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Generate impression based on findings. | Male, 60 years old. Reason: please assess PV, kidneys abdomen in patient unable to get CT, ongoing GI Bleed. LIVER: The liver measures 18.2 cm, with increased echogenicity, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow. Portal venous flow velocity = 0.4 m/sec.GALLBLADDER, BILIARY TRAC... | 1.The portal vein is patent.2.Increased hepatic echogenicity suggestive of fatty infiltration or parenchymal dysfunction.3.Mild splenomegaly. |
Generate impression based on findings. | Multiple scattered foci of susceptibility are again noted, most conspicuous in the left frontal lobe deep white matter. Thre is corresponding T1 hypointensity and less conspicuous T2 hypointensity, without evidence of any surrounding FLAIR hyperintensity to suggest presence of associated vasogenic edema. There is also... | Continued stable appearance of a few scattered foci of susceptibility supratentorially without evidence of corresponding enhancement. These are not significantly changed since outside baseline exams. Differential again includes multiple benign cavernomas versus treated metastatic lesions. |
Generate impression based on findings. | Female 75 years old Reason: 75 yo F with gout, and hyperparathyroidism, assess for erosions or CPPD arthropathy. History: repeated attacks of acute arthritis Pelvis: The bones are demineralized. There is mild osteoarthritis of the bilateral hip joints. There is no chondrocalcinosis or subchondral bone resorption. Degen... | Arthritic changes which are predominantly degenerative in nature. No erosions or evidence of CPPD arthropathy. |
Generate impression based on findings. | Female 61 years old; Reason: 61 year-old female s/p EGD with esophageal dilation in setting of cricopharyngeal bar. Esophagram requested to rule out perforation. History: as above Scout radiograph shows no evident air in the soft tissues. Single contrast esophagram shows no evidence of leak. This was performed in both ... | 1.No evidence of esophageal leak.2.Findings discussed with Dr. Kavitt |
Generate impression based on findings. | Clinical question: Rule out CVA. Signs and symptoms: Lethargy and alteration of mental status. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, C... | No acute intracranial process. |
Generate impression based on findings. | Clinical question: Alteration of mental status in a patient with atypical seizures and diabetes. Signs and symptoms: Alteration of mental status. Nonenhanced head CT: There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Extensive periv... | 1.No acute intracranial process.2.Extensive low attenuation of periventricular and subcortical white matter as detailed.3.Mild supratentorial ventriculomegaly representing ex vacuo dilatation.4.Encephalomalacia at the site of prior surgery in the right parietal and right parietal craniotomy. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA. Unenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Focus of encephalomalacia in the left posterior temporal lobe and a smaller focus in the left frontal lobe with re... | 1.No acute intracranial process. 2.Stable study since prior exam from 11 -- 5 -- 14. |
Generate impression based on findings. | Clinical question: Evaluate process. Signs and symptoms: Vision changes Nonenhanced head CT:No acute intracranial process. CT is insensitive for early detection acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unr... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Altered mental status, elevated INR. Signs and symptoms: Altered mental status. Nonenhanced head CT:There is no evidence of an acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular s... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate for acute changes. Signs and symptoms: Seizure, altered mental status. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is a slight prominence of cerebral cortical sulci for pat... | 1.No acute findings since prior head CT from 2013.2.Mild prominence of cerebral cortical sulci for patient's stated age of 37. |
Generate impression based on findings. | Peripheral vascular disease. Right below knee amputation. Bilateral iliac stents. Left foot numbness for one year. Concern for worsening perfusion to the left lower extremity. The lack of oral contrast limits evaluation of the bowel. The phase of intravenous contrast limits evaluation of the abdominal solid organs. Exa... | Extensive atherosclerotic disease with multiple occlusions in the iliac and proximal femoral vessels as described. Complete occlusion of three right femoral-popliteal bypass grafts. On the left, no significant inflow disease identified in multiple stents; superficial femoral artery is occluded with reconstitution of a ... |
Generate impression based on findings. | Clinical question: ICH. Signs and symptoms: ICH. Nonenhanced head CT:Examination redemonstrates a well-demarcated acute hematoma in the right basal ganglia without convincing evidence of interval change in its size, morphology or extend. There is mild surrounding vasogenic edema similar to prior study. Subtle associate... | 1.Stable right thalamic acute hematoma, mild surrounding edema and subtle mass effect on the third ventricle.2.Age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question: Evaluate for acute interval change. Signs and symptoms: History of left frontal lobe tumor status-post resection. Mental decline over proximal to the weeks. Nonenhanced head CT:There is no evidence of acute intracranial hemorrhage, edema, mass effect or midline shift.There is prominence of cortical s... | 1.No evidence of an acute intracranial process.2.Prominence of cortical sulci and supratentorial ventricular system without interval change since prior exam.3.Interval improvement of post operative changes of left frontal craniotomy.4.Small CSF density epidural collection under the craniotomy flap is noted. |
