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Generate impression based on findings. | Male 88 years old Reason: rt shoulder pain, compare w/ prior study. The bones are demineralized. Severe osteoarthritis affects the glenohumeral joint with bone on bone apposition and osteophyte formation. There is some narrowing of the acromiohumeral space raising the possibility of chronic rotator cuff tear. Moderate ... | 1. Severe osteoarthritis affects the glenohumeral joint and moderate osteoarthritis affects the acromioclavicular joint.2. Narrowing of the acromiohumeral space raising the possibility of chronic rotator cuff tear. |
Generate impression based on findings. | 39 years old Female. Reason: Hodgkin Lymphoma. History: H/O Hodgking Lymphoma s/p 6 cycles of AVD in need of end of treatment re-imaging. Please compare to prior studies. RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Please see diagnostic CT reports for details of the ne... | 1. Multiple new hypermetabolic lymph nodes in the pelvis and inguinal regions, highly suspicious for recurrence of lymphoma.2.Stable soft tissue density in the anterior mediastinum, which can be due to tumor or posttherapy change.3.Nonspecific focus of increased activity in the left supraclavicular region. Diagnostic C... |
Generate impression based on findings. | Female 61 years old Reason: scoliosis History: pain Minimal scoliosis of the thoracolumbar spine. No significant positive or negative coronal or sagittal balance.The bones are demineralized. Moderate/severe degenerative disk disease affects the C4-5 and C5-6 levels which appears to have progressed slightly from the pri... | 1. Minimal scoliosis of the thoracolumbar spine without significant positive or negative coronal or sagittal balance. 2. Degenerative disk disease, progressed in the cervical spine and unchanged in the lumbar spine, compared to prior study. 3. Facet osteoarthritis as described above. |
Generate impression based on findings. | Metastatic melanoma. Restaging. Assess disease. CHEST:LUNGS AND PLEURA: Linear atelectasis or scarring at both lung bases. No effusions. 4 x 7 mm left lingular nodule (image 39; series 4)MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes.CORONARY ARTERY CALCIFICATION: No significant coronary artery calcificati... | Extensive metastatic disease with reference measurements given above |
Generate impression based on findings. | 50 year-old female. Pain and swelling to the eminence and second and third metacarpal. No fracture or dislocation. There is suggestion of drooping osteophytes at the 2nd and 3rd metacarpal heads. Tiny osteophytes at the 2nd and 3rd proximal phalanx bases are also noted. There is scapholunate interval widening, consiste... | No fracture is identified. Findings suggestive of CPPD arthropathy. |
Generate impression based on findings. | Metastatic breast cancer, on therapy. There are several calvarial lesions with a permeative, moth eaten appearance, the largest of which is centered in the occipital bone and an additional one in the left parietal bone. There is underlying dural thickening. There is no evidence of acute intracranial hemorrhage or enhan... | 1. Large calvarial lesions with a permeative, moth eaten appearance in the occipital and left parietal bones and underlying dural thickening, consistent with metastases.2. No evidence of brain parenchymal metastasis. However, MRI would be more sensitive for small lesions. |
Generate impression based on findings. | 82-year-old female. Fall. Evaluate for fracture. Mild osteoarthritis affects the hips. No fracture or dislocation is evident on this single view. The bones are demineralized. Arterial calcifications in the pelvis and proximal thighs. | Osteoarthritis without evidence of a fracture. |
Generate impression based on findings. | Reason: concern for PE History: poor oxygenation with increased FiO2 and PEEP requirements PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus.LUNGS AND PLEURA: Right chest tube with tip at the right posterior apex. Moderate centrilobular and paraseptal emphysema. Dependent bilateral lower lobe consoli... | 1.No acute pulmonary embolus.2.Dependent bilateral lower lobe consolidation/atelectasis, most likely related to aspiration/infection. 3.Type A aortic dissection status post repair. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not appli... |
Generate impression based on findings. | Breast carcinoma. Follow-up ventricular catheter placement. There is interval placement of a right frontal approach Ommaya reservoir with tip of the ventricular catheter terminating in the right foramen of Monro. There is a suspected mass with surrounding edema in the superior semilunar lobule of the left cerebellar he... | 1. Interval placement of a right frontal approach Ommaya reservoir with tip of the ventricular catheter terminating in the right foramen of Monro. No evidence of hydrocephalus.2. Suspected mass with surrounding edema in the superior semilunar lobule of the left cerebellar hemisphere. Known leptomeningeal disease and te... |
Generate impression based on findings. | Reason: To determine if patient can take some oral tastes safely via spoon History: reflux, dysphagia, failure to thrive, underweight, feeding intoleranceEXAMINATION: Oropharyngeal motility study 4/24/15 Dana Sussman, speech and language therapist, supervised the examination.Two minutes 46 seconds of fluoroscopy was us... | Aspiration as above. Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | End-stage renal disease. Planning for kidney transplant The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: There is a 1.3 x 1.5 cm nodular opacity at the right lung base (image 24; series 4) which is indeterminate on imaging and could be evaluated with dedicated chest C... | 1. 1.5-cm spiculated right basilar pulmonary nodule; further evaluation with dedicated chest CT and/or PET scan is advised. This finding was discussed with the clinical service by telephone (pager number 6755) at the time of dictation. 2. Right common iliac to femoral artery bypass graft. Moderate calcifications. |
