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Generate impression based on findings. | Female 54 years old. Right and left thumb unable to flex and extend. Evaluate for bony pathology. Three views of the right thumb are provided. There is no fracture malalignment. There are no significant degenerative arthritic changes.Three views of the left thumb are provided. There is no fracture or malalignment. Ther... | Unremarkable study of the bilateral thumbs. |
Generate impression based on findings. | Altered mental status. History of metastatic small cell lung cancer. Multiple bilateral subcortical masses are identified, particularly in the left frontal lobe, left occipital lobe, right temporal lobe, and left cerebellar hemisphere. Many of the lesions appear to contain hemorrhagic components. There is extensive sur... | Multiple bilateral masses compatible with metastatic disease associated with extensive associated vasogenic edema and mild rightward midline shift. Many of the lesions appear to contain hemorrhagic components. A brain MRI with contrast would be useful for further characterization. |
Generate impression based on findings. | Reason: h/o untreated leiomyosarcoma, last CT 10/2014 History: as above CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: The heart size is within normal limits, no significant pericardial effusion. Multiple anterior mediastinal lymph nodes in the prevascular space, which are abnormal in mu... | 1.Significant interval enlargement of the heterogeneous, partially necrotic, multilobulated pelvic mass, consistent with recurrent tumor.2.Enlarging mass at the level of the cervical cuff.3.Interval enlargement of bilateral adnexal lesions.4.Anterior mediastinal lymphadenopathy, which is stable when compared to previou... |
Generate impression based on findings. | Abdominal distention. VIEW: Abdomen AP (one view) 4/18/15 408 hs. NG tip at the stomach. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | 7 day old male patient with retractions and abdominal distension/slight discoloration. Question of atelectasis or abnormality.VIEW: Chest and abdomen AP (two views) 4/18/2015 Enteric tube tip is in the stomach with sideport at the GE junction. Right upper extremity PICC tip is in the SVC. UVC has been removed.The cardi... | Resolution of pneumomediastinum. |
Generate impression based on findings. | Altered mental status and history of stroke. There is interval decrease in the size and attenuation of left frontal lobe hematoma as well as diminished edema with decreased effacement of the left lateral ventricle. There is no evidence of acute intracranial hemorrhage. There is an unchanged right parietal convexity cal... | 1. Interval evolution of the left frontal lobe hematoma and associated edema without evidence of acute intracranial hemorrhage.2. An unchanged right parietal convexity calcified extra-axial lesion that measures up to 7 mm in width likely represents a meningioma. 3. Findings suggestive of acute sinusitis versus sequela ... |
Generate impression based on findings. | 36 year old male with asthma, heavy tobacco/MJ smoker, fever, cough, admitted with multifocal pneumonia, question inhalation injury or chest x-ray. HIV negative. Per chart, positive Streptococcus pneumonia on sputum cultures. LUNGS AND PLEURA: Large geographic areas of groundglass and sub-solid air space opacity and co... | 1. Extensive pulmonary opacities containing pneumatoceles most consistent with necrotizing infection. Although the radiographic appearance is consistent with pneumocystis pneumonia, in the setting of a known positive Streptococcus pneumonia and sputum culture, this most likely represents multifocal pneumococcal pneumon... |
Generate impression based on findings. | The image quality is significantly degraded by motion artifact. There is now faint hypoattenuation in the left middle cerebral artery territory without hemorrhagic transformation. Redemonstrated is gyriform hyperattenuation centered in the posterior right middle frontal gyrus with associated hypoattenuation of the und... | 1. Large acute left middle cerebral artery territory infarct, but no hemorrhagic transformation or midline shift. However, the cerebrovascular system could not be evaluated further due to the lack of intravascular contrast from the minor contrast extravasation. 2. Evolution of the recent left middle cerebral artery ter... |
Generate impression based on findings. | Confusion. Possible stroke. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is a small amount of fluid in the maxillary sinuses. The mastoid air ... | No evidence of acute intracranial hemorrhage. 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. | 56-year-old female with metastatic breast cancer receiving chemotherapy. Evaluate response to treatment. CHEST:LUNGS AND PLEURA: There is progressive thickening of the pleura involving the left anterolateral chest when compared to prior exam. Please correlate with history of radiation therapy. No discrete parenchymal n... | Diffuse bony metastatic disease grossly stable.No significant change in visualized peritoneal disease although slight increase in abdominal fluid.Progressive hydronephrosisRight pelvic mass is difficult to visualize on today's exam, but likely stable.Increasing pleural thickening left hemithorax. |
Generate impression based on findings. | Neutropenic fever in stem cell transplant patient, bilateral frontal sinuses tender on exam. The left frontal sinus is hypoplastic and clear. The right frontal sinus is not pneumatized. There is unchanged scattered trace mucosal thickening in the ethmoid air cells and mucosal thickening in the left maxillary sinus. The... | The left frontal sinus is hypoplastic and clear. The right frontal sinus is not pneumatized. Unchanged scattered trace mucosal thickening in the ethmoid air cells and mucosal thickening in the left maxillary sinus. |
