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Generate impression based on findings. | Left ankle, evaluate stability of joint Again seen is an oblique fracture of the distal fibula extending to the level of the tibiotalar joint with approximately 3 mm of lateral displacement of the distal fracture fragment. On the AP view, the medial gutter is widened to approximately 6 mm, suggesting an injury to the d... | Distal fibular fracture with slight widening of the medial tibiotalar gutter suggesting a deltoid ligament injury. |
Generate impression based on findings. | Status post right shoulder arthroplasty revision Components of a reverse total shoulder arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Foci of gas density in the soft tissues reflect recent surgery. A catheter overlying the neck presumably represents ... | Postoperative changes of total shoulder arthroplasty revision as described above. |
Generate impression based on findings. | Reason: s/p craniotomy and aneurysm clipping on L 1mo prior History: L eye ptosis, L blurry vision, pain with eye mvmt The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient is status post left craniotomy and left sided aneurysm clip placement. No abnormal mass lesions are apprec... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Status post left craniotomy and aneurysm clip placement.3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Status post L5 -- S1 fusion There are posterior rods with screws entering the L5 and S1 vertebrae. Markers of an intervertebral spacer device at L5/1 are also noted. I see no findings to suggest hardware complication. A drain within the overlying soft tissues reflects recent surgery. | Postoperative changes of lumbosacral fusion as described above. |
Generate impression based on findings. | Status post stress test, evaluate joint congruency. Evaluation of fine detail is limited by overlying cast material. Again seen is an oblique fracture of the distal fibula with approximately 2 mm of posterolateral displacement of the distal fracture fragment. I see no additional fracture, and ankle joint alignment is w... | Distal fibular fracture. |
Generate impression based on findings. | Reason: evaluate for progression of left frontal contusion History: eval for progression of left frontal contusion Hyperattenuation along the anteromedial aspects of the frontal lobes is at least in part related to beam hardening artifact.The CSF spaces are appropriate for the patient's stated age with no midline shift... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. Hyperattenuation along the anteromedial aspects of the frontal lobes is at least in part related to beam hardening artifact.2.There is a left medial orbital blowout fracture associated prolapse of intraorbital contents into the left ethmoid air cells... |
Generate impression based on findings. | Reason: evaluate for intracranial bleeding History: headache, assault CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. Hyperattenuation along the anteromedial aspects of the frontal lobes is at least in part related to beam hardening artifact of some mild asymmetry may suggest ... | 1.Hyperattenuation along the anteromedial aspects of the frontal lobes (left more than right) is at least in part related to beam hardening artifact. The mild asymmetry may suggest a minor contusion. An MRI of the brain would help resolve this if clinically appropriate.2.There is a left medial orbital blowout fracture ... |
Generate impression based on findings. | 60 female with elevated INR and trauma. Right hip/pelvic pain. ABDOMEN:LUNG BASES: Cystic change left lung base.LIVER, BILIARY TRACT: Small amount of dependent material in the gallbladder.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKI... | Hematoma involving subcutaneous fat of the right posterior lateral low abdomen/pelvis without underlying fracture.Ventral hernia. |
Generate impression based on findings. | Female 33 years old Reason: r/o appendicitis,colitis, pelvic abnormality History: fever, n/v, abd pain ABDOMEN:LUNG BASES: Basilar dependent subsegmental atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No sig... | Findings compatible with acute pyelonephritis affecting the left kidney as described above. |
Generate impression based on findings. | Pain with palpation and movement. Fall 4/1. Assess for fracture. I see no fracture. Mild osteoarthritis affects the hip. | Mild osteoarthritis without fracture evident. If there is strong clinical concern for fracture, MRI may be considered for further evaluation. |
Generate impression based on findings. | Reason: eval for PE History: DOE and tachycardia PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus.LUNGS AND PLEURA: Moderate right pleural effusion with overlying atelectasis and consolidation, not significantly changed. Small left pleural effusion with chest tube, significantly changed.Reference le... | 1.No acute pulmonary embolus.2.Moderate right and small left pleural effusions with overlying consolidation and atelectasis. Left chest tube.3.Unchanged reference measurements. Please see recent surveillance examination.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proxim... |
