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Generate impression based on findings. | 46 year old male patient diagnosed with colon cancer with mets to liver is here for Therasphere mapping in conjunction with nuclear medicine. There is free tracer activity within the right lobe of the liver consistent with patient's recent mesenteric angiogram and Tc-99m MAA infusion into the right hepatic artery. No s... | No evidence of lung shunting. Radiotracer accumulation in the right hepatic lobe consistent with patient's recent right hepatic artery infusion. |
Generate impression based on findings. | Status post hemiarthroplasty. Single AP view of the left shoulder shows a left shoulder hemiarthroplasty device situated anatomic alignment. No acute fracture is evident. | Left shoulder hemiarthroplasty. |
Generate impression based on findings. | Bilateral knee pain. Four views of the left knee show no acute fracture or malalignment. No joint effusion is identified.Four views of the right knee show no acute fracture or malalignment. No joint effusion is identified. | No specific radiographic findings to account for the patient's symptoms. |
Generate impression based on findings. | 52 years, Female. Reason: Pt has a hx of constipation, poor hx per pt. History: constipation Approximately 25 Sitz markers are identified, predominantly within the ascending and transverse colon. There is a nonobstructive bowel gas pattern. Suture material projects over the distribution of the GE junction. | Approximately 25 Sitz markers distributed predominantly throughout the ascending and transverse colon. |
Generate impression based on findings. | Stepped on glass. Concern for retained glass in heel.VIEWS: Right foot AP/lateral (two views) 03/30/15 The bones are normal in appearance. No fracture is seen. No glass is identified. | Normal examination. |
Generate impression based on findings. | Left knee pain. Four views of the left knee with weight-bearing show no acute fracture or malalignment. Tiny osteophytes along the undersurface of the patella indicate minimal degenerative change. | Minimal patellofemoral joint degenerative change. |
Generate impression based on findings. | Staging base of tongue cancer, locally advanced.RADIOPHARMACEUTICAL: 15.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 89 mg/dL. Today's CT portion grossly demonstrates extensive atherosclerotic including coronary arterial calcifications. Excreted urinary contrast is seen from a previous enhanced CT.Today... | 1.Markedly hypermetabolic left base of tongue mass, compatible with tongue cancer.2.No definitive FDG avid metastatic disease. Two small bilateral mild to moderately hypermetabolic jugular lymph nodes at the level of the mandibular angle, left slightly larger than right. Given their lower levels of uptake these may be ... |
Generate impression based on findings. | A 65 year old female with history of breast cancer (chemo and radiotherapy) with related cardiomyopathy, atrial fibrillation with AV nodal ablation, ICD (2 endocardial leads in right atrium and right ventricle, and 1 epicardial lead in the left ventricle), on left ventricular assist device (since 12/5/2014. Now hospita... | 1. LVAD inflow cannula is angulated toward the interventricular septum. 2. LVAD outflow cannula takes just over a 90 degree bend near the anastomosis site with the ascending aorta. 3. The LV is mildly dilated with a mid-line interventricular septum. ***All gated images not available at time of this report. Will add ad... |
Generate impression based on findings. | 78-year-old female with altered mental status. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is mild diffuse cerebral volume loss and cavum septum pellucidum. There is no midline shift or herniation. There are cerebrovascular calcificati... | No evidence of acute intracranial hemorrhage or mass effect. Please note that CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion and there are no contraindications.I personally reviewed the Images and/or procedure with the Residen... |
Generate impression based on findings. | 65 years, Male. Reason: 65M s/p LVAD with constipation, abdominal pain. Evaluate ileus History: As above Mild gaseous distention of small and large bowel likely reflects a mild ileus. Surgical staples are seen in the right hemiabdomen and skin staples are seen along the right femur. A bullet fragment is noted in the mi... | Mild gaseous distention of small and large bowel likely reflects a mild ileus. |
Generate impression based on findings. | Status post ORIF right ankle fracture. Evaluate for healing. Three views of the right ankle show a side plate and screw device affixing the distal fibula and two orthopedic screws affixing the medial malleolus. The fracture lines are less distinct suggestive of healing. Alignment is grossly anatomic. Mild soft tissue s... | Orthopedic fixation of distal tibia and fibula fractures. |
Generate impression based on findings. | Female; 35 years old. Reason: breast cancer with lung and liver mets. Please compare to outside CT 2/2015 and measure using recist criteria 1.1 and immune response criteria History: pre chemo CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules have mildly increased in size, compatible with metastatic disease. ... | 1. Interval increased size in pulmonary metastases, bilateral hilar lymphadenopathy, right axillary lymphadenopathy, and hepatic metastasis.2. A short segment focal small bowel intussusception in the left lower quadrant (series 4/168) is new since prior study and most likely transient with no lead point mass evident or... |
