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Generate impression based on findings. | Basilar joint pain. Three views of the right wrist reveal no acute fracture or malalignment. The basilar joint appears normal. A small lucency in the radial metadiaphysis is most likely of no clinical significance. | No specific findings to account for the patient's pain. |
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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Multiple circular skin markers were placed over both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Left total hip. Three views of the left hip show a left total hip arthroplasty device in anatomic alignment without evidence of hardware complication. A small washer from previous hardware is superimposed over the greater trochanter. Surgical skin staples are noted about the left hip. No acute fracture is evident.Additional AP view of the pelvis shows severe osteoarthritis of the right hip with marked varus deformity. | Left total hip arthroplasty. |
Generate impression based on findings. | 49-year-old male with history of RCC CHEST:LUNGS AND PLEURA: Scattered calcified and noncalcified not significantly changed exam. No suspicious nodules or masses. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Heart size is normal without pericardial effusion. No visible coronary calcifications are detected within the limitations of this non-gated study. The trachea and mainstem bronchi are patent. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy.Interval increase in size of pathologic compression fracture of L1 with approximately 40 to 50% loss of height on the right. There appears to be mild extension of the vertebral column causing mild/moderate spinal canal stenosis. Lytic lesion is again seen T9 vertebral body, increased in size extending into the right pedicle and causing moderate to severe spinal canal stenosis. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged subcentimeter hypodense lesions in the liver.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Multiple enhancing adrenal nodules bilaterally are again seen. Superior posterior adrenal nodule measures 2.1 x 1.8 cm (series 3, image 110) previously 1.8 x 1.4 cm.Index right inferior adrenal gland nodule measures 22 x 17 cm (series 3, image 116), previously measuring 18 x 15 mm. Additional smaller nodules also appear to have increased in size.Index left adrenal gland nodule (series 3, image 118) measures 19 x 16 mm, previously 16 x 14 mm.KIDNEYS, URETERS: Status post left nephrectomy without evidence of local recurrence in the surgical bed. Unremarkable right kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Interval increase in size of pathologic compression fracture of L1 with approximately 40 to 50% loss of height on the right. There appears to be mild extension of the vertebral column causing mild/moderate spinal canal stenosis. Lytic lesion is again seen T9 vertebral body, increased in size extending into the right pedicle and causing moderate to severe spinal canal stenosis. Additional lytic lesion in the head of the left third rib likely a metastatic lesion.OTHER: No significant abnormality noted. | 1.No significant interval change in calcified and noncalcified pulmonary micronodules.2.Interval increase in size of index right adrenal gland nodules as described above.3.Interval increase in size of skeletal metastases to T9 and L1 vertebral body resulting in spinal canal stenosis as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional MLO views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Circular skin marker was placed over the left axilla. Scattered bilateral calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | ORIF Two views of the left forearm show side plates with multiple screws affixing both the distal radius and ulna in anatomic alignment. The fracture lines are less distinct suggestive of healing. | Orthopedic fixation of distal radius and ulnar fractures. |
Generate impression based on findings. | Cardiac arrest. Evaluate for hemorrhage Portable technique limits evaluation. No definite intracranial hemorrhage is identified. There is apparent petechial hyperdensity involving the left posterior frontal corona radiata, axial image 31 of 46 in series 1, which is likely artifactual. There is hyperdensity along the right tentorium which may also be artifactual. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is grossly maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. Streak artifact and noise related to portable technique makes evaluation difficult. No definite evidence of intracranial hemorrhage is seen. There is apparent hyperdensity along the right tentorium as well as a petechial hyperdensity in the left posterior frontal corona radiata which are favored to be artifactual. Consider nonportable CT study when patient can tolerate.2. No intracranial mass effect or herniation. No CT evidence of anoxic brain injury. |
Generate impression based on findings. | Pain. Pre-operative planning for right total hip arthroplasty Stryker/MAKO robotic hip system. CT images of the right hip show severe osteoarthritis of the right hip with joint space narrowing, subchondral sclerosis, and subchondral cyst formation. A right hip joint effusion is noted. No acute fracture is evident.Additional images of the pelvis show osteoarthritis of the left hip and a left hip joint effusion. Limited images of the bilateral knees are unremarkable. | Severe right hip osteoarthritis as above. |
Generate impression based on findings. | Claw toe (acquired). Two portable images of the left foot show interval placement of K wires through the second through fifth digits. No acute fracture is evident. | Interval placement of K wires through the second through fifth digits. |
Generate impression based on findings. | Stage IVb diffuse large B-cell lymphoma involving the sinus and multiple bony sites status post chemotherapy. Rhinorrhea. NECK: There is interval sclerosis of a lesion in the anteromedial portion of the left maxillary sinus wall. There is unchanged mild diffuse prominence of the Waldeyer's ring structures. However, there is a new subtle a subcentimeter focus of cortical dehiscence and sclerotic marrow in the left mandible in the region of hypermetabolism demonstrated on PET. There is no evidence of lymphadenopathy in the neck. The major salivary glands are unremarkable. The thyroid gland is mildly enlarged diffusely, without evidence of discrete lesions, which is unchanged. There are mild atherosclerotic calcifications bilateral carotid bulbs. The vasculature of the neck is otherwise grossly patent. There is a left subclavian venous catheter. There are findings related to prior sternotomy. The imaged portions of the lungs are clear.HEAD: The nasal cavity and paranasal sinuses are clear. There is no evidence of intracranial mass or abnormal enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The skull and scalp appear unchanged. The patient is edentulous and the left mandibular condyle is hypoplastic. | 1.Interval sclerosis of a lesion in the anteromedial portion of the left maxillary sinus wall, which corresponds to the treated diffuse large B-cell lymphoma. However, a new subcentimeter focus of cortical dehiscence and sclerotic marrow in the left mandible in the region of hypermetabolism demonstrated on PET may represent a new tumor deposit among other possibilities. 2.No evidence of significant lymphadenopathy in the neck. 3. Unchanged mild diffuse enlargement of the thyroid gland may represent thyroiditis.4. No evidence of intracranial lesions.5. The nasal cavity and paranasal sinuses are clear. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Stable focal asymmetry in the right upper inner quadrant.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Elbow pain and triceps. Four views of the left elbow show a left total elbow arthroplasty device appearing similar to the prior study. No acute fracture is evident. The radial prosthetic head again appears to be dislocated and does not articulate with bone. There is some lucency about the stem of the radial head prosthesis which could represent loosening, appearing similar to prior study. | Post-operative changes as above with possibly loosening of the radial head arthroplasty, appearing similar to the prior study. |
Generate impression based on findings. | Dysphagia and dysarthria. Dental artifact obscures much of the oral cavity and pharynx. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. The airways are patent. In fact, the trachea appears to be enlarged diffusely, suggestive of tracheomegaly. There are intracranial and carotid bifurcation vascular calcifications. There is mild mucosal thickening in the maxillary sinuses. The imaged portions of the lungs are clear. | No discernible upper aerodigestive track mass or extrinsic bony narrowing, although the evaluation is limited by the lack of intravenous contrast and dental artifact. However, there is suggestion of tracheomegaly. |
Generate impression based on findings. | 83 year old female with history of IDC s/p right lumpectomy and CRT, now presents with recurrent disease in left axilla. Focal increased activity in the left cervical spine, bilateral L4/L5 levels, and right L5/S1 level has progressed since the prior study but has the typical appearance of degenerative disease; this is also supported by same day CT findings. No suspicious osseous foci are identified to indicate metastatic disease. | No evidence of bone metastases. |
