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Generate impression based on findings. | Gunshot wound.VIEW: Pelvis AP (one view) 03/28/15, 1711 No projectile fragments are seen. The femoral heads are well directed into normally formed acetabula. No fractures are identified. | Normal examination. |
Generate impression based on findings. | Per EPIC, history of nasopharyngeal cancer status post resection (2012) with sphenoid osteomyelitis presented with fever and headaches and found to have meningitis. Patient presents with pain and fever. Evaluate for tumor, abscess, bleeding. CT head: There is no evidence of enhancing intracranial mass or mass effect. T... | 1. Findings compatible with chronic central skull base osteomyelitis, left otomastoiditis, and sinusitis, perhaps superimposed upon osteoradionecrosis; however, an acute on chronic infection cannot be excluded. No evidence of a drainable abscess. Erosive changes including the left occipital condyles and the left latera... |
Generate impression based on findings. | Reason: s/p hemiarthroplasty History: same Single view of the pelvis and single view of the left hip demonstrate hardware components of a left hip hemiarthroplasty in near anatomic alignment; no evidence of fracture or dislocation. Surgical clips, surgical drain, and iatrogenic gas are present in the soft tissues. Mild... | Left hip hemiarthroplasty as above. |
Generate impression based on findings. | Reason: hip implant trial History: na Single crosstable lateral view of the left hip demonstrates components of a left hip hemiarthroplasty. Large subcutaneous defect and iatrogenic gas are present. There is no evidence of acute fracture. | Intraoperative view of components related to left hip hemiarthroplasty. |
Generate impression based on findings. | Reason: r/o fracture or dislocation, evaluate joint space History: left shoulder pain Three views of the left shoulder demonstrate normal anatomic alignment, without evidence of acute fracture. The acromioclavicular joint is within normal limits. Tiny osteophytes along the inferior glenoid suggest minimal osteoarthriti... | No evidence of glenohumeral dislocation or acromioclavicular separation. |
Generate impression based on findings. | 22 year-old female with facial trauma, broken bones on outside imaging. Swelling. There is fracture involving the left medial orbital wall with medial herniation of orbital fat and deformity of the left medial rectus muscle. There is opacification of the left anterior and posterior ethmoid air cells. Small amount of fr... | 1. Left medial orbital wall fracture with medial herniation of orbital fat and deformity of the left medial rectus muscle. Correlate with clinical findings for possible muscle entrapment. Bilateral globes are intact. No retrobulbar hematoma.2. No other maxillofacial fracture. |
Generate impression based on findings. | Emesis. Liver transplant. Possible small bowel obstruction.VIEWS: Abdomen AP supine/upright (two views) 03/28/15 Contrast material is noted in the colon. No free peritoneal air is present. Air-fluid levels are identified both in small and large bowel. Postoperative changes are present from liver transplant. | No obstruction. Abnormal bowel gas pattern. |
Generate impression based on findings. | Blunt trauma to left eye and nose.VIEWS: Sinus series skull Waters/PA, sinuses lateral (3 views) 03/29/15 The left lip and tongue are pierced with ring and stud respectively.Left malar soft tissue swelling is present. The nose appears to be swollen, left greater than right. Paranasal sinuses are normally pneumatized. N... | No definite fracture. Soft tissue injury. CT may be helpful if further evaluation is needed. |
Generate impression based on findings. | Reason: ro infection, nodularity on cxr History: ro fungal infection LUNGS AND PLEURA: Patchy, multifocal pulmonary consolidation, with air bronchograms, compatible with infection. There are no nodules, cavitation or other findings to specifically suggest fungal etiology. No significant pleural effusion or pneumothorax... | Multifocal pulmonary consolidation, suggestive of infection, without specific evidence of suggest fungal etiology.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | History of cholesteatoma, mastoiditis, and multiple ENT surgeries. Evaluate for acute infection or bony inflammation. Per chart, patient presents with 3 week history of ear pain, right-sided headache, and intermittent tenderness. There are postsurgical changes of right sided mastoidectomy including resection of the oss... | Postoperative changes of right mastoidectomy and resection of the ossicles. There is soft tissue thickening in the right middle ear cavity without obvious osseous destruction and may represent granulation tissue or debris. No clear evidence of recurrent cholesteatoma although comparison with prior studies would be help... |
Generate impression based on findings. | Respiratory distress. Fever and atelectasis.VIEW: Chest AP (one view) 03/29/15, 0438 Tracheostomy and gastrostomy tubes are present.Cardiac silhouette size is normal. Atelectasis in right upper lobe continues. No other focal opacity is present. | Continued atelectasis and right upper lobe. |
Generate impression based on findings. | Reason: R/o PE History: Oxygen Desaturation PULMONARY ARTERIES: Suboptimal study secondary to poor bolus timing. Given the limitations, no evidence of acute pulmonary embolism. The main pulmonary artery is within normal limits.LUNGS AND PLEURA: Small bilateral pleural effusions, right greater than left and underlying c... | No evidence of acute pulmonary embolism. Bilateral small pleural effusions, and evidence of aspiration. Pulmonary infection cannot be excluded.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I personally reviewed the Image... |