Generate impression based on findings. | 66 years, Male. Reason: NG placement History: Encephalopathy with dysphagia There is a nasogastric tube with its tip projecting over the fundus of the stomach. The pelvis is excluded from the field of view. There is a nonobstructive bowel gas pattern. | There is a nasogastric tube with its tip projecting over the fundus of the stomach. |
Generate impression based on findings. | 64 year-old femal. History of vaginal cancer and SBO status post ex lap and lysis of effusions on 1/21, presenting on 2/4 with intra-abdominal fluid collections and surgical wound drainage status post IR placed drains. CT for reassessment of abscess/fistula. ABDOMEN:LUNG BASES: Interval resolution of small pleural effu... | 1. Stable positioning of the 3 percutaneous abdominal drains with interval resolution of fluid collections.2. Persistent nonspecific diffuse mild haziness/fluid in the pelvic fat, more confluent in the presacral region. |
Generate impression based on findings. | Male 49 years old Reason: SNIFF test History: dyspnea Bronchial stent unchanged. Catheter tip in the SVC. Bullet fragments project over the lower thorax.The right diaphragm is paralyzed, without motion during forced inspiration. | Right diaphragmatic paralysis. |
Generate impression based on findings. | HPV-related cT3N0Mx right tonsillar squamous cell carcinoma. Follow-up after completing CRT on 10/4/13. There are post-treatment findings in the neck, including right suprahyoid lymph node dissection and mild pharyngeal mucosal edema. There is no measurable residual mass in the right tonsillar fossa. There is no signif... | 1. Stable post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence.2. Bilateral nonspecific supraclavicular lymph nodes appear slightly more prominent, but are nevertheless subcentimeter in short axis and no significant lymphadenopathy is present elsewhere in the neck to suggest ... |
Generate impression based on findings. | Female 45 years old Reason: evaluate hepatic artery, celiac artery, portal system and TIPS History: evaluate hepatic artery, celiac artery, portal system and TIPS LIVER DOPPLER:TIPS: Patent.PORTAL VEINS: Patent.HEPATIC ARTERIES: Difficult to visualize, but arterial waveform seen within the right and left hepatic arteri... | 1.Difficult to visualize hepatic arteries. CTA with venous phase can be performed if there is a rise in LFTs to assess the hepatic arteries. |
Generate impression based on findings. | 58 year old female with history of unilateral leg swelling and pain. PULMONARY ARTERIES: There is a large filling defect within the right main pulmonary artery compatible with pulmonary embolus. While most of this appears chronic, the filling defect appears larger suggesting further propagation or additional embolic bu... | 1. Large pulmonary embolus in the right main pulmonary artery, likely chronic with a possible acute component. Findings compatible pulmonary hypertension.2. Stable findings of fibrosing mediastinitis.PULMONARY EMBOLISM: PE: Positive.Chronicity: Chronic.Multiplicity: Single.Most Proximal: Main.RV Strain: Negative. |
Generate impression based on findings. | Male, 2 years old. Respiratory failure. Evaluate PICC positionVIEW: Chest AP (one view) 3/30/15, 1455 Endotracheal tube below the thoracic inlet and above the carina. A gastrostomy tube is present. New right arm PICC, tip in the right atrium.The cardiothymic silhouette is normal.Subsegmental atelectasis, increasing in ... | Right arm PICC, tip in the right atrium. Increasing atelectasis. |
Generate impression based on findings. | 67-year-old male with history of pancreatic cancer and shortness of breath. PULMONARY ARTERIES: Large bilateral pulmonary emboli largest within the left lower and lingular pulmonary arteries as well as smaller emboli in the right upper, middle and lower lobar arteries. There is no evidence of right heart strain.LUNGS A... | 1. Bilateral acute pulmonary emboli with no evidence of right heart strain.2. New moderate sized right pleural effusion and small pericardial effusion.3. Cirrhosis, ascites, and findings of portal hypertension.4. Extensive metastatic disease as above.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Mult... |
Generate impression based on findings. | 17 year-old female with hepatitis, vomiting, abdominal pain ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions are present. The gallbladder has been removed. Common bile duct, common hepatic duct, left hepatic duct, and small portion of the right hepatic duct are mildly dilated. The common bile duct measures up to ... | 1.Retained stone in the distal common bile duct.2.Fat necrosis in the posterior and lateral subcutaneous fat. |
Generate impression based on findings. | Female, 82 years old, status post orthopedic and patient. Assess for bone damage, hardware failure. Posterior instrumented fusion has been performed with bilateral pedicle screws affixed to posterior stabilization rods from L2 through L5. The right-sided pedicle screws at L2 and L3 have pulled back from their original ... | 1.Retraction of the right-sided pedicle screws at L2, L3 and to a lesser degree L4, with a resultant posterior tilt of the associated stabilization rod.2.Lucency surrounding the left L2 pedicle screw may also reflect loosening, though the screw appears to maintain adequate positioning within the bone.3.Significant dege... |
