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Generate impression based on findings. | Male 83 years old; Reason: obstruction? History: constipation Multiple nonspecific gaseous distended loops of bowel. Normal amount of gas in the colon. No evidence of obstruction. Normal amount of stool. Suture wires are visualized the pelvis. | Nonobstructive bowel pattern. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Three 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. A partially obscured subcentimeter mass is present in the right upper outer quadrant... | Right breast mass. Spot compression imaging and possible ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Call back from screening mammogram for a mass in the left breast. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. A partially circumscribed mass seen in the screening mammogram is not well visualized on the compression views.Focused ultraso... | Clustered cysts with possible solid component and blood flow. Ultrasound guided aspiration is recommended.Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 53-year-old female with history of rheumatoid arthritis, evaluate for progression Right hand: A new plate and screw device affixes the distal radius in near-anatomic alignment. Moderate to severe osteoarthritis affects the basilar joint. Small lucencies within the scaphoid, lunate, and capitate may represent cysts or c... | Findings consistent with arthritis as detailed above, which appears predominantly degenerative in etiology without evidence of progression. |
Generate impression based on findings. | 66-year-old male with right alveolar squamous cell carcinoma. Status post resection with right-sided facial weakness. LUNGS AND PLEURA: There is interval development of multiple ground glass nodules and airspace opacities along the posterior aspect of the right lower lobe. No pleural effusion or pneumothorax. Scattered... | 1. Interval development of multiple ground glass nodules and airspace opacities along the posterior aspect of the right lower lobe compatible with aspiration with some degree of organization and partial resolution. 2. No evidence of metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Three MLO and 5 CC standard digital views (for a total of 16 images) of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Calcifications in the central left breast have lucent centers and a... | Left breast skin calcifications. 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. | 68-year-old with history of left breast cyst aspiration presents for follow-up study. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A known cyst is aga... | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 53-year-old female status post fall with left shoulder pain Four suture anchors are noted in the humeral head. Small foci of mineralization lateral to the humeral head may represent posttraumatic heterotopic ossification from prior surgery or calcific tendinosis, but are not typical of fracture fragments. Glenohumeral ... | Postoperative and degenerative changes as described above without evidence of fracture. |
Generate impression based on findings. | 74-year-old with history of benign right breast biopsy. Patient sister was diagnosed with ovarian cancer at 29. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribut... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: Assess lung transplant History: None LUNGS AND PLEURA: Interval resolution of multifocal subpleural consolidation in the right lung, with residual areas of scarring and rounded atelectasis.Partial clearing of right basilar ground glass opacity with residual fine nodular and tree in bud pattern consistent with b... | 1. Interval clearing of right lung air space opacities with residual scarring, atelectasis and pleural effusion.2. New stent in the bronchus intermedius and increased stenosis at the origin of the right upper lobe bronchus. |
Generate impression based on findings. | Right lower quadrant abdominal pain, evaluate for appendicitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No... | No appendicitis or other findings to account for the patient's pain. |
Generate impression based on findings. | 34 years old, Male, Reason: pt with metastatic melanoma s/p 4 cycles of chemotherapy please assess response to therapy and compare to previous imaging History: met melanoma CHEST:LUNGS AND PLEURA: Reference left lower lobe nodule is stable in size measuring 4 mm (series 4, image 57), previously measuring 4 mm in greate... | Metastatic disease in the chest, abdomen, and pelvis is overall decreased in size compared to prior study. |
Generate impression based on findings. | follow up for left cerebellar ischemic infarction. Re-demonstration of the left cerebellar and vermian acute ischemic infarction.No change of the lesion extent since prior exam.No evidence of hemorrhagic conversion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The osseous structures are unremarkab... | 1. No interval change of the extent and configuration of the left cerebellar acute ischemic infarction.2. No evidence of hemorrhagic transformation. |
