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Generate impression based on findings. | Clinical question: Rule-out acute process. Signs and symptoms: Headache and blurry vision. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, sulci, ventricular system, CSF is present... | 1.Acute intracranial process.2.Unremarkable calvarium and intracranial content. |
Generate impression based on findings. | A 10-year-old female status post pectus excavatum bar removal with small pneumothoraxVIEW: Chest AP (one view) 3/18/15 at 1459 Right apical pneumothorax is unchanged. No left pneumothorax. Right chest subcutaneous emphysema is noted. Bibasilar streaky opacities likely represent atelectasis. Increased left lower lobe st... | Unchanged small right pneumothorax. Increased left lower lobe atelectasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her sister. Two standard digital views of both breasts obtained on 6 total images were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Two adjacent... | Adjacent left breast masses for which further evaluation with spot compression and ultrasound are recommended. If it is possible to obtain the patient's prior mammograms, comparison would be potentially beneficial.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound... |
Generate impression based on findings. | Lung cancer CHEST:LUNGS AND PLEURA: Mild interval decrease in size of a centrally necrotic right hilar mass with extension towards the midline in the paravertebrally tissues. The mass remains inseparable from the collapsed esophagus as well as the right mainstem bronchus and right lower lobe proximal airways. The lesio... | Interval improvement compatible with treatment of the known primary and metastatic lesions. Reference measurements provided |
Generate impression based on findings. | 63-year-old with suspicious right breast mass with calcifications presents for ultrasound guided biopsy. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass at the right breast 11 o'clock position with associated hyperechoic foci compatible with calcifications. Th... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time. BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Increasing left breast calcifications with sonographic correlate. Ultrasound guided biopsy is requested. Left ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass with associated calcifications immediately beneath the skin and immediately below the nipple. The lesion was... | Successful ultrasound-guided core biopsy of the left breast lesion and clip placement. Calcifications were confirmed in one specimen. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 75 year-old returns for further work up of left breast calcifications. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. The calcifications of interest ar... | No mammographic evidence of malignancy. Calcifications in the left breast have a typically benign appearance. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended in 12 months. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.REC... |
Generate impression based on findings. | 19 year-old male with lupus and right shoulder painVIEWS: Right shoulder internal and external rotation (two views) 3/18/15 The humeral head is well seated at the glenoid fossa. No fracture or malalignment. No lucent or sclerotic lesion to suggest infarct. | Normal examination. |
Generate impression based on findings. | 78 years, Male. Reason: NG History: NG Ileus type gas pattern. There is a nasogastric tube with its tip projecting over the antrum of the stomach. | Nasogastric tube with its tip projecting over the antrum of the stomach. |
Generate impression based on findings. | 53-year-old female with suspicion for interstitial lung disease. LUNGS AND PLEURA: No focal consolidation, pleural effusion, or suspicious pulmonary nodules. No evidence of interstitial lung disease.MEDIASTINUM AND HILA: Heart size is normal. Mild coronary calcifications identified. No pericardial effusion. Small hiata... | No evidence of interstitial lung disease. |
Generate impression based on findings. | 67-year-old female for a lung nodule follow-up CHEST:LUNGS AND PLEURA: Mild bronchial wall thickening. Right lower lobe centrilobular or nodules with thickening and bronchiectasis has progressed. Scattered tree in bud opacities in the right upper and middle lobe. Debris is noted in the right lower lobe bronchi. Focal p... | Slight interval increase in bronchiectasis and bronchiolitis in the right lung base. This is now suspicious for indolent atypical mycobacterial infection. Improved left lung base atelectasis. No findings to suggest malignancy. |
Generate impression based on findings. | History of right mastectomy for breast cancer. No new complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalc... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually as long as her health otherwise remains good. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic... |
Generate impression based on findings. | 17 year old female with previously resected melanoma of left lower eyelid and left proptosis and concern for recurrence. This is a limited exam performed for the purposes of surgical localization. There is an unchanged left anterior middle cranial fossa arachnoid cyst that results in mild bowing of the posterior latera... | 1.Unchanged left middle cranial fossa arachnoid cyst with mass effect upon the left orbit and mild left proptosis.2.No gross intracranial mass lesions. Refer to the concurrent brain MRI for additional details.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Malignant breast cancer. Right lumpectomy with adjuvant chemotherapy and radiation. Recurrent disease in left axilla. Assess for metastases. CHEST:LUNGS AND PLEURA: Emphysematous changes again noted. No definite pulmonary metastases identified.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Status po... | Left axillary lymph nodes. Indeterminate subcentimeter hepatic lesions should be followed. |