Generate impression based on findings. | Shoulder pain. Hip pain. Question of FAI. Three views of the left shoulder show no acute fracture or malalignment.Two views of the left hip show no acute fracture or malalignment. Additional view of the pelvis shows no acute fracture. A spinal generator is noted. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | 66-year-old male with history of shortness of breath. PULMONARY ARTERIES: There are multiple bilateral filling defects in bilateral pulmonary arteries compatible with acute pulmonary emboli.LUNGS AND PLEURA: There is a large dense airspace opacity in the left lower lobe which may represent infarction or infection. Smal... | 1. Acute bilateral pulmonary emboli with no evidence of right heart strain.2. Large left and small right lower lobe opacities may represent evolving infarctions or less likely infection, although underlying nodules/masses cannot be excluded. Follow up to resolution is recommended.PULMONARY EMBOLISM: PE: Positive.Chroni... |
Generate impression based on findings. | Right distal femur pathologic fracture status post intermedullary rod with breakage of distal screws. Evaluate for healing. Two views of the right femur show an femoral intramedullary rod bridging a distal femoral diaphyseal fracture with one proximal and two distal interlocking screws. The distal interlocking screws a... | Orthopedic fixation of a distal femur fracture with unchanged fractured distal screws. |
Generate impression based on findings. | Female, 13 years old. Seizure, trauma, back pain.VIEWS: Thoracic spine AP, lateral, swimmers. Lumbar spine AP, lateral, lumbosacral junction lateral (6 views) 3/30/15, 1548 No acute fracture or malalignment.Vertebral body and disk space heights are maintained. | Normal examination. |
Generate impression based on findings. | 43-year-old male, assess for ascites and patency of liver vasculature. LIMITED ABDOMENLIVER: Measures 17.1 cm in length. There appear to be two large cysts at the periphery of the liver.BILIARY TRACT: Sludge within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is n... | 1. Findings favor large cysts in the liver. This can be confirmed with MRI or other cross-sectional imaging. Patent hepatic inflow and outflow vasculature. 2. Sludge within the gallbladder with no cholelithiasis or sonographic evidence of cholecystitis. 3. Incompletely visualized bilateral pleural effusions. |
Generate impression based on findings. | Radius lesion with pathological fracture Three views of the left wrist reveal a non-ossifying fibroma within the distal l diaphysis of the radius. When compared to previous exam of February the fracture line is no longer visible. | Healed fracture through nonossifying fibroma |
Generate impression based on findings. | Assess for size, alignment of L TKA implant, location and alignment of spacer. Left knee pain and flexion contracture s/p L TKA at OSH 9/2014. Four views of the left knee with weight-bearing show a left total knee arthroplasty device situated in anatomic alignment without evidence of hardware complication. No acute fra... | Left total knee arthroplasty device in anatomic alignment. |
Generate impression based on findings. | Female, 10 years old. Hip pain, limp. Evaluate for SCFEVIEWS: Pelvis AP, frog leg (two views) 3/30/15, 1617 No acute fracture or malalignment.The femoral heads are round, smooth, and was directed into well formed acetabula. The proximal femoral physes are normal in width, without evidence of epiphyseal displacement. | Normal examination. |
Generate impression based on findings. | Pain. Deformity of wrist. Three views of the right wrist show a faint lucency along the dorsal aspect of the distal radius, only seen on the lateral view, which is suspicious for a nondisplaced fracture. Probable old healed ulnar diaphyseal fracture. There is basilar joint/triscaphe osteoarthritis. | Vague lucency along the dorsal aspect of the distal radius is suspicious for a non-displaced fracture. |
Generate impression based on findings. | Knee pain status post meniscectomy. Four views of the right knee show no acute fracture or malalignment. No joint effusion is identified. | No specific radiographic findings to account for the patient's symptoms. |
Generate impression based on findings. | Knee pain/instability. Evaluate for redo ACL surgery. Evaluate bone tunnels from prior ACL surgery. CT images of the left knee show postsurgical changes of an ACL reconstruction with an interference screw within the distal femur and two screws within the tibial tuberosity. The femoral and tibial tunnels appear to be wi... | 1. Bone tunnels within normal limits of alignment.2. Loose body adjacent to the femoral tunnel. 3. Please refer to MRI report from the same date for ligamentous and meniscal findings. |
Generate impression based on findings. | Tripped. Pain on top of right foot. Rule-out fracture.VIEWS: Right foot AP/lateral/oblique (3 views) 03/30/15 Minimal soft tissue swelling is present on the dorsum of the foot. No fracture is seen. The bones are normal in appearance. | No fracture. |
Generate impression based on findings. | 65-year-old female with right sided neck pulsation. Evaluate for goiter. RIGHT LOBE MEASUREMENTS: Status post right thyroidectomyLEFT LOBE MEASUREMENTS: 2.6 cm x 1.5 cm x 1.4 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: No discrete nodules or masses are noted in the right thyroidectomy bed. LEFT LOBE: Heterogen... | Heterogeneous left thyroid gland with what appears to be a nodule at the inferior pole, unclear if this is part of the heterogeneous echotexture of the gland or a discrete nodule. This is amenable to biopsy a clinically warranted. |
Generate impression based on findings. | 55-year-old female with transaminitis, concern for shock liver versus Budd-Chiari. Evaluate for cholecystitis, biliary pathology. LIMITED ABDOMENLIVER: Increased echogenicity of the liver measuring 14.1 cm in length. No focal hepatic lesions.BILIARY TRACT: Sludge within the gallbladder. No gallbladder wall thickening. ... | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Patent inflow outflow hepatic vasculature.2. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No hydronephrosis.3. Sludge within the gallbladder with no evidence of cholelithiasis or sonographic ... |
