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Generate impression based on findings. | Male; 83 years old. Reason: evaluate for dx progression, hx of metatstatic RCC History: lymphadenopathy in cervical/sc nodes, weight loss Lack of intravenous contrast limits sensitivity for solid organ pathology.CHEST:LUNGS AND PLEURA: Stable scattered calcified and noncalcified micronodules compatible with prior granu... | 1.Stable left lower lobe nodule. 2.Status post left nephrectomy with nodules in the left renal bed, left retroperitoneum, and subcutaneous tissues adjacent to the left paraspinal musculature. Two of the nodules in the left retroperitoneum have mildly increased in size, suspicious for tumor.3.Indeterminant right hepatic... |
Generate impression based on findings. | 79-year-old male with history of laryngeal cancer. CHEST:LUNGS AND PLEURA: Overall significant decrease in size of bilateral pleural effusions. Basilar atelectasis has improved.There is moderate to severe apical predominant centrilobular emphysema and apical scarring. No suspicious pulmonary nodules identified.MEDIASTI... | 1. Decrease in size of bilateral pleural effusions. No suspicious pulmonary nodules.2. Stable mediastinal lymph nodes with measurements as above. |
Generate impression based on findings. | Female 61 years old; Reason: patient with advanced stage cerivcal cancer with bilateral percutaneous nephrostomy tubes, now stone noted in R kidney , want to assess stone History: none ABDOMEN:LUNGS BASES: No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No signi... | 1.No evidence of urinary tract stone.2.Gas and fluid collection in the cul-de-sac may represent infected loculation rather than fluid within the vaginal cuff. Clinical correlation is recommended to exclude abscess.3.Persistent evidence of fistulization to the bladder. |
Generate impression based on findings. | This is intraoperative stealth study and is nondiagnostic. There is expected postoperative bilateral frontal pneumocephalus and frontal burr holes. The DBS leads traverse the thalamus and enters the cerebral peduncle, left slightly lower than the right. Streak artifacts from DBS leads limits examination. No detectable... | Expected postoperative changes of DBS placement. Appropriateness of the lead placement should be determined by the referring physician. |
Generate impression based on findings. | Repair of diaphragmatic hernia. CHEST:LUNGS AND PLEURA: The right middle lobe appears to be compressed. Atelectasis is noted in both lung bases. The diaphragm cannot be visualized. MEDIASTINUM AND HILA: Mediastinum is shifted to the left. Branching pattern of the great vessels is normal.CHEST WALL: Feeding tube tip is ... | Bowel and liver in right anterior chest with mediastinum shifted to the left. Right middle lobe atelectasis. |
Generate impression based on findings. | Right hip pain. Evaluate for fracture, arthritis. Two views of the right hip show no acute fracture or malalignment. The right hip appears normal for the patient's age. There are vascular calcifications. | No acute fracture is evident. |
Generate impression based on findings. | RIGHT TEMPORAL BONE: There is slight narrowing of the cartilaginous external auditory canal with mild irregularity of the walls. The external auditory canal is clear. The tympanic membrane is silhouetted by adjacent opacification. The scutum remains sharp.There is near complete opacification of the right middle ear an... | 1. Near complete nonspecific opacification of bilateral middle ears without evidence of osseous erosions. Opacification of minimally pneumatized mastoid or cells. Please correlate clinically.2. Bilaterally narrowed cartilaginous external auditory canals which may be developmental, with irregularly of the walls, for whi... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of boils under her breasts. Family history of ovarian 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 fibrog... | 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 r... |
Generate impression based on findings. | Female 26 years old; Reason: RLQ pain, fever, pls r/o appendicitis History: RLQ pain, fever, vomiting ABDOMEN:LUNGS BASES: Mosaic attenuation/groundglass in the posterior lung bases may relate to expiration artifact.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. Gallbladder is unremarkable... | No evidence of appendicitis or other findings to account for right lower quadrant pain. |
Generate impression based on findings. | Low back pain, bilateral leg pain. Evaluate stability of spine and sagittal balance. Two views of the lumbar spine show disk space narrowing at L1/L2 and L2/L3 with anterior osteophyte formation. No acute fracture is evident. Alignment is anatomic.Spine survey radiographs demonstrate 2 cm of positive sagittal balance. | 1. Degenerative changes of the upper lumbar spine.2. Sagittal balance as above. |
Generate impression based on findings. | Male, 50 years old. Status post surgery with multiple surgical teams. Evaluate for RFO. There is a nasogastric tube with its tip projecting over the proximal body of the stomach, with its side port at the gastroesophageal junction. Skin staples, surgical clips, surgical coils, and a right iliac vascular stent are uncha... | 1.No unexpected radiopaque foreign object is identified.2.Nasogastric tube sideport at the gastroesophageal junction, repositioning or advancement is recommended.These findings were discussed by telephone with Dr. Yolanda Becker, the attending surgeon, on 3/24/2015 at 1427. |
Generate impression based on findings. | 56-year-old female with history of shortness of breath and elevated d-dimer. Evaluate for pulmonary embolus. PULMONARY ARTERIES: Technically adequate study. There is a large saddle embolus extending into the right lobar arteries and the left lower lobar artery. There is mild right heart strain.LUNGS AND PLEURA: There i... | Large saddle-type embolus with extension in the right lobar arteries and the left lower lobar arteries with evidence of mild right heart strain.Findings discussed with Dr. Sakaria at 1620 on 3/24/15.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Main.RV Strain: Positive. |
