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Generate impression based on findings. | 62-year-old male with history of right tonsillar squamous cell carcinoma. CHEST:LUNGS AND PLEURA: No suspicious pulmonary masses. No pleural effusions or consolidations.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. Scattered mildly enlarged mediastinal lymph nodes appearing similar to pri... | No evidence of metastatic disease or other significant abnormality. |
Generate impression based on findings. | 41 year old female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious morphology masses, microc... | No mammographic evidence of malignancy. Multiple bilateral benign morphology masses compatible with cysts as seen on a prior ultrasound. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 75-year-old male with tongue cancer. CHEST:LUNGS AND PLEURA: Probable debris along the right tracheal wall may represent aspirated material or secretions. No pleural effusion or pneumothorax. Right lung base scarring and linear atelectasis. Scattered nonspecific micronodules. No suspicious nodules or mass. Elevation of... | 1.No evidence of metastatic disease.2.Numerous bilateral hypoattenuating renal cysts. 3.Indeterminate left renal kidney cyst appearance may be a hyperdense or hemorrhagic cyst. Consider non-contrast CT for confirmation. |
Generate impression based on findings. | Female, 12 years old. Evaluate for mandible fracture. Chronic left mandibular osteomyelitis s/p s/p excision of sinus tract VIEWS: Mandible Panorex (1 view) 4/2/2015, 1327 No acute fracture or malalignment. The temporomandibular joints are normal.A 1cm lucency in the region of the root of the left mandibular third mola... | Postsurgical changes of the left mandible, without fracture or malalignment. |
Generate impression based on findings. | 17 year-old male with scoliosisVIEWS: Thoracolumbar spine AP with maximal leftward flexion (one view) 4/2/15 at 1252 A ventriculoperitoneal shunt tubing is seen. Vagal nerve stimulator device is in place. A gastrostomy tube is present. The left femoral head is superiorly positioned with respect to the acetabulum. Appro... | Thoracolumbar scoliosis with maximal leftward flexion as detailed above . |
Generate impression based on findings. | Male 68 years old Reason: metastatic neuroendocrine tumor, to liver History: pain in abdomen Several mild to moderately octreotide avid liver lesions are present consistent with metastases. Mildly increased activity in the L2, L3 and L4 vertebral bodies, as well as the mid thoracic spine consistent with osseous metasta... | 1.Multiple fairly mildly octreotide avid hepatic and multifocal osseous metastases.2.Skull focus which likely represents an additional osseous metastasis, with brain metastasis considered less likely. If clinically indicated, MR brain with and without contrast may be obtained for further evaluation. |
Generate impression based on findings. | 62-year-old male with right tonsillar squamous cell carcinoma. Neck: Streak artifact from dental hardware obscures surrounding structures. There are stable post-treatment findings in the right tonsillar region without measurable evidence of tumor recurrence. There is no significant lymphadenopathy in the neck. The airw... | 1. No evidence of tumor recurrence or significant lymphadenopathy in the neck.2. No evidence of intracranial metastases |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 69 years old Reason: Evaluate for metastatic disease; has advanced prostate and kidney cancers Diffusely increased activity in the L1 vertebral body with focal increase in the left aspect most likely representing pathologic compression fracture through metastatic lesion seen on CT. No convincing additional osseous... | 1.Findings very suspicious for L1 metastasis with associated pathologic fracture.2.No convincing osseous metastases elsewhere. However lytic lesions, such as RCC metastases, are often not well-visualized on bone scan, FDG PET may be considered as clinically indicated for further evaluation. |
Generate impression based on findings. | Left ankle gunshot wound.VIEWS: Left ankle AP/lateral/oblique (3 views) 04/02/15 A splint obscures detail. Alignment is anatomic. Few tiny projectile fragments are noted. | Anatomic alignment in splint. Residual projectile fragments. |
Generate impression based on findings. | Female 75 years old Reason: metastatic breast cancer - baseline prior to starting new treatment regimen History: known bone metastases Widespread osseous metastatic disease including the ribs, pelvis, femurs, spine, and humerus which have significantly progressed compared to prior exam with multiple new lesions. | Multifocal osseous metastatic disease, progressed from previous exam. |
Generate impression based on findings. | There is moderate opacification of the right maxillary sinus with air-fluid level and frothy appearing secretions. There are smaller areas of mucosal thickening in the left maxillary sinus. Bilateral infundibula are patent. There is moderate rightward septal deviation with a small septal spur. Bilateral mastoid air ce... | 1.Moderate right maxillary sinus opacification with fluid-level and frothy secretions which may represent acute sinusitis in the appropriate clinical setting. No findings to suggest an aggressive sinonasal process.2.Additional mild patchy ethmoid and left maxillary opacification as described above. |