Generate impression based on findings. | 44 year old man with vegetations on "Starfix lead." He is in need of complex extraction procedure and is referred to evaluate location of lead.CPT: 75571 Coronary anatomy: LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumfl... | 1.Coronary sinus lead location as described above.2. Moderate burden of coronary calcification is noted.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum t... |
Generate impression based on findings. | 49 year old female s/p OLT, with recent acute rejection. Please evaluate biliary tree prior to fascial closure. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is spontaneous but significantly delayed excreti... | Uniform uptake of tracer by the liver with spontaneous but significantly delayed excretion into bowel without clear delineation of the biliary system. This delay may be secondary to ileus and further evaluation can be considered after its resolution. Findings discussed with Dr. Renz, the attending physician, via teleph... |
Generate impression based on findings. | Clinical question: AMS signs and symptoms: AMS Nonenhanced head CT: There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Re-visualization of right temporal and right frontal foci of white matter low-attenuation with subtle interval dec... | 1.No acute intracranial process. 2.Visualization of previously known parenchymal white matter low-attenuation.3.Stable mildly prominent ventricular system with maintained midline. |
Generate impression based on findings. | Reason: eval PE History: h/o cancer, h/o DVT, CP, tachy, reported history of multiple myeloma PULMONARY ARTERIES: The examination is technically adequate for the evaluation of pulmonary embolism. No pulmonary embolus is present.LUNGS AND PLEURA: Nodular fissural density at the inferior right major fissure most compatib... | No pulmonary embolus is present. Interval appearance of nonspecific foci of ground glass with centrilobular nodules and bronchial wall thickening in the lower lobes suggestive of bronchiolitis/inflammation secondary to aspiration. Stable soft tissue nodule at the distal esophagus measuring 18 x 21 mm.PULMONARY EMBOLISM... |
Generate impression based on findings. | Clinical question: Rule out intracranial abnormalities. Signs and symptoms: Status post fall. Nonenhanced head CT:No detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Several periventricular and subcortical low attenuation white matter suspicious for age indeterminate mild sma... | No acute posttraumatic findings. Stable study since prior exam |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: Transient global amnesia. Nonenhanced head CT:No evidence of acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- whi... | Negative nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Patient with new left eye medial deviation. Please include the brainstem to evaluate sixth nerve. Signs and symptoms:as a bacterial Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebra... | 1.Unremarkable nonenhanced head CT.2.Chronic pansinusitis. |
Generate impression based on findings. | Reason: eval for fungal vs other pna History: wheezing, immunocompromised LUNGS AND PLEURA: Trace pleural effusions which are new. Straight interlobular septal thickening, concentrated in the lower lobes, with centrilobular patchy groundglass and nodularity. Bronchial wall thickening which is more prominent when compar... | Straight interlobular septal thickening concentrated in the lower lobes with trace pleural effusions, suggestive of resolving edema. Increased bronchial wall thickening with lower zone centrilobular groundglass and nodularity raises a question of atypical infection, given the immunocompromised state. |
Generate impression based on findings. | Female 60 years old Reason: look for SB sources of bleeding History: (+) coffee ground emesis, (+) melena, (-) EGD/c-scope ABDOMEN:LUNG BASES: New, small bilateral pleural effusions with overlying compressive atelectasis. Cardiac conduction device in situ.LIVER, BILIARY TRACT: Cholecystectomy clips.SPLEEN: No significa... | 1. New small bilateral pleural effusions.2. Dilated small bowel loops with an obstructive component, most likely related to low grade adhesions.3. There is nonspecific wall thickening of a 5.1cm segment of mid small bowel (series 80244, image 53). This is nonspecific but the appearance favors inflammatory/infectious et... |
Generate impression based on findings. | Clinical question: Hemorrhage?. Signs and symptoms: Forehead hematoma status post fall. Nonenhanced head CT:There is no detectable acute intracranial process and no evidence of calvarial abnormality. Subgaleal and subcutaneous hemorrhage and edema of a midline forehead is noted. The finding measures maximum of 10.5-mm ... | 1.Frontal subgaleal and scalp hemorrhage as detailed. 2.Unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | Clinical question: 62-year-old male with history of perimesencephalic subarachnoid hemorrhage. Presenting with gradually progressive worsening of right-sided sharp headache not responding to Tylenol. Subarachnoid hemorrhage?. Signs and symptoms: As above. Nonenhanced head CT:There is no detectable acute intracranial pr... | 1.Unremarkable nonenhanced head CT.2.Well pneumatized visualized paranasal sinuses, mastoid air cells and middle ear cavities. |