Generate impression based on findings. | Liver transplant with encephalopathy. There are new areas of hypoattenuation and swelling in the right medial parietal and occipital lobes and to a lesser extent in the left medial parietal lobe, with predominant white matter involvement. There is associated effacement of the posterior right lateral ventricle. There is... | New areas of edema in the posterior cerebral hemispheres, right greater than left, but no evidence of acute intracranial hemorrhage. Differential considerations include posterior reversible encephalopathy syndrome, infarcts, and perhaps less likely an infectious etiology. A brain MRI may be useful for further evaluatio... |
Generate impression based on findings. | 64-year-old female with COPD, bronchiectasis with multiple admissions for SOB since last study; most notably with tachycardia to 140's this admission. PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary caliber within normal limits. No evidence of right heart strain.LUNGS AND PLEURA: Predominately low... | 1. No evidence of pulmonary embolism. 2. Bilateral lower lobe and lingular bronchiectasis, bronchial wall thickening with mucus plugging and distal atelectasis increased from prior study. Trace bilateral pleural effusion.3. Persistent indeterminate 10mm ground glass nodule unchanged from 1/11/2015 but not present prior... |
Generate impression based on findings. | Female 45 years old Reason: abd pain, ulcer? History: diffuse abd pain worse with food 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 no... | Focal soft tissue thickening along the greater curvature of the stomach. This may represent an ulcer mound; EGD is recommended for further evaluation. |
Generate impression based on findings. | 15 years, Female, Reason: hyperthyroid wtih 3.4x2.8x2.7 cm right sided nodule by ulterasound--please assess nodule for hyperfunction History: tachycardia and tremor. There is focal increased activity in the right mid to lower thyroid compatible with a hyperfunctioning nodule with suppression of the remaining thyroid. T... | Single large hyperfunctioning right-sided thyroid nodule with suppression of the remainder of the gland. |
Generate impression based on findings. | Acute mental status change There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is a mucus retention cyst in the right sphenoid sinus. The imaged paranasal ... | No evidence of intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | Altered mental status and history of brain metastases. There is no evidence of acute intracranial hemorrhage. There previously demonstrated subcentimeter brain metastases are inconspicuous due to the non-contrast technique. The ventricles are unchanged in size and configuration. There is no midline shift or herniation.... | 1. No evidence of acute intracranial hemorrhage.2. There previously demonstrated subcentimeter brain metastases are inconspicuous due to the non-contrast technique. A brain MRI with contrast may be useful for further evaluation, if clinically warranted. |
Generate impression based on findings. | Female 102 years old Reason: diffuse abd pain History: diffuse abd pain ABDOMEN:LUNG BASES: Partially visualized reticulation and fibrotic changes in the lung bases is perhaps minimally progressed compared to prior.LIVER, BILIARY TRACT: Multiple subcentimeter hypoattenuation within the liver likely represent cysts.SPLE... | Dilated loops of the jejunum and ileum with relative decompression of the proximal and distal bowel with no definite transition point seen. Although this could represent an obstruction, given the ascites, this may represent a ischemic ileus. Correlation with serum lactate levels is recommended. |
Generate impression based on findings. | 6-year-old male patient with constipation, needs NG golytely. Evaluate NG tube placement. VIEW: Abdomen AP (one view) 4/16/2015 at 1902 hrs Enteric tube tip is in the stomach. Non-obstructive bowel gas pattern. Large amount of stool noted in the rectosigmoid and descending colon. No free intraperitoneal air, pneumatosi... | Enteric tube tip in the stomach. |
Generate impression based on findings. | Female 84 years old Reason: Evaluate for fracture History: pain, hematoma status post fall. Today patient fell at rehab Center, with hematoma anterior and medial patella. We see no fracture or malalignment. The knee joint appears normal for age. No joint effusion. Vascular calcifications are present. | No fracture evident. |
Generate impression based on findings. | 19 year-old male, with swelling, injury. Patient was playing basketball; when he jumped he landed on someone else's foot. Pain is on the lateral aspect of the ankle. Three views of the left ankle show soft tissue swelling along the lateral aspect of the ankle. We see no underlying fracture or malalignment. | Soft tissue swelling without fracture. |
Generate impression based on findings. | Fall, hematoma. Head: There is no evidence of acute intracranial hemorrhage or mass. There is unchanged mild diffuse cerebral white matter hypoattenuation and subcentimeter defects in the left pons and bilateral basal ganglia. The ventricles are unchanged in size and configuration. There is no midline shift or herniati... | 1. Evidence of small vessel disease and chronic left pons and bilateral basal ganglia lacunar infarct, but no evidence of acute intracranial hemorrhage or skull fracture.2. Extensive multilevel degenerative spondylosis of the cervical spine, but no evidence of acute fractures. |
