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Generate impression based on findings. | Female; 78 years old. Reason: New onset abdominal pain, unreponsive to narcotics, new onset CHF/AFib, likely COPD, HR 150s, diaphoretic, elevated lactate 2.9, r/o embolism to gut, dissection History: as above CT ANGIOGRAM: No acute aortic dissection or rupture. Normal caliber of the thoracic aorta, aside from an eccent... | 1. No acute aortic dissection or rupture. Small focal aneurysm of the thoracic aorta, as detailed above.2. Findings most compatible with CHF with cardiomegaly, pulmonary edema, right pleural effusion, and pericardial effusion.3. Cystic lesion in the left kidney which does not meet the criteria for a simple cyst and may... |
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, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of archite... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcificat... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
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, version 9.3. The breast parenchyma is heterogeneously dense. An asymmetry is seen at superior aspect in the left breast on the MLO view. No suspicious microcalci... | An asymmetry at superior aspect in the left breast on the MLO view. Spot compression view and possible ultrasound study are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 69 year-old female with multinodular goiter. LUNGS AND PLEURA: Low lung volumes. Scattered pulmonary micronodules, nonspecific. No pleural effusions or consolidations.MEDIASTINUM AND HILA: There is a large heterogeneously enhancing mass containing scattered calcifications arising from the inferior aspect of the right t... | 1. Large superior mediastinal lesion with significant adjacent mass effect causing marked tracheal narrowing and SVC compression. This lesion was biopsy proven to represent an oncocytic microfollicular multinodular goiter.2. Occlusive right internal jugular thrombus, likely chronic in etiology from venous stasis due to... |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. Two small circumscribed masses at th... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Images are significantly limited by patient motion. The ventricles and sulci are prominent, consistent with minimally progressed moderate age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and small oval areas of abnormal T2/FLAIR hype... | 1. Motion limited exam. No acute abnormality. No significant interval change in distribution of overall less conspicuous white matter lesions consistent with known demyelinating disease. Overall, mild T1 and T2 burden of disease. Probable underlying mild chronic small vessel ischemic changes.2. Severely motion limited ... |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcificat... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male, 26 years old. History of Hodgkin lymphoma, cholangitis and elevated liver enzymes. right sided abdominal painVIEW: Abdomen AP (one view) 3/31/15, 1641 Nonobstructive bowel gas pattern.Small to moderate stool burden.No free air. | No radiologic abnormality to account for the patient's symptoms. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses,... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Central line placementVIEW: Abdomen and chest AP (two views) 3/31/15 at 1646 hrs. NG tube terminates in the stomach. Tracheostomy tube again noted. Giant omphalocele still present. Right lower extremity PCVC is coiled likely in one of the collaterals of the right external iliac vein.Cardiac silhouette size is top norma... | Misplaced central line as described. |
Generate impression based on findings. | Reason: 47y/o female with prelim path left breast and left axillary node cancer; breast mass; r/o distant mets History: 47y/o female with prelim path left breast and left axillary node cancer; breast mass; r/o distant metsRADIOPHARMACEUTICAL: 9.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 95 mg/dL. Toda... | 1. Hypermetabolic left lateral breast mass is consistent with the patient's known malignancy. 2. Hypermetabolic left axillary lymph nodes are consistent with regional metastases. 3. Otherwise no FDG avid more distant metastatic disease. Several pelvic foci of increased metabolic activity are more likely benign although... |
Generate impression based on findings. | Stump swelling. Question of osteomyelitis. CT images of the left lower extremity show postsurgical changes of a above the knee amputation. There is irregularity and fragmentation of the distal femoral diaphysis at the osteotomy margin appearing similar to the prior study. The bone marrow seems to be preserved. However,... | 1. Diffuse soft tissue stranding of the distal thigh with possibly increased inflammatory change around the distal femur can be seen in the setting of cellulitis. No discrete fluid collection is identified. 2. Irregularity of the distal femur appears similar to the prior study; osteomyelitis cannot be excluded. |
Generate impression based on findings. | Chronic back pain. Evaluate for chronic back pain. Severe degenerative disk disease affects L4/5 and L5/S1. Facet joint osteoarthritis also affects the lower lumbar spine. There is a grade 1-2 anterolisthesis of L4 relative to L5 that appears stable between the flexion and extension view. Surgical clips overlie the L1 ... | Degenerative disk disease, facet joint osteoarthritis, and L4 anterolisthesis as above. |
