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Generate impression based on findings. | Male 10 years old Reason: eval for pneumonia, effusion size History: fevers, s/p OLT, tachypneaVIEW: Chest AP (one view) 5/1/15 Central line, NG tube and skin staples unchanged. Interval removal of abdominal drain. Cardiac silhouette size is enlarged but stable. Right lower lobe atelectasis and superimposed pleural eff... | Right lower lobe atelectasis and superimposed pleural effusion. |
Generate impression based on findings. | Reason: Eval cystic lesion for stability History: Eval cystic lesion for stability LUNGS AND PLEURA: Small cystic lesion in the right upper lobe (series 4/23) with thickening of the lateral wall, not significantly changed since the previous scan, but with a slight increase in wall thickness compared to earlier scans da... | Slight increase in the thickness of the wall of a right upper lobe cyst since 2012, which remains suspicious for indolent primary carcinoma. Further follow-up is recommended in 6 to 12 months. |
Generate impression based on findings. | 48 year old female with LLQ abdominal pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Three hypoattenuating right hepatic lobe lesions demonstrate discontinuous nodular peripheral enhancement. In the absence of known primary malignancy, these are most sugges... | 1.Status post hysterectomy. 2.Bilateral adnexal masses may represent ovarian lesions if ovaries were not removed at time of hysterectomy; correlation with surgical history is recommended. If ovaries remain, pelvic ultrasound should be considered to exclude ovarian torsion. |
Generate impression based on findings. | 86-year-old male status post left tibial lesion biopsy. Staging study. CHEST:LUNGS AND PLEURA: Bilateral scattered micronodules, some calcified. No suspicious pulmonary nodules identified.No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Few subcentimeter mediastinal lymph nodes, not enlarged by size cri... | 1.Heterogeneous mass obliterating the right renal pelvis with infiltrative extension into the right renal vein and possibly IVC, with additional significant attenuation of the right renal artery. Given the location, transitional cell carcinoma is favored over renal cell carcinoma. Cystoscopy for tumor sampling may be c... |
Generate impression based on findings. | 24-year-old male with history of renal medullary cancer. Evaluate for progression of metastatic disease. Pelvic pain. CHEST:LUNGS AND PLEURA: Ground glass opacities and tree-in-bud opacities primarily in the anterior segment of the right lower lobe may represent bronchiolitis from aspiration or infection. No focal cons... | 1.Heterogenous mass primarily within and obstructing the right renal collecting system. Given the appearance and location of tumor as described above, we would favor transitional cell carcinoma in the absence of the provided history of medullary cancer, which would remain lower on our differential. Benign clot may also... |
Generate impression based on findings. | 26-year-old female who underwent percutaneous endoscopic jejunostomy placement due to an ability to tolerate PO intake due to severe gastroparesis. Patient with severe abdominal pain postprocedure. ABDOMEN:LUNG BASES: Lung bases clear. Partially imaged pacemaker leads noted.LIVER, BILIARY TRACT: No significant abnormal... | No specific evidence of complication of the percutaneous jejunostomy tube. |
Generate impression based on findings. | 68 year old female with history of pancreatic malignancy. Distension and abdominal pain. ABDOMEN:LUNG BASES: New trace bilateral effusions.LIVER, BILIARY TRACT: Biliary stent again noted. Pneumobilia not significantly changed. Status post cholecystectomy. Previously described fluid collection along superior aspect of l... | 1.Continued interval growth of pancreatic head mass; highly likely to represent tumor progression, and superimposed inflammatory or infectious process should also be considered.2.New SMV thrombosis possibly representing tumor invasion. |
Generate impression based on findings. | 53 year old female with abdominal pain after eating whole bag of chips yesterday. ABDOMEN:LUNG BASES: Small hiatal hernia.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating left liver lesion, too small to further characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL G... | No findings to account for abdominal pain. |
Generate impression based on findings. | 57-year-old female with abdominal pain, pancreatitis. Evaluate for pancreatitis complications. CHEST:LUNGS BASES: Persistent trace bilateral pleural effusionswith improved basilar consolidation/atelectasis.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. Previously seen minimal intrahepatic ... | 1.No significant interval change in degree of pancreatic necrosis and surrounding inflammatory changes.2.New splenic infarct without current evidence of compromise of splenic vasculature. |