Generate impression based on findings. | Clinical question: 57-year-old male with new diagnosis of lung cancer. Signs and symptoms: Staging scan. Unenhanced head CT:There is no convincing evidence of an abnormal parenchymal or leptomeningeal enhancement to suggest metastatic disease. Calvarium is also unremarkable and without finding to suggest metastatic les... | Negative enhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate for change in IPH. Signs and symptoms: AMS hypotension. Nonenhanced head CT:Examination demonstrates interval decreased density of left temporal basal ganglia acute hematoma as well as subtle decreased in size. There is also less defined edge of the hematoma all consistent with evolution and... | 1.No convincing evidence of an acute or significant new finding since prior exam.2.Subtle decrease size, density and poorly defined edge of left hemispheric hematoma all suggestive of further evolution/improvement.3.Vasogenic edema and residual hematoma result in trace midline shift to the right without significant cha... |
Generate impression based on findings. | 56 year-old male with blood in his stool. ABDOMEN:LUNG BASES: No pleural effusions. Normal cardiac size without pericardial effusion.LIVER, BILIARY TRACT: There are stigmata of chronic portal vein thrombus at the level of the hepatic hilum with cavernous transformation/collaterals in the porta hepatis. There is partial... | 1. Findings of acute on chronic pancreatitis with secondary inflammatory changes of the duodenum. No discrete loculated fluid collection or new vascular complication.2. Cavernous transformation of the portal vein with partially occlusive thrombus in one of the collateral vessels.3. Moderate wall thickening of the cecum... |
Generate impression based on findings. | 82-year-old female with hypoxia. Evaluate for pulmonary embolism, lung cancer PULMONARY ARTERIES: No evidence of pulmonary. Main pulmonary artery measures 42 mm in caliber consistent with pulmonary arterial hypertension. No evidence of right heart strainLUNGS AND PLEURA: Scattered punctate micronodules. No suspicious p... | 1. No evidence of pulmonary embolism. 2. Cardiomegaly with bilateral small pleural effusions compatible with CHF.3. Patulous esophagus containing debris with mild bronchial wall thickening in the right lower lobe suggestive of aspiration. 4. Main pulmonary 3 is enlarged consistent with pulmonary arterial hypertension.P... |
Generate impression based on findings. | Reason: evaluate for PE History: tachycardia, tachypnea, elevated dimer, LLE swelling PULMONARY ARTERIES: This examination is technically evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: Centrilobular emphysema. The images were obtained in partial exhalation. Atelectasis of the rig... | No pulmonary embolism.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: 61 y/o F with neck pain after esophageal dilation (of cricopharyngeal bar), rule out perforation, omnipaque oral contrast only History: as above LUNGS AND PLEURA: Bilateral lower lobe atelectasis. Low lung volumes. No suspicious pulmonary nodules or masses. No focal consolidation, pneumothorax or pleural effusi... | 1.No specific evidence of esophageal leak. Please see separately dictated CT soft tissues neck and esophagram.2.Patulous esophagus with evidence of gastroesophageal reflux.3.Large left renal mass, incompletely evaluated. Recommend dedicated renal CT or MRI for further evaluation.4.Findings discussed with Dr. Kavitt by ... |
Generate impression based on findings. | Male 30 years old. Reason: partial amputation 2nd digit. History: partial amputation 2nd digit Three views of the left hand are provided. There is a comminuted fracture of the distal second phalanx with volar displacement of the distal fracture fragment and intra-articular extension into the DIP joint. There is an asso... | Fracture and soft tissue deformity of the second and third distal phalanges. |
Generate impression based on findings. | Female 72 years old; Reason: Colorectal cancer please assess and compare to previous imaging and provide index lesions for RECIST CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules, interval increase in size seen. Reference right lower lobe lung nodule demonstrates interval increase in size, measuring 1.5 x 1.4 cm, im... | 1. Enlarging lobulated necrotic rectal mass, extension into vaginal/perineal area seen. New presacral extraluminal air. Findings discussed with Dr. Polite and consistent with patient's known rectovaginal fistula, new pneumoperitoneum suspicious for breakdown of the fistula/bowel perforation. 2. New and enlarging pulmon... |
Generate impression based on findings. | Female 64 years old. Reason: fx traumatic injury. History: L arm pain, concern for domestic violence Three views of the left shoulder and three views of the left humerus demonstrate no fracture or dislocation. There is widening of the acromioclavicular joint likely secondary to prior surgery.Three views of the left elb... | No fracture or dislocation. |
Generate impression based on findings. | 20-year-old male. Soft tissue infection status post trauma. Evaluate for proximal phalangeal fracture or osteo? Diffuse soft tissue swelling of the proximal index finger. Subtle cortical regularity with periosteal reaction at the volar aspect of the second middle phalanx base, suspicious for a nondisplaced subacute fra... | Findings suspicious for a nondisplaced subacute fracture of the second middle phalanx base. |