Generate impression based on findings. | Esophageal cancer initial treatment strategy. CT demonstrates suspicious lymph nodes and lung nodule. Past history of squamous cell tongue carcinoma.RADIOPHARMACEUTICAL: 11.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion grossly demonstrates mid esophageal stent with surrounding focal masslike esophageal thickening. A spiculated approximately 1 cm posterior right upper lobe lung nodule is present. Scattered additional tree in bud and ground glass pulmonary opacities are seen throughout the left lung. Extensive atherosclerotic including coronary arterial calcifications are seen.Today's PET examination demonstrates a large markedly hypermetabolic mid esophageal mass (SUV max = 13.2) compatible with esophageal carcinoma. Note PET superimposed inflammatory activity from the adjacent esophageal stent may result in overestimation of extent of tumor involvement.A small but significantly hypermetabolic lymph node is seen in the right lower paraesophageal location in the inferior mediastinum (SUV max = 3.8). This is very suspicious for a regional lymph node metastasis.There are multiple punctate more mildly FDG avid lymph nodes fairly symmetrically in bilateral hilar and paratracheal locations. While additional lymph node metastases cannot be entirely excluded, given the appearance granulomatous inflammation is considered more likely. A right hilar lymph node uptake is provided for reference (SUV max = 2.8).In the posterior right upper lobe, a small spiculated lung nodule is significantly and abnormally FDG avid particularly for size (SUV max = 3.6). This is highly suspicious for tumor. Given its location and morphology, a synchronous primary lung cancer is considered likely although metastatic disease is also conceivable.Scattered elsewhere throughout the left lung there are mildly hypermetabolic ground glass and tree in bud lesions which appear most likely inflammatory.No suspicious FDG avid lesion is seen within the abdomen, pelvis, or visualized skeleton. Increased soft tissue activity surrounding both hips is consistent with inflammation. | 1.Markedly hypermetabolic mid esophageal mass, compatible with the diagnosis of esophageal cancer.2.Single significantly hypermetabolic right lower paratracheal lymph node is very suspicious for regional lymph node metastasis. Additional milder symmetric hilar and paratracheal small lymph node activity considered more likely inflammatory than additional tumor.3.Small but markedly hypermetabolic posterior right upper lobe nodule is highly suspicious for malignancy. Synchronous primary lung cancer is favored although metastatic disease is also a possibility.4.No evidence of metastatic disease to the abdomen, pelvis, or skeleton. |
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. Small circumscribed masses in the right upper outer and left lower inner quadrants are stable. Arterial calcifications are also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 12-year-old male with history of injury to left kneeVIEWS: Left knee AP, lateral (two views) 3/19/15 Staples in the proximal lateral tibia and fibula are unchanged in appearance without evidence of hardware complication. The prongs of the staples are parallel. It is difficult to assess alignment of the medial aspect of the tibial epiphysis and physis. The medial part of the proximal tibia is not seen in profile. No new fractures identified. Small joint effusion. Extensor mechanism is unchanged in appearance. | Small knee joint effusion. Proximal lateral tibia and fibula staples with parallel prongs and no evidence of complication. |
Generate impression based on findings. | 76 year old with history of right lumpectomy in 1989 followed by radiation and chemotherapy. History of left lumpectomy in 2000 followed by radiation, chemotherapy and tamoxifen. History of breast carcinoma in daughter diagnosed at the age of 43 and maternal cousin diagnosed at the age of 52. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Stable architectural distortion is present in left lumpectomy bed. Stable benign calcifications are present bilaterally. Surgical clips project over the left axilla. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 10 years old Reason: evaluate for healing fracture History: left shoulder injuryVIEWS: Left humerus AP in internal and external rotation 3/19/15 (two views) There is no evidence of acute or healing fracture. Alignment is anatomic. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast biopsy. Two standard digital views of both breasts and additional bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Arterial calcifications seen in both breastsNo suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 57 year old with history of bilateral benign breast biopsies, presents for annual mammogram. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Linear markers were placed on scars overlying both breasts. Benign calcifications are present bilaterally. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. In view of patient's dense breast tissue, tomosynthesis will be useful at the next screening mammogram. Whole breast ultrasound screening may also be useful. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 10-year-old female with lung nodule. LUNGS AND PLEURA: Previously noted spiculated lung nodule in the left upper lobe now appears cavitated with a mural density measuring 1.5 x 1.1 cm (series 3, image 22). This is likely fungal in origin and may represent an aspergilloma. No other suspicious pulmonary nodules or masses are identified. No consolidation. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No significant mediastinal, internal mammary, cardiophrenic, or retrocrural lymphadenopathy. Anterior mediastinal mass is not significantly changed in size measuring 4.6 x 1.6 cm (series 3, image 33), previously measuring 4.6 x 1.7 cm. no mass effect is present on the adjacent vessels.CHEST WALL: Right chest port with tip at the cavoatrial junction. No axillary lymphadenopathy.UPPER ABDOMEN: Visualized portions of the kidneys, liver, spleen enhance normally. | 1. Left upper lobe nodule is now cavitated and may be fungal in origin. This is likely an aspergilloma.2. Anterior mediastinal mass is unchanged. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts (total of 10 images) were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Loosely grouped calcifications in the left upper outer quadrant anterior depth need further evaluation with spot magnification views.No suspicious masses or areas of architectural distortion are present. | Loosely grouped calcifications in the left upper outer quadrant anterior depth need further evaluation with spot magnification views.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 61-year-old female with history of right mastectomy in 2000 for breast cancer presents for annual mammogram. No current breast 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 elements. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. If the patient submits her old mammograms, we can compare them with the current study to establish stability.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 45-year-old female with knee pain after fall. Four views of the left knee demonstrate trace joint effusion without underlying fracture or malalignment. | Trace joint effusion without evidence of acute fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast aspiration. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 49 year old female s/p OLT with increased total bilirubin, LFTs. Angiographic images are unremarkable. Fairly prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is prompt but significantly diminished excretion of tracer into the biliary tree and duodenum, with associated prolonged retention of radiotracer in the blood pool and soft tissues. Photopenic region in the right upper quadrant is compatible with ascites and persists on next-day imaging, arguing against a biliary leak. | 1.No evidence of vascular occlusion, biliary occlusion, or biliary leak.2.Biliary excretion, while present, is diminished and suggestive of global hepatocyte dysfunction. |
Generate impression based on findings. | 66 year old male patient with history of right breast invasive ductal carcinoma status post right mastectomy in 2009. Patient received radiation, chemotherapy. No new breast complaints. History of breast cancer in sister. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 85 year old male with altered mental status. There are multiple unchanged supratentorial infarcts including within the bilateral thalami, left occipital lobe, and right frontal lobe. There has been evolution of the previously seen left parietal infarct. There is extensive low attenuation within the supratentorial white matter compatible with age indeterminate small vessel ischemic disease as well as interval development of a focus of low attenuation within the right frontal white matter compatible with age indeterminate infarction. There is atherosclerotic calcification of the distal internal carotid and vertebral arteries. There is global volume loss. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There is a right lens implant. | 1.No evidence of acute intracranial hemorrhage.2.Extensive age indeterminate small vessel ischemic disease, multiple chronic infarcts, and interval development of a right frontal age-indeterminate infarct. If there is concern for acute infarction, MRI 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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Circular skin markers were placed over both breasts. Stable scattered bilateral calcifications, including minimal arterial calcifications.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional CC views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. A few benign calcifications in both breasts are stable. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and additional MLO views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign calcifications are stable in both breasts, especially in the right medial breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 56 years old Reason: RUQ US to evaluate for cholelithiasis History: NA.History from PETCT indicates lymphoma. LIVER: Enlarged 20.4-cm in length with no focal lesions. Diffusely echogenic consistent with fatty infiltration.Flow in the portal vein is hepatopedal velocity .2 m/secGALLBLADDER, BILIARY TRACT: Normal gallbladder. No intrahepatic or extrahepatic biliary dilatation. Common bile duct .2 cm in diameterPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Increased echogenicity suggestive of medical renal disease. 10.2 cm in length. No hydronephrosis hydroureter.OTHER: Morphologically normal 10.2 cm in length containing two small cysts. No hydronephrosis or hydroureter.The previously seen splenomegaly is resolved in the spleen is now normal in size measuring 11.7 cm in length.No evidence of ascites | Enlarged, fatty liver. Echogenic kidneys. Prior splenomegaly is resolved. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 67 years old Reason: evaluate for mass or obstructive lesion History: abdominal pain. Additional history from pathology report of 10/19/5 indicates history of signet ring cell type poorly differentiated gastric adenocarcinoma in the distal gastrectomy specimen. ABDOMEN:LUNG BASES: Punctate micronodule right lower lobe series 4 image 8.LIVER, BILIARY TRACT: Noncalcified gallstones containing gas. No focal liver lesions. No intrahepatic or extrahepatic biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Moderate right-sided hydronephrosis and hydroureter due to compression by the enlarged uterus. Decreased nephrogram on the right consistent diminished renal function relative to the left side.RETROPERITONEUM, LYMPH NODES: Fat stranding throughout the retroperitoneum makes evaluation of adenopathy insensitive. I cannot see a discrete measurable retroperitoneal nodes. Mild atherosclerosis common evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild scoliosis and degenerative changes.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Enlarged necrotic uterine mass occupying the entire uterus, containing gas throughout the endometrial cavity and possibly within the mass itself suggestive of necrosis of tumor. For baseline purposes in the axial plane, the uterus is measured on series 2 image 92, 9.3 x 8.4 cm. In the sagittal plane length of the uterine masses measures about 12-cm in length on image 52.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Large necrotic uterine mass. Mass compresses the right ureter causing hydronephrosis and diminished right renal function.Postsurgical changes consistent with history of partial gastrectomy. Gallstones. Micronodular right lower lobe.Case discussed with Dr.Saint-Hilaire. |
Generate impression based on findings. | Male, 59 years old. Two curvilinear radiopacities projected over the right upper quadrant are consistent with fiducial markers which are identified on prior CT. No unexpected radiopaque foreign body. Surgical drain in situ with tip projected over the right upper quadrant. Enteric feeding tube tip projected over the pylorus. | No evidence of unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Hussein, the fellow to attending surgeon Dr. Millis by myself Dr. Ward 03/19/15 at 12:33 |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history breast cancer diagnosed in a mother at age 40. Two standard digital views and additional CC and MLO views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Left upper outer quadrant benign calcifications have slightly progressed. Stable additional scattered bilateral benign calcifications.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 73 years old Reason: elevated liver enzymes and ammonia; eval liver and gallbladder, AKI History: see above LIVER: 17 cm in length. No focal lesions. Prominent hepatic veins suggestive of right-sided heart failure.Flow in the portal vein is hepatopedal peak velocity .2 meters/secondGALLBLADDER, BILIARY TRACT: Few mobile gallstones. No gallbladder wall thickening or tenderness to compression. No Intra or extrahepatic biliary dilatation. Common bile duct measures .7 cm in diameter. Common hepatic duct .6 cm in diameter. Gallbladder wall normal in thickness.PANCREAS: No significant abnormality noted.SPLEEN: 7 cm in length.KIDNEYS: Echogenic consistent with medical renal disease.Right kidney 10.2 cm in length. Left kidney 9.1 cm in length. No evidence of hydronephrosis or hydroureter on either side. ABDOMINAL AORTA: Not visualized due to a gas.INFERIOR VENA CAVA: Prominent intrahepatic IVC consistent with right-sided heart failure. Remainder the visualized IVC is unremarkable.OTHER: No evidence of ascites. Right pleural effusion. | Cholelithiasis with no evidence of cholecystitis or biliary dilatation. Fatty liver. Prominent hepatic veins. Right pleural effusion. Echogenic kidneys. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in sister at age 44. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Circular skin markers are placed over the right breast. Multiple bilateral intramammary lymph nodes are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male, 59 years old. Fiducial markers are redemonstrated in the right upper quadrant. Stable position of surgical drain and enteric feeding tube. No unexpected radiopaque foreign body. | No unexpected radiopaque foreign body.Findings discussed by myself and Dr. Ward with Dr. Hussein, fellow to Dr. Millis 03/19/15 at 12:35 |
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. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in maternal grandmother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign calcifications, including arterial calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother age 40. 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. Circular skin markers were placed over both breasts. Scattered benign calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 68 years old Reason: h/o lymphoma please restage History: Rhinorrhea. CHEST:LUNGS AND PLEURA: Granuloma right lung series 5 image 57. Atelectasis or scarring left lower lobe.MEDIASTINUM AND HILA: Central venous catheter tip SVC about RA junction. Heavy atherosclerotic calcification coronary arteries.CHEST WALL: Healed rib fractures left lower chest. Poststernotomy changes. Port-A-Cath left chest wall.ABDOMEN:LIVER, BILIARY TRACT: Post cholecystectomy. No intrahepatic or extra hepatic biliary dilatation. No focal liver lesions.SPLEEN: Splenomegaly 17.1-cm as measured on coronal image 56. Large multifocal areas of hypoperfusion suggestive of multifocal areas of infarction. This is not seen on the CT of the chest of 1/23/15. Underlying involvement with patient's known lymphoma cannot be excluded within the spleen. There are no peri-splenic nodes however. There is no evidence of subcapsular or perihepatic fluid in the splenic artery and vein enhance normally.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic changes aorta with mild ectasia and mild dilatation but no evidence of frank aneurysm. Largest aortic dimension 2.6-cm as measured on coronal image 74.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Osteoporosis. Mild loss of height of several vertebral bodies but roughly stable. T11 and L2.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of ascites. Scattered colonic diverticulosis. No evidence of diverticulitis. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: Some areas of fatty replacement.OTHER: Atherosclerotic changes iliac system no evidence of aneurysm. | Enlarged spleen with multifocal areas of hypoattenuation may represent areas of infarction possibly related to involvement previously or currently with lymphoma. Discussed with Dr. Kenneth Cohen.Bulging of the abdominal aorta that does not meet criteria for aneurysm as measured in the coronal plane. |
Generate impression based on findings. | Lung cancer initial treatment strategy.RADIOPHARMACEUTICAL: 12.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates an approximately 5 cm superior right lower lobe pulmonary mass. A second approximately 3 x 4 cm left upper lobe pulmonary mass is also present. Enlarged left AP window lymph nodes are seen. Lytic lesions involve bilateral iliac wings.Today's PET examination demonstrates a medium to large markedly hypermetabolic left upper lobe mass (SUV max = 27.7) compatible with tumor, likely primary lung cancer.A large superior right lower lobe pulmonary mass is also markedly hypermetabolic (SUV max = 22.0) and also compatible with tumor possibly a second synchronous primary lung cancer. Several enlarged markedly hypermetabolic left AP window lymph nodes (SUV max = 14.5) indicate regional lymph node metastases. Multiple additional smaller and much milder avid lymph node seen in fairly symmetrically in bilateral hilar and subcarinal locations may reflect superimposed inflammation or less likely additional lymph node metastases.No suspicious FDG avid lesion is identified within the abdomen.Within the pelvis, two large markedly hypermetabolic foci corresponding to lytic osseous lesions involving bilateral iliac wings (SUV max = 20.7) indicate bone metastases. A more subtle but still suspicious hypermetabolic osseous lesion involving the left anterolateral fifth rib likely represents an additional bone metastasis. | 1.Two markedly hypermetabolic lung masses in the left upper and right lower lobes, compatible with tumor. These may reflect bilateral synchronous primary lung cancers or a single lung cancer with a contralateral pulmonary metastasis.2.Multiple hypermetabolic mediastinal lymph node metastases, most notably in the left AP window.3.Several markedly hypermetabolic bone metastases, most notably involving bilateral iliac wings. |
