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Generate impression based on findings. | 52 year old female. Evaluate interval healing of right scaphoid fracture. Cortical irregularity along the distal radial epiphysis consistent with a healing fracture. Subtle band of sclerosis through the waist of the scaphoid consistent with a a healing nondisplaced fracture.Benign appearing elongated lesion in the dist... | Healing scaphoid and distal radius fractures. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 110 cm/sec.Right internal carotid artery: 92 cm/sec.Left middle cerebral artery: 117 cm/sec.Left internal carotid artery: 86 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Right knee pain for 3 months.VIEWS: Right knee AP/lateral/oblique (3 views) 04/09/15 A joint effusion is not present. The bones are normal in appearance. No fracture is identified. | Normal examination. |
Generate impression based on findings. | Female 71 years old Reason: Eval for OA History: LBP Bone demineralized. The lumbar vertebral bodies are normal in height. Multilevel degenerative disk disease affects the lower lumbar spine worst at L5-S1 with associated facet hypertrophic changes. There is grade 1 anterolisthesis of L5 on S1. There is a mild levoconv... | Degenerative arthritic changes as detailed above. |
Generate impression based on findings. | 28 years, Male. Reason: r/o obstruction History: ABD distention IABP marker is no longer identified. Multiple surgical drains project over the abdomen. Sternotomy wires appear similar to prior. External leads overlie the left hemiabdomen. A nonobstructive bowel gas pattern is identified.Please refer to concomitant ches... | No evidence of bowel obstruction. |
Generate impression based on findings. | Index finger fracture.VIEWS: Right index finger PA/lateral (two views) 04/09/15 The bones are normal in appearance. No fracture is identified. | Normal examination. |
Generate impression based on findings. | Reason: mets lung cancer, s/p adrenalectomy for mets, on Nivolumab, pls c/w previous study and evaluate tx response. History: lung ca CHEST:LUNGS AND PLEURA: Right apical scarlike opacity with calcifications, unchanged. A few scattered pulmonary micronodules, unchanged. No new or suspicious pulmonary nodules or masses.... | Stable disease. |
Generate impression based on findings. | Please note that evaluation is limited by suboptimal images secondary to the patient's scoliosis, motion and metallic artifact.Again seen is dextroscoliosis of the thoracolumbar spine. Posterior fusion hardware is present in the upper thoracic, lower thoracic, and L2-L4 lumbar spine, with associated metallic artifact.... | 1. Limited examination due to positioning related to the patient's scoliosis and motion.2. Unchanged low lying conus which abuts the dorsal dural margin. No new cord signal abnormality or syrinx. No ventral motion of the conus is identified on prone images, which may represent retethering in the appropriate clinical se... |
Generate impression based on findings. | Male 19 years old Reason: evaluating for dislocation/fx right thumb. History: s/p injury, thumb bent back \T\ dislocated, pt re-located \T\ now with significant swelling, pain at the mcp joint right thumb No fracture, malalignment or soft tissue swelling. | No fracture, malalignment or soft tissue swelling. |
Generate impression based on findings. | Male 36 years old Reason: persistent pain s/p marathon injury, evaluating for fracture and other abnormalities History: persistent pain No fracture, malalignment or soft tissue swelling. Bipartite lateral sesamoid noted. | 1. No fracture, malalignment or soft tissue swelling.2. Bipartite lateral sesamoid . |
Generate impression based on findings. | Female 75 years old. Reason: left knee pain. History: as above Four views of the left knee demonstrate no fracture, dislocation, or joint effusion. There are new small osteophytes along the medial tibiofemoral compartment indicating mild osteoarthritis. | Mild osteoarthritis of the left knee. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcificati... | 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. | 60 year old female who was recalled from screening mammogram for a circumscribed asymmetry within the inner left breast. No family history of breast cancer. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneo... | 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. | 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 almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this r... |
Generate impression based on findings. | Female 79 years old Reason: Eval for fx History: Pain s/p jamming 2 months ago. Comminuted fracture of the base of the distal phalanx with interarticular extension. Osteoarthritis of the first metatarsophalangeal joint with hallux valgus. | 1. Comminuted fracture of the base of the distal phalanx with interarticular extension.2. Hallux valgus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral cyst aspirations. 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 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. | 57-year-old female patient with bilateral breast pain 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 distribution. No suspicious masses, microcalcifications or are... | 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: NSA - Screening Mammogram. |