Generate impression based on findings. | 67 year old male with lung mass, lung cancer. CHEST:LUNGS AND PLEURA: Right middle lobe mass measuring 5.8 cm x 4.7 cm (series 6, image 61) previously 5.3 cm x 4.3 cm. The mass directly invades the right lower lobe through the major fissure and abuts both the major and minor fissures. Scattered nonspecific micronodules... | 1. No significant change in size of the right middle lobe mass with direct invasion of the right lower lobe through the major fissure and abutting the minor and major fissure again seen. Slight interval increase in right axillary, right subpectoral and right hilar lymph nodes. 2. Diffuse sclerosis and cortical thickeni... |
Generate impression based on findings. | CT Head: There are postoperative changes related to right-sided craniotomy with aneurysm clip placement in the anterior communicating artery region and the distal right internal carotid artery region. Streak artifact from the aneurysm clips somewhat limited evaluation of the area. There is no evidence of acute intracr... | 1. Postoperative changes related to right-sided craniotomy with aneurysm clip placement, which produces streak artifact somewhat limiting evaluation, but no additional aneurysms are identified within this limitation. 2. No discernible evidence for acute intracranial hemorrhage or mass effect. 3. Unchanged appearance of... |
Generate impression based on findings. | 67-year-old male with left flank cellulitis in the region of pancreatic drain, fever. There is mild infiltrative change in the subcutaneous tissues in the region of the left flank drain without focal fluid collection suggest abscess. Evaluation of the abdomen is significantly limited and I can't exclude residual fluid ... | Soft tissue cellulitis.Cannot exclude residual deep fluid collection in area of drain placement on this exam. |
Generate impression based on findings. | Assess for possible etiology of encephalopathy. Patient with SBP to 250s x 30 min in PACU post-operatively. Patient also with potential EtOH withdrawal and previously on prolonged ketamine infusion. The images are partly degraded by patient motion. There is no evidence of intracranial hemorrhage. The grey-white matter ... | No evidence of acute intracranial hemorrhage or cerebral edema.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 50 year-old male with acute on chronic renal insufficiency. RIGHT KIDNEY: The right kidney measures 9.9 cm in length. Echotexture likely slightly increased. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 10.1 cm in length. Echotexture likely slightly increased. No hydronephrosis, sh... | Echogenic kidneys without hydronephrosis. Free fluid within abdomen and pelvis. |
Generate impression based on findings. | Intracranial HTN, on Diamox, eval for interval changes. There has been interval insertion of a right transfrontal ventricular catheter that terminates in the right frontal horn. The ventricles are grossly unchanged in size and configuration. There is a prominent retrocerebellar CSF space, which likely represents a mega... | Expected findings related to interval ventricular catheterization. |
Generate impression based on findings. | Slurred speech and facial droop. There are postoperative changes related to right-sided craniotomy with aneurysm clip placement in the anterior communicating artery region and the distal right internal carotid artery region. Streak artifact from the aneurysm clips somewhat limits evaluation of the area. There is no evi... | 1. Postoperative changes related to right-sided craniotomy with aneurysm clip placement, which produces streak artifact somewhat limiting evaluation. 2. No evidence for acute intracranial hemorrhage or mass effect. 3. Unchanged appearance of the infarcts in the left parietal lobe and right occipital lobe. However, non-... |
Generate impression based on findings. | Intracranial hemorrhage. Evaluate for evolution. There is no significant interval change in the size of the hematoma with mild adjacent edema in left anterior temporal and inferior frontal lobe. There is evolution of the large subacute left temporal and occipital infarcts with regional mass effect. There is slight inte... | 1. No significant interval change in the left anterior temporal lobe and inferior frontal lobe hematoma with vasogenic edema and a small amount of extension into the subarachnoid space.2. Large early subacute left temporal and occipital infarcts with persistent gyriform foci of high attenuation involving the areas of i... |
Generate impression based on findings. | Evaluate for subdural hemorrhage and pneumocephalus. There are postoperative findings related to two right-sided burr hole placement for evacuation of subdural hematoma. There is slight interval decrease in size of pneumocephalus along the right frontal lobe with mass effect on the underlying parenchyma. There is sligh... | 1. Postoperative findings related to burr hole placement for right subdural hematoma evacuation with slight interval increase in size of right subdural fluid collection, which has otherwise decreased in attenuation, as well as persistent pneumocephalus. 2. Unchanged mild right to left midline shift measuring up to 4 mm... |
Generate impression based on findings. | Status post right MCA clipping. Evaluate for intracranial hemorrhage and hydrocephalus. There are postoperative findings related to a right frontotemporal craniotomy for aneurysm clip placement along the right middle cerebral artery with extensive right scalp and periorbital swelling. There is redemonstration of loss o... | 1. Postoperative findings related to a right frontotemporal craniotomy for right middle cerebral artery aneurysm clipping with recent infarcts in the right frontal and temporal lobes.2. Unchanged curvilinear hyperattenuation conforming to the right Sylvian fissure may represent subarachnoid hemorrhage.I personally revi... |