Generate impression based on findings. | Reason: PNA History: fever, cough x 1 weekVIEWS: Chest AP/lateral (two views) 4/15/15 18:24 Cardiothymic silhouette is unchanged. Streaky opacities in the right middle and lower lungs compatible with subsegmental atelectasis. Mild peribronchial wall thickening. No pleural effusions. | Bronchiolitis/reactive airway disease. RML and RLL subsegmental atelectasis. |
Generate impression based on findings. | Female 2 years old Reason: assess for PNA, effusion History: reported R sided PNA 1 week ago at OSH; 1 month cough, R sided chest/abd pain, feversVIEWS: Chest AP/lateral (two views) 4/16/15 The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. Peribronchial thickening ... | Peribronchial thickening and multifocal opacities as described. |
Generate impression based on findings. | Male 5 years old Reason: 5 yo M, new leukocytosis, inc respiratory secretions History: leukocytosis, secretionsVIEW: Chest AP (one view) 4/16/15 at 116 hours. Central line tip is at the right atrium. Cardiac silhouette size is top normal. Interval improvement in right upper lobe atelectasis with persistent left retroca... | Persistent left retrocardiac airspace opacity with interval improvement in right upper lobe atelectasis. |
Generate impression based on findings. | Sickle cell crisis.VIEWS: Right humerus AP in internal and external rotation 4/16/15 (two views) There is no evidence of bone infection. Punctate sclerosis of the proximal epiphyses of the right humerus may represent sequelae of osteonecrosis. | No evidence of bone infection. |
Generate impression based on findings. | Female 90 years old. Reason: fx/dislocation. History: pain Two views of the right femur are provided. Again seen is a bipolar hemiarthroplasty device with long femoral stem in anatomic alignment. There is a cable and claw device anchoring the greater trochanter with cerclage wires in the femoral diaphysis. There is no ... | Right long femoral stem bipolar hemiarthroplasty device without evidence of hardware complication. |
Generate impression based on findings. | Male 19 months old Reason: thumb PIP dislocation History: thumb PIP point tendernessVIEWS: Right hand AP and right and lateral oblique 4/16/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 51-year-old male with hematuria. Lack of intravenous and oral contrast limits evaluation for solid organ, vascular, and bowel pathology.ABDOMEN:LUNG BASES: No pleural effusions. Normal cardiac size without pericardial effusion.LIVER, BILIARY TRACT: Subcentimeter hepatic hypodensities are too small to characterize, stat... | No urinary system calculi or hydroureteronephrosis. Otherwise, unremarkable noncontrast CT. |
Generate impression based on findings. | Male 6 years old Reason: laceration with glass to foot VIEWS: Left foot AP, lateral and oblique 4/16/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. No radiopaque foreign bodies. | Normal examination. |
Generate impression based on findings. | Female 8 years old Reason: r/o fx History: fell on R knee while jumping w/p; knee in flexion, limpingVIEWS: Right knee AP, lateral and oblique 4/16/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 59 year old female. No history of trauma. Left shoulder pain. Evaluate for DJD. No fracture or dislocation. Mild sclerosis in the humeral head consistent with mild osteoarthritis. Mild AC joint osteoarthritis. | Mild glenohumeral joint and AC joint osteoarthritis. |
Generate impression based on findings. | Male, 58 years old.Surgical Case Information | Procedure(s): Procedure(s): | EXPLORATORY LAPAROSCOPY COMPLEX | Operating Room: CDOR 11 CENTRAL | Surgeon(s) and Role: | * Lisa Marie Cannon, M.D. - Primary Counts are correct per service. Two catheters overlie the lower abdomen (external to the patient per service). Enter... | No suspicious radiopaque foreign object is identified.Findings communicated by telephone to the attending surgeon, Dr. Cannon, at 22:19 on 4/15/15 by the resident radiologist on call. |
Generate impression based on findings. | Female 16 years old Reason: foreign body ingestion, in the stomach? History: AA battery ingestionVIEW: Abdomen lateral (one view) 4/16/15 at 418 hours Again a battery is identified in the mid upper abdomen. No evidence of free air or obstruction. | Foreign body ingestion. |
Generate impression based on findings. | Male 27 years old Reason: evaluate for appendicitis or abnormality History: 2 days h/o RLQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No signifi... | No CT findings to explain patient's right lower quadrant pain. |
Generate impression based on findings. | 57-year-old male with new diagnosis of lung cancer. (Left lower lobe grade 2 SCC) LUNGS AND PLEURA: Left lower lobe subpleural mass with internal dilated bronchioles and biopsy results of squamous cell carcinoma from outside hospital, measures 3.6 x 5.7 cm (series 7 image 89). Associated atelectasis. Severe upper lobe ... | 1.Left lower lobe subpleural mass and associated atelectasis correlates with known lung cancer.2.Additional nonspecific right middle and lower lobe nodules.3.Mildly enlarged subcarinal, left hilar, and cardiophrenic lymph nodes which did not demonstrate hypermetabolic activity on outside PET/CT.4.Mildly enlarged retrop... |
Generate impression based on findings. | The partially imaged upper esophagus is patulous, filled with oral administered contrast. There is no appreciable extraluminal fluid or gas to suggest perforation. There is no significant cervical lymphadenopathy by size criteria. The salivary glands and thyroid gland are normal in appearance. The oral tongue and floo... | No specific evidence of perforation involving the imaged portion of the upper esophagus. An esophagram may be useful for further evaluation of potential perforation. Patulousness of the esophagus may be related to the recent dilatation and/or achalasia related to the prior lap band surgery.I personally reviewed the Ima... |