Generate impression based on findings. | 49 years old, Male, Reason: fall, hx of neurosarcoid and TIA, persistent dizziness and nausea. History: fall, please eval for ICH There is no evidence of intracranial hemorrhage or mass. A small hyperdensity in the left basal ganglia is likely focal calcification. Calcification is present along the anterior falx. The g... | No evidence of intracranial hemorrhage, mass, or cerebral edema. Please note if there is suspicion for acute ischemia or active neurosarcoid, consider MRI for further evaluation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Stable benign calcifications are present bilaterally. No suspicious ma... | 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: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with 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. Diffusely scattered calcific... | There are three areas of clustered calcifications in the right upper outer breast that are increased compared to prior examination, currently measuring 3 cm. Adjacent to these calcifications, there is a focal asymmetry in the right upper outer breast that measures 8 mm. Recommend dedicated spot magnification and spot m... |
Generate impression based on findings. | Male 59 years old Reason: 59 yo with HCC please screen for progression of disease History: none ABDOMEN:LUNG BASES: Small left pleural effusion, minimally increased compared to previous studyLIVER, BILIARY TRACT: Cirrhotic morphology of the liver is redemonstrated. Index ablation cavity measures 3.4 x 2.3 cm image numb... | Cirrhosis and portal hypertension. No evidence of enhancement in the previous ablation cavities. However, there are several lesions in the liver enhancing at the arterial phase and washing out on the delayed phase consistent with hepatocellular carcinoma. MRI of the liver may be helpful if further evaluation of the ext... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcificati... | 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. | 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. Occasional scattered... | 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. | Evaluate for memory loss, history of paroxysmal atrial fibrillation and mitral/aortic valve replacement. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limit... | 1. Moderate degree of chronic small vessel ischemic changes and global parenchymal volume loss, commensurate with patient's advanced age. Small chronic left caudate head infarct.2. No intracranial mass or mass effect. |
Generate impression based on findings. | Spinal fusionVIEWS: Spine standing PA/lateral (two views) 04/09/15 Spinal fusion instrumentation extends from T3 to L2. Rods and hooks appear intact.Left cervicothoracic and right thoracolumbar curves are noted. Thoracic kyphosis is decreased. | No evidence of complication after posterior spinal fusion. |
Generate impression based on findings. | 29 years old, Male, Reason: evaluate for tooth abscess History: tooth ache, febrile to 40C Ill-defined heterogeneous enhancement in the sublingual area indicates inflammatory changes centered on the right sublingual space with a more focal area of hypodensity measuring 17 x 9 mm (series 6, image 18) compatible with a d... | 1. Inflammatory changes and edema in the right sublingual space with more focal area of hypodensity measuring 17 x 9 mm suggestive of developing abscess. Odontogenic disease as described above including prominent periapical lucencies surrounding the posterior two right mandibular molars. 2. Reactive cervical lymphadeno... |
Generate impression based on findings. | 82 year old female with history of pulmonary embolism PULMONARY ARTERIES: No evidence of pulmonary embolism. Pulmonary artery caliber within normal limits. No evidence of right heart strain. LUNGS AND PLEURA: Right middle lobe calcified micronodule consistent with prior granulomatous infection. No suspicious pulmonary ... | 1. No evidence of pulmonary embolism. 2. Large heterogeneous thyroid mass extending slightly below the aortic arch with deviation and moderate compression of the trachea, not significantly changed. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV ... |
Generate impression based on findings. | 35-year-old male. Complaining of pain in left wrist/thumb occ popping/base of thumb. Started 1 week ago. Patient works on an assembly line. Left thumb: No fracture, dislocation, or significant osteoarthritis. Left wrist: No fracture or dislocation. No significant degenerative arthritic changes. | No significant abnormality. |
Generate impression based on findings. | Altered mental status for one day No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.There is moderate... | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. |