Generate impression based on findings. | History of lumbar fusion for fracture. Evaluate hardware, bone fusion and stability. Surveillance imaging. There appear to be 6 lumbar type vertebrae which for the purposes of the study will be designated L1 through L6. Again seen is a posterior stabilization device with screws entering L1, L2, L4, and L5. I see no har... | Postoperative changes of spinal fixation with healing L3 fracture as described above. |
Generate impression based on findings. | Evaluate stability of spine and hardware. Surveillance imaging. Again seen is an anterior plate with screws entering the C5 and C7 vertebrae. I see no hardware complications. Spacers and bone graft material are again seen between the C5 and C7 vertebral bodies; there now appears to be bony bridging between C5 and C7. S... | Lower cervical spine fusion and C4 retrolisthesis as described above. |
Generate impression based on findings. | Status post left total knee arthroplasty Components of a left total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density in the anterior soft tissues reflect recent surgery. | Postoperative changes of left total knee arthroplasty as above. |
Generate impression based on findings. | Pain months status post fall. Fracture? I see no fracture, malalignment, joint effusion, or other findings to account for the patient's pain. | Normal-appearing elbow without fracture or other specific findings to account for the patient's pain. |
Generate impression based on findings. | Reason: neurological symptoms s/p carotid stent History: neurological symptoms s/p carotid stent. Acute onset aphasia and gazed deviation. Neck CTA: There is prevertebral sot tissue swelling and retropharyngeal fluid present which has not changed substantially in thickness compared to the prior exam.The patient is stat... | 1.No evidence for acute intracranial hemorrhage, mass effect or edema2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.No evidence for major intracranial vessel occlusion.4.Status post left carotid stent placement. There is reconstitution of the left ECA via collaterals. The pseu... |
Generate impression based on findings. | Clinical question: Altered mental status. Evaluate for subdural. Signs and symptoms: Subdural hematoma. Nonenhanced head CT:Examination demonstrate bilateral hemispheric subdural collections with evidence of interval increased size since prior study.Large left hemispheric subdural hematoma demonstrate mixed density con... | 1.Interval increased size of a large left hemispheric subdural with evidence of acute blood product and resultant 13-mm midline shift to the right.2.Smaller low attenuation right hemispheric subdural measuring at 11-mm thickness as detailed.3.No evidence of ventriculomegaly.4.Age indeterminate small vessel ischemic str... |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage, mass effect. Signs and symptoms: Altered mental status. Nonenhanced head CT:No detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces an... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: left-sided weakness Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are periventricular and subcortical attenuation are white matter as well as foci of a... | 1.No acute intracranial process.2.Age indeterminate small vessel ischemic strokes of mild-to-moderate degree. |
Generate impression based on findings. | Clinical question: Subdural hematoma? Signs and symptoms: Blunt head trauma, vomiting. Unenhanced head CT:There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, cisterns and spaces and gray -- white matte... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: Alteration of mental status. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spa... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | right side numbness 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 are ... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage, normal an acute hemorrhage in left temporal lobe with mass effect per report from outside hospital. Signs and symptoms: As above Nonenhanced head CT:Examination demonstrates an acute hematoma in the left anterior temporal lobe with subtle surrounding vasogenic edema.Hematoma ... | 1.Dissecting hematoma in the left anterior temporal lobe and left basal ganglia with surrounding edema and 4.4-mm rightward midline shift.2.Minimal extension of hemorrhage into the left lateral ventricle.3.No ventriculomegaly.4.Age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms:CVA Unenhanced head CT:No eminence of an acute ischemic stroke or parenchymal hemorrhage. CT however is insensitive for early detection acute nonhemorrhagic ischemic strokes.Examination demonstrate high density extra-axial collection in the right high convexity parietal region... | 1.CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Acute subdural in right high convexity parietal measuring up to 6.6-mm in thickness and 31-mm at the base.3.Anterior middle cranial fossa arachnoid cyst measuring at 36 x 21-mm.4.Small focus of scalp and subgaleal hemorrhage in right par... |
