2.No evidence of fracture.3.Small left supraorbital scalp soft tissue contusion. |
Generate impression based on findings. | Foot pain. Lump after trauma.VIEWS: Left foot AP/lateral/oblique (3 views) 03/18/15 Soft tissue swelling is noted on the dorsum of the foot adjacent to the cuneiforms.The cuboid has an extra projection medially and proximally. The space normally seen on the oblique view between the calcaneus and navicular contains portions of the cuboid. No fracture is present. | Soft tissue swelling. Unusual shape of the proximal medial portion of the cuboid. |
Generate impression based on findings. | Female; 77 years old. Reason: 77 year old female with history of lung cancer s/p resection with new right lung nodule seen on recent CT. Evaluate for growth from prior scan. CHEST:LUNGS AND PLEURA: Stable biapical scarring. Stable 5-mm right middle lobe nodule (series 4/78). Other scattered pulmonary micronodules in both lungs are stable. No new suspicious nodules or masses. Small left pleural effusion, not significantly changed.MEDIASTINUM AND HILA: Stable right thyroid nodule. Bilateral supraclavicular lymphadenopathy is stable. Mild superior mediastinal lymphadenopathy is also stable. For future reference, a prevascular lymph node measures 13 x 9 mm, previously 13 x 9 mm (series 3/28).CHEST WALL: Reference right axillary lymph node measures 1 x 0.8 cm, not significantly changed since prior study when it measured 1.1 x 1 cm (series 3/30).ABDOMEN:LIVER, BILIARY TRACT: High-density dependently within the gallbladder due to biliary sludge and/or stones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable retroperitoneal lymphadenopathy. Reference left periaortic lymph node conglomerate is not reliably measurable due to positional differences. For future reference, a left periaortic lymph node measures 17 x 8 mm, previously 17 x 8 mm (series 3/115). Extensive atherosclerotic calcifications of the abdominal aorta and its branch vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable degenerative arthritic changes of the lumbar spine including minimal anterolisthesis of L4 on L5.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absent or atrophic.BLADDER: No significant abnormality noted.LYMPH NODES: Stable left pelvic lymphadenopathy. Reference left inguinal lymph node measures 0.7 x 0.4 cm, not significantly changed since prior study when it measured 0.8 x 0.4 cm (series 3/173).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable degenerative arthritic changes of the lumbar spine including minimal anterolisthesis of L4 on L5.OTHER: No significant abnormality noted. | 1. Stable lung nodules including a 5-mm right middle lobe nodule. No new suspicious pulmonary nodule or mass.2. Stable lymphadenopathy. |
Generate impression based on findings. | 71-year-old male with bilateral hip pain. Two views of the left hip demonstrate moderate osteoarthritis. Chondrocalcinosis affects the labrum. Arterial calcifications are present in the soft tissues.Two views of the right hip demonstrate moderate osteoarthritis. Chondrocalcinosis affects the labrum. Arterial calcifications are present in the soft tissues. | Moderate osteoarthritis of the hips. |
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 almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign right intramammary lymph nodes are present. Benign calcifications also noted. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 32-year-old male status post fixation of left ankle fracture. Three views of the left ankle show trans-syndesmotic screws affixing the distal tibia and fibula, in near-anatomic alignment. Mild diffuse soft tissue swelling is present. We see no ankle fracture.Two views of the tibia/fibula demonstrate a spiral oblique fracture of the proximal fibular diaphysis, with slight anterolateral displacement of the distal fracture fragment. | Proximal fibular fracture and orthopedic fixation of the distal tibiofibular syndesmosis. |
Generate impression based on findings. | Reason: evaluate for changes History: cough soboe LUNGS AND PLEURA: In the upper lung zones mild subpleural reticular and groundglass opacities are present. In the lower lungs, more severe and diffuse ground glass and reticular opacities are present with multiple lucent lobules, not significantly changed from prior.Mild bronchial thickening is present but no significant bronchiectasis and no honeycombing. Several very small calcified nodules are present, likely related to previous granulomatous infection.MEDIASTINUM AND HILA: Multiple moderately enlarged lymph nodes are present throughout the mediastinum, some of which are partially calcified, unchanged from previous.Mild coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Very limited evaluation showing a few mildly enlarged nonspecific lymph nodes unchanged from previous. | Basilar predominant diffuse interstitial lung disease with a predominantly groundglass pattern and several lucent lobules at the lung bases, not significantly changed. As previously indicated the findings are compatible with nonspecific interstitial pneumonia (NSIP), and hypersensitivity pneumonitis. