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Generate impression based on findings. | Female 59 years old; Reason: infection, abscess, mets from CRC History: n/v/d, weakness, abdominal pain ABDOMEN:LUNG BASES: Extensive bilobar pulmonary metastatic disease. Calcified left hilar lymph nodes.LIVER, BILIARY TRACT: Liver is normal in morphology. No focal hepatic lesions. Hepatic and portal veins are patent.... | 1.No bowel obstruction.2.Cholelithiasis.3.Pulmonary metastases. |
Generate impression based on findings. | Female 41 years old Reason: assess instability History: left upper extremity radiculopathy Two views of the cervical spine are provided. Alignment is anatomic. Anterior osteophytes are again noted at C6, increased from prior exam. No evidence of acute fracture. Mild disk space narrowing at C5-6 and C6-7. | Degenerative changes, mildly progressed from prior exam. |
Generate impression based on findings. | Female, 9 years old. Status post fall on left side, with distal clavicular tenderness. Evaluate for fracture.VIEWS: Left shoulder, internal and external rotation (two views) 3/23/15, 2132 The humeral head is well directed into the glenoid fossa.The osseous structures and joint spaces are normal. | Normal examination. |
Generate impression based on findings. | Male; 36 years old. Reason: s/p perc chole now with acute abd. pain History: abd pain ABDOMEN:LUNGS BASES: Mild bibasilar dependent subsegmental atelectasis. Mild cardiomegaly. Mild mitral annular and coronary artery calcifications.LIVER, BILIARY TRACT: Interval placement of percutaneous cholecystostomy tube with tip w... | 1. Findings equivocal for mild, early appendicitis with new prominence of the appendix and mild nonspecific periappendiceal fatty stranding, which may be due to appendiceal inflammation versus postsurgical change from recent cholecystostomy tube placement. Folllow-up examination can be obtained as clinically indicated.... |
Generate impression based on findings. | 75 years, Female. Reason: replace NGT History: replace NGT Pelvis not included in the field of view. There is a nasogastric tube with its tip projecting over the middle third of the esophagus, with its side-port not included in the field of view. Again partially seen are dilated loops of small bowel measuring up to 4 c... | There is a nasogastric tube with its tip projecting over the middle third of the esophagus, with its side-port not included in the field of view. |
Generate impression based on findings. | There is hypoattenuation of the brainstem with extensive hemorrhage in the posterior fossa and bilateral cerebellum, increased in size from the prior examination. There is also increased edema with greater transtentorial and foramen magnum herniation and effacement of the fourth ventricle and aqueduct of Sylvius. An a... | 1.Progression of brain stem edema and progression of increased hemorrhage and edema in the cerebellar hemispheres are associated with greater transtentorial and foramen magnum herniation on today's exam compared to yesterday's exam.2.Increasing size of right occipital lobe parenchymal hemorrhage.3.Ventriculomegaly with... |
Generate impression based on findings. | 59 years, Male. Reason: evaluate for baclofen pump location and kinks in the system History: no improvement in spasticity with baclofen pump ?if tube is kinked Right lower quadrant baclofen pump in place, entirety of baclofen pump tubing not included in field of view, right lateralmost portion excluded, however imaged ... | Right lower quadrant baclofen pump, tubing incompletely imaged but imaged radioopaque portions without fracture or kinking. |
Generate impression based on findings. | Female 24 years old; Reason: r/o kidney injury History: vaginal bleeding ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEY... | 1.Etiology for the patient's vaginal bleeding is not evident.2.No CT evidence of kidney injury. |
Generate impression based on findings. | 49 years, Female. Reason: eval abdomen History: s/p ex lap There is a nasojejunal tube with its tip projecting over the proximal jejunum past the ligament of Treitz. There is a nasogastric tube with its tip projecting over the distal body of the stomach. Surgical clips project over the midline abdomen. IVC filter in pl... | Multiple dilated loops of dilated small bowel worrisome for small bowel obstruction. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (2/13/15, 2/25/15) performed at Northwestern Memorial Healthcare. For comparison, digital mammographic images (7/19/13) are available. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in p... | New cluster of calcifications at lower outer quadrant in the right breast. Stereotactic core biopsy is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 68-year-old male. History of GIST status-post chemo. Metastatic small cell lung cancer. Compare to previous study and evaluate treatment response. Lack of intravenous contrast limits for evaluation for solid organ and vascular structures.ABDOMEN:LUNG BASES: Moderate right and small left pleural effusions; refer to same... | Stable examination with unchanged perigastric lymph node and sclerotic vertebral body lesions. No new sites of disease. |
Generate impression based on findings. | Female, 5 months old. Intubated. Evaluate for interval change.VIEW: Chest AP (one view) 3/24/15, 0523 ET tube tip within the right mainstem bronchus. Enteric tube curled within the stomach. Lower extremity venous catheter, tip in the IVC.The cardiothymic silhouette is normal.Atelectasis involving the left lower lobe an... | Right mainstem bronchus intubation, with atelectasis of the right upper lobe and left lower lobes. |