Generate impression based on findings. | Reason: infection? History: unexplained source of sepsis and bandemia Evaluation is limited by significant respiratory motion artifact.LUNGS AND PLEURA: Redemonstration of the left upper lobe groundglass opacity current series 4, image 13), comparison measurement is difficult to make given changes in position/technique... | 1.Significant respiratory motion artifact limits exam, however there is evidence of round atelectasis in the left lower lobe. No discrete evidence of pulmonary infection.2.Redemonstration of bilateral breast masses, right greater than left, and multifocal significant lymphadenopathy, which appears to have mildly progre... |
Generate impression based on findings. | The image quality is degraded by motion artifact. The ventricles and sulci are prominent, consistent with mild global parenchymal volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are mild scattered areas of abnormal T2/FLAIR hyperintensity within the periventricular white ... | 1. Image quality is degraded by motion artifact. No intracranial mass or mass-effect. No evidence of acute infarct.2. Mild global parenchymal volume loss. 3. Mild chronic small vessel ischemic changes.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Gunshot wound ABDOMEN:LUNG BASES: No focal opacity is present. No pleural effusion or pneumothorax is identified.LIVER, BILIARY TRACT: Enhancement is normal. Gallbladder is incompletely distended and normal in appearance.SPLEEN: Intact. Normal enhancement. A small splenule is present.PANCREAS: Normal in appearance.ADRE... | Path of the projectile fragment does not enter the peritoneum. |
Generate impression based on findings. | Headache. Evaluate posterior fossa hemorrhage. Redemonstrated is a hematoma centered in the right cerebellum with subdural and subarachnoid extension and mild associated vasogenic edema. The hematoma is stable to slightly increased in size and measures 18 x 42 x 29 mm (AP x TR x CC), previously 16 x 42 x 27 mm. There i... | 1. Stable to minimally increased size of hematoma centered in the right cerebellum with subdural and subarachnoid extension and mild associated vasogenic edema. Slight increased prominence of the ventricles with increased periventricular hypoattenuation, suspicious for developing obstructive hydrocephalus and transepen... |
Generate impression based on findings. | Redemonstrated is a hematoma centered in the right cerebellum with subdural and subarachnoid extension and mild associated vasogenic edema. The hematoma is not significantly changed in size and measures 16 x 42 x 27 mm (AP x TR x CC), previously 17 x 42 x 42 mm. There is associated mass effect on the fourth ventricle.... | 1. Stable posterior fossa intraparenchymal hematoma involving the cerebellum with small subdural and subarachnoid components and minimal mass effect on the fourth ventricle. Stable to slightly increased prominence of the ventricles. 2. Chronic small vessel ischemic changes. 3. 2 mm aneurysm at the supraclinoid right in... |
Generate impression based on findings. | Reason: r/o pneumonia vs mass History: o2 requirement LUNGS AND PLEURA: Moderate bilateral pleural effusions. Diffuse confluent consolidation with peripheral ground glass opacities and subpleural sparing fracture the right long. Differential includes drug toxicity, adenocarcinoma (mucinous type), or less likely multifo... | 1.Moderate bilateral pleural effusions and diffuse confluent consolidation with surrounding ground-glass opacities is nonspecific, differential diagnosis includes drug toxicity, mucinous type adenocarcinoma, multifocal infection, or hemorrhage. Please correlate with clinical exam.2.Prominent axillary and mediastinal ly... |
Generate impression based on findings. | 24 day old former 24 week gestational aged twin with lactic acidosis respiratory distress and history of NEC.VIEWS: Chest and abdomen AP (two views) 03/29/15, 0457 Endotracheal tube tip is between thoracic inlet and carina. Right neck PICC has its tip at junction of superior vena cava and right atrium. Feeding tube tip... | Complications from surfactant deficiency. Development of a small amount of bowel gas. |
Generate impression based on findings. | Clinical information PULMONARY ARTERIES: No significant abnormality noted.LUNGS AND PLEURA: Small focal consolidation centrally in right upper lobe abutting the major fissure (series 10, image 43).MEDIASTINUM AND HILA: Trace pericardial effusion.CORONARY ARTERY CALCIFICATION: No significant abnormality.CHEST WALL: Few ... | Small focal consolidation right upper lobe may represent infection or neoplasm. Further evaluation by pulmonology and possible bronchoscopy is recommended.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I personally review... |
Generate impression based on findings. | 89-year-old female with history of COPD, CHF, and hypertension, presenting with chest pain and shortness of breath. Phase of IV contrast limits evaluation of the solid organs, lymph nodes and systemic vasculature.PULMONARY ARTERIES: Large caliber at the main pulmonary artery, measuring 3.5 cm in diameter, and prominent... | 1.Findings raising the question of pulmonary hypertension.2.Moderate cardiomegaly with severe coronary artery calcification.3.Moderate emphysema.4.Mild anterior lung fibrotic changes, nonspecific. May be related to prior inflammation, prior radiation therapy or interstitial lung disease from connective tissue disease s... |
Generate impression based on findings. | ICH, EVD There is a stable left frontal approach ventriculostomy catheter with tip near the left foramen of Monro. There is minimal interval evolution of right thalamic parenchymal hemorrhage with associated localized mass effect. Slight evolution of intraventricular blood products is also noted which are otherwise not... | Slight evolution of right thalamic parenchymal hemorrhage, intraventricular blood products, and minimal scattered subarachnoid blood products. No new mass-effect or herniation.Stable left frontal approach ventriculostomy catheter with no significant interval change in ventricular size. |
Generate impression based on findings. | 37-year-old female with history of supra-levator abscess with drain in place. Evaluate for abscess. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant a... | Abscess sees in the issue rectal fossa and left gluteal region with a thick walled tract extending between the two collections with likely involvement of the vagina, rectum and left low pelvic sidewall. |