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: There is scattered trace mucosal thickening and opacification of anterior ethmoid air cells.Maxillary sinuses: The left maxillary sinus and left ostiomeatal unit are clear. The right maxillary sinus is completely opacified, with lateralization of the upper medial wall, with central areas of hyperdensity which may relate to inspissated secretions. The right ostiomeatal unit is partially opacified.Posterior ethmoids: There is minimal mucosal thickening within posterior ethmoid air cells.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is mild rightward nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. The right mastoid air cells are underpneumatized, with opacification of the few aerated ones. There is age-appropriate global volume loss partially visualized, with likely minimal hypodense age indeterminate small vessel ischemic changes within the white matter. | Complete opacification of the right maxillary sinus with slight lateralization of the medial wall and central hyperdensity which may relate to inspissated secretions. This may represent early silent sinus syndrome, and clinical correlation is recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral benign calcifications are noted. Normal-sized lymph nodes 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. | History of lung cancer status post definitive RT. CHEST:LUNGS AND PLEURA: Severe at emphysema. Post therapeutic scarring related to radiation in the region of the prior left upper lobe nodule; the underlying lesion is not clearly appreciated, but the area of prior reference measures approximately 9 x 11 mm, previously 11 x 15 mm (4/43).Granuloma in the left lower lobe. Subtle groundglass opacity in the right lung anterior to hilum, best appreciated on coronal image 53 sagittal image 46 possibly represents radiation reaction and can be followed on subsequent exams, nonspecific at this time. No suspicious new lesions.MEDIASTINUM AND HILA: A nonindex right subcarinal lymph node has decreased in size (3/56), 8 mm, previously 11-mm. Additional small lymph nodes unchanged. Atherosclerotic calcification of the aorta and its branches including moderate coronary artery calcification.CHEST WALL: Small left internal mammary chain lymph nodes (3/29) unchanged compared to the last two examinations but were not present prior to the 3/26/2014 study.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small nonobstructing nephroliths. The right distal ureter appears slightly dilated which could be due to imaging during peristalsis however please correlate for symptoms of obstruction or infection. No hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches. The abdominal aorta is ectatic with a slowly enlarging posterior penetrating ulcer evolving into a saccular aneurysm in the infrarenal portion of the aorta measuring 11 x 15 mm (3/122).BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Left upper lobe nodule encompassed by post therapeutic scarring there is no longer readily visible, reference level measurements provided.2. Enlarging penetrating atherosclerotic ulcer evolving into a saccular aneurysm of the posterior infrarenal abdominal aorta. Consider interventional radiology consultation for possible stent placement. A. Chaudhary 3690 notified at 2:55 p.m. on 3/18/2015 by telephone.3. Stable very small left internal mammary chain lymph nodes. Decrease in size of a nonindex right subcarinal lymph node. |
Generate impression based on findings. | 16-month-old male with history of dysphagia for liquidsEXAMINATION: Oropharyngeal motility study 3/18/15 Beth Harrison, speech and language therapist, supervised the examination.50 seconds of fluoroscopy was used.Patient drank nectar thick liquid through valve cup and via spoon. Deep laryngeal penetration of nectar thick liquid was seen without cough. Aspiration with nectar thick liquid via spoon with spontaneous ejection. | Aspiration with nectar thick liquid with spontaneous ejection.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reduction. Two standard digital views of both breasts and a cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Parenchymal pattern changes are compatible with bilateral breast reduction. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 58 years, Male. Reason: Dobbhoff History: Dobbhoff There is a Dobbhoff tube with its tip projecting over the distal body of the stomach. There is a nonobstructive bowel gas pattern. | Dobbhoff tube with its tip projecting over the distal body of the stomach. |
