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Generate impression based on findings. | Reason: acute blood loss, eval source for bleeding History: stem cell transplant CHEST:LUNGS AND PLEURA: Dependent atelectasis bilaterally. Right apical focal consolidation compatible with early infection. No pneumothorax or pleural effusions.MEDIASTINUM AND HILA: Mild cardiomegaly. Engorgement of the pulmonary vascula... | 1.No evidence of acute thoracic, abdominal, or pelvic hemorrhage.2.Focal consolidation at right lung apex, which may represent early infection.3.Periportal edema compatible with aggressive hydration. 4.Mild diffuse mucosal enhancement of small and large bowel, which may represent mucositis/enteritis. 5.Small abdominal ... |
Generate impression based on findings. | 67 years, Female, Reason: Parathyroid adenoma. History: Parathyroid adenoma.. There is a subtle focus of increased activity in the along the inferior pole of the right thyroid which does not persist on delayed images and has some suspicion for a parathyroid adenoma. No suspicious activity is present on delayed images. | Subtle focus of increased activity just posterior to the right inferior thyroid pole. This is equivocal but of some suspicion for a parathyroid adenoma. It could also be secondary to a nodule of thyroid origin such as seen on recent ultrasound. |
Generate impression based on findings. | Reason: eval for evidence of malignancy or other explanation of chronic cough History: worsening cough and weight loss in former smoker with fam hx lung ca; normal PFTs LUNGS AND PLEURA: Scattered cysts, greatest in the left lower lobe where this is a cluster of cysts. Diffuse mild bronchial wall thickening and mild br... | Cystic changes in the lungs with mild bronchiectasis without evidence of malignancy or consolidation. |
Generate impression based on findings. | There is interval resolution of previous the seen immediate postoperative changes. There is increased prominence of the CSF space along the cerebellar tonsils appear rounded in morphology. The tip of the cerebellar tonsils extend to the level of the upper margin of the odontoid process, without significant interval ch... | 1. Interval resolution of previous immediate postoperative changes including complete resolution of prior pseudomeningocele.2. Increased visualization of subarachnoid space along the dorsal aspect of the dorsal neo-foramen magnum, caudal to the cerebellar tonsillar tip. However CSF flow imaging demonstrates relative sl... |
Generate impression based on findings. | 84 year old female, evaluate RUL lung nodule LUNGS AND PLEURA: Bilateral pulmonary nodules are again noted and not significantly changed. Previously referenced right lower lobe nodule measures 13 mm (series 4, image 59) previously 12 mm. No new pulmonary nodules or masses. No pleural effusion or pneumothorax.Bilateral ... | 1. Bilateral multiple pulmonary nodules unchanged. 2. Unchanged pancreatic and biliary ductal dilatation. |
Generate impression based on findings. | 83 year old female. Worsening pain. Evaluate for stress fracture or new abnormalities. Known severe OA. Severe osteoarthritis affects the left knee with tricompartmental bone on bone apposition and bulky osteophytes. Evaluation for progression of osteoarthritis cannot be performed as the prior exam was non weight-beari... | Severe osteoarthritis. |
Generate impression based on findings. | 64-year-old male with history of chronic HBV, evaluate for tumor. LIVER: The liver measures 14.2 cm, and there is no significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Cholelithiasis. No biliary dilatation, gallbladder wall thickening or other significant abnormalities noted.PANCREAS: No significant abnormalit... | Cholelithiasis, without findings of cholecystitis. No focal mass or biliary dilatation seen. |
Generate impression based on findings. | Ms. Rasmussen is a 49 year old female recall from screening mammogram for calcifications in the left lower inner breast. She has a family history of breast cancer in her maternal grandmother. Personal history of leukemia. Three standard views and four spot magnification views of the left breast were performed digitally... | High probability benign calcifications in the left lower inner breast. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months in order to confirm stability of these findings and to have a normal annual follow up for the right breast. All results and recom... |
Generate impression based on findings. | Male 30 years old. Reason: eval for presence of surgical hardware. History: family does not know if there is a rod from a fx/repair in February 2015, pt needs MRI A single portable view of the right hip is provided. Three parallel, cannulated orthopedic screws affix a femoral neck fracture in anatomic alignment. There ... | Orthopedic fixation of the right femoral neck fracture as described above. |
Generate impression based on findings. | 70-year-old male with history of left renal lesion. ABDOMEN:LUNG BASES: Bilateral pleural-based calcifications compatible with there is is exposure.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Diffuse hazy appearance of the pancreas.ADRENAL GLANDS: No significa... | 1. Large left renal lesion highly suspicious for renal cell carcinoma.2. Diffuse haziness surrounding pancreas is nonspecific. Correlate for clinical/laboratory signs of pancreatitis. |
Generate impression based on findings. | Female 33 years old. Reason: Eval for impingement. History: Pain Three views of the right shoulder are provided. There is mild deformity of the proximal humerus which may be related to old, healed trauma. There is no acute fracture or dislocation. There are no changes to suggest external impingement. | Mild deformity of the proximal humerus without evidence to suggest external impingement. No evidence of acute fracture or dislocation. |