Generate impression based on findings. | 32 year old female. Please evaluate for delayed gastric emptying. Visually there was significantly delayed gastric emptying with minimal progression of radiotracer into the bowel.Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:60 ... | Markedly delayed gastric emptying of liquid meal. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views 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, unchanged in pattern and distribution. No suspicious masses, microca... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 70-year-old male with hypercalcemia and hyperparathyroidism. Please evaluate for parathyroid adenoma for localization for second surgery. Previous history of parathyroidectomy. In the subcutaneous soft tissues of the anterior midline neck slightly above the isthmus, there is a small to medium sized markedly sestamibi-a... | 1.Significantly sestamibi-avid lesion as described above which may represent an unusually located parathyroid adenoma, neoplastic lesion, or inflammatory process. 2.No additional abnormal sestamibi-avid lesion is identified. |
Generate impression based on findings. | History of right T4N2bM0 right maxillary sinus cancer s/p chemoradiation completed September 2014 with right facial pain and swelling. Redemonstration of ill-defined infiltration of the right cheek soft tissues with overlying skin retraction. No discrete mass, abnormal fluid collection, or new lesion is identified. The... | 1. No evidence of progression of disease. 2. Stable rind of non-enhancing tissue in the right maxillary sinus. The floor of the sinus remains eroded, the severity of which is stable. |
Generate impression based on findings. | Metastatic melanoma status post 4 cycles of chemotherapy. There has been interval decrease in size of a cystic right supraclavicular lymph node, which now measures 29 x 26 mm, previously 31 x 32 mm in the axial plane. There are no other significantly enlarged lymph nodes in the neck based on size criteria. In addition,... | Interval decrease in size of the right supraclavicular lymphadenopathy and resolution of the subcutaneous and left posterior paraspinal muscle nodules. |
Generate impression based on findings. | 75 years old, Female, Reason: 75 yo f w/ h/o divertyiculosis p/w brbpr and hemoglobing drop, EGD negative History: GIB ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse Hepatic steatosis. Evidence of cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnorma... | 1.No large mass, acute inflammation, or active bleeding. 2.Nodular focus in the proximal sigmoid colon may represent a polyp. Due to technical error, the arterial and portal venous phase of the pelvis were not performed. Small enhancing masses could be missed and if there is clinical concern for this, a repeat enterogr... |
Generate impression based on findings. | 59-year-old male with fall, pain, decreased range of motion There is volar dislocation of the middle phalanx of the fifth finger relative to the proximal phalanx. There is also radial angulation and rotational deformity of the middle and distal phalanges relative to the proximal phalanx. A 4-mm crescentic density seen ... | Fifth PIP joint dislocation and possible fracture fragment as described above. |
Generate impression based on findings. | 90 year old woman presents for cardiac CT for evalution prior to possible TAVR CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with pseudo-bovine (normal variant) brachiocephalic branching pattern. There is minimal atherosclerosis of the proximal brachiocephalic vessels. No thoracic aortic aneurysm... | 1. Severe aortic valve calcification2. Thoracic aorta anatomy and measurements as above. A small penetrating aortic ulcer is noted in the descending thoracic aorta at the level of the diaphragm.3. Severe mitral annular calcification with significant extension onto anterior and posterior leaflets.4. Severe left atrial d... |
Generate impression based on findings. | Metastatic lung carcinoma ABDOMEN:LUNG BASES: Progression of multiple left lower rib metastasis with increase in surrounding soft tissue metastatic component. Left basilar pleural thickening unchanged.LIVER, BILIARY TRACT: Accounting for differences in technique, probably no significant change in left hepatic lobe meta... | Progression of multifocal lytic bony metastases with cortical disruption as described. Probably no significant change in hepatic metastasis. |
Generate impression based on findings. | Male, 47 years old.History of malignant neoplasm of the vertebral column. Retroperitoneal spinal exposure and paraspinal tumor removal.Trigger: Elevated BMI and multiple surgical teams. Counts are correct. Two lateral views of the abdomen are provided. Posterior spinal fusion hardware, intervertebral spacer device, pre... | No unexpected radiopaque foreign objects in the field of view. Possible high-riding enteric tube. These findings were discussed by telephone with Dr. Milner, the attending surgeon, on 1/2/2014 at 14:33. |
Generate impression based on findings. | Multiple myeloma status post chemotherapy, last December 2014. Increasing pain including hips. Evaluate for acute injury and/or disease progression.RADIOPHARMACEUTICAL: 12.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 98 mg/dL. Today's CT portion grossly demonstrates numerous lytic lesions throughout the... | 1.Interval improvement in previous hypermetabolic foci without convincing FDG avid tumor currently. Mild residual sternal activity may be remodeling bone from a treated metastasis. New small right 6th costovertebral focus considered more likely degenerative than tumor.2.Hypermetabolic soft tissue inflammatory activity ... |
Generate impression based on findings. | altered mental status Now the right PCA territorial acute ischemic infarction involving right occipital lobe, right posterior temporal lobe, and right thalami with effacement of sulci is very conspicuous.No evidence of hemorrhagic conversion.No change of non specific small vessel disease on bilateral periventricular wh... | 1. Acute ischemic stroke involving right PCA territory including right occipital lobe, right posterior temporal lobe and right postero-lateral thalami as described above.2. No evidence of hemorrhagic conversion.3. No change of non specific small vessel disease since prior exam. |
