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Generate impression based on findings. | 47 year old female with chronic cough, bronchiectasis, pulmonary sarcoid. Evaluate bronchiectasis, signs of aspergillosis LUNGS AND PLEURA: Severe upper lobe predominant traction bronchiectasis and fibrosis with right upper lobe cystic changes not significantly changed. Right upper lobe airspace opacities not significa... | No significant interval change in upper lobe predominant fibrotic changes consistent with known sarcoidosis. No specific evidence of aspergillosis. |
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, within the limitations of only postcontrast imaging. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. The visualized portions... | 1. Interval decreased size of soft tissue mass posterior to and indistinguishable from the right thyroid lobe consistent with patient's primary malignancy with decrease localized mass-effect including upon the esophagus, as well as slightly less caudal extension.2. Decreased right level 6 lymphadenopathy.3. Interval de... |
Generate impression based on findings. | Reason: head and neck cancer, post induction scans History: as above CHEST:LUNGS AND PLEURA: Nonspecific 4-mm left lower lobe pulmonary micronodule, unchanged. Scattered bilateral calcified granulomata. No pleural effusions.MEDIASTINUM AND HILA: Right chest port with catheter tip at the cavoatrial junction. No mediasti... | No evidence of metastases or other significant abnormality. |
Generate impression based on findings. | Locally recurrent HPV (+) right tonsil squamous cell carcinoma on IRB 121554 re-irradiation clinical trial with Abraxane, completed cycle 5 of AFHX on 2/27/15.. Neck: There is no significant interval change in the heterogeneous and ill-defined mass posterior to the angle of the mandible that measures up to approximatel... | 1. Interval decrease in size of the tumor in the right suprahyoid neck. 2. No evidence of intracranial metastatic disease. |
Generate impression based on findings. | Reason: decreased vision, difficulty speaking History: decreased vision, difficulty speaking The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain paren... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | 85 year old female, suspected left hip fracture. Patient states she fell on the stairs onto left hip. Left pain. Two views of the left hip show a comminuted intertrochanteric fracture with mild varus angulation as well as medial displacement of the left trochanter fracture fragment. Mild osteoarthritis affects the righ... | Comminuted intertrochanteric fracture as above. |
Generate impression based on findings. | Reason: h/o HNC and chemo, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: New right middle lobe atelectasis and right lower lobe inter and intra-lobular septal thickening and ground glass opacity may be related to aspiration. Scattered pulmonary micronodules are unchanged. No new or suspicious b... | 1.Interval decrease in circumferential diffuse thickening of the esophagus.2.Enlarged right hilar lymph node, nonspecific.3.Evidence of aspiration the right middle and lower lobes. |
Generate impression based on findings. | 71 years, Female, Reason: surveillance History: breast cancer, metastatic to lung and bone.RADIOPHARMACEUTICAL: 13.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 92 mg/dL. Today's CT portion of the neck grossly demonstrates no significant abnormalities.Today's PET examination demonstrates increased activi... | 1.Markedly hypermetabolic left posterior iliac lesion is significantly increased in activity and of moderate suspicion for osseous metastatic progression. However, given its somewhat atypical appearance on CT, this could also represent progression of a benign etiology.2.Additional hypermetabolic osseous lesions in the ... |
Generate impression based on findings. | Larynx cancer with cough rule out lung lesion. LUNGS AND PLEURA: No pleural fluid or pneumothorax. Motion artifact. Mild centrilobular and paraseptal emphysema. Scattered 2-3 mm micronodules, some of which may reflect intrapulmonary lymph nodes, too small to accurately characterize.A 4-mm nodule in the right middle lob... | No specific evidence of metastatic disease. A 4-mm right middle lobe nodule is indeterminate but more likely to be benign than malignant and additional micronodules are too small to characterize but suggestive of granulomas and intrapulmonary lymph nodes. Three month CT follow-up suggested to confirm stability and excl... |
Generate impression based on findings. | Cervical esophageal cancer s/p induction chemotherapy. There is marked interval decrease in size of the mass involving of the cervical esophagus, which is no longer discretely measurable. There is also considerable interval decrease in size of the lower neck and upper mediastinal lymphadenopathy. For example, a right l... | 1. Marked interval decrease in size of the cervical esophagus squamous cell carcinoma.2. Marked interval decrease in size of the cervical and upper mediastinal lymphadenopathy related to metastatic disease.3. Nonspecific subcentimeter right apical pulmonary nodule. |
Generate impression based on findings. | Rule out bowel obstruction, hernia, gastric pathology or pancreatitis. Epigastric pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy. No evidence of intrahepatic biliary ductal dilatation or enhancing liver masses.SPLEEN: No significant abnormality notedPANCREAS:... | Mild peripancreatic stranding and fluid near the tail suggesting acute pancreatitis; correlate with with lipase and amylase. Status post cholecystectomy. Punctate, nonobstructive left renal calculus. |
