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Generate impression based on findings. | 26 year old male patient with right lower quadrant pain, tenderness, vomiting, and diarrhea. Evaluate for appendicitis. ABDOMEN:LUNG BASES: Dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No ... | 1.Findings compatible with a chronic inflammatory process in the cecum and terminal ileum. If clinical concern exists for inflammatory bowel disease, an MR enterography can be obtained.2.Appendicoliths without evidence of appendicitis. |
Generate impression based on findings. | Status post right knee replacement with right knee pain. Right ankle pain, lateral malleolus. Four views of the right knee show a right total knee arthroplasty device in near anatomic alignment. There is no evidence of hardware complication.Moderate osteoarthritis affects the left knee as seen on the frontal view.Three... | 1. Total knee arthroplasty in near anatomic alignment.2. Mild ankle soft tissue swelling with otherwise no specific findings to account for the patient's pain. If there is clinical concern for a stress fracture, repeat radiographs may be obtained in 10 to 14 days. |
Generate impression based on findings. | Female 62 years old; Reason: rule out hernia or other intra abdominal pathology History: LLQ/groin pain, exacerbated with cough, reproducible on exam ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. The hepatic and portal veins are ... | 1.No bowel obstruction or abdominal hernia as clinically questioned.2.No abdominal or pelvic ascites.. |
Generate impression based on findings. | Lytic lesions noted on prior imaging; parietal bone on CT head and left iliac CT lumbar spine. SKULL: No discrete lytic lesions. Please note the lytic lesion seen on a recent CT scan is not visualized on this study.CERVICAL SPINE: The lower cervical spine is not seen on the lateral view due to overlying anatomy. Giving... | 1. No discrete lytic lesions. Arthritic changes and other findings as described above.2. Please note the pelvis abnormality seen on recent lumbar spine CT is not well visualized on this study; MRI of the pelvis may be considered to distinguish neoplasm from Paget's disease. |
Generate impression based on findings. | Right frontal sinus pain. There are hyperattenuating (~70 HU) secretions that partially opacify the left maxillary sinus. The other paranasal sinuses, including the right frontal sinus, are clear. The nasal cavity is clear. There is a 12 mm wide defect in the cartilaginous portion of the nasal septum. The lamina papyra... | 1. Partial opacification of the left maxillary sinus with what likely represents chronic secretions versus less likely fungal material. The other paranasal sinuses, including the right frontal sinus, are clear.2. A 12 mm wide defect in the cartilaginous portion of the nasal septum may be secondary to injury and vasocon... |
Generate impression based on findings. | PHARYNX/LARYNX: There are a few left-sided tonsilliths. The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. There is suggestion of aerated secretions within the visualized trachea. The upper esophagus is somewhat patulous. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The... | Unremarkable CT of the neck. No evidence of metastatic disease. |
Generate impression based on findings. | Female 55 years old Reason: 55 yo F with history of VHL with numerous pancreatic cysts (pancreas completely replaced by cystic lesions). Pt complains of abd pain, bloating, and pressure. UGI study with SBFT to r/o gastric outlet obstruction and SBO from cysts. History: abdominal pain, bloating, pressure, history of pan... | 1.Extrinsic compression upon the transverse duodenum resulting in moderate narrowing and mild upstream luminal dilatation.2.Thickened mucosal folds of the duodenal bulb, perhaps representing duodenal varices or possibly duodenitis. This could be further evaluated with direct visualization.3.Normal small bowel follow-th... |
Generate impression based on findings. | Male 74 years old; Reason: Pleural and peritoneal mesothelioma. Please compare to prior exam per RECIST History: Pleural/peritoneal mesothelioma ABDOMEN:LUNG BASES: Thickening in the right pleural space better imaged on the chest portion of the exam.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hep... | 1.Stable omental disease |
Generate impression based on findings. | 55-year-old female with tachycardia, hypotension, and right ventricular dysfunction PULMONARY ARTERIES: Limited examination due to motion. Within these limitations, there is no evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Tracheostomy tube is in place with out ... | 1.No evidence of pulmonary embolism2.large bilateral pleural effusions with adjacent atelectasis compatible with CHF. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 1-day-old female after second chest tube placementVIEW: Chest AP (one view) 4/1/15, 0445 The ET tube tip is between carina and thoracic inlet. Right chest tube with tip near the apex. Interval placement of right chest tube with tip directed inferiomedially. UVC in right atrium. UAC at T8. NG tube tip and proximal side ... | Right tension pneumothorax is slightly decreased after placement of second chest tube. |
Generate impression based on findings. | Reason: BL knee pain History: BL knee pain Four views of the left knee demonstrate moderate osteoarthritis with medial compartment joint space narrowing and tricompartmental osteophytosis, which has progressed significantly when compared to prior exam in 2008. There is no significant joint effusion or acute fracture.Si... | Interval worsening of bilateral osteoarthritis, as above. |