Generate impression based on findings. | Surgical clips, skin staples, two right upper quadrant surgical drains, NG tube with sidehole at GE junction; 4 towel clamps external to the patient. No unexpected radiopaque foreign body.Nonobstructive bowel gas pattern. | No unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Renz, the attending surgeon, on 5/1/2015 at 2123 hours. |
Generate impression based on findings. | Female, 50 years old.Rule out foreign body. Trigger: Incorrect needle count. Surgical clips and staples project over the right upper quadrant/right inferior thorax. Surgical drain in the pelvis. Dobbhoff tube tip in the gastric body with at the GE junction. No unexpected radiopaque foreign body.Nonobstructive bowel gas... | No unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Park, the attending surgeon, on 5/1/2015 at 1747 hours.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 56-year-old male with abdominal pain. Rule out obstruction. LVAD, cholecystectomy clips noted.Mild gaseous distention of a few loops of small bowel could indicate developing ileus. Average colonic stool burden. | Mild gaseous distention of a few loops of small bowel could indicate developing ileus. Continued follow up is suggested.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 79-year-old female status post tube placement. The pelvis is excluded from the field-of-view.Dobbhoff tube tip projects in the gastric body. Sternotomy fixation, epicardial pacing wires again noted. Nonobstructive bowel gas pattern.Left pleural effusion/retrocardiac opacity better evaluated on current chest radiograph. | Dobbhoff tube tip in the gastric body.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 71-year-old female with Dobbhoff tube; evaluate placement. The right upper quadrant and pelvis are excluded from field-of-view.Dobbhoff tube tip in the stomach. Retained contrast material in the transverse colon, likely from prior speech study. Nonobstructive bowel gas pattern.Bilateral pleural effusions and basilar op... | Dobbhoff tube tip in the stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 35-year-old male status post NJ placement. Right lateral abdomen and entire pelvis are excluded from the field-of-view.Enteric tube coiled twice in the stomach with tip in the distal gastric body. Nonobstructive bowel gas pattern. | Enteric tube coiled in the stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 35-year-old male status post NJ placement. Gastrografin administered. Left lateral abdomen and entire pelvis are excluded from the field-of-view.Enteric tube coiled twice in the stomach with tip in the distal gastric body. Interval injection of contrast into the gastric lumen. Nonobstructive bowel gas pattern. | Enteric tube coiled in the stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 35-year-old male status post NJ placement. Extremely limited view of the abdomen shows an enteric tube coiled in the upper abdomen, likely within the stomach. No free air. Nonobstructive bowel gas pattern. | Enteric tube coiled in the upper abdomen, likely within the stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 51 year old male with no BM x 3 weeks. Assess stool burden, bowel gas pattern. Retained contrast material throughout the colon, representing barium from yesterday's esophogram. Dense barium/stool particularly in the descending and proximal transverse colon. Moderate to large stool burden. Nonobstructive bowel gas patte... | Moderate stool burden.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: distended abdomen w/ tube feeds History: distended abdomen Dobbhoff tube tip in the distal gastric body. 2 mediastinal drains and one right chest tube partially imaged. Rectal catheter present. Nonobstructive bowel gas pattern. Exam is limited by overlying artifact | Limited exam without specific evidence of obstruction.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 72-year-old male with abdominal distention and rectal bleeding. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Noncontrast liver is unremarkable. Cholelithiasis again noted.SPLEEN: Noncontrast appearance of the spleen is normal.PANCREAS: Noncontrast appearance of the pancreas is normal.ADRENA... | 1.Findings suggestive of mild proctocolitis.2.Diverticulosis without evidence of diverticulitis.Findings were discussed via telephone with Dr. Goldsmith at 11:04 AM on 5/2/2015. |