Generate impression based on findings. | Male 19 years old Reason: gsw History: gsw Knee: Mottled gas within the soft tissues medial to the distal femoral metaphysis that appears predominantly subcutaneous but we cannot completely exclude deep involvement. We see no fracture or bullet fragments on the knee radiographs.Femur: Two views of the right femur shows... | Gas within the soft tissues medial to the knee with old bullet fragments in the proximal thigh but no new bullet fragments or fracture. |
Generate impression based on findings. | Followup T1N0 squamous cell cancer of the supraglottis status post radiation therapy in August of 2013, without clinical evidence of active disease. He does have a history of GERD-related laryngopharyngitis and has been taking omeprazole. There are post-treatment findings in the supraglottic region, but no evidence of ... | 1. Post-treatment findings in the supraglottic region, but no evidence of local measurable mass lesions or significant cervical lymphadenopathy based on size criteria, although the assessment is limited by the lack of intravenous contrast. 2. Nonspecific left thyroid nodule that measures up to 12 mm. A thyroid ultrasou... |
Generate impression based on findings. | 46 years, Female, Reason: secondary hyperparathyroidism, would like to evaluate for abnormal parathyroids. Examination is limited by patient body habitus, patient motion, and her inability complete the delayed imaging. No abnormal parathyroid tissue is identified, however. | Significantly limited exam but without abnormal parathyroid tissue identified. |
Generate impression based on findings. | Head CT: There is no evidence of acute intracranial hemorrhage or mass. There is mild cerebral white matter hypoattenuation. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is mucosal thickening in the maxillary sinuses bilaterally. The mastoid air cells are clear. H... | 1.No evidence of acute intracranial hemorrhage or mass.2.No evidence of vertebrobasilar system dissection.3.Nonspecific mild cerebral white matter hypoattenuation may represent small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | Reason: evaluate for vessel stenosis History: L sided weakness Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. The patient is assess aneurysm clip placement along the right mid M1 segment and then ... | 1.Findings suggest small foci of infarction in the right frontal lobe and right parietal lobe associated with some mild delay in perfusion to these specific areas in the right frontal and temporal lobes. The rest of the right MCA territory does not demonstrated any convincing delay in perfusion.2.CT angiogram in the re... |
Generate impression based on findings. | Female 42 years old Reason: Wrist trauma, pain History: Wrist trauma, pain We see no fracture, malalignment or other findings to account for patient's pain. | No fracture, malalignment or other findings to account for patient's pain. |
Generate impression based on findings. | 51-year-old female with a history of right breast biopsy demonstrating atypical ductal hyperplasia. No family history of breast cancer. 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 ... | 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. | The ventricles and sulci are prominent, consistent with moderate age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consis... | 1. No acute infarct. Mild-moderate chronic small vessel ischemic changes.2. Unremarkable noncontrast MR appearance of the orbits. |
Generate impression based on findings. | Reason: R distal 1/3 clavicle fracture VIEWS: AC joints without and with weights (2 views) 4/17/15 15:46 Redemonstration of fracture of the distal right clavicle. Widening of right acromioclavicular joint space measuring 24-mm without weights and 28mm with weights. Left acromioclavicular joint space remains normal at 4... | Right acromioclavicular joint separation. |
Generate impression based on findings. | 47 year old woman with HIV, cocaine use, chest pain, and transient t-wave abnormalities on ekg. She is referred to rule out significant CAD.CPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circu... | 1. There are no significant coronary artery stenoses present. 2. Mild circumferential left ventricular hypertrophy. 3. Small patent foramen ovale is noted.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attend... |
Generate impression based on findings. | 52 years, Female, Reason: breast cancer on letrozole with left hip pain History: met breast cancer on letrozole.RADIOPHARMACEUTICAL: 13.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 98 mg/dL. Today's CT portion grossly demonstrates a port catheter with tip in SVC. Sclerotic lesion within the left aspect ... | No FDG avid tumor currently. |
Generate impression based on findings. | PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postcontrast appearance of the salivary glands is unremarkable. The thyroid gland is unremarkable. ORAL ... | Unremarkable CT of the neck. Normal sized left level 5 lymph node corresponding to palpable area of concern. |
Generate impression based on findings. | Female 45 years old Reason: evaluate for arthritis History: joint pain Sacroiliac joints: The sacroiliac joints appear normal. Hypertrophy of the right L5 transverse process which articulates with the sacrum.Right knee: Mild/moderate osteoarthritis particularly affecting the patellofemoral joint. No joint effusion.Left... | Arthritic changes as described above which appear predominantly degenerative in etiology. |