Generate impression based on findings. | Worsening somnolence, evaluate for obstruction or change in hemorrhage. Again seen are post-procedural changes related to embolization of the quadrigeminal plate cistern arteriovenous malformation and associated aneurysms. There has been evolution of hematoma in the right hemi-midbrain without residual hyperdense blood... | 1. Evolving right midbrain and intraventricular hemorrhage. Residual hyperdense blood products in the right midbrain no longer identified.2. Stable to slight decrease in prominence of the ventricular system.3. Post-procedural changes related to embolization of the quadrigeminal plate cistern arteriovenous malformation ... |
Generate impression based on findings. | Ankle injury with pain in first metatarsal.EXAMINATION: Left foot AP/lateral/oblique (3 views) 03/28/15 The bones are normal in appearance. No fracture is seen. No soft tissue swelling is identified. | Normal examination. |
Generate impression based on findings. | Back pain.EXAMINATION: Thoracic spine AP/lateral (two views) 03/28/15 Vertebral body heights and disk spaces are maintained. No fracture is identified. T1 and T2 are not seen on lateral view and if pain is at this level a swimmer's view is recommended. | No abnormality identified. If pain persists MRI may be helpful in further evaluation. |
Generate impression based on findings. | 44-year-old male with history of acute pancreatitis with possible pancreatic necrosis and persistent fever despite antibiotics. Evaluate for pancreatic necrosis. ABDOMEN:LUNG BASES: Moderate to large left pleural effusion and smaller right pleural effusion with atelectasis.LIVER, BILIARY TRACT: No significant abnormali... | Pancreatic necrosis involving majority of the pancreatic parenchyma. Associated and loculated fluid within the abdomen and pelvis as well as thickening of adjacent bowel. |
Generate impression based on findings. | 40 year-old female with epigastric pain and bandemia. Evaluate for pancreatitis or other cause of pain. ABDOMEN:LUNG BASES: Partially visualized left breast implant.LIVER, BILIARY TRACT: No significant abnormality noted. Post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: Normal. Previously noted cha... | No findings to explain patient's abdominal pain and left shift. |
Generate impression based on findings. | 49-year-old female with empyema and chest tube. History of malignant neoplasm of corpus uteri. LUNGS AND PLEURA: Interval right chest tube placement with decreased right pleural effusion, now small. This effusion appears loculated with enhancing pleura, compatible with the history of empyema. There is a small loculatio... | 1.Small hydropneumothorax after right chest tube placement.2.Increased left pleural effusion.3.Esophageal changes consistent with known oncologic and surgical history.4.Cystic lesion in posterior left thyroid lobe.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 39-year-old female with abdominal pain and peripancreatic fluid collection. Known infected pancreatic pseudocyst with cyst gastrostomy and nasocystic drain. ABDOMEN:LUNG BASES: Improved left pleural effusion with atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted. Post cholecystectomy.SPLEEN: No signifi... | Decrease in peripancreatic fluid collection. No new findings to suggest source of abdominal pain. |
Generate impression based on findings. | 60 year-old male with recurrent pancreatitis. Dedicated pancreatic protocol to evaluate for cause of abnormality. Abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Pancreatic head is mildly prominen... | Stable appearance of the pancreas and biliary tract.Stable, mild adenopathy.Small, enhancing right renal mass which by size criteria does not require follow-up. |
Generate impression based on findings. | Altered mental status. There is no evidence of acute intracranial hemorrhage or mass effect. There are scattered foci of low attenuation in the periventricular and subcortical white matter, age-indeterminate chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. T... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Mild age-indeterminate chronic small vessel ischemic changes. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.I personally reviewed the Images and/or... |
Generate impression based on findings. | CT head: The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no acute intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. There is moderate mucosal thickening of the bilateral ethmoid and bilateral sphenoid sinu... | 1. No acute intracranial hemorrhage or mass effect.2. No evidence of venous sinus thrombosis.3. Mild paranasal sinus disease. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Status post fall with head injury. Evaluate for intracranial hemorrhage. There is soft tissue contusion and laceration in the forehead region without underlying calvarial fracture. Subtle tiny hyperdensity involving the adjacent right frontal cortex is most likely artifactual. There is no evidence of acute intracranial... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Soft tissue contusion and laceration in the forehead region without underlying calvarial fracture. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 50 year-old female with abdominal pain. Prior Bilroth II. Exam slightly limited by low dose CT technique.ABDOMEN:LUNG BASES: Resolved left pleural effusion.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver without mass on portal venous phase imaging.SPLEEN: No significant abnormality notedPANCREAS: There is mild ... | Stable CT of the abdomen and pelvis except for decrease in ascites.No change in small pancreatic mass.No change in cirrhotic -- appearing liver.No change in right renal mass.Improved ascites.Marked vascular calcification. |