Generate impression based on findings. | 1-day-old female with pneumothoraxVIEW: Chest AP (one view) 4/1/15, 0621 The ET tube is above the carina and below the thoracic inlet. Repositioning of second right chest tube with both chest tube tips directed cranially. UVC in right atrium. UAC at T8. NG tube tip and proximal side hole in the gastric body.Increasing ... | Increasing moderate to large right tension pneumothorax with leftward mediastinal shift. |
Generate impression based on findings. | 40-year-old female with new swelling/mass in the left superior breast overlying a rib for one month. Three standard views of the left breast and spot compression at the site of concern were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density... | No sonographic or mammographic evidence of malignancy. Clinical correlation with physical exam findings is recommended. As long as the patient's physical examination is concordant with these results, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS... |
Generate impression based on findings. | Male 31 years old; Reason: assess pleural effusion on cxr, assess abdomen. History: O2 requirement, distended abdomen CHEST:LUNGS AND PLEURA: Large partially loculated left pleural effusion, filling the left hemithorax with near complete atelectasis of the left lung with residual small aerated portion at the left apex.... | 1.Thick-walled, enhancing left pleural effusion, suggesting superimposed infection with associated near complete atelectasis of the left lung. There is thoracic inlet and anterior mediastinal lymphadenopathy. Aspiration of fluid for cytology and to facilitate left lung reexpansion is recommended in the first instance. |
Generate impression based on findings. | 53 year old female patient with right flank pain. Evaluate for kidney stone. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of oral and intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Basilar scarring.LIVER, BILIARY TRACT:... | 1.Nonspecific right paracolic gutter inflammatory changes without evidence of appendicitis, ascending colon abnormalities, or gallbladder pathology. This finding can be seen in pancreatitis, duodenal/antral ulcers, as well as pyelonephritis.2.Mild peripancreatic inflammatory changes are nonspecific in the setting of no... |
Generate impression based on findings. | 25 day old former 27 to 28 week gestational age patient with desaturations and increased oxygen requirement.VIEW: Chest AP (one view) 04/01/15, 0245 Endotracheal tube tip is at thoracic inlet. Feeding tube tip is in gastric body.Hazy opacity has developed in the left perihilar region. Subsegmental atelectasis is identi... | Lung opacities may be atelectasis or pneumonia. |
Generate impression based on findings. | 2-year-old male with pain and decreased weight-bearing.VIEWS: Right tibia-fibula AP, lateral (two views) 3/31/15 at 2258 No fracture or malalignment. No significant soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Status post right calvarial craniotomy with pneumocephalus. Improving residual subdural blood and mild residual midline shift. Trace layering subdural blood remains along the right tentorium. A focus of known ischemia within the posterior limb of left internal capsule continues to become more prominent compatible with... | 1.Expected postoperative changes with improving residual subdural blood and mild midline shift.2.Expected evolution of the left posterior limb internal capsule ischemia. |
Generate impression based on findings. | Reason: prosthetic assess History: post-op Three views of the left knee demonstrate hardware components of a total knee arthroplasty, in anatomic alignment, without radiographic evidence of hardware complication or acute fracture. There is evidence of heterotopic bone formation adjacent to the joint, similar to prior.T... | Bilateral total knee arthroplasties, as above. |
Generate impression based on findings. | 56-year-old female with family history of breast cancer diagnosed in mother age 59. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign calcifica... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: 67 yo female with right shoulder pain s/p fall. Pain mostly along right supraclavicular region. Possible rotator cuff tendonitis. History: right shoulder pain Three views of the right shoulder demonstrate normal anatomic alignment, without evidence of acute fracture. The acromiohumeral interval is within normal... | Degenerative changes, without evidence of acute fracture or dislocation. |
Generate impression based on findings. | Reason: assess healing History: S/P acromion fracture Three views of the left shoulder demonstrate normal anatomic alignment without evidence of acute fracture. Vacuum joint phenomenon indicates the absence of a joint effusion. | No acute fracture or malalignment. |
Generate impression based on findings. | Female 2 months old Reason: increase atelectasis History: increased Flow requirementVIEW: Chest AP (one view) 4/1/15 The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. Multifocal opacities of the right upper lobe and both lung bases like atelectases. No effusions or... | Multifocal lung opacities as described. |
Generate impression based on findings. | Pain in the spine. Evaluate possibility of compression fracture. Three views of the thoracic spine show no compression fracture. Small osteophytes project from a few of the thoracic vertebrae. Surgical clips are noted in the right upper quadrant.Five views of the lumbar spine show no compression fracture. The intervert... | Minimal degenerative arthritic changes with no compression fracture evident. |
Generate impression based on findings. | Reason: bone scan with right trochanter met, eval for fracture History: breast cancer Two views of the left hip demonstrate normal anatomic alignment without evidence of acute fracture. The intertrochanteric metastasis seen on recent bone scan is not evident on this radiograph. Surgical clips are present in the right h... | No evidence of acute fracture or malalignment. No osseous metastasis is seen on the study. |