Generate impression based on findings. | known cerebellar ICH follow up. Vermian and right cerebellar ICH is re-demonstrated.Comparing to prior study, the extent of subdural and subarachnoid hemorrhage appear to be reduced since prior exam.Gross configuration and size of the ICH do not show any significant interval change, however, the mass effects appear to ... | 1. Decreased extent of subarachnoid and subdural hemorrhage since prior exam.2. Slightly decreased mass effects of ICH but gross size and configuration of vermian and right cerebellar ICH have not been changed since prior exam.3. Ventricle size remains stable. |
Generate impression based on findings. | Clinical question: Assess for progression of subdural hematoma. Signs and symptoms: subdural hematoma. Nonenhanced head CT:Examination redemonstrated a stable right parietal high convexity subdural hematoma with suggestion of some interval decreased size. Subdural measures approximately 4 mm in thickness compared to pr... | 1.Slight interval decreased size of right parietal subdural since prior exam.2.Mild scalp and subgaleal increased density and small focus of depression of outer table of calvarium in right parietal region similar to prior exam.3.Grossly similar findings of small vessel ischemic strokes. |
Generate impression based on findings. | Reason: evaluating for fracture History: pt with acute onset left ring finger pain after trauma during rugby, 3 days ago. swelling, ecchymosis, limited mobility pain is greatest between PIP \T\ DIP, not joints. Three views of the left fourth digit demonstrate soft tissue swelling without evidence of acute fracture or d... | There is no acute fracture or malalignment. |
Generate impression based on findings. | 77-year-old female patient with history of hypertension presents with focal right lower quadrant pain x 3 weeks. No evidence of infection. Note that patient motion mildly limits examination. Given its limitation, the following observations are made:ABDOMEN:LUNG BASES: There is a 1.0 cm nodule in the left lower lobe (se... | 1.No acute intra-abdominal abnormalities to account for patient's symptoms.2.Endometrial cavity fullness is greater than expected given patient's age. Dedicated pelvic ultrasound can be obtained for further evaluation.3.No significant interval change in bilateral lung nodules since 2012. |
Generate impression based on findings. | Clinical question: Intraoperative imaging. Signs and symptoms: Same Nonenhanced head CT:Examination performed while a stereotactic device is secured to the patient's calvarium. No evidence of complication from placement of a stereotactic device is identified.There is no evidence of any acute intracranial process. The v... | Nonenhanced head CT as a surgical guidance prior and after placement of a left-sided DBS as detailed above. |
Generate impression based on findings. | Reason: fracture History: pain and swelling post injury Three views of the left middle finger demonstrate a comminuted fracture of the third distal phalangeal tuft, with mild volar and radial displacement of the distal fracture fragments. There is significant associated soft tissue swelling. | Comminuted fracture of the distal phalangeal tuft as above. |
Generate impression based on findings. | Reason: eval fracture History: pain Two views of the left tibia/fibular unremarkable. Three views of the left ankle demonstrate mild soft tissue swelling along the lateral aspect of the ankle. A 5-mm ossific density projecting dorsally from the anterior talus may represent a small avulsion fracture versus a normal vari... | Mild soft tissue swelling. Small ossific density dorsal to the anterior talus may represent a small avulsion fracture versus accessory ossicle. Please correlate with point tenderness. |
Generate impression based on findings. | RFO trigger: Surgery length greater than 8 hours RFO trigger: R/O RFO Suspected RFO location: abdomen Name of suspected RFO: unknown Attending Surgeon name/pager: Dr. Ferguson Body Mass Index (BMI): 19.89 There is a nasogastric tube with its tip projecting over the fundus of the stomach. A percutaneous jejunostomy cath... | No expected radiopaque foreign object identified.These findings were discussed by telephone with Dr. Ferguson, the attending surgeon, on 4/1/2015 at 18:00. |
Generate impression based on findings. | Reason: eval dislocation History: clinical dislocation, h/o same Single view of the mandible does not demonstrate temporomandibular joint dislocation on this limited view. No mandibular fracture is evident. There are multiple dental caries. | No frank temporomandibular joint dislocation. If there is high clinical concern, CT would be more sensitive. |
Generate impression based on findings. | 44 years, Male. Reason: ? acute changes, free air, severe stomach pain History: Acute abdominal pain post surgical Mild gaseous distention of the stomach. There is a nonobstructive bowel gas pattern. Low lung volumes. | There is a nonobstructive bowel gas pattern. Supine radiographs are insensitive for the detection pneumoperitoneum and an upright chest is recommended as clinically indicated. |
Generate impression based on findings. | 7 year old male with febrile seizures. There is no evidence of intracranial hemorrhage. There is subtle apparent left greater than right low attenuation within the subcortical white matter of the superior frontal gyri, which retrospectively are likely present on the prior exam. The ventricles and basal cisterns are nor... | 1.No evidence of acute intracranial hemorrhage.2.Grossly stable subtle apparent low attenuation within the subcortical superior frontal gyri is non-specific. These could relate to prominence of perivascular spaces often noted in this location, or possibly artifactual, and could be further characterized with MRI to excl... |