Generate impression based on findings. | Female, 45 years old. Reason: assess flow of liver vasculatures (hepatic artery) History: worsening liver function Limited examination due to patient positioning habitus.PORTAL VENOUS: The main portal vein is patent, with normal hepatopetal flow. The left portal vein is patent with expected hepatofugal flow toward the ... | Elevated hepatic artery velocities, with no elevation of the resistive index. Expected portal venous flow directionality status post TIPS. |
Generate impression based on findings. | 57 year old with palpable lump in the left breast Three standard views of both breasts and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A t... | Highly suspicious mass in the left breast at 8 o'clock position. Surgical consultation is recommended. Results and recommendations were discussed with the patient.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | There is a mucous retention cyst in the left sphenoid sinus. Trace bilateral maxillary mucosal thickening. Minimal anterior ethmoid opacification. The remaining paranasal sinuses including the frontal sinuses are clear. There is evidence of prior endoscopic sinus surgery including bilateral uncinectomy and right-sided... | Minimal paranasal sinus disease as detailed above. |
Generate impression based on findings. | 78 year old female status post NG tube placement. Motion artifact limits examination. The pelvis is incompletely visualized. NG tube tip projects at the level of the body of the stomach. Nonobstructive bowel gas pattern. Residual contrast is noted throughout the colon. Persistent bilateral pleural effusions and bibasil... | NG tube tip projects at the level of the body of the stomach. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 116 cm/sec.Right internal carotid artery: 155 cm/sec.Left middle cerebral artery: 135 cm/sec.Left internal carotid artery: 129 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 42 year old female who has a complaint of right breast focal pain and palpable abnormality. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts, and two spot compression views of the right breast, were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is ... | No mammographic or sonographic 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Colloid goiter follow up. There is no significant interval change in size of the heterogeneous nodules within the left thyroid lobe with associated trachea deviation and narrowing. There is no significant cervical lymphadenopathy based on size criteria. The thyroid salivary glands are unremarkable. There is a retrophar... | No significant interval change in size of the bulky heterogeneous nodules within the left thyroid lobe with associated trachea deviation and narrowing. |
Generate impression based on findings. | 18 month old male, Reason: evaluate healing of fracture History: right humerus injuryVIEWS: Right humerus AP and lateral (2 views) 4/9/2015 14:31 Bony remodeling of the proximal and mid-diaphysis of the humerus. Persistent periosteal reaction. Soft tissue swelling has decreased. | Healing right humerus proximal metaphyseal fracture with bony remodeling. |
Generate impression based on findings. | 38 years, Male. Reason: NJ tube placement History: NJ tube placement The lower abdomen and pelvis are not included in the field of view. The enteric tube is coiled multiple times within the stomach with the tip projecting at the level of the antrum of the stomach. Nonobstructive bowel gas pattern. The lung bases appear... | The enteric tube is coiled multiple times within the stomach with the tip projecting at the level of the antrum of the stomach. |
Generate impression based on findings. | 66 year-old female. Pain. Evaluate right forearm. Again seen is a comminuted, minimally angulated fracture of the mid ulnar diaphysis. Mild callus formation adjacent to the fracture line is consistent with an attempt at healing. | Healing ulnar diaphyseal fracture. |
Generate impression based on findings. | 51 year-old female. Pain. No fracture or dislocation. No significant arthritic changes. | No significant abnormality. |
Generate impression based on findings. | 54 year old female. Severe elbow pain post fall. No acute fracture, dislocation, or elbow joint effusion. Well-corticated ossific density next to the medial epicondyle is most likely an unfused apophysis, representing normal variant anatomy. | No significant acute abnormality. |
Generate impression based on findings. | Female 62 years old Reason: eval frac History: pain Three views of the left hand demonstrate indistinct fracture lines of the previously seen second metacarpal diaphyseal and fifth metacarpal neck fractures indicating healing. Three views of the left knee are provided. The fracture line of the the previously seen nondi... | Healing fractures as above. |
Generate impression based on findings. | 49 year-old female. Right hip and low back pain after slip and fall off chair to concrete floor. No fracture, dislocation, or other significant abnormality. | No fracture. |