Generate impression based on findings. | 11 year old female with head banging and history of VP shunt.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 3/18/15 A left occipital approach ventriculostomy catheter with tip near the midline is present. Shunt tubing exits the skull via a left parietal b... | Discontinuity of the shunt catheter. Moderate stool burden with distended urinary bladder. |
Generate impression based on findings. | Lung cancer restaging status post chemoradiation.RADIOPHARMACEUTICAL: 16.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 180 mg/dL. Today's CT portions of the neck, abdomen, and pelvis grossly demonstrate left brain lesions with surrounding edema causing mass effect with rightward shift of the midline stru... | 1.Significant progression of tumor with multiple new and larger hypermetabolic metastases including new brain, bone, pulmonary, and adrenal metastases.2.Note the left brain metastases are causing mass effect with midline shift. Please see today's brain MRI for further details. |
Generate impression based on findings. | There is mild rightward convexity of the lumbar spine. There is 4-mm grade 1 anterolisthesis of L4 on L5, with a vacuum disk at this level. Bilateral L4 spondylolysis is noted. Trace vacuum phenomenon is also present at T12-L1. The scout lateral view and the sagittal reformatted images demonstrate the remainder of the... | 1. Grade 1 anterolisthesis of L4 on L5 secondary to chronic bilateral L4 spondylolysis.2. Moderate to severe central spinal canal stenosis as well as moderate to severe right and moderate left foraminal narrowing at L2-L3.3. Moderate to severe right foraminal narrowing at L4-L5.4. Nonobstructing left renal calculi. Ple... |
Generate impression based on findings. | Reason: h/o mantle cell lymphoma now w/ lymphoma cells in the peripheral blood smear RADIOPHARMACEUTICAL: 12.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion demonstrates mild pulmonary apical paraseptal emphysema and basilar atelectasis/scarring. There are mildly enlarged port... | 1.Multiple hypermetabolic lymph nodes, most notably in the abdomen but also in the thorax, highly suspicious for tumor activity.Widespread marrow and diffuse splenic activity, which while it may conceivably represent benign marrow stimulation is considered more likely to represent diffuse tumor involvement (particularl... |
Generate impression based on findings. | Fracture A plate and screw device affixes a healing fracture of the proximal-mid humeral diaphysis in near anatomic aligned. Fracture lines are less distinct on the current study than on the prior study indicating some interval healing. I see no hardware complications. | Orthopedic fixation of healing humerus fracture. |
Generate impression based on findings. | Pain. Healing fracture of fifth metatarsal? Again seen is a comminuted but predominantly transverse fracture through the proximal tuberosity of the fifth metatarsal with slight lateral displacement of the tuberosity fracture fragment. Overall, the findings are similar to those seen on the prior study. The small density... | Fracture of the fifth metatarsal base appearing similar to the prior study. |
Generate impression based on findings. | Reason: history of large squamous cancer of left cheek follow up CT, follow up lung nodule found on CT History: history of large squamous cancer of left cheek follow up CT, follow up lung nodule found on CT LUNGS AND PLEURA: Index left lower lobe, well-defined micronodule is stable in size measuring 3 mm (series 5, ima... | Unchanged 3-mm left lower lobe nodule, favoring a benign lesion such as a granuloma. Conservative follow-up CT is recommended in 4 to 6 months. Severe atherosclerotic calcification of the renal arteries bilaterally with a small aneurysmal dilatation of the right renal artery as described above. |
Generate impression based on findings. | 15-year-old female with back pain during sports.VIEWS: Thoracic spine AP, lateral, swimmers (3 views) 3/18/15 No fracture. Vertebral heights and disk spaces are maintained. There are 13 rib pairs. Mild left lumbar curve. | Mild left lumbar curve without fracture. |
Generate impression based on findings. | Reason: Restaging breast cancer, stage IV History: Restaging. CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant centrilobular emphysema. Apical scarring unchanged. Scattered pulmonary nodules are redemonstrated, some of which are new or increased. A reference right lower lobe subpleural nodule measures 12 x 6 mm ... | 1.Scattered pulmonary nodules, some of which are new or increased in size.2.Increased bilateral axillary lymphadenopathy, as above. |
Generate impression based on findings. | Tophaceous gout. Evaluate for gouty erosions. Three views of the left hand show soft tissue swelling about numerous interphalangeal joints including the second MCP joint and second, fourth, and fifth PIP joints. There are early erosions of the head of the fourth metacarpal. Three views of the right hand show significan... | Soft tissue swelling and erosions as described above. |
Generate impression based on findings. | 68-year-old female callback from screening for posterior left breast asymmetry. Family history of breast cancer diagnosed in sister age 36 and in cousin. Full field and spot compression CC and ML views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed... | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 71 years old; Reason: 71M with UC now POD7 from lap assisted TAC with ileoorectal anastomosis, please evaluate for intraabdominal source of symptoms History: nausea, emesis, abdominal distention, decreased bowel function, decreased appetite ABDOMEN:LUNGS BASES: Patchy left lower lobe air space disease, suspicious ... | 1. Status post subtotal colectomy with ileorectal anastomosis seen. Distended stomach and dilated small bowel with sites of focal/segmental narrowing in distal ileum and at level of ileorectal anastomosis, air seen beyond these sites, see description above. Given patient's relatively recent postoperative state, finding... |