Generate impression based on findings. | Female 16 years old Reason: AAA battery swallowing History: AAA battery swallowingVIEW: Abdomen AP (one view) 4/16/15 A tubular radiopaque foreign body consistent with a battery overlying the left upper abdominal quadrant. No evidence of obstruction or free air. | Foreign body ingestion as described. |
Generate impression based on findings. | 65 years, Female. Reason: further evaluation of dilated bowel loops History: persistent nausea/vomiting Multiple dilated loops of small bowel are again seen with air fluid levels, which may represent a partial small bowel obstruction. The featureless loop of bowel in the left lower quadrant is again noted. The pelvis i... | Dilated loops of small bowel with air fluid levels which may represent a partial small bowel obstruction. |
Generate impression based on findings. | Male 9 years old Reason: infected foot after stepping on nail History: infected foot after stepping on nailVIEWS: Left with AP, lateral and oblique 4/16/15 (3 views) Punctate radiopaque density in between the second and third proximal phalanx may represent foreign body, please correlate with the site of puncture. | Possible foreign body retention as described. |
Generate impression based on findings. | 35-year-old male with Crohn's disease and prior small bowel obstruction. Presents with abdominal pain and concern for obstruction. ABDOMEN:LUNG BASES: Minimal dependent subsegmental atelectasis. No pleural effusions. Normal cardiac size and pericardial effusion.LIVER, BILIARY TRACT: No focal hepatic lesion, biliary duc... | No evidence of a small bowel obstruction. Mild focal bowel dilatation and stasis proximal to the neoterminal ileum without specific evidence of bowel inflammation. No specific findings of an acute abnormality. |
Generate impression based on findings. | 64 year old female new NG tube placement. The lower abdomen and pelvis are not included in the field of view. NG tube tip projects at the level of the body of the stomach, unchanged in position. Nonobstructive bowel gas pattern. Large left pleural effusion with underlying atelectasis/consolidation, as well as bilateral... | 1. NG tube tip projects at the level of the body of the stomach.2. Bilateral opacities, large left pleural effusion and cardiomegaly suggestive of infection/aspiration or edema, better characterized on recent chest radiograph. |
Generate impression based on findings. | 65 years, Female. Reason: evaluate for obstruction History: persistent n/v Multiple distended loops of bowel again noted in the abdomen. A relatively featureless loop of bowel is noted in the left lower quadrant. Air is seen within the distal colon. Rounded density in the left lung base likely represents stool within t... | 1. Distended loops of bowel within the abdomen. Upright radiographs were subsequently obtained. Please see subsequent report for further detail. 2. Rounded density in the left lung base likely represents stool within the bowel; however, a follow up chest radiograph may be obtained to confirm. |
Generate impression based on findings. | Reason: R/o pneumonia History: Cough, high feversVIEWS: Chest AP/lateral (two views) 4/16/15 4:06 No pleural effusions or pneumothorax. No focal pulmonary opacity. Cardiothymic silhouette is normal. The aortic arch, cardiac apex and stomach are left-sided. Contrast noted in the collecting system. | Normal examination. |
Generate impression based on findings. | Male 75 years old Reason: eval for abscess/fluid collection History: s/p lap chole, fevers, leukocytosis, weight loss ABDOMEN:LUNG BASES: Left pleural calcification, unchanged.LIVER, BILIARY TRACT: Interval cholecystectomy. There is a collection in the gallbladder fossa measuring 6.6 x 3.6 cm image number 34, series nu... | Air containing fluid collection the gallbladder fossa associated with multiple surrounding abscesses involving the duodenal well and the space between gallbladder fossa and stomach, hepatic flexure, duodenum. Gastric outlet obstruction caused by inflammation and abscess in the duodenal wall. Mild intrahepatic biliary d... |
Generate impression based on findings. | 64 year-old female status post NG tube placement. The pelvis is not included in the field of view. NG tube tip projects at the level of the body of the stomach. Nonobstructive bowel gas pattern. Large left pleural effusion with underlying atelectasis/consolidation, as well as bilateral opacities. Cardiomegaly, unchange... | 1. NG tube tip projects at the level of the body of the stomach.2. Bilateral opacities, large left pleural effusion and cardiomegaly suggestive of infection/aspiration or edema, better characterized on recent chest radiograph. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate global volume loss greater than expected for the patient's stated age. There is also prominence of the cerebellar sulci, also related to volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is patchy abnormal ... | No acute intracranial hemorrhage. Probable mild age-indeterminate small vessel ischemic changes, advanced for patient's stated age, along with greater than expected global volume loss. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended. |
Generate impression based on findings. | Reason: evaluate stage of head and neck cancer History: maxillary sinus cancer CHEST: LUNGS AND PLEURA: No pleural effusion. Subsegmental atelectasis within the bilateral lower lobes and lingula. Small pulmonary cyst within the right upper lobe. Biapical pleural parenchymal scarring. No suspicious pulmonary nodule.MEDI... | No evidence of metastatic disease.Prominence of the left areola. Correlation to physical examination is recommended. |