Generate impression based on findings. | 20-year-old male with intermittent bilateral testicular pain RIGHT TESTIS: Measures 5.4 cm x 2.8 cm x 4.3 cm and is normal in echogenicity.LEFT TESTIS: Measures 5.2 cm x 2.7 cm x 3.3 cm and is normal in echogenicity.RIGHT EPIDIDYMIS: Measures 4.9 cm x 0.7 cm x 1.2 cm and is normal in echogenicity.LEFT EPIDIDYMIS: Measu... | Left sided varicocele, otherwise no intratesticular masses or inflammatory changes. |
Generate impression based on findings. | Female 51 years old Reason: s/p sleeve gastrectomy eval for reflux/ hiatal hernia History: reflux and weight regain. Limited scout radiograph of the upper abdomen showed a nonobstructive bowel gas pattern. Lung bases appear unremarkable. Postsurgical changes compatible with a sleeve gastrectomy. The distal end of the s... | 1. Distal end of sleeve gastrectomy appears patent and measures 1.0 cm in diameter. 2. No obstruction to flow of contrast.3. Spontaneous gastroesophageal reflux to distal third of the esophagus which cleared in under 30 seconds. |
Generate impression based on findings. | Reason: s/p ORIF right tibial plateau fracture, evaluate for healing History: above Two views of the right tibia/fibula demonstrate orthopedic plate and screw device affixing a healed right proximal tibial fracture in near-anatomic alignment. No fracture plane is evident. The bones appear diffusely demineralized. | Healed tibial plateau fractures as described above. |
Generate impression based on findings. | 1-day-old female with pneumothoraxVIEW: Chest and abdomen AP (two views) 4/1/15 at 0835 The ET tube is above the thoracic inlet. Two right chest tubes have their tips directed cranially. UVC in right atrium. UAC at T8. NG tube tip and proximal side hole in the gastric body.Slight decrease in right tension pneumothorax ... | Slight decrease in right tension pneumothorax. Mildly dilated loops of bowel in a disorganized bowel gas pattern. |
Generate impression based on findings. | Male; 68 years old. Reason: Please evaluate for malignancy History: h/o Sarcoidosis, COPD, severe HF, found to have Lytic lesions on skull (CT Head) and iliac spine (CT lumbar sp), and has prior Right sided Lung lesion CHEST:LUNGS AND PLEURA: Previously described 14 x 15 mm opacity within a right lower lobe segmental b... | 1. Previously described opacity within a right lower lobe segmental bronchus has resolved. Otherwise, no significant interval change in the appearance of the chest.2. No specific evidence of intra-abdominal or pelvic malignancy.3. Stable nonspecific lytic lesions in the ribs and left iliac bone. |
Generate impression based on findings. | Reason: painful TSA is it in position or loose History: pain Three views of the right shoulder demonstrate hardware components of a total reverse right shoulder arthroplasty, in near-anatomic alignment. There is no radiographic evidence of loosening or hardware failure. Degenerative changes affect the acromioclavicular... | Total right shoulder arthroplasty in anatomic alignment, without radiographic evidence of complication or loosening. |
Generate impression based on findings. | Recent CVA with drop foot, pain, and edema for 3 months along the third, fourth, and fifth metatarsals. Evaluate for stress fracture of the third, fourth, and fifth metatarsals. Three views of the right foot are provided. The bones appear demineralized. We see no fracture. Moderate osteoarthritis of the first MTP joint... | Osteoarthritis without fracture evident. If there is strong clinical concern for a stress fracture, repeat radiographs may be obtained in 10 to 14 days. |
Generate impression based on findings. | Status post left wrist fusion. Assess healing. Three views of the left wrist again show a dorsal plate with screws entering the distal radius, the third metacarpal, and an additional screw with its tip overlying the trapezoid. We see no evidence of hardware complication. Deformity of the distal radius represents a comb... | Postoperative changes of wrist fusion as described above. |
Generate impression based on findings. | The bilateral hippocampal regions are symmetric. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are d... | Unremarkable MRI of the brain. |
Generate impression based on findings. | 71-year-old female status post left lumpectomy in 1996 for DCIS with adjuvant radiation therapy. The patient has a right sebaceous cyst. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | History of T2N0 right parotid salivary duct carcinoma, status post right total parotidectomy with preservation of facial nerve on 6/5/14 and chemotherapy. There are postoperative findings from right parotidectomy, which appear similar to the prior exam. There is no evidence of measurable mass lesions or significant lym... | 1. Post-treatment findings related to right parotidectomy without evidence of measurable mass lesions or significant lymphadenopathy in the neck.2. Partial right otomastoid opacification, which is nonspecific, but may relate to eustachian tube dysfunction or infection. |
Generate impression based on findings. | 2-year-old male with fever and coughVIEWS: Chest AP/lateral (two views) 3/31/15 at 2319 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Bronchial wall thickening suggestive of bronchiolitis/reactive airway disease pattern. No focal pulmonary opacities. No pleural effusi... | No pneumonia. Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | Reason: prosthetic assess History: post-op Single AP view of the pelvis demonstrates hardware components of a total right hip arthroplasty in near-anatomic alignment, without evidence of hardware complication or acute fracture. Severe degenerative changes of the left hip are grossly unchanged. Mild to moderate osteoart... | Right total hip arthroplasty, as above. Severe osteoarthritis of the left hip is seen on AP view. |