Generate impression based on findings. | 51 years, Female. Reason: 51F w/ h/o abd pain and diarrhea on PDL1 inhibitor clinical trial (risk for colitis/perforation); eval for colonic dilation or free air History: abd pain There is a nonobstructive bowel gas pattern. Below average stool burden. Supine radiographs are insensitive for the detection of free air. | There is a nonobstructive bowel gas pattern. Supine radiographs are insensitive for the detection of free air. |
Generate impression based on findings. | 66 years, Male. Reason: eval stool burden History: pre colonoscopy, abd distention Below-average stool burden. There is a nonobstructive bowel gas pattern. There is mild gaseous distention of the stomach. Surgical clips project over the right upper quadrant. Degenerative changes of lower lumbar spine hips. | Below-average stool burden. |
Generate impression based on findings. | 79 years, Male. Reason: evaluate Dobbhoff placement History: Dobbhoff replaced There is a Dobbhoff tube with its tip projecting over the fundus of the stomach, with the guidewire still in place, and the tubing appearing kinked at the distal end of the guidewire. Surgical wires and clips project over the midline thorax.... | Dobbhoff tube with its tip projecting over the fundus of the stomach, with the guidewire still in place, tubing appears kinked at the distal end of the guidewire. |
Generate impression based on findings. | Reason: evaluate extent of involvement of mass History: intraoral mass Study is limited by lack of intravenous contrast.There is large invasive soft tissue mass in the left hemi-oral cavity. Exact measurements of the mass is limited by inability to distinguish between soft tissue component and obstructive sinus secreti... | Large invasive soft tissue mass in the left hemi-oral cavity with bony destructions and suspected perineural spread as above. Contrast studies of the CT of the neck and MRI of the head and skull base are recommended for further evaluation. |
Generate impression based on findings. | 3-day-old male post UAC and UVC placementVIEWS: Chest and abdomen AP (two views) 3/23/15 at 2116 Endotracheal tube is between the thoracic inlet and the carina. The nasogastric tube tip and proximal sidehole is in the gastric body. UAC is between the level of T5 and T6. The UVC is in the right portal vein.The cardiothy... | UVC in right portal vein. Persistent mild diffuse granular lung haziness consistent with surfactant deficiency. |
Generate impression based on findings. | 71-year-old with history of left lumpectomy for breast cancer in 2011. Patient received adjuvant radiation therapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements... | 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. | Male, 1 day old. Reason: check UAC placement VIEW: Chest and abdomen AP (two views) 3/23/15, 2055 The umbilical artery catheter is curled within the lower abdomen, with tip directed inferiorly in the right lower quadrant, likely within an iliac artery branch.Enteric tube with distal side port below the level of the GE ... | Malpositioned umbilical artery catheter, with tip likely within an iliac artery branch. |
Generate impression based on findings. | 44 years, Female. Reason: 44 female with metastatic breast cancer, nausea/vomiting, assess for obstruction/free air History: nausea/vomiting Right lower lobe pleural effusion. Bibasilar opacities are better evaluated on the chest radiograph from the same day. There is a nonobstructive bowel gas pattern. Below average s... | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | 68-year-old male history of metastatic small cell lung carcinoma status post chemotherapy. LUNGS AND PLEURA: A large right pleural effusion has significantly increased in size when compared to prior with fluid now present within the major fissure. Referenced right upper lobe parenchymal and pleural based nodules are no... | Increase in size of large right pleural effusion. Accurate tumor measurements are difficult due to adjacent pleural fluid, however referenced right mediastinal lymph node conglomerate has not significantly changed. |
Generate impression based on findings. | 67 years, Female. Reason: nausea and vomiting History: N//V The nasogastric tube has been removed. The bilateral surgical drains have been removed. The skin staple line is no longer evident. Anastomotic suture material is seen in the right lower quadrant. Surgical clips project over the mid pelvis. Bilateral pleural ef... | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | There is redemonstration of postoperative changes from previous craniotomy for resection of a high right frontal parietal convexity meningioma. There is stable appearance of underlying FLAIR hyperintense encephalomalacia and hemosiderin staining at the convexity, along the superior right frontal gyrus. There is again ... | 1. Stable postoperative changes without evidence of meningioma recurrence.2. Stable appearance of small additional meningioma along the right temporal lobe.3. Stable mild-moderate chronic small vessel ischemic changes. |
Generate impression based on findings. | 66-year-old female. Endometrial cancer. Compare to 1/7/2015 scan and provide bidimensional measurements per RECIST. CHEST:LUNGS AND PLEURA: Right lower lobe reference subpleural nodule is 1.2 cm (series 5, image 70), previously 0.5 cm, consistent with a metastasis.Near complete resolution of previously seen left lung b... | Right lower lobe nodule has significantly increased in size, consistent with a metastasis. Mild increased size of large destructive sacral mass. Other reference lesions are not significantly changed. |
Generate impression based on findings. | Lower back pain following fall. Evaluate for fracture. Five views of the lumbar spine show severe disk space narrowing at L4/L5 with grade 1 anterolisthesis of L4 on L5. There is severe disk space narrowing at L5/S1 with vacuum disk phenomenon. Extensive vascular calcifications are noted.AP view of the pelvis and two v... | Right femoral neck fracture. |