Generate impression based on findings. | The cervical spine is in normal alignment, with straightening of the normal cervical lordosis. The vertebral body and disk heights are well-maintained. There is mild disk desiccation at C2-C3 through C4-C5. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine. There is an incidental partially empty sella. There is relative platybasia. There is mild mucosal thickening in the maxillary sinuses. | Unremarkable MRI of the cervical spine aside from mild early disk desiccation along the upper cervical spine. No significant spondylotic changes. |
Generate impression based on findings. | Ependymoma status post surgery Two views the lumbar spine reveal laminectomy at L2, L3, and L4. Otherwise negativeTwo views of the thoracic spine reveal a slight scoliosis with convexity to the right. Otherwise unremarkable | Postsurgical changes in the lumbar spine. |
Generate impression based on findings. | There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber, without evidence of stenosis or occlusion.Both vertebral artery origins are patent. The vertebral arteries are co-dominant. There is no evidence of stenosis or occlusion.Axial and coronal fat saturated T1-weighted images are unremarkable within limitations of artifact, without evidence of mural hematoma.Focal tortuosity of the cavernous left internal carotid arteries is again noted. | Unremarkable MRA of the neck. |
Generate impression based on findings. | Female 76 years old Reason: H/o lymphoproliferative disorder s/p rituximab please restage History: LUQ discomfort CHEST:LUNGS AND PLEURA: Small scar left apex series 5 image 9. Unchanged from 3/10/14.MEDIASTINUM AND HILA: Risk changes hundred and andCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Post cholecystectomy. No focal liver lesions or biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst, and a few punctate probable cyst in the left kidney. Otherwise unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Atrophic or surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered colonic diverticulosis. No evidence of ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No pathologic size nodes. No evidence of splenomegaly or other findings to explain left upper quadrant discomfort. |
Generate impression based on findings. | Right-sided solitary pulmonary nodule. For lung cancer initial treatment strategy. Patient also describes a past history of bladder cancer with multiple prior bladder surgeries.RADIOPHARMACEUTICAL: 12.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion grossly demonstrates an approximately 2.5 cm lobular nodule in the right middle lobe, similar to recent diagnostic CT. Emphysematous changes are present most notably in the upper lobes. A large lobular soft tissue density mass with some peripheral calcification is seen within the bladder along its anterior margin, also not significantly change from recent diagnostic CT.Today's PET examination demonstrates the right middle lobe nodule to be markedly hypermetabolic (SUV max = 14.2). This is highly suspicious for malignancy, likely primary lung cancer.No additional suspicious hypermetabolic lesion is identified indicate metastatic disease. Specifically, the mediastinum and hilar regions as well as the liver, adrenal glands, and visualized skeleton demonstrate no suspicious FDG avid lesion.The anterior bladder mass demonstrates decreased activity relative to excreted physiologic urine. | 1.Markedly hypermetabolic right lobe middle lobe lung nodule, highly suspicious for malignancy, likely primary lung cancer.2.No suspicious FDG avid lesion to indicate metastatic disease.3.Large bladder mass demonstrates only slight FDG accumulation. However, FDG-PET is not accurate for evaluating bladder lesions and bladder malignancy is not excluded on the basis of this exam. Clinical correlation and correlation with cystoscopy is requested. |
Generate impression based on findings. | Male, 11 years old. History of constipation. Determine stool burden. VIEWS: Abdomen supine and upright (two views) 3/19/2015, 1236 Nonobstructive bowel gas pattern.Small to moderate stool burden.No pneumatosis, portal venous gas, or free air. | Small to moderate stool burden. |
Generate impression based on findings. | Female; 47 years old. Reason: 47 yo male with hx of resected retroperitoneal sarcoma; please evaluate for any abnormalities and or recurrence History: retroperitoneal sarcoma CHEST:LUNGS AND PLEURA: Multiple scattered pulmonary nodules are unchanged. Index right lower lobe nodule measures 6 x 6 mm (series 6/53), unchanged since prior study on 12/8/14. Slightly larger left lower lobe nodule is also unchanged. No new suspicious pulmonary nodules or masses. Minimal bibasilar subsegmental atelectasis and/or scarring. No pleural effusions.MEDIASTINUM AND HILA: Previously seen enlarged cardiophrenic lymph node has decreased in size. No mediastinal or hilar lymphadenopathy by CT size criteria. Normal heart size. No pericardial effusion. No visible coronary artery calcifications. Mild diffuse esophageal thickening, likely related to gastroesophageal reflux.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter hypoattenuating lesion in the posterior right hepatic lobe.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: Interval resolution of loculated fluid collection in the right inferior retroperitoneal resection cavity. Small amount of perihepatic ascites persists.There is a small lesion of predominantly fat density in the right superior retroperitoneum posteromedial to the right hepatic lobe along the right posteromedial diaphragmatic surface which measures up to 3.2 x 1.3 cm (series 4/90), which in retrospect was on prior exam dated 12/10/14 when it measured up to 2.7 x 0.9 cm. There is slightly increased soft tissue density seen at its the superior aspect (series 4/83). This lesion is suspicious for residual or recurrent liposarcoma with slight interval growth.BOWEL, MESENTERY: Jejunojejunal anastomosis appears patent. Prominence of jejunum proximal to the anastomosis has decreased, though some slight dilation persists, again likely reflecting post surgical change. Stable appearance of gastric band without evidence of slippage; normal angle of Phi measuring 54 degrees.BONES, SOFT TISSUES: Midline surgical scar.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Midline surgical scar.OTHER: Small amount of pelvic free fluid, likely physiologic. | 1. Small predominantly fatty right superior retroperitoneal lesion as detailed above suspicious for residual or recurrent liposarcoma with slight interval growth since 12/10/14.2. Interval resolution of loculated fluid collection within the right inferior retroperitoneal surgical bed. Small amount of perihepatic ascites persists. 3. Stable pulmonary nodules. No new suspicious pulmonary nodules or masses.Findings discussed by telephone with Dr. Rogan at 2:30 p.m. on 3/19/15. |
Generate impression based on findings. | Female 57 years old Reason: Evaluate interval change in size of pancreatic leak History: nausea and vomiting ABDOMEN:LUNG BASES: Unchanged subpleural nodularity. No pleural effusion.LIVER, BILIARY TRACT: Coarse left hepatic calcification is unchanged. Changes status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: Changes status post distal pancreatectomy, with associated surgical clips and fat stranding. Fluid collection in the expected region of the pancreatic neck measures 2.6 x 1.5 cm (image 42 series 3) previously 4.6 x 2.6 cm. Interval improvement of associated mass effect on the confluence of the splenic vein and SMV.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta.BOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: Midline anterior abdominal incision, with subcutaneous fluid collection measuring 2.5 x 1.1 cm (image 41 series 3) previously 2.1 x 0.9 cm.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Interval decrease in size peripancreatic fluid collection.2.Slight increase in size in subcutaneous fluid collection adjacent to midline incision, with mild surrounding inflammatory changes. |
Generate impression based on findings. | Male; 62 years old. Reason: Patient w/ fever, and elevated bili, evaluate for gallbladder dysfunction. Angiographic images are unremarkable. Slightly delayed extraction of radiotracer from the blood pool is noted. Subsequently, tracer accumulates uniformly within the liver. Fairly prompt excretion of radiotracer into the biliary system indicates a patent CBD, but the magnitude of tracer excretion is diminished as further evidenced by prolonged blood pool and background retention as well as persistent hepatic retention of the radiopharmaceutical at 3 hours. The gallbladder is not seen at one hour but begins to appear at two hours, compatible with a patent cystic duct. | 1.Patent cystic and common bile ducts without evidence of biliary obstruction or acute cholecystitis.2.Markedly prolonged hepatic retention of radiotracer, which is suggestive of nonspecific but significant global hepatocyte dysfunction. |
Generate impression based on findings. | 62 years, Female. Reason: evaluate for bowel distention/volvulus History: hypoactive bowel sounds, pain Scattered gas within the colon, but otherwise a generalized paucity of bowel gas. No evidence of pneumoperitoneum. | Paucity of bowel gas and no evidence of pneumoperitoneum. |