Generate impression based on findings. | Female; 76 years old. Reason: Patient with Ovarian cancer needs re-evaluation and compare to prior scans. Per RECIST 1:1 bi-dimensional measurements where applicable. History: Patient with Ovarian cancer needs re-evaluation and compare to prior scans. Per RECIST 1:1 bi-dimensional measurements where applicable. CHEST:L... | 1.Interval increased size of metastatic lesions.2.Severe hydronephrosis of the right kidney, increased since prior study, with new mild interval right renal cortical thinning. Stable right ureteral stent. |
Generate impression based on findings. | 5-month-old female with fever and tachycardiaVIEW: Chest AP (one view) 4/2/15 at 1340 Interval placement of left central line with tip in the right atrium. Interval removal of lower extremity central catheter. Cardiothymic silhouette is normal. Significant interval decrease in pulmonary edema. Mild right upper lobe and... | Interval placement of left central line with tip in right atrium. Right upper lobe and left lower lobe residual hazy opacity likely represents atelectasis or residual edema. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microca... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | HEAD: There is no evidence of acute intracranial hemorrhage. There is no mass, mass-effect, or midline shift. The ventricles and sulci are normal in size and configuration. A nonspecific 9-mm lucent lesion is seen in the left parietal calvarium, possibly a hemangioma. There is mild edema of the occipital scalp soft ti... | 1.No acute intracranial abnormality. If there is high clinical suspicion for intracranial involvement of leukemia, MR with gadolinium contrast can be considered. 2.No findings to suggest sinusitis. |
Generate impression based on findings. | Female 49 years old Reason: S/p OLT with elevated AlkPhos PORTAL VENOUS: Main portal vein is patent with hepatopetal flow, an increased velocity of 80 cm/s and spectral broadening. The intrahepatic main portal vein has more mildly increased velocity of 42 cm/s. The right and left portal veins are patent with normal vel... | 1. Increased velocity with corresponding aliasing at the main portal vein anastomosis suspicious for stenosis. No evidence of portal vein thrombosis. 2. The remaining veins and arteries are patent. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, including very dense elements in each retroareolar region. ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.The sensitivity of mammography for detecting breast cancer is decreased in patients with dense breasts such as this patient. Physical exam assumes a more important ro... |
Generate impression based on findings. | Male 3 months old Reason: eval for left expansion History: ETT, previous right mainstem intubationVIEW: Chest AP (one view) 4/2/15 at 1351 hrs ET tube terminates below thoracic inlet. Misplaced NG tube has proximal side port above the GE junction (the NG tube appears to be coiled in the oropharynx.). Persistent complet... | Persistent left lung atelectasis, concerning for mucous plugging after ET tube repositioning. |
Generate impression based on findings. | Reason: fx History: pain, redness Three views of the right ring finger demonstrate subtle lucency along the radial aspect of the base of the fourth distal phalanx, which may suggest a nondisplaced fracture, if this corresponds to the region of the patient's pain. There is mild soft tissue swelling. Alignment is preserv... | Suggestion of nondisplaced fracture through the base of the fourth distal phalanx, 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 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or ar... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: S/p Left total knee arthroplasty History: S/p Left total knee arthroplasty Two views of the left knee demonstrate total knee arthroplasty in near-anatomic alignment; no evidence of fracture or dislocation. Surgical clips, surgical drain, and iatrogenic gas are present in the soft tissues. | Total knee arthroplasty as above. |
Generate impression based on findings. | Left MCA stroke HEAD:There is no evidence of acute intracranial hemorrhage, edema, mass, mass effect or midline shift. Large focus of encephalomalacia involving the cortex and subcortical white matter of the left frontal lobe with minimal parenchymal calcification is consistent with a large chronic left MCA ischemic st... | 1.Severe stenosis of the bilateral vertebral arteries at origin and lower neck. 2.Calcification of the bilateral internal carotid arteries without significant narrowing as above.3.Occluded posterior MCA division compatible with prior infarct. 4.Right IJ thrombus at the central venous catheter entry site. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural di... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: pre-op History: pain AP view of the pelvis demonstrates severe osteoarthritis of the right hip with bone-on-bone apposition and extensive subchondral sclerosis. Mild osteophytes affect the left hip. Degenerative changes affect the sacroiliac joints. | Osteoarthritis as above. |
Generate impression based on findings. | 62-year-old female patient with diagnosis of retroperitoneal dedifferentiated in well-differentiated liposarcoma. Repeat CT for follow up. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules.MEDIASTINUM AND HILA: No mediastinal or axillary lymphadenopathy. Cardiac size within normal limits without pericardial effus... | 1.Overall progression of metastatic disease with new and increasing serosal implants in the anterior abdomen and pelvis. Previously measured reference lesions in the liver and pancreatic head are not significantly changed compared to prior examination.2.Short segment of small bowel within the left hemiabdomen appears t... |