Generate impression based on findings. | Reason: rule out fracture vs dislocation History: limited ROM, pain Three views of the left shoulder demonstrate normal anatomic alignment, without evidence of acute fracture. There is no significant acromioclavicular joint separation. | No acute fracture or dislocation. |
Generate impression based on findings. | 46 years, Female. Reason: assess for obstructive gas pattern vs large stool burden History: as above There is a nonobstructive bowel gas pattern. Above average stool burden. Surgical clips project over the right upper quadrant. No evidence of pneumoperitoneum. | Nonobstructive bowel gas pattern and no evidence of pneumoperitoneum. |
Generate impression based on findings. | 11 year old female with hip painVIEWS: Pelvis AP, frog leg (two views) 3/31/15 2136 Right slipped capital femoral epiphysis. Joint space is maintained. The medial cortex of the right femoral neck is thickened indicating this may be an acute on chronic injury. The left hip is normal. Small amount of feces is present wit... | Right SCFE, acute on chronic. |
Generate impression based on findings. | 32 years, Female. Reason: evaluate for SBO History: Crohn's flare, bilious emesis Right nephroureteral stent in place, position unchanged from the prior CT examination. There is a nonobstructive bowel gas pattern. Right lower quadrant ostomy. Surgical clips project over the right upper quadrant. | There is a nonobstructive bowel gas pattern. Supine radiographs are insensitive for the detection pneumoperitoneum and an upright chest is recommended as clinically indicated. |
Generate impression based on findings. | 54-year-old female patient with right lower quadrant pain. Evaluate for appendicitis versus uterine pathology. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Multiple probable hepatic cysts are not significantly changed compared to prior MRI in 2012.SPLEEN: No significant abnormality noted.P... | 1.Physiologically significant mild to moderate hydronephrosis with 3-mm stone at the ureterovesical junction.2.Nonspecific mild thickening of the descending colon. |
Generate impression based on findings. | Reason: h/o r avascular necrosis History: pain in r hip Single view of the pelvis demonstrates minimal sclerosis of the bilateral femoral heads, left greater than right, better seen on the previous CT scan, consistent with avascular necrosis. There is no significant subchondral lucency or collapse, or acute fracture ev... | Minimal bilateral avascular necrosis, left greater than right, without subchondral collapse. |
Generate impression based on findings. | 33-year-old female with pleurisy, pleuritic chest pain PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Central airways are patent. No pleural effusion or pneumothorax. No focal consolidation. No suspicio... | No evidence of pulmonary embolism. No significant pleural or pulmonary abnormality is identified.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 78 years, Female. Reason: 78 yo with SBO on prior xray, verify NG tube placement History: SBO, Gaseous distention of multiple loops of small bowel and paucity gas in the colon, most consistent with small bowel obstruction. There is a nasogastric tube with its tip projecting over the antrum of the stomach. Retrocardiac ... | Findings consistent with small bowel obstruction, not significantly changed from the prior exam. |
Generate impression based on findings. | 1-day-old female with respiratory distressVIEW: Chest and abdomen AP (two views) 3/31/15, 2217 ET tube terminates below thoracic inlet. UVC tip is at the RA/IVC junction. UAC tip is at T8. NG tube tip is in the gastric body with proximal sidehole near the GE junction. Angiocath was placed in the right hemithorax.Interv... | Interval development of large tension pneumothorax. PIE. |
Generate impression based on findings. | 78 years, Female. Reason: 78yo F with lactic acidosis and abdominal tenderness. History: abd tenderness Multiple loops of dilated small bowel with a paucity of gas in the colon most consistent with small bowel obstruction, increased from the prior CT examination. Bilateral delayed renal nephrograms consistent with rena... | Findings suggestive of small bowel obstruction. |
Generate impression based on findings. | Male 37 years old; Reason: eval for SBO, infection, etc History: abd pain ABDOMEN:LUNG BASES: Left basal scarring/atelectasis.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions are too small to characterize. These are unchanged compared to prior study. The lesion in the posterior right hepatic lobe measuring 0... | 1.No evidence of bowel obstruction.2.Large left sacral decubitus ulcer extending to the ischium with changes of chronic osteomyelitis as detailed above. Overall the appearance is not significantly changed compared to prior study. |
Generate impression based on findings. | 3 years old male with head trauma after fall during soccer. HEAD: 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. There is a small amount of swe... | 1.No evidence of acute intracranial hemorrhage. 2.Nondisplaced acute fracture of the inferior left aspect of the frontal bone extending into the left orbital roof where there is a nondisplaced comminuted fracture without evidence of trauma to the globe. |