Generate impression based on findings. | History of stem cell transplant with chronic sinusitis who presents with neck tenderness and left ear pain. There appears to be mild mucosal swelling and hypoattenuation in the oropharynx, particularly in the region of the left tongue base with effacement of the left vallecula. Otherwise, there is no evidence of measur... | 1. Apparent mild mucosal swelling in the oropharynx may represent an upper respiratory infection, but no evidence of mass or significant lymphadenopathy in the neck.2. Fluid within the left mastoid air cells and middle ear may represent otomastoiditis.3. Diffuse sinonasal opacification may represent represents acute up... |
Generate impression based on findings. | Female 19 years old Reason: assess for video capsule History: abdominal painVIEW: Abdomen AP (one view) 1/2/15 at 1415 hrs Mild amount of fecal accumulation with no evidence of obstruction or free air. Video capsule is no longer visualized. | Video capsule no longer visualized. No evidence of obstruction or free air. |
Generate impression based on findings. | Abdominal pain, evaluate for obstruction. ABDOMEN:LUNG BASES: Emphysema and mild basilar atelectasis. Right upper lobe pleural based mass not included in field of view.LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormali... | 1.No acute findings to account for patient's pain.2.Cholelithiasis without cholecystitis.3.Medical renal disease. |
Generate impression based on findings. | History of abdominal pain and gram-negative sepsis, evaluate for abscess or typhlitis. ABDOMEN:LUNG BASES: Bilateral small pleural effusions with associated atelectasis/consolidation.LIVER, BILIARY TRACT: The gallbladder is mildly distended. There is new pericholecystic fluid, mild gallbladder wall thickening, and righ... | 1.Findings concerning for acute cholecystitis. Recommend ultrasound for further evaluation. Findings communicated to to Blummer, Stefanie at 2:45 p.m. 2.Possible chronic inflammation of the ascending colon.3.Bilateral small pleural effusions and associated atelectasis/consolidation. |
Generate impression based on findings. | 55-year-old male with metastatic lung cancer LUNGS AND PLEURA: Please note comparisons are made with attenuation CT with significant motion artifact from recent PET/CT.Reference left paramediastinal mass measures 19 x 12 millimeters (series 5, image 25), not significantly changed when compared to recent PET/CT.Linear s... | 1. Reference left paramediastinal mass and adjacent postradiation changes are not significantly changed when compared to recent PET/CT.2. Redemonstration of multiple osseous and pleural based metastatic lesions, which have not substantially changed in the short interval.3. No new nodule/mass. |
Generate impression based on findings. | 60-year-old with history of pituitary tumor status post resection presenting with right breast mass (retroareolar 9 o'clock position) and nipple discharge. MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, un... | Bilateral gynecomastia without focal mass lesion. As long as the patient's exam remain stable, no further imaging is required.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Metastatic lung carcinoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty liver again noted. Stable hepatic cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable right adrenal nodule best seen on image 46 of series 7 measuring 2.1 x... | Stable examination. |
Generate impression based on findings. | PICC lineVIEW: Chest AP (one view) 1/2/15 1325 Right PICC line tip at the superior cavoatrial junction.The cardiac silhouette is mildly enlarged.There is pulmonary vascular redistribution, without focal lung opacities or specific evidence of edema. | Mild cardiomegaly without edema. |
Generate impression based on findings. | Two year old female with ventricular shunt experiencing vomiting A right parietal ventricular catheter is present with tip terminating in the adjacent to the left lateral ventricle frontal horn, unchanged in position. The lateral and third ventricles are smaller than the comparison. Hypodensity is present throughout th... | The lateral and third ventricles are smaller than the comparison.1.Hypodensity is present throughout the white matter without associated mass effect, which appears more prominent than the comparison study, however this may be due to a background of some interval white matter myelination maturation.2.Previously demonstr... |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mas... | Negative unenhanced brain CT. SPECIFICALLY, there are no CT findings to explain the patient's symptoms. If there remains a high clinical suspicion for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | 49-year-old male with knee pain Small osteophytes indicate mild osteoarthritis. There is slight varus deformity of the knee. Similar findings are seen affecting the left knee on the frontal view. | Mild osteoarthritis. |
Generate impression based on findings. | 64 year-old female with tachycardia. History of recent hip fracture repair and immobility. The examination was terminated early due to the patient's inability to cooperate with the examination. Limited images were provided from the contrast bolus timing sequence. No diagnostic images were provided/obtained to evaluate ... | Nondiagnostic examination which was terminated early secondary to the patient's inability to cooperate with the examination. |