Generate impression based on findings. | 54-year-old female with history of right foot and ankle pain. Three views of the right foot demonstrate slight plantar flexion of the talus, the head of which is slightly inferiorly subluxed with respect to the navicular. Mild osteoarthritis affects the midfoot. There is mild diffuse soft tissue swelling. Small lucenci... | Arthritic changes as described above, including talonavicular joint subluxation, midfoot osteoarthritis, and probable small erosions of the forefoot. The talonavicular subluxation may reflect a neuropathic arthropathy, but the small forefoot erosions suggest the possibility of an inflammatory arthritis. |
Generate impression based on findings. | Postop. Prosthetic assessment. Three views of the pelvis and two views of the right hip show a right total hip arthroplasty device situated in anatomic alignment without evidence of hardware complication. No acute fracture is evident. | Right total hip arthroplasty without evidence of hardware complication. |
Generate impression based on findings. | RFO trigger: Urgent change in planned procedure Suspected RFO location: Abdomen/Pelvis Name of suspected RFO: Instruments,sponges,needles. Attending Surgeon name/pager: Dr. Bales/ 3710 or room phone # 69410. Interval placement of a right nephroureteral stent with the distal tip terminating in the distribution the bladd... | No unexpected radiopaque foreign object is identified.These findings were discussed by telephone with Dr. Bales, the attending surgeon, on 3/18/2015 at time. |
Generate impression based on findings. | 21-year-old male with small lump and tenderness near inguinal canal, per patient left-sided. RIGHT TESTIS: 4.0-cm x 2.6 cm x 2.1 cm.LEFT TESTIS: 4.3 cm x 3.0-cm 0.2 cmRIGHT EPIDIDYMIS: 1.1 cm x 0.8 cm x 0.8 cmLEFT EPIDIDYMIS: 0.9 cm x 1.4 cm x 0.8 cm. OTHER: Bilateral varicoceles, left greater than right. Area of left ... | Bilateral varicoceles, left greater than right which corresponds to area of left sided palpable mass. |
Generate impression based on findings. | Shoulder fracture Three views of the right shoulder reveal a comminuted impacted surgical neck of the humerus fracture. There are degenerative changes at f the glenohumeral joint but no dislocations. | Comminuted impacted surgical neck fracture of the humerus |
Generate impression based on findings. | 57 year old female. Right flank colic-like pain x 2 days. Assess for kidney stone. Lack of intravenous and oral contrast limits evaluation for solid organ and bowel pathology.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality note... | No renal or ureteral stones. No specific findings to explain the patient's symptoms. |
Generate impression based on findings. | 54-year-old female with history of head and neck cancer and chemoradiation therapy. CHEST:LUNGS AND PLEURA: Stable right apical scarring. No suspicious pulmonary nodules, focal consolidation, or pleural effusion.MEDIASTINUM AND HILA: Left chest wall port catheter tip in the right atrium. Heart size is normal. No perica... | 1.No significant interval change in osseous metastases. 2.Stable left hepatic lobe lesion; metastasis not excluded. |
Generate impression based on findings. | Neuroblastoma s/p autoSCT, thrombocytopenic with worsening SAH. There is no significant change in the scattered foci of subarachnoid hemorrhage. The grey-white matter differentiation appears to be intact. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. There is new fluid... | No significant change in the scattered foci of subarachnoid hemorrhage. |
Generate impression based on findings. | Male 18 years old; Reason: r/o appendicitis History: rlq tenderness ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, UR... | 1.No overt acute abdominal or pelvic process to account for right lower quadrant tenderness. A small pocket of free fluid is nonspecific, as described above. |
Generate impression based on findings. | Malignant uterine neoplasm. Papillary serous carcinoma. CHEST:LUNGS AND PLEURA: Previously referenced left upper lobe opacity measures 3.0 cm x 1.7 cm, equivocally smaller suggesting this represents scarring (image 31; series 5). No new mass lesions are identified. Stable postsurgical changes in the right upper lobe. M... | No substantial interval change. Left upper lobe opacity probably represents scarring as it slightly smaller on today's examination. Stable subcentimeter mediastinal lymph node. |
Generate impression based on findings. | 54-year-old male with a history of AML, pre-allogenic stem cell transplant evaluation. LUNGS AND PLEURA: No focal consolidation, pleural effusion, or suspicious nodules.MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. No coronary calcifications are detected within the limitations of this non-gat... | No evidence of infection or malignancy. |
Generate impression based on findings. | Reason: Please assess for metastatic CA History: Prior breast CA, now with C-spine contrast-positive lesions. RADIOPHARMACEUTICAL: 11.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion demonstrates bilateral hip prostheses and degenerative changes throughout the lumbar facets as ... | 1. Small region of moderate activity in the left lower cervical spine posterior elements correlating with the area of enhancement on the recent MRI may represent benign inflammation, particularly as there is similar appearing more clearly benign degenerative activity in the lower lumbar spine. However, tumor activity i... |