Generate impression based on findings. | 59-year-old man with history of fall. HEAD: There is no evidence of acute intracranial hemorrhage. There is no depressed calvarial fracture. There is no mass, mass-effect, or midline shift. The ventricles and basal cisterns are normal in size and configuration. The paranasal sinuses and mastoid air cells are clear. CER... | 1.No acute intracranial abnormality.2.No acute fracture or malalignment of the cervical spine.3.Multilevel facet joint arthropathy with narrowing of the bilateral neural foramina at C3/C4. MR of the cervical spine can be considered for further evaluation as clinically warranted. |
Generate impression based on findings. | 51-year-old female with history of breast cancer, now with shortness of breath and new effusion, evaluate for metastatic disease pulmonary embolus PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits. LUNGS AND PLEURA: Large r... | 1.No evidence of pulmonary embolism2.Large right pleural effusion with compressive atelectasis in nodular/plaque-like areas of pleural thickening suspicious for pleural metastasis with malignant effusion.3.Bilateral pulmonary nodules suspicious for metastases although infectious process cannot definitively be excluded.... |
Generate impression based on findings. | Male, 8 years old. Are fell. Laparoscopy converted to open. Per OR, no unaccounted for instruments.VIEW: Abdomen AP (one view) 3/31/15, 2344 Enteric tube tip in the stomach. Surgical drain terminates over the right lower quadrant, within an ostomy. Surgical sutures in the lower abdomen. Right femoral catheter tip at th... | No unexpected radiopaque foreign object.These findings were discussed by telephone with Dr. Mak, the attending surgeon, on 4/1/15 at 12:19 a.m. |
Generate impression based on findings. | 72 years, Female. Reason: Eval for NGT lines positioning after pulling back slightly. History: as above The pelvis is excluded from the field of view. Multiple dilated loops of small bowel measuring up to 3.5 cm in diameter compatible with small bowel obstruction and unchanged from recent CT. There is a nasogastric tub... | Nasogastric tube tip projects over the proximal body of the stomach. No significant interval change in small bowel obstruction when compared to recent CT. |
Generate impression based on findings. | There is interval increase in the hyperdense blood in the suprasellar cistern, which is well demarcated. Compare to preoperative outside MRI, the shape of the hemorrhage corresponds to shape of the tumor. Scattered sub-arachnoid hemorrhage including the sylvian fissures. Continued increase in the prominence and size o... | 1.Continued increase in the prominence and size of patchy hypoattenuation of the right insula and right anterior frontal gyrus, which now extends to include the right head of the caudate and right anterior temporal lobe. 2.Interval increase in the hyperdense blood in the suprasellar cistern, which is well demarcated an... |
Generate impression based on findings. | 58-year-old male patient with HIV and left lower quadrant pain. Evaluate for diverticulosis or abscess. Lipase=23. ABDOMEN:LUNG BASES: Left basilar scarring/atelectasis.LIVER, BILIARY TRACT: The gallbladder is mildly distended without CT evidence of cholecystitis.SPLEEN: Chronic splenic vein thrombosis with perigastric... | 1.Increased hypoattenuation in the pancreatic tail is suggestive of acute pancreatitis, however, in the setting of normal pancreatic enzymes, these findings are concerning for an infiltrative mass. Further evaluation with MR imaging or endoscopic ultrasound is recommended.2.Chronic pancreatitis with obliteration of the... |
Generate impression based on findings. | Male; 69 years old. Reason: h/o pancolitis with rising lactic acid, assess for worsening infection/dilation History: see above ABDOMEN:LUNGS BASES: Small right pleural effusion and bibasilar dependent atelectasis/consolidation, similar to prior study. Gynecomastia.LIVER, BILIARY TRACT: No focal hepatic lesions.SPLEEN: ... | 1. Nonspecific pancolitis appears slightly improved. No pneumatosis, portal venous gas, or free air.2. Multiple small splenic infarcts. |
Generate impression based on findings. | 1-day-old female with pneumothoraxVIEW: Chest and Abdomen AP (two views) 4/1/15 at 0001 The ET tube is near the carina. Interval repositioning of right chest tube. UVC in right atrium. UAC at T7. NG tube tip and proximal side hole in the gastric body.Cardiothymic silhouette is normal. Persistent small to moderate right... | Persistent small to moderate right tension pneumothorax. |
Generate impression based on findings. | Male, 27 days old. Changed ETT given worsening sats despite increased vent settings, mucus plug in previous ETT found.VIEW: Chest AP (one view) 4/1/15, 0130 ET tube tip below the thoracic inlet and above the carina. Enteric tube with distal side port below the GE junction. Central line terminates in the right atrium. P... | Multifocal opacities and persistent lung haziness, with small bilateral effusions. Question of healing fracture of the mid-distal right clavicle. |
Generate impression based on findings. | 55 years, Female. Reason: eval cause of leukocytosis, r/o obstruction History: leukocytosis, abd distention The pelvis is excluded from the field of view. There is a Dobbhoff tube with its tip projecting over the duodenum, just proximal to the ligament of Treitz. There is a nasogastric tube with its tip projecting over... | Nonspecific bowel pattern with a paucity of bowel gas, not significantly changed from the prior exam. |