Generate impression based on findings. | Female 16 years old Reason: foreign body History: abd painVIEW: Abdomen AP (one view) 4/16/15 at 759 hours. Tubular radiopaque foreign body is again identified in the left upper abdominal quadrant. No evidence of obstruction or free air. | Foreign body ingestion as described. |
Generate impression based on findings. | Reason: r/o appy History: 3 days periumbilical/RLQ pain w/F to 105; not able to visualize on US ABDOMEN:LUNG BASES: Lung bases are clear.LIVER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation is identified. Gallbladder wall is thin without pericholecystic fluid collection.SPLEEN: Splenule noted... | Normal-appearing appendix without inflammatory changes. |
Generate impression based on findings. | Female 9 years old Reason: possible right 2nd and 3rd toe fracture History: pain and swelling after traumaVIEWS: Right foot AP, lateral and oblique 4/15/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 60-year-old male with cough, hemoptysis, consolidation on chest x-ray. Evaluate etiology of hemoptysis in setting of suspected pneumonia and orthopic heart transplant in October 2014 PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary artery caliber measures 30 mm, upper limits of normal. No evidence ... | 1. Patchy bilateral ground glass opacity bilaterally which may represent aspiration, atypical infection or hemorrhage. 2. Trace residual mediastinal and substernal fluid collections likely postsurgical. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicabl... |
Generate impression based on findings. | Clinical question: Right-sided neglect, assess for old CVA. Signs and symptoms: As above. 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 nonhemorrhagic ischemic strokes.Small focus of lo... | 1.Small focus of low-attenuation in left basal ganglia/frontal lobe suspicious for an age indeterminate small vessel ischemic stroke. No prior exams for comparison. This finding can be further assessed with an MRI exam.2.Unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | Male 29 years old; Reason: 29M w/ Crohn's s/p ileocecectomy, sigmoidectomy, and diverting loop ileostomy on 4/1; now with leukocytosis History: eval for fluid collection ABDOMEN:LUNGS BASES: Right and left lower lobe micronodules measuring 4 mm in diameter each. In retrospect, unchanged from the prior exam of 5/21/2007... | 1.Persistent high-grade mechanical small bowel obstruction probably to the level of the ostomy. Bowel loops do enhance normally with no intramural air. Nevertheless, there is a risk of ischemia due to the severe dilatation.2.Decrease in size of loculated pelvic fluid collection. No new loculated collections to suggest ... |
Generate impression based on findings. | Female 40 days old Reason: ex 27 weeker now DOL 38 with abdominal distention concerning for NEC VIEW: Abdomen AP (one view) 4/16/15 at 347 hours. NG tube terminates in the stomach. Right lower extremity central line tip is at the right common iliac vein. Disorganized, nonspecific abdominal gas pattern. No evidence of o... | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is increased confluence of areas of abnormal low density in the periventricular and subcortical white matter, consistent with progressed moderat... | 1. No acute intracranial abnormality. Left frontal subgaleal hematoma and scalp swelling without fracture.2. Progressed mild to moderate small vessel ischemic changes.3. No acute fracture or traumatic subluxation within the cervical spine, with trace degenerative subluxations as noted above. Multilevel moderate spondyl... |
Generate impression based on findings. | Abdominal pain and vomiting This study is limited due to lack of intravenous contrast.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... | Small left UVJ stone causing mild left-sided hydronephrosis and hydroureter. Bilateral nephrolithiasis. |
Generate impression based on findings. | Abdominal distentionVIEW: Abdomen AP (one view) 4/15/15 at 1723 hrs. NG tube terminates in the stomach. Right lower extremity central line terminates at the right common iliac vein.Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Female, 50 years old. Reason: two days RUQ pain with fever eval for biliary or hepatic etiology History: RUQ pain and fever LIVER: The liver measures 17.4 cm, with homogeneous echotexture, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or ext... | No cholelithiasis or evidence of acute cholecystitis. |
Generate impression based on findings. | Male 7 months old Reason: rib fractures History: burnVIEWS: Right and left oblique views of the chest. 4/15/15 (two views) Cardiac silhouette size is normal. No focal lung opacities effusions pneumothorax. Visualized osseous structures look intact. Mild bowel distention. | No evidence of rib fractures. |
Generate impression based on findings. | Female 82 years old Reason: colorectal mass? History: abd pain, melena ABDOMEN:LUNG BASES: Emphysema and bilateral small pleural effusions and dependent atelectasis. Cardiomegaly.LIVER, BILIARY TRACT: Hepatomegaly.SPLEEN: Nonspecific, hypodense lesions in the spleen of unknown significance and etiology. An index lesion... | No CT findings to explain patient's melena. Colonic neoplasms cannot be excluded by CT.Nonspecific hypodense lesions in the spleen. |