Generate impression based on findings. | Female; 58 years old. Reason: assess for enterocutaneous fistula, need oral contrast History: increased abd drain output, s/p JP drain fell out 3/31 ABDOMEN:LUNG BASES: Small pleural effusions and mild right basilar dependent nonspecific atelectasis/consolidation. New mild pneumomediastinum around the distal descending... | 1. Interval removal of a right upper abdominal surgical drain with a small amount of upper abdominal pneumoperitoneum near the prior location of the drain tip.2. Apparent enterocutaneous fistula from the biliary limb stump through the tract of the prior surgical drain.3. New mild pneumomediastinum and pneumoretroperito... |
Generate impression based on findings. | Reason: great toe pain r/o gout History: pain no trauma Three views of the left foot demonstrate normal anatomic alignment without evidence of acute fracture. The great toe is unremarkable, without evidence of gout. | No evidence of gout or other findings to explain patient's pain. |
Generate impression based on findings. | 51-year-old male with history of lung cancer and bronchoesophageal fistula, recently stented, with new onset tachycardia. PULMONARY ARTERIES: There is a small filling defect within a right middle lobe subsegmental artery of questionable clinical significance. There is no large central pulmonary embolus.LUNGS AND PLEURA... | 1. Isolated small acute pulmonary embolus in a right middle lobe subsegmental artery. This is of questionable clinical significance.2. Interval placement of midesophageal stent with persistent loculated mediastinal air collection which communicates with the bronchial tree.3. Fluid filled central bronchi bilaterally wit... |
Generate impression based on findings. | Reason: prosthetic assess History: post-op Single AP view of the pelvis demonstrates hardware components of a left total hip arthroplasty, in anatomic alignment, without radiographically evidence of hardware complication. Mild osteoarthritis affects the right hip on the AP view.Two views of the left hip demonstrates af... | Postoperative changes of left total hip arthroplasty and left total knee arthroplasty, as above. |
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. | 15-month-old male with fever and coughVIEWS: Chest AP/lateral (two views) 4/1/15 at 0103 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Mild bronchial wall thickening suggestive of bronchiolitis/reactive airway disease. No focal pulmonary opacities. No pleural effusion... | Bronchiolitis/reactive airway disease pattern. No pneumonia. |
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. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifica... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Mammogram works best when searching for changes. Submission of prior mammogram is, therefore, recommended for future reference. If the patient submits her old mamm... |
Generate impression based on findings. | Images were obtained for stereotactic purposes, and are limited due to the streak artifact from the surrounding brain. There is a stable right frontal approach ventriculostomy catheter the right frontal horn. The ventricles are stable in size, again with moderate dilatation of the lateral and third ventricles. There i... | Limited preoperative STEALTH exam with no significant interval change in supratentorial ventricular dilatation and complex fourth ventricular mass. |
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. Stable benign calcifi... | 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. | Male, 4 years old. Neuroblastoma undergoing prescreening for stem cell transplant. Evaluate for new lesions, spread of disease CHEST:LUNGS AND PLEURA: Moderate to large right pleural effusion, increased from prior, with mild associated compressive atelectasis. Trace left pleural effusion. Left lung dependent atelectasi... | 1. Lymphangiographic contrast material within the mesenteric and retroperitoneal lymph nodes. Decreasing ascites.2. Increasing right pleural effusion.3. Decreasing prominence of abdominal lymph nodes. Stable sclerotic lesions in the thoracic spine. No new sites of disease identified. |
Generate impression based on findings. | 61 year old female with known bilateral breast cysts. Patient has had a benign surgical biopsy of the right breast and two stereotactic benign core biopsies of the left breast. No new breast complaints Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast par... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. In view of extremely dense breast tissue, whole breast ultrasound for supplemental screening may be considered. Results and recommendations were discussed w... |
Generate impression based on findings. | Reason: Evaluation of rhizopus pneumonia History: Pneumonia LUNGS AND PLEURA: Marked improvement in focal bilateral upper lobe air space opacities with residual reticulonodular opacities, consistent with resolving fungal infection.A large masslike subpleural opacity in the left lower lobe which previously contained air... | 1.Resolving upper lobe opacities consistent with infection.2. Persistent left lower lobe subpleural masslike opacity with central necrosis consistent with infection and possibly infarction.3. Increased left subpulmonic pleural effusion. |
Generate impression based on findings. | Female 31 years old; Reason: Assess vasculature and location of previous transplanted organs prior to repeat transplant History: prior kidney transplant - need information re: implantation ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant ... | 1.No calcific arteriosclerotic disease of the aorta. |