Generate impression based on findings. | T1N2bM0 right base of tongue cancer, status post resection on December 28, 2011 and chemoradiation completed on June 2, 2012. There are stable post-treatment findings. There is no evidence of mass lesions or significant cervical lymphadenopathy. For example, a right level 1B lymph node with preserved fatty hilum measur... | No evidence of locoregional tumor recurrence or significant lymphadenopathy in the neck. |
Generate impression based on findings. | The image quality is significantly degraded by motion artifact. There is now faint hypoattenuation in the left middle cerebral artery territory without hemorrhagic transformation. Redemonstrated is gyriform hyperattenuation centered in the posterior right middle frontal gyrus with associated hypoattenuation of the und... | 1. Large acute left middle cerebral artery territory infarct, but no hemorrhagic transformation or midline shift. However, the cerebrovascular system could not be evaluated further due to the lack of intravascular contrast from the minor contrast extravasation. 2. Evolution of the recent right middle cerebral artery te... |
Generate impression based on findings. | Tenderness over right mandible after being struck with metal object. There is a hematoma in the subcutaneous tissues overlying the right mandibular angle. There is a minimally displaced fracture of the right posterior mandibular body and angle, traversing teeth # 31 and 32. The temporomandibular joints are intact. Ther... | Minimally displaced fracture of the right posterior mandibular body and angle with an overlying subcutaneous hematoma. |
Generate impression based on findings. | Difficult to intubate esophagus at time of EGD. There is no evidence of mass lesions in the upper aerodigestive track mass lesions or significant cervical lymphadenopathy based on size criteria. The hypopharynx is patulous, however. There are bilateral subcentimeter hypoattenuating thyroid nodules. The salivary glands ... | 1. No evidence of mass lesions in the upper aerodigestive track mass lesions.2. Nonspecific subcentimeter hypoattenuating thyroid nodules. Thyroid ultrasound may be useful for further evaluation.3. Multiple dental caries. |
Generate impression based on findings. | History of malignancy with severe headache. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and sulci are slightly more prominent compared to prior study, consistent with parenchymal volume loss. There are scattered punctate and confluent areas of hypoattenuation in the periventricu... | 1. Interval increase in parenchymal volume loss with no evidence of acute intracranial hemorrhage or mass effect. Evaluation for intracranial lesions is otherwise limited on this non-contrast study. CT or MRI with contrast would be useful for further evaluation, if there are no contraindications.2. Presumed chronic sma... |
Generate impression based on findings. | Chronic nasal congestion, sinus pressure; markedly deviated nasal septum on exam. There is a 4 mm wide retention cyst in the left maxillary sinus and a 3 mm wide retention cyst within the right ethmoid sinus. The other paranasal sinuses are clear. The nasal cavity is clear. There is a left concha bullosa associated wit... | 1. Small retention cysts in the left maxillary sinus and right ethmoid sinus. The other paranasal sinuses are clear. 2. Left concha bullosa associated with predominantly rightward nasal septal deviation and spur formation. |
Generate impression based on findings. | Status post chemoradiation for tongue base staged as T4aN2b. . Head: There is no evidence of intracranial mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are... | 1. No evidence for local tumor recurrence or neck lymphadenopathy.2. No evidence of intracranial metastases. |
Generate impression based on findings. | Previous stroke and new retroorbital headache. Head: There is no evidence of acute intracranial hemorrhage or mass. There are unchanged areas of encephalomalacia in the bilateral posterior cerebral hemispheres and bilateral cerebellar hemispheres superimposed upon a background of mild diffuse cerebral white mater hypoa... | 1. Chronic infarcts in the bilateral posterior cerebral hemispheres and bilateral cerebellar hemispheres, but no evidence of acute intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. No evidence of sinusitis or orbital mass. |
Generate impression based on findings. | Metastatic papillary thyroid cancer, status post surgery in 10/2014. There are postoperative findings related to thyroidectomy and neck dissection. There is no evidence of mass lesions or significant lymphadenopathy in the neck. There is mild plaque at the bilateral carotid bifurcations. There is evidence of right voca... | 1. Post-treatment findings without evidence of mass lesions or significant lymphadenopathy in the neck. 2. Partially imaged lungs nodules. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Chronic sinusitis and otolagia. There are bubbly secretion sin the right sphenoid sinuses and mucosal thickening at the bilateral sphenoethmoid recesses. The other paranasal sinuses are clear. The nasal cavity is also clear. The nasal septum is essentially midline. However, there is irregularity of the nasal skeleton. ... | 1. Findings suggestive of acute sphenoid sinusitis.2. Irregularity of the nasal skeleton likely represents chronic fractures.3. Unremarkable bilateral temporal bones. |
Generate impression based on findings. | MVA last night. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is a cavum septum pellucidum. The ventricles are otherwise normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid ... | No evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | Reason: evaluate SAH History: headache, neck pain Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenos... | 1.Subarachnoid and interventricular blood with mild ventriculomegaly.2.No evidence for aneurysm.3.No evidence for cervicocerebral occlusive disease.4.Findings were discussed with Dr Khader-Eliyas at the time of the exam. |