Generate impression based on findings. | 40-year-old male with history of colon cancer presenting with right breast palpable lump at the 3 o'clock position. Clinical suspicion of a sebaceous cyst, but evaluate for metastasis. MAMMOGRAPHY: Three standard views of both breasts as well as CC and mediolateral spot compression views of the right breast were perfor... | Sebaceous cyst corresponding to the site of the patient's palpable abnormality. No mammographic evidence of malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 30 year-old male with low back pain Mild to moderate degenerative disk disease affects L5/S1. Alignment is within normal limits. Vertebral body heights are maintained. | Degenerative disk disease. |
Generate impression based on findings. | 57 year old female with history of intracranial hemorrhage experiencing headache. Previously demonstrated hematoma in the right head of caudate nucleus with extension to the right lateral ventricle and choroid has resolved. There is no evidence of rehemorrhage. The ventricles are unchanged in size or shape without evid... | Resolution of previously demonstrated right caudate-centered hematoma without CT evidence of rehemorrhage. |
Generate impression based on findings. | Reason: evaluate for evidence of DAH History: hemoptysis LUNGS AND PLEURA: Moderate bilateral pleural effusions, larger on the right, with associated basilar compressive atelectasis. Mild dependent atelectasis and a posterior upper lobes.No evidence of diffuse alveolar hemorrhage. Interstitial edema which was evident o... | Bilateral pleural effusions and atelectasis. No evidence of pulmonary edema, which has apparently resolved, or diffuse alveolar hemorrhage. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 12/15/2011 from AHC Beverly in Chicago IL. Submitted outside study was compared to the current mammogram dated 12/2/2014. Breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. There has been benign ... | No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual right unilateral diagnostic mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 64 year-old male with a history of metastatic lung carcinoma. LUNGS AND PLEURA: Note is made of paraseptal emphysema with an upper lobe predominance. Right apical bulla, unchanged. Postsurgical changes of prior left upper lobectomy and post radiation therapy changes, appearing similar to the prior study. Multiple bilat... | No significant interval change in reference left lateral chest wall mass, consistent with a biopsy proven history of metastatic disease. No new foci of metastatic disease are identified. Please refer to the accompanying CT abdomen and pelvis report for additional details. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 12/15/2011 from AHC Beverly in Chicago IL. Submitted outside study was compared to the current mammogram dated 12/2/2014. Breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. There has been benign ... | No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual right unilateral diagnostic mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Focal asymmetry is present in the medial superior left brea... | Focal left breast asymmetry. Spot compression views and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 56 years old Reason: Active small bowel crohn's disease ? History: Abdominal pain and diarrhea ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant... | Large cystic mass arising from the right ovary suspicious for an ovarian neoplasm without a definite solid components, more likely to be benign. Further evaluation with pelvic ultrasound is recommended.No MR evidence of active inflammation involving the small bowel segments. |
Generate impression based on findings. | Female 15 years old; Reason: 15y/o h/o perf appy, now w hematuria/CVA tenderness LIVER: 14.2 cm in length. Normal hepatic echotexture, without focal lesions. Patent portal vein with hepatopetal flow.GALLBLADDER, BILIARY TRACT: Laying gallbladder sludge, without wall thickening or biliary ductal dilation.PANCREAS: No si... | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reduction. History of breast cancer in mother diagnosed at age 78. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scatter... | Stable bilateral benign masses. New focal right breast asymmetry. Spot compression imaging and possible ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Right paratracheal lung mass. Evaluate for lung cancer/initial staging.RADIOPHARMACEUTICAL: 13.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 91 mg/dL. Today's CT portion grossly demonstrates an approximately 3.5 cm right paratracheal soft tissue mass containing punctate calcification, stable. Left hilar ... | 1.Markedly hypermetabolic right paratracheal mass, highly suspicious for malignancy such as primary lung cancer.2.No FDG avid metastatic disease identified.3.Probable prior right posterior brain infarct would be better evaluated on dedicated brain CT or MR imaging as clinically warranted. |