Generate impression based on findings. | 73-year-old female with neuroendocrine tumor on observation therapy. Evaluate for interval growth. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No adenopathy or other significant abnormality noted.CORONARY ARTERY CALCIFICATION: Moderate.CHEST WALL: No significant abnormality noted.ABDO... | 1. Minimal change in the multiple hepatic peripheral lesions as measured above. 2. No change in size in the large dominant mesenteric abdominal/pelvic mass or the associated adjacent mesenteric lymph nodes. 3. Decreased wall thickening and pelvic small bowel with minimal residual of uncertain etiology. 4. No new abnorm... |
Generate impression based on findings. | 44 year old female with metastatic breast cancer, regurgitation/vomiting. GI requesting gastric emptying study History: nausea/vomiting Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was cal... | Gastric emptying within normal limits. |
Generate impression based on findings. | 50 year old with history of right lumpectomy in 2009 for IDC and DCIS. Patient received radiation and chemotherapy. History of benign left percutaneous and excisional biopsies. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast pa... | 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: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | History of lung cancer status post chemotherapy completed 2010. Restaging exam. Liver abnormality on recent CT.RADIOPHARMACEUTICAL: 14.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates an approximately 12-mm sub-solid pulmonary nodule in the left upper lobe. ... | 1.Left upper lobe and right middle lobe pulmonary nodules have increased in size and metabolic activity, highly suspicious for malignancy such as synchronous primary lung cancers or possibly metastases.2.No other suspicious FDG avid lesion elsewhere. Specifically, the liver demonstrates no focus of abnormal increased t... |
Generate impression based on findings. | 64-year-old female with history of perihilar abnormality on recent chest radiograph and long smoking history. Evaluate for potential mass. LUNGS AND PLEURA: There is scattered upper lobe predominant peripheral bronchiectasis, interlobular septal thickening and reticulation as well as foci of peripheral ground-glass opa... | 1. No suspicious hilar masses, lymph nodes, or pulmonary nodules.2. Nonspecific pulmonary findings of fibrosis including chronic hypersensitivity pneumonitis. Further workup with dedicated ILD CT protocol may be considered if clinically warranted.3. Enlarged paratracheal lymph node which is likely reactive in etiology. |
Generate impression based on findings. | 66 years, Female. Reason: check ngt placement History: nausea The nasogastric tube has been retracted with the tip now terminating in the distal esophagus. LVAD, sternotomy hardware and pacemaker leads unchanged. There is persistent gaseous distention of both large and small bowel suggestive of ileus or partial small b... | Nasogastric tube has been retracted with the tip now terminating in the distal esophagus. |
Generate impression based on findings. | Need to focus on the thoracolumbar junction. Has instability above fusion. Focus on L1/T12. Low back pain. Four views of the lumbar spine show screws within the pedicles of L2-S1 with posterior stabilization rods and interposed disc spacers. Anterior fixation hardware is noted at L3/L4, L4/L5, and L5/S1.There has been ... | Spinal fixation hardware as above. |
Generate impression based on findings. | Reason: Lung cancer s/p CRT, eval response History: Lung cancer s/p CRT, eval response CHEST:LUNGS AND PLEURA: There is a significant interval decrease in size of the right perihilar mass (image 51 series 4) now measuring 2.2 cm x 3.6 cm previously measuring 4 cm x 5.1 cm.There is again demonstration of narrowing of th... | 1.Interval decrease in size of this central right hilar/perihilar mass.2.There is persistent bronchial compression and subsequent distal atelectasis within the right lower lobe.3.Interval decrease in right paratracheal lymphadenopathy.4.No new sites of disease identified. |
Generate impression based on findings. | Reason: Change in nodules History: thryoid cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Using similar measurement technique, there has been no significant interval change in the previous the reference metastatic nodules. For example, the left lower lobe lesion measures 15 x 16 m... | Stable size of the reference metastatic nodules. No new suspicious pulmonary nodule or pleural effusion. |
Generate impression based on findings. | Status post right total hip arthroplasty with anterior approach. AP view of the pelvis and single view of the right hip show a right total hip arthroplasty device situated in anatomic alignment without evidence of hardware complication. No acute fracture is identified. A surgical drain is noted in the soft tissues of t... | Right total hip arthroplasty. |
Generate impression based on findings. | Male; 61 years old. Reason: Lung Transplant Evaluation History: SOB Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 64.4 % of peak activity (normal >70 %)1 ... | Gastric emptying within normal limits. |
Generate impression based on findings. | Male; 77 years old. Reason: metastatic prostate cancer, evaluation of disease after 9 cycles of investigational therapy. Areas of increased radiotracer activity in the lower lumbar spine and sacrum are compatible with metastases based on correlation with recent CT and are not significantly changed. No new abnormal osse... | Stable osseous metastatic disease. No new suspicious lesions identified. |