Generate impression based on findings. | 58-year-old female with fever. Status post laparotomy for small bowel obstruction. Rule out intra-abdominal source of fever. ABDOMEN:LUNG BASES: Segmental atelectasis in the right lung base. No focal consolidation or pleural effusion. Trace pericardial fluid is noted.LIVER, BILIARY TRACT: The liver enhances homogeneous... | 1.Interval placement of loop ileostomy.2.Multiloculated fluid collection surrounding the afferent loop, suggestive of abscess. 3.Abscess tracks toward small ventral abdominal wall defects underlying the surgical wound. Inflammatory changes and soft tissue gas foci overlie the defect in a tract-like fashion. Correlate c... |
Generate impression based on findings. | 17-year-old female with constipation.VIEW: Abdomen AP (one view) 5/2/2015, 0542 hours. Moderate colonic stool burden. Nonobstructive bowel gas pattern. | Moderate colonic stool burden.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Postoperative changes from previous left pterional craniotomy and clipping of an aneurysm in the region of the left basal ganglia are again noted. The walls of the aneurysm remain densely calcified, with surrounding encephalomalacia and associated left frontal horn ex vacuo dilatation. There is again prominent ill-def... | 1. No acute intracranial hemorrhage.2. Stable postoperative changes.3. Stable appearance of likely extra-axial hyperattenuation along the inferior left frontal lobe, which may represent foreign body reaction or possibly an extra-axial neoplasm such as a meningioma. |
Generate impression based on findings. | Reason: concern for fracture History: Localized pain prox 1/3 radius with supination, pronation and squeezing handVIEWS: Right forearm AP lateral (2 views) 5/1/2015 18:18 No definite fracture or dislocation identified. | No definite fracture or dislocation identified. |
Generate impression based on findings. | Rule out fracture, right toe painVIEWS: Right foot AP oblique lateral (3 views) 5/1/2015 18:30 Mild soft tissue swelling. No fracture or dislocation is identified. | No fracture or dislocation is identified. |
Generate impression based on findings. | Fall, headache No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are multiple patc... | 1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. 2. Moderate chronic small vessel ischemic disease.3. Deformity of the left medial orbital wall likely relate... |
Generate impression based on findings. | 61-year-old male with drain in place, output decreases to less than 5 cc per day, mild tenderness right lower back developed in last 3-4 days, drain out of position? Evaluate for resolution or abscess. ABDOMEN:LUNG BASES: 8 mm left lung base nodule, not significantly changed from previously remeasured at 7 mm.LIVER, BI... | 1.Continued resolution of right retroperitoneal hematoma.2.No measurable collection surrounds the present pigtail catheter tip.3.Few nondrainable fluid locules and significant soft tissue thickening persist. |
Generate impression based on findings. | Male 4 years old Reason: fracture History: laceration to nail bed of 3rd finger on right handVIEWS: Right hand AP and lateral (2 views views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 16 months old Reason: amputated R 5th digit History: s/p trauma with doorVIEWS: Right hand AP and lateral 5/2/2015 (2 views) Partial amputation of the distal phalanx of the right fifth finger. Bone of the distal phalanx although is exposed appears to be intact. | Partial amputation of the distal phalanx of the right fifth finger. |
Generate impression based on findings. | Back pain. Rule out acute process. Thoracic spine: Vertebral body heights and alignment are preserved. No fracture evident. Mild to moderate multilevel degenerative disc disease with anterior osteophyte formation, particularly affecting the mid-upper thoracic spine.Lumbar spine: Vertebral body heights and alignment are... | Degenerative arthritic changes without acute abnormality. |
Generate impression based on findings. | Cyst, concern for compression No intracranial hemorrhage is identified. Again seen is a superior cerebellar arachnoid cyst with mild mass effect on the superior vermis and tectum. No suspicious intracranial mass or evidence of mass-effect elsewhere. No midline shift or herniation. Gray-white differentiation is maintain... | 1. No acute intracranial findings.2. As seen on recent MRI, there is a superior cerebellar cistern arachnoid cyst with mild local mass effect on the superior vermis and tectum. |
Generate impression based on findings. | Reason: fracture History: L forearm and wrist pain s/p fallVIEWS: Right wrist PA oblique lateral (3 views), right forearm AP lateral (2 views) 5/1/15 20:41 Nondisplaced buckle fracture of the distal radius. | Nondisplaced buckle fracture of the distal radius. |