Generate impression based on findings. | Reason: s/p left lower lobectomy on 4/16/15 POD 0 History: chest tubeVIEW: Chest AP (one view) 4/16/15 21:20 Interval placement of left chest tube. Epidural catheter in place. Postsurgical changes of left hilum with pulmonary opacity likely postsurgical/atelectasis. Small left apical pneumothorax. Right upper lobe opac... | Postoperative changes of left lung and small apical pneumothorax. Right upper lobe atelectasis. Findings suggestive of postoperative ileus. |
Generate impression based on findings. | 19 year-old male with pain, evaluate for fracture. Patient hurt left knee playing basketball. There is a small joint effusion. We see no fracture line. There is slight flattening of the articular surface of the lateral femoral condyle which may simply reflect normal anatomy, although this may be seen in patients who ha... | Small joint effusion, other findings as described above. If there is concern for internal derangement such as ACL injury, MRI may be obtained for further evaluation. |
Generate impression based on findings. | 67 years, Male. Reason: Pancreatic fluid s/p drain placement Cystogastrostomy stents overly the upper abdomen. A left lateral abdominal wall percutaneous drainage catheter is noted. Questionable electronic device overlies the left upper quadrant. No evidence of bowel obstruction.Limited images of the thorax demonstrate... | Left lateral abdominal wall percutaneous drain in expected position. No evidence of bowel obstruction. |
Generate impression based on findings. | Thrombocytopenia, fall, headache. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is mild atrophy in the posterior fossa. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is mild mucosal thicken... | 1. No evidence of intracranial hemorrhage or mass.2. Rightward deviated septum. |
Generate impression based on findings. | Reason: eval for effusions/ infection History: fevers, AMS, resp distress, now intubated (history of heart transplant) LUNGS AND PLEURA: Interval increase in bilateral lower lobe consolidation/atelectasis. New small bilateral pleural effusions. Interval decrease in left lingular patchy air space opacity. Previously ide... | 1.New bilateral lower lobe consolidation and atelectasis and small pleural effusions.2.Interval decrease in left lingular patchy air space opacity.3.Previously seen largest nodules in the bilateral lower lobes are now obscured by consolidation and atelectasis. Continued follow-up is still recommended. |
Generate impression based on findings. | 18 year-old male with history of assault, evaluate for fracture. Five views of the lumbar spine show no fracture or malalignment. | No fracture evident. |
Generate impression based on findings. | 49 years, Female, Reason: history of abnormal thyroid function tests and questionable thyroid nodules, please evaluate for thyroiditis versus Graves' disease versus hot nodule History: fatigue, dry skin. The thyroid images demonstrate the suggestion of decreased activity in the left lower, right middle and right lower ... | 1.Several very small cold nodules bilaterally corresponding to findings on ultrasound but without dominant nodule.2.No scintigraphic evidence of Graves' disease, toxic nodule(s) or thyroiditis. |
Generate impression based on findings. | 18 year-old male with history of assault, evaluate for fracture, T1 fracture. Three views of the cervical spine show no fracture, but please refer to cervical spine CT report for further information. Alignment is within normal limits. | No fracture evident. |
Generate impression based on findings. | 41 year old female patient with screening mammogram and obscured masses in the right upper breast. An ML view and four spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in... | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 51-year-old male with pain, evaluate for fracture. Additional history: Patient smashed finger yesterday. Three views of the left ring finger show mild soft tissue swelling, but we see no fracture or malalignment. | Soft tissue swelling, with no fracture. |
Generate impression based on findings. | Recent craniotomy, surgical site drainage. Denies fevers. Denies headaches. There are postoperative findings related to left sided craniotomy for resection of a cavernous malformation. There has been interval decrease in size of the extra-axial fluid collection deep to the craniotomy, which now measures up to 2 mm in w... | Postoperative findings related to left sided craniotomy with interval decrease in size of the nonspecific extra-axial fluid collection deep to the craniotomy. Likewise, the scalp fluid collection has resolved with mild residual subcutaneous stranding, although cellulitis cannot be excluded. |
Generate impression based on findings. | Female, 38 years old. Reason: eval for evidence of renal injury History: AKI RIGHT KIDNEY: The right kidney measures 12.2 cm, with mildly increased cortical echogenicity. No shadowing calculi. Minimal prominence of the right collecting system, without evidence of obstruction.LEFT KIDNEY: The left kidney measures 14.6 c... | Mildly increased renal cortical echogenicity suggests medical renal disease. No significant hydronephrosis. |
Generate impression based on findings. | Kidney stones The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: A few scattered micronodules are nonspecific.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Hypodens... | No evidence of renal calculi or hydronephrosis. Left adrenal adenoma. |