Generate impression based on findings. | 50 year-old male status post ostomy placement. Now with abdominal distention, also status post kidney transplant. ABDOMEN:LUNG BASES: Small left pleural effusion and bibasilar atelectasis.LIVER, BILIARY TRACT: Hepatic parenchyma appears normal without significant abnormality. Portal venous and hepatic venous structures... | 1. Left iliac fossa transplant kidney without abnormality noted. Atrophic native bilateral kidneys again seen. 2. Postoperative changes seen in small bowel diffusely with right lower quadrant ostomy -- extensive ascites is seen with peritoneal thickening diffusely raising question of chronic inflammation or infection. ... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reduction surgery. Two standard digital views of both breasts with repeat left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 10 years old Reason: distal femur fx of aVIEWS: Left knee AP lateral at 4/2/15 (two views) Four K wires are affixing a Salter-Harris one fracture of the distal femur to anatomic alignment. Cast material obscures fine bone detail. | Left distal femur Salter-Harris one fracture fixation and casting described. Alignment is anatomic. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious m... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: pre-op ct mako robotic for left tha History: pain Severe osteoarthritis affects the right hip with significant joint space narrowing and extensive subchondral cyst formation. Degenerative arthritis fracture the sacroiliac joints. Suture material in the right lower quadrant likely reflects previous bowel surgery... | Severe osteoarthritis of the right hip. |
Generate impression based on findings. | ScoliosisVIEWS: Thoracic and lumbar spine AP, supine 4/2/15 (one views) PDA clip and VP shunt catheter noted. A metallic slider body of the upper overlying the left upper abdomen quadrant. There is a 93 thoracic dextroscoliosis and 23 degrees thoracolumbar levoscoliosis with no segmentation or fusion defects.Mild amoun... | Thoracic dextroscoliosis and thoracolumbar levoscoliosis as described. |
Generate impression based on findings. | Prostate cancer restaging. No abnormal osseous foci are identified to indicate metastatic disease. The small densely sclerotic pelvic foci on CT are therefore most likely benign such as bone islands.Mild symmetric diffuse increased activity along the periosteum of bilateral femurs, tibias, fibulae, and forearms suggest... | 1.No evidence of bone metastases.2.Mild hypertrophic osteoarthropathy of the upper and lower extremities. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No extra-axial fluid collections. Mild subcortical and periventricular white matter hypoattenuation compatible with age indeterminant small vessel ischemic disease. Scattered nonspecific mineralization of t... | 1.No evidence for acute intracranial abnormality. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia and MRI can be considered for further evaluation.2.Subcortical and periventricular white matter hypoattenuation compatible with age indeterminant small vessel ischemic disease. |
Generate impression based on findings. | There are small scattered areas of mucosal thickening noted in the maxillary sinuses, otherwise the paranasal sinuses are clear. The bilateral ostiomeatal complexes are patent. There is minimal S-shaped septal deviation to the right anteriorly and to the left posteriorly. Bilateral mastoid air cells and middle ears ar... | Minimal mucosal thickening in the inferior maxillary sinuses. Paranasal sinuses are otherwise clear. |
Generate impression based on findings. | Reason: S/p revision Left TKA History: S/p revision Left TKA Two views of the left knee demonstrate total knee arthroplasty in near-anatomic alignment; no evidence of fracture or dislocation. Surgical clips, surgical drain, and iatrogenic gas are present in the soft tissues. | Total knee arthroplasty as above. |
Generate impression based on findings. | Again seen are postsurgical changes of endoscopic sinonasal surgery including bilateral uncinectomy, middle turbinectomy, and ethmoidectomy. The osteomeatal units are widely patent. There is mild mucosal thickening of the right maxillary sinus, decreased compared to the exam from 5/20/14. Additionally, there is partia... | 1.Mild mucosal thickening in the right maxillary sinus, decreased from the prior examination, and bilateral ethmoid cavities, similar to prior examination. Paranasal sinuses are otherwise clear.2.Extensive postsurgical changes as detailed above. |
Generate impression based on findings. | 16-year-old male with mandibular fractureVIEWS: Mandible Panorex (one view) 4/2/15 at 1348 Again seen is the oblique fracture of the posterior body of the left mandible extending to the unerupted most posterior left inferior molar. Interval placement of plate and screw device overlying the fracture. Surgical clips are ... | Left posterior mandibular body fracture extending to the unerupted molar with interval placement of plate and screw device. |
Generate impression based on findings. | No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No extra-axial fluid collections. There are extensive periventricular and subcortical low attenuation white matter as well as left basal ganglia on left thalamus highly suggestive of age indeterminant small... | No evidence for acute intracranial abnormality. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia and MRI can be considered for further evaluation. |