Generate impression based on findings. | Female 51 years old Reason: evaluate for stricture in pt with GERD History: abd pain dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus demonstrated mucosal irregularity of the distal esophagus, best seen... | 1.Mucosal irregularity of the distal esophagus best seen on the single contrast phase, perhaps representing esophagitis.2.Small hiatal hernia, somewhat increased in size from the prior examination.3.Spontaneous gastroesophageal reflux with delayed clearance.4.Minor motor abnormality. |
Generate impression based on findings. | 57-year-old female with mesothelioma on observation, evaluate extent of disease CHEST:LUNGS AND PLEURA: New thickening and ectasia of a left upper lobe bronchus likely post-inflammatory in etiology. Loculated left subpulmonic air and fluid collection measuring higher than with simple fluid density is not significantly ... | 1.Overall stable extent of pleural disease, lymph node measurements, and chest wall soft tissue foci.2.Unchanged loculated air and left pleural fluid collection containing diaphragmatic mesh raises the question of infection. |
Generate impression based on findings. | Right L4 symptoms Moderate degenerative disk disease affects L1/2. The remaining intervertebral disk spaces are maintained. Vertebral body heights are preserved. Alignment is within normal limits. Small osteophytes project from the anterior aspects of the vertebral bodies. | Degenerative disk disease at L1/2; I see no specific findings to suggest to suggest an etiology for the patient's right L4 symptoms. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 59 years, Male. Reason: r/o obstruction History: abd distention There is a percutaneous gastrostomy tube with its tip projecting over the prepyloric stomach. There is a nonobstructive bowel gas pattern. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 37 years old; Reason: 37 year old female with Castleman's disease involving the lymph nodes in the left axilla. Evaluate extent of disease. History: Enlarged left axillary LN s/p biopsy last week. CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart si... | 1.Left axillary lymphadenopathy. |
Generate impression based on findings. | Stable right frontal approach ventriculostomy catheter, with tip in the right frontal horn. There is an adjacent right anterior parietal burr hole noted just posteriorly, as well as an old burr hole in the right occipital region. In addition, there has been interval creation of a new right paramedian frontal burr hole... | 1. Expected postoperative changes following new right paramedian frontal approach catheter placement with tip in the cystic component of the posterior fossa mass, with interval decreased size and localized mass effect of the cyst.2. Dilated lateral and third ventricles remain stable. |
Generate impression based on findings. | 82-year-old female with bilateral ILC status post AI for 2 months. On review of the prior studies, there is a right 10 o'clock mass with clip and left 7 o'clock mass with clip, both 5 cm from the nipple. Both are targeted for separate seed placements. The procedure, risks including bleeding, mistargeting (need to place... | Two successful seed placements of known bilateral breast cancers.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Flank pain and hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted.RETROPERITONE... | Negative for acute, inflammatory, or neoplastic process. |
Generate impression based on findings. | 72-year-old with history of right mastectomy for breast cancer. Three standard views of the left breast with repeat left MLO view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No dominant mass, suspicious microcal... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: 64yr old male with history of MM; post-auto sct evaluation History: evaluate SKULL: Two views of the skull show prominent vascular markings, with no definite myelomatous lesions.CERVICAL SPINE: Orthopedic hardware affixing occiput to C6, with no definite myelomatous lesions. Moderate to severe degenerative disk... | Multiple lytic lesions, consistent with multiple myeloma, not significantly changed when compared to prior study. |
Generate impression based on findings. | Correlating with the abnormality on bone scan, there is an extensive lytic expansile mass in the left parietal calvarium with associated minimal epidural soft tissue component, and mild mass effect upon the underlying parenchyma. The destructive mass measures at least 19 mm in greatest thickness including the epidural... | 1. Large lytic lesion involving the left parietal bone consistent with a metastasis, with mild epidural extension which results in mild localized mass effect on subjacent parenchyma.2. Foci of hyperattenuation likely representing enhancement concerning for metastases in the right occipital lobe. MRI of the brain with a... |
Generate impression based on findings. | 80-year-old female with history of lung nodule. 17mm nodule on outside CT in 1/2015, PET revealed moderately increased uptake, biopsy showed necrosis. CHEST:LUNGS AND PLEURA: There is a smoothly marginated solid pulmonary nodule located in the anterior aspect of the left upper lobe measuring 17 x 11 mm (image 20 of ser... | Bilateral smoothly marginated upper lobe pulmonary nodules, the largest located in the left upper lobe, measuring 17 x 11 mm, stable or slightly decreased when compared to the prior CT. Given the multiplicity, smoothly marginated appearance and relatively low FDG avidity, granulomatous infection, possibly histoplasmosi... |