Generate impression based on findings. | 35-year-old female. Bilateral foot pain. Right foot: No fracture, dislocation, or significant arthritic changes.Left foot: Small plantar heel spur. No fracture, dislocation, or significant arthritic changes. | No specific findings to explain the patient's pain. |
Generate impression based on findings. | Clinical question: Structural abnormalities that might underlying seizures. Signs and symptoms: Seizure d/o. Enhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass effect midline shift or hydrocephalus. CT however is insensitive for early detection of acute nonhemorrhagic ischemic stroke.Unr... | Unremarkable enhanced head CT. |
Generate impression based on findings. | Seizure and head trauma. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp so... | 1. No evidence of intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of seizure foci.2. No skull fracture is identified.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 53 year old female with history of type A dissection repair on 6/2013. Vascular: Redemonstration of graft material in the ascending aorta just distal to the sino-tubular junction. No type A dissection is seen. There is a type B dissection, which extends inferiorly into the right common iliac artery and right external i... | Postoperative changes of type A dissection repair, without evidence of a dissection recurrence. Type B dissection, and other findings are unchanged over the interval. |
Generate impression based on findings. | 44 year old male. Status post ORIF left open ankle fracture 8/2014. A side plate and screws fracture affix a distal fibular fracture in near anatomic alignment. Two screws affix the medial malleolus. No radiographic evidence of hardware complication. The fibular fracture line is indistinct indicating an attempt at heal... | Orthopedic fixation of distal fibular and medial malleolus fractures. |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage or mass. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift. There is no intracranial hemorrhage. There are minimal patchy areas of abnormal low density in the periventricular and subcortical white matter, consistent with stable mild chronic small vessel ischemic... | 1. No acute intracranial abnormality. Stable mild chronic small vessel ischemic changes with chronic left superior frontal gyrus infarct.2. Stable appearance of prominence of the extra-axial space peripherally in the posterior fossa suggestion of perhaps mild mass effect upon the adjacent cerebellar parenchyma. These m... |
Generate impression based on findings. | Male 12 years old Reason: eval alignment VIEWS: Right tibia-fibula AP and lateral 4/23/15 (two views) External fixator device and soft tissue drain has been applied. Coming up fractures of the distal tibia and fibula are in near anatomic alignment. | Postsurgical changes as described. |
Generate impression based on findings. | Male 84 years old. Reason: eval for fracture. History: swelling, fall Three views of the left hand are provided. There is severe osteoarthritis of the basilar joint. There is also osteoarthritis of the scaphotriquetral articulation. There is no acute fracture or malalignment. | No evidence of acute fracture or malalignment. Osteoarthritis as described above. |
Generate impression based on findings. | 84-year-old male with history of painless hematuria. 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: Left renal cy... | Findings compatible with bladder diverticulosis and cystitis cystica likely the result of chronic stasis and outlet obstruction. Direct visual inspection is recommended as an underlying neoplasm cannot be entirely excluded. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Patient describes a previously palpable area in her right armpit. Family history of breast cancer in 3 paternal aunts. Two standard digital views of both breasts, repeat left MLO view and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Correlation with physical exam is recommended for the patient's axillary area of concern if it recurs.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 33 years, Male, Reason: 33M s/p jejunostomy takedown, creation of descending end colon with continued drops in Hgb despite transfusion and upper and lower GI scope History: Continued Hgb drop. The angiographic phase images shows two large regions of decreased activity within the liver corresponding to large hypodensiti... | Intermittent active GI bleeding in the right abdomen, most likely within small bowel. A right colonic hemorrhage is also conceivable but considered less likely. |
Generate impression based on findings. | Relapsed CLL: Currently enrolled in clinical trial. There has been interval decrease in size of the lymph nodes throughout the neck. For example, a right level 2A lymph node measures 8 x 12 mm, previously 11 x 18 mm, a right level 5B lymph node measures 5 x 6 mm, previously 10 x 12 mm, and a left supraclavicular lymph ... | Interval decrease in size of the lymph nodes throughout the neck, indicating treatment response. |
Generate impression based on findings. | Ground-level fall, external swelling/ecchymosis. There is a small left frontal scalp contusion. However, there is no evidence of acute intracranial hemorrhage or skull fracture. There is diffuse patchy cerebral white matter hypoattenuation, which may represent small vessel ischemic disease. The ventricles and sulci are... | No evidence of acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | There has been significant interval reduction in size of the left cerebral convexity subdural collection, which measures 6 mm in greatest thickness on the current exam compared to previous 22 mm. there is no homogeneously slightly hyperdense with respect to brain parenchyma which may indicate some interval rebleeding.... | 1. Overall significant decreased thickness of left cerebral convexity subdural hematoma, although the collection is no mildly hyperdense with respect to brain parenchyma suggesting interval rebleeding. Significantly reduced associated mass effect.2. Stable ventricular size and ventriculostomy catheter. |