Generate impression based on findings. | 43-year-old female with known fibroadenoma in the left breast presents for annual mammogram. 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 heterogeneously dense, unchanged in pattern and distribution. Clip f... | No mammographic evidence of malignancy. Stable fibroadenomata in the left breast. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. In view of patient's dense breasts, tomosynthesis will be useful for screening purposes. Results and recommendations were... |
Generate impression based on findings. | Female 23 years old Reason: s/p laparoscopic surgery 1 week ago here with abdominal pain and vomiting, assess for SBO History: abdominal pain and vomiting ABDOMEN:LUNG BASES: Trace bibasilar atelectasis with associated small pleural effusions. LIVER, BILIARY TRACT: Multiple subcentimeter hypoattenuating lesions again s... | 1.Submucosal edema and mucosal hyperenhancement of the distal small bowel, likely related to enteritis, which may be infectious, inflammatory or ischemic in etiology. Dilated loops of proximal small bowel may reflect ileus, also perhaps exacerbated by the aforementioned inflammation which may be contributing to an elem... |
Generate impression based on findings. | 53-year-old male with history of right upper lobe pulmonary nodule. LUNGS AND PLEURA: Subtle mosaic attenuation pattern is redemonstrated particularly at the periphery of the bases. There are scattered areas of peribronchial groundglass opacities. There are scattered calcified and noncalcified pulmonary micronodules, n... | 1. Mild mosaic attenuation pattern could be indicative of small airways or small vessel disease.2. Part solid nodule in the right upper lobe is no longer visualized. No suspicious pulmonary nodules or masses. |
Generate impression based on findings. | Male; 60 years old. Reason: Met Pancreas Cancer: Restaging History: N/A CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal cardiac size without pericardial effusion. No significant coronary calcifications. Stable ... | 1. Slightly increased soft tissue infiltration within the resection bed on serial examinations, as detailed above. As a result, recurrent disease cannot be excluded. Close attention at follow-up is recommended.2. Stable size of left hepatic lesion, but there is new mild left intrahepatic biliary ductal dilation distal ... |
Generate impression based on findings. | 11-year-old male with asthma cough and feverVIEW: Chest AP (one view) 3/24/15 The cardiothymic silhouette is normal. No focal pulmonary opacities. No pleural effusion or pneumothorax. Large lung volumes and mild bronchial wall thickening consistent with reactive airways disease/bronchiolitis pattern. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Male; 83 years old. Reason: evaluate for bone metastasis, hx of prostate cancer and RCC with acute c-spine pain radiating up back of head. Postsurgical changes compatible with left nephrectomy. No abnormal osseous foci are identified to indicate metastatic disease. Mild degenerative changes and levoscoliosis, both invo... | No evidence of bone metastases. |
Generate impression based on findings. | Reason: evaluate for progression. History: leiomyosarcoma. LUNGS AND PLEURA: Demonstration of innumerable pulmonary nodules strain progressive mild increase in size.Reference right upper lobe nodule (image 24 series 4) now measures 16 mm x 17 mm previously measuring 15 mm x 17 mm.Reference left lower lobe subpleural no... | Redemonstration of innumerable pulmonary nodules that have minimally and progressively increased in size over the last 8 months. No new sites of disease identified. |
Generate impression based on findings. | 12-year-old male with rolled ankleVIEWS: Left ankle AP, oblique, lateral (3 views) 3/24/15 Mild lateral soft tissue swelling. The ankle mortise joint is maintained. No fracture or malalignment. | Mild soft tissue swelling without fracture or malalignment. |
Generate impression based on findings. | Female 58 years old Reason: metatarsal fracture? History: pain and tenderness to palpation No acute fracture is identified. Alignment is anatomic. The bones and soft tissues are unremarkable in appearance. | No findings to account for patient's symptoms. |
Generate impression based on findings. | Reason: mets lung cancer, brain mets. s/p 1st line therapy and palliative RT to mediastium. Pls c/w previous study and evaluate dx status. History: lung ca CHEST:LUNGS AND PLEURA: Stable centrilobular and paraseptal emphysema.Site of previous wedge resection at the left lower lobe similar in appearance with soft tissue... | New soft tissue nodule at the peritoneum lateral to the hepatic capsule at the level of the gallbladder measuring 9 x 12 mm suspicious for metastasis.Suprahepatic IVC lymph node is decreased in size.Interval decreased size of the intracardiac mass containing central necrosis. Using similar measurement technique by the ... |
Generate impression based on findings. | Female 43 years old Reason: Rule out left ankle fracture History: Patient sustained ankle injury due to fall this morning; fell on top of her ankle No acute fracture is identified. Alignment is anatomic. Bones and soft tissues are unremarkable in appearance. | No findings to account for patient's symptoms. |
Generate impression based on findings. | Male 77 years old Reason: right ring finger PIP joint stiffness History: stiffness There is joint space narrowing and osteophyte formation affecting the interphalangeal joints, distal greater than proximal. There is also soft tissue swelling. | Soft tissue swelling and degenerative changes as above. |
Generate impression based on findings. | 81-year-old male with history of possible nodule on recent chest radiograph. LUNGS AND PLEURA: There is moderate apical predominant centrilobular emphysema. Scattered calcified and noncalcified pulmonary micronodules, nonspecific. Focal area of subpleural scarring along the posterior aspect of the right upper lobe. No ... | 1. No suspicious pulmonary nodules.2. Moderate apical predominant emphysema. |