Generate impression based on findings. | Male, 13 years old. Back painVIEWS: Thoracic spine AP, lateral (two views) 4/1/15, 0944 Normal thoracic kyphosis. The vertebral body and disk space heights are maintained.The T1 through T3 levels are not visualized on lateral imaging.No acute fracture or malalignment. | No abnormality noted. The T1 through T3 levels are not visualized on lateral imaging. If the pain is at these levels, a swimmer's view is recommended. |
Generate impression based on findings. | Nasopharyngeal cancer status post CRT and surgery. There are post-treatment findings in the nasopharyngeal and sinonasal regions with a defect in the exosurface of the clivus and prominent mucosal thickening in the bilateral maxillary sinuses and to a lesser extent in the anterior ethmoid cavity. There is diffuse hyper... | Post-treatment findings in the nasopharyngeal region without evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. Indeed, diffuse hyperenhancement of the nasopharyngeal mucosal space likely represents mucositis with underlying scar or granulation tissue rather than viable ... |
Generate impression based on findings. | Right proximal humerus fracture, evaluate for healing. Status-post ORIF right tibial plateau fracture, evaluate joint line. Two views of the right knee are provided. Again seen is a plate and screw device affixing a comminuted intra-articular fracture of the lateral tibial plateau. There is approximately 5 mm of depres... | Healing fractures as described above. |
Generate impression based on findings. | Female 66 years old; Reason: Recurrent ovarian cancer currently on chemotherapy. Assess treatment response and extent of disease. History: Recurrent ascites. CHEST:LUNGS AND PLEURA: There are scattered pulmonary micronodules. There is pleural thickening at the apices and some mild pleural nodularity which are unchanged... | 1.Stable exam. |
Generate impression based on findings. | known left hemispheric ICH follow up. Post craniectomy and hematoma evacuation. Re-demonstration of left fronto-parietal ICH with left fronto-parietal craniectomy, minimal brain swelling, surrounding brain edema and midline shift toward right side, no change since prior exam.There is no evidence of new ischemic or hemo... | 1. Post hematoma evacuation with left frontoparietal craniectomy status, no change since prior exam.2. No evidence of new acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | Male 59 years old; Reason: 59M w/ h/o excisional inguinal LN bx at OSH c/b infected seroma s/p bedside i\T\D on 3/1, now with residual groin pain. Please assess for underlying abscess History: groin pain ABDOMEN:LUNG BASES: Evaluation of lung parenchyma limited by motion. Bibasilar atelectasis and scarring, unchanged. ... | 1.Interval resolution of gas and fluid within a left inguinal collection. Residual soft tissue density may represent postsurgical change/scarring, further described above. |
Generate impression based on findings. | Female; 30 years old. Reason: Hyperthyroidism, evaluate for Graves versus toxic adenoma. The thyroid images demonstrate a diffusely enlarged gland with fairly uniform uptake, slightly more pronounced on the left. In addition, several small bilateral nodules exhibiting decreased activity are visualized in both lower pol... | Findings consistent with Graves disease and several small bilateral superimposed nodules, some mildly functioning and some non-functioning. |
Generate impression based on findings. | Shoulder pain. Evaluate for AC separation. Acromioclavicular and glenohumeral joint alignment is within normal limits. Minimal osteoarthritic changes affect the shoulder. There is a tiny focus of mineralization adjacent to the greater tuberosity that may reflect calcification the distal fibers of the rotator cuff. | Mild degenerative arthritic changes as described above; I see no acromioclavicular joint separation. |
Generate impression based on findings. | Status post revision posterior arthrodesis. Evaluate PSF, L5 -- S1 TLIF. There are posterior stabilization rods with screws entering L5, S1, and now both iliac wings. I see no hardware complications. Amorphous density along the posterior aspect of the lumbar spine presumably represent bone graft material. Again seen is... | Postoperative changes of lumbosacral fusion as described above. |
Generate impression based on findings. | 36 year old with known right breast cancer presents for research biopsy of I-SPY protocol. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 12 x 25 x 21 mm at the 10 o’clock position with increased vascularity, 10 cm from the nipple. The lesion was re... | Successful ultrasound-guided core biopsy of the right breast cancer. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 74-year-old male with pleural and peritoneal mesothelioma LUNGS AND PLEURA: Postsurgical changes to the right hemithorax with associated volume loss and intact diaphragmatic mesh. Unchanged nodular pleural/pericardial thickening adjacent to the right atrium (series 5, image 55).Reference measurements as below:At the le... | Slight interval improvement of pleural disease including reference measurements. Other findings as above. |
Generate impression based on findings. | The STIR images are degraded by motion artifact. The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are well-maintained. There is mild disk desiccation along the lumbar spine. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord an... | Overall, mild lumbar spondylotic changes with predominantly left-sided disk pathology at L2-L3 through L5-S1. Resultant mild left foraminal narrowing at L4-L5. Left paracentral/foraminal disk protrusion at L2-L3 approaches the exiting left L2 nerve root without impingement. No significant central spinal canal stenosis ... |