Generate impression based on findings. | Female 31 years old. Reason: upright in the brace History: s/p corpectomy Two views of the lumbar spine are provided. The patient is status post corpectomy of the L2 vertebral body with interval placement of metallic spacer and orthopedic screws. The lumbar spine is in anatomic alignment without evidence of hardware co... | Corpectomy of the L2 vertebral body as described above. |
Generate impression based on findings. | Female 75 years old Reason: L knee pain s/p fall - please eval History: L knee pain. Also lower back pain. Four views of the left knee demonstrate are provided. There is no fracture or dislocation.Three views of the lumbar spine are provided. There are osteophytes along the anterior aspect of the lumbar vertebrae. Alig... | No acute abnormality of the left knee or lumbar spine. |
Generate impression based on findings. | Knee stapling surgery in 2013. Blount's disease.VIEWS: Right knee AP/lateral (two views) 04/09/15 Distal femoral, proximal tibial, and proximal fibular physes have fused. The staples remain in place in the lateral aspects of the bones. The prongs of the staples remain parallel. | Postoperative changes. |
Generate impression based on findings. | Reason: pna vs aspiration vs malignancy History: hypoxia, infiltrate on cxr, heavy smoker LUNGS AND PLEURA: Biapical pleural-parenchymal scarring. Mild upper lobe predominant centrilobular and paraseptal emphysema. Bilateral diffuse, right greater than left, tree in bud opacities and bronchial/bronchiolar wall thickeni... | Diffuse bronchiolitis compatible with infection, possibly due to recurrent aspiration. Associated lymphadenopathy, likely reactive . |
Generate impression based on findings. | 60 year-old male with history of renal cell carcinoma. CHEST:LUNGS AND PLEURA: 9 x 7 mm lingular solid lung nodule (series 6, image 76), compared to 7 x 7 mm previously. Multiple additional small pulmonary nodules are subjectively slightly increased in size. Mild upper lobe predominant centrilobular emphysema. MEDIASTI... | Interval mild increase in size of multiple solid pulmonary nodules, suspicious for metastatic disease. No new sites of disease are evident. Continued short-term surveillance is recommended. |
Generate impression based on findings. | Female 45 years old Reason: s/p traumatic fall to R knee. Point tenderness on patella. History: see above Four nonweightbearing views of the right knee are provided. There is no fracture, dislocation, or joint effusion. There is no prepatellar soft tissue swelling. | Normal examination of the right knee. |
Generate impression based on findings. | 13 day old female patient with respiratory distress syndrome and intimated. Evaluate for endotracheal tube placement.VIEW: Chest AP (one view) 4/9/2015 Endotracheal tube tip is below the thoracic inlet and above the carina. The enteric tube tip is in the stomach which is on the left side. UVC catheter is in the right a... | Right lung atelectasis. |
Generate impression based on findings. | Female, 58 years old.Surgical Case Information | Procedure(s): Procedure(s): | LAPAROSCOPIC VENTRAL/UMBILICAL HERNIA REPAIR | Operating Room: CDOR 19 CENTRAL | Surgeon(s) and Role: | * Mustafa Hussain, M.D. - Primary No unexpected radiopaque foreign object is identified. Corkscrew tacks, surgical clips in the right upp... | No unexpected radiopaque foreign object.These findings were discussed by telephone with Dr. Hussain, the attending surgeon, on 4/9/15 at 15:10. |
Generate impression based on findings. | Nasopharyngeal mass demonstrated marginal zone lymphoma. Initial whole body staging.RADIOPHARMACEUTICAL: 15.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 83 mg/dL. Today's CT portion grossly demonstrates bilateral parapharyngeal mass like soft tissue enlargement, right greater than left. Borderline enlar... | Widespread hypermetabolic tumor involving bilateral parapharyngeal masses, lymph nodes in the neck through pelvis, and diffuse osseous involvement. |
Generate impression based on findings. | Age: 68 years. Sex : Male. Reason for study: Reason: mass History: choking; ftt. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. The exam was positive for penetration and positive for aspirati... | The exam was positive for penetration and positive for aspiration. Other findings, as above. |
Generate impression based on findings. | Male, 26 years old. Reason: rising transaminitis, r/o stone and r/o patency History: see 1 LIVER: The liver measures 17.8 cm, with normal echotexture, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. T... | Splenomegaly as seen on prior CT imaging. No biliary ductal dilatation or evidence of cholecystitis. A focus of sludge or a small polyp is noted in the gallbladder wall. Recommend continued follow up imaging in 6 months. |