Generate impression based on findings. | Male, 27 days old. Reason: chest expansion, ETT location. Frequent desats, brady's, transitioned to oscillator todayVIEW: Chest AP (one view) 3/31/15, 2002 ET tube tip below the thoracic inlet and above the carina. Enteric tube with distal side port below the GE junction. Central line terminates in the right atrium. Pe... | Unchanged multifocal opacities and persistent lung haziness, with small bilateral effusions. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distributio... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male, 27 days old. Evaluate for lung pathology, ETT placement, chest expansion. On oscillator History: Desat to 60's, on 100% O2VIEW: Chest AP (one view) 4/1/15, 0052 ET tube tip below the thoracic inlet and above the carina. Enteric tube with distal side port below the GE junction. Central line terminates in the right... | Multifocal opacities and persistent lung haziness, with small bilateral effusions. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcificat... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Scattered benign calcifications are u... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Recurrent congenital diaphragmatic hernia into pericardium. Diaphragmatic repair with Cormatrix.VIEW: Chest AP (one view) 04/01/15, 0248 Endotracheal tube tip is at thoracic inlet. Gastrostomy tube remains in place.Right pleural effusion has increased in size. The right heart border is partially obscured. Subsegmental ... | Increase in right pleural effusion. |
Generate impression based on findings. | Female, 13 years old. Pain and swelling. Evaluate for fracture.VIEWS: Right hand PA, lateral, oblique (3 views) 3/31/15 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distributio... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Castleman's disease involving the lymph nodes in the left axilla. There are partially-imaged enlarged left axillary and subpectoral lymph nodes. However, there is no evidence of mass lesions or significant lymphadenopathy in the neck. The thyroid and major salivary glands are unremarkable. The major cervical vessels ar... | Partially-imaged enlarged left axillary and subpectoral lymph nodes related to Castleman's disease. Otherwise, the lymph nodes in the neck are not particularly enlarged. |
Generate impression based on findings. | Male; 63 years old. Reason: Evidence of cirrhosis or liver vessel disease, PLEASE PERFORM TRIPLE PHASE LIVER PROTOCOL History: Cirrhosis on biopsy ABDOMEN:LUNG BASES: Scattered pulmonary micronodules. ICD/pacemaker leads in place. Cardiomegaly.LIVER, BILIARY TRACT: Mild hepatomegaly with the right hepatic lobe measurin... | 1. Mild hepatomegaly and findings suggestive of passive congestion. Large amount of abdominopelvic ascites.2. Appearance of the celiac artery origin suggestive of median arcuate ligament syndrome. |
Generate impression based on findings. | HEAD: There is a focal, small subgaleal hematoma of the left parieto-occipital scalp without underlying calvarial fracture. There is no acute intracranial hemorrhage. There are no masses, mass effect, or midline shift. The ventricles and sulci are normal in size and configuration. There is scattered opacification of t... | 1.Small subgaleal hematoma over the left occipital scalp without underlying fracture or intracranial hemorrhage.2.Fracture of the mandibular alveolar ridge involving the tooth sockets of ADA # 23 - 26 without extension through the body of the mandible.3.Scattered mucosal thickening suggestive of rhinitis and sinusitis ... |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Scattered benign calcifications are u... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distributio... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 30 year-old female patient with abdominal pain and recent pancreatectomy/splenectomy for mucinous cyst. ABDOMEN:LUNG BASES: Bilateral scarring.LIVER, BILIARY TRACT: Stable right hepatic lobe hemangioma adjacent to the gallbladder fossa. Fatty liver infiltration.SPLEEN: Status post splenectomy.PANCREAS: Status post dist... | Postsurgical changes from distal pancreatectomy and splenectomy without evidence of complication or recurrent disease. |
Generate impression based on findings. | There is redemonstration of multiple and confluent areas of FLAIR hyperintensity in the periventricular and subcortical white matter as well as involving the body and splenium of the corpus callosum, consistent with known demyelinating lesions. There are also persistent lesions in the left brachium pontis. There is a ... | 1. No significant interval change in appearance of supratentorial and infratentorial demyelinating lesions, with overall mild to moderate T1 and T2 burden of disease. Visualization of a few additional left temporal lobe white matter lesions may be related to differences in technique.2. Grossly stable C2-3 cervical cord... |