Generate impression based on findings. | 49 years old, Male, Reason: Evaluate for possible occult maligancy History: 49 yo M w/ NICM, s/p ICD, with VF arrest and ICD lead clot and possible PE Lack of IV contrast limits the ability to assess vascular patency and abdominal parenchyma. Within these limitations the following observations are made:CHEST:LUNGS AND ... | No evidence of occult malignancy. Please note lack of IV contrast limits the ability to assess vascular patency and abdominal parenchyma. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in mother diagnosed at age 43. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | History of pancreatitis and peripancreatic fluid collections, evaluate for interval change. ABDOMEN:LUNG BASES: Moderate bilateral pleural effusions with associated compressive atelectasis/consolidation appearing similar to prior.LIVER, BILIARY TRACT: Status post cholecystectomy. There is mild dilatation of the intra a... | 1.Extensive necrotizing pancreatitis with some residual enhancing parenchyma in the body and tail. Peripancreatic loculated fluid collections with slight interval decrease in size of lesser sac component which no longer contains gas.2.Extensive main portal vein thrombus with extension into much of the right portal vein... |
Generate impression based on findings. | Male 63 years old; Reason: obstruction? 63M prostrate ca; no BM x 3 weeks History: no BM x 3 weeks Nonobstructive bowel gas pattern. Improvement in the stool burden. Diffuse sclerotic osseous metastases again seen. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 18 years old; Reason: Evaluate hepatic vessels and flow. r/o VOD History: increased bilirubin LIVER: Liver echogenicity is normal. No intrahepatic biliary ductal dilatation is seen. The liver measures 18.8 cm in length.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and normal in appearance. No gallblad... | No evidence of venoocclusive disease. |
Generate impression based on findings. | Male 3 months old Reason: eval for PNA, infiltrate History: Hypoxia, cough, feverVIEW: Chest AP (one view) 1/2/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Left lower lobe opacity, likely atelectasis or pneumonia. No effusions or pneumothorax. | Left lower lobe opacity, likely atelectasis or pneumonia. |
Generate impression based on findings. | History of ORIF with pins palpable on exam. Please assess for hardware stability/migration. A side plate and screws affix the distal fibula in near-anatomic alignment. I see no hardware complications; specifically, I see no radiographic evidence of loosening or migration. I see no fracture. Tibiotalar joint osteophytes... | Orthopedic fixation of the distal fibula and mild osteoarthritis as described above. |
Generate impression based on findings. | Solitary pulmonary nodule right upper lobe.RADIOPHARMACEUTICAL: 15.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates an approximately 17-mm nodule in the periphery of the right upper lobe. There is a subtle approximately 5-mm nodule in the left upper lobe. D... | 1.Markedly hypermetabolic right upper lobe pulmonary nodule, highly suspicious for malignancy, likely primary lung cancer.2.Weakly FDG avid subcentimeter left upper lobe pulmonary nodule may be inflammatory although an additional tumor focus cannot be entirely excluded.3.No suspicious FDG avid lesion to indicate tumor ... |
Generate impression based on findings. | Female 2 years old Reason: emesis w shunt VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 1/2/15 Cranial deformities are again noted. Intracranial portion of the VP shunts system is unchanged in position. The extracranial VP shunt catheter does not show an... | No evidence of VP shunt malfunction. |
Generate impression based on findings. | Male 67 years old; Reason: NG first line check placement History: NG first line check placement Note that the pelvis was not included in the exam. The nasogastric tube tip is in the body of the stomach with the sidehole at or above the gastroesophageal junction. Multiple persistently dilated and gaseous loops of bowel ... | The nasogastric tube tip is in the body of the stomach with the sidehole at or above the gastroesophageal junction. |
Generate impression based on findings. | 39 year old with 5 years of intermittent yellowish nipple discharge. Mammogram: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, ... | No mammographic or sonographic evidence of malignancy. Clinical follow up is recommended for the nipple discharge. 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.RECOMMEN... |
Generate impression based on findings. | 52 years old, Male, Reason: Recent peritoneal hematoma, cecal pneumatosis History: incresed abd pain CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions with a loculated left pleural effusion that is mildly increased in size. Bibasilar atelectasis and scarring. Paraseptal emphysema.MEDIASTINUM AND HILA: Calcifica... | 1.Near complete resolution of benign cecal pneumatosis with residual small pockets of intramural air. 2.Left perinephric hematoma is not significantly changed in size. In the setting of spontaneous hemorrhage, underlying neoplasm such as angiomyolipoma or renal cell carcinoma cannot be excluded. |
Generate impression based on findings. | 49-year-old male with history of rheumatoid arthritis and pain Right hand: There is nonuniform narrowing of the second metacarpophalangeal joint with small osteophytes and mild deformity of the underlying second metacarpal head, which could represent chronic erosive remodeling from rheumatoid arthritis. Round lucency i... | Arthritic changes as described above, likely representing a combination of osteoarthritis and mild chronic inflammatory arthritis such as rheumatoid arthritis, albeit with somewhat atypical radiographic features. |
Generate impression based on findings. | 83-year-old female status post fall with rib pain Right hip: No fracture or malalignment. Mild osteoarthritis affects the hip. Arterial calcifications are noted in the soft tissues.Ribs: The bones are demineralized. No rib fracture is evident. Compression deformity of the seventh thoracic vertebral body with approximat... | 1. Mild osteoarthritis affecting the right hip.2. T7 vertebral body compression fracture which is age indeterminate but new from prior chest radiographic dated 3/15/2011. Additional arthritic changes as detailed above. No rib fracture is evident. |