Generate impression based on findings. | 65-year-old female with history of incidental lung nodule. LUNGS AND PLEURA: Right lower lobe solid pulmonary nodule measures 7 mm (image 231 of series 8). Biapical scarring. No pleural effusions or evidence of infection.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No mediastinal or hila... | Right lower lobe solid pulmonary nodule. Continued follow-up in 6 months is recommended. |
Generate impression based on findings. | Pain with PT with a pop. Question of loose or dislocated TSA. ROTATOR CUFF: The rotator cuff is incompletely evaluated on this examination. SUPRASPINATUS OUTLET: The acromioclavicular joint is normal. GLENOHUMERAL JOINT AND GLENOID LABRUM: There are hardware components of a right total shoulder arthroplasty. There is n... | 1. No specific evidence of loosening, however, this cannot be entirely excluded given suboptimal opacification of the joint. No evidence of dislocation.2. Small amount of contrast within the joint with extravasation of contrast into the soft tissues raises the question of capsular disruption. |
Generate impression based on findings. | 42-year-old male with hematuria. Preop for transplant nephrectomy. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted in the liver. Patient is status post cholecystectomy with no other biliary tract abnormality.SPLEEN: No significant abnormality notedPANCREAS: No ... | 1. Enlarged right iliac fossa transplant kidney with heterogeneous appearance most consistent with chronic rejection. No other abnormalities in transplant kidney. 2. Bilateral atrophic kidneys with increasing cystic change. Scattered calcifications are seen around the cysts and in the parenchyma. New subcentimeter calc... |
Generate impression based on findings. | There are postoperative findings related to transpedicular screws and rods placed for posterior spinal fusion at the L4 through S1 levels. There is also an implanted device posterior to the sacrum containing wires that terminate near the right L4-L5 and the left L5-S1 facets. There is a minimally displaced and angulat... | 1. Technically-successful CT lumbar myelogram with flourosocopic-guided lumbar puncture and intrathecal contrast injection.2. Please note for the purposes of numbering, there is transitional anatomy with a rudimentary disc space between L5-S1. Postoperative findings related to L4 through S1 posterior spinal fusion are ... |
Generate impression based on findings. | Reason: pre-op History: pain Moderate to severe joint space narrowing of the left knee is present, without significant osteophytosis. Mild osteoarthritis affects the left hip.Mechanical axis radiographs reveal near neutral alignment of the knee with respect to the neutral mechanical axis. | Moderate-severe joint space narrowing of the left knee. Near neutral alignment of the knee with respect to the neutral mechanical axis. |
Generate impression based on findings. | 65-year-old female patient past medical history of atrial fibrillation, hypertension, hyperlipidemia and TIA presents with lower quadrant abdominal pain, suggestive fevers, nausea, and diarrhea. Evaluate for diverticulitis, appendicitis, malignancy. ABDOMEN:LUNG BASES: 7-mm right lower lobe right nodule is unchanged (s... | 1.No acute intra-abdominal findings to account for patient's abdominal pain.2.Incidental 7-mm right lower lobe pulmonary nodule again noted. Recommend follow up imaging as clinically indicated. |
Generate impression based on findings. | Male; 71 years old. Reason: prostate cancer- s/p RALP - please evaluate with attention to left external iliac nodes. History: prostate cancer- s/p RALP - please evaluate with attention to left external iliac nodes. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality note... | No pelvic lymphadenopathy or other significant abnormality. |
Generate impression based on findings. | 76 years, Male. Reason: eval for free air, etc History: abd pain, ?Acute abd Chronic segmental megacolon not significantly changed from the prior study. No definite evidence of free air. Gastric distention with elevated left hemidiaphragm unchanged. Visualized lung bases are unremarkable. | No definite evidence of free air. Chronic segmental megacolon unchanged from 2/24/2015 and prior. |
Generate impression based on findings. | 62 year old with a lump in right axilla. History of left lumpectomy for invasive ductal carcinoma in 1999. Patient received radiation and chemotherapy. History of benign right breast biopsy. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma... | Inflamed sebaceous cyst in the right axilla, for which clinical follow up is recommended. No mammographic evidence of malignancy. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 64 years, Male. Reason: NG tube placed History: tube The pelvis is excluded from the field of view. There is an enteric tube with its tip projecting over the distal descending duodenum. Cholecystectomy clips are noted. Sternotomy hardware unchanged. Please refer to concomitant chest radiograph for thoracic findings. | Enteric tube tip projects over the distal descending duodenum. |
Generate impression based on findings. | 89-year-old female with bilateral hip and lower back pain. Two views of the left hip demonstrate mild to moderate osteoarthritis with mild joint space narrowing and osteophytosis. Extensive vascular calcifications are present in the soft tissues. Surgical clips are noted overlying the left hemipelvis.Two views of the r... | 1.Severe multilevel degenerative arthritic disease of the lumbar spine as above. 2.Chronic appearing compression deformity along the left aspect of the L2 vertebral body.3.Mild to moderate osteoarthritis of the hips. |