Generate impression based on findings. | 80 year old female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral benign calcifications again noted. | 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. | There is mild mucosal thickening involving the maxillary sinuses, right relatively worse on left. There is small air-fluid level on the right. There is some narrowing involving the bilateral osteomeatal units. The frontal sinus and frontoethmoidal recesses are clear. The anterior ethmoid air cells are clear. The posterior ethmoid air cells are clear. The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is rightward nasal septal deviation and right nasal septal spur which narrow the right nasal passage. There is mucosal thickening along the right inferior turbinate. Maxillary defect compatible with cleft palate noted.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. | 1. Minimal mucosal thickening involving the maxillary sinuses with small air-fluid level on the right. Paranasal sinuses are otherwise clear.2. Rightward septal deviation and septal spur which narrow the right nasal passage.3. Midline maxillary osseous defect compatible with cleft palate. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral benign calcifications are noted. 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.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. | 77-year-old male with shortness of breath LUNGS AND PLEURA: Patchy peribronchial distribution air space opacities throughout the right lung. Right upper lobe predominant reticulonodular and groundglass opacities with moderate pleural effusion. Right lower lobe consolidation is unchanged from multiple prior radiographs compatible with round atelectasis. There is intralobular and mild interlobular septal thickening. Bronchial wall thickening and mild bronchiectasis. Pleural calcification at the lung base.Left upper lobe anterior coarse pleural calcification. The left lung is otherwise unremarkable.MEDIASTINUM AND HILA: LVAD device is present. No significant mediastinal or hilar lymphadenopathy.Severe cardiomegaly. No pericardial effusion.CHEST WALL: Left chest wall ICD with leads unchanged.No axillary, cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Streak artifact from LVAD limits the study. Enlarged left adrenal gland with nodular contour. | 1.Right lung bronchopneumonia with moderate sized pleural effusion suggestive of Mycoplasma pneumonia or less likely Legionella.2.Pleural calcification suggestive of asbestos related pleural disease with rounded atelectasis at right lung base. |
Generate impression based on findings. | Reason: hx lung CA, pls compare to previous and evaluate History: none CHEST:LUNGS AND PLEURA: Postsurgical findings in the right hemithorax with a loculated apical hydropneumothorax.The soft tissue surrounding the staple line is consistent with contusion and seroma.Moderate free effusion in the right base.Small groundglass nodule in the left lower lobe (series 7/71) measures 8 x 8 mm, present in retrospect on recent previous scans and unchanged. Although this is stable in the short-term, the morphology is highly suspicious for primary adenocarcinoma in situ.MEDIASTINUM AND HILA: Bilateral thyroid cysts, unchanged.Mildly enlarged high right paratracheal lymph node measuring 9 mm and probable interval resection of a previously enlarged lower right paratracheal lymph node.Mild coronary artery calcification.No pericardial effusion.CHEST WALL: Focal sclerosis posteriorly in the T1 vertebral body, unchanged, likely benign.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Large hemangioma in the posterior right lobe, unchanged..SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Postsurgical right loculated hydropneumothorax.2. 8mm persistent left lower lobe ground glass nodule suspicious for primary adenocarcinoma, in situ or minimally invasive. |
Generate impression based on findings. | Mesothelioma, follow-up LUNGS AND PLEURA: AP 8-mm groundglass nodule in the left apex (image 16 series 5) is unchanged. Scarring in both lung bases. No suspicious new focal nodules or masses. No effusions.MEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and pericardium are within limitsSmall hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Please refer to the concomitant abdomen CT due to patient history and dedicated imaging | No evidence of interval change above the diaphragms and a appearing small groundglass nodule in the left upper lobe |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious morphology masses, microcalcifications or areas of architectural distortion are present. Bilateral benign morphology masses are again noted, similar to prior studies allowing for differences in positioning. Bilateral benign calcifications are also again seen. | 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. | 10-year-old female with low back and knee pain during sportsVIEWS: Lumbar spine AP, right oblique, left oblique, lateral, lateral lumbosacral junction (five views), knees standing AP, notch, knees sunrise, left knee lateral, right knee lateral (right knee four views, left knee four views) 3/18/15 Lumbar spine: The vertebral heights and disk spaces are maintained. No spondylolysis or spondylolisthesis. Moderate amount of stool is present.Left knee: No fracture or malalignment. No joint effusion. No significant soft tissue swelling.Right knee: No fracture malalignment. No joint effusion. No significant soft tissue swelling. | Normal examinations. |