Generate impression based on findings. | Metastatic nasopharyngeal cancer treated with TFHx on 7/19/14. There are post-treatment findings in the nasopharynx, without evidence of measurable tumor in this region. There is a newly apparent subcentimeter hyperattenuating lesion in the anterior left masseter muscle. There are also findings related to right neck di... | 1. Newly apparent lesion in the left masseter muscle may represent a metastasis versus an inflammatory process or hematoma. Ultrasound or MRI may be useful for further characterization if clinically warranted. 2. Post-treatment findings in the neck with interval interval resolution of ill-defined heterogeneity of the i... |
Generate impression based on findings. | There is significant degeneration of both temporomandibular joints, although more severe on the left. There is significant flattening of the mandibular condyles bilaterally. There is subchondral cyst formation, as well as subtle increased density suggested in the left temporomandibular joint which may represent minera... | 1. Severe left much greater than right temporomandibular joint degenerative changes with intraarticular mineralization suggested on the left, which could relate to synovitis or CPPD. MRI of the TMJs, especially the left, is recommended for further evaluation.2. Scattered dental caries. Please correlate with dental exam... |
Generate impression based on findings. | 27-year-old male with left forearm and wrist pain. Three views of the left wrist and two views of the left forearm demonstrate a nondisplaced comminuted, but predominantly transverse fracture of the distal ulnar diaphysis. No additional fractures of the forearm or wrists are identified. | Nondisplaced comminuted fracture of the distal ulnar diaphysis. No acute fracture is seen in the wrist. |
Generate impression based on findings. | Female; 71 years old. Reason: Cholangiocarcinoma please assess extent of disease and provide index lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Small right pleural effusion.MEDIASTINUM AND HILA: Mild mediastinal and bilateral hilar lymphadenopathy. ... | 1. Increased size of gallbladder carcinoma invading adjacent right hepatic lobe with new satellite lesion in the right hepatic lobe since 2/14/15.2. Stable extensive upper abdominal, retroperitoneal, and pelvic lymphadenopathy.3. Mediastinal and bilateral hilar lymphadenopathy, suspicious for metastatic disease.4. Gros... |
Generate impression based on findings. | Female, 3 years old. Swallowed penny 3/11/15 no sxs (not seen in stool)VIEW: Abdomen AP/lateral (two views) 3/18/2015, 1618 A coin is seen in the right lower quadrant, in the cecum.Nonobstructive bowel gas pattern.No pneumatosis, portal venous gas, or free air.Moderate stool burden. | Coin (penny or nickle) within the cecum without evidence of obstruction. |
Generate impression based on findings. | 55-year-old female with left foot pain. Four views of the left foot demonstrate prominent osteophytes projecting dorsally from the first tarsometatarsal joint, as well as mild osteoarthritis affecting the first metatarsophalangeal joint. Mild deformity of the fifth proximal phalanx may reflect prior trauma or surgery. | Osteoarthritis as above. |
Generate impression based on findings. | Reason: 60M with intraductal carcinoma of the prostate on biopsy, please assess for bone metastasis. Right frontal cranial activity correlates with prior craniotomy defect. A punctate area of radiotracer uptake along the left supraorbital ridge is commonly benign. There is no suspicious osseous focus to specifically su... | No evidence of bone metastasis. |
Generate impression based on findings. | 44-year-old male with history of trigger finger. Three views of the right hand demonstrate a small ossicle along the lateral aspect of the second metacarpophalangeal joint, which may represent a small intra-articular loose body. A tiny ossicle is also seen projecting lateral to the third metacarpal head. Round lucencie... | Small cysts in the second and third metacarpal heads with tiny ossicles in the adjacent soft tissues are of questionable clinical significance. The ring finger appears normal. |
Generate impression based on findings. | 51-year-old male with right elbow pain. Four views of the right elbow demonstrate a tiny spur projecting from the coronoid process of the ulna, otherwise unremarkable. There is no joint effusion evident; no acute fracture or malalignment. | Tiny spur projecting from the coronoid process of the ulna, otherwise normal exam. |
Generate impression based on findings. | Uterine malignancy. Solitary pulmonary nodule and enlarged large lymph nodes. CHEST:LUNGS AND PLEURA: Probable calcified granuloma in the right lower lobe. Several micronodules can be followed. Statistically, these are likely postinflammatory.MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes should be followe... | Scattered small lymph nodes. Pulmonary micronodules. These findings can be followed. |
Generate impression based on findings. | Dysphagia; resistance met upon intubation of cervical esophagus with endoscope; CT neck and chest to rule out extrinsic compression. There are postoperative findings in the anterior lower neck. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The airways ar... | 1. No evidence of an upper aerodigestive track mass.2. Findings suggestive of acute upon chronic sinusitis in the appropriate clinical setting. |