Generate impression based on findings. | Male 47 years old; Reason: renal calculi? History: R flank pain The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: There is a 7.0 x ... | 1.No renal stones.2.8.3-cm soft tissue mass in the caudate lobe is incompletely evaluated on this noncontrast study. The differential considerations include primary or secondary hepatic neoplasm. Liver abscess is a differential consideration. Triphasic liver MRI is recommended for further evaluation. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses,... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Repair of recurrent congenital diaphragmatic hernia into the pericardium.VIEW: Chest AP (one view) 03/31/15, 1716 Endotracheal tube tip is above carina. Gastrostomy tube is in place.Right pleural effusion has increased in size and is now moderate. Subsegmental atelectasis is present in left lower lobe. Mediastinum is s... | Increase in right pleural effusion. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distorti... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 64-year-old female with shortness of breath, evaluate for pulmonary embolism PULMONARY ARTERIES: Technically inadequate examination due to failure of auto-injector, contrast bolus was hand injected. No repeat examination was performed due to acute renal insufficiency. Within these limitations, no large central pulmonar... | 1.Technically inadequate examination. Within these limitations, there is no evidence of pulmonary embolus to the lobar level.2.Upper lobe predominant interstitial lung disease is not significantly changed and compatible with sarcoidosis. 3.Increased right upper lobe and lower lobe peribronchial opacity may represent in... |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. Scattered benign calcifications and mild arterial calcifications are noted i... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 1-day-old female with pneumothoraxVIEW: Chest crosstable lateral (one view) 4/1/15, 0352 The ET tube is between carina and thoracic inlet. Right chest tube with tip overlying the SVC directed posteriorly. UVC in right atrium. UAC at T8. NG tube tip and proximal side hole in the gastric body.Right pneumothorax located a... | Chest tube tip not located anteriorly. |
Generate impression based on findings. | 49-year-old female patient status post colectomy presents with abdominal pain and decreased ostomy output. Evaluate for obstruction. ABDOMEN:LUNG BASES: Lingular scarring noted.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL... | 1.Post surgical changes from colectomy and right lower quadrant ileostomy without evidence of obstruction.2.Small presacral collection and findings suspicious for fistula tract versus granulated tissue to the level of the anus and left labia. Further evaluation with MR pelvis with fistula protocol can be obtained. |
Generate impression based on findings. | Male 65 years old; Reason: resected stage IV melanoma please assess response to therapy and compare to previous imaging History: met melanoma CHEST:LUNGS AND PLEURA: Postsurgical changes in the left upper lobe with a surgical resection margin. There are a few scattered pulmonary granulomata. There are few scattered a m... | 1.Stable exam without new sites of disease allowing for the lack of intravenous contrast. |
Generate impression based on findings. | Male 42 years old; Reason: eval for obstruction, multiple bowel surgeries History: abd pain vomiting distension ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Punctate hypoattenuating lesion in the left hepatic lobe is too small characterize but may represent a cyst. Cholelithiasis.SPLEEN: N... | 1.Ventral abdominal wall Richter's hernia with surrounding inflammatory changes and secondary partial small bowel obstruction. 2.Chronic inflammation of segments of small bowel including the neoterminal ileum, as well as the gastric pylorus and proximal duodenum. This is consistent with chronic inflammatory bowel disea... |
Generate impression based on findings. | Status post bifrontal craniotomy with expected pneumocephalus. Transcallosal approach with small amount of hemorrhage along the surgical tract. Punctate high density at the left foramen of Monro, which is denser than the colloid cyst seen on prior CT and likely represents focal hemorrhage and not residual cyst. Mild h... | Expected postoperative changes. |
Generate impression based on findings. | Drowning and intubation.VIEW: Chest AP (one view) 04/01/15, 0217 Endotracheal tube tip is above the carina. Feeding tube tip is in gastric fundus. Two left chest tubes remain in place. Lower extremity PICC tip is at junction of intra-and infrahepatic IVC.Soft tissue edema continues.Pneumomediastinum is slightly smaller... | Decrease in pneumomediastinum and subcutaneous emphysema. |
Generate impression based on findings. | 43-year-old female with left 12-1 o'clock IDC. MRI biopsy of adjacent focus with benign results. Left partial mastectomy and left sentinel biopsy are planned. On review of the prior studies, outside post procedure mammogram 2/9/2015. Target ill defined mass and clip morphology are located in the left breast in the uppe... | Successful needle localization of the left breast mass and clip.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: Point tenderness upper thoracic spine. Evaluate for compression deformity. History: History of osteoporosis. Now with mid to upper back pain. Four views of the cervical spine demonstrate disk space narrowing at C4-5 and C5-6, as well is anterior vertebral body osteophytes at C4 and C5, indicative of degenerativ... | Multilevel degenerative arthritic changes, as above. No compression fracture is identified. |