Generate impression based on findings. | ET tube terminates below the thoracic inlet. Central line tip is at the right atrium. Mediastinal tip and NG tube unchanged.Cardiac silhouette size is top normal. Diffuse lung haziness, right lower lobe opacity likely atelectases.Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pn... | Right lower lobe opacity likely atelectasis.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | 3-year-old male with increased work of breathing VIEWS: Chest AP/lateral (two views) 3/30/15 at 2234 Tracheostomy tube with tip at the thoracic inlet. Gastrostomy tube in the left upper quadrant.Normal cardiothymic silhouette. Peribronchial thickening consistent with bronchiolitis or reactive airway disease. Background... | Peribronchial thickening consistent with bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Female, 11 years old. Fall yesterday, now with ankle swelling and tenderness. Tenderness at lateral malleolus and base of fifth metatarsalVIEWS: Right ankle AP, lateral, oblique. Right foot AP, lateral, oblique (6 views) 3/30/15, 1800 No acute fracture or malalignment.Normal fifth metatarsal apophysis.Mild soft tissue ... | Soft tissue swelling, without fracture or malalignment. |
Generate impression based on findings. | 68 year old male with abdominal pain, hemoglobin drop. Evaluate for bleed, abscess. ABDOMEN:LUNG BASES: There is improved aeration of the visualized lung fields. Moderate bilateral pleural effusions increased from prior study with adjacent compressive atelectasis. LIVER, BILIARY TRACT: Liver is normal in morphology. St... | 1. Increased bilateral pleural effusions with adjacent compressive atelectasis. There has been interval improved aeration of the visualized lung fields however suggestive of improving infectious process. 2. No evidence of abscess or retroperitoneal hematoma. |
Generate impression based on findings. | 2-year-old male with pain, concern for fractureVIEWS: Left foot AP, oblique and lateral (3 views) 3/31/15 at 0120 Cortical angulation at the base of first metatarsal is a buckle fracture. Dorsal soft tissue swelling is present. No other fractures are identified. | Buckle fracture of the base of the first metatarsal. |
Generate impression based on findings. | Respiratory insufficiencyVIEW: Chest AP (one view) 3/31/15 at 418 hours. ET tube terminates below the thoracic inlet. Central line tip is at the right atrium. Gastrostomy tube noted. Thoracolumbar levoscoliosis is present.Cardiac silhouette size is normal. Bibasilar and right upper lobe atelectasis are again noted. | Persistent multifocal opacities. |
Generate impression based on findings. | Clinical question: Renal mass versus chronic changes. Signs and symptoms: Pulsatile headache and forgetfulness. Nonenhanced head CT:There is no detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes however.Examination demonstrates very subtle small foci of... | 1.No acute intracranial process.2.Finding suggestive of mild age indeterminate small vessel ischemic strokes.3.Unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | Male, 15 years old. Pain, status post trauma.VIEWS: Left foot AP, lateral, oblique (3 views) 3/30/15, 1811 The osseous structures and joint spaces are normal.No significant joint effusion. Mild dorsal soft tissue swelling. | Mild soft tissue swelling, without acute fracture or malalignment. |
Generate impression based on findings. | 10-year-old male evaluate for pneumoniaVIEW: Chest AP (one view) 3/31/15 at 0126 The cardiothymic silhouette is normal. Bronchial wall thickening is present consistent with bronchiolitis/reactive airway disease. Blunting of the right costophrenic angle may indicate a small right pleural effusion. Atelectasis is present... | Bronchiolitis/reactive airway disease pattern. Small right pleural effusion. Left lower lobe atelectasis. |
Generate impression based on findings. | Female 16 years old Reason: 16y F s/p liver transplant, width partial SBO and constipation, eval for interval changes VIEW: Abdomen AP (one view) 3/31/15 at 524 hours. Interval slight decrease in fecal accumulation. No evidence of obstruction or free air. | Interval improvement in fecal loading with no obstruction. |
Generate impression based on findings. | 65-year-old female patient with diarrhea and vomiting. Evaluate for fistula leak. CHEST:LUNGS AND PLEURA: No significant interval change in left upper lobe pleural-based nodule, currently measuring 5 mm (series 4 image 24).Other subpleural and peripheral micronodules measuring up to 5 mm are again noted, some of which ... | 1.Enterocutaneous fistula along the upper midabdominal wall. It is unclear if this fistula communicates with the adjacent transverse colon or inflamed blind ending biliary loop. Recommend fluoroscopic fistulogram to determine loop of bowel involved.2.Postsurgical changes from esophagojejunostomy.3.Stable micronodules i... |
Generate impression based on findings. | Male, 17 years old. Headache, abdominal pain. Recent shunt revision. Evaluate shunt.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) date The ventriculostomy catheter terminates in the left middle cranial fossa, and courses toward the valve, without fractur... | No evidence of shunt malfunction. |
Generate impression based on findings. | Incontinence, decreased rectal tone, evaluate for metastasis No destructive lesions are appreciated within the cervical spine. The cervical vertebral bodies are appropriate in height. There is loss of normal cervical lordosis. Moderate degenerative changes are seen throughout the lumbar spine with loss of disk height, ... | 1. No destructive lesions are appreciated within the cervical, thoracic, or lumbar spine to indicate metastatic disease. Bone scan may be helpful for assessing osseous metastatic disease as clinically appropriate.2. Degenerative changes in the cervical, thoracic, and lumbar spine without high-grade spinal canal stenosi... |