Generate impression based on findings. | Male 17 years old Reason: History of medial epicondyle fracture s/p ORIF No joint effusion is present. There is a discrete, sharp fracture line involving the medial epicondyle suggestive of nonunion. | Finding suggestion of nonunion of medial epicondyle. |
Generate impression based on findings. | Male 24 years old Reason: assess stability and degeneration History: low back pain, leg pain Vertebral body heights and intravertebral disk spaces are maintained. No acute fracture. Alignment is anatomic on neutral, flexion and extension. | Unremarkable examination with no evidence of instability. |
Generate impression based on findings. | Female; 45 years old. Reason: please eval for rising bilirubin in pt with metastatic colon cancer with liver mets on study drug which can cause immune mediated liver disease. Eval for biliary obstruction vs disease progression History: hyperbilirubinemia LUNG BASES: Multiple pulmonary nodules in the partially visualize... | 1. Significantly increased left hepatic metastases with large porta hepatis mass causing new complete occlusion of the main portal vein.2. New tubular hypoattenuating structure coursing through the mid left hepatic lobe (series 4/41) may represent thrombosed left portal vein versus dilated left hepatic bile duct. Ultra... |
Generate impression based on findings. | 65 year old female status post left mastectomy in 2013 for IDC with DCIS, presents today for routine follow up. Patient received chemotherapy and radiation. No current breast complaints. History of benign right breast biopsies. Family history of breast carcinoma in her mother and maternal aunt. Three standard views of ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral 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. | 3-year-old male with chronic granulomatous disease now with tachypnea LUNGS AND PLEURA: Small bilateral pleural effusions with associated bibasilar compressive atelectasis. Ground glass opacities in the right upper lobe and scattered confluent opacities in left upper lobe likely represent infectious or inflammatory cha... | 1.Small bilateral pleural effusions with associated bibasilar compressive atelectasis. Scattered groundglass and confluent opacities in the right and left upper lobes may be infectious or inflammatory in etiology.2.Unchanged prominent left axillary lymph node. |
Generate impression based on findings. | 74-year-old with history of left lumpectomy for invasive lobular carcinoma in 2013, and right benign excisional biopsy in 2013, presents for annual mammogram. 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 he... | 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: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 73 years old; Reason: Evaluate for progression of metastatic disease; compare to previous scan History: None CHEST:LUNGS AND PLEURA: Multiple bilateral metastatic lung nodules, stable to mildly decreased in size. Reference right lower lobe lung nodule mildly decreased in size, measuring 1.3 x 1.1 cm, image 88 seri... | 1. Multiple bilateral metastatic lung nodules and metastatic mediastinal adenopathy, stable to mildly decreased in size as above.2. Left-sided pleural-based probably metastatic mass stable to mildly increased in size.3. Unchanged indeterminate right adrenal nodule. |
Generate impression based on findings. | The ventricles and sulci are within normal limits for age. There is no midline shift or mass effect. There is no intracranial hemorrhage, within the limitations of only postcontrast imaging. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. The visualized ... | 1. Unremarkable contrast-enhanced CT of the brain.2. Chronic nasal bone fractures. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or midline shift. No extra-axial fluid collections. Left thalamic, anterior limb of left internal capsule and right corona radiata chronic appearing CSF-density lacunar infarcts with ex vacuo dilatation of the adjacent porti... | 1.No evidence for acute intracranial hemorrhage. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia and MRI can be considered for further evaluation.2.Scattered chronic lacunar infarcts and other moderate age indeterminate small vessel ischemic disease, somewhat advanced for patient's stated... |
Generate impression based on findings. | Female, 45 years old status post lap sponge retrieval. Previously seen lap sponges in the right hemiabdomen and radiopaque geometric density in the left upper quadrant are no longer visible on this examination. There are multiple surgical clips and skin staples present. There is a nasogastric tube with its tip projecti... | Previously seen lap sponges in the right hemiabdomen and radiopaque geometric density in the left upper quadrant are no longer visible on this examination. Additional findings as above.These findings were discussed by telephone with Dr. Ahn, the attending surgeon, on 3/24/2015 at 1534. |
Generate impression based on findings. | 47 year old female who has a complaint of self palpated in mass in her outer left breast. Family history of breast carcinoma in her sister, maternal aunt, paternal grandmother, and two maternal cousins. MAMMOGRAM: Three standard views, and 2 spot compression views, of the left breast were performed digitally and review... | No mammographic or sonographic 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. | 25 years, Female. Reason: pt c/o abdominal pain with pressure, nausea, and constipation. Pt scheduled for lap rectopexy on 3/26 History: nausea, constipation, pain, rectal prolapse Previously seen sitz markers are no longer identified on this examination. There is a moderate to large stool burden, predominantly in the ... | Previously seen sitz markers are no longer identified. Nonobstructive bowel gas pattern with moderate to large stool burden. |