Generate impression based on findings. | Reason: back pain with radiculopathy History: same Four views of the lumbar spine including flexion and extension demonstrate normal anatomic alignment without evidence of instability or acute fracture. The vertebral body heights and disk spaces are preserved. Tiny anterior vertebral body osteophytes suggest minimal os... | No evidence of instability. Minimal degenerative changes as above. |
Generate impression based on findings. | Female 6 days old Reason: interval changes History: respiratory distressVIEW: Chest AP (one view) 4/2/15 at 1445 hrs. ET tube terminates below thoracic inlet. NG tube tip is at the lower thoracic esophagus. Right sided cardiac apex and stomach, again noted. Right positioning of abdomen and aorta is also again identifie... | Misplaced NG tube.Multifocal opacities as described. |
Generate impression based on findings. | 25 years, Female. Reason: IUD location. Sono shows IUD is not in the uterus or immediately adjacent. Pls eval History: none Upper abdomen is not included in field of view. No IUD is identified as clinically questioned. Nonobstructive bowel pattern with average stool burden. Pelvic phleboliths are noted. | No IUD identified in the pelvis as clinically questioned. |
Generate impression based on findings. | 82 years, Female, Reason: severe aortic stenosis. CT for sizing of annulus, aorta, and iliofemoral system History: dyspnea, chest pain. CHEST:LUNGS AND PLEURA: Basilar and right middle lobe atelectasis with areas of scattered mosaic attenuation. 5-mm right lower lobe nodule (80518/41) is new from the prior exam. Additi... | 1.Enlargement of the left atrium with left atrial calcifications which may be seen in the setting of mitral valvular stenosis.2.Enlargement of the pulmonary arteries is suggestive of pulmonary hypertension.3.Slightly hyperdense lesion in the left kidney. Recommend ultrasound for further evaluation.4.Cystic lesion in th... |
Generate impression based on findings. | Male; 73 years old. Reason: restaging Prostate cancer, initial therapy was radiation therapy 10-15 years ago History: prostate cancer, evaluation for metastatic disease ABDOMEN:LUNG BASES: Moderate coronary artery calcifications.LIVER, BILIARY TRACT: Small right hepatic cyst.SPLEEN: No significant abnormality notedPANC... | No evidence of metastatic disease. No suspicious osseous lesions, though bone scintigraphy would be more sensitive and accurate indicator of osseous metastatic disease. |
Generate impression based on findings. | Right groin pain. Question of inguinal hernia or acetabular injury. CT images of the pelvis show cortical thickening and coarse trabeculation of the entire right hemipelvis including the iliac bone, ischium, pubic rami, acetabulum, and right sacrum consistent with history of Paget's disease. No acute fracture is eviden... | 1. Paget's disease of the right pelvis. 2. Minimally complex hypodense renal lesions are incompletely evaluated on this examination. CT or ultrasound is suggested for further evaluation. |
Generate impression based on findings. | Female 48 years old History: Head and neck cancer clinical trial post cycle 4RADIOPHARMACEUTICAL: 10.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 103 mg/dL. Today's CT portion chest, abdomen and pelvis no significant pathology.Today's PET examination again demonstrates markedly hypermetabolic, multifoca... | 1.Multifocal, markedly hypermetabolic tumor in the left neck, mildly progressed in extent and metabolic activity from prior examination.2.No FDG evident tumor in the chest, abdomen or pelvis.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 72 year-old female with right wrist and left knee pain status post fall Three views of the right wrist demonstrate subtle cortical lucency along the dorsal aspect of the distal radius, with an ossific density within the adjacent soft tissues, suspicious with a nondisplaced distal radial fracture. No intra-articular ext... | 1.Suggestion of a nondisplaced fracture of the posterior distal radius. Repeat radiographs in 7 to 10 days is suggested.2.Osteoarthritis of the knees, as above. |
Generate impression based on findings. | Head and neck cancer, status post treatment with known right pleural biopsies. Neck: There are post-treatment findings related to left partial glossectomy, neck dissection, and thyroidectomy. There is distortion of the reconstructed tongue base and diffuse mucosal enhancement, but no evidence of measurable mass lesions... | 1. Post-treatment findings in the neck without convincing evidence of recurrent tumor or significant lymphadenopathy.2. No evidence of acute intracranial metastases.3. Multiple nodules within the partially-imaged lungs and right pleural thickening are compatible with metastases. Please refer to the separate chest CT re... |
Generate impression based on findings. | Female; 75 years old. Reason: pancreatic protocol, please evaluate for pancreatic lesion or inflammation History: diarrhea, weight loss, pancreatic insufficiency ABDOMEN:LUNG BASES: Partially visualized lung bases demonstrate emphysematous changes, honeycombing in the right middle lobe, and and mild bibasilar scarring,... | No significant abnormality. |
Generate impression based on findings. | Status post fall. Injury and swelling.VIEWS: Right wrist AP, lateral and oblique 4/2/15 (3 views) There is a greenstick/transverse fracture of the distal right radius with dorsal and medial angulation. | Radial fracture as described. |