Generate impression based on findings. | Male 2 years old Reason: ileus History: abd distensionVIEW: Abdomen AP (one view) 5/2/2015 at 0623 hours Gastrostomy tube and abdominal surgical sutures are again noted. Thoracolumbar levocurvature still present. Persistent bowel distention and disorganized abdominal gas pattern. No evidence of obstruction or free air. | Persistent bowel distention and disorganized abdominal gas pattern. |
Generate impression based on findings. | Dislocation of finger. Post reduction. Again seen is diffuse bone demineralization and soft tissue swelling with a persistent dorsal dislocation of the right middle finger, appearing similar to prior study. No definite fracture is visualized, however, a fracture along the dorsal aspect of the base of the middle phalanx... | Persistent dorsal dislocation of the right middle finger.. Fracture cannot entirely be excluded and follow-up imaging may be needed. |
Generate impression based on findings. | Altered mental status, rule out hemorrhage The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present. Hypodense foci are present in the right caudate nucleus and adjacent to the left caudate nucleus with... | 1.No evidence for acute intracranial hemorrhage or mass effect. 2.Moderate chronic small vessel ischemic disease with multiple, age-indeterminate but likely chronic, lacunar infarcts involving the left thalamus, right caudate head, and bilateral external capsules. Please note CT is insensitive for the early detection o... |
Generate impression based on findings. | History: Swelling. Reason: Injury. Diffuse soft tissue swelling about the right middle finger with underlying dorsal dislocation of the middle phalanx in relation to the proximal phalanx. No definite fracture is visualized, however, given the limitation of diffuse bone demineralization, a fracture along the dorsal aspe... | Dorsal dislocation of the right middle finger at the PIP joint. Fracture cannot entirely be excluded and follow-up imaging may be needed. |
Generate impression based on findings. | Male 15 days old Reason: evaluate bilateral mandibular distractors hardware for positioning VIEWS: Head AP and lateral 5/2/2015 at 0744 hours (2 views) Interval bilateral mandibular distractors placement. Hardware appears to be intact and in place. NG tube and ET tube are also visualized. | Post surgical changes of bilateral mandibular osteotomy and destructive placement. |
Generate impression based on findings. | 82-year-old male with lower back and left hip pain with radiculopathy down the left thigh, unable to walk. Assess for T12 compression fracture. Thoracic spine: There is mild exaggeration of the thoracic kyphosis and a slight rightward curve of the thoracic spine. The bones appear demineralized. There is mild-moderate m... | 1.No evidence of acute compression fracture including the T12 level as clinically questioned.2.Thoracic and lumbar degenerative changes as described above. There is moderate spinal canal stenosis at L4-5.3.Focal opacities in the left lower lobe are partially visualized and may be be related to atelectasis versus and in... |
Generate impression based on findings. | Reason: fracture History: s/p fall; RUE pain and deformityVIEWS: Left forearm AP lateral (2 views) 5/1/15 23:47 Overlying cast limits evaluation of fine bone detail. Fracture of the radius and ulna are again seen with mild dorsal angulation. Distal radial fracture fragment remains medially displaced approximately half ... | Reduction of radial and ulnar fractures. |
Generate impression based on findings. | Reason: fracture History: s/p fall; RUE painVIEWS: Left wrist PA and oblique (2 views), left forearm AP and crosstable lateral (2 views) 5/1/15 21:19 Fracture of the mid diaphysis radius and ulna. There is medial and dorsal angulation of the distal fragment. Distal radial fragment is displaced approximately half bone w... | Fracture of the mid diaphysis radius and ulna. |
Generate impression based on findings. | 63-year-old female with hypertension, tachycardia, history of malignancy for assessment of pulmonary embolism PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: No pneumothorax. Trace left pleural effusion.... | 1.No evidence of pulmonary embolism.2.Multiple new solid nodules in bilateral lungs, right greater than left, with increase in mediastinal lymphadenopathy compatible with progression of metastatic disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applica... |
Generate impression based on findings. | History: Knee pain. Reason: Knee pain. Small joint effusion with tricompartmental osteophytes and joint space narrowing representing near severe osteoarthritis. There are multiple ossicles particularly posterior to the knee and presumably within a Baker's cyst. No fracture or malalignment is evident. | Near severe osteoarthritis. |