Generate impression based on findings. | 74 year old female status post right lumpectomy in 2001 lumpectomy for DCIS, presents today for routine follow up. Patient received radiation therapy and Tamoxifen. No current breast complaints. No family history of breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid o... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 51 years old; Reason: Appendicitis? History: RLQ abdominal pain ABDOMEN:LUNGS BASES: Minimal basilar scarring/atelectasis.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion.SPLEEN: No focal splenic lesion.PANCREAS: No focal pancreatic lesion.ADRENAL GLANDS: No adrenal nodularity or thick... | No evidence of appendicitis. |
Generate impression based on findings. | Known femoral neck fracture. Evaluate for distal femur fracture. Two views of the right femur again show a right femoral neck fracture with superior displacement of the distal fracture fragment. No distal femur fracture is identified. There are extensive vascular calcifications. Degenerative changes are noted at the ri... | Right femoral neck fracture. |
Generate impression based on findings. | 73 year old female with history of dyspnea exertion and cough for 6 months since starting methotrexate therapy. LUNGS AND PLEURA: Minimal bilateral pleural thickening and atelectasis, but otherwise no significant pulmonary abnormality. No specific evidence of methotrexate toxicity.MEDIASTINUM AND HILA: The heart size i... | 1. No specific evidence of methotrexate pulmonary toxicity.2. Enlarged and nodular thyroid gland. A dedicated thyroid ultrasound may be considered if clinically warranted.3. Minimal pleural nodularity has the appearance of a resolving pleural effusion. If possible, comparison to outside imaging would be helpful to conf... |
Generate impression based on findings. | Patient had fall onto back last night after slipping. Patient landed flat on back. L-spine tenderness. Five views of the lumbar spine show no acute fracture. Vertebral body heights and disk spaces are preserved. Alignment is anatomic. Minimal anterior osteophytes are noted compatible with minimal degenerative. | Minimal degenerative change without acute fracture. |
Generate impression based on findings. | Swelling. Evaluate for osteomyelitis. Three views of the right ankle show no acute fracture or malalignment. There is soft tissue swelling about the ankle.Three views of the right foot show a small linear metallic density in the lateral plantar soft tissues with associated swelling; this likely represents a foreign bod... | Linear metallic foreign body in the plantar soft tissues likely represents a foreign body; correlate with physical examination. No radiographic evidence of osteomyelitis. |
Generate impression based on findings. | Female; 93 years old. Reason: Evaluate for expansion of thoracoabdominal aneurysm, PE (secondary) History: Chest pain, tachycardia CHEST:LUNGS AND PLEURA: Right upper lobe mass suspicious for primary lung carcinoma measures 3.2 x 2.9 cm (series 8/26), previously 3.2 x 2.9-cm. New mild hypoattenuation centrally within t... | 1. Stable size of thoracoabdominal aortic aneurysm since prior study on 1/22/15 without evidence of acute dissection or rupture. Interval increased eccentric mural thrombus throughout the aorta when compared to prior contrast enhanced exam on 7/18/14.2. Stable size of right upper lobe mass, presumed to represent a carc... |
Generate impression based on findings. | Female 73 years old; Reason: rule out recurrence or metastasis History: history of renal cell carcinoma, sp nephrectomy ABDOMEN:LUNGS BASES: Emphysema.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. Multiple large gallstones are redemonstrated, unchanged.SPLEEN: No focal splenic lesion.PANC... | No specific findings of tumor recurrence or metastases. |
Generate impression based on findings. | 8 year-old male with increased work of breathingVIEWS: Chest AP/lateral; abdomen upright and supine (4 views) 3/24/15 Mediastinal surgical clips remain in place. Catheter is present at the junction of the IVC and right atrium.Chest: The cardiothymic silhouette is unable to be evaluated on this exam pulmonary opacities.... | Interval improvement of aeration of the right lung with persistent postsurgical changes and subsegmental atelectasis. Disorganized bowel gas pattern with air-fluid levels, obstruction cannot be excluded on this examination. |
Generate impression based on findings. | 44 year old with lumpy left breat, which is larger than the right breast, 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 composed of scattered fibroglandular elements. The left breast is slightly larger than... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 61-year-old male history of kidney neoplasm. Evaluate for progression of metastatic disease. CHEST:LUNGS AND PLEURA: Persisting small right lower lobe pleural effusion with adjacent atelectasis. Slight convex nature at the apex of atelectasis is seen (series 4 , image 79 and series 3, image 79) which may relate to roun... | 1. Status post right nephrectomy. 2. Increasing size of left supraclavicular and paraesophageal lymph node metastases. 3. Minimal change in right hepatic or perihepatic metastatic lesion. 4. Either rounded atelectasis or focal metastatic lesion in right lung base posteriorly, unchanged. 5. Right pleural effusion and at... |
Generate impression based on findings. | 66 years, Female. Reason: assess for obstruction History: nausea, emesis, melena, abdominal pain Limited study, right flank is not entirely included in field of view. There are dilated loops of small bowel measuring up to 3.4 cm in diameter which are seen in the transverse colon; these findings are suggestive of a part... | Evidence of partial small bowel obstruction. A radiolucent focus is seen in the liver without evidence of surrounding radiolucent foci, this may represent pneumobilia or may be artifactual in nature. |