Generate impression based on findings. | History of previous jaw locations, feels same. No point tenderness or trauma. Question of jaw dislocation. Panorex radiograph of the mandible shows mild subluxation of the right temporomandibular joint. No acute fracture is evident. Metal wires are noted about multiple teeth. | Mild subluxation of the right TMJ. |
Generate impression based on findings. | History of seizure with bilateral hip and possible femur fracture at OSH. Leg pain. Two views of the left femur again show severe left acetabular protrusio with secondary degenerative changes. No acute fracture is evident. Severe joint space narrowing is noted at the left knee. | No acute fracture is evident. |
Generate impression based on findings. | Ankle pain after fall. Evaluate for fracture. Three views of the left ankle show no acute fracture or malalignment. No soft tissue swelling or ankle joint effusion is seen. | No acute fracture is evident. |
Generate impression based on findings. | 56 years, Male. Reason: check ngt placement History: nausea Limited study due to patient's body habitus and exclusion of bilateral flanks. Interval placement of NG tube with its tip overlying the gastroesophageal junction and side-port in the distal esophagus. LVAD and ICD are unchanged from the prior exam. Fractured s... | NG tube sideport in distal esophagus, recommend advancement by approximately 13 cm. |
Generate impression based on findings. | 52-year-old with history of dense breasts. Prior benign biopsy of the right breast. 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. No suspicious mass, suspicious microcalcifica... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. In view of the dense breasts, tomosynthesis will be useful for her next screening mammogram. Results and recommendations were discussed with the patient. BIRADS: 1... |
Generate impression based on findings. | Pain. Evaluate basilar joint. Three views of the right thumb show possible subluxation of the basilar joint seen on a single view. No significant degenerative changes are noted at the joint. No acute fracture is evident. | Possible subluxation of the basilar joint seen on a single view. |
Generate impression based on findings. | Female 79 years old Reason: History of compression fracture lumbar spine, evaluate healing. Evaluate sagittal balance. Cervical spine curvature History: back pain, surveillance imaging The bones appear severely demineralized suggesting osteopenia/osteoporosis. There is 17 degree right curve of the thoracolumbar spine f... | 1.Rightward curve of the thoracolumbar spine and positive sagittal balance as described above. 2.Limited assessment for vertebral fractures, recommend CT or MRI if further evaluation is desired. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is an... | No acute intracranial abnormality. |
Generate impression based on findings. | Mild lobulated irregularity involving the anterior right vocal cord (series 5 image 55) measuring approximately 1 cm. This may represent residual lesion or recent postsurgical changes. No other lesions are appreciated involving the larynx. Laryngeal cartilages are intact. Nonspecific mild soft tissue asymmetry of the ... | 1.There is lobulated irregularity involving the right anterior vocal cord which measures approximately 1 cm and may represent residual lesion or post treatment change. Correlate with recent endoscopic findings. No other lesions within the larynx are appreciated.2.Nonspecific soft tissue asymmetry at the right base of t... |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent... | No acute intracranial abnormality on these limited sequences. Probable mild age indeterminate small vessel ischemic changes. |
Generate impression based on findings. | Female 78 years old; Reason: 78 y/o female me Met Colon Ca on Chemo. Compare to prior scan History: Met Colon Ca CHEST:LUNGS AND PLEURA: Right lower lobe posterior subpleural nodule is unchanged, measuring 0.9 x 0.8 cm (series 4, image 79), previously in 0.9 x 0.7 cm. No new suspicious pulmonary nodules are identified.... | 1.Stable nonspecific right lower lobe subpleural nodule.2.Prominent right hilar lymph node, unchanged since at least 2013, remains nonspecific.3.Unchanged hypoattenuating right hepatic lobe lesion likely represents stable metastatic disease. |
Generate impression based on findings. | History of rheumatoid arthritis. Assess instability. Four views of the cervical spine show no acute fracture. Vertebral body heights are maintained. There is disk space narrowing at C4/C5, C5/C6, and to a lesser degree C6/C7. Anterior osteophytes are also noted at these levels. There is a grade 1 anterolisthesis of C4 ... | Degenerative changes and anterolisthesis of C4 on C5 as above. |
Generate impression based on findings. | 78 years, Female. Reason: evaluate causes of abdominal distention. History: abdominal distention Mild diffuse gaseous distention of both large and small bowel. There is a large stool burden distributed throughout the colon, predominantly affecting the right colon and rectum. There are degenerative changes of the lower ... | Findings suggestive of constipation and fecal impaction, clinical correlation is recommended. |
Generate impression based on findings. | Reason: 47 yo F with hx of IVDU p/w low back pain, found to have L5-S1 diskitis, lumbar osteomyelitis, needing biopsy for culture per ID recommendation History: IV drug use (last 3 days PTA), back pain, MRI findings of lumbar diskitis/osteomyelitis Serial CT images obtained during the biopsy procedure demonstrate the n... | 1.L5-S1 disk space biopsy for diskitis and osteomyelitis. Two samples were sent for pathology in formalin jars and the others were placed in two test tubes and sent for microbiologic analysis. |