Generate impression based on findings. | Reason: Patient with history of prostate cancer s/p prostatectomy and radiation. Now with recurrence of PSA and retroperitoneal adenopathy. Has left hip pain. Evaluate for prostate metastasis. Multiple bilateral posterior and lateral rib lesions are identified with suspicious features including non-full-thickness rib i... | Bilateral rib lesions and right scapular lesion with some lucent and sclerotic CT correlate lesions are highly suspicious for osseous metastases or conceivably multiple myeloma given lytic CT correlates. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: The maxillary sinuses are clear. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bi... | Unremarkable CT of the sinuses. |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage. Signs and symptoms: alteration of mental status. Unenhanced head CT:Examination demonstrate no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Findings suggestive of age indeterminant small vessel i... | 1.No acute intracranial process.2.Age indeterminant small vessel ischemic strokes.3.Small round focus of slightly high density in the anterior right middle cranial fossa. Differential of an aneurysm or a small mass should be considered. Follow-up with brain MRI and MRA is recommended. |
Generate impression based on findings. | Clinical question: Hemorrhage. Signs and symptoms: Weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is been sensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces. Questionable visu... | No acute intracranial process. |
Generate impression based on findings. | Clinical question: Hemorrhage. Signs and symptoms: Weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differe... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Cause of new seizure in patient with new heart transplant. Signs and symptoms: Partial seizure. Nonenhanced head CT:There is no convincing evidence of an acute intracranial process.There is paucity of cortical sulci for patient's stated age. Although this may be within normal possibility of mild gene... | 1.No definitive evidence of acute intracranial process.2.Paucity of the cortical sulci and small size of supratentorial ventricular system could be within normal however possibility of subtle cerebral edema cannot be entirely excluded. |
Generate impression based on findings. | 41-year-old female for diagnostic mammogram to evaluate the right breast pain, few weeks ago for which she went to the emergency room. She was sent home with Tylenol as needed. Today, her pain has subsided, appears more cyclical. Patient does not palpate a lump. Three standard views of both breasts were performed digit... | No mammographic evidence of malignancy. No suspicious abnormality in the right breast corresponding to patient's right breast pain. Right breast pain should be managed clinically. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendat... |
Generate impression based on findings. | Female, 17 years old. Chest pain, elevated D Dimer. Evaluate for PE. PULMONARY ARTERIES: Technically adequate exam, without evidence of pulmonary embolism.LUNGS AND PLEURA: No focal opacities. No pleural effusions. Scattered small calcified nodules, compatible with prior granulomatous disease. No suspicious pulmonary n... | No evidence of pulmonary embolism or other acute abnormality. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign biopsy in the past in the left breast. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern... | 13-mm bilobed asymmetry in the medial right breast with a possible correlate in the inferior right breast needs further evaluation with spot compression views and possible ultrasound.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 40 years old; Reason: Please evaluate for intra-abdominal bleeding s/p hysterectomy History: Hgb 5 ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No sig... | Status post hysterectomy. No evidence of active bleeding. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Multiple oval to round masses, few partially circumscribed, few wel... | 1. Multiple oval to round masses, few partially circumscribed, few well-circumscribed are identified in both breast. There is a broad differential for these masses and hence comparison with prior mammograms is recommended to confirm stability. 2. A small cluster of calcifications is also identified in the left upper ou... |
Generate impression based on findings. | 67 years, Male. Reason: dht History: dht There is a Dobbhoff tube with its tip projecting over the antrum of the stomach. There is a nonobstructive bowel gas pattern. The pelvis is excluded from the field of view. Residual contrast opacifies the small bowel. Cardiomegaly. Pacemaker leads in expected position. Nonspecif... | Dobbhoff tube with its tip projecting over the antrum of the stomach. Nonspecific focal retrocardiac opacity, follow up recommended. |
Generate impression based on findings. | 68 years, Female. Reason: ileus/obstruction History: vomiting There is a nonobstructive bowel gas pattern. Round density projected over the left ilium likely reflects retained contrast in a diverticulum. Right upper quadrant surgical clips in place. Above average stool burden. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 68 years old Reason: thoracic mass History: dysphagia, anorexia and weight loss CHEST:LUNGS AND PLEURA: No consolidation, pleural effusion or pneumothorax. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No pericardial effusion.CHEST WALL: No significant abn... | 1.No CT findings to account for patient's dysphagia.2.Cystic pancreatic lesion, which may represent sidebranch IPMN. Recommend further evaluation with MRCP or ERCP. |
Generate impression based on findings. | 53 years, Female. Reason: drive line assessment History: syncope LVAD in place. Artificial valve and pacemaker leads identified. Imaged drive line without fracture; however, drive line external patient is not well-visualized. See chest radiograph report for full evaluation of the chest.There is a nonobstructive bowel g... | Imaged drive line without fracture; however, drive line external patient is not well-visualized. |
Generate impression based on findings. | 7-month-old female with intussusception status post resection, now with abdominal distention and bloody stoolVIEWS: Abdomen AP and crosstable lateral (two views) 3/19/15 Nasogastric tube tip and proximal sidehole are within the gastric body.Staple line and surgical materials are noted in the right hemiabdomen. Diffuse ... | Dilated featureless bowel in the left and mid abdomen are favored to represent an ileus in the early postoperative period, however an early obstruction is also included in the differential. |