Generate impression based on findings. | 47 years Female with HCC status post right lobe hepatectomy, assess ascites, organomegaly; Dopplers to rule out portal/hepatic vein thrombosis. LIVER: Status post right lobe hepatectomy. The left lobe measures 14.3 cm in length and demonstrates coarse, heterogeneous echotexture. Mass lesion cannot be excluded.GALLBLADD... | 1.Patent hepatic vasculature.2.Status post right hepatectomy. Heterogeneous echotexture likely reflects known cirrhosis, though mass lesion cannot be excluded.3.Large right pleural effusion with probable loculations abutting the right diaphragm. |
Generate impression based on findings. | Prematurity. Umbilical line placement.VIEW: Chest and abdomen AP (two views) 3/24/15 at 617 hours. Right mainstem bronchus intubation. UAC terminates at T8 and UVC tip is at the right atrium. Cardiac silhouette size is normal. Improvement in bilateral lung aeration with interval resolution of focal opacities. Minimal d... | Misplaced ET tube and repositioning of umbilical lines as described.Interval resolution of focal opacities with persistent lung haziness likely due to RDS. Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Reason: evaluate for metastasis. History: seizure The patient is status post right parietal craniotomy for removal of a mass. There is encephalomalacia present at the right parietal lobe at the location of the patient's prior mass.The visualized portions of the paranasal sinuses are clear. The visualized portions of th... | 1.Although there is no evidence on this CT scan for new metastatic disease, MRI and with gadolinium is more sensitive in detecting metastases then a noncontrast CT of the head. Indeed, a recent MRI from 2/9/15 indicates the presence of a left cerebellar mass which cannot be readily appreciated on this noncontrast CT of... |
Generate impression based on findings. | Male 16 years old History: fractureVIEWS: Right AP, lateral and oblique 3/24/15 (3 views) Right tibial distal epiphyseal screw are again noted. Healing fracture is in anatomic alignment. | Healing fracture, in anatomic alignment with no evidence of hardware complications. |
Generate impression based on findings. | Postoperative changes are evident bilaterally at the L2-L3 and L3-L4 with partial resection of the ligamentum flavum and suggestion of medial facetectomies. Laminotomy defects are also suggested.The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are stable, with... | 1. Interval postoperative changes with improvement of the appearance of the central spinal canal at L3-L4 and minimally at L2-L3.2. Left lumbar paraspinal muscular edema which may be posttraumatic. Please correlate clinically.3. No significant interval change in multilevel severe spondylosis as detailed above. This inc... |
Generate impression based on findings. | Male, 41 days old. Reason: r/o signs of free air concerning for NEC History: distended, firm belly, bilious emesisVIEWS: Abdomen AP, crosstable lateral (two views) 3/24/15, 0057 Enteric tube tip in the stomach, with distal side port just above the level of the GE junction. Right central venous catheter, tip in right at... | Gastric distention and paucity of bowel gas, without free air. |
Generate impression based on findings. | InjuryVIEWS: Right elbow AP and lateral 3/24/15 (two views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Status post fracture.VIEWS: Left forearm AP and lateral 3/24/15 (two views) Healing fractures of the left radius and ulna diaphyses are in anatomic alignment. Fracture lines are less conspicuous. | Healing fractures in anatomic alignment. |
Generate impression based on findings. | Right first finger pain after fall.VIEWS: Right hand AP, lateral and oblique on 3/24/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 1-year-old female with respiratory insufficiencyVIEW: Chest AP (one view) 3/24/15 at 0840 Gastrostomy and tracheostomy tubes are unchanged. Cardiac silhouette is unable to be assessed due to left lung atelectasis. Persistent complete opacification of the left hemithorax secondary to complete atelectasis of left lung. I... | Persistent complete atelectasis of the left lung with improved aeration in the right lung. |
Generate impression based on findings. | Abdominal distention. Brown residuals.VIEW: Abdomen and chest AP (two views) 3/24/15 at 855 hours. Right mainstem bronchus intubation. NG tube terminates in the stomach. Mediastinal clip unchanged. Cardiac silhouette size is normal. Right upper and left lower lobe atelectasis on a background of diffuse lung haziness. N... | Right mainstem bronchus intubation with multifocal opacities and diffuse lung haziness. Normal abdominal gas pattern. |
Generate impression based on findings. | Female; 86 years old. Reason: TAVR evaluation, pulmonary nodule evaluation History: TAVR eval, pulm nodule seen on CXR VESSELS:Severe atherosclerosis of the abdominal aorta and its branch vessels with smallest residual luminal diameters detailed below. Atherosclerotic narrowings of the origins of the celiac artery, SMA... | 1.Severe atherosclerosis of the abdominal aorta and its branch vessels causing decreased luminal diameters as detailed above.2.7-mm focus of arterial hyperenhancement in the superior pole of the right kidney, which may be due to intraparenchymal aneurysm versus solid lesion. 3.Nonspecific loculated pelvic fluid collect... |