Generate impression based on findings. | 50 year-old female with history of uterine sarcoma. CHEST:LUNGS AND PLEURA: Scattered calcified and noncalcified pulmonary micronodules. No suspicious nodules or masses. No pleural effusions or specific evidence of infection.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No mediastinal or ... | 1. Heterogeneous uterus and abnormal appearing uterine stripe with a large heterogeneous exophytic mass. This may represent a fibroid or site of patient's biopsy proven adenosarcoma. Correlation with pelvic ultrasound recommended.2. Scattered pulmonary micronodules, indeterminant. Follow up recommended.3. Tiny osseous ... |
Generate impression based on findings. | Female, 37 years old. Reason: enlarged liver on physical exam History: as above LIVER: The liver measures 15.1 cm, with homogeneous echotexture, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. The com... | Distended gallbladder with sludge and stones. These findings may be seen in chronic cholecystitis. No evidence of acute cholecystitis. |
Generate impression based on findings. | 57-year-old female patient with history of left lumpectomy in 2002. 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, unchanged in pattern and distribution. Post surgical scar is re-demon... | 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: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 57 year-old female with new neck mass and history of follicular lymphoma. CHEST:LUNGS AND PLEURA: No suspicious pulmonary masses or nodules. No pleural effusion.MEDIASTINUM AND HILA: Normal cardiac size without pericardial effusion. Multiple small mediastinal lymph nodes are not significantly increased in size, unchang... | Mixed tumor response with regions of interval decrease in lymphadenopathy (axillary and left external iliac chain) and regions of increased lymphadenopathy (mediastinal, retroperitoneal and right inguinal region).Please refer to the separately dictated report of the CT of the neck for further characterization of the pa... |
Generate impression based on findings. | Fracture.VIEWS: Left humerus AP/lateral (two views) 04/09/15 Periosteal reaction and callus formation are noted around the proximal humeral metaphysis and extending to the proximal small diaphysis. The metaphysis is irregular along its proximal border with the physis. | Further healing of the proximal humeral fracture. |
Generate impression based on findings. | Male 59 years old Reason: restage lymphoma History: new recurrence of mantle cell lymphomaRADIOPHARMACEUTICAL: 14.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion grossly demonstrates enlarged bilateral cervical lymph nodes. There are multiple prominent axillary, mediastinal, su... | Widespread hypermetabolic tumor involving lymph nodes from the neck to pelvis, bowel, and spleen. |
Generate impression based on findings. | 49 year old female with history of left breast retroareolar abscess, status post drainage presents for evaluation of a palpable mass in the left retroareolar region at 8 o'clock position and left axillary region as marked by the referring surgeon. A targeted left ultrasound was performed for the palpable area of concer... | Complex fluid collection corresponding to the palpable abnormality left areolar region, consistent with a chronic abscess.Reactive left axillary lymph node noted.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Fracture.VIEWS: Right wrist PA/lateral (two views) 04/09/15 Corner fracture of the radius has almost completely healed. The periosteal reaction has been completely incorporated. | Almost complete healing of radial fracture |
Generate impression based on findings. | Clinical question: Hemorrhage. Signs and symptoms: Syncope, vomiting. Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.There are patchy foci of low-attenua... | 1.No acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Findings of age indeterminate small ischemic strokes of mild degree.3.Significant rightward nasal septum deviation and a bony septal spur. Well pneumatized all paranasal sinuses and mastoid air cells. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 159 cm/sec.Right internal carotid artery: 125 cm/sec.Left middle cerebral artery: 134 cm/sec.Left internal carotid artery: 108 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 90 year old female with tachycardia, rule out pulmonary embolism PULMONARY ARTERIES: Small filling defect in a subsegmental branch of the right lower lobe pulmonary artery (series 7, image 202) compatible with pulmonary embolism. Main pulmonary artery caliber upper limits of normal. No evidence of right heart strain.LU... | 1. Very small subsegmental pulmonary embolus in the right lower lobe of uncertain clinical significance. 2. Cardiomegaly with bilateral small pleural effusions compatible with congestive heart failure. Findings were discussed with Dr. Sandeep Pulimi by phone on 4/9/2015 at 5:00 PM. PULMONARY EMBOLISM: PE: Positive.Chro... |
Generate impression based on findings. | Female, 28 years old. Reason: cholelithiasis History: epigastric pain LIVER: The liver measures 15.2 cm, with homogeneous echotexture, and no focal lesion. Diffuse mildly increased hepatic echogenicity, compatible with fatty infiltration of the liver.The main portal vein is patent, with normal hepatopetal flow.GALLBLAD... | Mild fatty infiltration of the liver, without acute abnormality. |