Generate impression based on findings. | Male, 64 years old, with stroke. Hypoattenuation involving the left caudate head and extending into the left basal ganglia is seen compatible with ischemic injury of indeterminate but potentially chronic time course. Also noted is patchy periventricular hypodensity which also likely reflects microvascular ischemic dise... | 1. Hypoattenuation involving the left caudate head and adjacent basal ganglia is compatible with ischemic injury. This is probably chronic given the CT appearance, but CT is insensitive in this regard and if clinical concern exists for acute ischemia, further evaluation with MRI is recommended.2. Elsewhere, patchy micr... |
Generate impression based on findings. | Female 12 months old Reason: r/o pna History: crackles, fever, tachypneaVIEWS: Chest AP/lateral (two views) 1/2/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Peribronchial thickening and left lower lobe opacity, likely atelectasis or pneumonia . No effusions or... | Peribronchial thickening and left lower lobe opacity, likely atelectasis or pneumonia |
Generate impression based on findings. | Female 4 years old Reason: r/o pna History: cough, fever, cracklesVIEWS: Chest AP/lateral (two views) 1/2/15 Cardiac silhouette size is normal. Peribronchial thickening, left lower lobe and lingular opacity, likely atelectasis or pneumonia. | Peribronchial thickening, left lower lobe and lingular opacity, likely atelectasis or pneumonia. |
Generate impression based on findings. | 60 year old male with metastatic thyroid cancer. Please evaluate for bone metastases prior to treatment.RADIOPHARMACEUTICAL: 15.5 mCi F-18 NaF Today's CT portion grossly demonstrates innumerable bilateral metastatic lung nodules. There is a small to medium left pleural effusion. Tracheostomy is in place. Postsurgical c... | Multifocal osseous metastases. |
Generate impression based on findings. | Male 51 years old Reason: r/o obstruction History: 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 significant abnormality notedKIDNEYS, URETERS: ... | No CT findings to explain patient's abdominal pain. Borderline enlarged retroperitoneal lymph nodes and left inguinal hernia are unchanged. |
Generate impression based on findings. | 27-year-old male status post fall with knee and ankle pain, rule out fracture Knee: No fracture or dislocation is evident. Ankle: Mild soft tissue swelling is present about the ankle without fracture evident. There may be a small tibiotalar joint effusion. | 1. No knee fracture.2. Mild soft tissue swelling about the ankle without fracture evident. |
Generate impression based on findings. | Male 65 years old Reason: evaluate for bladder rectal fistula, r/o intra-abdominal abscess History: feculent material from urethra ABDOMEN:LUNG BASES: Bilateral small pleural effusions and atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant ... | Large fistula between the sigmoid colon and the bladder. Significant amount of fecal material is noted within the bladder. |
Generate impression based on findings. | Male 38 years old Reason: r/o abscess History: sepsis ABDOMEN:LUNG BASES: Bibasilar dependent atelectasis and small amount of pleural effusions. Pneumonia cannot be excluded in the lung bases.LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant a... | Dependent atelectasis and small amount of pleural effusion at the lung bases. Pneumonia cannot be excluded. Fat containing left inguinal hernia.Fatty infiltration of the liver. |
Generate impression based on findings. | Female 84 years old Reason: pt w/ sacral abscess question of abscess vs osteo History: febrile UTERUS, ADNEXA: Ossified leiomyoma.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sacrum decubitus ulcer involving ... | Extensive decubitus ulcer with possible perianal fistula. Inflammation encases the coccyx and distal sacrum and osteomyelitis is likely. MRI may be helpful for further evaluation of the bones and possible perianal fistula.Calcified fibroid. |
Generate impression based on findings. | Recurrent cervical cancer status post 3 cycles of chemotherapy. Assess response.RADIOPHARMACEUTICAL: 15.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates multiple thoracic calcifications involving parenchymal and mediastinal granulomas as well as involving th... | 1.Significant interval decrease in the previous hypermetabolic cervical/vaginal lesion with milder residual activity currently suggestive of inflammation or some residual tumor metabolism.2.While there is no definitive FDG avid tumor elsewhere, a subcentimeter mildly hypermetabolic left inguinal lymph node has progress... |
Generate impression based on findings. | Female 9 months old Reason: DHT placement History: replacement of DHTVIEW: Abdomen AP (one view) 1/2/15 at 1704 hrs. Feeding tube terminates at the antral pyloric region. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Feeding tube positioning as described. |