Generate impression based on findings. | Female 53 years old Reason: s/p L proximal humerus ORIF A plate and screw device affixes a fracture of the proximal humerus in near anatomic alignment. We see no hardware complications. | Orthopedic fixation of proximal humerus fracture. |
Generate impression based on findings. | 53-year-old female with history of low TSH and multinodular goiter who presents for concern for toxic nodule. The thyroid images demonstrate focus of increased activity in the right lower thyroid lobe; additionally, medially adjacent to this increased focus, there is a focus of decreased activity in the right lower thy... | 1.Findings consistent with a hot and a cold nodule in the right lower thyroid lobe. 2.Mildly increased thyroid uptake. |
Generate impression based on findings. | Increased work of breathing, hypoxiaVIEWS: Chest AP (1 views) 4/24/15 11:57 Tracheostomy tip below the thoracic inlet and above the carina. Cardiothymic silhouette is normal. Subsegmental retrocardiac atelectasis. No pleural effusions, or pneumothorax. | No evidence of pneumonia. Subsegmental retrocardiac atelectasis. |
Generate impression based on findings. | Reason: metastatic CA lung to liver. Status of disease, currently off therapy. History: pain RUQ CHEST:LUNGS AND PLEURA: Postsurgical and post radiation changes of a right upper lobectomy. Interval increase in size and number of bilateral pulmonary nodules compatible with metastases. Previous reference left upper lobe ... | 1.Significant interval increase in size and number of pulmonary and hepatic metastases.2.Interval increase in size of pancreatic mass and retroperitoneal lymphadenopathy.3.Splenic vein and left portal vein thrombosis, unchanged.4.Interval increase in intraductal biliary ductal dilatation and significant gallbladder dis... |
Generate impression based on findings. | 56 year old female with newly diagnosed breast cancer who presents for evaluation of osseous metastatic disease. No abnormal osseous foci are identified to indicate metastatic disease. | No evidence of bone metastases. |
Generate impression based on findings. | Malignant rectal cancer at the rectosigmoid junction. Laparoscopic robotic assisted low anterior resection with anastomosis followed by ostomy takedown. Abscess drain placement March 9. Evaluate for resolution of perirectal abscess ABDOMEN:LUNG BASES: Calcified nodule medially at the left lung base.LIVER, BILIARY TRACT... | Postsurgical and post drainage changes in the presacral space with loss of fat planes and residual soft tissue density in this region. I cannot identify a discrete fluid collection. Small presacral and upper abdominal lymph nodes. |
Generate impression based on findings. | 41 year old female patient with previously seen focal asymmetries in the right breast presents for 6 month follow up. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in patter... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female, 47 years old.Trigger: Post transplant No suspicious radiopaque foreign object is identified. Nonobstructive bowel gas pattern. Right-sided surgical drain and nephroureteral stent project in the right lower quadrant, expected position per Dr. Becker. Surgical clips project in the right upper quadrant and pelvis.... | No suspicious radiopaque foreign object is identified. Enteric tube side port likely proximal to the gastroesophageal junction; recommend advancing at least 8 cm. These findings were discussed by telephone with Dr. Becker, the attending surgeon, on 4/24/15 at 13:39. |
Generate impression based on findings. | 62 year old female with history of metastatic breast cancer. Surveillance on chemotherapy. CHEST:LUNGS AND PLEURA: Mild bibasilar atelectasis/scarring, somewhat improved from prior. Nodular pleural thickening is again seen, however this has subjectively decreased in conspicuity over the interval. The previously seen le... | 1.Reference lymph nodes are stable to slightly decreased in size over the interval.2.Right adrenal nodule is unchanged in size, and remains suspicious for a metastatic lesion.3.Pleural nodularity has slightly decreased in conspicuity over the interval. |
Generate impression based on findings. | Breast cancer with liver metastases CHEST:LUNGS AND PLEURA: Right subpleural reticulation consistent with radiation changes. Scattered micronodules without suspicious nodule or mass. No pleural effusions.MEDIASTINUM AND HILA: Left supraclavicular lymphadenopathy measures 3.3 x 3.0 cm (series 3, image 7), previously 3.4... | 1.Decreasing retroperitoneal and hepatic metastases.2.Stable or decreasing mediastinal lymphadenopathy.3.No new metastases. |
Generate impression based on findings. | 34 year old male. Right elbow pain. No fracture, dislocation, or significant arthritic changes. | No specific findings to explain the patient's symptoms. |
Generate impression based on findings. | Age: 71 years. Sex : Male. Reason for study: Reason: eval for dysphagia History: difficulty swallowing. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtain... | The exam was positive for penetration and positive for aspiration. Please refer to concomitant speech pathology report for further details and feeding recommendations. |