Generate impression based on findings. | Reason: r/o fx, volar plate esp of 5th finger History: ttp over volar plate, yanked finger Three views of the right fifth digit demonstrate an oblique comminuted fracture through the fifth proximal phalanx, with intra-articular extension at the PIP aspect, and which extends proximally to the metadiaphysis. There is dor... | Comminuted fracture of the fifth proximal phalanx as above. |
Generate impression based on findings. | Sudden onset of left shoulder pain for two weeks, hemarthrosis on aspiration, on Coumadin. Evaluate for fracture. Three views of the left shoulder show no acute fracture or dislocation. The bones appear demineralized. Moderate osteoarthritis affects the acromioclavicular joint. Mild osteoarthritis affects of the glenoh... | Osteoarthritis without fracture. |
Generate impression based on findings. | Blister and pain in the left heel, decreased circulation. Question of bone pathology. Three views of the left foot show no acute fracture or malalignment. | No acute fracture is evident. |
Generate impression based on findings. | Small finger fracture Three views of the right fifth digit reveal two K wires fixing a fracture at the base of the fifth proximal phalanx. The proximal interphalangeal joint is held in flexion. No change from the previous. | Fracture of the right fifth proximal phalanx fixed with K wires. |
Generate impression based on findings. | Pain over olecranon process. Question of an abnormality of the bone. Four views of the right elbow show no acute fracture or malalignment. No elbow joint effusion is identified. There is a tiny olecranon enthesophyte. There is no soft tissue swelling over or distention of the olecranon bursa. | Enthesopathic changes without acute abnormality. |
Generate impression based on findings. | 74 year old with right breast pain. History of right lumpectomy in January 2012 for breast cancer, followed by radiation therapy. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribut... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Next study is in November 2015. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mamm... |
Generate impression based on findings. | Deep infection of right total knee arthroplasty. Evaluate for progressive loosening. Two views of the right knee show a hardware components of a total knee arthroplasty situated in anatomic alignment. Lucency about the cement bone interface of the femoral stem is unchanged from the 2014 study. No acute fracture is evid... | Total knee arthroplasty device appearing similar to the prior study. |
Generate impression based on findings. | Knee pain. Status post ACL reconstruction. Two views of the right knee show postoperative changes of ACL reconstruction. No acute fracture is evident. A small joint effusion is present. | Small knee effusion without fracture. |
Generate impression based on findings. | 25-year-old male status post assault Maxillofacial: There is a comminuted fracture of the nasal bone with slight leftward deviation. The nasal septum is intact. No additional facial fracture is noted. The orbits, paranasal sinuses, and zygomatic arches are intact. The mandible including the temporomandibular joints are... | 1. Comminuted nasal bone fracture.2. No acute intracranial abnormality. |
Generate impression based on findings. | 33-year-old female with head and neck cancer status post treatment with known right pleural biopsies CHEST:LUNGS AND PLEURA:Loculated right subpulmonic effusions. Foci of air within the fluid is likely iatrogenic provided history of intervention. Diffuse right pleural thickening. Right pleural drain enters between the ... | 1.Innumerable solid and groundglass nodules bilaterally suspicious for metastatic disease. 2.Loculated right subpulmonic pleural effusion. Foci of air within the fluid is likely iatrogenic provided history of intervention. Please correlate clinically. Diffuse right pleural thickening may reflect metastatic disease. |
Generate impression based on findings. | Male 69 years old Reason: need imaging for planning History: History of head and neck cancer and small bowel cancer.RADIOPHARMACEUTICAL: 11.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 112 mg/dL. Today's CT portion of the pelvis demonstrates a several subtle soft tissue densities nodular lesions in the ... | 1.Markedly hypermetabolic upper esophageal mass consistent with esophageal cancer, slightly progressed in size from previous.2.Hypermetabolic paraesophageal and bilateral jugular lymph node metastases, slightly progressed.3.Probable carcinomatosis, new from previous exam, which may be due to history of small bowel carc... |
Generate impression based on findings. | Male 72 years old Reason: left total hip History: left total hip Left hip: Components of a total left hip arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Vascular calcifications are present in the femoral vessels.Pelvis: Bone mineralization is normal. ... | 1.Total hip left arthroplasty without radiographic evidence of hardware complication.2.Severe right hip osteoarthritis. |
Generate impression based on findings. | Prostate cancer. Rising PSA. Markedly increased activity seen in the left with corresponding severe degenerative changes seen on CT. Severe degenerative activity is also noted at the right knee.Mild activity is seen in the mid lumbar spine at several levels but most notably at T7/8. Considered more likely degenerative/... | 1.No definitive osseous metastases. Mild osteoblastic activity at the left fourth rib and mid thoracic spine considered more likely benign although tumor not entirely excluded. Correlation with thoracic CT may be useful for further evaluation of these sites. Alternatively, F-18 PET bone scan may be diagnostic.2.Severe ... |