Generate impression based on findings. | Clinical question: Rule stroke. Signs and symptoms: Weakness Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for the detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter d... | 1.No acute intracranial process. CT is insensitive for detection of acute nonhemorrhagic ischemic strokes.2.Unremarkable and stable exam since prior study. 3.Considering provided clinical information for current study and previous CT from March 2015 follow-up with an MRI exam is recommended. |
Generate impression based on findings. | 44-year-old female with history of epigastric pain and bilateral lower abdominal pain. ABDOMEN:LUNG BASES: 4-mm left lower lobe pulmonary micronodule.LIVER, BILIARY TRACT: No suspicious hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnor... | 1. Small hiatal hernia.2. Incidental 4-mm left lower lobe pulmonary micronodule. Follow up per Fleisher Society guidelines is recommended. |
Generate impression based on findings. | 52 year old female who has a complaint of palpable area within the medial right breast, and physician palpated thickening within the left breast. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts, as well as a cleavage view, were performed digitally and reviewed with the aid of R2 CAD ... | 1. Sebaceous cyst corresponding to the palpable finding in the right breast.2. No mammographic or sonographic abnormality within the left breast. 3. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually.... |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are screening mammogram dated 2/12/2015 with bilateral breast ultrasound dated 2/12/2015 performed at Vassar Brothers Medical Center. For comparison, mammograms dated 2/6/2014, 1/31/2013 and 1/26/2012; left breast ultrasound dated 7/3/2014, bilateral br... | No suspicious appearing calcifications or mass seen on mammogram or ultrasound. Patient's copy of MR breast was damaged and service is requesting a new copy. An addendum or a new report will be made after the MR breast is submitted.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Clinical question: History of chronic sinusitis. Signs and symptoms: Headache. Nonenhanced maxillofacial CT:Frontal sinuses are well pneumatized and unremarkable. Unchanged since prior exam. Ethmoid sinuses are well pneumatized and without evidence of disease. The stable since prior exam.Sphenoid sinus is well pneumati... | 1.Minute chronic sinus disease as detailed. Improved since prior exam.2.Moderate leftward nasal septum deviation again noted.3.Unremarkable mastoid air cells and middle ear cavities and images through the orbits. |
Generate impression based on findings. | 12-year-old male patient with pain. Question of left third toe fracture.VIEWS: Left foot AP, left third toe oblique/lateral (3 views) 4/9/2015 There is a transverse fracture of the head of the third digit proximal phalanx with slight dorsal angulation of the distal fracture fragment. Soft tissue swelling is noted about... | Transverse fracture of the third digit proximal phalanx. |
Generate impression based on findings. | 67-year-old female. MAKO protocol for surgical planning. Right hip pain and limited ROM. Planning RTA. Severe osteoarthritis of the right hip with bone on bone apposition, subchondral cysts, and osteophytes. Osteoarthritis also affects the left hip. Mild osteoarthritis of the bilateral sacroiliac joints.Moderate degene... | Severe right hip osteoarthritis. |
Generate impression based on findings. | Female 47 years old Reason: Concern for osteophyte History: Pincer nail and pain No fracture malalignment or soft tissue swelling. Minimal osteoarthritis at the distal interphalangeal joint. | No fracture malalignment or soft tissue swelling. Minimal osteoarthritis at the distal interphalangeal joint. |
Generate impression based on findings. | 81 years old, Female, Reason: evaluate for acute intracranial abnormality History: dizziness, hx of subdural hematoma, recent coumadin re-start There is no evidence of acute intracranial hemorrhage. There is a right temporal convexity mass compatible with a meningioma that measures approximately 10 mm in width, which i... | 1. No evidence of acute intracranial hemorrhage.2. No significant interval change in size of the right temporal convexity mass compatible with meningioma, although the mass is smaller compared to December 2014.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 35 years old Reason: s/p bunionectomy History: Persistent Pain Postsurgical changes related to prior bunionectomy surgery. Mild osteoarthritis of the first metatarsophalangeal joint. | Postsurgical changes related to prior bunionectomy surgery. Mild osteoarthritis of the first metatarsophalangeal joint. |