Generate impression based on findings. | 56 year old with history of occult primary right breast cancer status post right axillary lymph node dissection, chemotherapy and radiation therapy in 2010. History of benign left breast biopsy. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, ... | 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. | 10-month-old female, a nasojejunal tube.VIEW: Chest AP (one view) 3/24/15 Left-sided central line with tip in SVC. Feeding tube tip may be coiled in the stomach or near the duodenojejunal junction. An IVC stent is present. Partially visualized biliary drain is unchanged. Multiple surgical clips and staples are noted in... | Feeding tube tip may be coiled in the stomach or near the duodenuojejunal junction. If no biliary outflow is obtained from NJ tube, recommend installation of approximately 30 cc of air to confirm position when next clinically necessary abdominal radiograph is obtained. |
Generate impression based on findings. | Premature with coffee ground emesis , or 4 perforation.VIEWS: Chest and abdomen AP, abdomen cross table lateral (3 views) 3/24/15 at 901 hours. ET tube terminates below the thoracic inlet. Central line tip is at the right atrium. NG tube proximal side ports are above the GE junction. Mediastinal clip unchanged.Cardiac ... | Multifocal opacities.Almost complete gasless abdomen with no evidence of free air. |
Generate impression based on findings. | Palpable area of concern in the right breast. Three standard views of both breasts and right spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No dominant mass, suspicious microcalcifications or areas of archit... | No mammographic evidence of malignancy. No suspicious finding at the palpable area of concern. Correlation with physical examination is recommended and if physical exam findings are discordant with benign imaging, further evaluation such as referral to breast surgery is recommended. Otherwise, bilateral screening mammo... |
Generate impression based on findings. | 58 year old female status post right lumpectomy in 2012 for invasive ductal carcinoma and DCIS with nodal involvement, presents today for routine follow up. Patient received radiation, chemotherapy, and Arimidex. No current breast complaints. Family history of breast carcinoma in her sister and maternal first cousins. ... | Stable postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagno... |
Generate impression based on findings. | 59-year-old male with history of GI stromal tumor. Screening CT. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules again seen, some of which are calcified. No significant change. No new foci of airspace disease seen. No pleural disease.MEDIASTINUM AND HILA: Stable appearance to the prior reference anterior media... | 1. No evidence of recurrent or metastatic disease from GI stromal tumor. 2. Multiple small skin lesions seen consistent with patient's known history of neurofibromatosis. 3. Small ventral abdominal wall hernia containing small bowel without complication. 4. Bilateral inguinal hernias containing only mesenteric fat. |
Generate impression based on findings. | Female; 19 years old. Reason: rule out warm or toxic nodule vs. thyroiditis History: palpitations, heat intolerance. Recent TSH lower limits of normal with normal T4. The thyroid images demonstrate uniform activity in a gland of normal size and configuration. No discrete hot or cold nodules are identified. The 3-hour r... | Uniform thyroid activity with upper normal to slightly elevated uptake. This uptake may be inappropriately high in the setting of low TSH, possibly reflecting mild Graves disease. |
Generate impression based on findings. | 62 year-old female with HBV, evaluate for HCC. LIVER: Coarse echotexture of the liver measuring 13.7 cm in length. No focal hepatic lesions. The main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Shadowing stones within the gallbladder. No gallblad... | 1. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions.2. Cholelithiasis with no evidence of cholecystitis. |
Generate impression based on findings. | Infiltration of the neck fat planes is again noted, most likely due to post-treatment changes.PHARYNX/LARYNX: There is persistent prominence of soft tissue along Waldeyer's ring, likely similar allowing for differences in soft palate position. The nasopharynx, oropharynx, hypopharynx, and larynx are otherwise unremark... | 1. Interval further enlargement of pathologic appearing right greater than left cervical lymphadenopathy and new right level IIb lymph node. Persistent slight prominence of soft tissue along Waldeyer's ring. Findings could represent recurrent disease, although other etiologies for isolated cervical lymphadenopathy rema... |
Generate impression based on findings. | 61-year-old female. Right renal transplant with hematuria. Evaluate for lesions. RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality noted. No perinephric collection.KIDNEY: Normal echogenicity of the transplant kidney, which measures 10.6 cm in length and contains a 1.2 cm c... | No focal mass in the transplant kidney as clinically questioned. Unremarkable transplant renal vasculature. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of left breast (2/19/15) performed at Christie Clinic. An oval-shaped, circumscribed hypoechoic mass measuring 18 x 11 mm is visualized at 5 o'clock position, 1 cm from nipple in the left breast. Some blood flow near the surface of... | Benign appearing mass in the left breast at 5 o'clock position, likely a fibroadenoma. Short term follow-up with ultrasound can be performed in 6 months. Alternatively, palpation guided biopsy may be performed if clinically indicated. BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No ... |
Generate impression based on findings. | 51 year old male status post right partial nephrectomy, please assess differential function. The posterior abdominal radionuclide angiogram demonstrates absent blood flow in the right inferior pole, compatible with partial nephrectomy. Brief hyperemia within a lesion in the left mid kidney corresponds to the known rena... | 1.Abnormal renal morphology bilaterally reflecting partial right nephrectomy as well as large left mid renal mass. The remaining renal parenchyma functions normally and without evidence of obstruction. 2.Mildly asymmetric renal parenchymal functional contribution, left providing more function than right, as quantified ... |