Generate impression based on findings. | There is prominence of the lateral and third ventricles with respect to the sulci. The cerebellar tonsils are minimally pointed and extend 6 mm below the level of the foramen magnum. There is moderate associated crowding at this level. The cerebral aqueduct appears grossly patent. There is no midline shift or mass eff... | 1. No acute intracranial hemorrhage.2. Disproportionate prominence of the lateral and third ventricles with respect to sulci. No definite cerebral aqueduct stenosis on CT. Normal pressure hydrocephalus could be considered and clinical correlation is recommended, although the fourth ventricle appears more normal in size... |
Generate impression based on findings. | Male, 41 days old. Evaluate for necVIEW: Chest and abdomen AP (two views) 3/24/15, 1614 ET tube tip is below the thoracic inlet and above the carina. Enteric tube terminates in the stomach. Right arm PICC tip is at the SVC/RA junction. PDA ligation clips unchanged in position.The cardiac silhouette size is normal. Diff... | Complications from surfactant deficiency. Persistent abnormal bowel gas pattern; NEC is likely. |
Generate impression based on findings. | Invasive left base of tongue cancer. There is a soft tissue mass centered at the left base of tongue which extends inferiorly to involve the vallecula bilaterally and abuts the epiglottis. Mass measures approximately 2.2x2.1x2.2 cm. The pre-epiglottic fat is preserved. Oral tongue appears uninvolved. There are scattere... | 1. Left base of tongue mass extending inferiorly into the vallecula bilaterally and dorsally abutting the epiglottis. Finding is consistent with known primary neoplasm.2. No significant cervical lymphadenopathy. 3. No intracranial metastatic disease. |
Generate impression based on findings. | Male 58 years old; Reason: staging exam History: prostate cancer -research CT of the prostate for research. | 1.CT of the prostate performed for research. |
Generate impression based on findings. | Female 51 years old; Reason: H/o Hodgkin Lymphoma, please restage; also ovarian cyst History: h/o mass CHEST:LUNGS AND PLEURA: Right paramediastinal bronchiectasis and fibrotic changes. No dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Infiltrativ... | 1.Stable exam with residual infiltrative soft tissue in the mediastinum and right paramediastinal fibrosis and bronchiectasis. |
Generate impression based on findings. | 56-year-old male with metastatic colon cancer. CHEST:LUNGS AND PLEURA: Two nonspecific micronodules are again seen in the left lung (series 5, image 44 and series 5 image 20) each measuring approximately 4 mm. Both of these lesions are stable or slightly smaller than the reported 6 mm previously. No new nodules are see... | 1. Decreased thickening of the sigmoid colon/descending colon an area of presumed colon cancer. Associated adjacent mesenteric lymph node has also decreased in size. 2. Significant decrease in size of the hepatic metastatic lesions. 3. Marked decrease in the periaortic lymphadenopathy. 4. Decrease in size of two small ... |
Generate impression based on findings. | Male 56 years old; Reason: eval for lymphoma - initial staging History: new diagnosis of MZL CHEST:LUNGS AND PLEURA: There is multiple small sub-solid and solid nodules in the left lower lobe. Largest measuring 0.7 x 0.5 cm (image 73/series 5).The pleural spaces are clear. The central airways are patent.MEDIASTINUM AND... | 1.Mediastinal and left lower lobe pulmonary nodules.2.Diffuse thickening of the left renal pelvis and proximal ureter suspicious for disease involvement. 3.Peritoneal nodularity.4.Thickened small bowel in the right lower abdomen representing disease involvement. |
Generate impression based on findings. | History of recurrent micropapillary borderline ovarian cancer. Suspicious lesions left adnexa and left inguinal lymph nodes on recent MRI. Restaging exam.RADIOPHARMACEUTICAL: 10.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates an approximately 2.5 x 3.5 cm ... | No suspicious significantly FDG avid lesion. However, given their suspicious appearance on recent MRI, both the left adnexal lesion and the left inguinal lymph node remain suspicious for non-FDG avid tumor. In such a case, FDG-PET would of course be insensitive for other potential metastatic sites in this patient. |
Generate impression based on findings. | Male 51 years old; Reason: hematuria History: hematuria ABDOMEN:LUNGS BASES: No focal consolidation, pleural effusion, or suspicious pulmonary nodules.LIVER, BILIARY TRACT: Three right hepatic lobe hypodense lesions with fill in on delayed phase, suggestive of benign hemangiomas. Other subcentimeter hepatic hypodensiti... | Right upper pole collecting system infundibular protruding soft tissue mass with calcification with collecting system wall thickening more diffusely extending into the right renal pelvis. This may represent chronic inflammatory changes, though malignancy cannot be excluded. |
Generate impression based on findings. | Male; 66 years old. Reason: Patient being treated for suspected paraneoplastic syndrome with rapid cognitive decline, hypertonia, and cerebellar signs. Evaluate for underlying malignancy.RADIOPHARMACEUTICAL: 13.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 118 mg/dL. Today's limited CT portion grossly de... | 1.No convincing FDG avid tumor. Symmetric mild to moderately hypermetabolic bilateral hilar and paratracheal lymph nodes, most likely representing benign granulomatous inflammation. |
Generate impression based on findings. | Female; 75 years old. Reason: 75 female with pancreatic cancer with known liver mets. Rising LFTs s/p biliary stents. Per interventional GI requesting CT to assess biliary system/mass effect History: Hyperbilirubinemia ABDOMEN:LUNG BASES: Large right and moderate left pleural effusions, partially visualized. Moderate n... | 1.Stable appearance of pancreatic adenocarcinoma with thrombosis of the splenic and superior mesenteric veins.2.Diffuse hepatic metastases, similar to prior study.3.Interval placement of two common bile duct stents. Mild intrahepatic biliary ductal dilation in the right hepatic lobe, similar to prior study.4.Findings s... |