Generate impression based on findings. | Clinical question: Progressive metastatic breast cancer, assess for brain metastases. Signs and symptoms: As above. Enhanced head CT:The examination demonstrates a focus of enhancement in the anterior tip of the right temporal lobe measuring 6 x 8-mm in size and with extensive surrounding vasogenic edema and regional m... | 1.Multiple small enhancing metastatic lesions of bilateral cerebral hemispheres with surrounding vasogenic edema and regional mass effect as detailed/measured above.2.No hemorrhage, ventriculomegaly or midline shift.3.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. |
Generate impression based on findings. | 2-year-old male with fever and coughVIEWS: Chest AP/lateral (two views) 3/31/15 at 0151 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Mild peribronchial thickening consistent with bronchiolitis or reactive airway disease pattern. No focal pulmonary opacities. No pleur... | Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | Female 4 months old Reason: Is there evidence of fracture History: Rising alk phosVIEWS: Lung bone survey. Right and left humerus, forearm, femur and tibia-fibula AP 3/30/15 (8 view/s) There is no evidence of acute or healing fractures, malalignment or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 3-year-old female with high fever and respiratory symptomsVIEWS: Chest AP/lateral (two views) 3/31/15 at 0158 The aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. Mild peribronchial thickening is present consistent with bronchiolitis/reactive airway disease pattern. No pneumonia... | Mild reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. X-shaped noted in the left lower, outer quadran... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures ar... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Clip from prior benign biopsy seen in ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Reason: fx History: left knee pain and swelling Four nonweightbearing views of the right knee again show severe osteoarthritis, as well as a moderate joint effusion. Ossicles lying within the posterior aspect of the knee joint may represent loose bodies. There is slight lateral displacement of the tibia in relation to ... | Joint effusion and severe osteoarthritis, without evidence of acute fracture. |
Generate impression based on findings. | 5-month-old male with increased work of breathingVIEW: Chest AP (one view) 3/31/15 at 0510 Interval removal of endotracheal tube. Interval removal nasogastric tube and right femoral line. Right upper extremity peripheral catheter with tip in cephalic vein.The cardiothymic silhouette is normal. Increased right upper , r... | Increased atelectasis in the bilateral lung bases and upper lobes. |
Generate impression based on findings. | 26-year-old male with history of ALL and fungal infections now presenting with fever. LUNGS AND PLEURA: Right lower lobe consolidation has decreased in size, however the lesion is now cavitary and measures 20 x 13 mm. No air-fluid levels are present. There is small amount of focal bronchiectasis and atelectasis/consoli... | Right lower lobe consolidation has decreased in size and is now cavitary indicating continued improvement of invasive fungal infection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. No history of breast cancer diagnosed in her mother at age 65. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Stable ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: eval cervical spine for ?trauma s/p fall History: neck pain Three views of the cervical spine are provided. Evaluation of the cervicothoracic junction is partially limited secondary to overlying anatomy. No fracture is identified. There is grade 1 retrolisthesis of C2, C3, and C4, which may be an artifact of pa... | No fracture of the cervical spine is evident. If further imaging is clinically warranted, consider CT. |
Generate impression based on findings. | 26 year old male with jaw pain, evaluate for mandibular fracture Oblique fracture through the left parasymphyseal mandible, extending adjacent to the anterior aspect of the mental foramen and through the expected location of the left canine, which is absent. There is adjacent soft tissue swelling and multiple foci of g... | Left parasymphyseal and displaced right ramus mandibular fractures as described above. TMJ alignment appears normal. |
Generate impression based on findings. | Reason: evaluate for osseous mets or occult injury/fracture History: pain; h/o prostate cancer Two views of the right hip demonstrate hardware components of a total right hip arthroplasty device, with slight vertical orientation of the acetabular cup; however, there are no radiographic signs of loosening. Surgical clip... | 1.Sclerotic foci in the body of the right pubic bone and the L5 vertebral body may represent metastatic disease, but are unchanged from CT in 2014.2.Hardware components of a right total hip arthroplasty.3.No acute fracture is evident. |
Generate impression based on findings. | Status post right frontal temporal craniotomy. Skin staples and surface drain compatible with recent surgery. There is small amount of extra-axial blood product and pneumocephalus underneath the craniotomy, compatible with recent surgery. There is also hyperdense blood in the suprasellar resection bed with subarachnoi... | 1.Expected postoperative changes without significant change from prior study.2.Patchy areas of hypoattenuation of the right insula and right anterior frontal gyrus, which may be edema or ischemia. This area appears more prominent compared to prior study. MRI may be helpful for further evaluation. |