Generate impression based on findings. | Status post burn.VIEWS: Left ankle AP, lateral and oblique 4/15/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Reason: evaluate for PE History: hemoptysis, tachypnea, chest pain. History of breast cancer. PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus. No evidence of right heart strain. LUNGS AND PLEURA: Previously referenced left lower lobe nodule and additional bilateral nodules are obscured by consolida... | 1.No acute pulmonary embolus.2.Left lower lobe pneumonia. Recommend short term radiographic follow up to resolution. 3.Previous reference pulmonary nodules are obscured by consolidation or no longer visualized. Recommend continued CT surveillance for breast cancer. 4.Unchanged reference mediastinal lymph node.5.Increas... |
Generate impression based on findings. | Reason: r/o osteo History: black finger tip s/p injury 6 weeks ago w/suturesVIEWS: Left hand PA, left middle finder oblique and lateral (3 views) 4/15/15 20:21 Tuft of the left middle distal phalanx is separated from the rest of the distal phalanx. The separated tuft is indistinct and likely being resorbed. Infection c... | Tuft of the left middle distal phalanx is separated and indistinct, likely being resorbed but infection cannot be excluded. Soft tissue defect and swelling of distal left middle finger. |
Generate impression based on findings. | 63-year-old male with right-sided abdominal pain. Evaluate for stones. Lack of intravenous and oral contrast limits evaluation for solid organ, vascular, and bowel pathology.ABDOMEN:LUNG BASES: Minimal dependent atelectasis. No pleural effusions. Normal cardiac size without pericardial effusion.LIVER, BILIARY TRACT: Su... | Findings favoring a recently passed right sided stone with mild right-sided hydroureteronephrosis and perinephric fluid and less likely the stone is impacted in the ureterovesical junction given its near midline location. |
Generate impression based on findings. | Respiratory insufficiency.VIEW: Chest AP (one view) 4/16/15 at 513 hours. ET tube terminates at the thoracic inlet. Central line unchanged. Thoracolumbar levoscoliosis again noted. Cardiac silhouette size is normal. Right upper and lower lobe opacities may represent atelectasis or pneumonia. | Persistent multifocal opacities. |
Generate impression based on findings. | Female 92 years old. Reason: eval for frx. History: pain, fall Two views of the left femur demonstrate an intertrochanteric fracture. There is osteoarthritis of the left knee. The AP view of the pelvis demonstrates bilateral hip osteoarthritis with osteophyte formation and joint space narrowing. There is severe degener... | Intertrochanteric fracture as described above. |
Generate impression based on findings. | 70 year-old female status post fall. There is no evidence of intracranial hemorrhage, mass effect or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. The calvaria and skull base are unremarkable. The mastoid air cells are clear. There is a subcentimeter left sphenoid sinus retenti... | No evidence of acute intracranial hemorrhage or skull fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 64 years old Reason: eval for retroperitoneal bleed History: dropped Hg The study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Bilateral dependent atelectasis. Cardiomegaly.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant a... | No evidence of retroperitoneal hematoma. Small omental infarct versus epiploic appendicitis, likely not of clinical significance. |
Generate impression based on findings. | 66 years, Female. Reason: r/o SBO History: ab skin graft, colostomy, abdominal pain, N/V A nonobstructive bowel gas pattern is identified. Dextroscoliosis of the lumbar spine. Right lower quadrant ostomy. Bowel suture line is noted. The bones appear demineralized. Degenerative changes affect the lumbar spine and bilate... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 54-year-old male with epigastric pain and elevated lipase. Evaluate for pancreatitis. ABDOMEN:LUNG BASES: No pleural effusions. Normal cardiac size without pericardial effusion.LIVER, BILIARY TRACT: No focal hepatic lesion, biliary ductal dilatation or vascular abnormality. Partially contracted gallbladder without calc... | Findings of acute pancreatitis without complication. |
Generate impression based on findings. | New onset seizure appear right for acute process. There is a right holohemispheric subdural collection that consists of hyperattenuating components layering dependently with otherwise low to intermediate components elsewhere. Overall, the collection measures up to 19 mm in width. There is mass effect upon the underlyin... | 1.A mixed attenuation right holohemispheric subdural collection with associated 5 mm of midline shift may represent an acute to subacute upon chronic hematoma, although precise dating of the process is limited.2.A left subdural fluid collection may represent a chronic subdural hematoma or hygroma. |
Generate impression based on findings. | Male 81 years old Reason: concern for malignancy, abnomral liver on chest CT History: dysphagia, weight loss, ABDOMEN:LUNG BASES: CardiomegalyLIVER, BILIARY TRACT: No focal liver lesions are seen in the liver.SPLEEN: No significant abnormality notedPANCREAS: There is an ill-defined soft tissue density in the mid body o... | Ill-defined soft tissue density involving the body of the pancreas causing upstream pancreatic ductal dilatation and encasing the SMA and celiac trunk. Peritoneal carcinomatosis and ascites. Significant cardiomegaly and atrophic bilateral kidneys.Indeterminate, subcutaneous soft tissue densities in the gluteal region w... |
Generate impression based on findings. | Reason: fracture, dislocation History: inversion injury to right foot and ankle while running today. moderate pain and swelling over 5th metatarsalVIEWS: Right foot AP oblique lateral (3 views), right ankle AP oblique lateral (3 views), 4/15/15 20:33 Right foot: Soft tissue swelling of the dorsum of the foot. No fractu... | Soft tissue swelling without fracture or dislocation. |