Generate impression based on findings. | 62 years, Male. Reason: 62M w/ mantle cell lymphoma and splenomegaly and acute onset abd/lower chest pain. eval for possible free air vs splenic rupture History: abd / chest pain No evidence of pneumoperitoneum. Scattered air-fluid levels best seen in the left lateral decubitus position may represent developing obstruction and continued follow up with abdominal radiographs is recommended. Streaky bibasilar opacity suggest atelectasis. Mild degenerative lower lumbar spine and hips. | Scattered air-fluid levels best seen in the left lateral decubitus position may represent developing obstruction and continued follow up with abdominal radiographs is recommended. |
Generate impression based on findings. | Reason: 55 F w/ likely HP now off steroids, improving. Eval for improvement History: see above. LUNGS AND PLEURA: Bilateral mild diffuse subpleural reticular opacities are markedly improved from the previous exam. No pleural effusion or suspicious pulmonary nodules.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No coronary calcifications detected. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Orthopedic hardware is noted in the lower cervical spine. Severe degenerative disease at T4-5. No suspicious focal osseous lesion is identified.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Marked interval improvement in subpleural opacities, which are nonspecific and differential considerations include organizing pneumonia, less likely hypersensitivity pneumonitis or NSIP. |
Generate impression based on findings. | 37 years, Female. Reason: lateral abdominal view standing , to eval shunt tubing. History: shunt , abdominal pain eval for changes Again seen is lumboperitoneal shunt catheter tubing with the tubing entering the spinal canal at the L2-3 level, without evidence of kinking or fracture of the imaged tubing . The Codman Hakim valve is set to approximately 90 mm H2O. Gastric band in place. | Imaged lumboperitoneal shunt catheter tubing intact, with the Codman Hakim valve set to approximately 90 mm H2O. |
Generate impression based on findings. | Male 24 years old; Reason: metastatic testicular cancer, s/p multiple surgeries, assess for progression CHEST:LUNGS AND PLEURA: New small left pleural fluid, in region of previously seen left paraspinal mass, and mild left posterolateral chest wall subcutaneous induration and nodularity, likely iatrogenic in etiology. Small lingular atelectasis/scarring. Indeterminant 2 mm left lower lobe pleural-based lung nodule, image 86 series 4. Stable 2 mm pleural-based nodular focus in right middle lobe, image 82 series 4. Micronodularity seen along left major fissure, without significant change accounting for differences in technique, may reflect intrapulmonary lymph nodes, measuring up to 5 mm on image 68 of series 4.MEDIASTINUM AND HILA: Multiple mediastinal surgical clips. No measurable disease seen at level of previously visualized necrotic subcarinal lymph node. Stable prominent right hilar lymph node, measuring 1.6 x 1.5 cm, nonspecific. CHEST WALL: Status post sternotomy. Bilateral gynecomastia. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple retroperitoneal surgical clips, related to prior nodal dissection. Cluster of retroperitoneal/left paraaortic lymph nodes again visualized, no significant change, for example, left paraaortic lymph node measuring 1.2 x 0.9 cm, image 147 series 3. Multiple subcentimeter upper abdominal preaortic lymph nodes with surrounding mesenteric fat stranding again seen, without significant change. Periceliac soft tissue induration. Mild left upper quadrant mesenteric fat stranding. Previously seen left psoas hypoattenuating focus not as well visualized. BOWEL, MESENTERY: Sigmoid colon diverticulosis without evidence of acute diverticulitis. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Stable left external iliac nodal mass, measuring 3.1 x 1.6 cm, image 191 series 3. Right internal iliac node essentially stable, measuring 2.2 x 1.4 m on image 177 series 3, previously measured 2.2 x 1.6 cm.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. | 1. New small left pleural fluid, in region of previously seen left paraspinal mass, and mild left posterolateral chest wall subcutaneous induration and nodularity and left upper quadrant mesenteric fat stranding, likely iatrogenic in etiology and correlation with patient's procedural history recommended. No measurable disease seen at level of previously visualized necrotic subcarinal lymph node. 2. Stable retroperitoneal and pelvic adenopathy as above. 3. Previously seen left psoas hypoattenuating focus not well visualized on current exam. |
Generate impression based on findings. | 60 year-old female with palpable lump in the right and left breasts. Right lump is tender. The skin over the palpable lumps are marked by Dr. Chhablani.Focused ultrasound did not detect cystic or solid masses at the area of palpable lump. Breast tissue in the right breastappears slightly hyperechoic, suggesting mild inflammation. | No solid or cystic mass in either breast. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
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: There is lobulated opacity in the dependent left maxillary sinus, likely representing mucosal retention cyst polyp. There is also focal opacity along the superomedial margin of the sinus, which partially opacifies the left accessory ostium. A patent right accessory ostium is visualized. The right maxillary sinus is 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 to moderate 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. | Small mucosal retention cyst or polyp along the floor of the left maxillary sinus. Patent bilateral ostiomeatal units. Mild-moderate nasal septal deviation. |
Generate impression based on findings. | 90 year-old female with history of bilateral hip and groin pain. Moderate osteoarthritis affects the right hip; mild/moderate osteoarthritis affects the left hip. There is no evidence of fracture or malalignment. There is osteophytosis of the pubic symphysis. Moderate degenerative changes affect the bilateral sacroiliac joints. There is significant degenerative disease of the lower lumbar spine, including lower lumbar facet joint osteoarthritis. Pedicle screws and fusion of L4-5 and evidence of prior laminectomy are noted. | Degenerative changes as described above. |
Generate impression based on findings. | There is a pattern of diffuse patchy diffusion restriction of the supratentorial cortex as well as the bilateral basal ganglia and thalami, which is better seen on the ADC map. There is associated diffuse T2/FLAIR signal abnormality as well as patchy T2 hyperintense signal of the deep gray nuclei and corpus callosum. There is thin gyriform T1 hyperintense and T2 hypointense signal of the cortex diffusely, suggestive of possibly early laminar necrosis. There is blurring of the grey-white junction.The brainstem and cerebellum are within normal limits. The ventricles and sulci are within normal limits, without significant sulcal effacement. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is fluid in the bilateral mastoids and middle ears.MRA HEAD | 1. Constellation of findings most suggestive of hypoxic-ischemic encephalopathy with associated mild cerebral edema. Additional superimposed conditions such as encephalitis or post-ictal appearance/status epilepticus cannot be excluded. Underlying abnormality such as mitochondrial disease is felt to be unlikely.2. Intracranial arterial structures are grossly patent.3. No evidence of venous sinus thrombosis. |
Generate impression based on findings. | 61-year-old female with neck cancer, evaluate for recurrence LUNGS AND PLEURA: The central airways are patent. No pneumothorax or pleural effusion. No suspicious nodules or masses. No focal consolidation. Scattered nonspecific subcentimeter micronodules.MEDIASTINUM AND HILA: Heart size is normal without pericardial effusion. No visible coronary calcifications are detected within the limitations of this non-gated study. The trachea and mainstem bronchi are patent. Aberrant right subclavian artery is noted, normal variant. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary, cardiophrenic, or retrocrural lymphadenopathy. No suspicious osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No specific evidence of metastatic disease. |
Generate impression based on findings. | Reason: history metastatic renal cancer, assess for progression History: none. LUNGS AND PLEURA: Previously seen right lower lobe nodule measures 8 mm (series 5, image 50), previously 4 mm. While no other suspicious pulmonary nodule identified, this lesion is suspicious for a solitary metastasis given the clinical history of malignancy.MEDIASTINUM AND HILA: Right IJ catheter tip at the superior cavoatrial junction. Heart size is normal. No pericardial effusion, and slightly irregular thickening is unchanged since at least 6/20/2013. No coronary calcifications detected.CHEST WALL: No suspicious focal osseous lesion.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy and right nephrectomy. Mildly atrophic pancreas. | Interval growth of a right lower lobe nodule, concerning for a solitary pulmonary metastasis. |