Generate impression based on findings. | Male 65 years old Reason: abscess, infectoin History: ams, h/o recent abscess ABDOMEN:LUNG BASES: Mild left lower lobe bronchiectasis with new associated parenchymal opacities concerning for developing infection. Partially visualized subcarinal lymphadenopathy. Partially visualized pulmonary nodules.LIVER, BILIARY TRAC... | 1.No evidence of acute abdominal infection. There has been complete resolution of the previously noted right lower quadrant fluid collection.2.No significant interval change in the right superior lobe renal mass, mesentery nodules/lymph nodes, pulmonary nodules and osseous metastatic disease.3.New focal lung opacities ... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Maternal aunt diagnosed with breast carcinoma. The patient has a personal history of cervical carcinoma. Two standard digital views of both breasts and additional bilateral CC views were performed and reviewed with the aid of R2 CAD 9.3. The breast parench... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 28 years, Male. Reason: s/p OHT History: emesis Greater than average stool burden. Relative paucity of small bowel gas, but no specific evidence of obstruction. Partially imaged sternotomy wires and surgical clips in the right inferior mediastinum and right inguinal region are unchanged. Interval removal of pericardial... | Relative paucity of small bowel gas without specific evidence of obstruction. Greater than average stool burden. |
Generate impression based on findings. | 52 year old female with SOB, leg swelling, pleuritic chest pain. Evaluate for pulmonary embolism. PULMONARY ARTERIES: Filling defects within a segmental branch of the left upper lobar pulmonary artery (series 8, image 107) and subsegmental branch of right lower lobar pulmonary artery (series 8, image 196) are compatibl... | 1. Small acute pulmonary emboli within a segmental left upper lobe branch and subsegmental right lower lobe pulmonary arterial branches. 2. Small area in the right lower lobe of what likely represents subsegmental atelectasis however cannot exclude a very small infarct given proximity of nearby pulmonary embolus. PULMO... |
Generate impression based on findings. | There is no evidence of fracture or subluxation. The vertebral column alignment is within normal limits. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. C2/3: No significant spinal canal stenosis or neuroforaminal narrowing.C3/4: No significant spinal canal stenosis or n... | 1. No fracture or malalignment of the cervical spine. No significant spinal canal stenosis.2. Degenerative changes and neuroforaminal narrowing of the cervical spine at C4-C5 and C5-C6 as detailed above. |
Generate impression based on findings. | Recent jaw fracture. There is an oblique 2 mm displaced and comminuted fracture of the right mandibular body. There is also a 4 mm displaced and comminuted fracture of the base of the left mandibular condyle. There is soft tissue swelling surrounding the fractures. The temporomandibular joints are intact. There are mul... | Oblique 2 mm displaced and comminuted fracture of the right mandibular body and a 4 mm displaced and comminuted fracture of the base of the left mandibular condyle. |
Generate impression based on findings. | Male, 55 years old, with right face and arm contractions/paresthesias. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is nor... | 1.No acute intracranial abnormality.2.Sinus mucosal inflammation. |
Generate impression based on findings. | Status post brain biopsy. There is a new right frontal burr hole with small amount of pneumocephalus and blood products along the biopsy tract. A biopsy clip is present in the right subinsular region. There are also prior post-operative changes related to a right-sided craniotomy with evidence of extensive areas of hyp... | 1. Post-operative changes related to right frontal approach biopsy of the right subinsular region with a small amount of pneumocephalus and blood products along the biopsy tract. 2. Prior post-operative changes in the right frontal and temporal lobes. Assessment for tumor is otherwise limited on this study. Please refe... |
Generate impression based on findings. | Reason: evaluation preoperatively esophageal leiomyoma History: evaluation preoperatively esophageal leiomyoma CHEST:LUNGS AND PLEURA: A few and scattered punctate pulmonary micronodules. Nodule along the left major fissure likely represents an intrapulmonary lymph node. No suspicious pulmonary nodules are masses.No pl... | Esophageal submucosal mass compatible with patient's history of esophageal leiomyoma. No lymphadenopathy. No pulmonary nodules. |
Generate impression based on findings. | 65 years, Female. Reason: confirm NG placement History: nausea/vomiting/abdominal pain Enteric tube tip overlies the gastric body, with the side-port just beyond the gastroesophageal junction. Again seen are multiple dilated loops of small bowel, measuring up to 4.7 cm in diameter, compatible with known high-grade smal... | Enteric tube tip overlies the gastric body. Bowel gas pattern consistent with small bowel obstruction. |