Generate impression based on findings. | Male 80 years old Reason: R index finger inflamed. Look for any joint erosions or crystal deposits. History: above There is swelling of the soft tissues of the index finger particularly distally. There is a small erosion along the radial aspect of the head/neck of the middle phalanx of the index finger. This is nonspec... | Soft tissue swelling of the index finger with a small middle phalanx erosion that is nonspecific but could represent gout. The possibility of infection is considered less likely unless there is an overlying skin defect. |
Generate impression based on findings. | 49 year-old male. Status post left knee bicompartmental arthroplasty. Two views of the left knee show hardware components of a patellofemoral and medial bicompartmental arthroplasty device situated in near anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and gas density ... | Post-operative changes of a bicompartmental arthroplasty, as described above. |
Generate impression based on findings. | Female 27 years old Reason: eval left groin node History: left groin palpable lymph node, family h/o lymphoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Small accessory splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significan... | Essentially normal CT of the abdomen and pelvis without lymphadenopathy. |
Generate impression based on findings. | Reason: evaluate for free air. History: abdominal distention, feeding intoleranceVIEW: Abdomen lateral cross table (one view) 4/17/15 16:30 No free air is noted. Disorganized nonobstructive bowel gas pattern. NG tube tip in the stomach. | No free air. |
Generate impression based on findings. | Female, 36 years old, status post trauma to the head and face. Assess for bleeding or fracture. 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 ... | 1. No acute intracranial abnormality.2. No facial bone fracture is seen. At most, there may be mild soft tissue injury of the left cheek. |
Generate impression based on findings. | NSCLC s/p RT. Questionable palpable lymph node, non-tender along right neck near prominent vessels. There is asymmetric prominence of the right inferior internal jugular vein, which can represent a normal variant. There is no evidence of mass lesions or significant lymphadenopathy in the neck. The thyroid and major sal... | 1. Asymmetric prominence of the right inferior internal jugular vein, which can represent a normal variant, but no evidence of mass lesions or significant lymphadenopathy in the neck.2. Nonspecific scattered foci opacities in the partially-imaged lungs. Please refer to the separate chest CT report for additional detail... |
Generate impression based on findings. | 58 years, Male, Reason: Pt is a 58 yo male w/ hx of MCL; pre-auto sct evaluation History: evaluate.RADIOPHARMACEUTICAL: 14.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 114 mg/dL. Today's CT portion grossly demonstrates a left shoulder arthroplasty. Right port catheter tip terminates in the right atrium.... | 1.Hypermetabolic right basilar opacities and perianal activity are present but most likely infectious/inflammatory.2.Otherwise no suspicious FDG avid lesions to suggest tumor activity currently. |
Generate impression based on findings. | 68 year old female with history of ESRD on HD, severe AS, COPD and dementia with recent history VT/VF arrest in setting of critical AS, referred for CT for workup for valve replacement. CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic... | 1. Ascending aorta anatomy as above. 2. Moderate calcification of trileaflet aortic valve 3. Moderate left ventricular hypertrophy with a sigmoid septum of moderate severity. 4. Significant biatrial dilation. 5. Moderate multi-vessel coronary calcification.This portion of the report pertains to the heart and great vess... |
Generate impression based on findings. | 92-year-old male. Foot pain, swelling, ulcer on 2nd toe. Three views of the left foot show that the bones are demineralized but we see no focal osteolysis to suggest osteomyelitis. Mild degenerative arthritic changes affect the foot. A plate and screw device affixes the distal fibula. Mild diffuse soft tissue swelling,... | Soft tissue swelling and other findings as above without radiographic evidence of osteomyelitis. |
Generate impression based on findings. | 54 year old female. Pain. Evaluate for fracture. Evaluation of the forearm is slightly limited due to inability to optimally position the patient. Given this limitation, we see no fracture. A small density overlying the anterior aspect of the elbow joint may represent an osteophyte but we cannot entirely exclude the po... | No fracture is evident. Other findings as above. |
Generate impression based on findings. | 31-year-old male. Pain, swelling over bone. Evaluate for stress fracture of the second and third metatarsal bones. We see no stress fracture or other specific findings to account for the patient's pain. | No stress fracture is evident. If further imaging is clinically warranted, repeat radiographs may be obtained in 10 to 14 days; alternatively, MRI may be considered. |