Generate impression based on findings. | Evaluate for changes in bleed: Altered mental status There is expected evolution of the left anterior temporal lobe hematoma with extension into the insula and basal ganglia with surrounding vasogenic edema. There is mild mass effect on the left lateral ventricle, decreased from prior. There is no significant residual ... | Expected interval evolution of the hematoma centered in the left temporal lobe with extension of hemorrhage into the ventricular system, as evidence by decreased surrounding edema and mass effect compared to the prior exam. No new intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Reside... |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 128 cm/sec.Right internal carotid artery: 107 cm/sec.Left middle cerebral artery: 89 cm/sec.Left internal carotid artery: 85 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 46-year-old female with history of periumbilical lymphadenopathy. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Tiny right hepatic lobe hypodensity is incompletely characterized.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant a... | 1. No evidence of periumbilical lymphadenopathy as clinically queried.2. Enlarged heterogeneous uterus may simply be the sequela of fibroids, however a dedicated pelvic ultrasound is recommended.3. Small Bartholin's cyst. |
Generate impression based on findings. | Male 46 years old; Reason: Status post AVR and ascending aneurysm repair in Nov 2014, using Bioroot and 30 mm Valsalva graft as per EPIC operative report. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No focal airspace opacities, pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Postsurgical ... | Postsurgical changes s/p aortic root and ascending aneurysm repair. No aneurysm or interval dissection involving the native ascending aorta, transverse arch, or descending thoracic aorta. Please see measurements above. |
Generate impression based on findings. | Central retinal vein occlusion. The bilateral orbits appear unremarkable. The globes and ocular adnexa are intact. There is no evidence of mass lesions within the orbits. There facial soft tissues and intracranial structures are unremarkable. There is retention cyst formation within the left maxillary sinus. There is r... | Unremarkable orbits, although CT is insensitive for the detection of central retinal vein occlusion. |
Generate impression based on findings. | Female 58 years old Reason: foot pain and edema History: foot pain and edema Right foot: Midfoot osteoarthritis. No fracture or malalignment. Diffuse soft tissue swelling and edema. The Achilles' tendon is indistinct but this likely relates to diffuse edema rather than Achilles' tendon abnormality. Insertional enthesop... | 1. Osteoarthritis.2. Bilateral soft tissue swelling and edema. |
Generate impression based on findings. | 56 year old female with hemoptysis. Evaluate for pneumonia vs. malignancy LUNGS AND PLEURA: Severe predominantly centrilobular emphysema with scattered cysts bilaterally. There is bronchial wall thickening bilaterally. Multifocal areas of airspace opacity with air bronchograms in the right middle lobe and basilar segme... | 1. Nodule in the right upper lobe is moderately suspicious for neoplasm. Assuming there are no prior outside scans available for comparison, follow up in 6 months is recommended. 2. Multifocal areas of airspace opacities with air bronchograms could represent aspirated blood products or aspiration. 3. Severe emphysema w... |
Generate impression based on findings. | 27-year-old female. Pain. Follow-up fracture. Right knee: An intramedullary rod and screws affix a comminuted intraarticular fracture of the proximal tibial epiphysis to the mid diaphysis in near anatomic alignment. Some of the fracture lines are indistinct, indicating interval healing. Ossific densities superimposed o... | Orthopedic fixation of a comminuted intraarticular tibial fracture. Healing fibular fracture. |
Generate impression based on findings. | Follicular lymphoma. There are enlarged lymph nodes in the neck. For example, a left supraclavicular lymph node measures 30 x 40 mm and a left level 4 lymph node measures 28 x 35 mm. There are also partially-imaged axillary and upper mediastinal lymph nodes. There is mild subcutaneous stranding in the left supraclavicu... | Increased lymphadenopathy in the left supraclavicular region and left lower neck suggests lymphoma progression. Comparison is otherwise limited without an available recent neck CT. Please refer to the separate chest CT report for additional details regarding lymphadenopathy elsewhere. |
Generate impression based on findings. | Female 30 years old Reason: r/o fx,. Fell backwards onto outstretched hand when ice skating 1 month ago History: wrist pain, worse with yoga. Bone mineralization is normal. No fracture, malalignment or soft tissue swelling. | No fracture, malalignment or soft tissue swelling. |
Generate impression based on findings. | Respiratory failure and PICC placement.VIEW: Chest AP (one view) 04/09/15, 1607 Right upper extremity PICC tip is at junction of right atrium and inferior vena cava. Endotracheal tube tip is between thoracic inlet and carina.Right upper lobe airspace disease continues. Right lower lobe also has opacities. Left perihila... | Worsening lung opacities. |