Generate impression based on findings. | 25-year-old male with right lower quadrant pain, vomiting. Evaluate for appendicitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality not... | No diagnostic abnormality seen. Normal examination of the abdomen and pelvis. Specifically normal-appearing appendix visualized and no evidence of appendicitis. |
Generate impression based on findings. | Female 55 years old Reason: Total right shoulder and total right elbow arthroplasty. Right shoulder: Components of a total right shoulder arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. There is moderate osteoarthritis of the AC joint. No acute fractur... | Total right shoulder and right elbow arthroplasty as detailed above. |
Generate impression based on findings. | 62-year-old male with hematuria. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Probable subcentimeter hemangioma in right lobe of liver (series 7, image 25). No other significant liver parenchymal or other abnormality seen. Gallbladder shows gallstones without other biliary tract complicatio... | 1. No etiology for hematuria seen. 2. Gallstones without other biliary tract complication. 3. No other diagnostic abnormality seen. |
Generate impression based on findings. | Left breast cancer status post chemotherapy.RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 1.0 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the left axilla, representing the sentinel node(s). This region was ... | Sentinel node identified in the left axilla. |
Generate impression based on findings. | History of ankylosing spondylitis. Evaluate for stage. Six views of the cervical spine show straightening of normal cervical lordosis. There is syndesmophyte throughout the cervical spine. No acute fracture is evident. Vertebral body heights are maintainedThree views of the thoracic spine show syndesmophyte formation t... | Findings consistent with ankylosing spondylitis. |
Generate impression based on findings. | Questionable fracture on an emergency department study Three views of the right ankle reveal lateral soft tissue swelling. No fractures are identified.Please note that the questionable fibular fracture was in the proximal diaphysis included on the previous knee exam. | Soft tissue swelling. Otherwise negative ankle study. Please note that the questionable fracture from March 29 was on the knee exam |
Generate impression based on findings. | Male, 13 years old. Polycystic kidney disease. KIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 11.0 cm Left: 11.3 cm Mean for age: 10.0 cm Range for age: 8.4 - 11.6 cmADDITIONAL OBSERVATIONS: Innumerable cysts of varying... | Innumerable cysts of varying sizes throughout the kidneys. The kidneys are upper normal in size. Findings compatible with known autosomal dominant polycystic kidney disease.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified ... |
Generate impression based on findings. | Call back from screening mammogram for new focal asymmetries in the left breast. An ML view and three spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. A lobulated mass is demonstrated at upper at her quadrant in the left breast measuring 10 mm. Other asymmetri... | Suspicious mass in the left breast at one o'clock position, 7 cm from nipple, for which ultrasound guided biopsy is recommended. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 50 year old with left breast pain presents for ultrasound study. Status post left lumpectomy for DCIS in January 2015 and radiation therapy. Left whole breast ultrasound was performed. There are a few cysts; at two o'clock, 6 o'clock, and 8 o'clock position without increased blood flow. No findings suggesting abscess f... | A few cysts in left breast. No sonographic evidence for abscess. Findings are discussed with Dr. Chhablani and Dr. Jaskowiak. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | There are post-treatment findings with persistent diffuse pharyngeal mucosal space, retropharyngeal space, and parapharyngeal space edema. The heterogeneous conglomerate of left level 2 lymph nodes measures up to 16 mm in short axis, previously 18 mm in short axis. The left level 3 lymph node measures 7 mm in short ax... | 1. Post-treatment findings in the neck with stable to slight decrease in size of the left suprahyoid lymphadenopathy,which may contain recurrent tumor, treatment effects, and or inflammatory changes. 2. Persistent extensive dental disease. |
Generate impression based on findings. | History of radiation for head and neck cancer now with pain, swelling, and possible exposed bone. Panorex radiograph shows no acute fracture or dislocation. There is minimal periapical lucency about a left mandibular molar. Dental fillings are noted. | No evidence of bone destruction. |
Generate impression based on findings. | Female 78 years old Reason: right hand pain History: right hand pain Bone mineralization is normal. Alignment is anatomic. There is moderate joint space narrowing at the interphalangeal joints and mild joint space narrowing at the metacarpophalangeal joints.Mild to moderate joint space narrowing at the carpometacarpal ... | Osteoarthritis of the interphalangeal joints and carpometacarpal joints. |
Generate impression based on findings. | Pain, swelling. Question of knee injury, evaluate for fracture. Four views of the left knee show no acute fracture or malalignment. No joint effusion is identified. | No acute fracture is evident. |
Generate impression based on findings. | Knee pain. Evaluate for degenerative disease Four views of the right knee are unremarkable. No significant degenerative change. No fractures or dislocations. | Negative right knee examination |