Generate impression based on findings. | 70 year-old female with groin and upper thigh purulent drainage UTERUS, ADNEXA: Post hysterectomy. No masses.BLADDER: No significant abnormality notedLYMPH NODES: Left external iliac lymph node on image 35/91 measuring 1.2 x 2.3 cm. Non-enlarged inguinal nodes bilaterally.BOWEL, MESENTERY: No significant abnormality no... | Complex left subcutaneous fluid collection in the groin consistent with abscess. Other focal areas of skin thickening and subcutaneous enhancement. |
Generate impression based on findings. | Reason: Ms. Placek is a 75 y.o F with h/o metastatic melanoma to the right pleura here with acute SOB. 20% peripheral eosinophilia. Would like high-res CT to evaluate for pneumonitis or other acute changes History: SOB LUNGS AND PLEURA: Severe centrilobular emphysema. Moderate loculated right pleural effusion, which is... | 1.Severe centrilobular emphysema.2.Interval improvement of moderate loculated right pleural effusion.3.Marked pleural nodularity of the right the thorax, consistent with known history of metastatic melanoma.4.Interval worsening of right basilar reticular opacities, which may relate to post-radiation changes. However, s... |
Generate impression based on findings. | 80-year-old male with history of ulcerative colitis, now with rectal bleeding, hypotension and elevated white count. Evaluate for rectal abscess. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. Small focus of accessory s... | 1. Obstructing calculi distal left ureter with progressive hydronephrosis. Nonobstructing calcified bilaterally.2. Stable AAA.3. Multiple complex but small renal masses, some new when compared to the prior exam, likely represent bilateral renal neoplasms.4. Fluid collection in the rectal bed. |
Generate impression based on findings. | History of metastatic melanoma status post 4 cycles of Pembrolizumab. Please evaluate response to therapy and compared to previous imaging. There are postoperative findings related to left neck dissection. There is no significant interval change in the cervical lymph nodes. For example, a left level 1B lymph node measu... | 1. Postoperative findings in the left neck without significant interval change in the cervical lymph nodes.2. Please refer to separate report for findings in the chest.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 29-year-old female with fever and right lower quadrant pain. 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 notedKIDNEYS, URETERS: No si... | Left adnexal cystic mass or collection with trace pelvic fluid. This would be best evaluated with transvaginal ultrasound. |
Generate impression based on findings. | 40 year-old female with left upper quadrant pain and obstipation. History of multiple prior abdominal surgeries. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No ... | Narrowing of the transverse duodenum at the level of the superior mesenteric artery. Presumed adhesions involving small bowel without obstruction.Focal areas of narrowing involving distal colon without obstruction.Uterine fibroid. |
Generate impression based on findings. | History of left tonsillar squamous cell carcinoma status post CRT. Compare to previous measurements. There are stable post-treatment findings in the neck without evidence of mass lesions in the region of the oropharynx or significant lymphadenopathy in the neck. The salivary glands are unchanged. There is an unchanged ... | Stable post-treatment findings in the neck without evidence of tumor recurrence or significant cervical lymphadenopathy. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 67-year-old female post HIPEC with wound dehiscence. Evaluate for intra-abdominal/abdominal wall fluid collection. Appendiceal carcinoma/carcinomatosis. ABDOMEN:LUNG BASES: New, large pleural fusions with basilar atelectasis.LIVER, BILIARY TRACT: Nodular contour of the liver. SPLEEN: Interval splenectomy.PANCREAS: No s... | Loculated fluid adjacent to the pancreas/stomach which appears simple.Dehiscent wound without fluid collection.Marked improvement in peritoneal carcinomatosis.Significant, bilateral pleural effusions. |
Generate impression based on findings. | 39-year-old male with history of HIv, now with abdominal pain, fever and nausea/vomiting 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 ... | Acute appendicitis. There is a small amount of adjacent fluid as well as trace of ascites in the upper abdomen. |
Generate impression based on findings. | 44-year-old female with constipation on narcotics. Examination demonstrates residual barium within nondistended colon. Mild/moderate fecal material. G-tube balloon overlies the left upper quadrant. Bony structures are intact. No bowel dilatation. | No bowel dilatation. Mild/moderate fecal material in colon. |
Generate impression based on findings. | Atypical hemangioma at T11 on MRI. There is mild dextro convex curve of the thoracic spine, which may be positional. The vertebral column alignment is otherwise within normal limits. The vertebral body and disc space heights are preserved. There is no evidence of fracture. There is no significant spinal canal stenosis.... | CT appearance of the thoracic spine is within normal limits. No suspicious osseous lesion is seen at T11 or elsewhere in the thoracic spine. Outside MRI if made available may be helpful for correlation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 62 year old female with generalized abdominal pain. History of cholangiocarcinoma with ascites and biliary drain. Possible ileus. Relative paucity of small and large bowel gas. No distended bowel identified although fluid filled loops cannot be excluded. There does not appear to be extensive fecal material within colon... | Paucity of bowel gas. |
Generate impression based on findings. | 61-year-old male with abdominal distention. Desaturation. Bowel gas pattern is nonspecific with moderate gas in nondistended small and large bowel. Staghorn calculus overlies the right kidney. Bony structures are intact. | No significant bowel dilatation. |