Generate impression based on findings. | Female; 43 years old. Reason: To eval for any structural change or any tumor History: Weight loss Lack of intravenous contrast limits sensitivity for solid organ pathology.CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules measuring up to 5 mm in the left apex (series 5/20), most likely post infectious or inflamm... | 1. No findings to explain the patient's symptoms.2. Scattered pulmonary micronodules are most likely post infectious or inflammatory in etiology. Follow-up can be obtained as clinically indicated. 3. Fibroid uterus. |
Generate impression based on findings. | 57-year-old female with history of abdominal pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS,... | Diverticulosis without evidence of diverticulitis. |
Generate impression based on findings. | Reason: checking for pulmonary fibrosis/ILD History: fatigue, DOE, reduced DLCO LUNGS AND PLEURA: Dependent atelectasis. Nodule along the right minor fissure likely represent an intrapulmonary lymph node. Left lower lobe pulmonary micronodule measures 4 mm (series 5 image 56). No evidence of fibrosis or honeycombing. N... | No evidence of fibrosis or ILD. |
Generate impression based on findings. | CLL CHEST:LUNGS AND PLEURA: Stable peripheral micronodulesMEDIASTINUM AND HILA: Interval decrease in size of mediastinal lymph nodes. Reference precarinal lymph node best seen on image 44 series 3 now measures 1.1 x 0.8 cm; this is in comparison to 1.7 x 1.3 cm on 12/17/2014.CORONARY ARTERY CALCIFICATION: None.CHEST WA... | Interval decrease in size of adenopathy. No new adenopathy. |
Generate impression based on findings. | Reason: evaluate healing of left elbow epiphyseal separation History: left elbow injury with surgery and pinningVIEWS: Left elbow AP oblique lateral (3 views) 4/23/15 13:43 Status post removal of cast. Three K wires fixing the distal humerus in near anatomic alignment. No evidence of hardware complication. Periosteal r... | Healing distal humerus fracture. |
Generate impression based on findings. | Reason: Restaging; Lung cancer s/p 2 cycles adjuvant History: Restaging LUNGS AND PLEURA: Postsurgical changes of the right hemithorax. Loculated apical hydropneumothorax has slightly decreased compared to prior. Soft tissue surrounding the staple line has decreased compared to prior.Small subsolid nodule in the left l... | 1.Slight interval decrease in right postsurgical changes including right apical loculated hydropneumothorax and seroma/hematoma surrounding the staple line.2.Unchanged left lower lobe sub-solid nodule suspicious for indolent adenocarcinoma.3.Please separately dictated CT abdomen and pelvis performed on the same day. |
Generate impression based on findings. | Reason: Eval for mass History: h/o lymphoma CHEST:LUNGS AND PLEURA: Left basilar scarring. MEDIASTINUM AND HILA: Low attenuation left thyroid nodule. No lymphadenopathy. Heart size is normal.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: No lymphadenopathy. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. SPLEEN: No sig... | No evidence of lymphadenopathy or mass. |
Generate impression based on findings. | Female 27 years old. Reason: follow up; r/o new fx. History: pain, swelling Two views of the right knee are provided. An intramedullary rod and multiple screws affix a comminuted intra-articular fracture extending from the proximal tibial to the tibial metaphysis in near-anatomic alignment. The fracture lines appear le... | Orthopedic fixation of a comminuted intra-articular tibial fracture as described above. |
Generate impression based on findings. | Diffuse large B cell lymphoma CHEST:LUNGS AND PLEURA: Interval appearance of numerous subcentimeter right lung nodular opacities associated with interval increase in size of small right pleural effusion. MEDIASTINUM AND HILA: The previously described enlarged left internal mammary lymph node is no longer measurable.COR... | Significant interval decrease in size of left axillary mass. Destructive bony changes of left scapula and left shoulder again noted. Reference internal mammary adenopathy no longer measurable.Interval appearance of numerous subcentimeter right lung nodular opacities associated with interval increase in size of small ri... |
Generate impression based on findings. | Female 59 years old. Reason: eval for fracture. History: foot pain Three views of the right foot are provided. There is diffuse soft tissue swelling most prominent in the dorsum. There are mild degenerative changes most prominent in the MTP joints of the first digit with associated mild hallux valgus deformity. There i... | Diffuse soft tissue swelling without evidence of acute fracture or malalignment. |
Generate impression based on findings. | Male 70 years old; Reason: Pancreas cancer please assess and provide index lesion measurements per RECIST History: As above CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules, primarily in right lower lobe, without significant change. Reference right lower lobe lung nodule unchanged accounting for differences in techni... | 1. Multiple pulmonary nodules, primarily in right lower lobe, without significant change. 2. Stable ill-defined soft tissue induration around aorta, IVC and celiac artery and SMA, underlying metastatic adenopathy cannot be entirely excluded. Soft tissue attenuation also encircles the portal vein near the confluence as ... |