Generate impression based on findings. | Altered mental status, evaluate ICH No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. Compared to 10/1/2009, there is been interval progression of volume loss as well as increase in the caliber of the late... | 1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. Progression of volume loss compared to 10/1/2009 with increase in caliber of the ventricular system, which... |
Generate impression based on findings. | History: Pain ROM. Reason: Evaluate for fracture/dislocation. Right shoulder: Anterior dislocation with the previously seen moderate Hill-Sachs deformity. No acute fracture evident. Mild degenerative changes are noted.Left shoulder: Anterior dislocation with a fracture of the greater tuberosity which is likely subacute... | Bilateral anterior shoulder dislocations with a fracture of the greater tuberosity of the left shoulder which is likely subacute. Please correlate with timing of the incident. |
Generate impression based on findings. | Headaches No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.There is moderate opacification involving the b... | 1. No evidence of acute intracranial hemorrhage or mass effect. If there is continued suspicion for a structural intracranial abnormality, consider MRI for more sensitive evaluation.2. Paranasal sinus opacification as above. |
Generate impression based on findings. | Reason: Assess for osteoarthritis versus other. History: Pain, decreased range of motion. Right hip: Mild joint space narrowing representing mild osteoarthritis, which appears similar to the prior CT study from 2014.Sacroiliac joints: Mild bilateral osteoarthritis. | Mild osteoarthritis as above. |
Generate impression based on findings. | Reason: follow up History: intubatedVIEW: Chest AP (one view) 5/2/15 6:31 ET tube tip is below thoracic inlet. NG tube tip is below the diaphragm and extends beyond the field of view. Side port is near the GE junction. Cardiothymic silhouette is normal. Mild improvement of the right upper lobe atelectasis. No pleural e... | Mild improvement of the right upper lobe atelectasis. |
Generate impression based on findings. | Reason: Intra-Abdominal Injury History: Pediatric Trauma ABDOMEN:LUNG BASES: Subsegmental atelectasis of the lung base, left greater than right. No pericardial effusion.LIVER, BILIARY TRACT: Patent portal vein. No focal hepatic abnormality. Normal-appearing gallbladder. No intrahepatic or extrahepatic biliary dilatatio... | 1.Subsegmental atelectasis of the lung bases, left greater than right.2.Small amount of pelvic free fluid.3.No definite evidence of abdominal solid organ injury.4.No fracture or dislocation of osseous structure is identified. |
Generate impression based on findings. | There is no intracranial hemorrhage. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. Minimal mucosal thickening is seen in the left maxillary sinus. The visualiz... | 1. No evidence of intracranial hemorrhage or mass effect.2. No evidence of intracranial aneurysm. |
Generate impression based on findings. | Fall with head trauma. Evaluate for bleed. CT head: There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is deformity of t... | 1.Mild left parietal scalp contusion, but no evidence of underlying calvarial fracture, acute intracranial hemorrhage or mass effect.2.Chronic right orbital blowout fracture.3.Mild multilevel degenerative changes of the cervical spine without acute fracture or subluxation.I personally reviewed the Images and/or procedu... |
Generate impression based on findings. | Female 22 days old Reason: is there pneumatosis/compare gas pattern to previous film History: abdominal distentionVIEW: Abdomen AP (one view) 5/2/2015 at 0839 hours NG tube terminates in the stomach. Disorganized, slightly distended and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosi... | Disorganized, slightly distended and nonspecific abdominal gas pattern. |
Generate impression based on findings. | Female 7 years old Reason: left hand History: swollenVIEWS: Left hand AP, lateral and oblique at 5/2/2015 (3 views) There is soft tissue swelling of the medial aspect of the left hand, with no evidence of fracture or malalignment. | Soft tissue swelling with no fracture or malalignment. |
Generate impression based on findings. | Trauma.VIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), 5/1/2015, 2315 hours. Note is made that quality of the examinations are limited due to patient position. ET tube tip is below thoracic inlet. NG tube terminates at the stomach. The aortic arch, cardiac apex and stomach a... | Normal chest, cervical spine and pelvis. |