Generate impression based on findings. | 63-year-old male with history of esophageal perforation and subsequent empyema, for evaluation of mediastinal/paraesophageal fluid collection. LUNGS AND PLEURA: Central airways are patent. No pleural effusion or pneumothorax.Interval removal of bilateral chest tubes with resolution of the pleural effusions and improvem... | 1.Right paraesophageal mediastinal collection appears similar to the prior exam. 2.New right middle lobe tree in bud opacities likely represents bronchiolitis from infection or aspiration. 3.Unchanged ground glass opacities may represent atypical adenomatous hyperplasia, adenocarcinoma in situ or minimally invasive ade... |
Generate impression based on findings. | 48-year-old with DJD status post L4/L5 fusion at outside hospital. Back pain. There is partial sacralization of L5, with hypertrophy of the left transverse process which articulates with the underlying sacrum. Apparent narrowing of the L5/S1 intervertebral disk space likely reflects this partial sacralization. There is... | Postoperative changes of lower lumbar spine fusion and other findings as described above. |
Generate impression based on findings. | Male; 83 years old. Reason: evaluate for aortic aneurysm dissection History: h/o 5.3 cm aortic aneurysm, p/w chest pain CT ANGIOGRAM:No acute aortic dissection or rupture.Stable ascending aortic aneurysm measuring up to 5.2 cm in greatest AP dimension (series 12/85). Mild to moderate atherosclerotic calcifications of t... | 1. No acute aortic dissection or rupture. Stable ascending aortic aneurysm.2. 5-mm proximal right ureteral stone causing mild upstream right hydroureteronephrosis. Mild proximal right urothelial thickening and enhancement, likely due to inflammation.3. Mild nonspecific patchy groundglass opacities in the right upper lo... |
Generate impression based on findings. | Reason: evaluate L THA History: s/p L THA 6 weeks ago Two views of the left hip demonstrate hardware components of a left total hip arthroplasty in anatomic alignment, without evidence of hardware complication or acute fracture. Interval removal of surgical drain.Single AP view of the pelvis demonstrates the aforementi... | Left total hip arthroplasty as above. |
Generate impression based on findings. | Deformity and pain. Fracture of fourth toe? There is a comminuted but predominantly oblique fracture through the neck and diaphysis of the proximal phalanx of the fourth toe, with fracture fragments in near anatomic alignment. The fracture does not appear to extend to either articular surface. | 4th toe fracture as described above. |
Generate impression based on findings. | Reason: Left thumb metacarpal autograft reconstruction, s/p revision ORIF for fracture, evaluate for healing History: above Three views of the left hand demonstrate a plate and screw device affixing the first metacarpal bone graft, in near-anatomic alignment. There is no evidence of hardware complication. No specific r... | Postoperative changes of first metacarpal reconstruction as above. |
Generate impression based on findings. | Postoperative changes are seen from recent posterior lumbar interbody fusion of L4 through S1, with bilateral pedicle screws at these levels. Interbody spacers with graft material are seen in the L4-5 and L5-S1 disk spaces. There is no evidence of instrumentation complication. Prominent fluid is noted in the subcutane... | 1. Postoperative changes from interval posterior fusion of L4 through S1, with stable trace grade 1 anterolisthesis of L4 on L5. No evidence of instrumentation complication or acute fracture. Somewhat prominent subcutaneous emphysema noted suggesting innumerable punctate foci of aeration within postoperative fluid.2. P... |
Generate impression based on findings. | Male 3 months old Reason: evaluate venous anatomy History: Down syndrome with abnormal venous anatomy on echo LUNGS AND PLEURA: Subsegmental atelectasis of the right upper lobe and left lower lobe. No effusion or pneumothorax.MEDIASTINUM AND HILA: Leftward mediastinal displacement due to pectus excavatum. Haller index ... | Left innominate vein dilatation with no evidence of obstruction and of unknown clinical significance.Compression of the airway by the right subclavian artery that may be the reason for stridor.Pectus excavatum as described.Dr. Peter Varga was present during the elaboration of this report and agrees with the findings. |
Generate impression based on findings. | Low back pain with pain in the hips and right leg Three views of the lumbar spine are provided. The bones are slightly demineralized. There appears to be mild diffuse loss of height L3, L4, and L5, but I suspect that this is chronic in etiology and not necessarily of any current clinical significance. Mild degenerative... | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 50 year-old male patient with history of pseudocyst. Evaluate pancreatic pseudocyst and gastric thickening. ABDOMEN:LUNG BASES: Stable right upper lobe nodule measures 4 mm (series 4 image 7). Stable right lower lobe pleural-based nodule measures 5 mm (series 4 image 17). Small cluster of nodules in the right lower lob... | 1.Improved anterior intra-abdominal edema and resolution of peripancreatic fluid collections.2.Anterior abdominal wound dehiscence.3.Abdominal aortic aneurysm measuring up to 2.2 cm in diameter. |
Generate impression based on findings. | Scoliosis There is multilevel degenerative disk disease predominately affecting the cervical and lumbar spine. Facet joint osteoarthritis also the cervical and lumbar spine. There is 35 to 40 degrees of dextrorotoscoliosis of the thoracolumbar spine as measured from the superior endplate of T11 to the inferior endplate... | Scoliosis and other findings as described above. |