Generate impression based on findings. | Reason: r/o free air, obstruction History: abd pain, vomiting, hx GSW to abd w/pancreatitisVIEWS: Abdomen supine and upright 4/16/15 (two views) 22:49 Redemonstration of punctate metallic foreign body in the LUQ, stable from prior study. No new radiopaque foreign body. Nonobstructive bowel gas pattern. No pneumoperiton... | No pneumoperitoneum or pneumatosis. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 76-year-old male post TAVR, now with hypotension evaluate for hemorrhage. ABDOMEN:LUNG BASES: No significant abnormality noted Post TAVRLIVER, BILIARY TRACT: Liver has a cirrhotic morphology. Dependent gallstones within the gallbladder.SPLEEN: Borderline splenomegaly.PANCREAS: No significant abnormality notedADRENAL GL... | Dissecting hematoma involving the subcutaneous tissues of the right abdominal wall and thigh.Cirrhotic morphology of the liver.Stable AAA.Gallstones. |
Generate impression based on findings. | 77 years, Female, Reason: Rule out chronic thromboembolic disease History: Pulmonary hypertension. The comparison chest CT performed on 4/15/2015 demonstrates biapical ground glass opacities, right basilar rounded atelectasis and small right pleural effusionThe ventilation images showed a small amount of decreased vent... | Low probability of pulmonary embolus. |
Generate impression based on findings. | 56 year old woman with with tachycardia and hypotension, evaluate for intra-abdominal abscess. The following observations are made given the limitations of an unenhanced studyABDOMEN:LUNG BASES: Left lower lobe pulmonary mass (series 4, image 11) measures 1.7 x 3.1 cm, is unchanged. Enlarging left and smaller right ple... | 1.No intra-abdominal abscess identified. 2.Stable left lower lobe pulmonary mass. 3.Increasing effusions with associated compressive atelectasis/consolidation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are pre... | 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. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distributio... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 10 year old female patient with erythema, swelling, severe TTP of right foot and ankle for four days. Unable to bear weight. Question of osteomyelitis. VIEWS: Right foot AP, oblique, lateral (3 views), Right ankle AP, oblique, lateral (3 views) 4/16/2015 No acute ankle fracture is evident. The ankle mortise is intact. ... | No acute fracture is evident. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable scattered calcifications in both breasts... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: check Dobbhoff placement History: check Dobbhoff placement Dobbhoff tube tip overlies the antrum. The NG tube has been retracted, with the tip overlying the gastric body. Moderate stool burden. The stomach appears under distended. The lower abdomen and pelvis are excluded from the field-of-view. Please refer to... | Dobbhoff tube tip overlies the antrum. |
Generate impression based on findings. | Reason: 10 year old F with right ankle injury, decreased weight bearing and lateral and medial malleolar tenderness History: pain and lateral and medial malleolar tendernessVIEWS: Right ankle AP oblique lateral (3 views) 4/16/15 22:59 No fracture or dislocation. Achilles tendon is intact. | No fracture or dislocation. |
Generate impression based on findings. | Male 69 years old Reason: eval for fluid collections, esp prostate, renal stones. prefer noncon due to recent dye load w ctpe History: neutropenic fever, urinary urgency, hematuria, dysuria. Additional history from chart: Patient has acute myeloid leukemia The lack of intravenous contrast limits evaluation of the solid... | No specific evidence of intra-abdominal infection as clinically queried. Multiple mildly enlarged pelvic and mesenteric lymph nodes may be reactive in etiology. Mild, non--- specific mesenteric fat stranding in the mid -- upper abdomen. |
Generate impression based on findings. | 63 years, Female, Reason: 63 F w s/p ex lap, SBR, ventral hernia repair r/o PE History: new onset SOB and tachycardia. The comparison chest radiograph performed on 4/16/2015 demonstrates minimal basilar atelectasis/scarringThe ventilation images large defects in the left mid to lower lung on single-breath and wash-in i... | Low probability of pulmonary embolus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal medical history of vaginal cancer diagnosed at the age of 34. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution.... | No 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. | 64 years, Male. Reason: 64yo male with obstipation and abd pain. History: abd pain and obstipation Interval increase in gaseous distention of the transverse colon at the hepatic flexure, without definite evidence of obstruction. Air is visualized distally within the rectum. Degenerative changes affect the lumbar spine. | Interval increase in gaseous distention of the transverse colon, particularly at the hepatic flexure, without evidence of definite obstruction. |
Generate impression based on findings. | Looking for source of vaginal bleeding. Recent hysterectomy. ABDOMEN:LUNG BASES: 4-cm Nodular air space opacity anteriorly at the left lung base (image 16; series 4) with adjacent mild bronchiectasis and bronchial wall thickening consider aspiration or early pneumoniaLIVER, BILIARY TRACT: No significant abnormality not... | Multiple fluid collections in the central pelvis; consider hematomas or abscesses. Correlate with pelvic ultrasound exam as clinically indicated. Left lower lobe pneumonia versus aspiration. |