Generate impression based on findings. | Images are limited by patient motion artifact. Correlating with previous body CT exam, there appear to be 12 rib bearing vertebrae and 6 lumbar appearing vertebrae. Therefore, there is transitional lumbosacral anatomy. For the purposes of this exam the last fully formed disk is at L6-S1. The previous identified L1 fra... | 1. Transitional spinal anatomy as detailed above. Please note that counting convention differs from the prior MRI lumbar spine report. If surgery is to be contemplated, correlation with imaging of the entire spine is recommended.2. Stable appearance of chronic compression deformity of L2 and mild concavity of the super... |
Generate impression based on findings. | Lung cancer status post two cycles of adjuvant therapy, restaging ABDOMEN:LUNG BASES: Loculated anterior right hydrothorax.LIVER, BILIARY TRACT: Large right hepatic lobe hemangioma, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality n... | No evidence of metastatic disease. |
Generate impression based on findings. | Ms. Crawford is a 72 year old female presenting with a four week history of left breast pain. Family history of breast cancer in paternal aunt. Personal history of rheumatoid arthritis. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is alm... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, due in Nov 2015. Patient should follow up with her primary care physician regarding her breast pain. All results and recommendation were discussed with the patient... |
Generate impression based on findings. | Female 84 years old Reason: assess for fracture History: fall Left shoulder: No fracture or malalignment. The bones are demineralized. Severe osteoarthritis affects the glenohumeral joint with near bone-on-bone apposition. There is severe narrowing of the acromiohumeral distance to approximately 2 mm, consistent with c... | 1. Severe osteoarthritis at the glenohumeral joint with chronic rotator cuff tear but no fracture.2. Osteoarthritis affects the elbow joint with probable associated chondrocalcinosis but no definite fracture. |
Generate impression based on findings. | 72 years old, Female, Reason: DJD, Stenosis, vertebrobasilar insufficiency There is no evidence of fracture. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. There a degenerative changes of the cervical spine that are most pronounced at the C5-6 and C6-7 levels with at l... | Degenerative changes of the cervical spine that are most pronounced at the C5-6 and C6-7 levels.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 64 year old female with shortness of breath, left pleural thickening, restrictive lung disease on PFT's, evaluate for progression. LUNGS AND PLEURA: Small left pleural effusion slightly increased with associated pleural thickening and adjacent compressive atelectasis.Punctate calcified micronodules compatible with prio... | Slightly increased left pleural effusion with mild pleural thickening and adjacent compressive atelectasis. No evidence of underlying infection or tumor. |
Generate impression based on findings. | 65 year old female with history of ovarian cancer. Assess for ventral hernia and mass in hernia sac CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CORONARY ARTERY CALCIFICATION: Mild.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRAC... | Fat-containing ventral hernia as above. |
Generate impression based on findings. | 55 year old female patient with screen detected complex cyst in the 8 o'clock position of the right breast presents for ultrasound guided cyst aspiration and clip placement. Targeted right breast ultrasound re-identified the target cyst for aspiration. The lesion to be targeted is a complex cyst measuring 6 x 4 x 6 mm ... | Successful ultrasound-guided aspiration of the right breast cyst with clip placement. Fluid was not sent for cytology.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female 69 years old Reason: Fracture, OA History: Knee pain, fall Right knee: Mild sharpening of the tibial spines with small osteophyte formation. There is mild narrowing of the medial patellofemoral joint. Findings are consistent with mild/moderate osteoarthritis. Large enthesophytes at the superior and inferior aspe... | 1. Mild/moderate osteoarthritis affects the right knee but no fracture is evident.2. Soft tissue swelling over the medial malleolus without fracture or malalignment. |
Generate impression based on findings. | Male 62 years old; Reason: S/p cardiac surgery, extended course complicated by septic shock, liver failure, pneumonia, shock liver, with distended bowel on KUB. Eval etiology History: distention Suboptimal exam secondary to patient motion artifact.ABDOMEN:LUNGS BASES: Evaluation of parenchyma suboptimal due to extensiv... | 1. Suboptimal exam secondary to patient motion artifact.2. Findings suspicious for partial small bowel obstruction as described. Mild circumferential ileal wall thickening seen.3. Persistent anterior mediastinal collection, stable to decreased in size.4. Worsening splenic infarcts.5. Increasing ascites.6. Improving ple... |
Generate impression based on findings. | 87 year old female with Merkel Cell Cancer right cheek. LUNGS AND PLEURA: Right lower lobe micronodule with a flat appearance (series 4, image 66) most consistent with a benign intrapulmonary lymph node. No suspicious pulmonary nodules or masses. There are peripheral areas of subsegmental atelectasis. No pleural effusi... | No specific evidence of metastatic disease to the chest. |
Generate impression based on findings. | Recently diagnosed Merkel cell carcinoma of the right cheek. The patient previously had an excisional biopsy completed on 4/7/2015. Neck: There are postoperative findings in the right cheek with mild linear skin thickening, but no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size... | 1. Postoperative findings in the right cheek with mild linear skin thickening, but no evidence of measurable mass lesions or significant cervical lymphadenopathy.2. No evidence of intracranial metastases.3. Diffuse osteopenia with compression fractures of the T2 and T3 vertebral bodies. MRI of the spine may be useful f... |