Generate impression based on findings. | Facial swelling/nasal deformity after walking into pole. There appears to be mild subcutaneous stranding and swelling along the right nasal ala. There is an incidental anomalous vascular channel through the left nasal bone. However, there is no evidence of nasal skeleton fracture or other maxillofacial fractures. There... | Right nasal contusion and mild nasal septal deviation, but no evidence of maxillofacial fracture. |
Generate impression based on findings. | Intra-op imaging CDOR #23. There is a stereotactic frame in position without associated complications. Beam hardening artifact otherwise limits detailed assessment of the intracranial structures. | Intraoperative CT with stereotactic frame. |
Generate impression based on findings. | Neutropenic stem cell transplant patient with + cornovirus, rhinorrhea, cough, congestion. There are postoperative findings related to bilateral uncinectomy. There is moderate mucosal thickening in the maxillary and ethmoid sinuses. There is also mild mucosal thickening in the right sphenoid sinus, The other paranasal ... | Postoperative findings related to bilateral uncinectomy with inflammatory changes in portions of the paranasal sinuses. |
Generate impression based on findings. | Recent travel to Mexico, chest pain, elevated d-dimer. PULMONARY ARTERIES: Technically adequate contrast opacification; no pulmonary embolus is identified. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: No pleural fluid or pneumothorax. Within the ED medial aspect of the anterior segment of the right ... | No evidence of pulmonary embolus. 2.1-cm anterior right upper lobe nodule with associated ipsilateral hilar, mediastinal and intrapulmonary lymphadenopathy. Signs of lymphatic congestion or obstruction are also present in this segment. Given the recent travel history, infection such as a mycosis endemic to Mexico (Cocc... |
Generate impression based on findings. | 59 year old female with shortness of breath, evaluate for pulmonary embolism PULMONARY ARTERIES: No evidence of pulmonary embolism. Pulmonary artery caliber within normal limits. No evidence of right heart strain.LUNGS AND PLEURA: Punctate calcified nodule in the right upper lobe compatible with prior granulomatous dis... | No evidence of pulmonary embolism. No findings to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 50 year-old female with history of right empyema status post decortication with tachypnea, tachycardia, hypercarbia and right lower lobe changes. Evaluate for pulmonary embolism and other pulmonary pathology. PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limit... | 1. No evidence of pulmonary embolism. 2. Aspiration bronchiolitis with pneumonitis and bronchopneumonia. Additionally there is focal cavitary lesion in the left lower lobe periphery which is suspicious for a small abscess. A cavitary septic or thrombotic embolus is considered less likely cannot be ruled out. 3. Signs o... |
Generate impression based on findings. | Female 57 years old. Reason: right hand synovitis, arthritis History: see above Three views of the right hand are provided. No significant soft tissue swelling. No acute fracture or malalignment. | Unremarkable study of the right hand. |
Generate impression based on findings. | Female 16 years old Reason: r/o fracture History: pain at 3rd, 4th and 5th phalanxVIEWS: Left foot and ankle AP, lateral and oblique 4/17/15 (6 views) Fusion of the distal and mid phalanx of the third fourth and fifth toe with no fracture, malalignment or soft tissue | Phalangeal fusion (normal variant) as described. |
Generate impression based on findings. | Female 84 years old. Reason: fracture vs OA History: fall Four nonweightbearing views of the left knee are provided. There is no joint effusion, fracture or malalignment. There is bone on bone apposition of the medial compartment with tricompartmental osteophytes indicating severe osteoarthritis.A single view of the pe... | Severe osteoarthritis of the left knee. |
Generate impression based on findings. | Female 16 years old Reason: r/o fracture History: wrist pain and h/o fallVIEWS: Left wrist AP, lateral and oblique and 4/17/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 14 years old Reason: humeral fx History: humeral fxVIEWS: Left shoulder AP in internal and external rotation. Left humerus AP and lateral and left elbow AP and lateral 4/17/15 (5 views) Cast material obscures fine bone detail. There is a pathological fracture through a bone cyst of the proximal diaphysis of the le... | Pathologic fracture of the left humerus as described. |
Generate impression based on findings. | Reason: L sided rib fracture, eval splenic laceration History: L flank and abdominal pain ABDOMEN:LUNG BASES: Basilar ground-glass opacities, which likely represent atelectasis, left greater than right. Small left pleural effusion.LIVER, BILIARY TRACT: Status post cholecystectomy. No suspicious hepatic masses.SPLEEN: N... | 1.Minimally displaced left seventh, eighth, and ninth rib fractures.2.No evidence of splenic laceration, as clinically queried.3.Indeterminant left adrenal nodule, for which dedicated adrenal CT may be obtained. |
Generate impression based on findings. | Male 6 years old Reason: R wrist deformity History: R wrist deformityVIEWS: Right forearm AP and lateral right wrist AP, lateral and oblique 4/17/15 (5 views) Salter-Harris two fracture of the distal right radius with minimal dorsal displacement. | Distal Salter-Harris two fracture of the right radius as described. |