Generate impression based on findings. | Metastatic nasopharyngeal cancer treated with TFHx on 7/19/14. There are post-treatment findings in the nasopharynx, without evidence of measurable tumor in this region. There is a newly apparent subcentimeter hyperattenuating lesion in the anterior left masseter muscle. There are also findings related to right neck di... | 1. Newly apparent lesion in the left masseter muscle may represent a metastasis versus an inflammatory process or hematoma. Ultrasound or MRI may be useful for further characterization if clinically warranted. 2. Post-treatment findings in the neck with interval interval resolution of ill-defined heterogeneity of the i... |
Generate impression based on findings. | 75-year-old male with dysphasia for NG tube position. August pattern within normal limits for the large amount of fecal material in the colon. NG tube tip in the region of the gastric body. Vena caval filter present with tip at the L2 level. Bony structures intact. | NG tube tip in stomach. |
Generate impression based on findings. | Right parotid adenoid cystic carcinoma with metastases status post chemoradiation presenting with facial droop. There are post-surgical changes related to a right parotidectomy and right lymph node dissection. There is unchanged ill-defined soft tissue in the right parotid bed without definite evidence of a measurable ... | 1. Post-surgical changes related to a right parotidectomy with unchanged ill-defined soft tissue in the right parotid bed without definite evidence of a measurable mass. No evidence of significant cervical lymphadenopathy. Given provided history of facial droop, consider MRI for better evaluation for perineural tumor s... |
Generate impression based on findings. | 49 year old female with abdominal pain and distention after liver transplant. When compared to prior exam, there has been improvement in bowel distention of dilated loops of small bowel with mild fold thickening identified in the right abdomen. Scattered gas/fluid levels on lateral decubitus view without free intraperi... | Improvement in bowel distention. |
Generate impression based on findings. | 62-year-old male for evaluation of Dobbhoff tube placement. Dobbhoff tube tip in the post bulbar duodenum. Moderate gas in nondistended small and large bowel. Residual contrast within renal collecting systems bilaterally. Bony structures intact. | Dobbhoff tip in the post bulbar duodenum. |
Generate impression based on findings. | 64-year-old female for evaluation of NG tube placement. NG tube tip in the region of the gastric body. Visualized bowel gas pattern within normal limits. Bony structures are intact. | NG tube tip in stomach. |
Generate impression based on findings. | 56-year-old male with dysphasia for NG tube placement. NG tube coiled within the stomach with tip extending retrograde in the body. Moderate gas in nondistended small and large bowel. Bony structures intact. | NG tube coiled within stomach. |
Generate impression based on findings. | 60 year-old female with epigastric abdominal pain and GI bleed. Residual contrast in nondistended colon. There remain mildly dilated loops of small bowel mid abdomen without sniffing change. Clips overlie the right upper quadrant. Bony structures are intact. | No change in mildly distended small bowel. |
Generate impression based on findings. | 62-year-old female with abdominal pain, flatulence. Curvilinear densities in the right abdomen likely represents mildly coded fecal material in the right colon from prior CT. Moderate fecal material within colon. No small bowel dilatation. Bony structures are intact. | Moderate fecal material in colon. |
Generate impression based on findings. | Metastatic thyroid carcinoma for follow-up. Neck: There are postoperative findings related to total thyroidectomy. There is no evidence of tumor recurrence. There are scattered subcentimeter lymph nodes which are nonspecific. No pathologically enlarged or necrotic lymph nodes are seen. The airways are patent. The major... | 1. No evidence of locoregional tumor recurrence or significant lymphadenopathy. 2. No evidence of intracranial metastases.3. There are bilateral pulmonary nodules likely representing metastases. Please refer to separate chest CT report for details.I personally reviewed the Images and/or procedure with the Resident/Fell... |
Generate impression based on findings. | 78-year-old male for NG tube placement. NG tube tip now in the region the gastric fundus. Diffuse gaseous filled small bowel and colon without obvious distention. Bony structures are intact. | NG tube tip in gastric fundus |
Generate impression based on findings. | 56-year-old male for NG tube placement. NG tube acutely angled in the stomach with the tip extending cephalad in the fundus. Due to retracted approximately 10 cm and then advanced. Visualized bowel gas pattern within normal limits. Bony structures intact. | Acute angulation of NG tube in stomach |
Generate impression based on findings. | 55 year old female with hepatitis and abnormal liver function. Evaluate for portal venous thrombosis. LIVER: Echogenic and relatively small. No focal hepatic abnormality. Peak velocity in the main portal vein of 23 cm/sec with appropriate flow direction. Hepatic artery patent.GALLBLADDER, BILIARY TRACT: Gallbladder con... | Gallstones with borderline distended gallbladder and trace pericholecystic fluid. The appearance is not specific without wall thickening and with associated ascites. Patent main portal veinsmall, echogenic liver. |
Generate impression based on findings. | 61-year-old female post tips placement with altered mental status. PORTAL VENOUS: Patent with appropriate flow direction. Limited portal venous tracing demonstrates patency and appropriate flow direction in the main portal vein. The left portal vein adequately visualized with inadequate Doppler tracings.HEPATIC ARTERIE... | Exam is somewhat limited. Velocities are reason for distal tips stenosis.Report to Kiran Pandey at pager 2434: 2:57 PM 3/29/15 |