Generate impression based on findings. | 82-year-old with history of right mastectomy for inflammatory breast cancer. Patient is also status post left lumpectomy 2004. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pat... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral 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. | 65 year old female with multiple medical problems and worsening abdominal pain status post duodenal polyp EMR ABDOMEN: Evaluation of the solid abdominal organs is limited by lack of intravenous contrast.LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter hepatic hypodensity in the left hepa... | Duodenal inflammatory changes without pneumoperitoneum or other unexpected findings. Findings relayed to Dr. Waxman at the time of dictation. |
Generate impression based on findings. | 79 year old male with MRSA PNA and L sided effusion on previous CT, culture positive for GPC from L sided thora , reevaluating for persistence of effusion. LUNGS AND PLEURA: Bilateral, lower lobe predominant extensive consolidation with multiple areas of cavitation not significantly changed. Interval placement of right... | Bilateral predominantly lower lobe consolidation with cavitation and pleural effusions not significantly changed. |
Generate impression based on findings. | 65 years, Female. Reason: assess for obstipation History: 65 y.o. with a history of celiac disease and diarrhea/RUQ abdominal pain Average stool burden. Nonobstructive bowel gas pattern. Small bowl loop in the right upper quadrant with apparent bowel wall thickening. Surgical clips project in the right upper quadrant. ... | Nonobstructive bowel gas pattern. Small bowl loop in the right upper quadrant with apparent bowel wall thickening. |
Generate impression based on findings. | 61-year-old female. Neck pain. Status post cervical fusion. Posterior rods and screws traverse the C4 to C6 vertebral levels. No radiographic evidence of hardware complication. Straightening of the cervical spine; alignment is otherwise unremarkable. Severe degenerative disk disease affects C4-5 and C5-6 and moderate d... | Post-surgical findings of posterior fusion of the C4 to C6 vertebral levels. |
Generate impression based on findings. | 58 years, Female. Reason: check feeding tube placement History: check feeding tube placement Interval advancement of Dobbhoff tube, with the tip likely distal to the ligament of Treitz. Surgical drains are again noted, terminating in the right upper quadrant and left upper quadrant. Multiple surgical clips again projec... | Interval advancement of Dobbhoff tube, likely terminating distal to the ligament of Treitz. |
Generate impression based on findings. | Female 57 years old. Reason: pain. History: pain Four weight-bearing views of the right knee are provided. There is a small joint effusion. There is osteophyte formation affecting the patellofemoral joint most prominent laterally. This appears similar to prior study. There is no acute fracture or dislocation. | Small joint effusion and mild osteoarthritis as described above. |
Generate impression based on findings. | 64 years, Female. Reason: rule out perforation, intraabdominal bleed or acute abdominal process History: chest pain, sob Relative paucity of bowel gas, without radiographic evidence of obstruction. Surgical drain terminates in the right upper quadrant. Surgical clips overlie the right hemipelvis. New midline skin stapl... | Relative paucity of bowel gas, without radiographic evidence of obstruction. Please note, supine imaging is insensitive for the detection of pneumoperitoneum. |
Generate impression based on findings. | Clinical question: CVA. Signs and Symptoms: CVA Nonenhanced head CT:No evidence of an acute intracranial finding. CT however is insensitive for the early detection of an acute ischemic stroke.Unremarkable cerebral cortex, cortical sulci, CSF spaces, ventricular system and the gray - white matter differentiation.Unremar... | 1. No acute intracranial finding. CT however is insensitive for the early detection of an acute ischemic stroke.2. Atrophic globes. |
Generate impression based on findings. | Female 55 years old. Reason: ? fracture History: wrist pain Three views of the right wrist are provided. There is no fracture or malalignment.Two views of the right forearm are provided. There is an anterior joint effusion of the elbow with a cortical irregularity of the radial head suspicious for a radial head fractur... | There is a cortical irregularity of the radial head with associated anterior joint effusion of the elbow suspicious for a radial head fracture. Recommend dedicated elbow radiographs to further characterize. |
Generate impression based on findings. | Impaired sense of smell in the setting of fungemia. The paranasal sinuses are clear. The nasal cavity is also clear. There is a left concha bullosa. The nasal septum is deviated slightly to the right with a small spur. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered b... | 1. No evidence of sinusitis.2. Chronic infarct in the left middle cerebral artery territory |
Generate impression based on findings. | Female 9 months old Reason: seizing History: seizingVIEW: Chest AP (one view) 4/23/15 at 1516 hrs. Central line terminates at the RA/SVC junction. The gastrostomy tube again noted. Interval decreasing in upper abdomen no bowel distention.Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax. | No focal lung opacities. |