Generate impression based on findings. | Female, 14 years old. Reason: rule out fracture, patellar tendon rupture History: pain, swellingVIEWS: Right knee, AP, lateral, oblique (3 views) 3/18/2015, 1900 Patella alta. Indistinctness of the patellar tendon.Small joint effusion.No acute fracture is identified. | Patella alta and indistinctness of the patellar tendon, concerning for patellar tendon rupture. No fracture. Recommend MRI for further evaluation. |
Generate impression based on findings. | Male 24 years old; Reason: SBO? History: abdominal pain.Additional history from pathology report of 10/21/2014 indicates history of hypertension, end-stage renal disease on hemodialysis with failed kidney transplant, antiphospholipid syndrome, polymyositis. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, B... | 1.Severe submucosal edema, dilatation and wall hyperenhancement involving the entire jejunum with some hyperenhancement of the ileum associated with marked generalized ascites. Rule out ischemia, angioneurotic edema related to ACE inhibitors hypertension, small vessel embolic disease causing ischemia if the patient is ... |
Generate impression based on findings. | 77-year-old male with shortness of breath and history of metastatic lung cancer, evaluate for pulmonary embolus PULMONARY ARTERIES: Technically adequate examination with pulmonary emboli in the left upper lobar and segmental arteries of uncertain chronicity. Main pulmonary artery measures 2.8 cm.LUNGS AND PLEURA: Saber... | 1.Pulmonary emboli in the left upper lobar and segmental arteries of indeterminate chronicity, but potentially acute.2.Extensive reticular and air space opacities in the left upper lobe and superior segment of the lower lobe with traction bronchiectasis compatible with postradiation change. There may be a component of ... |
Generate impression based on findings. | 84 years, Female. Reason: r/o obstruction History: projectile vomiting There is a nonobstructive bowel gas pattern. No evidence of pneumoperitoneum. Gastrostomy tube projects over the stomach. Large rectal stool burden unchanged. There are degenerative changes of the mid spine. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | 24 years, Female. Reason: free air History: abdominal pain There is a nonobstructive bowel gas pattern. Supine radiographs are insensitive for the detection of free air and an upright chest is recommended. | There is a nonobstructive bowel gas pattern. Supine radiographs are insensitive for the detection of free air and an upright chest is recommended. |
Generate impression based on findings. | 10-year-old female with abdominal pain, nausea and vomitingVIEW: Abdomen AP (one view) 3/19/15 Large stool burden. Nonobstructive bowel gas pattern. No pneumatosis or free air. | Large stool burden. |
Generate impression based on findings. | 46 years, Female. Reason: Placement of R ureter stent History: R flank pain Right nephroureteral stent with distal tip projecting over the urinary bladder, unchanged since the 2/7/2015 exam. Surgical clips project over the right midline abdomen. There is an IVC filter in place. There is a nonobstructive bowel gas patte... | Right nephroureteral stent position unchanged since the 2/7/2015 exam |
Generate impression based on findings. | 29 years, Male. Reason: abd fullness, constipation, eval stool burden History: abd fullness, constipation There is diffuse gaseous distention of the large bowel which may reflect colonic ileus or distal obstruction. Previously administered oral contrast opacifies portions of the ascending and descending colon. Retrocar... | Diffuse gaseous distention of large bowel, which may reflect colonic ileus or distal large bowel obstruction. |
Generate impression based on findings. | 53 year old female who was recalled from screening mammogram for architectural distortion at posterior upper quadrant in the left breast . Mammogram: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously de... | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 37 years, Male. Reason: abdominal pain, assess for bowel pathology, stool burden History: abdominal pain No evidence of pneumoperitoneum. There is a nonobstructive bowel gas pattern. Below average stool burden. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | 54 years, Male. Reason: verify NG tube placement History: s/p NG tube placement for decompression There is an NG tube in place with the tip below the diaphragm, but not identified definitively. There is extensive opacification of the right lung suggestive of pleural effusion with associated consolidation/atelectasis. T... | NG tube tip below the diaphragm, but not definitely identified. |
Generate impression based on findings. | 40 year-old female with chest pain and shortness of breath. Evaluate for PE. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: Diffuse fine nodular pattern with upper lobe predominance may be mildly progressed progressed from the pre... | 1.No evidence of pulmonary embolism.2.Stigmata of sarcoidosis with decreased lymphadenopathy and progression of pulmonary disease.3.Incompletely evaluated new hepatic dome lesion, which may represent a granuloma given the history of sarcoidosis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: N... |
Generate impression based on findings. | 64 years, Male. Reason: placement of R fem line History: see above Right femoral central venous catheter tip terminates in the distribution of the right common iliac vein. There is diffuse gaseous distention of the stomach. There is a gastrostomy tube in place. There is a nonobstructive bowel gas pattern. | Right femoral central venous catheter tip terminating in the distribution of the right common iliac vein. There is diffuse gaseous distention of the stomach. |