Generate impression based on findings. | Male 63 years old Reason: 63 yo M with history of esophageal rupture in January 2015 s/p esophageal stenting, esophagram to confirm healing History: history of esophageal perforation. Scout radiograph of the chest unremarkable. Postprocedural hardware is seen in the area of the distal esophagus. Single contrast evaluat... | 1. No frank extravasation of contrast to suggest an esophageal leak. 2. Mildly delayed transit of contrast through the GE junction, may reflect localized edema given recent instrumentation in region, no fixed luminal narrowing demonstrated. |
Generate impression based on findings. | Female 51 years old Reason: History of dysphagia. Unclear etiology. An EGD showed no lesions in the esophagus other than esophagitis. History: Dysphagia. Scout radiograph of the chest demonstrate subtle bibasilar opacities suggest atelectasis.Double contrast evaluation of the esophagus and gastric cardia/fundus reveale... | 1.Spontaneous gastroesophageal reflux to the level of the thoracic inlet.2.Small hiatal hernia. |
Generate impression based on findings. | 73 years, Male. Reason: New NGT placement. Eval for placement in stomach History: As above There is a nasogastric tube with its tip projecting over the fundus of the stomach. There is a right nephroureteral stent in place. Surgical clips project over the right upper quadrant.There are multiple markedly dilated loops of... | 1.NG tube the tip projecting over the fundus of the stomach.2.Multiple dilated loops of small bowel and gas in the colon suggestive of ileus or partial small bowel obstruction. |
Generate impression based on findings. | 65 years old male with pancreatic cancer on chemo holiday. CHEST:LUNGS AND PLEURA: Minimal basilar scarring/atelectasis. No suspicious pulmonary nodules. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Right chest wall port catheter tip at the superior cavoatrial junction. No coronary calcifications de... | 1.Interval increase in size of pancreatic mass with new splenic vein thrombosis.2.Marked interval increase in size and number of hepatic metastases. |
Generate impression based on findings. | 66-year-old male. History of T1 HG bladder cancer managed with BCG 2003, now with hematuria. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Subcentimeter hypoattenuating focus in the right hepatic lobe is too small to characterize (series 7, image 22). Nodular peripherally enhancing lesion in... | Eccentric wall thickening of the anterior and left bladder, concerning for primary bladder malignancy. No evidence of metastatic disease. |
Generate impression based on findings. | Female; 66 years old. Reason: lung cancer History: lung cancer ABDOMEN:LUNG BASES: Increased right lower lobe masslike consolidation. Please see report from dedicated CT chest performed concomitantly.LIVER, BILIARY TRACT: Mild hepatomegaly, similar to prior study. Hypoattenuation in the region of the falciform ligament... | 1. No evidence of metastatic disease in the abdomen and pelvis.2. Increased right lower lobe masslike consolidation. Please see report from dedicated CT chest performed concomitantly. |
Generate impression based on findings. | Male 44 years old Reason: Evaluate stability of spine and r/o abnormality History: Neck, right arm and right lower extremity pain Four views of the lumbar spine are provided. Alignment is anatomic. Vertebral body heights are maintained. No acute fracture.Four views of the cervical spine are provided. Anterior sideplate... | Orthopedic fixation of C4 through C6 without evidence of complication. Normal exam of the lumbar spine. |
Generate impression based on findings. | 10-year-old female with pes planovalgusVIEWS: Left and right foot weight-bearing AP, oblique, lateral and (6 views) 3/24/15 Left foot: Calcaneal pitch measures 17 degrees. The talocalcaneal angle measures 32 degrees. No fractures.Right foot: Calcaneal pitch measures 17 degrees. The talocalcaneal angle measures 31 degre... | Mild pes planovalgus as detailed above. |
Generate impression based on findings. | Reason: 51 yo F with ?ARDS History: hypoxia LUNGS AND PLEURA: There is consolidation of the left lower lobe with and associated small left pleural effusion.Diffuse air space and groundglass opacities throughout both apical sparing is compatible with extensive edema, although hemorrhage cannot be excluded.Right dependen... | 1.ET tube tip within the proximal right mainstem bronchus.2.Complete consolidation/atelectasis of the left lower lobe with associated small left pleural effusion. Concomitant infection cannot be excluded. 3.Diffuse air space and groundglass opacities compatible with compatible with extensive edema, although hemorrhage ... |
Generate impression based on findings. | 56 year old with history of occult primary right breast cancer status post right axillary lymph node dissection, chemotherapy and radiation therapy in 2010. History of benign left breast biopsy. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, ... | 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. | 40 year-old male history bladder cancer status post radical cystectomy. Evaluate for metastatic disease. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted in the liver. Status post cholecystectomy with slight prominence of the proximal biliary tract but without ... | 1. Status post cystoprostatectomy with continent neobladder. 2. No evidence of recurrent or metastatic disease seen. |