Generate impression based on findings. | [69-year-old female with altered mental status, fall with head trauma. Evaluate for hemorrhage.] Again seen are postoperative changes of prior frontal craniotomy. There are bifrontal parafalcine extra-axial densities, on the left measuring 1.6 cm in maximum diameter with attenuation of 50 Hounsfield units, and on the r... | 1. No evidence of intracranial hemorrhage or significant intracranial mass effect.2. Bifrontal extra-axial densities as described likely represent residual/recurrent meningiomas with mild local mass effect. Suggest comparison with priors or further evaluation with MRI.3. Postoperative changes of prior craniotomy with e... |
Generate impression based on findings. | Headache. Evaluate for increased intracranial pressure. Patient has history of HIV/AIDS. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Redemonstrated are dystrophic calcifications of ... | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Again seen are dystrophic calcifications of the bilateral basal ganglia and bilateral frontal subcortical white matter. These are nonspecific and can be seen in the young age group with entities such as infections (such as congenital HIV), mitochondrial ... |
Generate impression based on findings. | Altered mental status status post pedestrian versus auto. CT head: There are subarachnoid blood products within the bilateral central sulci. Additional hyperattenuating foci at the bilateral temporoparietal and peri-Rolandic regions, likely represent additional foci of hemorrhagic contusion and subarachnoid hemorrhage.... | 1.Subarachnoid hemorrhage within the bilateral central sulci with additional foci of subarachnoid hemorrhage or hemorrhagic contusion in the bilateral peri-Rolandic and temporoparietal regions.2.Large subgaleal hematoma with scalp contusion and laceration along the right aspect of the vertex. No underlying calvarial fr... |
Generate impression based on findings. | 70-year-old female with dyspnea, history of lung cancer PULMONARY ARTERIES: Nondiagnostic examination.LUNGS AND PLEURA: Significant interval progression of radiation fibrosis with areas of consolidation particularly involving the right lung with associated rightward mediastinal shift. A superimposed infection cannot be... | Patient had contrast extravasation as detailed above technique section.Progression of posttreatment changes/radiation pneumonitis with increased consolidation involving the right lung compatible with organizing pneumonia and fibrosis. No convincing evidence of acute infection.PULMONARY EMBOLISM: PE: Nondiagnostic.Chron... |
Generate impression based on findings. | 69-year-old female with syncope. Evaluate for hemorrhage. Per chart, "69 yo F with PMH of neurofibromatosis with multiple cranial meningiomas (s/p right craniotomy for resection of a right frontal meningioma in 2011), seizure disorder s/p craniotomy (on keppra 1000 mg BID and lyrica 100 mg BID) and hypothyroidism who p... | 1. No definite evidence of intracranial hemorrhage or significant intracranial mass effect.2. Bifrontal extra-axial densities as described above may represent residual/recurrent meningiomas with mild local mass effect. Suggest comparison with priors or further evaluation with MRI.3. Postoperative changes of prior crani... |
Generate impression based on findings. | Reason: how are lung fields History: increase respiratory supportVIEW: Chest AP (one view) 5/2/15 9:19 Tracheostomy tube tip is at the thoracic inlet. Right lower extremity PICC tip is in the right atrium. G tube in place. Interval removal of NG tube. Cardiomegaly unchanged. Patchy atelectasis in the right upper lobe a... | Unchanged pulmonary opacities. Interval increase in the abdominal gas. |
Generate impression based on findings. | 70-year-old female with dyspnea PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Severe centrilobular emphysema. No pneumothorax or pleural effusion. 10 mm subpleural nodule in the right lung (series ... | 1.No evidence of pulmonary embolism.2.10 mm subpleural nodule in the right lung base. Follow-up in 3 months is recommended according to current Fleischner Society recommendations.3.Severe centrilobular emphysema.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not ... |
Generate impression based on findings. | Reason: evaluate for acute change History: worsening mental status Since the prior exam a left medial frontal lobe hematoma has significantly enlarged and extended to the medial left parietal lobe. It currently measures 73x32mm axial dimension and 72x59mm sagittal dimensions. It measured 25x41mm axial dimension on the ... | Since the prior exam the patient's left frontal hematoma has significantly expanded and includes the medial left parietal lobe. There is now associated midline shift, subarachnoid hemorrhage and intraventricular hemorrhage. |