Generate impression based on findings. | Male 62 years old. Reason: back pain, radiculopathy. Eval for effusion, subcutaneous air. History: fever, hx of hiv, severe l knee pain. History: as above Four views of the lumbar spine are provided. There is lumbar spine scoliosis with convexity to the left. Severe degenerative disk disease affects the lower lumbar sp... | 1. Moderate joint effusion of the left knee without evidence of acute fracture.2. Severe degenerative disk disease of the lower lumbar spine. |
Generate impression based on findings. | Male 3 days old Reason: Bloody stools, is there pneumatosis History: previous film concerning for pneumatosisVIEW: Abdomen AP (one view) 4/18/15 at 419 hours. NG tube terminates in the stomach. Disorganized, almost gasless and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestin... | Disorganized, almost gasless and nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 3 days old Reason: evaluate for pneumatosis, free air, portal venous gas History: 34 wk infant with bloody stool, abnormal xray, concern for NECVIEW: Abdomen crosstable lateral (one view) 4/17/15 at 1935 hrs. NG tube terminates in the stomach. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruc... | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 3 days old Reason: evaluate ABD gas pattern and dilation, evidence of pneumatosis History: 34 wk infant now DOL 1 with bloody stoolVIEW: Abdomen AP (one view) 4/17/15 at 1847 hrs. NG tube terminates in the stomach. Disorganized, slightly distended abdominal gas pattern with no evidence of obstruction or free air. ... | Findings concerning for pneumatosis intestinalis with no evidence of free air or obstruction. |
Generate impression based on findings. | Female 2 years old Reason: r/o fracture History: refuses to bear weight after being fallen on by large child on skatesVIEWS: Right tibia-fibula AP and lateral 4/1715 (two views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 14 years old Reason: Assess for C spine fracture History: peds vs autoVIEWS: Cervical spine AP and lateral 4/18/15 at 0 54 hours. (Two views) Mild adenoid hypertrophy , question of pharyngeal radiopaque debris. Vertebral body heights and disk spaces are maintained. Straightening of the cervical lordosis is likely ... | Pharyngeal debris and adenoid hypertrophy, as described with no evidence of fracture or malalignment. |
Generate impression based on findings. | 15-year-old female patient with chest pain status post fall. Evaluate for fracture.VIEWS: Chest PA/lateral (two views) 4/17/2015 The cardiac silhouette size is normal. No focal lung opacity, pleural effusion, or pneumothorax is identified. No rib fracture is seen. | No fracture is evident. |
Generate impression based on findings. | Male 14 years old Reason: please eval for renal injury - IV contrast only History: hematuria s/p trauma ABDOMEN:LUNG BASES: No focal lung opacities, effusions or pneumothorax. No pericardial effusion.LIVER, BILIARY TRACT: No evidence of liver laceration. No intra-or extrahepatic biliary duct dilatation.SPLEEN: No evide... | No evidence of acute injury. |
Generate impression based on findings. | 15-year-old female with pain status post fall. Evaluate for fracture.VIEWS: Pelvis AP and frog leg lateral (two views) 4/17/2015 No acute fracture or malalignment is evident. Stool is noted within the colon. | No acute fracture is evident. |
Generate impression based on findings. | Female 33 years old. Reason: Foreign body removed? History: laceration Three views of the right hand are provided. Again seen is soft tissue swelling and foci of gas density within soft tissues along the ulnar aspect of the MCP joint of the first proximal phalanx. There is no definitive evidence of foreign body. | Soft tissue swelling without definite evidence of a foreign body. |
Generate impression based on findings. | Fall. Dysequilibrium. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is marked atherosclerotic calcification of the intracranial arterial vasculature. There is mild non-specific hypoattenuation in the periventricular white matter, compatible ag... | No evidence of acute intracranial hemorrhage or skull fracture. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 13-year-old female with pain after fall. Question of fracture. VIEWS: Right clavicle AP and axial (two views), right shoulder internal and external rotation (two views) 4/18/2015 There is an oblique fracture of the distal to middle third of the clavicle with approximately two and a half shaft widths of inferior displac... | Clavicle fracture. |
Generate impression based on findings. | Male 14 years old Reason: trauma with localized pain, r/o fx History: painVIEWS: Right wrist AP and lateral left shoulder AP in internal and external rotation. 4/17/15 (4 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 18 year-old male patient with sickle cell disease, right forearm swelling. Evaluate for osteomyelitis/infection or bony lesion.VIEWS: Right forearm AP and lateral (two views) 4/18/2015 No acute fracture or malalignment is evident. There no specific radiographic evidence of osteomyelitis. No soft tissue swelling is seen... | No acute fracture is evident. |
Generate impression based on findings. | Female 33 years old Reason: Foreign body. History: laceration with glass Three views of the right hand are provided. There is soft tissue swelling and foci of gas density within the soft tissues along the ulnar aspect of the MCP joint of the first proximal phalanx. There is no definitive evidence of foreign body. There... | Soft tissue swelling without definite evidence of a foreign body. |