Generate impression based on findings. | Female 64 years old; Reason: eval EVAR with renal, SMA, celiac artery stents History: abdominal pain, rising leukocytosis, AKI The following observations are made given the limitations of an unenhanced study.CHEST:LUNGS AND PLEURA: New bilateral pleural effusions with overlying compressive atelectasis. Emphysematous changes in both lung apices. Motion artifact.MEDIASTINUM AND HILA: No significant abnormality noted. Left thyroid nodules. No significant adenopathy.CHEST WALL: Ill-defined right axillary hematomaABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion. Gallbladder remains filled with contrast material.SPLEEN: Calcified splenic granuloma, unchanged.PANCREAS: Hypodense pancreatic lesions better characterized on recent enhanced CT.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: Status post left nephrectomy. In the right kidney, there is enhancement at the inferior pole which probably represents occlusion of an accessory renal artery and delayed perfusion. Right nephroureteral stent redemonstrated unchanged. Stable subcentimeter right renal hypodensities, too small to further characterize. Punctate nonobstructing right renal stone as noted previously.RETROPERITONEUM, LYMPH NODES: Since prior examination, there's been interval placement of an aortic endograft with snorkels extending into the celiac axis, SMA, and right renal artery (although these are difficult to evaluate without contrast). Status post aorto-bifemoral graft. Large abdominal aortic aneurysm and femoral artery aneurysms are better characterized on recent dedicated CTA. The aneurysm sac appears stable in size evidence of acute hemorrhage.BOWEL, MESENTERY: Bowel is normal in caliber without evidence of obstruction or ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Upper abdominal drain enters right of midline and coils in the left upper quadrant.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Bladder is empty. Foley catheter are noted in the bladder lumen.LYMPH NODES: Single prominent stable nonspecific left pelvic lymph node, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Unchanged pelvic free fluid as described previously. | Status post complex aortic endograft repair with snorkels into distal vessels as described above. New bilateral pleural effusions with overlying atelectasis. Right axillary hematoma. Other findings are relatively stable compared to prior. |
Generate impression based on findings. | Status post radiation therapy. Lung cancer and history of COPD. Please follow-up CHEST:LUNGS AND PLEURA: Interval increasing in size in the small focal nodule observed in the right middle lobe adjacent to the major fissure (image 60 series 4). This finding is more stellate in appearance and currently measures 11 x 10 mm, previously 10 x 8 mm. Both the small satellite nodule and extension towards the pleural surface with associated thickening is also more advanced than suspicious. Adjacent bronchiolitis and groundglass opacities are also observed.Extensive moderate centrilobular emphysematous changes without additional superimposed nodules or masses. No effusions.MEDIASTINUM AND HILA: Mild cardiomegaly with coronary calcifications unchanged.No distinct lymphadenopathy. The right hilar reference node remains 1.2 cm (image 54 series 3). The reference right paratracheal lymph node again is also unchanged, measuring 7 mm (image 20 series 3)CHEST WALL: Dextroscoliosis with marked scattered degenerative changes unchanged. No suspicious new lytic or blastic lesions observedABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered hepatic cysts unchanged. Gallbladder unremarkableSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Again mild interval continued enlargement and better delineation of the right middle lobe focal spiculated density suspicious for primary malignancy. Reference measurements otherwise provided |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 82 years old; Reason: elevated PSA, concern for metastatic prostate cancer History: prostate cancer CHEST:LUNGS AND PLEURA: Extensive fibrotic disease, particularly subpleural and most pronounced in dependent lower lobes. Punctate right-sided calcified granuloma. No definite lung nodule or mass seen.MEDIASTINUM AND HILA: Mild mediastinal and hilar adenopathy. Reference pretracheal lymph node measuring 0.9 x 0.9 cm, image 20 series 3. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Scattered hypoattenuating lesions, largest measuring simple fluid and located in hepatic dome, measuring 2.1 x 1.8 cm. Additional multiple hypoattenuating lesions seen that are too small to characterize. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal hypoattenuating lesions that are too small to characterize.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease.BOWEL, MESENTERY: Moderate to large stool burden, no bowel obstruction. Duodenal diverticulum formation. Moderate-sized hiatal hernia.PELVIS:PROSTATE, SEMINAL VESICLES: Prominent heterogeneous and calcification containing prostate gland, measuring 4.5 cm.BLADDER: Mild circumferential wall thickening, may reflect sequela of chronic bladder outlet obstruction. LYMPH NODES: No enlarged pelvic lymphadenopathy. Reference right external iliac lymph node measuring 0.7 by 0.5 cm on image 176 series 3. BONES, SOFT TISSUES: Multilevel degenerative changes of spine and levoscoliosis seen. Intervertebral disk space narrowing particularly pronounced at L5/S1 level. Mild retrolisthesis of L2 on L3 seen. Please refer to concomitant nuclear medicine bone scan from same day for additional findings. Small ill-defined soft tissue induration in right inguinal area, image 169 series 3, correlation with prior intervention/procedure. | 1. Mild mediastinal and hilar adenopathy. 2. Small ill-defined soft tissue density in right inguinal area, may reflect small scarring or hematoma and correlation with prior intervention/procedure suggested.3. Prominent heterogeneous and calcification containing prostate gland, measuring 4.5 cm. Mild circumferential wall thickening, may reflect sequela of chronic bladder outlet obstruction. 4. More sensitive evaluation for osseous metastatic disease would be achieved with bone scintigraphy, please refer to concomitant nuclear medicine bone scan from same day for additional findings.5. Moderate-sized hiatal hernia. |
Generate impression based on findings. | Pain posterior to acromion Three views of the left shoulder reveal mild osteophyte formation at the acromioclavicular joint. No acute abnormalities. No fractures or dislocations. | Very mild degenerative changes at the acromioclavicular joint |
Generate impression based on findings. | 13-day-old male intubated with chronic lung diseaseVIEW: Chest AP (one view) 3/18/15, 1428 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 tip in SVC unchanged. Left lower quadrant Penrose drain is unchanged.The cardiothymic silhouette is normal. Persistent bilateral coarse lung opacities with the PIE pattern unchanged aeration of the lungs bilaterally. No focal pulmonary opacity. Left costophrenic angle appears less blunted. Increased diffuse soft tissue swelling. The right diaphragm is at the ninth rib. The left diaphragm is between the ninth and 10th ribs. | Unchanged appearance of the lungs in a PIE pattern. Increased diffuse soft tissue swelling. |
Generate impression based on findings. | 50 year-old female with left breast swelling a few months ago that has now resolved. Three standard views of both breasts were performed for a total of 12 images digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered calcifications have slightly progressed in a benign fashion, particularly on the right.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Sickle cell disease. Fever and cough.VIEWS: Chest PA/lateral (two views) 3/18/15 The cardiac silhouette is mildly enlarged. Sickle cell bone changes are present. Mild streaky atelectasis in the left lower lobe. No pleural effusion. | No pneumonia or evidence of acute chest. |
Generate impression based on findings. | 67 years old, Male, Reason: peritoneal mesothelioma s/p resection, eval EOD, compare to previous ABDOMEN:LUNG BASES: No significant abnormality noted. Please refer to report from dedicated chest CT performed concomitantly.LIVER, BILIARY TRACT: Multiple subcentimeter hypoattenuating liver lesions appear unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts are unchanged. Nonobstructing left renal stone.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post omentectomy with resection of previously seen omental caking and nodularity. No evidence of residual or recurrent disease.BONES, SOFT TISSUES: Stable degenerative arthritic changes of the thoracolumbar spine with grade 1 anterolisthesis L3 on L4.OTHER: No significant abnormality.PELVIS:PROSTATE, SEMINAL VESICLES: Stable prostatomegaly.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See above.BONES, SOFT TISSUES: Stable degenerative arthritic changes of the thoracolumbar spine with grade 1 anterolisthesis L3 on L4.OTHER: A probable venous varicosity just posterior to the seminal vesicle appears stable. | No evidence of residual or recurrent disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Prior benign left breast biopsy. Family history of breast cancer in her maternal grandmother. 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. Unchanged position of the left breast biopsy clip and associated asymmetry. A few scattered benign calcifications are noted. | 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. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.