Generate impression based on findings. | Pedestrian struck. Traumatic intracranial hemorrhage. There is no significant interval change in the subarachnoid blood products within the bilateral central sulci with additional foci of hemorrhagic contusions or subarachnoid hemorrhage at the bilateral temporoparietal and peri-Rolandic regions. The ventricles and bas... | 1.No significant interval change in bilateral central sulci subarachnoid hemorrhage as well as additional foci of hemorrhagic contusions/subarachnoid hemorrhage in the bilateral peri-Rolandic and temporoparietal regions.2.Large subgaleal hematoma with scalp contusion and laceration along the right aspect of the vertex.... |
Generate impression based on findings. | Reason: evaluate for acute change History: worsening mental status Since the prior exam a left medial frontal lobe hematoma has not significantly enlarged. It extends to the medial left parietal lobe. It currently measures 73x32mm axial dimension and 72x59mm sagittal dimensions and is unchanged.A ventriculostomy tube n... | 1.Since the prior exam from 4pm the patient's left frontal hematoma has not significantly expanded. There is associated midline shift, subarachnoid hemorrhage and intraventricular hemorrhage.2.A ventriculostomy tube has been placed. |
Generate impression based on findings. | 73-year-old male with fall, concern for subdural hematoma. There is no acute intracranial hemorrhage, mass effect, or midline shift. The ventricles and sulci appear unremarkable in size and configuration. The brain parenchyma appears within normal limits with preserved gray-white differentiation. The calvarium appears ... | No evidence of subdural hematoma or other acute intracranial abnormality.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: evaluate for acute change History: worsening mental status Since the prior exam a left medial frontal lobe hematoma has not significantly enlarged. It extends to the medial left parietal lobe. It currently measures 73x32mm axial dimension and 72x59mm sagittal dimensions and is unchanged. It extends and abuts th... | 1.Since the prior exam from 4pm the patient's left frontal hematoma has not significantly expanded. There is associated midline shift, subarachnoid hemorrhage and intraventricular hemorrhage.2.A ventriculostomy tube has been placed and is stable. The ventricles are stable. |
Generate impression based on findings. | Altered mental status. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is scattered opacification of the bilateral ethmoid sinuses. There is nonspecific opacification of the parti... | No evidence of acute intracranial hemorrhage or mass effect.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: ich History: ich There is a hematoma centered in the right thalamus measuring 39 x 26 mm axial dimensions Another hematoma is present in the left basal ganglia and anterior limb of internal capsule measuring 28 x 27 mm axial dimensions. There is marked intraventricular blood bilaterally involving all ventricles... | 1.There is a large hematoma centered in the right thalamus hematoma which is stable.2.There is a large hematoma centered in the left basal ganglia which is stable.3.There is associated intraventricular blood. Periventricular hypodensities associated with this could in part be related to so-called transependymal migrati... |
Generate impression based on findings. | Status post fall. Evaluate for intracranial hemorrhage. CT head: There is no evidence of acute intracranial hemorrhage or mass effect. There is mild parenchymal volume loss. The ventricles and basal cisterns are normal in size and configuration. There are scattered punctate and confluent areas of abnormal low attenuati... | 1.No evidence of acute intracranial hemorrhage or mass effect.2.Moderate chronic small vessel ischemic changes. 3.Advanced degenerative changes of the cervical spine, most prominent at C4-C5 through C6-C7, with variable multilevel neural foraminal stenosis as described above. No acute fracture of the cervical spine.4.P... |
Generate impression based on findings. | 51-year-old female with syncope, shortness of breath, and chest pain PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Mild bronchial wall thickening and mosaic attenuation compatible with small airways di... | No evidence of pulmonary embolism.Mild bronchial wall thickening and mosaic attenuation compatible with small airways disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I personally reviewed the Images and/or procedur... |