Generate impression based on findings. | Male; 51 years old. Reason: evaluate for disease recurrence, please compare to prior imaging 12/4/2014, 6/3/2014 History: history of BCLU lymphoma s/p EPOCH-R CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified, or unchanged. No new or suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Stable index right hilar lymph node measuring 1.1 x 1.1 cm, previously 1.1 x 1.1 cm (3/44). No mediastinal lymphadenopathy. Heart size is normal without pericardial effusion. No visible coronary artery calcifications.CHEST WALL: Right chest port with catheter tip in the SVC.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable small right nonobstructing renal stones. Mild prominence of the ureters bilaterally is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical findings related to partial colectomy with anastomosis at the ileocolonic region. No bowel obstruction or evidence of colitis.BONES, SOFT TISSUES: Small fat-containing paraumbilical and left inguinal hernias.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical findings related to partial colectomy with anastomosis at the ileocolonic region. No bowel obstruction or evidence of colitis. BONES, SOFT TISSUES: Small fat-containing paraumbilical and left inguinal hernias. Stable degenerative arthritic changes of the lumbar spine with grade 1 anterolisthesis of L5 on S1.OTHER: No significant abnormality noted | Stable examination with stable nonspecific right hilar lymph node. |
Generate impression based on findings. | 57 year old female with history of left mastectomy in 2012. Short term follow up recommended on 10/21/2014 for right lateral breast asymmetry. Family history of breast cancer in maternal grandmother diagnosed in 70s and paternal great aunt. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Previously described asymmetry in the right lateral breast is stable. Right inner breast biopsy clip is unchanged in position.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, right diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 74-year-old female with left foot pain, concern for osteomyelitis. Three views of the left foot demonstrate diffuse demineralization suggestive of osteopenia. There is no radiographic evidence of osteomyelitis. There is fusion of the middle and distal phalanges of the fifth digit, which may be postsurgical or related to remote trauma. There is moderate osteophytes of the first metatarsophalangeal joint with disk space narrowing and subchondral sclerosis. Erosions along the medial aspect of the head of the first metatarsal may reflect a history of inflammatory arthritis. Large osteophytes project from the dorsal aspect of the talus, suggesting osteoarthritis of the hindfoot. Extensive vascular calcifications are present in the distal leg and foot. | Degenerative changes of the foot as described above, without evidence of acute fracture or osteomyelitis. |
Generate impression based on findings. | 68-year-old female with history of lung malignancy, for evaluation CHEST:LUNGS AND PLEURA: Multiple bilateral irregularly marginated modules are again seen without significant interval change. These lesions are noted to have extension to the pleura as well as architectural distortion and retraction.Reference right upper lobe nodule measures 2.5 x 1.5 cm (series 5, image 137), previously 2.5 x 1.5 cm. Reference left lower lobe nodule along the major fissure is decreased in size measuring 2.4 x 3.3 cm, previously 3.0 x 3.6 cm (series 5, image 147). Index right lower lobe, superior segment nodule is unchanged in size measuring 1.3 cm (series 5, image 98). Additional scattered bilateral focal opacities are similar in size.Bilateral pleural effusions, left greater than right, are not significantly changed since prior exam.MEDIASTINUM AND HILA: Heart size is normal without pericardial effusion. Mild coronary artery calcification. The trachea and mainstem bronchi are patent. No significant mediastinal or hilar lymphadenopathy. Right chest port tip is at the superior cavoatrial junction.CHEST WALL: Multiple sclerotic osseous lesions are observed scattered throughout the thoracic and lumbar spine without evidence of interval change. Specifically no new blastic or lytic lesions observed.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged severe left kidney hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: IVC stent is again 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.No significant interval change in size reference pulmonary lesions as described above. Interval decrease in size of left lower lobe nodule likely reflect decrease in surrounding fluid around the solid component.2.Stable pleural effusions.3.Stable sclerotic osseous lesions. |
Generate impression based on findings. | Evaluation is limited by beam hardening artifact and portable technique. Patient is intubated. Redemonstration of stable bilateral frontal, right sylvian fissure, and bilateral occipital subarachnoid hemorrhage. No significant mass effect from the hemorrhage. No midline shift. Ventricle size is without change. Gray-white matter differentiation is preserved. Right maxillary sinus, bilateral sphenoid sinuses, and scattered ethmoid air cell opacity. | Stable appearing scattered foci of subarachnoid hemorrhage. |
Generate impression based on findings. | No intracranial mass or mass-effect. No midline shift or herniation. No abnormal parenchymal or meningeal enhancement. Contrast limits evaluation for small hemorrhages however no evidence of intracranial hemorrhage is appreciated. The gray-white matter differentiation is preserved. The ventricles and sulci are normal in size. Paranasal sinuses and mastoid air cells are clear. Calvarium is intact. | No CT evidence of intracranial metastatic disease. No intracranial mass or mass-effect. |
Generate impression based on findings. | 39-year-old male with history of right hip pain. Two views of the right femur demonstrate an intramedullary rod affixing a healed mid-diaphyseal fracture, in near-anatomic alignment, with proximal and distal interlocking screws. An old screw tract is noted in the distal femur.Single view of the right hip demonstrates gross deformity of the right femoral head with subchondral collapse and bony remodeling of the femoral head and acetabulum.Single view of the pelvis demonstrates the aforementioned deformity of the right hip. Left hip is within normal limits. | 1.Posttraumatic osteoarthritis of the right hip as described above.2.Healed right femoral fracture without hardware complications. |
Generate impression based on findings. | Reason: HCC, eval for metastases History: HCC. LUNGS AND PLEURA: Mild centrilobular emphysema. Right apical scarring, partially calcified. Scattered calcified micronodules, compatible with prior granulomatous disease. No suspicious pulmonary nodules identified. No focal consolidation or pleural effusion is present.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Severe aortic valve calcifications are noted. Mild coronary calcifications are seen. No significant mediastinal or hilar lymphadenopathy. Small hiatal hernia.CHEST WALL: No suspicious focal osseous lesion. Mild degenerative changes affect the visualized spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. Large right hepatic lobe lesion, better evaluated on recent CT. | No specific evidence of pulmonary metastases. |
Generate impression based on findings. | Reason: R/o mediatinal nodes. R/o recurrence. History: h/o medullary thyroid cancer, s/p resent resection of mediastinal nodes. Calcitonin decreased, but not fully. This is a follow up study.. LUNGS AND PLEURA: No suspicious pulmonary nodules. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Extending from the inferior margin of the thyroidectomy bed immediately deep to the new sternotomy site, there is infiltrative soft tissue density extending inferiorly to the level of the aortic arch in the right superior mediastinum. No discrete adenopathy in this area. This may represent post surgical change, however local recurrence cannot be excluded. Heart size is normal. No pericardial effusion. Severe coronary calcifications and mild tricuspid valve calcifications are noted. Prominent right hilar lymph nodes measure up to 10 mm in short axis (series 5, image 46).CHEST WALL: No suspicious focal osseous lesion. Sternotomy fixation and moderate degenerative changes of the visualized spine are noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Multiple left renal cysts and other bilateral subcentimeter hypodensities, too small to further characterize. | Ill-defined soft tissue density deep to the new sternotomy likely represents a postoperative changes, however local recurrence cannot be excluded. |
Generate impression based on findings. | 82 year old with history of right lumpectomy for breast cancer in 1989, followed by radiation and chemotherapy. A hard mass is palpated in the right breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. Right breast is significantly smaller than the left breast, due to prior surgery and radiation. The breast parenchyma is composed of scattered fibroglandular elements. Extensive arterial calcifications are present in both breasts. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. There is a very firm palpable mass in the right posterior upper outer quadrant, which feels like a part of rib cage or ossification /calcification. Focused ultrasound shows a dense shadowing structure without blood flow , consistent with benign calcified mass.Multiple attempts were made to radiograph the area of firm lump, but it was not successful. | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unchanged, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 53 years old Reason: LLQ pain, r/o diverticulitis History: Nausea, vomiting, diarrhea, LLQ abdominal pain ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral adrenal thickening.KIDNEYS, URETERS: Left renal hypoattenuating lesions, most likely representing cysts largest measuring 2 cm and the left inferior pole. RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: The distal end of the appendix is dilated, with extensive surrounding inflammatory changes/fat stranding, consistent with acute appendicitis. There is inflammation and wall thickening of the adjacent sigmoid colon secondary to the appendicitis. There is surrounding low-attenuation, which may be phlegmon/forming abscess possibly due to perforation but no discrete fluid collection is identified. No free air or pneumatosis is identified. Extensive inflammatory changes are presumably adherent to adjacent small and large bowel.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: Findings of acute appendicitis as described above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Findings of acute appendicitis, with extensive surrounding inflammatory changes including phlegmon/early abscess formation, possible perforation, and secondary inflammation in the colon. |