Generate impression based on findings. | 65-year-old male. Left thigh lesion, not biopsied because it was believed it was myositis ossifications. Routine follow-up. Again seen in the left vastus intermedius muscle is myositis ossificans with focal continuity superiorly with the anterior proximal diaphysis of the femur. There is interval maturation of ossifica... | Interval maturation of myositis ossificans in the vastus intermedius muscle. |
Generate impression based on findings. | Reason: 59 yo M with RA, concerning for ILD/emphysema (long hx of smoking) History: sob LUNGS AND PLEURA: Scattered calcified and noncalcified pulmonary micronodules. No suspicious pulmonary nodules or masses. Basilar predominant mild reticulation and bronchiectasis compatible with fibrosis. Left upper lobe anterior su... | Mild basilar and upper medial anterior predominant reticulation and bronchiectasis compatible with pulmonary fibrosis in a possible UIP pattern. |
Generate impression based on findings. | 75-year-old female with history of cholangiocarcinoma who presents for evaluation.RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates numerous bilateral pulmonary nodules as well as subcentimeter mediastinal and hilar lymph nodes. There ... | 1.Markedly hypermetabolic foci within the liver consistent with known history of cholangiocarcinoma.2.Multiple hypermetabolic pulmonary nodules, mediastinal nodes, and hilar lymph nodes highly suspicious for metastatic disease.3.Mild to moderately hypermetabolic ascending and transverse colonic wall activity which may ... |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no suspicious solid or cystic mass identified. There are bilateral benign morphology masses ... | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | AMS and stroke. There is no evidence of acute intracranial hemorrhage. There are multiple supratentorial and infratentorial areas of hypoattenuation, which are newly apparent or more conspicuous. The ventricles and basal cisterns are unchanged in size. There is no midline shift or herniation. There is an atelectatic an... | Interval evolution of multifocal acute to early subacute infarcts, without hemorrhagic transformation or significant mass effect. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 61-year-old male with history of high-level EBV. Evaluate for lymphadenopathy. CHEST:LUNGS AND PLEURA: No suspicious nodules.MEDIASTINUM AND HILA: Heart size normal no pericardial effusion. No mediastinal or hilar lymphadenopathy.CORONARY ARTERY CALCIFICATION: None.CHEST WALL: Normal morphology axillary lymph nodes are... | No significant lymphadenopathy as clinically queried. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Right breast benign biopsy. Two standard digital views of both breasts and additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Scar marker overlies the righ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: restaging s/p cycle 2 for NSCLC (CT scheduled as outpt 4/24/15 at 9:30am; can it be done inpt at same time?) Thank you. History: Non small cell lung ca s/p cycle 2 chemo admitted with sepsis CHEST:LUNGS AND PLEURA: Right apical scarring and volume loss compatible with prior surgery. Previously identified focal ... | 1.Bibasilar opacities likely edema and pleural effusions, slightly increased compared to prior. 2.Enlarging nonspecific mediastinal lymphadenopathy.3.Posttreatment changes in the right hemithorax. Previously identified enhancing and hypermetabolic focal atelectasis no longer enhances and may have represented postsurgic... |
Generate impression based on findings. | 27-year-old female. Deep ankle pain in a runner, increasing distance and speed. Evaluate for compression fracture. No fracture, dislocation, or other significant abnormality is evident. | No evidence of a fracture. |
Generate impression based on findings. | Movement disorder. Evaluate for Parkinson's disease versus essential tremor. Decreased activity in the putamina bilaterally. | Decreased activity in the putamina suggestive of Parkinson's disease. |
Generate impression based on findings. | 65-year-old male who presents for restaging of head and neck cancerRADIOPHARMACEUTICAL: 13.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion grossly demonstrates mildly enlarged bilateral cervical and mediastinal lymph nodes. Minimal residual right middle lobe opacity. Mild peric... | 1.No definite evidence of tumor. 2.Granulomatous disease involving the mediastinum and hilar lymph nodes. 3.Nonspecific focus of hypermetabolic activity in the chest wall adjacent to the sternum as well as at the site of the gastric suture.4.Hypermetabolic left axillary lymph node likely inflammatory in etiology. |
Generate impression based on findings. | 50 year old female with known bilateral cysts presents for annual mammogram. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distr... | 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. | Male 59 years old; Reason: colon cancer follow up History: none CHEST:LUNGS AND PLEURA: No solid pulmonary lesions. The pleural spaces are clear.Minimal subsegmental atelectasisMEDIASTINUM AND HILA: Minimal coronary calcifications. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER... | 11-mm hypodense nodule in the liver that should be followed. I could not identify this on previous examinations however this area was suboptimally visualized on both available prior studies. |
Generate impression based on findings. | 62-year-old female with history of metastatic breast cancer on surveillance chemotherapy who presents for evaluation Numerous abnormal osseous foci compatible with metastatic foci are seen including throughout the spine, pelvis, bilateral ribs, sternum, calvarium, right clavicle, and right femoral neck. There is a new ... | Overall stable widespread osseous metastatic disease as above |