Generate impression based on findings. | Female 70 years old Reason: concern for diverticulitis, cannot get IV contrast given AKI but PO ok History: abdominal pain. The exam is not sensitive detecting lesions in the solid organs are vasculature due to the lack of intravenous contrast. Given that limitation, the following observations are made:ABDOMEN:LUNG BAS... | Cholelithiasis with no evidence of cholecystitis.Mild splenomegaly.Atherosclerotic disease. Scattered small lymph nodes of doubtful clinical significance. |
Generate impression based on findings. | Male, 71 years old. Reason: Cirrhosis, HCC screening LIVER: The liver measures 10.6 cm, with coarse echotexture and nodular contour, 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 common bile duc... | Cirrhotic liver morphology without focal lesion. |
Generate impression based on findings. | 60 year old male with severe fluctuant rash over sternum, significant concern for infection. LUNGS AND PLEURA: Scattered bilateral patchy areas of consolidation and ground glass opacity involving the lung bases and right middle lobe which may represent atelectasis although cannot exclude an occult infection. No pleural... | Scattered bilateral patchy areas of consolidation and ground glass opacity involving may represent atelectasis although cannot exclude an occult infection such viral/fungal pneumonia given history of stem cell transplant. |
Generate impression based on findings. | 66 year-old female with history of leukemia. Presenting with sepsis, abdominal pain and diarrhea. Lack of intravenous and oral contrast limits evaluation for solid organ, vascular, and bowel pathology.ABDOMEN:LUNG BASES: There is right midlung and focal ground-glass left anterior lower lobe consolidation/atelectasis, w... | Right mid lung consolidation/atelectasis is suspicious for infection and/or aspiration. No acute intra-abdominal process. |
Generate impression based on findings. | Male 31 years old. Reason: hx of dislocation of elbow eval s/p splinting. History: above Fine bone detail is obscured by overlying plaster. The elbow is in anatomic alignment. The previously seen fracture fragment is not visible on the current study. | Right elbow as described above. |
Generate impression based on findings. | Male 31 years old. Reason: dislocation post reduction. History: elbow dislocation Four views of the right elbow are provided. There is elevation of the anterior fat pad indicating a joint effusion. Alignment is anatomical. There is a small fragment along the radial head consistent with a fracture. | Radial head fracture as described above. |
Generate impression based on findings. | Reason: trauma with right shoulder pain, chest painVIEWS: Right shoulder AP and axillary (2 views), chest AP (one view), pelvis AP and frog leg (two views) 4/15/15 23:37 Shoulder: No fracture or dislocation.Chest: Cardiothymic silhouette is normal. The aortic arch, cardiac apex and stomach are left-sided. No pleural ef... | Normal examination. |
Generate impression based on findings. | Female 37 years old; Reason: 37F s/p wedge resection, OR USN showing additional liver lesions History: Evaluate for additional liver lesions. ABDOMEN:LUNGS BASES: Extensive bibasilar atelectasis. Small right pleural effusion.LIVER, BILIARY TRACT: 9.4 x 8.2 cm (series 11 image 31) geographic area encompassing a large po... | 1.Postsurgical changes liver, peritoneum (free air and fluid) and abdominal wall.2.Large intrahepatic hematoma.3.Bilateral nephrolithiasis and mild caliectasis, unchanged. |
Generate impression based on findings. | Female, 35 years old. Reason: Is there a hepatic vein thrombosis? History: Abd pain, n/v/diarrhea with ascites PORTAL VENOUS: The portal veins are patent, with normal hepatopetal flow. The main portal vein has flow velocity of 0.2 m/sec. The left and right portal veins each have flow velocities of 0.1 m/sec.HEPATIC ART... | 1. The hepatic veins are patent. The portal veins have normal hepatopetal flow.2. High resistance hepatic artery waveforms, suggestive of chronic hepatic parenchymal dysfunction or venous congestive disease. |
Generate impression based on findings. | Clinical question: Evaluate for stability of hemorrhage versus contrast extravasation. Signs and symptoms: Slurred speech and weaker on the right Unenhanced head CT:The examination redemonstrates a focus of acute hematoma in the anterior left sylvian fissure without convincing evidence of any significant change in its ... | 1.Acute hemorrhage in the anterior aspect of the left sylvian fissure without significant change in size, extent or density.2.Large subacute left temporal and occipital ischemic stroke with regional mass-effect demonstrate no significant change in size or extent.3.Petechial/linear foci of high density within the stroke... |
Generate impression based on findings. | Reason: bronchiolitis vs PNA History: increased WOB, course breath sounds, hypoxiaVIEWS: Chest AP/lateral (two views) 4/15/15 22:20 The aortic arch, cardiac apex and stomach are left-sided. Cardiothymic silhouette is normal. Mild peribronchial thickening. Subsegmental atelectasis at the right upper lobe. | Bronchiolitis/reactive airway disease. |
Generate impression based on findings. | Ms. Acevez is a 46 year old female with a personal history of benign right breast biopsy (apocrine metaplasia) in October 2014. She has a family history of breast cancer in her twin sister, mother (diagnosed at the age of 46) and maternal grandmother (diagnosed at the age of 74). She has no current breast related compl... | 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.Patient's family history was reviewed. Given extensive family history, a consultation with the high risk... |