Generate impression based on findings. | Female 7 years old Reason: r/o fx History: foot painVIEWS: 4/18/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 9 years old Reason: r/o fracture History: possible defect lower sternum laterally on the left side, also pt tenderness at 4-5 ribVIEWS: Sternum lateral and both obliques on 4/18/15 (3 views) There no evidence of fracture or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 9 years old Reason: r/o fracture History: point tenderness on chest, h/o Osteogenesis ImperfectaVIEWS: Chest AP/lateral (two views) 4/18/15 The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. No focal lung opacities. No effusions or pneumothorax.Visualized oss... | Normal examination. |
Generate impression based on findings. | Male 1 day old Reason: ex 32 ? w patient intubated for RDS History: evaluate placement of ETT and lung fieldsVIEW: Chest AP (one view) 4/18/15 at 1653 hrs. Right mainstem bronchus intubation. NG tube terminates at the stomach. The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size... | Right mainstem bronchus intubation.Bibasilar opacity on a background of diffuse lung haziness consistent with TTN versus RDS. |
Generate impression based on findings. | Male 8 months old Reason: collapse History: distressVIEW: Chest AP (one view) 4/19/15 at 415 hours. ET tube terminates below thoracic inlet. NG tube tip is in the stomach. Cardiac silhouette size is normal. Right upper lobe atelectasis development. Peribronchial thickening unchanged. | Interval NG and ET tube placement.Right upper lobe atelectasis development. |
Generate impression based on findings. | Male 8 months old Reason: Please evaluate for possible opacity concerning for pneumonia History: Respiratory distress, inspiratory wheezes, but no fever or hypoxiaVIEWS: Chest AP/lateral (two views) 4/18/15 at 1713 hrs Cardiac silhouette size is normal. Peribronchial thickening, large lung volumes, flattened diaphragms... | Bronchiolitis pattern as described. |
Generate impression based on findings. | Female 101 years old Reason: ro abdominal pathology History: abdominal pain, lactic acid This study is limited due to lack of intravenous contrastABDOMEN:LUNG BASES: Right hemidiaphragm is elevated.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of cholecystitis. The dome of the liver is excluded from the CT.S... | Limited study due to lack of intravenous contrast. Significant distention of the rectum with stool.Elevated right hemidiaphragm. |
Generate impression based on findings. | Status post fracture reduction.VIEWS: Right ankle AP, lateral and oblique 4/19/15 123 hours (3 views) Cast material obscures fine bone detail. Oblique fracture of the distal fibula, medial tibial malleolar fracture as well some or two fracture of the distal tibia are in near anatomic alignment. | Status-post casting as described. |
Generate impression based on findings. | Male 17 years old Reason: sprain vs fracture History: swelling to right lower leg after fall from skateboardVIEWS: Right tibia-fibula AP and lateral right ankle AP, lateral and oblique 4/18/15 (5 views) Oblique fracture of the distal fibula , transverse fracture of the medial malleolus and Salter-Harris type II fractur... | Distal Tibia and fibula fractures as described |
Generate impression based on findings. | Trauma.VIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), date, time The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. Vertebral body heights and disk spaces are normal. No fr... | Normal chest, cervical spine and pelvis. |
Generate impression based on findings. | Female 5 years old Reason: constipation History: colicky post prandial periumbilical abd pain with constipationVIEW: Abdomen AP (one view) 4/18/15 2342 hrs Minimal amount of fecal accumulation , no evidence of obstruction, free air or ascites. | Normal examination. |
Generate impression based on findings. | Female 5 years old Reason: Fracture/dislocation of right great toe History: presents s/p injury to right great toe (drawer falling on top of toe)VIEWS: Right foot AP, lateral and oblique 4/18/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. Type density over the plant... | Possible fifth toe foreign body as described, please correlate clinically. |
Generate impression based on findings. | Male 8 months old Reason: intestinal obstruction, ileus History: vomitingVIEW: Abdomen AP (one view) 4/19/15 at 212 hours Giant omphalocele again noted. NG tube terminates at the stomach. Bowel loops are again noted on omphalocele. Obstruction cannot be excluded. | Obstruction cannot be excluded. |
Generate impression based on findings. | Male 16 years old Reason: r/o fracture, History: lateral pain right kneeVIEWS: Right knee AP, lateral and oblique 4/18/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 4 days old Reason: is there an abnormality History: NECVIEW: Abdomen AP (one view) 4/19/15 at 353 hours. NG tube terminates in the stomach. Disorganized, slightly improved in the interval and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Slight improvement in abdominal gas pattern. |
Generate impression based on findings. | Syncope. Evaluate for intracranial lesion. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There are scattered foci of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific. There is a 7 mm... | 1. No evidence of acute intracranial hemorrhage. 2. Nonspecific subcentimeter calcification in the left frontal lobe, which may represent sequela of prior granulomatous process, infection, and perhaps less likely neoplasm. Follow up with a brain MRI may be useful if there are no contraindications.3. Nonspecific scatter... |
Generate impression based on findings. | Bloody stoolVIEW: Abdomen AP (one view) 4/18/15 at 1206 hrs. NG tube terminates at the stomach. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Interval improvement in abdominal gas pattern with persistent disorganization as described. |