Generate impression based on findings. | Reason: 10 yo F w/ right sided limp History: right sided limp Right hip: Round smooth femoral epiphysis is appropriately seated in the well developed acetabulum.Right tibia/fibula: No fracture or dislocation.Right knee: No fracture or dislocation. No joint effusion. | No fracture or malalignment. |
Generate impression based on findings. | 50 year-old male who presents for evaluation for bronchogenic carcinomaRADIOPHARMACEUTICAL: 14.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 92 mg/dL. Today's CT portion grossly demonstrates bilateral enlarged cervical and mediastinal lymph nodes. Small nonspecific groundglass focus on the right upper lo... | 1.Hypermetabolic right breast tissue. Further evaluation with mammography and/or ultrasound is recommended.2.Bilateral hypermetabolic cervical lymph nodes. Differential considerations include lymphoma, granulomatous disease, versus metastatic disease.3.Nonspecific mildly hypermetabolic left axillary and bilateral ingui... |
Generate impression based on findings. | Reason: head and neck cancer compare to previous with measurements. History: as above LUNGS AND PLEURA: No sign of pulmonary or pleural metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.The heart size is normal as is the pericardium.CORONARY ARTERY CALCIFICATION: Mild.CHEST WALL: Mild de... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 26-year-old male with history of retinoblastoma, esthesioneuroblastoma, and relapsed osteosarcoma who presents for evaluation There is increased activity in the maxilla, bilateral maxillary sinuses, as well as of the right orbit. No additional abnormal osseous foci are identified. | Increased activity in the maxilla, bilateral maxillary sinus, and right orbit. While findings may be postsurgical in etiology, underlying tumor cannot be excluded. |
Generate impression based on findings. | Reason: History of retinoblastoma, esthesioneuroblastoma, and relapsed osteosarcoma, t-cell therapy trial evaluation. History: no new s/s LUNGS AND PLEURA: Small linear scar right middle lobe adjacent to the fissure, unchanged as far back as it least 2007 and a little clinical significance.No evidence of pulmonary or p... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 31 year-old female with nausea and vomiting with history of chemotherapy. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 54.7 % of peak activity (normal >7... | Gastric emptying within normal limits.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 6-year-old female with a history of straight series lung carcinoma who presents for re restagingRADIOPHARMACEUTICAL: 14 . mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 128 mg/dL. Today's CT portion grossly demonstrates large right lower lobe mass. There is nodular thickening of the right adrenal gland as w... | 1.Hypermetabolic right lower lobe pulmonary mass highly suspicious for lung carcinoma.2.Hypermetabolic subcarinal and right hilar lymph nodes.3.Hypermetabolic adrenal glands, left greater than right, suspicious for metastatic disease. |
Generate impression based on findings. | Reason: 5 years s/p LLL for squamous cell carcinoma History: follow up LUNGS AND PLEURA: Postsurgical changes of a left lower lobectomy. Moderate to severe centrilobular emphysema. New right upper lobe diffuse ground glass opacity. New bibasilar tree in bud and ground glass opacity and atelectasis. New small right and ... | Interval increase in right middle lobe diffuse ground glass opacity and bibasilar atelectasis tree in bud and ground glass opacities compatible with aspiration. |
Generate impression based on findings. | 25 year old female with history of episodic nausea, vomiting and chest pain. Evaluate for cholelithiasis/cholecystitis. LIVER: Slightly increased echogenicity of the hepatic parenchyma. No biliary dilatation or other significant abnormality.GALLBLADDER, BILIARY TRACT: No biliary dilatation. The gallbladder is within no... | The gallbladder is within normal limits, without findings of cholecystitis or other evidence to explain the patient's pain. |
Generate impression based on findings. | Reason: compare to prior study: AML with history of diffuse tree-in-bud opacities, and right lung ground glass infiltrates History: improving cough despite influenza B (flu diagnosed 4/15/15) LUNGS AND PLEURA: Previously identified tree in bud opacities have significantly improved or result, except for a new area affec... | Waxing and waning tree in bud opacities consistent with bronchiolitis, for the most part improved. Interval improvement in right lower lobe groundglass subpleural region which could of represented focal fungal infection improving with recovering counts. |
Generate impression based on findings. | Reason: eval for ILD History: history of ANCA vasculitis with unresolving cough/sob LUNGS AND PLEURA: Scattered areas of scarring/discoid atelectasis similar to the prior exam.Again noted is mild bronchial/bronchiolar wall thickening.Scattered stable micronodules.No suspicious pulmonary nodules or masses.No focal areas... | Mild bronchial and bronchiolar wall thickening without focal airspace opacities. No evidence of air trapping. No suspicious pulmonary nodules or masses. |
Generate impression based on findings. | 59-year-old male. Knee pain. Evaluate for OA. Minimal osteoarthritis affects the right knee with sharpening of the tibial spines and very mild medial tibiofemoral compartment joint space narrowing. Enthesopathic changes at the quadriceps tendon insertion on the patella. | Minimal osteoarthritis. |