Generate impression based on findings. | Subdural hematoma status post evacuation via burr holes. There are postoperative findings of a subdural hematoma via two parietal burr holes. The residual extra-axial collection is predominately air anteriorly measuring up to 25 mm in greatest thickness. There is a small amount of residual extra-axial fluid measuring u... | 1. Expected postoperative findings of right subdural hematoma evacuation via burr holes with decreased size of extra-axial fluid and associated mass effect.2. No significant interval change in the left subdural fluid collection, which may represent a chronic subdural hematoma or hygroma. |
Generate impression based on findings. | Reason: evaluate for fracture History: swelling, tendernessVIEWS: Left forearm AP and lateral (2 views), Left hand PA and lateral (2 views), Left wrist PA oblique lateral (3 views) 4/16/15 23:18 Left elbow: No acute fracture or dislocation.Left wrist: Non-displaced fracture of the ulnar styloid process. Wrist soft tiss... | Non-displaced fracture of the ulnar styloid process. |
Generate impression based on findings. | Increased WOB and coarse breath soundVIEWS: Chest AP/lateral (two views) 4/16/2015 The cardiothymic silhouette is normal in size. Minimal patchy atelectasis in the right upper lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis in the right upper lobe.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 16 year old male patient with history of gunshot wound. Questionable of bullet fragment migration.VIEWS: Right humerus AP and lateral (two views) 4/16/2015 Redemonstration of a comminuted fracture of the mid-humerus with interval osseous bridging of the fracture fragments with thick periosteal reaction/cortical thicken... | 1. Healing humerus fracture.2. Central lucency within the fracture; this may be secondary to the fracture or represent early sequestrum formation and should be followed. |
Generate impression based on findings. | 50 year-old female, with pain, follow-up fracture. Two views of right wrist show volar plate and screws affixing comminuted fracture of the distal radius in near anatomic alignment. We see no hardware complications. Majority of the fracture is concealed by overlying hardware, but portions of the fracture on lateral vie... | Orthopedic fixation of distal radius fracture. |
Generate impression based on findings. | HypercarbiaVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. Right internal jugular central line again noted. Mediastinal drain and left chest tube in place. The epicardial pacer leads are again noted. Cardiomegaly unchanged. Minimal perihilar atelectasis not significantly changed. No pleural effusi... | Minimal perihilar atelectasis not significantly changed. |
Generate impression based on findings. | 65 year old female status post right lumpectomy in 2006 for invasive ductal carcinoma with medullary features, presents today for routine follow up. Patient received radiation and chemotherapy. No current breast complaints. Family history of breast carcinoma in her maternal grandmother. Three standard views of both bre... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: 44 yo F with sarcoid, eval for interval change History: sarcoid, declining lung function LUNGS AND PLEURA: Diffuse bilateral peribronchovascular nodules and interstitial thickening, slightly increased compared to prior. Bibasilar scarring.No pleural effusions. Nodular pleural thickening, unchanged.MEDIASTINUM A... | Diffuse peribronchovascular nodules and interstitial thickening, slightly increased compared to prior, and extensive lymphadenopathy, slightly decreased compared to prior, compatible with patient's biopsy proven sarcoid. Previously identified hepatic and splenic abnormalities cannot be re-evaluated without the use of i... |
Generate impression based on findings. | 68-year-old male with right knee pain. Four views of the right knee show small tricompartmental osteophytes indicating mild osteoarthritis. There is a fabella posteriorly, but additional small ossicles overlying the posterior soft tissues may represent loose bodies. Osteoarthritis affects the left knee seen on frontal ... | Osteoarthritis. |
Generate impression based on findings. | Status post aneurysm clipping. There is redemonstration of postoperative changes related to a right frontotemporal craniotomy. There is suggestion of an ill-defined area of cortical hypoattenuation in the right middle frontal gyrus, which could be artifactual. Images are limited by streak artifact from motion, skin sta... | 1. No significant interval change in the expected postoperative changes following right MCA bifurcation and distal right MCA aneurysm clipping. Likely trace postoperative subarachnoid blood products along the right superior sylvian fissure.2. Suggestion of ill-defined area of cortical hypoattenuation in the right middl... |
Generate impression based on findings. | 87-year-old female with history of femoral neck fracture status post ORIF. Two views of left hip are provided. Four orthopedic screws affix femoral neck fracture in near-anatomic alignment. Fracture line is indistinct suggesting healing. There has been slight interval impaction compared to prior study with screw tips p... | Orthopedic fixation of femoral neck fracture as above. |
Generate impression based on findings. | 86 year-old male status post NG tube placement. Nonobstructive bowel gas pattern. Dobbhoff tube tip projects at the level of the body of the stomach. The guidewire is in place. There is a focus of calcification projecting over the left iliac fossa, corresponding to the findings on prior CT examination of indeterminate ... | Dobbhoff tube tip projects at the level of the body of the stomach. |