Generate impression based on findings. | 48 years old, Male, Reason: ? AAA, dissection History: chest pain, BLE paresthesias Angiogram: No evidence of dissection, aortic aneurysm, or significant stenosis. The origins of the great vessels from the celiac axis, SMA, renal arteries, and IMA are all patent.CHEST:LUNGS AND PLEURA: No significant abnormality notedM... | No evidence of dissection, aortic aneurysm, or significant stenosis. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Male 15 days old Reason: NG position / Foley position History: psot op bowel resection /ileostomy.VIEW: Abdomen AP (one view) 1/2/15 at 1704 hrs. Feeding tube terminates about GE junction. A urinary bladder catheter is noted. Contrast material in bowel loops is no longer visualized. Disorganized, nonspecific abdominal ... | Misplaced NG tube. |
Generate impression based on findings. | Reason: r/o PE History: SOB, tachycardia PULMONARY ARTERIES: Technically adequate study. No acute pulmonary embolism to the segmental level. The main pulmonary artery is of normal caliber.LUNGS AND PLEURA: Minimal dependent atelectasis.MEDIASTINUM AND HILA: Multiple large thyroid nodules, the largest of which measures ... | 1. No evidence of pulmonary embolism to the segmental level.2. Large heterogeneous anterior mediastinal mass, which extends along the left hilum, is concerning for neoplastic process. Differential diagnosis includes lymphoma, germ cell tumor, and although atypical for patient's age, thymic neoplasm should also be consi... |
Generate impression based on findings. | Female 10 years old Reason: 10 yo F ADHD, speech delay p/w status epilepticus now intubated. Evaluate lung fields and ETT position. History: intubatedVIEW: Chest AP (one view) 1/3/15 at 619 hours. Central line tip is at the RA/SVC junction. ET tube terminates in the thoracic inlet. Proximal side port of NG tube is abov... | Interval retraction of NG tube. |
Generate impression based on findings. | Respiratory distress of the newborn.VIEW: Chest AP (one view) 1/2/15 at 2328 hrs. Tracheostomy tube tip is at the thoracic inlet. NG tube is present. Cardiac silhouette size is top normal. No change in large lung volumes, right lung hyperinflation and left lower lobe atelectasis on a background of diffuse haziness. No ... | Interval retraction of tracheostomy tube.Persistent right lung hyperinflation and left lower lobe atelectasis. |
Generate impression based on findings. | 92 years old, Male, Reason: infection? appy? cancer? History: AMS, diffusely tender abdomen. IV only; Patient is altered and will not be able to drink PO contrast. ABDOMEN:LUNG BASES: Images of the lungs are somewhat degraded by motion. Bibasilar dependent atelectasis.LIVER, BILIARY TRACT: Interval progression of diffu... | 1.Interval progression of diffuse hepatic metastases.2.Left inguinal hernia containing multiple dilated loops of small bowel concerning for partial small bowel obstruction. |
Generate impression based on findings. | 59-year-old male status post reduction A splint now overlies the fifth digit. Interval reduction of the fifth DIP joint, now in near-anatomic alignment. A small osseous fragment adjacent to the ulnar aspect of the head of the fifth phalanx likely represents a small fracture fragment. There is soft tissue swelling about... | Status fifth DIP joint reduction, now in near-anatomic alignment. |
Generate impression based on findings. | Male 7 years old Reason: eval fracture History: prior fractureVIEWS: Left hand AP, lateral and oblique 1/3/15 (3 views) There is a Salter-Harris two fracture of the proximal phalanx of the left fifth finger with medial angulation. | Salter-Harris two fracture of the proximal phalanx of the left fifth finger as described. |
Generate impression based on findings. | Female 14 years old Reason: R/O fracture History: pain along 5th metatarsal and heelVIEWS: Right foot AP, lateral and oblique 1/3/15 (3 views) There is a nondisplaced fracture of the base of the fourth metatarsal. | Nondisplaced fracture of the right fourth metatarsal. |
Generate impression based on findings. | Right frontal approach Rickham catheter has been exchanged for EVD with the tip at the midline at the level of the frontal horns. Right parietal approach ventricular catheter, tip in the body of the right lateral ventricle, unchanged. No change in the orphaned left sided intraventricular catheter.The ventricular syste... | 1.Perhaps a slight decrease in ventriculomegaly.2.No evidence of intracranial abscess or intracranial hemorrhage. |
Generate impression based on findings. | Male 12 years old; Reason: evaluate for fracture or dislocation History: dog bite with lacerations to 3rd and 4th digitVIEWS: Right hand PA/lateral (2 views) 1/2/15 Soft tissue defects are noted at the distal aspects of the middle and ring fingers. No underlying fracture or malalignment is present. No radiopaque foreig... | No fracture or malalignment. |
Generate impression based on findings. | 91 year-old female status post toe amputation, rule out osteomyelitis The bones are diffusely demineralized. Status post amputation of the majority of the third toe except for the base of the proximal phalanx. The distal margins of this osseous fragment are somewhat indistinct, which is nonspecific, but could be postop... | Status post third toe amputation with indistinct margins of the residual base of the proximal phalanx, which may be postoperative in etiology or due to osteomyelitis. If further evaluation is clinically warranted serial imaging should be considered. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial bleed. |
Generate impression based on findings. | 48-year-old female post splint placement Interval splint placement about a comminuted spiral humerus fracture. There is approximately 1.3 cm persistent medial displacement of a medial fracture fragment. | Splinted humerus fracture as detailed above. |