Generate impression based on findings. | There are remote postoperative changes of the right paranasal sinuses/nasal cavity, including resection of the right nasal turbinates, anterior and lateral walls of the right maxillary sinus, right posterior ethmoid air cells and right sphenoid sinus. Redemonstrated is extensive soft tissue opacity within the expected... | 1. Extensive post-surgical changes from remote right paranasal sinus and nasal cavity surgery. No significant change compared to prior in the soft tissue opacity extending into the right aspect of the clivus/expected location of the right sphenoid sinus with extension into right skull base foramina as detailed above. M... |
Generate impression based on findings. | 55-year-old male with pancreatic carcinoma and colon carcinoma post chemotherapy with nausea and vomiting. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY ... | Cannot exclude local recurrence in the location of the pancreatic head resection bed.Interval development of gastric wall thickening which could be inflammatory.Extensive fecal material in the residual colon.No change in biliary tract mild dilatation. Stent in place. |
Generate impression based on findings. | Thyroid cancer, evaluate for recurrence. Tg not suppressed. There are postoperative changes related to total thyroidectomy and neck dissection. There is no discernible mass lesion in the thyroidectomy bed. There are scattered subcentimeter cervical lymph nodes that are not significantly enlarged. The salivary glands ar... | 1. Stable post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence. 2. Scattered nonspecific lymph nodes in the neck, which are otherwise not particularly enlarged. |
Generate impression based on findings. | 40 year-old male with a history of lymphoma and GI involvement. Left lower quadrant pain. 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... | Mild, non-perforated diverticulitis versus epiploic appendagitis descending colon.Unable to reach Jean Ridgeway, and no covering pager. Emailed: Unable to reach you today. Patient Dwayne Jones, MR 931344 with very mild, non-perforated diverticulitis descending colon. 3-29-15 at 3:35 PM. Due to mild nature, did not atte... |
Generate impression based on findings. | History of buccal cancer status post CRT. Please compare to prior. Evaluation for tumor recurrence is slightly limited by lack of intravenous contrast. There are post-treatment changes without gross evidence of mucosal based mass lesion or significant cervical lymphadenopathy. The thyroid and major salivary glands are ... | Slightly limited non-contrast study. Stable post-treatment changes without gross evidence of mucosal based mass lesion or significant cervical lymphadenopathy. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Per chart history of T3N2b p16+ L tonsillar cancer s/p chemoradiation completed 4/6/12 with subsequent R lung oligometastasis s/p SBRT completed 05/24/2013, then with progressed disease in lung on PET 3/2014, s/p VATS wedge resection with findings of multiple parenchymal and pleural-based nodules. Started pembrolizumab... | Post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence or significant lymphadenopathy in the neck. Please refer to separate report for findings in the chest. |
Generate impression based on findings. | The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body are well-maintained. There is mild loss of disc height at C5-6 and C6-7. The marrow signal is mildly heterogeneous. The spinal cord is of normal caliber and signal. There is no pathological enhancement.C2-C3: Posterior disc ... | 1. Degenerative changes throughout the cervical, thoracic and lumbar spine, most prominent at C5-6, C6-7, and L5-S1, with variable foraminal stenosis as described above. No significant spinal canal stenosis. 2. Ventral bridging osteophytes in the lower thoracic spine which may be related to diffuse idiopathic skeletal ... |
Generate impression based on findings. | 60 year-old male with gist tumor. Evaluate for recurrent disease. CHEST:LUNGS AND PLEURA: Densely calcified granuloma in the left upper lobe.MEDIASTINUM AND HILA: No significant abnormality notedCORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant ... | No evidence of recurrent disease. No interval change. |
Generate impression based on findings. | 50 year-old male with malignant melanoma post therapy. Evaluate response. CHEST:LUNGS AND PLEURA: Right lower lobe nodule is ill-defined measuring 4 mm on today's exam. Interval resection of left medial pleural nodule. There is asymmetric soft tissue in this region measuring 1.4 x 2.7 cm on image 75/102 associated with... | Although there is no decrease in small right lung nodule with presumed postoperative change involving the left pleura and decrease in size of reference left lobe mass, there has been significant enlargement of previously noted mass near the hepatic venous confluence. |
Generate impression based on findings. | 63 old female with history of metastatic renal cancer with multiple prior therapies. CHEST:LUNGS AND PLEURA: Reference left upper lobe nodule measures 0.8 x 1 cm without significant change. There are multiple, scattered nodules throughout both lungs which are unchanged or perhaps minimally enlarged when compared to the... | Progression of widespread metastatic disease. |
Generate impression based on findings. | episode of unresponsiveness, residual dysarthria, left side drooling. No evidence of acute ischemic or hemorrhagic lesion.Left basal ganglia and external capsule and bilateral pontine chronic infarctions are again demonstrated, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkabl... | 1. No evidence of acute ischemic or hemorrhagic lesion.2. No change of multifocal chronic ischemic infarctions since prior exam as described above. |
Generate impression based on findings. | 35-year-old male patient with abdominal pain vomiting. Evaluate for obstruction. ABDOMEN:LUNG BASES: Basilar atelectasis and scarring, left greater than right. Cardiomegaly.LIVER, BILIARY TRACT: Mild hepatomegaly. Status post cholecystectomy. Multiple hypoattenuating liver lesions are too small to characterize and like... | 1.No acute intra-abdominal abnormalities given limitation of paucity of intra-abdominal fat.2.Atrophic native kidneys and renal osteodystrophy compatible with history of focal segmental glomerulosclerosis.3.Mild prominence of the common bile duct likely secondary to cholecystectomy. |