Generate impression based on findings. | Male; 61 years old. Reason: s/p sigmoidectomy on 3/16, eval for anastomotic leak, ileus, infection History: above ABDOMEN:LUNG BASES: Small bilateral pleural effusions, partially visualized. Moderate bibasilar dependent atelectasis/consolidation, for which underlying infection cannot be excluded. Severe coronary artery... | Postsurgical changes from sigmoidectomy with primary colorectal anastomosis. Large para-anastomotic contrast leak with resultant large amount of extraluminal contrast, ascites, or pneumoperitoneum. No discrete intra-abdominal or pelvic abscess is evident.Per Epic chart, the patient has been transferred to the operating... |
Generate impression based on findings. | 62 year old female with enlarged left axillary lymph node. History of benign left breast core biopsy in 2009. Left ultrasound re-identified the target lymph node for biopsy. The lesion to be targeted is an enlarged lymph node measuring 19 mm in the left axilla with normal vascularity. The lesion was readily visible.PRO... | Successful ultrasound-guided core biopsy of the left axillary lymph node and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: lung CA, s/p chemo and RT. Followup History: cough CHEST:LUNGS AND PLEURA: Redemonstration of postsurgical and post radiation changes involving the right lung with considerable volume loss and scarring.New focal airspace opacities in left upper lobe (image 38 series 7) and superior segment of the left lower lob... | 1.Stable size of left hilar mass.2.New focal airspace opacities in the left upper and left lower lobes suggestive of infection/aspiration.3.No new suspicious pulmonary nodules or masses. No new sites of disease. |
Generate impression based on findings. | Reason: evaluate for parotid pathology History: left submandibular swelling, weight loss There is an 14 x 13mm hyperdense mass in the left parotid gland and just behind the head of the left mandible.Superficial to the left the submandibular gland there is a 9 x 14 mm nodule present most likely representing a lymph node... | 1.There is a left parotid gland mass present.2.There are numerous small nodules present along the long bilaterally. Differential considerations include infection, granulomatous disease as well as metastases.3.Superficial to the left the submandibular gland there is a 9 x 14 mm nodule present most likely representing a ... |
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. Focal asymmetries in the left upper outer breast and right central medial breast are s... | Focal asymmetries in both breasts, for which comparison with prior is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Stable right frontal approach ventriculoperitoneal shunt with tip terminating near the fragment of Monro. Disproportionately enlarged ventricles without significant change from prior study. The radiopaque portions of the shunt are intact. No acute intracranial hemorrhage is identified. No evidence of intracranial mass... | 1.No acute intracranial abnormality. 2.The ventricular size is without significant change from prior study. Stable shunt. |
Generate impression based on findings. | 66-year-old female with history of poorly differentiated non-small cell carcinoma. LUNGS AND PLEURA: Reference right upper lobe spiculated nodule measures 17 mm, previously 11 mm (image 40 series 6). Nodularity at the lateral aspect of the right upper lobe has increased in size measuring 8 mm previously 3 mm (image 65 ... | 1. Progressing tumor burden as above with right lower lobe post obstructive consolidation/pneumonia.2. Left hepatic lobe lesions are slightly more conspicuous but this may be due to technical factors, although continued followup is recommended. |
Generate impression based on findings. | 39 years, Male. Reason: evaluate stool burden History: G tube site still open Moderate/large stool burden distributed throughout the descending colon. There is a severe left hip protrusio deformity with associated hypertrophic changes. Coil material is seen in the left hemipelvis. There is a nonobstructive bowel gas pa... | Moderate/large stool burden distributed throughout the descending colon. |
Generate impression based on findings. | Pain. Question of healing fracture. Three views of the right ankle shows diffuse swelling about the ankle. An ossicle inferior to the lateral malleolus appears to be corticated and is unlikely to be acute in etiology. No acute fracture is evident. The ankle mortise is intact. | No acute fracture is evident. |
Generate impression based on findings. | Fall. Large joint effusion. A splint is present.A moderate to large joint effusion is identified. Soft tissue swelling is present especially anteriorly.The superior cortex of the talar neck is slightly irregular. No other probable or possible fracture is seen. | Possible nondisplaced fracture of the superior cortex of the talar neck. Large joint effusion. |
Generate impression based on findings. | 75 years, Male. Reason: kidney stones History: stones Again seen are left sized calcifications compatible with left renal calculi seen on CT dated 6/18/2014, not significantly changed from most recent abdominal radiograph. A small group of amorphous punctate calcifications overlying the expected location of the right k... | Small bilateral intrarenal calculi, it should be noted that the presence of renal calculi is suboptimally evaluated with radiographs. |
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. Bilateral benign calcifications including arter... | 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. | Fracture.VIEWS: Left wrist PA/lateral (two views) 03/24/15 The cast has been replaced. Both bones fracture of the distal forearm has more callus but on the prior exam. Alignment is near-anatomic | Healing both bones fracture of distal forearm. |