Generate impression based on findings. | Male 2 months old Reason: evaluate for tube placement History: postextubationVIEW: Chest and abdomen AP (two views) 4/18/15 at 1213 hrs. ET tube terminates above the thoracic inlet. NG tube tip is in the stomach. Right upper extremity central line tip is at the confluence of both innominate veins. Mediastinum clip unch... | Misplaced ET tube.Improvement in lung aeration as described.Minimally distended and nonspecific abdominal gas pattern. |
Generate impression based on findings. | Female 16 years old Reason: evaluate for obstruction of common bile duct History: increased LFTs, bilirubin, sludge seen on EGD ABDOMEN:LIVER, BILIARY TRACT: No evidence of intra-or extrahepatic biliary duct dilatation. No evidence of biliary stones. Gallbladder was not visualized.SPLEEN: No significant abnormality not... | 1.No evidence of biliary duct dilatation. |
Generate impression based on findings. | History of word difficulties and altered mental status with active cancer on chemotherapy. Evaluate for metastasis. There is no evidence of acute intracranial hemorrhage or mass effect. There are scattered foci of hypoattenuation in the white matter, which are nonspecific. The ventricles and basal cisterns are normal i... | 1. No evidence of acute intracranial hemorrhage or mass effect. Evaluation for intracranial metastasis is otherwise limited on this noncontrast study. If there are no contraindications, contrast enhanced CT or MRI would be more sensitive.2. Nonspecific scattered foci of white matter hypoattenuation, likely representing... |
Generate impression based on findings. | Female 24 years old Reason: flank pain History: r/o nephrolithiasis 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 acute abdominal pain. |
Generate impression based on findings. | Male 57 years old Reason: aortic dissection? History: sob CHEST:LUNGS AND PLEURA: Large right-sided pleural effusion. Cardiomegaly.MEDIASTINUM AND HILA: No evidence of aortic dissection as questioned. No evidence of thoracic aortic aneurysm. Coarse calcification in the walls of the aortic arch. SVC is chronically throm... | No evidence of aortic dissection as questioned. Large amount of right-sided pleural effusion.Extensive atherosclerotic calcifications throughout the vascular system.Chronic occlusion of the superior vena cava and stenosis of the inferior IVC and extensive venous collaterals.Other findings as described above. |
Generate impression based on findings. | Male 22 years old Reason: fx? History: fall on low back. Three views of the lower lumbar spine show no acute fracture or dislocation. Vertebral body heights and alignment are preserved.Two views of the sacrum/coccyx show no acute fracture or malalignment. | No acute fracture or malalignment. |
Generate impression based on findings. | Female 33 years old Reason: r/o PE History: new SOB, DOE, CP. PULMONARY ARTERIES: Technically adequate study. No acute pulmonary embolus. Main pulmonary artery is normal in caliber. No evidence of right heart strain.LUNGS AND PLEURA: There are small bilateral pleural effusions, right greater than left. Fluid is also no... | 1.No acute pulmonary embolus.2.Mild to moderate pulmonary edema.3.Bilateral pleural effusions.PULMONARY EMBOLISM: PE: None. Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 27 years old Reason: eval for fx History: peds vs auto. AP view of the pelvis shows no acute fracture or malalignment. | No acute fracture or malalignment. |
Generate impression based on findings. | Male 32 years old Reason: r/o fracture History: swelling, pain. Three views of the right second finger show no acute fracture or malalignment. | No acute fracture or malalignment. |
Generate impression based on findings. | Male 8 months old Reason: follow up History: post operative cardiacVIEW: Chest AP (one view) 4/19/15 at 219 hours. Central line terminates at the SVC. Mediastinal clip, epicardial pacer leads and left-sided chest tube unchanged.Cardiac silhouette size is enlarged and stable. Left lower lobe subsegmental atelectasis. No... | Left lower lobe subsegmental atelectasis. |
Generate impression based on findings. | Male 8 months old Reason: r/o obstruction and pneumatosis History: vomiting with feeds, post-opVIEW: Abdomen AP (one view) 4/18/15 at 1613 hrs. Left-sided chest tube, urinary bladder catheter and epicardial pacer leads are again noted. Interval removal of pericardial drain. Disorganized, nonspecific abdominal gas patte... | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 2 months old Reason: evaluate for interval change in lung fields History: increased work of breathingVIEW: Chest AP (one view) 4/18/15 at 1700 hrs. NG tube terminates in the stomach. Mediastinal clip unchanged. Cardiac silhouette size is abnormal but stable. Right upper and left lower lobe atelectases on a backgro... | Multifocal opacities on a background of chronic lung disease. |
Generate impression based on findings. | Male 28 years old Reason: r/o fx History: s/p fall heel pain. Three views of the right foot show no acute fracture or malalignment. There is, perhaps, minimal soft tissue swelling about the heel of the foot. | No acute fracture or malalignment. |
Generate impression based on findings. | Status post head injury. There is a right parietal scalp hematoma that measures up to 5 mm in thickness without underlying calvarial fracture. 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 hernia... | Right parietal scalp contusion without underlying calvarial fracture or evidence of 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 52 years old Reason: diverticulitis; Gallstones History: abd 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, UR... | Distended stomach with oral contrast. Etiology is unknown. Clinical correlation and if necessary further evaluation with an upper GI study or endoscopy may be helpful. |