Generate impression based on findings. | Trauma.VIEWS: Chest AP (one view), and pelvis AP (one view), 4/17/15, 2034 hrs. The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. The femoral heads are directed into the acetabula. No pelvic fracture is seen. | Normal chest, and pelvis. |
Generate impression based on findings. | Male 51 years old. Reason: line placement? History: abnormal CXR. Two views of the skull are provided. There is no evidence of fracture. The right venous catheter has migrated with tip now in the internal jugular vein at the level of the C2 vertebral body. | Venous catheter as described above. |
Generate impression based on findings. | Female 10 years old Reason: post reduction History: Status post left radius fracture.VIEWS: Left wrist AP and lateral 4/17/15 (two views) Cast material obscures fine bone detail. Transverse fracture of the distal diaphysis of the distal radius is in near anatomic alignment. | Status post reduction and casting of transverse fracture of the distal radius as described. |
Generate impression based on findings. | 10 week old female patient with trauma.VIEW: Chest and abdomen AP (two views) 4/18/2015 The aortic arch, cardiac apex, and stomach are on the left. The cardiothymic silhouette is upper limits of normal. No focal lung opacity, pleural effusion, or pneumothorax is identified. No displaced rib fracture is seen.The stomach... | No fracture is evident. |
Generate impression based on findings. | Fall 2 days ago. Unsteady gait since fall. There are right frontal and right occipital scalp contusions, without skull fracture. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles and basal cisterns are prominent but unchanged, compa... | Scalp contusions without skull fracture or acute intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 10 years old Reason: eval for fracture History: pain, fallVIEWS: Left wrist AP, lateral and oblique. Left forearm AP and lateral and left elbow AP, lateral and oblique 4/17/15 (8 views) There is a transverse fracture of the distal diaphysis of the left radius with dorsal and lateral angulation. Normal left elbow... | Distal radius fracture as described. |
Generate impression based on findings. | Reason: s/p recent skin flap surgery involving groin, hx cholecystectomy History: RUQ pain, no BM/flatus ABDOMEN:LUNG BASES: Basilar atelectasis. Severe coronary artery calcifications and calcified hilar lymph nodes are partially visualized. LIVER, BILIARY TRACT: Status post cholecystectomy. Hypoattenuation of the hepa... | 1.Dilatation of the proximal small bowel, with relative caliber change in the anterior right lower quadrant, which is suggestive of partial small bowel obstruction. This may be secondary to adhesive disease. No gross bowel wall abnormality or mass.2.Air and fluid collection in the right groin raises suspicion for absce... |
Generate impression based on findings. | 10 week old female patient with trauma.VIEWS: Cervical spine AP and lateral (two views) 4/18/2015 No acute fracture is identified. No prevertebral soft tissue swelling. Reversal of the normal cervical lordosis may be due to muscle spasm or positioning from c-collar. | No fracture is evident. |
Generate impression based on findings. | Female 11 years old Reason: possible R acetabular fx History: possible R acetabular fxVIEWS: Pelvis in right and left obliques. 4/17/15 (two views) There is no evidence of fracture, malalignment or soft tissue swelling. | No evidence of fracture. |
Generate impression based on findings. | Status post trauma.VIEWS: Left clavicle AP and axial 4/17/15 at 2121 hrs. (Tube views) Transverse fracture of the mid left clavicle with inferior angulation is again identified. | Left clavicle fracture as described. |
Generate impression based on findings. | History of right temporal cavernous malformation status post resection with increasing seizure. Evaluate for mass lesion. There are postoperative findings related to a right temporal craniotomy. There is a mildly hyperattenuating ovoid area that measures up to 15 mm with surrounding hypoattenuation in the right inferio... | Postoperative findings related to right temporal craniotomy with what may represent a mass lesion, such as recurrent cavernous malformation, versus a late subacute hematoma that measures up to 15 mm with surrounding edema in the medial right temporal lobe. Further evaluation via CT or MRI with contrast would be useful.... |
Generate impression based on findings. | 64 year-old female with loculated perihepatic fluid collection, fever, IR placed drain 4/16. Evaluate proper placement of perihepatic drain, right lower lobe opacity. CHEST:LUNGS AND PLEURA: Right lower lobe 7 mm nodule (series 4, image 35) unchanged. No new suspicious nodules or masses. Loculated right pleural effusio... | 1. Loculated right pleural effusion with areas of pleural enhancement suspicious for a developing pleural space infection/empyema. Please note that the volume of fluid is too small for percutaneous drain placement and it does not appear that the cranial aspect of this abnormally enhancing portion of the pleura has wall... |
Generate impression based on findings. | Altered mental status. Evaluate for cerebrovascular accident. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are unchanged in size and configuration. There are scattered punctate foci of hypoattenuation in the periventricular and subcortical white matter, which a... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Non-specific scattered punctate foci of white matter hypoattenuation, which likely represent mild small vessel ischemic changes. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical c... |