Generate impression based on findings. | 49-year-old female. Positive ANA, foot pain and swelling. Back pain and stiffness, inflammatory features. Evaluate for inflammatory arthritis. Evaluate for sacroiliitis. Right foot: Mild hallux valgus deformity and minimal 1st MTP joint osteoarthritis. No erosions are evident. Tiny plantar and posterior calcaneal spurs... | Osteoarthritis and hallux valgus deformity. No radiographic evidence of sacroiliitis or an inflammatory arthropathy. |
Generate impression based on findings. | Reason: newly diagnosed breast cancer History: newly diagnosed breast cancer CHEST:LUNGS AND PLEURA: Scattered punctate nonspecific pulmonary micronodules. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Small mediastinal hilar lymph nodes. No significant mediastinal or hilar lymph... | 1.Right breast mass compatible with patient's history of breast cancer. Enlarged right axillary lymph nodes suspicious for local metastasis.2.No evidence of distant metastases. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Volume loss left lung post left upper lobectomy.Numerous small pulmonary nodules in both lungs with subtle interval increase in numbers and size.Some of these nodules demonstrate cavitation.Left basilar scarring unchanged.L.... | Continued progressive increase in number and size of numerous pulmonary micronodules suspicious of metastatic disease. |
Generate impression based on findings. | Female 11 years old Reason: right ankle pain since Nov, heard crack in ankle today History: difficulty weight bearingVIEWS: Right ankle AP, lateral and oblique 4/24/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Reason: 60 y/o with MCTD, mild restrictive disease, c/o DOE, evaluate changes History: DOE LUNGS AND PLEURA: Mosaic attenuation compatible with small airways or small vessels disease. No evidence of fibrosis. No consolidation, pleural effusion, or pneumothorax. No suspicious pulmonary nodules or masses.MEDIASTINUM AND ... | 1.No evidence of interstitial lung disease. No pulmonary abnormality.2.Stable enlarged prevascular lymph nodes. |
Generate impression based on findings. | 46 year old female patient with small masses in right lower inner quadrant on screening mammogram. RIGHT DIAGNOSTIC MAMMOGRAM: An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular den... | Multiple masses in the 2 to 3 o'clock position of the right breast in a ductal distribution. Recommend ultrasound guided biopsy of the largest mass with blood flow.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: eval for evidence of hydrocephalus History: headache, VP shunt There is redemonstration of enlargement of the trigones of the lateral ventricles representing colpocephaly. The left lateral ventricle is larger than the right lateral ventricle. The ventricles are unchanged in size since the prior exam. The ventri... | 1.Stable ventriculostomy tube position.2.Stable size of ventricles with colpocephaly. The left lateral ventricle is larger than the right lateral ventricle.3.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | 39 old female with history of right lower quadrant pain. Fevers. Evaluate for pelvic or colonic abnormality, and for appendicitis. ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: No biliary dilatation or perihepatic fluid collections. The gallbladder is distended, without significant abnormality... | 1.Equivocal colonic wall thickening, may be due to underdistention with contrast or could represent a nonspecific colitis. 2.No small bowel destruction, pneumatosis or evidence of appendicitis.3.Small fat-containing umbilical hernia, correlate with physical exam to exclude this as the etiology of the patient's pain. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Mild to moderate upper lobe predominant centrilobular and paraseptal emphysema. Scattered pulmonary micronodules are unchanged. No new or suspicious pulmonary nodules or masses. No pleural effusions.Tracheostomy tube in plac... | 1.No evidence of metastases.2.Interval decrease in right hilar lymphadenopathy compared to prior.3.Complete occlusion of the distal abdominal aorta and bilateral common iliac arteries, unchanged. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. Artifact in the left axillary images is not a significan... | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female patient with history of breast cysts. Family history of breast carcinoma in her sister diagnosed at 43 years of age. BILATERAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, ... | Waxing and waning bilateral cysts, right greater than left. 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: ... |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Stable scattered micronodules.Interval clearing of left lower lobe cavitating nodule.No new suspicious pulmonary nodules or masses.Right apical scarring.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymp... | Interval clearing of the previously noted left lower lobe cavitating nodule. No evidence of metastatic disease. |
Generate impression based on findings. | CT HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns 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 extracranial soft tissues are unremarkable. CTA... | 1. Interval increase in size of the partially imaged type B aortic dissection with increased of thrombosis in the proximal false lumen, as well as a new small left pleural effusion. The findings raise the possibility of impending rupture. 2. A 3 mm aneurysm projects laterally off the inferior division of the right midd... |