Generate impression based on findings. | 64-year-old male with history of head and neck cancer. Evaluate for metastatic disease. Please refer to same day CT of the head and neck for further details.CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules some of which are calcified, nonspecific. No suspicious pulmonary nodules or masses. No pleural effusions.... | 1. No convincing evidence of metastatic disease.2. 1.3 cm calyceal calculus in the left kidney. |
Generate impression based on findings. | 77-year-old female with Merkel cell cancer. Compare to prior CT. Post chemotherapy with increased fatigue, anorexia, assess for progression. CHEST:LUNGS AND PLEURA: Apical pleural nodularity/scarring is again seen.No suspicious pulmonary nodules or masses. Minimal bibasilar atelectasis. No pleural effusion or pneumotho... | 1. Large heterogeneous pancreatic mass again seen slightly increased in size and invading the adjacent duodenum with new internal foci of gas within the mass suspicious for fistulization with the adjacent bowel. 2. Periceliac and pelvic adenopathy increased from prior study as measured above. |
Generate impression based on findings. | Feeding tube placementVIEW: Abdomen AP (one view) 3/24/15 at 1640 hrs. Feeding tube is coiled in the stomach. Mild bowel distention with no evidence of obstruction or free air. | Feeding tube positioning as described. |
Generate impression based on findings. | 25-year-old female with signs and symptoms of a kidney stone. Within the limits of a non-IV contrast enhanced examination which limits evaluation for solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No sign... | 1. Punctate nonobstructing right calyceal kidney stone. No evidence of urinary tract obstruction. No hydronephrosis. |
Generate impression based on findings. | Female; 79 years old. Reason: History of NHL s/p treatment. Please restage. Assess paraspinal lesions too. Back mass had increased large cells.RADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 81 mg/dL. Today's CT portion grossly demonstrates scattered bilateral pulmonary ground glass... | 1.Significant interval improvement in tumor burden as described above, indicating a partial metabolic response to therapy. No new FDG avid lesions identified. 2.However, findings suspicious for residual metabolically active tumor in the soft tissues surrounding the spine at the thoracolumbar junction. |
Generate impression based on findings. | Lung cancer treatment strategy. New lung nodules. PET avid lesion in lingula.RADIOPHARMACEUTICAL: 9.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion of the neck and pelvis demonstrates stents within bilateral common iliac arteries. Extensive degenerative changes are seen of the ... | 1.Numerous markedly hypermetabolic bilateral pulmonary nodules and masses. These are suspicious for malignancy such as primary lung cancer with numerous pulmonary metastases. However, inflammatory lesions may be contributing to the appearance. The largest most metabolically active lesion is seen at the anterior left lu... |
Generate impression based on findings. | 15-year-old female status-post jammed right fifth digitVIEWS: Right fifth digit PA, oblique, lateral; right hand PA, oblique, lateral (6 views) 3/24/15 No significant soft tissue swelling the fifth digit or hand. No fracture or malalignment. | Normal examination. |
Generate impression based on findings. | Female; 55 years old. Reason: disease surveillance for metastatic breast cancer. There is a small, cortically based focus of increased activity in the lateral proximal right femur, which is faintly visible to a lesser degree on the prior study given the benefit of hindsight. While nonspecific, this lesion is not likely... | No convincing bone metastases. Small cortically based focus of increased activity in the proximal right femur, most likely benign and suggestive of an evolving stress fracture. Correlation with patient history or plain radiographs can be considered if further evaluation is warranted. |
Generate impression based on findings. | 49 year old female with breast cancer; surgery 3/25/15- left axillary SNBx and bilateral mastectomy. RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 1.071 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the left ... | Sentinel node identified in the left axilla. |
Generate impression based on findings. | 12 y/o female with recurrent relapsing ALL. Pre-transplant evaluation. The patient’s weight of 39.1 kg and height of 155 cm were used for all calculations.Raw GFR = 128 mL/minBSA = 1.31 m2Estimated GFR/m2 = 97 mL/min/m2Estimated GFR/m2 * 1.73 m2 (average adult BSA) = 169 mL/min (adult GFR equivalent) | GFR measurements as above. |
Generate impression based on findings. | Breast cancer metastatic to bone, restaging on new antiestrogen therapy.RADIOPHARMACEUTICAL: 10.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion grossly demonstrates diffuse right anterior breast skin thickening. Extensive postsurgical changes are seen involving the lower thora... | 1.Progression of hypermetabolic osseous metastatic activity in the right pelvis.2.Subcentimeter but new and significantly hypermetabolic right breast nodule, very suspicious for additional recurrent tumor.3.New symmetric hypermetabolic bilateral axillary lymph nodes may be inflammatory or additional tumor progression. |
Generate impression based on findings. | 66-year-old female status post LVAD with nausea, vomiting and abdominal pain. Evaluate for bowel obstruction. Within the limits of a non-IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: LVAD dev... | 1. Focal abnormal mural wall fold thickening in the mid jejunum. This is nonspecific in appearance -- see above discussion. Mild disproportionate more proximal bowel compared with more distal is seen but not to a degree suggestive of high grade obstruction although patient has NG tube and if this is been used for sucti... |