Generate impression based on findings. | dysconjugate gaze and new onset headache and ptosis. NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axi... | 1. No evidence of acute ischemic or hemorrhagic lesion.2. No evidence of intracranial arterial aneurysm, stenosis or evidence of arteriovenous shunting.3. Mild luminal stenosis of the right vertebral artery ostium. |
Generate impression based on findings. | Reason: 45M with DM2 c/b peripheral neuropathy, multiple diabetic ulcers, right 2nd toe gangrene, ?osteo, ?fractures Three views of the right foot show dorsal dislocation of the first toe relative to the first metatarsal. The sesamoid bones appear proximally translated, and additional foci of heterotopic ossification a... | 1.On the right foot, there is osteomyelitis of the bones of the second metatarsophalangeal joint and possibly other sites as well, with additional findings as described above.2.On the left foot, chronic-appearing erosions at the second metatarsophalangeal joint may represent osteomyelitis, although it is difficult to d... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of CLL since 2010 and melanoma in situ since 2007. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in distribution. ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Status post right frontal temporal craniotomy. Skin staples and surface drain compatible with recent surgery. There is small amount of extra-axial blood product and pneumocephalus underneath the craniotomy, compatible with recent surgery. There is also hyperdense blood in the suprasellar resection bed with subarachnoi... | 1.Expected postoperative changes.2.Patchy areas of hypoattenuation of the right insula and right anterior frontal gyrus, which may be edema or ischemia. |
Generate impression based on findings. | 26 -day-old male with endotracheal tube and increased work of breathing.VIEW: Chest AP (one view) 3/31/15 at 0503 Endotracheal tube tip is at the thoracic inlet. Feeding tube tip is at GE junction with proximal side hole above the GE junction. Right neck PCVC tip is in superior vena cava. Blood pressure cuff appears in... | Increased coarse bilateral lung opacities in a background of chronic lung disease. Marked moderate soft tissue edema persists. |
Generate impression based on findings. | History of aneurysm. Neutropenic fever with altered mental status. Evaluate for bleed versus stroke. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are unchanged in size and configuration. There is redemonstration of a left frontal periventricular white matter le... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Redemonstration of a left frontal periventricular white matter lesion. Subtle hypoattenuation in the bilateral basal ganglia was not clearly present on the prior exam. These are equivocal and may represent age-indeterminate ischemic lesions. Please note ... |
Generate impression based on findings. | 69 years, Male. Reason: r/o toxic megacolon History: brbpr, cdiff There is a nonobstructive bowel gas pattern. Left retrocardiac opacities suggest atelectasis/scarring. Cardiomegaly. No evidence of megacolon. Dextroscoliosis of the thoracolumbar spine is present. | Nonobstructive bowel gas pattern, no evidence of megacolon. |
Generate impression based on findings. | Reason: left foot pain, r/o fracture History: navicular tenderness Three views of the left ankle demonstrate mild soft tissue swelling along the lateral aspect of the ankle. A subcentimeter ossicle along the distal margin of the fibula appears well corticated, and is likely related to old trauma rather than an acute fr... | Mild soft tissue swelling, without acute fracture. |
Generate impression based on findings. | 26 years, Male. Reason: 26 yo M hx of ALL on abx for osteomyelitis with new diarrhea. Eval for toxic megacolon History: abdominal pain and distension with diarrhea There is a nonobstructive bowel gas pattern. The spleen is enlarged. Superior portions of both upper quadrants not included in the field-of-view. | Splenomegaly. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 41-year-old female patient with right lower quadrant pain, nausea, and vomiting. Evaluate for appendicitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significa... | 1.No acute intra-abdominal pathology to account for patient's symptoms.2.Lobular uterus most likely represents fibroids. |
Generate impression based on findings. | 27 years, Female. Reason: abdominal pain in patient with history of colectomy. looking for evidence of obstruction History: nausea, abdominal pain Multiple dilated loops of small bowel measuring up to 4.8 cm in maximal diameter with associated air-fluid levels consistent with bowel obstruction. No evidence of pneumoper... | 1.Findings compatible with small bowel obstruction.2.Cephalad positioned fetus. |
Generate impression based on findings. | 49-year-old male with left eye swelling, rule out fracture versus globe rupture MAXILLOFACIAL: Irregularity and deformity of the left globe with internal high density/blood product which extends posteriorly into the retrobulbar space. There is associated proptosis and extensive soft tissue swelling about the left orbit... | 1. Left globe rupture with associated hemorrhage, proptosis and extensive periorbital soft tissue swelling as described above. No facial fracture.2. No evidence of acute intracranial hemorrhage, skull fracture or mass effect. |