Generate impression based on findings. | Female 41 years old. Reason: abnormality. History: pain to lateral foot and heel Three views of the right foot are provided. There is no large joint effusion. There may be soft tissue swelling along the lateral aspect of the midfoot. There is a small plantar heel spur. There is no evidence of acute fracture or malalign... | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | LUNG APICES/Chest Wall: The visualized lung apices are clear. Note is made of partially visualized pacemaker leads and a pacemaker device in the left anterior chest wall.VASCULATURE: The aortic arch and great vessels are widely patent. The right brachiocephalic vein is also patent. RIGHT ARM: Multiple metallic densiti... | 1. Metallic densities compatible with bullet fragments within the soft tissues surrounding the distal humeral diaphysis as well as within the distal humerus. 2. Patent axillary, brachial, radial and ulnar arteries. 3. Wedge shaped hypodense area in the right parietoocciptal region of the brain suggestive of age indeter... |
Generate impression based on findings. | The previously seen scattered foci of diffusion restriction are no longer appreciated, with only minimal if any residual corresponding FLAIR hyperintensity. These again are predominantly along the watershed zones of the cerebral hemispheres. Previous sulcal enhancement with corresponding FLAIR hyperintensity has resol... | 1. Interval expected evolution of previously seen punctate scattered supratentorial likely watershed zone infarcts. No new infarct identified.2. Interval complete resolution of previously seen cerebral sulcal enhancement.3. Right greater than left mastoid fluid, which is nonspecific. Please correlate clinically. |
Generate impression based on findings. | 52 year-old who was recalled from screening mammography for calcifications in the right breast. An ML view and two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in p... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | There are expected post-operative findings related to a right frontal burr hole and craniotomy for resection of a right frontal lobe cavernous malformation. There is fluid, blood products and air within the resection cavity. There is a rim of hypodensity around the cavity, presumably representing vasogenic edema. Ther... | Expected post-operative findings related to a right frontal craniotomy for resection of a right frontal lobe cavernous malformation. Assessment for residual lesion is otherwise limited on this non-contrast CT. |
Generate impression based on findings. | 58 years, Male, Reason: eval for bone mets History: Liver cancer vs. mets, also reported history of colon mass on imaging, and strong family history of colon cancer. No abnormal osseous foci are identified to indicate metastatic disease. Increased activity overlying the pelvis is within patient's diaper and repeat imag... | No evidence of bone metastases. |
Generate impression based on findings. | Question of fracture: cervical spine tenderness. There are small posterior disc-osteophyte complexes at C5-6 and C6-7 with mild spinal canal stenosis. There is no evidence of cervical spine fracture. There is straightening of the vertebral column alignment in the sagittal plane. The vertebral body and disc space height... | 1. No evidence of cervical spine fracture.2. Degenerative spondylosis at C5-6 and C6-7 with mild spinal canal stenosis. A cervical spine MRI may be useful for further characterization, if there are no contraindications. |
Generate impression based on findings. | Clinical question: Evaluate for acute intracranial process. Signs and symptoms: AMS. Nonenhanced head CT:There is no acute intracranial finding. CT however is insensitive for early detection of an acute nonhemorrhagic stroke.There is a single tiny focus of low attenuation in the left basal ganglion which is a nonspecif... | 1.There is no acute intracranial finding. CT however is insensitive for early detection of an acute nonhemorrhagic stroke.2.Single small focus of low-attenuation in the left basal ganglial is a nonspecific finding however in proper clinical setting could represent an age indeterminate lacunar infarct . |
Generate impression based on findings. | Breast carcinoma CHEST:LUNGS AND PLEURA: Biapical scarring.MEDIASTINUM AND HILA: Subcentimeter bilateral thyroid nodules.CORONARY ARTERY CALCIFICATION: None.CHEST WALL: Multifocal gas foci within the chest subcutaneous tissues. Bilateral breast prostheses. 1 x 2.4 cm loculated fluid collection within the left axilla; f... | No evidence for metastatic process. Bilateral breast prostheses. Expected postoperative changes including benign-appearing loculated left axillary fluid collection and multifocal chest subcutaneous gas foci. |
Generate impression based on findings. | Female 60 years old. Reason: +RF. Evaluate for RA. History: pain Three views of the right foot are provided. There is no fracture or malalignment. No erosions are evident. There are uniformly narrowed tarsal joint spaces which are suspicious for inflammatory arthritis. Three views of the left foot are provided. There i... | Uniformly narrowed tarsal joint spaces which are suspicious for an inflammatory arthritis such as rheumatoid arthritis. |
Generate impression based on findings. | 59 year old male with metastatic ALK positive lung cancer. CHEST:LUNGS AND PLEURA: Postsurgical changes of right lower lobectomy. Multiple pulmonary nodules and masses are noted bilaterally, some of which are unchanged but some appear increased in size. For example, a right upper lobe nodule measures 11 mm x 9 mm (seri... | Bilateral pulmonary nodules and masses compatible with metastatic disease, some of which have increased in size with reference measurements as above. |