Generate impression based on findings. | Male 25 years old; Reason: evaluate for SBO History: abdominal pain ABDOMEN:LUNG BASES: Bibasilar dependant atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URE... | 1.Small bowel obstruction with transition point in the lower mid abdomen, may reflect site of stricturing or adhesive disease. Fluid and inflammatory changes around the dilated segment of bowel raises the possibility of ischemia. Chronic inflammatory changes within the bowel consistent with provided history of inflamma... |
Generate impression based on findings. | 89 year-old female patient with abdominal pain. Evaluate for ischemia. ABDOMEN:LUNG BASES: Bibasilar scarring and atelectasis. Coronary artery calcifications.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No sign... | 1.Right hydronephrosis with obstructing renal calculus measuring 7 mm. Cannot rule out superimposed infection.2.Greater than expected soft tissue within the endometrial cavity given patient's age. Recommend further evaluation with dedicated pelvic ultrasound and correlation with clinical history for vaginal bleeding.Fi... |
Generate impression based on findings. | follow up of cerebellar ICH Re-demonstration of the cerebellar (mainly vermian) ICH, IVH and SAH with surrounding edema. No significant interval change since prior exam.Slightly enlarged ventricle size (19.1mm, right frontal horn of lateral ventricle at the level of foramen of Monroe), no significant interval change si... | No change of cerebellar IVH, IVH and SAH extent.No change of ventricle size since prior exam. |
Generate impression based on findings. | Right hip pain.VIEWS: Pelvis AP/frog leg (two views) 03/29/15 The round, smooth femoral heads are well directed into normally formed acetabula. No fracture is present. The bones are normal in appearance. | Normal examination. |
Generate impression based on findings. | Post evacuation of the left ICH. The left fronto parietal ICH with postoperative status, grossly no significant interval change of the extent of hemorrhage, surrounding edema and postoperative changes such as air densities and left fronto-parietal craniectomy status.No change of ventricular hemorrhage since prior exam.... | 1. Slightly decreased the degree of midline shift to right side since prior exam.2. Otherwise no change of postoperative changes and IVH since prior exam. |
Generate impression based on findings. | 22 years, Female. Reason: r/o obstruction History: abd pain Previously administered oral contrast opacifies the descending and sigmoid colon. There is a nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 24 day old former 24 week gestational aged twin with respiratory distress.VIEW: Chest AP (one view) 03/29/15, 1316 Endotracheal tube tip is between thoracic inlet and carina. Feeding tube tip is at GE junction. Right neck PCVC has its tip in superior vena cava. A portion of left lower quadrant drain is again seen.Soft ... | Complications from surfactant deficiency, unchanged.Probable early rickets. |
Generate impression based on findings. | Male, 21 years old. Abdominal pain. Evaluate for obstruction. ABDOMEN:LUNG BASES: No focal consolidation or pleural effusions.LIVER, BILIARY TRACT: No focal hepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation. The gallbladder is normal.SPLEEN: Normal size, without focal lesion.PANCREAS: Normal si... | No evidence of bowel obstruction or other acute abnormality to account for the patient's symptoms.Mildly prominent mesenteric and retroperitoneal lymph nodes, significantly decreased from 12/2012, in a patient with Hodgkin lymphoma. |
Generate impression based on findings. | 72 years, Male. Reason: evaluate cause of abdomen distension History: abdominal distension Large right pleural effusion with associated compressive atelectasis. Vascular stent projects over the midline abdomen. There is a moderate stool burden. There is a nonobstructive bowel gas pattern.There is a right pleural effusi... | Nonobstructive bowel gas pattern.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 13 year old female with new onset right sided headache and concern for hemorrhage or pseudotumor. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear... | 1.No evidence of intracranial hemorrhage.2.Moderate irregularity of the left mandibular condyle may reflect TMJ degeneration or a congenital variation. |
Generate impression based on findings. | Pulmonary hypertension. 6-month-old former 29 to 30 week gestational age patient.VIEWS: Chest and abdomen AP (two views) 03/29/15, 2138 Tracheostomy tube tip is at thoracic inlet. Feeding tube tip is just distal to GE junction.Lung volumes are large with hemidiaphragm is between 10 and 11 posterior ribs. Coarse bilater... | Chronic lung disease. Abnormal bowel gas pattern. |
Generate impression based on findings. | Female 76 years old; Reason: eval for pathology History: abd pain ABDOMEN:LUNG BASES: Basal scarring, slightly increased compared to prior study.LIVER, BILIARY TRACT: Cholelithiasis. Subcentimeter hypoattenuating liver lesions are too small to characterise but are stable compared to prior study and may represent cysts.... | 1.Cholelithiasis.2.New left inguinal hernia without obstruction.3.Severe arteriosclerotic changes as detailed above. 4.Cystic lesion within the pancreatic tail is stable compared to prior study but new since study of 2010. This may represent an IPMN (intraductal papillary mucinous neoplasm) but may be further evaluated... |
Generate impression based on findings. | 88 year-old male with abdominal distention, cannot rule out free air on AXR. Please note lack of IV contrast limits evaluation for bowel pathology. ABDOMEN:LUNG BASES: Bilateral small pleural effusions, right greater the left. Cardiomegaly with small pericardial effusion is noted. Partially visualized pacemaker leads.L... | 1. Small amount of free air in the lower abdomen and pelvis as noted above with small amount of free fluid and adjacent inflammatory changes involving the rectosigmoid colon. Given history of traumatic Foley catheter placement, findings favor bladder injury. Cystogram can be obtained to exclude a urine leak. Another co... |