Generate impression based on findings. | Female 19 days old Reason: evaluate for interval change in pcvc line placement after pulling back History: pulled pcvc backVIEW: Chest and abdomen AP (one view) 4/18/15 at 1708 hrs. ET tube terminates below thoracic inlet. NG tube tip is in the stomach. Right lower extremity central line tip is at the right atrium. Car... | Question of pneumatocele development as described.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Seizure. Evaluate for hydrocephalus. Redemonstrated is a left parietal approach shunt catheter with the tip terminating at the midline, similar to prior exam. The ventricles are unchanged in size and configuration. There is no evidence of acute intracranial hemorrhage. There is agenesis of the corpus callosum, effaceme... | 1. Unchanged position of a left parietal approach shunt catheter with unchanged ventricular size.2. Findings consistent with known Chiari malformation and agenesis of the corpus callosum.3. No evidence of acute intracranial hemorrhage., I personally reviewed the Images and/or procedure with the Resident/Fellow and agre... |
Generate impression based on findings. | Female 44 years old Reason: eval for bowel perf/mets History: abdl pain CHEST:LUNGS AND PLEURA: Bilateral, extensive, central groundglass opacities involving the entire lungs with slight upper lobe predominance. Previously described nodular opacities are not well seen. They may be the result versus obscured by the exte... | Bilateral significant groundglass opacities involving both lungs extensively. This is likely secondary to infection. Differential diagnosis includes acute hemorrhage or drug reaction. |
Generate impression based on findings. | Female 21 years old Reason: evaluate for fracture History: pain at the 5th metatarsal. Three views of the right foot show no fracture or malalignment. There is mild soft tissue swelling about the lateral aspect of the right fifth metatarsal. However there is no underlying fracture or malalignment.Three views of the rig... | No acute fracture or malalignment. |
Generate impression based on findings. | Male 16 years old Reason: abdominal pain and emesis History: abdominal pain and emesisVIEW: Abdomen AP (one view) 4/18/15 at 1845 hrs. Bullet fragments are again noted. Normal abdominal gas pattern. No evidence of obstruction or free air. | Normal examination. |
Generate impression based on findings. | Female 3 years old Reason: collapse or infiltrate History: respiratory distressVIEW: Chest AP (one view) 4/19/15 at 206 hours. Tracheostomy tube and right subclavian Port-A-Cath unchanged. Cardiac silhouette size is normal. Right middle and lower lobe opacity, either atelectasis or pneumonia. No effusions or pneumothor... | Right multifocal opacities either atelectasis or pneumonia. |
Generate impression based on findings. | Male 10 years old Reason: follow up History: liver transplant with resp failureVIEW: Chest AP (one view) 4/19/15 at 226 hours. Central lines terminates at the RA/SVC junction. ET tube tip is above the carina. NG tube , abdominal drain and abdominal skin staples unchanged.Cardiac silhouette size is enlarged but stable. ... | Small lung volumes are multifocal opacities as described. |
Generate impression based on findings. | Altered mental status. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There are mild carotid siphon calcifications. There is partial opacification of ... | 1. No evidence of acute intracranial hemorrhage or mass.2. Partial opacification of the partially-imaged ethmoid sinuses may represent sinusitis. |
Generate impression based on findings. | Female 55 years old Reason: bowel obstruction/ stricture History: Lower abd 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 notedKID... | Interval development of an abscess between the small bowel loops in the left lower quadrant. Etiology is unknown.Delayed nephrogram and mild calyectasis of the left kidney secondary to compression of the left ureter by the pelvic abscess. |
Generate impression based on findings. | Male 4 years old Reason: follow up History: post operative cardiacVIEW: Chest AP (one view) 4/19/15 at 232 hours. Central line tip is at the RA/SVC junction. Epicardial pacer leads again noted. Cardiac silhouette size is top normal but stable. No focal lung opacities, effusions or pneumothorax. | No focal lung opacities. |
Generate impression based on findings. | Female 43 days old Reason: Assess dilated bowel gas loops History: Abdominal distension in premature infantVIEW: Abdomen AP (one view) 4/19/15 at 348 hours. NG tube terminates in the stomach. Right lower extremity venous access tip is at the right common iliac vein. Normal abdominal gas pattern. No evidence of obstruct... | Normal abdominal gas pattern. |
Generate impression based on findings. | Female 16 days old Reason: is there an abnormality? History: abd distentionVIEW: Abdomen AP (one view) 4/19/15 at 408 hours. NG tube terminates in the stomach. Bibasilar one haziness noted. Normal abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Normal abdominal gas pattern. |
Generate impression based on findings. | Persistent vertigo. Evaluate for hemorrhage. There is no evidence of acute intracranial hemorrhage or mass effect. There is mild periventricular cerebral white matter hypoattenuation. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are carotid sipho... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Mild periventricular cerebral white matter hypoattenuation may represent small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the ... |