Generate impression based on findings. | ICH, stroke. There is gyriform hyperattenuation centered in the posterior right middle frontal gyrus with associated hyperattenuation of the underlying white matter. There is a background of diffuse cerebral white matter hypoattenuation. There is bilateral basal ganglia mineralization, left more than right. There is sl... | Gyriform hyperattenuation involving the posterior right frontal lobe with associated hyperattenuation of the underlying white matter likely represent hemorrhagic transformation of a recent infarct superimposed upon a background of small vessel ischemic disease. A brain MRI may be useful for further evaluation if there ... |
Generate impression based on findings. | Reason: traumaVIEWS: Left femur AP and lateral (2 views) pelvis AP (one view), chest AP (one view) 4/15/15 23:12 Femur: No fracture or dislocation. Soft tissue defect noted in the posterior/medial thigh.Pelvis: No fracture or dislocation.Chest: Cardiothymic silhouette is normal. The aortic arch, cardiac apex and stomac... | Soft tissue defect noted in the posterior/medial thigh. No fracture or dislocation. Normal chest. |
Generate impression based on findings. | Female 59 years old Reason: left knee pain History: left knee pain Bone mineralization is normal. There is mild genu varus.Severe osteoarthritis affects the left knee with bone on bone apposition in the medial compartment. There are tricompartmental osteophytes. Possible trace joint effusion. No acute fracture or malal... | Severe left knee osteoarthritis. |
Generate impression based on findings. | 22 year-old female with throat tightness, dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Some barium contamination is noted, which is external to the patient, on her gown. Double contrast evaluation of the esophagus and gastric cardia/fundus re... | Unremarkable examination of the esophagus. |
Generate impression based on findings. | 54 years, Male. Reason: evaluate for etiology of constipation History: constipation Greater than average stool burden, with stool noted in the descending and transverse colon. Relative paucity of bowel gas, otherwise, nonobstructive bowel gas pattern. | Greater than average stool burden. No specific evidence of obstruction. |
Generate impression based on findings. | Status post cardiac surgeryVIEW: Chest AP ET tube has been removed in the interval. Right internal jugular central line with tip in the SVC. Bilateral chest tubes are noted. Epicardial pacer leads are present. Multiple surgical clips in the left superior mediastinum. Cardiothymic silhouette at the upper limits of norma... | Left lower lobe atelectasis increased from prior study. |
Generate impression based on findings. | Reason: 17 month old male with germline APC mutation at risk for hepatoblastoma, please evaluate for hepatic masses History: germline APC mutation LIVER: Liver measures 9.2-cm with normal echogenicity. No focal mass lesion identified. Main portal vein is patent with velocity of 0.4 m/sec.GALLBLADDER, BILIARY TRACT: No ... | Normal examination. |
Generate impression based on findings. | 52 years, Female. Reason: eval for acute obstruction History: abdominal pain, constipation Multiple mildly dilated loops of small bowel in the left upper quadrant with differential air-fluid level seen on the upright film are suggestive of developing small bowel obstruction versus ileus. Stool and air seen within the c... | Findings suggestive of developing small bowel obstruction, versus ileus. |
Generate impression based on findings. | Male 49 years old Reason: 49M hx HTN p/w Type B aortic dissection. follow up after having BP control. Thanks History: None CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Again noted is a type B aortic dissection without fracture involving the descending thoracic aorta with intimal flap be... | No significant change in the previous described type B aortic dissection without evidence of rupture. |
Generate impression based on findings. | Evaluate pleural effusionVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. Right upper extremity PICC with tip at the confluence of the brachiocephalic veins. NG tube tip in the stomach. Cardiothymic silhouette normal. Bilateral pleural effusions not significantly changed. Right upper lobe atelectas... | Bilateral pleural effusions not significantly changed. |
Generate impression based on findings. | Subdural hematoma. There is a large right holohemispheric mixed attenuation subdural hematoma, which is not significantly changed in size, measuring 19 mm in maximum thickness, with the more hyperattenuating components located posteriorly. There is persistent mass effect upon the underlying brain parenchyma and approxi... | 1.No significant interval change in the mixed attenuation right holohemispheric subdural collection, which may represent an acute to subacute upon chronic hematoma, although precise dating of the process is limited.2.No significant interval change in the left subdural fluid collection, which may represent a chronic sub... |
Generate impression based on findings. | Premature lungVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. The umbilical venous catheter tip within the left portal vein. Cardiothymic silhouette normal. The pneumomediastinum in the midline in the upper thoracic region is not significantly changed. Di... | Pneumomediastinum not significantly changed. |
Generate impression based on findings. | Male 11 years old Reason: r/o fracture History: finger injury playing volleyballVIEWS: Left hand AP and left fourth finger lateral and oblique 4/16/15 (3 views) There is a transverse fracture we dorsal angulation of the distal epiphyses of the mid phalanx of the left fourth digit. | Left forefinger mid phalanx fracture as described. |
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