Generate impression based on findings. | Male, 60 years old. Reason: hepatitis B, eval for HCC History: HBV LIVER: The liver measures 18.9 cm, with increased echogenicity. A small round hypoechoic/cystic lesion in the right hepatic lobe measures 0.7 x 0.5 x 0 .8 cm, without vascularity. Although not definitively seen on prior imaging conus was identified on t... | Hepatic steatosis with subcentimeter cystic lesions as described above which are unchanged. No suspicious liver lesions identified. |
Generate impression based on findings. | Reason: evaluate for bony involvement History: tender to palpationVIEWS: Left femur AP and lateral (2 views) 4/16/15 23:33 No fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | Female; 67 years old. Reason: stem cell transplant patient with dilated bowel concerning for an ileus. History: abdominal distension, vomiting ABDOMEN:LUNG BASES: Mild patchy dependent bibasilar air space opacities, right greater than left, for which infection cannot be excluded.LIVER, BILIARY TRACT: Cholelithiasis.SPL... | New extensive, diffuse colonic pneumatosis intestinalis, best appreciated on lung windows. Mild scattered foci of free pneumoperitoneal and retroperitoneal air, which can be seen in the setting of extensive pneumatosis. No definite mesenteric venous gas. No portal venous gas. Overall, the findings are suspicious for ma... |
Generate impression based on findings. | Reason: assess for cord compression, fracture History: back pain, hx of breast ca thoracic spine:Compression fracture is present at T4 and T7 with 40% loss vertebral body height at T4 and 50% loss of vertebral body height at T7. These are mainly endplate compressions. There is no associated retropulsion of compromise t... | 1.No compression fractures present at T4 and T7. Although morphologically these may appear to be benign compression fractures, given this patient's clinical history these are suspicious for metastases. MRI would help further characterize these.2.Multiple sclerotic lesions in the left iliac bone are suspicious for metas... |
Generate impression based on findings. | TachypneaVIEW: Chest AP ET tube tip immediately above the carina. NG tube tip in the stomach. The stomach is distended. Left central line and left PICC again noted. The surgical drain at the right upper quadrant is unchanged. Midline skin staples are again noted. Cardiothymic silhouette cannot be evaluated. Minimal imp... | Minimal improved aeration in the left upper lobe. |
Generate impression based on findings. | 16-year-old male patient with history of gunshot wound.VIEWS: Chest PA/lateral (two views) 4/16/2015 The cardiac silhouette size is normal. No focal lung opacity, pleural effusion, or pneumothorax. Right humerus fracture and bullet fragments are noted. | No acute cardiopulmonary abnormality. |
Generate impression based on findings. | 47 years, Male. Reason: evaluate placement of DHT History: DHT placed The right hemiabdomen and pelvis are not included in the field-of-view. Nonobstructive bowel gas pattern. Dobbhoff tube tip projects at the level of the distal body of the stomach. Streaky left basilar opacity most consistent with subsegmental atelec... | Dobbhoff tube tip projects at the level of the distal body of the stomach. |
Generate impression based on findings. | 18 month old female patient with cough and possible foreign body ingestion.VIEWS: Chest AP/lateral (two views) 4/16/2015 The aortic arch, cardiac apex, and stomach are on the left. The cardiothymic silhouette is normal in size. There is marked peribronchial thickening. No focal lung opacity, pleural effusion, or pneumo... | Bronchiolitis/reactive airways disease pattern.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Line placementVIEW: Chest AP and abdomen AP ET tube tip at the origin of the right mainstem bronchus. The umbilical venous catheter tip within the right atrium. The umbilical arterial catheter tip at T10. Cardiothymic silhouette normal. Right upper lobe atelectasis new from prior study. Diffuse lung haziness bilaterall... | Malpositioned ET tube. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views, additional right CC view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications... | 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. | Reason: infiltrate History: distressVIEW: Chest AP (one view) 4/17/2015 2:04 Stable enlarged cardiothymic silhouette. Stable minimal left retrocardiac opacity, compatible with atelectasis. No pneumothorax or pleural effusions. Central line tip is in the right atrium/IVC. | Stable minimal left retrocardiac atelectasis. |
Generate impression based on findings. | History of breast cancer with metastases tot he brain status post biopsy. There are expected post-operative changes related to a stereotactic left suboccipital burr hole placement for a left cerebellar lesion biopsy. Minimal blood products are present at the biopsy site. There is again an area of hypoattenuation in the... | Expected post-operative changes related to biopsy of a left cerebellar lesion with minimal blood products at the biopsy site. Assessment for tumor is otherwise limited on this study. Please refer to the separate brain MRI report for additional details. |