Generate impression based on findings. | HypoxiaVIEW: Chest AP (one view) 1/2/15 2305 Surgical sutures and Penrose drain again noted.Normal cardiac silhouette.Post-surgical changes in the left lung. Small left pleural effusion, similar to prior. Decreased left lower lobe atelectasis. No focal lung opacities or pneumothorax. | Decreased LLL atelectasis. |
Generate impression based on findings. | 48-year-old female, evaluate for fracture Humerus: There is a comminuted spiral fracture of the mid diaphysis of the right humerus with medial angulation of the distal fragment as well as medial displacement of an additional osseous fragment by up to 1.5 cmShoulder: Glenohumeral alignment is within normal limits. No fr... | Comminuted spiral fracture of the humeral diaphysis. |
Generate impression based on findings. | 15 y/o F hx Crohn's with severe draining fistulae c/f abscess History: labial pain and swelling, purulent drainage.EXAMINATION: MRI of the pelvis without and with IV contrast. 1/2/15 1718 UTERUS, ADNEXA: Normal in appearance. BLADDER: Normal in appearance.LYMPH NODES: Enlarged bilateral inguinal lymph nodes.BOWEL, MESE... | Multiple complex fistulous and sinus tracts extending from the posterior wall of the rectum and through the perineum, which are increased in extent compared to the prior examination. Particularly, there is increased extent of edema in the labia major bilaterally with possible fistulous tract in the right labia majora. |
Generate impression based on findings. | Redemonstrated is chronic ischemic injury in the right basal ganglia and medial temporal lobe. There are also scattered foci of hypoattenuation in the periventricular white matter.No evidence of parenchymal edema or loss of gray-white distinction is seen. No intracranial hemorrhage or abnormal extra-axial fluid collec... | 1. No acute intracranial hemorrhage.2. Evidence of extensive prior ischemic injury in the right basal ganglia and medial temporal lobe. |
Generate impression based on findings. | Reason: Eval R lung abscess, necrotizing pneumonia History: Septic, known R lung infiltrate/abscess, s/p L lung transplant and R lung volume reduction and endobronchial valves LUNGS AND PLEURA: Status post left lung transplant. Small interval decrease of left basilar opacity, with residual consolidation/atelectasis and... | 1. Persistent large, loculated collection of fluid and air in the right lung; there has been interval resolution/drainage of the majority of the fluid, which has been replaced with air, with a small residual component of pleural fluid/thickening. The extensive right basilar consolidation/atelectasis is similar to prior... |
Generate impression based on findings. | 37 year-old female in motor vehicle collision Humerus: No fracture of the humerus. Alignment is anatomic. Mild degenerative changes affect the pubic symphysis.Ankle: Minimal soft tissue swelling about the ankle without fracture visualized. Alignment is anatomic.Lumbar spine: Small anterior osteophytes indicate minimal ... | Mild degenerative changes without fracture or malalignment. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial process. If there remains clinical concern for an acute ischemic event and no contraindication to MR, MRI of the brain is recommended. |
Generate impression based on findings. | 66-year-old male status post reduction of clinical anterior shoulder dislocation Minimal osteoarthritis affects the shoulder. The glenohumeral joint is in near-anatomic alignment. No fracture is visualized. | Status post shoulder reduction with no fracture visualized. |
Generate impression based on findings. | 57 years old, Female, Reason: eval progression of RCC History: cough, wheezing CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules bilaterally compatible with metastases. Largest nodule in the left upper lobe measures 1.9 x 1.6 cm (series 5, image 23). There is a bulky confluent mass in the right suprahilar/hi... | 1.Large right perihilar mass encasing vessels and bronchus with endobronchial invasion of the right main stem bronchus. Multiple bilateral pulmonary nodules consistent with metastasis.2.Left periaortic lymph nodes adjacent to the left nephrectomy surgical bed may represent metastasis or local recurrence. |
Generate impression based on findings. | 65-year-old male with history of osteoarthritis, fall on right knee Tricompartmental osteophytes and medial greater than lateral joint space narrowing without fracture visualized. There is a small joint effusion. | Moderate osteoarthritis without fracture. |
Generate impression based on findings. | 57-year-old female with history of lower extremity ulcer There is marked diffuse reticulation of the subcutaneous fat about the leg. Soft tissue ulceration is noted along the lateral aspect of the distal fibula. There is chronic appearing periosteal reaction about the distal fibula without osteolysis, which is new from... | Soft tissue swelling, ulceration, and chronic appearing periosteal reaction about the distal fibula which may represent chronic osteomyelitis, but there is no bone destruction. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas.The ventricles and sulci are prominent compatible with volume loss, not significantly changed. There are no masses, mass effect or midline shift. Again seen is prominent periventricular hypoattenuation and are... | 1.No evidence of acute intracranial hemorrhage.2.No change in the extensive age indeterminant small vessel ischemic disease and encephalomalacia. No definite evidence of acute ischemia. Please note that CT is insensitive for the detection of early nonhemorrhagic stroke. If clinical concern remains high, further evaluat... |
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