Generate impression based on findings. | 74 year old with history of aortic stenosis, liver cirrhosis, diabetes and hypertension presenting for evaluation for potential transcatheter aortic valve replacement (TAVR). CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. The thoracic aorta is not sig... | 1. Likely bicuspid aortic valve with severe aortic valve calcification. 2. Ascending aortic graft noted. Thoracic aortic anatomy as above. 3. Tortuous bilateral subclavian arteries. 4. Descending aorta is regions of moderately protruding atheroma. 5. Moderate to severe multivessel coronary calcification noted. 6. Sever... |
Generate impression based on findings. | 31year-old female with history of ventriculoperitoneal shunt, presenting with syncope. There is redemonstration of a right frontal approach ventriculostomy catheter with tip at the level of the foramen of Monro and is unchanged in position. There is no evidence of acute intracranial hemorrhage or mass effect. The ventr... | Stable appearance of ventriculostomy catheter without acute intracranial abnormality. |
Generate impression based on findings. | 44-year-old female with history of bibasilar infiltrates on outside hospital CT. LUNGS AND PLEURA: There are dense bibasilar air space opacities containing air bronchograms. There is a small left pleural effusion.MEDIASTINUM AND HILA: Heart size is enlarged, however there is no pericardial effusion. Scattered mildly en... | 1. Bibasilar consolidations most compatible with multifocal pneumonia.2. Cardiomegaly. |
Generate impression based on findings. | 8-month-old male with increasing shortness of breathVIEW: Chest AP (one view) 3/31/15 at 0712 Nasogastric tube tip is past the GE junction the proximal sidehole above the GE junction. The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Diffuse bilateral fluffy airspace opac... | Diffuse fluffy airspace opacities may represent atelectasis or pneumonia on a background of bronchiolitis/regularly disease. |
Generate impression based on findings. | abnormal eye movement. 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical ... | Normal brain and neck MRA as described above. |
Generate impression based on findings. | 49 years, Male. Reason: abd pain s/p IABP replacement History: as above Suboptimal study. Nonobstructive bowel gas pattern with paucity of air. Left upper quadrant radiodensity may reflect a splenic granuloma. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 82 years, Female. Reason: Evaluate for right ureteral stent position History: Right flank pain Right-sided nephroureteral stent extends from the region of the right renal fossa to the distribution of the urinary bladder. There are severe degenerative changes of the right hip and mild degenerative changes of the left hi... | Right-sided nephroureteral stent extending from the region of the right renal fossa to the urinary bladder. |
Generate impression based on findings. | 97 years, Female. Reason: evaluate for intraadbominal process History: leukocytosis, emesis Generalized paucity of bowel gas. Retrocardiac opacity suggests atelectasis/consolidation. Probable small bilateral pleural effusions. There are dense atherosclerotic calcifications of the abdominal aorta and its branches. Curvi... | 1.Paucity bowel gas. 2.Radiopaque curvilinear density in the midline lower pelvis is of uncertain significance and clinical correlation is recommended. |
Generate impression based on findings. | 57-year-old male with history of hemoptysis and abdominal pain. CHEST:LUNGS AND PLEURA: There is a large, complex multiloculated cavitary lesion in the right upper lobe with adjacent traction bronchiectasis, architectural distortion, and upper lobe volume loss. Innumerable subpleural cysts occupy much of the remaining ... | 1. Large complex multiloculated cavitary lesion in the right upper lobe which is thought to represent a cavitary infection such as TB or other necrotizing pneumonia, although an underlying primary malignancy cannot be entirely excluded. Moderate to severe emphysema.2. Chronic posttraumatic skeletal deformities as above... |
Generate impression based on findings. | Female; 56 years old. Reason: Abdominal pain, history of kidney transplant History: Abdominal 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 ab... | 1. No small bowel mass or other bowel abnormality is evident.2. Atrophic native kidneys containing small, nonobstructing renal calculi. |
Generate impression based on findings. | 64 years, Female. Reason: 64F admitted with colonic dilation/ileus, now with +flatus, persistent abdominal distension; assess for colonic dilation prior to prep for cscope History: abdominal distension Multiple air containing loops of dilated small bowel with air in the colon and rectum may reflect an ileus or partial ... | Multiple air containing loops of dilated small bowel with air in the colon and rectum may reflect an ileus or partial small bowel obstruction. |
Generate impression based on findings. | There is advances destructive change at the T10/T11 disc space with destruction of the adjacent vertebral endplates. There is a soft tissue attenuating paraspinous collection which may represent abscess or phlegmon measuring approximately 7 x 5 cm in axial dimension. There is loss of vertebral body height of T10 and T... | 1.Findings compatible with diskitis-osteomyelitis at T10/T11 with associated paraspinous phlegmon/abscess (better defined on recent outside MR), loss of vertebral body heights, and exaggeration of kyphosis.2.Bilateral severe neural foraminal stenosis at T10/T11 with mild central spinal canal stenosis.3.Retropulsed osse... |
Generate impression based on findings. | Injury, pain, ultrasound suggestive of healing rib fracture. Evaluate for rib fracture. Metallic BBs denote the site of the patient's pain. No specific evidence of an acute rib fracture. | No rib fracture is identified. |
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