Generate impression based on findings. | 48-year-old female. Left knee pain. Moderate osteoarthritis affects the left knee with marked medial tibiofemoral compartment and lateral patellofemoral joint space narrowing as well as tricompartmental osteophytes. Comparison cannot be made to the prior examination as it was non weight-bearing. Small knee joint effusi... | Osteoarthritis. |
Generate impression based on findings. | PEA arrest. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is minimal periventricular white matter hypoattenuation, which may represent age-indeterminate small vessel ischemic disease. There is mild diffuse cerebral volume loss. There is no mid... | No evidence of acute intracranial hemorrhage, mass, or discernible cerebral edema.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 47 years, Male. Reason: S/P LVAD. post-op eval for VAD position with deep VAD pocket History: post-op eval Gaseous distention of the small bowel, and colon without evidence of obstruction. Moderate stool burden. LVAD, AICD leads, and sternotomy wires and plates in place, unchanged in position. Left sided pleural effusi... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Evaluate for hydrocephalus and possible shunt. There is a midline frontal cranioplasty and posterior midline vascular clips, but no evidence of an intracranial shunt device. There is extensive left frontal lobe encephalomalacia and volume loss communicating with the frontal horn of the left lateral ventricle. There als... | Post-surgical fnidings with extensive left frontal lobe porencephalic cyst formation, but no evidence of intracranial shunt device. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 49-year-old female with history of recurrent stage III ovarian carcinoma. CHEST:LUNGS AND PLEURA: Calcified right upper lobe pulmonary micronodule, unchanged. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Confluent heterogeneous enhancing soft tissue mass in the right superior mediastinum measures 6.0 x 3.9 cm,... | Mild improvement in appearance of metastatic disease with reference measurements as above. |
Generate impression based on findings. | 27 years, Female. Reason: 5 mm right kidney stone on outside CT History: right flank pain Radiopaque density projecting at the level of the interpolar region of the right kidney, consistent with the stated history of renal stone. Relative paucity of small bowel gas without evidence of obstruction. Average stool burden. | 6-mm radiodensity consistent with the stated history of a right renal stone. |
Generate impression based on findings. | Clinical question: Mental status changes, rule out hemorrhage. Signs and symptoms: Subdural status post evacuation. Unenhanced head CT:There is no convincing evidence of interval increased hemorrhage or new hemorrhage since prior study. Acute subdurals along the tentorial leaves (left greater than right) demonstrates s... | 1.No convincing evidence of new hemorrhage since prior study.2.Small subdurals along the bilateral tentorial leaves and the falx posteriorly demonstrate no change to possible subtle decreased size.3.Stable postoperative changes of the left hemispheric subdural resection with minimal residual blood since prior exam.4.St... |
Generate impression based on findings. | Reason: Tongue Cancer; please include measurements History: as above CHEST:LUNGS AND PLEURA: Scattered calcified and noncalcified pulmonary micronodules, unchanged, and likely benign. No new or suspicious pulmonary nodules or masses. No pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Hea... | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: Evidence, extend of Crohn's involvement History: Recently diagnosed Crohn's disease involving stomach, duodenum and colon. Abdominal pain, weight lossEXAMINATION: MR enterography without and with IV contrast 4/24/15 ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion. No intrahepatic or extrahepatic biliary d... | Mildly dilated and featureless terminal ileum and mildly dilated duodenum, which may be sequela of chronic inflammation. |
Generate impression based on findings. | 78-year-old female patient with screen detected focal asymmetry with calcifications the left upper outer breast. LEFT BREAST DIAGNOSTIC MAMMOGRAM: Left ML, left CC, left XCC, one spot magnification, and one spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is... | Oval focal asymmetry in the left upper outer quadrant appears benign in morphology. Benign left breast calcifications. 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 w... |
Generate impression based on findings. | Female 6 years old Reason: middle finger pain History: finger pain Oblique intra-articular fracture of the distal aspect of the proximal phalanx of the middle/long finger. | Oblique intra-articular fracture of the distal aspect of the proximal phalanx of the middle/long finger. |
Generate impression based on findings. | Female 32 years old Reason: left hip pain History: hip pain Left hip: The joint space is well-preserved. No fracture or malalignment. Pelvis: Nonspecific asymmetric stranding in the soft tissues along the lateral aspect of the proximal femur. | Nonspecific asymmetric stranding in the soft tissues along the lateral aspect of the proximal femur. Clinical correlation is recommended. |
Generate impression based on findings. | 62-year-old female. Right proximal humerus fracture. Again seen is a comminuted, predominately transverse fracture through the neck and greater tuberosity of the right humerus. Mild impaction of the fracture fragments. Again seen are bone fragments in the region of the inferior glenohumeral joint. | Right proximal humerus fracture. |
Generate impression based on findings. | 78-year-old female. Status post revision right TSA. Interval placement of a total reverse shoulder arthroplasty, which appears in anatomic alignment on this single limited view. Foci of air in the soft tissues reflect recent surgery. | Total reverse shoulder arthroplasty device. |