Generate impression based on findings. | Male 51 years old; Reason: hx emphysematous chole, bowel obstruction, lymphoma History: fever, open wound from chole malodorous and potential rib exposed Portions of the left abdomen are excluded from the field-of-view.CHEST:LUNGS AND PLEURA: Pleural effusion, mildly increased compared to prior with adjacent compressiv... | 1.Stable size of right lower quadrant mass/fluid collection with new gas, raising the possibility of superimposed infection.2.Right anterior abdominal wall ulceration/wound has increased in depth compared to prior study.3.Skin and soft tissue thickening and infiltration in the left abdominal wall is incompletely imaged... |
Generate impression based on findings. | 68-year-old female with right hip pain, left leg weakness. Two views of the right hip demonstrate minimal osteoarthritis. No fracture or malalignment is evident.Two views of the left hip demonstrate minimal osteoarthritis. No fracture or malalignment is evident.Two views of the left femur demonstrate moderate osteoarth... | Minimal hip osteoarthritis and moderate left knee osteoarthritis. No evidence of fracture or malalignment. If pain persists, consider MRI. |
Generate impression based on findings. | Male; 54 years old with history of lung cancer. Reason: SBO History: abdominal distention, abdominal pain Lack of intravenous contrast limits sensitivity for solid organ pathology.ABDOMEN:LUNG BASES: Moderate right pleural effusion with pleural thickening, partially visualized and similar to prior study. Dense atelecta... | 1. Increased carcinomatosis and ascites.2. No bowel obstruction. Prominent jejunal loops may be due to mild ileus secondary to the carcinomatosis.3. Stable dense atelectasis/consolidation of the right lung base with moderate right pleural effusion and pleural thickening, partially visualized. Underlying infection canno... |
Generate impression based on findings. | Reason: cerebellar infarct/bleed; vertebral artery dissection History: occipital headache, eye redness and blurred vision, intermittent vertigo HEAD:No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. Gray-white matter differentiation is preserved. The imaged... | 1.Normal-appearing intracranial and cervical vasculatures with minimal atherosclerotic changes. No evidence of vertebral artery dissection is clinically questioned.2.Asymmetric non-enhancement of the right cavernous sinus. This is likely due to variant venous drainage given lack of any associated imaging findings, but ... |
Generate impression based on findings. | 3-year-old female with bright red blood per rectumVIEWS: Abdomen AP and left lateral decubitus (two views) 3/19/15, 0612 and 0615 Nonobstructive bowel gas pattern. Air-filled right colon is in normal position. No pneumatosis, free air, or portal venous gas. | Normal examination. |
Generate impression based on findings. | Please note this examination is limited by the timing of contrast.Neck CTA: The right internal carotid artery is occluded from its origin at the bifurcation. There is atherosclerotic plaque at the left carotid bifurcation without significant stenosis by NASCET criteria. There is no evidence of dissection or aneurysm o... | 1.Occlusion of the entire right ICA from its origin.2.Scattered atherosclerotic calcification but no dissection, aneurysm, or significant stenosis of the remaining cervical vasculature.3.Chronic right MCA territory infarct.4.Right lung apex opacity, better evaluated on concurrent CT chest, abdomen, and pelvis. |
Generate impression based on findings. | Shoulder pain. Question of osteoarthritis. Three views of the left shoulder show severe joint space narrowing, osteophyte formation, and degenerative changes of the humeral head; this is increased compared to the prior study. There is mild to moderate osteoarthritis of the acromioclavicular joint.Three views of the rig... | Severe osteoarthritis of the bilateral glenohumeral joints. |
Generate impression based on findings. | Dedicated images through the sella demonstrate a normal height of the pituitary gland. There is a small linear area of hypoenhancement along the posterior aspect of the anterior pituitary gland, adjacent to the posterior pituitary bright spot. There is additional possible corresponding T2 hypointensity on the coronal ... | Thin linear area of hypoenhancement just anterior to the posterior pituitary bright spot with suggestion of corresponding T2 hypointensity. This may represent an incidental pars intermedia cyst given its location and signal characteristics. |
Generate impression based on findings. | 59-year-old male with shortness of breath, evaluate for pulmonary embolism PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Large pleural effusions with adjacent dense compressive atelectasis/consolidatio... | 1.No evidence of pulmonary embolism.2.Large bilateral pleural effusions, likely malignant without significant change.3.Diffuse bronchial wall thickening and thickened interlobular septa may reflect a component of edema.4.Mediastinal lymphadenopathy not significantly changed in size.5.Numerous sclerotic bone lesions com... |
Generate impression based on findings. | 66-year-old female with hypoxia. Evaluate for PE. PULMONARY ARTERIES: Diagnostic to the segmental level, no pulmonary embolus is identified.LUNGS AND PLEURA: Low lung volumes appeared mild basilar scarring/atelectasis. No focal consolidation, pleural effusion, or suspicious pulmonary nodules.MEDIASTINUM AND HILA: Moder... | No evidence of pulmonary embolism or other findings to account for hypoxia. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 16-year-old male with placement of femoral port.VIEWS: Chest AP, abdomen AP (two views) 3/18/15 Chest: Median sternotomy wires are unchanged. Cervical plates and screws remain in place. Interval placement of left femoral port with tip at the IVC - right atrial junction. A single right atrial line remains in place.Cardi... | Femoral port with tip at the IVC are, right atrial junction. |