Generate impression based on findings. | Female 10 years old Reason: fx History: swellingVIEWS: Right ankle AP, lateral and oblique 4/23/15 (3 views) Soft tissue swelling but no fracture, malalignment or joint effusion. | Soft tissue swelling with no fracture. |
Generate impression based on findings. | 48-year-old female patient with history of benign right breast biopsy in 2011. Family history of breast cancer in sister and mother. BILATERAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and 2 spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma i... | Multiple right breast cysts. 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 within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. There is a small amount of fluid in the right middle ear and mastoids, with patchy opacification of ethm... | Probable caput succedaneum at the parietal convexity without evidence of intracranial hemorrhage. |
Generate impression based on findings. | Male 4 years old Reason: eval for fracture; finger caught in hinge of door History: pain and swellingVIEWS: Left AP and left fourth finger lateral and oblique 4/23/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 10 years old Reason: concern for possible fracture, hit L ankle against a metal bar on playground History: inability to bear weightVIEWS: Left ankle AP, lateral and oblique 4/23/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | There is 9 millimeter grade 2 anterolisthesis of L4 on L5 which appears degenerative in etiology. The scout lateral view and the sagittal reformatted images demonstrate the remainder of the lumbar spine to be in normal alignment, with a normal lumbar lordosis. The vertebral body heights are well-maintained. There is m... | 1. Grade 2 anterolisthesis of L4 on L5 which appears degenerative in etiology. Moderate bilateral foraminal narrowing at this level.2. Up to moderate central spinal canal stenosis at L3-L4 with possible impingement descending L4 nerve roots. |
Generate impression based on findings. | Epilepsy with drop attacks: CT for intraoperative use. Intraoperative guidance images show a stereotactic head frame in position. There are postoperative findings related to right sided craniotomies and left frontal burrs holes with tissue deficiency in the anterior right temporal lobe. There is no evidence of gross ac... | Intraoperative guidance images show a stereotactic head frame in position without apparent associated complications. |
Generate impression based on findings. | Female 45 years old Reason: L Wrist Mass History: same Left wrist: Innumerable small well-circumscribed, calcified densities are identified within the soft tissues surrounding the carpal bones. The bones of the wrist are otherwise unremarkable.Right clavicle: There is erosion of the distal clavicle indicating hyperpara... | Multiple calcified densities about the wrist joint and acromioclavicular joint suggestive of calcium hydroxyapatite deposition disease secondary to renal osteodystrophy. There is erosion of the distal clavicle consistent with hyperparathyroidism. |
Generate impression based on findings. | 39-year-old female. Pain. Evaluate for injury. Comminuted, predominantly oblique extra-articular fracture of the fifth metatarsal distal diaphysis with medial displacement of the distal fracture fragment by approximately 1 bone shaft width. Associated soft tissue swelling. | Fifth metatarsal fracture. |
Generate impression based on findings. | 65-year-old male with history of abdominal aortic aneurysm and thoracic aorta dissection. Iliac aneurysm. AAA one-month follow-up. VASCULAR:Postoperative findings of dissection repair are again seen in the aortic arch. No evidence of persistent or recurrent dissection. Infrarenal abdominal aortic aneurysm (sagittal ima... | 1.Postoperative findings of thoracic aorta dissection repair, without interval change or dissection recurrence.2.Left renal mid pole enhancing lesion, increased in size, cannot exclude malignancy.3.Abdominal aortic aneurysm, bilateral iliac ectasia, and other findings as above. |
Generate impression based on findings. | Metastatic pancreatic carcinoma with worsening abdominal pain CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CORONARY ARTERY CALCIFICATION: None.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Interval increase in size and numbe... | Interval increase in size and number of bilobar hepatic metastases. Interval increase in size of pancreatic head primary mass. Interval increase in regional metastatic adenopathy. |
Generate impression based on findings. | Reason: eval for infection, inflammation, clot History: abdominal pain, immunosuppression ABDOMEN:LUNG BASES: Lung bases are normally aerated. No pleural effusions.LIVER, BILIARY TRACT: Small perihepatic ascites. No focal hepatic lesion. No intrahepatic or extrahepatic biliary ductal dilatation. No gallbladder wall thi... | 1.No evidence of venous thrombosis.2.Abdominal and pelvic ascites. |
Generate impression based on findings. | Subarachnoid space appears prominent superiorly along the frontal lobes. The ventricles and sulci are otherwise within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are few scattered foci of T2/flutter hyperintensity within the periventricular white matter bilaterally... | 1. No MR evidence of Chiari malformation. Normal CSF flow.2. Scattered foci of nonspecific FLAIR hyperintensity within the periventricular white matter.3. Stable partial visualization of syringohydromyelia which extends into the lower thoracic cord. Normal conus termination without MR imaging findings to suggest tether... |
Generate impression based on findings. | Female 59 years old Reason: toe pain No fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | Status post liver transplant; evaluate blood flow PORTAL VENOUS: Patent portal vessels with normal directional flow. Main portal vein velocity 51 cm/sec.HEPATIC ARTERIES: No significant abnormality noted.HEPATIC VEINS: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No signi... | Patent hepatic vessels with normal directional flow. |