Generate impression based on findings. | Female 73 years old Reason: eval pancreatitis complications History: lipase 3k, epigastric abd pain This study is limited due to extravasation of intravenous contrastABDOMEN:LUNG BASES: Dependent atelectasis at the lung bases. Dilated esophagus.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significan... | Limited study due to lack of intravenous contrast. CT findings consistent with acute pancreatitis. Complications of acute pancreatitis cannot be evaluated with this noncontrast CT.Small amount of ascites and left nephrolithiasis.Extravasation of the intravenous contrast as described above. |
Generate impression based on findings. | Esophageal cancer with failed gastric pull up now status post jejunal interposition with purulent median sternotomy incision; evaluation for leak, abscess, or fistula is requested with PO enteral contrast and IV contrast. There are postoperative findings related to esophagectomy and jejunal interposition and resection ... | 1. Postoperative findings related to esophagectomy and jejunal interposition with persistent fluid and gas collection anterior to the jejunal interposition at the level of the thoracic inlet and posterior to the dehiscent median sternotomy incision. The fluid collection appears to contain extraluminal contrast material... |
Generate impression based on findings. | Right foot injury.VIEWS: Right foot AP, lateral and oblique 4/18/15 (3 view/s) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 59 years old Reason: eval for abscess History: hx of prior sugery ABDOMEN:LUNG BASES: Bilateral basilar opacities suggestive of aspiration/atelectasis. Bilateral small pleural effusions.LIVER, BILIARY TRACT: Mild intrahepatic biliary prominence. Common bile duct is also dilated throughout its course measuring up... | Bibasilar opacities in the lung bases suggestive of aspiration. |
Generate impression based on findings. | Female 51 years old Reason: cough, hemoptysis History: cough, hemoptysis. LUNGS AND PLEURA: Again seen are diffuse bilateral centrilobular areas of groundglass opacities which appear to have improved when compared to the prior CT, but may represent a recurrent or resolving pulmonary hemorrhage or early edema. A focal a... | 1.Bilateral groundglass opacities have improved when compared to prior CT and may represent a recurrent or resolving pulmonary hemorrhage or early edema.2.Interval improvement in left lower lobe consolidation/atelectasis. |
Generate impression based on findings. | Female 63 years old Reason: eval for dissection History: chest pain, HTN, asymmetric BP CHEST:LUNGS AND PLEURA: Bilateral small pleural effusions.MEDIASTINUM AND HILA: Extensive atherosclerotic calcification of the aorta and its branches without evidence of dissection. Small amount of thrombus in the SVC around the tip... | Significant atherosclerotic changes with stenosis of the bilateral renal arteries as described above. No evidence of aortic dissection.Large collection within the right adductor muscles.Possible thrombus within the right femoral vein.Dr. Anyanwu was notified and acknowledged about the above findings at the time of dict... |
Generate impression based on findings. | Pain and fever. Evaluate known neck abscess. There is interval placement of a tracheostomy tube and a nasoenteric tube. Two new surgical drains have been placed in the left neck with slight overall decrease in size of the transpatial fluid collection involving the left parapharyngeal space, submandibular space, parotid... | 1. Interval placement of new surgical drains in the left neck with slight overall decrease in size of the transpatial fluid collection compatible with abscess. However, the retropharyngeal component of the abscess has slightly increased in size.2. Interval placement of a tracheostomy tube and a nasoenteric tube. 3. App... |
Generate impression based on findings. | Male 55 years old Reason: Assess for PE; new hypoxia; R calf enlarged. 55F METAST RENAL CELL CA S/P L NEPHRECTOMY History: worsening hypoxia, right calf enlarged (does have new L pleural effusion). PULMONARY ARTERIES: No acute pulmonary embolus. There is extrinsic compression of the left upper lobe pulmonary artery by ... | 1.No acute pulmonary embolus.2.Overall metastatic disease burden has significantly increased when compared to the prior exam, particularly with innumerable new pulmonary nodules, bilateral pleural effusions with overlying compressive atelectasis and increase in size of left pleural-based disease.PULMONARY EMBOLISM: PE:... |
Generate impression based on findings. | Male 92 years old Reason: Rectal cancer; evaluate for response and/or progression History: See Above CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCORONARY ARTERY CALCIFICATION: Severe.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRAC... | Interval Decrease in the rectal wall thickening and the size of the right external iliac lymph node as described above. |
Generate impression based on findings. | Male 75 years old Reason: Evaluate for PE - 75 yo M w h/o hairy cell leukemia and rheumatologic disease with acute onset SOB, pleuritic chest pain, resp alkalosis History: SOB, inc wob, respiratory alkalosis, CP. PULMONARY ARTERIES: Technically adequate study. There is no acute pulmonary embolus. Main pulmonary artery ... | 1.No acute pulmonary embolus.2.Interval decrease in mediastinal lymphadenopathy as described above.3.Note is made of prominent hilar lymph nodes, however given that prior examinations are performed without contrast, no comment can be made regarding chronicity or changes in size of these nodes.4.Stable pulmonary nodules... |
Generate impression based on findings. | Female 43 days old Reason: ex 27 weeker now 1 mo with concern for NEC starting on 4/17 History: abdominal distentionVIEW: Abdomen AP (one view) 4/19/15 at 913 hours NG tube terminates in the stomach. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or porta... | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Left sided weakness. Evaluate for intracranial hemorrhage. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There are mucus retention cysts in the bilateral maxillary sinuses. The oth... | No evidence of acute intracranial hemorrhage or mass effect. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, MRI of the brain is recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this... |