Generate impression based on findings. | Female 77 years old Reason: pt with central chest pain that spread across entire chest today, has cardiac cath at OSH yesterday History: chest pain CHEST:LUNGS AND PLEURA: No pleural effusion, consolidation or pneumothorax. No suspicious pulmonary nodules or masses. Minimal left paramediastinal atelectasis.MEDIASTINUM ... | 1.No evidence of aortic dissection, aortic aneurysm, or other CT findings to account for patient's chest pain. |
Generate impression based on findings. | 43-year-old female status post right lumpectomy in June, 2014 followed by radiation and hormonal therapy presents for first postlumpectomy bilateral diagnostic mammogram. Three standard views of both breasts and two spot magnification views of right breast were performed digitally and reviewed with the aid of R2 CAD 9.... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 80 years old; Reason: intra-abdominal infectious source History: abdominal pain, nausea, vomiting ABDOMEN:LUNG BASES: Streaky basilar atelectasis, unchanged compared to prior. Left basal pulmonary granuloma.LIVER, BILIARY TRACT: Cholelithiasis. Distended gallbladder.SPLEEN: Stable splenic granulomas.PANCREAS: No... | 1.3.8 cm loculated fluid collection in the pelvis is nonspecific and may represent loculated simple fluid/infection/hematoma.2.Postoperative changes related to cystectomy and ileal conduit formation.3.Severe calcific arteriosclerosis of the abdominal aorta and branch vessels with chronic thrombosis of the left external... |
Generate impression based on findings. | 65-year-old female with right IJ/ SVC clot. R IJ tunneled permacath, neck pain with dialysis. LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Multiple bilateral hypoattenuating thyroid nodules. No evidence of superior vena cava or right internal jugular vein thrombosis. Right IJ catheter tip in... | No evidence of SVC or right IJ thrombosis within the limitations of a CT exam; optimal evaluation is by venography.New intrahepatic biliary ductal dilatation, incompletely evaluated. |
Generate impression based on findings. | Male, 23 days old. Evaluate for NEC History: Increased abdominal extension, emesis, history of CDHVIEW: Abdomen AP (one view) 3/19/2015, 0511 ET tube below the thoracic inlet and above the carina. Enteric tube terminates in the stomach, with distal side port below the level of the GE junction. Right lower extremity cen... | Unchanged cardiopulmonary appearance. Disorganized, nonspecific bowel gas pattern. |
Generate impression based on findings. | Left upper extremity weakness, evaluate for pathology. Per chart, patient has a history of stage IVb endometrial adenocarcinoma. There is an enhancing mass in the left anterior aspect of the superior frontal gyrus measuring 20 x 24 x 27 mm AP, transverse, and craniocaudal dimensions. There is mild intrinsic hyperintens... | Evidence of intracranial metastatic disease with at least 3 enhancing lesions identified on postcontrast CT. The largest two lesions are in the left frontal lobe and the right cerebellar hemisphere. There is associated edema and mass-effect including mild rightward midline shift. There is minimal effacement of the four... |
Generate impression based on findings. | 4-month-old male with respiratory distress VIEW: Chest AP (one view) 3/19/15, 0348 Endotracheal tube tip is between the thoracic inlet and the carina. Nasogastric tube tip in proximal spinal in the gastric body. Cardiac silhouette is top normal, unchanged. Interval improvement in bibasilar atelectasis. Persistent left ... | Persistent but improved bibasilar atelectasis. Increased right upper lobe atelectasis. Opacity in the right costophrenic angle may represent overlying material or small pleural effusion. |
Generate impression based on findings. | 52 year-old female with wrist fracture. Cast material obscures fine bone detail. Comminuted, predominantly transverse fracture of the distal radial metaphysis, with mild impaction and dorsal and radial displacement of the distal fracture fragment. A small ossific density next to the ulnar styloid, presumably represents... | Comminuted fracture of the distal radius as above. Probable avulsion fracture of the ulnar styloid. |
Generate impression based on findings. | Endometrial cancer with neuropathy, assess for brain metastases. There is no evidence of intracranial mass or abnormal enhancement. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and m... | No evidence of intracranial metastases. |
Generate impression based on findings. | Reason: stem cell transplant patient with hemoptysis History: cough. LUNGS AND PLEURA: Patchy ground glass and consolidation in the lower lobes are compatible with aspiration and/or infection. Trace right pleural effusion.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No coronary calcifications de... | Bilateral lower lobe groundglass and air space opacities are compatible with aspiration or infection. Hemorrhage is also a differential consideration given the clinical history of hemoptysis. |
Generate impression based on findings. | Male 71 years old Reason: diverticulosis History: LUQ/LLQ pain. Additional information from Epic: History of CLL and prostate cancer status post prostatectomy. ABDOMEN:Lack of intravenous contrast limits evaluation of abdominal organs.LUNG BASES: Multiple pulmonary nodules are noted in the right lung base the largest m... | 1.Extensive retroperitoneal lymphadenopathy with conglomerate lymph node, and resulting moderate left hydronephrosis.2.9-mm right pulmonary nodule. Recommend 3 month follow up. |
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