Generate impression based on findings. | Reason: metastatic breast CA to lung, right chest wall On chemo. Followup scan History: right chest wall pain CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules compatible with metastases have increased in size compared to prior.Reference measurements as follows:1.Right upper lobe nodule has increased in size, measuri... | 1.Progression of disease involving the lungs, pleura, pericardium, and right chest wall.2.Progression of right axillary and hilar lymphadenopathy. |
Generate impression based on findings. | 27 year old female. Shin pain. Evaluate for stress fracture. Again seen are two staples affixing the proximal tibia and one affixing the proximal fibula, unchanged. No evidence of a fracture. Linear density in the proximal tibial diaphysis, unlikely to be of clinical significance. | No evidence of a stress fracture. |
Generate impression based on findings. | Female 31 years old. Reason: rule out acute pathology, fractures History: sciatica. severe back pain Four views of the lumbar spine are provided. There are five lumbar vertebrae. There are no compression fractures. The disk spaces are normal for age. The neural foramen are widely patent. Postoperative clips are noted. | No degenerative changes of the lumbar spine. |
Generate impression based on findings. | 47-year-old female with history of metastatic breast cancer to liver. Evaluate for progression of hepatic disease. CHEST:LUNGS AND PLEURA: Left lower lobe pulmonary nodule measures 14 x 13 mm, previously 10 x 10 mm (image 55 of series 5). New moderate right pleural effusion.Scattered calcified and noncalcified pulmonar... | Interval progression of extensive metastatic disease with reference measurements as above. |
Generate impression based on findings. | Male 60 years old Reason: f/u fracture History: pain Tension wires affix a transverse fracture patella in near-anatomic alignment. No hardware complication is evident. The fracture lines are less distinct.The bones are demineralized. | Healing patellar fracture. |
Generate impression based on findings. | Removal of cast. Scaphoid fracture.VIEWS: Left wrist PA/lateral/oblique (3 views) 04/09/15 The transverse fracture of the distal scaphoid has almost completely healed. A cortical notch is seen along its lateral surface. No avascular necrosis is identified. | Almost completely healed scaphoid fracture with no evidence of complication. |
Generate impression based on findings. | Male, 24 years old. Reason: eval for cholecystitis History: RUQ/epigastric pain, fever LIVER: The liver measures 21.5 cm, with homogeneous echotexture, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. ... | No evidence of cholecystitis. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 126 cm/sec.Right internal carotid artery: 84 cm/sec.Left middle cerebral artery: 112 cm/sec.Left internal carotid artery: 93 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Male, 65 years old. Reason: ? gallstones History: right shoulder pain,bloating LIVER: The liver measures 15.8 cm, without focal lesion. Diffusely increased hepatic echogenicity, compatible with fatty infiltration of the liver.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No in... | Fatty infiltration of the liver. No evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | Scoliosis and spine fusion.VIEWS: Spine standing PA/lateral (two views) 04/09/15 Posterior spinal fusion instrumentation extends from T4 to L4. Rods, hooks, and pedicle screws are intact.Right curve between T4 and T10 measures 40 degrees. Left curve between T11 and L3 measures 25 degrees.Thoracic kyphosis and lumbar lo... | No evidence of complication after spinal fusion. |
Generate impression based on findings. | Fell on left ankle last afternoon and cannot bear weight. Tenderness over lateral aspect of foot.VIEWS: Left foot AP/lateral/oblique (3 views) 04/09/15 The foot is normal in appearance. No fracture is identified. No soft tissue swelling is seen. | Normal examination. |
Generate impression based on findings. | Port placement. Lymphoma.VIEW: Chest AP (one view) 04/09/15, 1634 Left upper extremity PICC has been removed. A lower extremity port is present. The port overlies the medial aspect of right posterior rib 12. The tip is in the right atrium.Cardiac silhouette size is normal. Subsegmental atelectasis is present in the lef... | Port tip in right atrium. |
Generate impression based on findings. | 55 year old female with atypical chest painMEDICATIONS: Aspirin, Atorvastatin, Metformin, Insulin, Lisinopril, SitagliptinCPT Code: 75574 Resting EKG: Normal sinus rhythmResting BP, HR, and Symptoms: 116/68 mmHg; 69 bpmHyperemia BP, HR, and Symptoms: 135/76 mmHg; 83 bpm; the patient experienced mild chest pain (unchang... | There are no significant coronary artery stenoses present. The posterior descending artery is not well visualized. |
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