Generate impression based on findings. | 78 years, Female. Reason: 78yo F w/ AMS, now s/p Dobbhoff History: as above There is a Dobbhoff tube with its tip projecting over the distal body of the stomach. The pelvis is excluded from the field of view. Cerclage wires project over the right upper quadrant. There is a paucity bowel gas. | Dobbhoff tube with its tip projecting over the distal body of the stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Atypical headache No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There is parti... | 1. No evidence of intracranial hemorrhage or mass effect. 2. Partial right sphenoid sinus opacification. |
Generate impression based on findings. | 60 years, Female. Reason: Dobbhoff position History: Dobbhoff migration The nasogastric tube has been removed. Interval placement of a Dobbhoff tube with tip projecting over the proximal gastric body. There is severe gaseous distention of the stomach, appearing similar to the prior examination. Additionally, there is g... | Dobbhoff tube to project over the proximal gastric body. Gaseous distention of both large and small bowel suggestive of ileus although distal obstruction is not excluded.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | postoperative status of the left frotoparietal ICH and IVH follow up No significant interval change of left fronto-parietal craniectomy, left fronto-parietal ICH postoperative changes, surrounding edema, extent of IVH and the location of the ventriculostomy tube inserted through left frontal burr hole since prior exam.... | No change of left fronto-parietal ICH with postoperative status since prior exam.No new ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | 6 year old male with sickle cell disease and acute chest syndrome as well as supratherapeutic PTT on heparin. There is a 47 x 34 mm intraparenchymal hematoma centered within the left occipital lobe. There is mild surrounding edema and resultant mass effect upon the atrium and left occipital horn as well as mass effect ... | 1.47 mm left occipital lobe intraparenchymal hematoma with mild mass-effect and midline shift.2.Mild bilateral frontal subarachnoid hemorrhage.3.Foci of low-attenuation within the left frontal and left cerebellar white matter are most compatible with age indeterminate infarctions.4.Paranasal sinusitis and nonspecific r... |
Generate impression based on findings. | 22-year-old male patient with history of colectomy with diverting loop ileostomy presents with abdominal pain. Evaluate for small bowel obstruction versus incarcerated hernia. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality n... | 1.Diverting ileostomy parastomal hernia without evidence of obstruction.2.Nonspecific prominent perirectal lymph nodes are mildly increased compared to prior examination. |
Generate impression based on findings. | 8-year-old male with history of headache and fever, vomitingVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 3/29/15 at 2124 Again seen is a right parietal approach shunt with tip in the midline. The shunt exits the cranium via parietal burr hole coursing d... | No evidence of shunt malfunction. |
Generate impression based on findings. | 65 years, Male. Reason: s/p NGT placement History: s/p NGT placement There is gaseous distention of multiple loops of small bowel which may reflect postoperative ileus although distal obstruction is not excluded. There is a right lower quadrant ostomy. Lucency over the right upper quadrant represents pneumoperitoneum, ... | Persistent gaseous distention multiple loops of small bowel compress suggests ileus versus distal obstruction. NG tube with tip projecting over the prepyloric stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 49-year-old female with GIST on Gleevec. Evaluate extent of disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Small thyroid nodules.CORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN... | Stable examination without evidence for recurrent disease. Cervix is large but unchanged. |
Generate impression based on findings. | 78-year-old female with altered mental status No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial... | 1. No evidence of intracranial hemorrhage or mass effect. 2. Moderate chronic small vessel ischemic disease as well as a right occipital infarct which is also likely chronic. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical su... |
Generate impression based on findings. | Reason: eval for fx History: slammed door on pointer finger Three views of the right index finger demonstrate soft tissue swelling, without evidence of underlying fracture or malalignment. | There is no acute fracture or malalignment. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No extra-axial fluid collections. Gray-white matter differentiation is preserved. The osseous structures are unremarkable. There is proptosis of the left orbit. There is interval increase of the circumferen... | 1.No evidence of acute intracranial hemorrhage or intracranial mass-effect. 2.Interval increase of circumferential soft tissue mass involving the intraorbital left optic nerve with mild left orbit proptosis. 3.Consider MRI of the brain with contrast to follow-up the intracranial extent of patient's lymphoma. 4.Diffuse ... |
Generate impression based on findings. | Drowning and pneumothorax.VIEW: Chest AP (one view) 03/30/15, 0254 Endotracheal tube tip is between thoracic inlet and carina. Feeding tube tip is in stomach. Lower extremity PICC has its tip at junction of intra- and intrahepatic IVC. Left chest tube remain place.Soft tissue edema is worsening.Subcutaneous emphysema a... | Persistent left pneumothorax and pneumomediastinum. Increasing soft tissue edema. |
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