Generate impression based on findings. | Female 35 years old; Reason: Evaluate for progression of metastatic disease; compare to previous scan History: pain/bloating CHEST:LUNGS AND PLEURA: No lesion. There are scattered areas of pulmonary atelectasis. A small right pleural effusion is new.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No ... | 1.Slight increase in the size of the liver lesion2.Mild increase in the ductal dilatation due to obstruction at the level of head of pancreas.3.Decreased ascites and slight decrease in the primary pancreatic neoplasm . |
Generate impression based on findings. | There is a large subdural hematoma overlying the entire left cerebral hemisphere and tracking along the posterior falx. This hematoma demonstrates layering high attenuation blood products with additional internal septated high attenuation, stable from the prior examination. The left subdural hematoma measures 22 mm in... | 1.No appreciable interval change in appearance of large left hemispheric subdural hematoma or smaller right hemispheric subdural hematoma.2.Stable 7-mm rightward midline shift without evidence of ventricular entrapment or uncal herniation. |
Generate impression based on findings. | History of left mastectomy 7/2012 for DCIS. History of right breast DCIS status post right lumpectomy 8/2012 and right breast reduction on 9/2012 with residual microscopic foci of DCIS. Patient received right breast radiation. No current breast complaints. Three standard views of the right breast were performed digital... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 38-year-old female with right fifth toe pain status post injury. Three views of the right foot demonstrate normal anatomic alignment, without evidence of acute fracture. No significant soft tissue swelling or joint effusion is evident. | There is no acute fracture or malalignment. |
Generate impression based on findings. | Male, 2 months old. Reason: interval changes History: intubated, pulmonary edemaVIEW: Chest AP (one view) 4/1/15, 0314 ET tube tip at the level of the carina. Enteric tube with distal side port below the GE junction.The cardiothymic silhouette is normal.Hyperexpanded lungs bilaterally, with increased aeration of the ri... | Persistent bilateral lung hyperexpansion, without focal lesion. |
Generate impression based on findings. | Female 52 years old; Reason: llq abdominal pain History: llq abdominal pain, gi bleeding ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormal... | 1.Colitis extending from the distal transverse colon to the proximal sigmoid colon with additional inflammatory changes involving the rectum. While the differential includes infectious/inflammatory and ischemic etiologies, inflammatory etiology is felt most likely. 2. Hypoattenuating lesion in the left kidney is not fu... |
Generate impression based on findings. | Female; 41 years old. Reason: r/o colitis History: worsening abdominal exam, increased lactic acid ABDOMEN:LUNG BASES: Moderate bilateral pleural effusions with adjacent bibasilar atelectasis/consolidation, similar to prior study. Mild diffuse ground-glass opacity in the partially visualized lung bases, which may be du... | 1. New moderate diffuse small bowel wall thickening, and to a lesser extent colonic wall thickening, most suggestive of ischemic bowel given the patient's clinical history. No pneumatosis, portal venous gas, or free air.2. New attenuation of the abdominal aorta branch vessels, including the bilateral iliac arteries, an... |
Generate impression based on findings. | Male, 2 months old. Intubated with bradycardiaVIEW: Chest AP (one view) 3/31/15, 2056 ET tube tip at the level of the carina. Enteric tube with distal side port below the GE junction.The cardiothymic silhouette is normal.Hyperexpanded lungs bilaterally, with increased aeration of the right lower lobe. No focal pulmonar... | Bilateral lung hyperexpansion, without focal lesion. Subcutaneous emphysema in the neck may relate to prior pneumomediastinum. |
Generate impression based on findings. | 46-year-old female with dyspnea, evaluate for pulmonary embolism PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Central airways are patent. No pleural effusion or pneumothorax. Calcified granuloma i... | No evidence of pulmonary embolism. No significant pulmonary or pleural abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: fell Friday r/o fx History: pain 1st metacarpal Three views of the left wrist demonstrate open growth plates, no acute fracture or malalignment is evident. There is no significant soft tissue swelling.Three views of the left thumb demonstrate open growth plates, no acute fracture or malalignment is evident. The... | There is no acute fracture or malalignment. |
Generate impression based on findings. | 37-year-old who is recalled from screening mammography for a left breast mass. An ML view and two spot compression views of the left breast were performed digitally 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 distribut... | Low suspicion mass in the left breast measuring close to 2 cm. This finding may represent a fibroadenoma. Management options were discussed with the patient, and she prefers biopsy which is a reasonable option.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
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