Generate impression based on findings. | Female 52 years old Reason: 52 y/o woman with metatatic breast cancer on chemotherapy with rising tumor marker. Assess for progression of disease. History: Rising tumor marker. CHEST:LUNGS AND PLEURA: Bilateral pulmonary metastatic lesions, again noted. Index right middle lobe lesion measures 4 x 7 mm image number 44, ... | Diffuse bone metastases, unchanged.Interval increase in the size of the lung metastases and the amount of peritoneal carcinomatosis.Evaluation of the liver for focal lesions is very limited to to severe fatty infiltration. |
Generate impression based on findings. | Cervical spine: There is no evidence of fracture. There is reversal of the usual cervical lordosis. There are scattered lytic lesions on a background of demineralization. There is degenerative cervical spondylosis, most prominent at C4-5, C5-6 and C6-7, with moderate loss of disc height, diffuse idiopathic hyperostosi... | 1. Multiple osteolytic lesions on a background of osteopenia of the cervical and thoracic spine as well as osseous destruction with associated soft tissue lesion of the left posterior 12th rib are compatible with known multiple myeloma, although superimposed bone metastases are not excluded. In particular, a pathologic... |
Generate impression based on findings. | Male 48 years old Reason: MET COLON CANCER HAS NOT HAD THERAPY SINE DECEMBER 2014 SECONDARY TO BOWEL INCARCERATION History: MET COLON CANCER CHEST:LUNGS AND PLEURA: Scattered, nonspecific micronodules.MEDIASTINUM AND HILA: Index anterior mediastinal lymph node measures 2.1 x 1.4 cm image number 33, series number 3, not... | Interval progression of disease with new liver metastases and interval increase in the size of the left lower quadrant mass causing left hydronephrosis by compressing the left ureter. Other findings as described above. |
Generate impression based on findings. | Male 65 years old Reason: r/o acute PE History: chest pain, SOB, hx of DVT/PE. PULMONARY ARTERIES: No acute pulmonary embolus. The main pulmonary is slightly enlarged, and measures approximately 35 mm which is unchanged from the prior exam. There is no evidence of right heart strain.LUNGS AND PLEURA: Again seen are sma... | No acute pulmonary embolus.PULMONARY EMBOLISM: PE: None.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 4 months old Reason: is there increased bowel distention History: abd distention VIEW: Abdomen AP (one view) 4/19/15 at 922 hours. Left lower extremity central line terminates in the right atrium. NG tube apparently terminates in the mid thoracic esophagus. Soft tissue lung persist. Bibasilar patchy opacities wi... | There sided pleural effusion and retraction of the NG tube as described.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 44 years old Reason: Intra-abd fluid collection/abscess s/p Whipple History: Increasing leukocytosis ABDOMEN:LUNG BASES: Bibasilar dependent atelectasis.LIVER, BILIARY TRACT: Pneumobilia. Index subcentimeter hypodensities in the liver is unchanged measuring 9-mm image number 39, series number 3.SPLEEN: No signific... | Changes secondary to Whipple surgery. Previously noted collection extending into the right retroperitoneum from the level of the pancreatic anastomosis appears to be better organized. Significant wall thickening, moderate distention of the anastomosed jejunal loop in the right upper quadrant and associated fat strandin... |
Generate impression based on findings. | New onset migraine with aura. CT: There is no discernible correlate for the punctate focus of susceptibility effect demonstrated on the prior brain MRI. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and config... | 1. While there is no discernible correlate for the punctate focus of susceptibility effect demonstrated on the prior brain MRI, there appears to be a small developmental venous anomaly in the right anterior cingulate gyrus, suggesting that the abnormality on the MRI likely represents a cavernous malformation. 2. No evi... |
Generate impression based on findings. | There are bullet fragments within the right masticator, parapharyngeal, and prevertebral spaces. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The p... | 1. Bullet fragments within the right masticator, parapharyngeal, and prevertebral spaces. 2. Occlusion of the right cervical internal carotid artery likely related to the prior gun shot injury with reconstitution at the petrous segment.3. No evidence of acute intracranial hemorrhage or cerebral aneurysms.4. Dental dise... |
Generate impression based on findings. | Female 80 years old Reason: Patient with hx of thyroid cancer treated with multiple surgeries and I131. Has lung lesions with hx histoplasmosis, lung cancer and hx renal cancer History: hx lung lesions with histoplasmosis, renal cell cancer, and thyroid cancer does not uptake I131. Assess progression of nodules CHEST:L... | No significant change from previous study. |
Generate impression based on findings. | Male 75 years old Reason: Evaluate for known neck abscess History: pain, fevers. LUNGS AND PLEURA: There are bilateral pleural effusions with overlying compressive atelectasis unchanged from prior exam. Again seen is a punctate micronodules right lung base, unchanged from recent CT and presumably benign in nature. Ther... | 1.Small bilateral pleural effusions with overlying compressive atelectasis unchanged from the prior exam.2.Mild bronchial wall thickening at the lung bases may be due to aspiration.3.No pneumomediastinum or extension of inflammatory changes to the chest. Please refer to same day CT soft tissue neck for additional findi... |
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