Generate impression based on findings. | 84-year-old male with abdominal pain and history of volvulus. Rule-out volvulus. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKID... | 1. No evidence for sigmoid volvulus or other volvulus of the colon and no intestinal tract abnormality specifically seen. 2. No diagnostic abnormality seen to account for patient's symptomatology. |
Generate impression based on findings. | 31-year-old female with abdominal pain, nausea with vomiting.? Pancreatitis.? Small bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Shows normal morphology. No enlargement is seen. No masses. N... | No abnormality seen to account for patient's symptomatology. Specifically, no evidence of bowel obstruction and normal appearing pancreas. |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage. Signs and symptoms: 45481 Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- whi... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Cause of comatose state. Signs and symptoms: Comatose. Nonenhanced head CT:There is no detectable intracranial hemorrhage, edema, mass effect, midline shift or ventriculomegaly.Mild periventricular and subcortical low attenuation of white matter although nonspecific considering patient's stated age c... | 1.No acute intracranial process.2.Mild age indeterminate small vessel ischemic strokes.3.No significant change since prior exam. Consider MRI exam for further assessment. |
Generate impression based on findings. | Clinical question: Evaluate for CVA. Signs and symptoms: Evaluate for CVA. Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, mass-effect, midline shift or hydrocephalus.Periventricular, subcortical, basal ganglial and pontine foci are parenchymal attenuation highly suggestive of age indeterminat... | 1.Mild to moderate age indeterminate small vessel ischemic strokes.2.No acute intracranial hemorrhage or mass effect.3.CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA Nonenhanced head CT:No detectable acute intracranial hemorrhage, edema, mass effect or midline shift or hydrocephalus. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are subtle periventricular and subcortical foci of low attenuation w... | 1.No acute intracranial process.2.Mild to moderate age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question: Intracranial mass, edema or hemorrhage. Signs and symptoms: Concern for seizure, episode of generalized fashion 45 minutes PTA.? History of past seizures. Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass, mass effect, midline shift or hydrocephalus.There is a focu... | 1.No acute intracranial process.2.Small wedge-shaped low-attenuation in the left cerebellum concerning for a chronic ischemic stroke. No prior exams for comparison. |
Generate impression based on findings. | Clinical question: Rule out ischemia. Signs and symptoms: Facial droop. Nonenhanced head CT: There is no detectable acute intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are subtle periventricular and subco... | 1.No acute intracranial process.2.Age indeterminate small vessel ischemic strokes of mild-to-moderate degree. |
Generate impression based on findings. | Clinical question: AMS, not talking much, reaching, history of IV thrombus and atrial fibrillation. Signs and symptoms: As above. Nonenhanced head CT:Examination demonstrates fairly extensive periventricular and subcortical low attenuation of white matter consistent with aging determinate the small muscle ischemic stro... | 1.Extensive age indeterminate small vessel ischemic strokes with interval progression since prior exam.2.CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes |
Generate impression based on findings. | 16 year old male with NF2 POD #16 (3/9) status post right vestibular schwannoma resection, presenting with fever and CSF drainage from surgical site as well as altered mental status and headache. There postoperative findings related to recent right retrosigmoid craniectomy for right vestibular schwannoma resection. The... | 1.Postoperative findings related to recent right retrosigmoid craniectomy with an enlarging subjacent extra-axial fluid collection that extends through the calvarial defect into the extracranial soft tissues concerning for CSF leak.2.Decreasing mass effect within the posterior fossa.3.Violation of the posterior mastoid... |
Generate impression based on findings. | syncope, falls No evidence of acute ischemic or hemorrhagic lesion on this scan.Minimal to mild diffuse brain atrophy is age appropriate and no change since prior exam.Minimal non specific small vessel ischemic disease findings do not show any interval change since prior exam. The ventricles, sulci, and cisterns are sy... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | obtunded, afebrile Patient is intubated.No evidence of acute ischemic or hemorrhagic lesion.Calcified pineal gland which might be clinically insignificant. However, if clinically indicated, brain MRI can be considered for further evaluation.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | 59-year-old male patient with history of multiple fluid collections and rectal cancer. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Small left pleural effusion is slight... | 1.Mild interval decrease in size of perihepatic fluid collections.2.Interval TIPS placement.3.Interval decrease in ascites.4.Mild persistent proximal small bowel dilatation is improved compared to prior examination. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: Headache. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic stroke.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- whi... | Unremarkable nonenhanced head CT. |
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