Generate impression based on findings. | Right hip/thigh pain. Evaluate for osteoarthritis. First MTP pain. Evaluate for hallux rigidus. Single view of the pelvis and bilateral hips show no acute fracture or malalignment. Heterotopic ossification is noted in the soft tissues adjacent to the left lesser trochanter.Three views of the left foot with weight-beari... | Osteoarthritis at the first MTP joint. |
Generate impression based on findings. | Pain. Question fracture. Metallic BBs denote the site of the patient's pain. No acute rib fracture is identified. | No acute rib fracture is identified. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is an incidental cavum septum pellucidum et vergae The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal parenchymal signal. There is no diffusion abnormality. Scattered trace subdural blood products are again... | No new acute intracranial abnormality. Scattered likely birth-related trace subdural hematomas, as noted on CT. |
Generate impression based on findings. | Male 58 years old Reason: djd? History: pain and loss of motion Bone mineralization is slightly decreased. Alignment is anatomic. Moderate osteoarthritis affects the radiocapitellar joint and the ulnotrochlear joint with osteophytesChronic changes are noted in the medial epicondyle with small ossicles.Probable small jo... | Moderate right elbow osteoarthritis. |
Generate impression based on findings. | 41 year old female call back from screeners for increased right upper outer quadrant calcifications in a segmental distribution. Prior history of benign right breast biopsy. Clip is just posterior to the calcifications. Right ultrasound re-identified the target calcifications for biopsy. The calcifications to be target... | Successful ultrasound-guided core biopsy of the right breast calcifications and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: chronic headache, History: chronic headache, sinusitis Minimal mucosal thickening of the left anterior ethmoid air cell. Otherwise the frontal, sphenoid, and maxillary sinuses are clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is norma... | 1.Minimal mucosal thickening of the left anterior ethmoid air cell. No significant sinonasal disease. 2.Mild anterior position of the mandibular condyles, which may be related to open-mouth position. Correlate for TMJ dysfunction. |
Generate impression based on findings. | The internal auditory canals are symmetrical and normal in size and signal intensity. The inner ears are normal, with normal T2 signal and no pathological enhancement. No abnormal mass or abnormal enhancement is seen within the cerebellopontine angle, cisterns bilaterally or within the internal auditory canals. The se... | 1. Unremarkable contrast-enhanced MR appearance of the inner ear structures and IACs.2. Unremarkable contrast-enhanced MR appearance of the brain.3. Extensive paranasal sinus disease, concerning for acute sinusitis especially on the left. Please correlate clinically.4. Likely reactive lymphoid tissue within the Waldeye... |
Generate impression based on findings. | Male 60 years old Reason: osteoarthritis History: left hip pain Bone mineralization is normal. Alignment is anatomic. There is mild joint space loss and tiny osteophytes. No acute fracture or malalignment.Mild osteoarthritis affects the symphysis pubis. | Mild left hip osteoarthritis. |
Generate impression based on findings. | Stage IIIC fallopian tube cancer with new left cervical enlarged lymph node, assess for other evidence of disease. There is lower cervical and upper mediastinal lymphadenopathy. For example, a dominant left level 4 lymph node measures 35 x 47 x 39 mm. The lymphadenopathy deviates and perhaps encases the left common car... | Lower cervical and upper mediastinal lymphadenopathy likely represents metastatic disease. |
Generate impression based on findings. | 46 year old female with altered mental status and liver failure. There is no evidence of intracranial hemorrhage. There are unchanged mild scattered patchy foci of low-attenuation within the periventricular white matter most compatible with chronic small vessel ischemic disease. The ventricles and basal cisterns are no... | 1.No evidence of acute intracranial hemorrhage or mass effect.2.Unchanged probable mild chronic small vessel ischemic disease.3.Paranasal sinus mucosal thickening and secretions may represent sinusitis. |
Generate impression based on findings. | RIGHT TEMPORAL BONE: The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp.The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact.The inner ear structures have a normal morphology. The bony coverings of the cochlea, v... | 1. Unremarkable CT of the temporal bones.2. Significant paranasal sinus opacification including left maxillary sinus air-fluid level concerning for acute sinusitis. Please correlate clinically. |
Generate impression based on findings. | Female; 44 years old. Reason: Ct scan per living kidney donor protocol History: Living kidney donor CT ANGIOGRAM:Normal caliber of the abdominal aorta and its branch vessels. No significant atherosclerotic disease. The SMA, celiac artery, single bilateral renal arteries, and IMA are patent. There is early branching not... | 1. Early branching of the bilateral renal arteries, but otherwise, there is a conventional renal anatomy.2. CTA abdomen was only performed, though CTA abdomen and pelvis was ordered. If images of the pelvis are required, the patient can return for pelvis imaging at no additional charge. |
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