Generate impression based on findings. | Endometrial carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Stable thyroid nodulesCORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Fatty infiltration of the liver.SPLEEN: No significant abnormality noted.PANCREAS: No ... | Stable exam without evidence for measurable metastatic disease. Fatty infiltration of liver. |
Generate impression based on findings. | Reason: eval for fx History: knee pain sports Four views of the left knee demonstrate normal anatomic alignment without significant degenerative changes or acute fracture.Four views of the left knee demonstrate normal anatomic alignment without significant degenerative changes or acute fracture. | Unremarkable exam of the knees. |
Generate impression based on findings. | Reason: Evaluate for ankle fracture History: Pain with edema lateral right ankle - questionable trauma Three views of the right ankle demonstrate significant bilateral soft tissue swelling about the ankle, lateral greater than medial. There is no evidence of acute fracture or malalignment.Three views of the right foot ... | Significant soft tissue swelling of the foot and ankle, without acute fracture. |
Generate impression based on findings. | Reason: Eval for periosteal bone formation History: pain in feet Views of the bilateral knees are unremarkable. There is no evidence of periosteal reaction or acute fracture.Views of the bilateral lower legs are unremarkable. There is no evidence of periosteal reaction or acute fracture.Views of the bilateral ankles ar... | No evidence of periosteal reaction or acute fracture. |
Generate impression based on findings. | 57-year-old female with history of right lumpectomy in 2006 for grade 3 IDC followed by chemotherapy and radiation therapy. History of bilateral breast reduction in 2007. History of benign left breast biopsy in the 12 o'clock position in 2012 for fat necrosis. No current breast complaints. Three standard views of both ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 56 years old Reason: s/p gastric bypass 7/2014 evaluate for stenosis vesus fistula History: oral intake intolerance, malnutrition Single contrast evaluation of the distal esophagus and stomach demonstrated postsurgical changes compatible with an end to side gastrojejunal anastomosis and gastrectomy, with a small... | Small remnant gastric pouch without evidence of stenosis or fistula as clinically questioned. |
Generate impression based on findings. | Pain Three views of the right foot are provided. There is a 1.5-cm well corticated ossicle along the medial aspect of the first tarsometatarsal joint which could represent an old fracture fragment or perhaps a developmental variant. I see no acute fracture. There is an approximately 1 cm rounded lucency within the navi... | 1.Ossicle along the medial aspect of the first tarsometatarsal joint may reflect old trauma or a developmental variant.2.1 cm rounded lucency in the navicular is nonspecific but may represent a cyst or ganglion. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 48-year-old female with 1.5 months of heel pain. Three views of the left foot demonstrate normal anatomic alignment without evidence of acute fracture. A plantar heel spur is present. No significant soft tissue swelling. | Plantar heel spur, as above. |
Generate impression based on findings. | Reason: Lumbar radiculopathy History: Lumbar radiculopathy Two views of the lumbar spine demonstrate a posterior stabilization rod and screws entering the L4 and L5 vertebral bodies, similar to prior. There is no radiographic evidence of hardware complication. Moderate degenerative disk disease affects L5-S1. There is ... | Postoperative changes related to lower lumbar spinal fusion, without evidence of complication. |
Generate impression based on findings. | Pain There is a 2-mm ossicle seen on the lateral view along the dorsal aspect of the carpus that could conceivably represent a small triquetral avulsion fracture fragment as suggested previously, but this is equivocal, and I cannot determine with certainty if this finding is acute or chronic. Mild osteoarthritis affect... | Tiny density along the dorsal aspect of the carpus could conceivably represent a triquetral avulsion fracture as suggested previously, but I am not sure if this is an acute or chronic finding. Other findings as above. |
Generate impression based on findings. | Female 43 years old Reason: assess for sma History: abd pain bloating Double contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peri... | 1.Normal appearing esophagus and stomach.2.Perhaps slightly diminished duodenal peristalsis, the significance of which is uncertain.3.No evidence of SMA syndrome as clinically questioned. |
Generate impression based on findings. | RIGHT TEMPORAL BONE: There are postoperative findings related to prior repair of a perforated tympanic membrane and cholesteatoma resection. There is a persistent defect within the inferior portion of the thickened and retracted reconstructed tympanic membrane and scattered subcentimeter opacities adjacent along the t... | 1. Postoperative findings within the right ear with multiple areas of middle ear opacities with mild blunting of the scutum and erosions along the posterior wall of the middle ear cavity with dehiscence of the second genu region of the facial nerve canal that may represent recurrent cholesteatoma amidst granulation tis... |
Generate impression based on findings. | Assess prosthesis Three views of the right knee reveal a total knee arthroplasty in anatomic alignment. No evidence of loosening or hardware failure. Three views of the left knee reveal a total knee arthroplasty in anatomic alignment. No evidence of loosening or hardware failure. | Total knee arthroplasties in anatomic alignment. |
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