Generate impression based on findings. | Recurrent stage III borderline ovarian carcinoma with right supraclavicular lymphadenopathy: occasional shortness of breath. There has been decrease in size of the conglomerate of right supraclavicular lymphadenopathy, which contains areas of necrosis, calcifications, and signs of extracapsular extension, now measuring... | 1. Interval decrease in size of the metastases in the right neck, right superior mediastinum, and right apical pleural region. Please refer to the separate chest CT report for additional details.2. Persistent thrombosis of the inferior right internal jugular vein with reconstitution via collateral vessels superiorly. |
Generate impression based on findings. | Reason: ex 24 weeker, recurrent new desats, DOL10VIEW: Chest AP (one view) 4/24/15 15:28 ET tube tip is below the thoracic inlet and above the carina. NG tube tip is near the GE junction. UAC tip overlies T9 vertebra. Right extremity PICC tip in the SVC. Cardiac silhouette size is top normal or mildly enlarged. Atelect... | NG tube tip near the GE junction. Recommend advancement. Atelectasis of the RUL and RML. Stable diffuse hazy pulmonary opacity compatible with PIE. |
Generate impression based on findings. | Polycystic ovary and preeclampsia with proteinuria and CKD KIDNEYS: Right kidney measures 13.0 cm in length. The left kidney measures 12.6 cm in length. Normal renal echotexture without hydronephrosis.AORTA: Peak systolic velocity of 0.7 m/secRIGHT RENAL ARTERY: Peak systolic velocity of 0.8 m/sec. The parenchymal resi... | Normal grayscale ultrasound and doppler of the kidneys. |
Generate impression based on findings. | Movement disorder. Evaluate for Parkinson's disease versus essential tremor. Normal symmetric activity is seen in the basal ganglia. | Normal examination. No evidence of nigrostriatal dopaminergic dysfunction. Given the history, these findings are suggestive of essential tremor. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are diagnostic left breast mammogram dated 2/6/2015; stereotactic left breast biopsy dated 2/19/2015 performed at South Bend Clinic. For comparison, mammograms from 1/22/2014, 1/30/2014 and 8/4/2013 during 6 month follow up periods are available. Diagno... | 4.6 cm cluster of amorphous calcifications in the left upper outer quadrant with biopsy proven ADH and microcalcifications. High risk MRI screening can be considered and surgical consultation is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female 56 years old Reason: ?abnormality of anterior rib 7 or 8 just medial to the midclavicular line. Focal tenderness-chronic in sickler. No rib fracture. No specific findings to account for patient's tenderness. | No rib fracture. No specific findings to account for patient's tenderness. |
Generate impression based on findings. | 70 year-old female. Left shoulder pain, rotator cuff tear. Evaluate for bone changes. Mild glenohumeral joint osteoarthritis. No fracture or dislocation. High riding humeral head consistent with a chronic rotator cuff tear. Left chest wall port is noted. | High riding humeral head consistent with a chronic rotator cuff tear. |
Generate impression based on findings. | Male 73 years old Reason: 73 y/o with + RF, fatigue, weight loss, evaluate for any changes History: 73 y/o with + RF, fatigue, weight loss, evaluate for any changes Right foot: Joint space narrowing and osteophyte formation at the first, second, and third metatarsophalangeal joints consistent with moderate osteoarthrit... | 1. Symmetric metacarpophalangeal joint narrowing suggests rheumatoid arthritis.2. Osteoarthritis in the hands and feet as described above.3. Radiopaque foreign body in the soft tissues of the distal second finger. |
Generate impression based on findings. | 78-year-old female patient with screen detected focal asymmetry with calcifications the left upper outer breast. LEFT BREAST DIAGNOSTIC MAMMOGRAM: Left ML, left CC, left XCC, one spot magnification, and one spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is... | Oval focal asymmetry in the left upper outer quadrant appears benign in morphology. Benign left breast calcifications. 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 w... |
Generate impression based on findings. | Asymptomatic female patient with history of breast cysts. Family history of breast carcinoma in her sister diagnosed at 43 years of age. BILATERAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, ... | Waxing and waning bilateral cysts, right greater than left. 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: ... |
Generate impression based on findings. | Trauma.VIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), 4/24/15, 1549 hrs. The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. Vertebral body heights and disk spaces are norma... | Mild adenoid hypertrophy, otherwise normal examination. |
Generate impression based on findings. | Male, 46 years old, with history of cT1-T2 N2b stage IVa right base of tongue squamous cell carcinoma. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Neck:Bulky mucosa at the right tongue base has ... | 1.Response to treatment of both the tongue base lesion and the right neck adenopathy.2.No evidence of intracranial metastases. |