Generate impression based on findings. | There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. There is interval resolution of the left internal carotid artery dissection seen on 11/26/2014. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Mild motion artifact somewhat limits evaluation, but both vertebral artery origins are patent. The right vertebral artery is dominant. There is no evidence of flow-limiting stenosis or occlusion. There is no abnormality on the T1 fat sat images.Limited imaging of the intracranial structures demonstrate two left cerebellar lesions corresponding to previously seen lesions with T2 hypointense rims and susceptibility, compatible with previous hemorrhagic insults. | No evidence of previously seen left internal carotid artery dissection. Patent bilateral cervical internal carotid arteries. |
Generate impression based on findings. | Female 57 years old Reason: fracture, mass? History: severe elbow pain There is mild to moderate joint space narrowing at the radiocapitellar joint. There are small osteophytes. No acute fracture or malalignment. The soft tissues are unremarkable | Osteoarthritis of the radiocapitellar joint. |
Generate impression based on findings. | Postop, prosthetic assessment. Pain, preop. Two views of the left hip show a total left hip arthroplasty in anatomic alignment without evidence of hardware convocation. There is maturation of heterotopic bone about the lesser trochanter. No acute fracture is evident.AP view the pelvis additionally shows a right Birmingham hip resurfacing. No acute fracture is identified. Bone length radiographs show approximately 11 degrees of genu varus deformity. There is severe osteoarthritis of the left knee. | 1. Bilateral hip arthroplasties as above.2. Severe osteoarthritis of the left knee. |
Generate impression based on findings. | 62 year-old female status post right total knee arthroplasty. Two views of the right knee demonstrate hardware components of a total knee arthroplasty in near-anatomic alignment; no evidence of fracture or dislocation. Surgical clips, surgical drain, and iatrogenic gas are present in the soft tissues. | Total knee arthroplasty as above. |
Generate impression based on findings. | Reason: evaluate progression of pulm nodules, also evaluate cause of left sided rib pain History: rib pain. LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules are redemonstrated, unchanged in size and number. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Heart size is normal. Moderate coronary and aortic valve calcifications. No pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Healed left lateral fourth and fifth rib fractures noted. No suspicious focal osseous lesion identified. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. | Stable pulmonary micronodules.Healed lateral right fourth and fifth rib fractures. |
Generate impression based on findings. | 63-year-old male with history of left total shoulder arthroplasty. Single view of the left shoulder demonstrates hardware components of a left total shoulder arthroplasty in near-anatomic alignment, without evidence of hardware complication. Ossific densities are present in the axillary region. Subcutaneous gas is likely iatrogenic. A catheter device projects over the lower neck. | Total left shoulder arthroplasty as above. |
Generate impression based on findings. | Female 75 years old Reason: pre-op History: pain Severe osteoarthritis affects the right knee with bone on bone apposition in the medial compartment. There are tricompartmental osteophytes. There is slight compressive deformity of the medial tibial plateau which appears chronic.Contralateral left knee shows severe medial compartment joint space narrowing.Mechanical axis of the right lower extremity is 10 degrees of varus. | Severe osteoarthritis of the right knee with mechanical axis as detailed above. |
Generate impression based on findings. | There is focal oval area of intrinsic T1 hyperintensity within the posterior half of the anterior pituitary gland, abutting the posterior pituitary bright spot. There is corresponding T2/FLAIR hypointensity. Following contrast, this area does not demonstrate enhancement with respect to the surrounding enhancing glandular tissue. This area of abnormality measures 11 mm transverse by 6 mm AP by 7 mm CC. The lesion does not demonstrate dropout of signal on fat saturated postcontrast images. Although thin section coronal imaging is not available, images suggest that the upper margin of the perhaps slightly prominent gland does approach and may possibly abut the undersurface of the optic chiasm. The infundibulum has a slightly less vertical course than expected. The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no other areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The remainder of midline structures and craniocervical junction are within normal limits. | Subcentimeter T1 hyperintense and T2 hypointense lesion which does not enhance along the posterior half of the anterior pituitary gland. Slight prominence of the gland, likely within normal limits for the patient's age. Upper margin of the gland approaches and perhaps minimally abuts the undersurface of the optic chiasm without displacement. The finding may represent incidental hemorrhagic or proteinaceous pituitary cyst or other lesion. Correlation with serum hormones is recommended and clinical correlation is advised to exclude the possibility of recent pituitary apoplexy; follow-up imaging may be obtained as clinically indicated. |
Generate impression based on findings. | Pain and stiffness. Evaluate for osteoarthritis. Four views of the right knee show marked medial joint space narrowing. No acute fracture is evident. No joint effusion is seen.Four views of the left knee show marked medial joint space narrowing. No acute fracture is evident. No joint effusion is identified. | Marked osteoarthritis. |
Generate impression based on findings. | Female 83 years old Reason: trauma to L foot (fell) with pain x 2 weeks. hx of osteoporosis. r/o fracture History: L foot pain - ttp over 5th mtp distally Bone mineralization is decreased. There is mild hallux valgus deformity.There is a subtle minimally displaced fracture of the fifth metatarsal head best seen on the oblique radiograph. There is adjacent soft tissue swelling.Osteoarthritis affects the phalanges and the midfoot.There are Achilles tendon insertional enthesophytes and a small calcaneal heel spur | Subtle minimally displaced fracture of the fifth metatarsal head. |
Generate impression based on findings. | Clinical question: Rule out intracranial mass. Signs and symptoms: Headache. Nonenhanced head CT:There is no detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes. There is no evidence of mass or mass effect or midline shift.There is extensive periventricular and subcortical low attenuation of white matter highly suggestive of the indeterminate small vessel ischemic strokes. There is resultant mild expansion of lateral ventricles. Cortical sulci and CSF spaces are mainly the normal for patient's stated age.Calvarium and soft tissues of the scalp are unremarkable. Unremarkable orbits, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process or a mass.2.Findings of age indeterminate small vessel ischemic strokes of moderate to advanced degree. |
Generate impression based on findings. | Male 2 years old Reason: evaluate healing fracture History: right ankle fractureVIEWS: Right ankle AP, lateral and oblique 3/19/15 (3 views) Cast material obscures fine bone detail. Healing oblique fracture of the distal right tibia with callus formation and periosteal reaction is in anatomic alignment. | Healing fracture, in anatomic alignment after casting. |
Generate impression based on findings. | Female 69 years old; Reason: LUQ tenderness, hepatomegaly on exam, history of partial right nephrectomy for clear cell renal cell carcinoma ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Stable left hepatic dome hypoattenuating lesion, too small to characterize, image 23 series 3. Liver and spleen normal in size. SPLEEN: Liver and spleen normal in size. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post partial right nephrectomy with associated postsurgical sequela including right retroperitoneal surgical clips seen. Mild/moderate parenchymal heterogeneity at this level most likely iatrogenic in etiology. No definite enhancing soft tissue nodularity seen at level of postoperative bed to suggest local tumor recurrence. Symmetric renal parenchymal enhancement otherwise. Previously visualized nonobstructing right sided 6 mm calculus not seen. Mild asymmetric fullness of right adrenal collecting system, no significant ureteral dilatation seen. Ureter not followed along its course easily secondary to retroperitoneal surgical clips. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left-sided colon diverticulosis without evidence of acute diverticulitis. Normal appendix.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Stable nonpathologically enlarged small external iliac and inguinal lymph nodes.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance, degenerative spinal disease, endplate sclerosis most pronounced at L4/5 level. New right anterolateral ventral abdominal herniation of fat and portion of right colon, likely iatrogenic in etiology. | Normal sized liver and spleen.Postsurgical findings related to partial right nephrectomy as described. |