Generate impression based on findings. | 18 year-old male with history of known ulcer, evaluate for osteomyelitisVIEWS: Right ankle lateral, AP (2 views) 3/24/15 Soft tissue inflammation is noted posterior to the calcaneus and along the medial mid foot. Demineralization of the ankle and mid foot is seen, appearing similar to the prior exam. No cortical destru... | Soft tissue swelling without evidence of osteomyelitis. |
Generate impression based on findings. | Male 25 years old Reason: greater tuberosity fracture Redemonstration of minimally displaced fracture of the greater tuberosity of the humerus, with fracture line appearing slightly less distinct compared to prior exam. | Healing greater tuberosity fracture. |
Generate impression based on findings. | Ankle pain. Status post ORIF of ankle fracture. Three views of the left ankle show a side plate and screw device affixing the distal fibula with a syndesmotic screw and two K wires through the medial malleolus. The fracture lines are less distinct indicating healing. Increased periosteal reaction is noted along the med... | Healing trimalleolar fracture. |
Generate impression based on findings. | 65 year old with history of right lumpectomy for DCIS in 2000 followed by radiation therapy. History of left abscess drainage. History of breast carcinoma in mother diagnosed at the age of 74 and sister diagnosed at the age of 64. No current breast complaints. Three standard views of both breasts were performed digital... | 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; 63 years old. Reason: Stage IV melanoma w/o disease now w PET showing hypermetabolic activity in liver - assess for masses c/w met disease (tri-phasic liver protocol) History: Rule out metastatic recurrence ABDOMEN:LUNG BASES: Stable nonspecific peripheral right lower lobe micronodule (series 10/28). Stable non... | 1. Three hepatic metastases are new since prior CT on 12/26/15.2. Stable small indeterminate gallbladder polyps.3. Stable indeterminate left adrenal nodules. If further characterization is clinically indicated, adrenal protocol CT or MRI can be performed.4. Stable small nonspecific right lower lobe micronodule. |
Generate impression based on findings. | Right knee pain. Four views of the right knee show marked medial and lateral joint space narrowing and tricompartmental osteophytes. No acute fracture is evident. There is a moderate joint effusion. | Marked osteoarthritis appearing similar to the prior study. |
Generate impression based on findings. | 3-year-old male with pleural effusion.VIEW: Chest AP (one view) 3/24/15 Right IJ catheter terminates in the right atrium. Left upper extremity PICC tip is in the SVC.Cardiac silhouette size is at the upper limits of normal. Small bilateral pleural effusions with bibasilar air space opacities which represent atelectasis... | Small bilateral pleural effusions and bibasilar air space opacities which may represent atelectasis or layering effusions. |
Generate impression based on findings. | 64 year old asymptomatic female presents for bilateral diagnostic mammogram. Family history of breast carcinoma in her maternal aunt in her 70s. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, u... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Fall, pain in lower pelvis area. Three views of the pelvis show severe osteoarthritis of the right hip. Moderate osteoarthritis affects the left hip. No acute fracture is evident. | No acute fracture is evident. |
Generate impression based on findings. | Female 73 years old Reason: evaluate for osteomyelitis distal phalanx right hallux History: non-healing ulcer distal tip right hallux Three views of the right great toe again shows ulceration in the soft tissues about the great toe, with soft tissue swelling and underlying osteolysis of the distal phalanx suspicious fo... | Osteomyelitis of the distal pharynx of the great toe. |
Generate impression based on findings. | Multiple myeloma patient on clinical drug trial. Evaluate for left ankle/foot fracture. Patient dropped can of soup on left ankle/foot Friday complaining of increased pain on the top of the left foot. Three views of the left ankle show no acute fracture or malalignment. No ankle joint effusion is seen.Three views of th... | No acute fracture is evident. |
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. Circumscribed mass in the left central breast i... | 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. | 41 years, Female. Reason: Evaluate for ileus History: abdominal distension/pain Motion artifact limits study. There is a paucity of air in the bowel gas generally, which may reflect fluid-filled bowel loops, a small amount of air is seen in small bowel loops. Centralization of air filled bowel loops may reflect ascites... | Paucity of bowel gas air, may reflect fluid containing bowel loops, only small air seen in small bowel. While there is no definitive evidence of bowel obstruction, continued followup recommended to exclude developing small bowel obstruction. |
Generate impression based on findings. | Female 69 years old Reason: assess L2 compression fx History: DOI 1/15/2015 Right curve of the thoracolumbar spine. The bones appear demineralized suggesting osteopenia/osteoporosis. L2 compression fractures difficult to visualize for technical reasons. Alignment appears anatomic. Disk space narrowing is noted at L4-5 ... | L2 compression fracture, which is difficult to visualize. Degenerative changes as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy in 2000. Family history of breast cancer diagnosed in maternal aunt in her 50s. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchym... | New asymmetry in the right axillary tail, for which additional views, including spot compression, laterally exaggerated CC view and possible ultrasound are recommended.BIRADS:0 - INCOMPLETE; Need additional imaging evaluation RECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
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