Generate impression based on findings. | Status post right lumpectomy for breast cancer in January 2012 with reexcision in February 2012 followed by radiation. No current breast complaints. Three standard views of both breasts and 2 spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of ... | 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. | Abdominal distentionVIEW: Abdomen AP NG tube tip in the stomach. Right lower extremity PICC unchanged. There is mild dilation of the small bowel loops but improved from prior study. No pneumatosis or pneumoperitoneum. Minimal patchy atelectasis left lower lobe. | Dilation of small bowel loops improved from prior study. |
Generate impression based on findings. | Reason: hx of head and neck cancer, compare to previous with measurements. History: as above CHEST:LUNGS AND PLEURA: Innumerable bilateral pulmonary nodules compatible with metastases are not significantly changed compared to prior. Reference left lower lobe 17 x 11 mm metastasis is unchanged (series 6 image 59).Refere... | Stable pulmonary metastases. |
Generate impression based on findings. | Female, 28 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer, sp thyroidectomy (no RAI) RIGHT LOBE: Status post thyroidectomy. No focal lesion in the thyroid bed.LEFT LOBE: Status post thyroidectomy. Echogenic material in the left thyroid bed measures 0.6 x 0.3 x 0 .6 cm, similar to prior.ISTHMU... | Stable postoperative appearance of the thyroid bed, with an unchanged hypoechoic nodular lesion in the expected position of the isthmus. |
Generate impression based on findings. | Reason: Cardio-Pulmonary Assessment History: correction of Tetralogy of Fallot/pulmonary atresia on 4/16/15, POD1. VIEW: Chest AP (one view) 4/17/15 5:29 ET tube tip below thoracic inlet and above the carina. Right internal jugular central line tip in the SVC. Mediastinal drain and left chest tube in place. The epicard... | Minimal left perihilar atelectasis not significantly changed. |
Generate impression based on findings. | 19 year old female with pain, follow-up fracture. Three views of the left ankle again show plate and screw device affixing fibular diaphysis in anatomic alignment. Fracture is slightly less distinct on current exam compared to prior study suggesting interval healing. No hardware complication is seen. Two orthopedic scr... | Orthopedic fixation of distal fibula and tibia fractures in anatomic alignment. |
Generate impression based on findings. | Reason: Cardio-Pulmonary Assessment History: correction of Tetralogy of Fallot/pulmonary atresia on 4/16/15, POD0VIEW: Chest AP (one view) 4/16/15 21:25 ET tube tip below thoracic inlet and above the carina. Right internal jugular central line tip in the SVC. Mediastinal drain and left chest tube in place. The epicardi... | Minimal left perihilar atelectasis not significantly changed. |
Generate impression based on findings. | HypercapniaVIEWS: Chest AP and lateral ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Umbilical lines unchanged. Right chest tube in place with the sidehole in the subcutaneous tissue. Cardiothymic silhouette normal. Bilateral lung atelectasis increased in the interval predominantly ... | Bilateral lung atelectasis and PIE not significantly changed. |
Generate impression based on findings. | Postoperative cardiac surgeryVIEW: Chest AP Right internal jugular central line in place. Bilateral chest tubes and epicardial pacer leads again noted. Cardiomegaly unchanged. Patchy atelectasis in the left lower lobe. No pleural effusion or pneumothorax. | Postoperative exam without complication. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in maternal grandmother and paternal aunt. 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. Beni... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or ar... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: right sided crackles; former smoker History: dyspnea; cough LUNGS AND PLEURA: Biapical scarring. Moderate upper lobe predominant paraseptal and centrilobular emphysema. Scattered pulmonary micronodules, the largest measures 3 mm in the right upper lobe. Lower lobe atelectasis and scarring. No focal consolidatio... | Moderate emphysema. Scattered nonspecific pulmonary micronodules measuring up to 3 mm. Recommend follow CT in 1 year to confirm stability. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Known cyst in the left upper outer quadrant. History of breast cancer in mother. 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 ... | Known left breast cyst. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 62-year-old male with history of clavicular fracture. Again seen is a fracture through the medial aspect of the clavicle appearing similar to prior exam, although inferior aspect of the fracture is slightly less distinct suggesting some callous formation. Surgical clips are seen overlying the scapula. | Clavicle fracture as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, additional right MLO view, and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 60 years old Reason: restaging History: metastatic colon ca CHEST:LUNGS AND PLEURA: Minimal apical bullous changes. No dominant or suspicious pulmonary nodules. Resolution of previous pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Right chest port with tip at the cavoatrial junctio... | 1. Interval decrease in size of left hepatic metastatic lesion and right pleural effusion. Osseous metastatic disease, intra-abdominal lymphadenopathy and presacral soft tissue thickening are stable.2. Loculated fluid collection in the right hemiabdomen without evidence of superinfection. |
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