Generate impression based on findings. | Male, 15 years old. History of ligamentous injury.VIEWS: Cervical spine, flexion and extension (two views) 3/19/2015, 1354 The anterior atlantodental interval measures 6.2 mm on flexion, greater than normal for age.Unchanged mild pseudosubluxation of C2 over C3, a normal variant.No acute fracture.The cervical soft tissue structures are normal. | Findings compatible with atlantoaxial instability. |
Generate impression based on findings. | Male 67 years old Reason: L THA History: L THA Two views of the left hip shows a total hip arthroplasty device in near-anatomic alignment without radiographic evidence of hardware complication. Skin suture staples remain.AP pelvis shows the aforementioned left hip arthroplasty device.There is a right hip arthroplasty device with adjacent heterotopic bone formation.Osteoarthritis affects the lumbar spine. | Total left hip arthroplasty without radiographic evidence of hardware complication. |
Generate impression based on findings. | Female 70 years old Reason: pre-op History: pain Left knee: Bone mineralization is normal. There is severe joint space narrowing in the extensor compartment and moderate joint space narrowing in the lateral compartment. There are tricompartmental osteophytes. No acute fracture or malalignment. No joint effusion.Contralateral right knee shows a total right knee arthroplasty device in near-anatomic alignment.Single AP view of the pelvis shows mild osteoarthritis affecting both hips with tiny osteophytes. No acute fracture or malalignment.Mechanical axis of the left lower extremity is 3 degrees of valgus. | Severe left knee osteoarthritis and mechanical axis as detailed above. |
Generate impression based on findings. | 59-year-old female with chest radiograph abnormality LUNGS AND PLEURA: Central airways are patent. No pneumothorax or pleural effusion. A 5-mm nodule in the right lower lobe (series 5, image 48). Scattered nonspecific micronodules in the left lung. Atelectasis along the major fissure at the left lung base likely reflects the opacity seen on the prior radiograph.MEDIASTINUM AND HILA: Mild cardiomegaly. No pericardial effusion. No visible coronary calcifications are detected within the limitations of this non-gated study. The trachea and mainstem bronchi are patent. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Mild degenerative changes affect the spine. No axillary, cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Cystic lesion in the left lobe of the liver with simple fluid attenuation likely represents a benign cyst. Status post cholecystectomy. | Atelectasis along the major fissure at the left lung base likely reflects the opacity seen on the prior radiograph. |
Generate impression based on findings. | Evaluate total hip arthroplasty Two views of the right knee reveal a total knee arthroplasty in anatomic alignment. No fractures or dislocations . | Total knee arthroplasty in anatomical alignment |
Generate impression based on findings. | 70 year-old male with weight loss CHEST:LUNGS AND PLEURA: No pleural effusion. No suspicious nodule or mass. No focal consolidation. Scattered nonspecific micronodules.MEDIASTINUM AND HILA: Heart size is normal without pericardial effusion. Mild coronary artery calcification. The trachea and mainstem bronchi are patent. No significant mediastinal or hilar lymphadenopathy. .CHEST WALL: No suspicious osseous lesions. No axillary, cardiophrenic, or retrocrural lymphadenopathy. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Differential low attenuation of the right lobe of the liver may reflect fat infiltration. No focal liver lesions.SPLEEN: Splenule are present.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate calcifications within the left kidney may reflect passive calcification or nonobstructing renal stones, decreased in number from the prior exam. Multiple hypodense lesions in the kidneys bilaterally likely represent renal cysts. Additional subcentimeter hypodense lesions in the kidneys bilaterally are too small to further characterize but likely reflect additional renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Enlarged gastrohepatic ligament lymph node measures 11 mm (series 4, image 92) is unchanged. Mild atherosclerotic calcification of the abdominal aorta without evidence of aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Bone island in the left iliac wing. No suspicious osseous lesions.OTHER: No significant abnormality noted. | No findings to account for the patient's weight loss. |
Generate impression based on findings. | 47 years, Male, Reason: Eval for thrombus near non coronary cusp / LVAD outflow kink or thrombus History: increased power / ldh / signs of hemolysis Suspected Vad thrombus. CHEST:LUNGS AND PLEURA: Mild paraseptal emphysema. Calcifications are seen along the right posterior pleural which is thickened. There is a trace right pleural effusion and a small left pleural effusion with associated atelectasis. No suspicious nodules or masses are present.MEDIASTINUM AND HILA:There are enlarged paraesophageal, para-aortic and subcarinal lymph nodes. An enlarged right upper paratracheal node measures 1.4 cm in short axis (7/133). An aberrant right subclavian artery arising from a left aortic arch is present. A right internal jugular catheter tip terminates in the SVC.There is an LVAD with no evidence of obstruction of the inflow cannula throughout the cardiac cycle. There is a low density collection extending from the inferior aspect of the device within the left anterior chest wall musculature measuring approximately 10.7 x 5.3 cm. This measures slightly higher attenuation than water, possibly old hematoma or seroma. A portion of the drive line is within the collection, however the drive line itself is intact and is free of surrounding fat induration. The inflow cannula is free of thrombus. The outflow cannula extending to the ascending aorta is patent with normal sessile amount of mural thrombus lining the graft. No kink of the outflow cannula is present; the aortic anastomosis is nonstenotic.The left ventricle is dilated. A complete annuloplasty ring is present.CHEST WALL: ICD in the left chest wall with leads extending into the right atrial appendage, coronary sinus and right ventricular apex. Median sternotomy wires intact. Right IJ cental catheter terminates at the superior cavoatrial junction. There is low density focus at the confluence of the left and right brachiocephalic veins which is atypical for inflow venous mixing and raises the question of small venous thrombus. No central pulmonary embolus is present.ABDOMEN: Left adrenal nodule measuring 4.1 x 3.0 cm (80784/113) of water attenuation likely represents an adenoma. | 1.No evidence of LVAD outflow obstruction.2.Collection of slightly higher attenuation than water, possibly old hematoma or seroma, along the inferior aspect of the LVAD pocket within the anterior abdominal wall musculature. No enhancement to suggest abcess.3.Low density focus at the confluence of the left and right brachiocephalic veins which is atypical for inflow venous mixing and raises the question of small venous thrombus. No central pulmonary embolus is present.4.Small left and trace right pleural effusion. Right pleural calcifications may be from old hemorrhage/empyema or asbestos exposure.5.Left adrenal adenoma. |
Generate impression based on findings. | 73 years, Male. Reason: Dobbhoff placement History: Dobbhoff placement Respiratory motion limits evaluation. There is a Dobbhoff tube with its tip just beyond the GE junction, advancement is recommended. There is a nonobstructive bowel gas pattern. | Dobbhoff tube with its tip just beyond the GE junction, advancement is recommended. |
Generate impression based on findings. | Pain. Two views of the cervical spine show anterior osteophyte formation from C3 to C7. Alignment is anatomic. No acute fracture is evident.Three views of the lumbar spine show anterior osteophyte formation throughout the lumbar spine. There is degenerate disk disease at L3/L4, L4/L5, and L5/S1. No acute fracture is evident. | Degenerative changes as described above. |
Generate impression based on findings. | Pain. Two views of the right hip show severe osteoarthritis of the hip with exuberant osteophyte formation, severe joint space narrowing, and subchondral sclerosis. No acute fracture is evident.Additional AP view of the pelvis shows severe osteoarthritis of the left hip with exuberant osteophyte formation, severe joint space narrowing, and subchondral sclerosis. No acute fracture is evident. | Severe osteoarthritis of the bilateral hips. |
Generate impression based on findings. | History of fall, CVA. Question of osteoarthritis, fracture. Four views of the right knee show no acute fracture or malalignment. No joint effusion is identified.Four views of the left knee show no acute fracture or malalignment. No joint effusion is identified. | Normal appearing knees for the patient's age. |
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