Generate impression based on findings. | Five day old female patient with gastroschisis and line placement.VIEW: Chest AP (one view) 4/17/2015 Right internal jugular central venous catheter tip is at the superior atriocaval junction. Enteric tube tip is in the stomach. ET tube is at the thoracic inlet. The cardiothymic silhouette size is normal. There is patc... | Left upper lobe atelectasis. |
Generate impression based on findings. | Reason: eval abdominal pain, decrease hgb, possible gi bleed History: see above ABDOMEN:LUNG BASES: Bibasilar atelectasis/scarring and trace bilateral pleural effusions. Moderate coronary artery calcifications.LIVER, BILIARY TRACT: Status post cholecystectomy. The hepatic parenchyma is unremarkable.SPLEEN: Subcentimete... | 1.No evidence of GI bleed.2.Findings reflective of recent gastrostomy tube insertion, including soft tissue inflammation around the catheter, and air within the anterior abdominal wall.3.Induration of the posterior soft tissues overlying the lumbar spine may represent post surgical scarring; please correlate for eviden... |
Generate impression based on findings. | Female 42 days old Reason: Ex 27weeker now for 5 weeks with concern for NEC History: abdominal distentionVIEW: Abdomen AP (one view) 4/18/15 at 337 hours. NG tube terminates in the stomach. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous g... | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Female 42 days old Reason: ex 27 week now 5 weeks old with concern for NEC History: abdominal distentionVIEW: Abdomen AP (one view) 4/18/15 at 340 hours. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. NG tube terminates in the stomac... | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | 75 year old male for Dobbhoff tube placement. August pattern is within normal limits. Dobbhoff tube tip in the region of the gastric fundus -- body. Bony structures are intact. | Dobbhoff tube tip in region of gastric fundus -- body |
Generate impression based on findings. | 62 year-old female for OG tube placement. Extensive fecal material throughout nondistended colon. No gross small bowel dilatation. NG tube tip in the region of the gastric antrum. Bony structures are intact. NG tube | OG tube Tip in the antrum. |
Generate impression based on findings. | Infant dropped by grandparent about 2-3 feet on hard floor. Evaluate for intracranial hemorrhage or fracture. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid a... | Overriding of the bilateral lambdoid sutures, which can be positional, associated with dehydration, or related to trauma, Otherwise, no evidence of acute intracranial hemorrhage, mass effect, or calvarial fracture. |
Generate impression based on findings. | 70 year-old female for Dobbhoff tube placement. Visualized osseous pattern within normal limits. Dobbhoff tube tip in the region of the gastric antrum/duodenal bulb. Bony structures are intact. Bilateral pleural effusions with atelectasis noted. Tip right-sided venous catheter in the superior vena cava. | Dobbhoff tube tip in the region of the gastric antrum/duodenal bulb |
Generate impression based on findings. | Trauma. Evaluate for intracranial hemorrhage. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is opacification of the right mastoid and partial opacification of the right middle e... | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. No evidence of skull fracture.3. Opacification of the right mastoid and partial opacification of the right middle ear, which may represent otomastoiditis. |
Generate impression based on findings. | Female 18 days old Reason: Ex 27 weeker with hx PTX now s/p chest tube removal on 4/17 History: respiratory distressVIEW: Chest AP (one view) 4/18/15 at 417 hours. ET tube terminates below thoracic inlet. UVC tip is at the right atrium. Interval removal of right-sided chest tube and UAC. NG tube terminates at the stoma... | Multifocal opacities as described with overall improvement in lung aeration.Interval removal of UAC and right-sided chest tube area |
Generate impression based on findings. | 71-year-old male for evaluation of Dobbhoff tube placement. Dobbhoff tube tip at the level of the distal antrum angled study retrograde. No obvious bowel abnormality although only the extreme upper abdomen included on the image. The bony structures are intact. Tip right-sided SGC is in the region of the main pulmonary ... | Dobbhoff tube tip in the gastric antrum. See above. |
Generate impression based on findings. | Reason: intrabd infection History: skin changes and fever at surgical site with purulent drainage to jp ABDOMEN:LUNG BASES: Trace basilar dependent atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy. The hepatic parenchyma is unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnor... | 1.Anterior lower abdominal wall postsurgical changes, with findings compatible with abscess formation, and extensive adjacent soft tissue inflammation surrounding the surgical drain.2.Right inguinal lymphadenopathy. |