Generate impression based on findings. | Reason: evaluate right lung field, ett placement, picc placement History: post op gastroschisis,VIEW: Chest AP (one view) 4/23/15 16:27 ET tube tip below the thoracic inlet and above the carina. NG tube tip is in the stomach. Right PICC tip in the SVC. Cardiothymic silhouette is normal.Complete right lung atelectasis. ... | Complete right lung atelectasis and left retrocardiac atelectasis. |
Generate impression based on findings. | Male 17 years old. Reason: pain. History: pain Four views of the right shoulder are provided. The shoulder is unremarkable in appearance without evidence of acute fracture or dislocation. | Unremarkable study of the right shoulder. |
Generate impression based on findings. | The cervical cord is of normal caliber and signal. There is unchanged kyphotic deformity of the upper cervical spine with abnormal appearance of the bowel mentally dysplastic upper cervical vertebrae. Posterior postoperative changes are again seen along the cervical spine.There is redemonstration of multilevel bilater... | 1. No significant interval change in appearance of multiple neurofibromas along the face and neck, involving upper cervical foramina, as well as the right much greater than left brachial plexus. Referenced neurofibromas are slightly smaller than in 2013.2. Stable appearance and caliber of the visualized cord. |
Generate impression based on findings. | Female 7 days old Reason: interval improvement in lung aeration History: resp insufficiencyVIEW: Chest AP (one view) 4/23/15 1631 hrs. ET tube terminates below thoracic inlet. Umbilical lines unchanged. Vertebral body malformation unchanged. Replogle catheter not visualized. Cardiac silhouette size is normal. Interval ... | Interval improvement in lung aeration as described. |
Generate impression based on findings. | 80 year old woman with history of hypertension and severe mitral regurgitation presenting prior to mitral valve surgery. CPT: 75572 There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm is noted. No protruding aortic atheroma or thrombus is noted in t... | 1.Patent thoracic aorta, abdominal aorta, and major branch vessels, without evidence of aneurysmal dilatation, dissection, or significant stenoses. No horseshoe or concentric calcification within access vasculature. Please see thoracic and abdominal measurements above. 2.Marked left atrial dilation with thickening of t... |
Generate impression based on findings. | 32 years, Female, Reason: 32 y.o with locally advanced left breast cancer with multiple pos Axila LN. and Right breast DCIS-evaluate for systemic mets History: Bil breast cancer, Left axilla mets s/p Bil mastectomy w reconstruction. No abnormal osseous foci are identified to indicate metastatic disease. | No evidence of bone metastases. |
Generate impression based on findings. | 60 years, Female, Reason: lytic lesion on head CT, assess for other bony lytic lesions versus mets History: large lytic lesion found on head CT. There is a focus of increased uptake in the right frontal calvarium corresponding to lytic lesion on CT. No additional areas of increased uptake are present. | Solitary focus of increased uptake in the right frontal calvarium corresponding to lytic lesion on CT. No additional osseous lesions are identified. Differential diagnosis includes neoplasm, such as a plasmacytoma or metastasis and chronic osteomyelitis. |
Generate impression based on findings. | 53 year old male with history of possible gastric volvulus on outside hospital CT examination with dysphagia and left upper quadrant abdominal pain. Single contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. During the exam, no spontaneous or provoked g... | Findings consistent with an entirely intrathoracic stomach/large hiatal hernia complicated by mesenteroaxial gastric volvulus, without evidence of acute obstruction. The patient was informed of the signs and symptoms associated with complications related to gastric volvulus. The patient denies any current symptomatolog... |
Generate impression based on findings. | 64 years, Female. Reason: tense abdomen History: abd pain Air distended loops of small and large bowel in a nonobstructive bowel gas pattern. IVC filter is unchanged in position. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Reason: r/o PE History: tachypnea, oxygen desaturation PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus.LUNGS AND PLEURA: Interlobular septal thickening and ground glass. Moderate bilateral pleural effusions with overlying atelectasis. Scattered pulmonary nodules, not significantly changed muscle wh... | 1.No acute pulmonary embolus.2.Findings compatible with CHF/hypervolemia including interlobular septal thickening, ground glass, and pleural effusion.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: tachycardia History: tachycardia PULMONARY ARTERIES: Technically adequate to the segmental level. No acute pulmonary embolus. No evidence of right heart strain.LUNGS AND PLEURA: Left lower lobe atelectasis/consolidation. Right basilar linear atelectasis and/or scarring. A few scattered pulmonary micronodules ar... | 1.No acute pulmonary embolus.2.Left lower lobe atelectasis/consolidation.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 65-year-old female with history of abdominal pain. ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: Cholecystectomy clips noted. No biliary dilatation. No additional significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No s... | 1.Findings consistent with diverticulitis, without abscess or perforation identified.2.Small umbilical fat containing hernia. |
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