Generate impression based on findings. | Triple negative breast cancer on anti-PD-L1 therapy. There has been interval increase in size of a heterogeneous left supraclavicular lymph node that measures up to 35 x 30 mm, previously 23 x 27 mm. The lymph node is indistinct from the adjacent musculature and left internal jugular vein. There is also partially image... | 1. Interval increase in size of the metastatic left supraclavicular lymphadenopathy may represent a treatment effect versus tumor progression. 2. Partially imaged upper mediastinal lymphadenopathy that also likely represents metastatic disease appears to have decreased in size slightly. Please refer to the separate che... |
Generate impression based on findings. | Reason: Evaluate interval changes History: s/p arrest 3 mo ex 28 wk maleVIEW: Abdomen AP (one view) 4/24/15 Tracheostomy tube tip below the thoracic inlet and above the carina. G-tube in place. Left femoral venous access tip in left common iliac vein. Urinary catheter in place. Rectal temperature probe in place. Cardio... | Interval improvement of right upper lobe, left upper lobe, and left lower lobe atelectasis. Paucity of bowel gas. |
Generate impression based on findings. | 64 year old female. Pain. Evaluate for OA/RTC disease. Right shoulder: No fracture, dislocation, or significant arthritic changes are evident. Glenohumeral joint alignment is anatomic.Left shoulder: Mild osteoarthritis affects the glenohumeral joint with small subchondral humeral head cysts. No fracture or dislocation.... | Mild left shoulder osteoarthritis. Unremarkable right shoulder radiograph. |
Generate impression based on findings. | Female, 52 years old, with left facial droop. Assess for hemorrhage. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. A small deposit of fatty tissue is noted incidentally along the posterior falx.No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is n... | No acute intracranial abnormality. |
Generate impression based on findings. | 49-year-old female with history of islet cells transplant on 4/20 now with dropping hemoglobin. ABDOMEN:LUNG BASES: Small right pleural effusion. Mild bibasilar atelectasis.LIVER, BILIARY TRACT: There is a large heterogeneous subcapsular fluid collection along the anterior aspect of the liver extending inferiorly compa... | 1. Large subcapsular hepatic hematoma with adjacent mass effect on the liver.2. Large volume ascites which is higher density than simple fluid. This may indicate a small amount of blood products within the ascitic fluid. |
Generate impression based on findings. | 23-year-old male with history of Crohn's status post ileocecectomy. Evaluate extent of ileal disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant... | Findings suggestive of inflammation/colitis near the ileocolic anastomosis as above. Cannot exclude fistula from the colon to a nearby loop of distal ileum (coronal image 79). No additional significant abnormality. |
Generate impression based on findings. | Female 8 years old Reason: s/p fall; please evaluate for fracture/malalignment History: s/p fall with back painVIEWS: Thoracic spine AP, lateral and swimmers view. Lumbar spine AP and lateral 4/24/15 (5 views) Vertebral body heights and disk spaces are maintained. No fracture or malalignment. No spondylolyses. | Normal examination. |
Generate impression based on findings. | Female, 40 years old, status post cavernoma resection. Evaluate postoperative resection bed for hemorrhage. The right frontal lobe resection cavity is stable in size and morphology. The quantity and attenuation characteristics of blood product within the cavity are unchanged relative to the immediate prior exam. Contin... | 1.Stable appearing right frontal resection cavity.2.No significant interval change in the quantity or attenuation characteristics of blood product within the resection cavity. |
Generate impression based on findings. | 72 year old female. Patient now with worsening knee pain. History of traumatic injury in the distant past. Mild osteoarthritis affects the left knee with mild medial tibiofemoral compartment joint space narrowing and sharpening of the tibial spines. Chondrocalcinosis of the lateral meniscus. Arterial calcifications in ... | Mild osteoarthritis and chondrocalcinosis. |
Generate impression based on findings. | Female, 32 years old, with idiopathic intracranial hypertension and new left exotropia and proptosis. Evaluate for mass. The globes are round and symmetric. The left globe is mildly proptotic relative to the right, on the order of 1 to 2 mm at most. The extraocular muscles are symmetric and normal in caliber. The intra... | 1.Mild proptosis of the left globe relative to the right.2.No evidence of any intraorbital mass or other specific finding to account for the proptosis. |
Generate impression based on findings. | Febrile, acute pancreatitis ABDOMEN: LUNG BASES: Subpleural cystic changes suggest chronic interstitial disease. Small bilateral pleural effusions and left basilar consolidation/atelectasis.LIVER, BILIARY TRACT: Mild intrahepatic biliary ductal dilation. Gallstones.SPLEEN: The splenic vein is attenuated but patent.PANC... | 1.Pancreatic necrosis involving the majority of the pancreas. 2.Pleural effusions and left basilar consolidation / atelectasis. |
Generate impression based on findings. | 63-year-old male with history of renal cell cancer and mediastinal mass. CHEST:LUNGS AND PLEURA: Calcified subpleural nodules in the left lower lobe appear similar to prior. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Calcified right superior mediastinal mass measures 3.6 x 3.4 cm, previously 3.9 x ... | 1. Right superior mediastinal mass is stable in size and appearance.2. Multicystic left kidney compatible with patient's known polycystic kidney disease. Although these cystic lesions appear somewhat stable compared to the prior exam, detection of RCC is difficult in these cases.3. Vascular abnormalities of the chest a... |
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