Generate impression based on findings. | History of concussion with worsening headache and new emesis. Evaluate for intracranial bleed. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a small mucus retention cyst in r... | No evidence of acute intracranial hemorrhage or mass effect. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 52-year-old female with gastroparesis and abdominal pain. Bowel gas pattern is nonspecific with moderate gas in nondistended small and large bowel. Gastrojejunal tube similar to prior exam. Clips overlie the upper abdomen. Bony structures are intact. Phleboliths in pelvis. | No evidence of bowel obstruction. |
Generate impression based on findings. | 44-year-old male with left upper and left lower quadrant pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: Mild atelectasis or scarring at the lung bases.LIVER, BILIARY TRACT: Small, non-specific low attenuation foci within the left lobe of the liver are too small to characterize.SPLEEN: No significant abnormality... | Findings above acute diverticulitis involving the descending colon without perforation or abscess. |
Generate impression based on findings. | 59 year old female with shortness of breath, evaluate for pulmonary embolism PULMONARY ARTERIES: No evidence of pulmonary embolism. Pulmonary artery caliber within normal limits. No evidence of right heart strain.LUNGS AND PLEURA: Punctate calcified nodule in the right upper lobe compatible with prior granulomatous dis... | No evidence of pulmonary embolism. No findings to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 66 years old. Reason: stiffness, intermittent pain in R knee, evaluate for structural abnormality. History: stiffness, intermittent pain in R knee, evaluate for structural abnormality Four non-weightbearing views of the right knee are provided. There is no joint effusion, fracture, or dislocation. The knee is un... | Unremarkable study of the right knee. |
Generate impression based on findings. | Trending mental status changes. History of metastatic small cell lung cancer. The multiple bilateral subcortical masses with extensive surrounding vasogenic edema are unchanged with 3 mm of rightward midline shift. There is no evidence of herniation otherwise. There is partial effacement of the 4th ventricle is unchang... | Unchanged appearance of the multiple bilateral masses compatible with metastatic disease associated with extensive associated vasogenic edema and mild rightward midline shift. Some of the lesions appear to contain hemorrhagic components. A brain MRI with contrast would be useful for further characterization.I personall... |
Generate impression based on findings. | 20 year-old female with right lower quadrant pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Focal fatty deposition at the level of the ligamentum.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, UR... | No bowel abnormality identified.If gynecologic pathology is suspected would recommend pelvic ultrasound. |
Generate impression based on findings. | Altered mental status. There is no evidence of acute intracranial hemorrhage or mass. There is unchanged diffuse cerebral white matter hypoattenuation. There are also more discrete foci of hypoattenuation in the left thalamus and right basal ganglia. The ventricles are unchanged in size and configuration, being mildly ... | 1. No evidence of acute intracranial hemorrhage.2. FIndings suggestive of chronic small vessel ischemic disease and lacunar infarction. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | Reason: 50 yr old female with stage IIIC ovarian cancer, s/p TAH/BSO and multiple chemotherapy cycles. Currently s/p 9 cycles Olaparib vs placebo (GOG 3004) protocol. Please assess current disease status and compare with 8/2/14 baseline scan. History: fatigue and weakness CHEST:LUNGS AND PLEURA: A 3-mm nodule at the ri... | Stable examination as above. No new sites of neoplastic disease. |
Generate impression based on findings. | Per EPIC, history of HTN, sickle cell trait, schizophrenia who initially presented to an OSH on 4/8/2015 for hypertensive urgency with associated slurred speech and also found to be in new-onset atrial fibrillation, and decompensated CHF and COPD. On 4/11, she acutely became lethargic and not moving her left arm and an... | 1. Interval development of an acute left middle cerebral artery territory infarct.2. Persistent gyriform hyperattenuation involving the posterior right frontal lobe with associated hyperattenuation of the underlying white matter likely represent hemorrhagic transformation of a recent infarct superimposed upon a backgro... |
Generate impression based on findings. | 69-year-old female with newly diagnosed endometrial cancer. Evaluate for for extent of disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Calcification in non--- enlarged hilar lymph nodesCORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER,... | Endometrial mass consistent with patient's diagnosis of endometrial carcinoma. Uterine fibroid.Retroperitoneal and pelvic adenopathy.Free fluid in pelvis. |
Generate impression based on findings. | 66-year-old female, evaluate lung fields on CT abdomen/pelvis, r/o septic emboli (prior VRE bacteremia). LUNGS AND PLEURA: Multifocal patchy areas of atelectasis bilaterally, most prominent in the superior segment of the right lower lobe (series 5, image 47) which are most suggestive of sequelae of a subacute infection... | 1. Multifocal patchy areas of atelectasis bilaterally; the appearance is most suggestive of sequela of subacute or treated infection over leukemic infiltration. Although treated septic emboli could have this appearance, the lack of any nodular or cavitary lesions would be highly atypical for an acute process.2. Ectatic... |
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