Generate impression based on findings. | Reason: Assess stool burden History: constipation, GI bleed Moderate stool burden. Nonobstructive gas pattern. Surgical clips noted in the pelvis. Embolization coils project over the distribution of the gastroduodenal artery. | Moderate to slightly above average stool burden. |
Generate impression based on findings. | 22-year-old female with shortness of breath PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: No focal consolidation. A 4 mm node or scarlike opacity in the left costophrenic angle. No pneumothorax or ... | No evidence of pulmonary embolism.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 51-year-old male with chest pain LUNGS AND PLEURA: Apical bulla without evidence of pneumothorax. Mild apical predominant centrilobular emphysema. No suspicious nodule or mass. No pleural effusion. Right lung base calcifications may represent prior granulomatous disease. MEDIASTINUM AND HILA: The heart size is normal w... | Apical bulla without pneumothorax. Mild apical predominant centrilobular emphysema.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 55-year-old female with shortness of breath and increased O2 requirement PULMONARY ARTERIES: Suboptimal opacification of the pulmonary arteries. With these limitations, there is no evidence of pulmonary embolus to the segmental level.LUNGS AND PLEURA: No pneumothorax or pleural effusion. Subsegmental atelectasis and/or... | 1.Limited examination without evidence of a central pulmonary embolus.2.Subsegmental atelectasis and/or scarring at the lung bases.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I personally reviewed the Images and/or pro... |
Generate impression based on findings. | Reason: ileocolonic CD, perianal abscess follow-up, had recent perianal pain History: perianal pain PELVIS:Redemonstrated previously seen 10:00 enhancing perianal fistula (12:138) which extends to the ischioanal fossa anteriorly and follows a similar tract to the previously seen fistula terminating at the base of the s... | 1.Redemonstrated fistulas as described above are similar to prior MRI, although no definitive subcutaneous abscess is seen on today's scan.2.Asymmetric enhancement and signal of the left peripheral zone of the prostate gland could indicate prostatitis. |
Generate impression based on findings. | Reason: evaluate for intracranial injury History: head injury, visual changes The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visua... | No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | There is a chronic infarct involving the right middle, inferior frontal and anterior portion of the superior temporal gyrus, right basal ganglia, and insula with encephalomalacia and ex vacuo dilatation of the right lateral ventricle and midline shift to the right due to volume loss. There is mild chronic volume loss ... | 1.Chronic right MCA territory infarct. No acute intracranial hemorrhage or mass-effect. 2.Asymmetric narrowing and irregularity of the right middle cerebral artery which is at least in part due to diminished demand. No intracranial aneurysm or flow-limiting stenosis in the head or neck.3.Small linear filling defect wit... |
Generate impression based on findings. | Male 54 years old; Reason: hematuria History: hematuria CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Significant coronary artery calcifications.CHEST WALL: Calcified right hilar nodes.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. Fatty liver.SPLEEN: No significant abnormality not... | 1.No CT identifiable cause of hematuria.2.Coronary artery calcifications as above.3.Cholelithiasis and fatty liver.4.Nonobstructing right nephrolithiasis. |
Generate impression based on findings. | Reason: r/o ich History: s/p MVC CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinus... | 1.No evidence for cervical spine fracture2.No evidence for acute intracranial hemorrhage mass effect or edema.3.Reversal of the normal cervical curvature may be positional though it could also be due to muscle spasm. |
Generate impression based on findings. | 60-year-old female status post exploratory laparoscopy/BSO with serous borderline tumor with focus of high-grade ovarian cancer. Assess for metastatic disease. CHEST:LUNGS AND PLEURA: Scattered micronodules, some calcified. No focal consolidation or pleural effusion. No suspicious pulmonary nodularity.MEDIASTINUM AND H... | 1.No specific evidence of metastatic disease. 2.Right hepatic lobe lesion likely represents hemangioma; attention on subsequent surveillance imaging is recommended. |
Generate impression based on findings. | Reason: CT ENTEROGRAPHY: History of undetermined colitis. She has inflammation in the bladder and we suspected an entero-vescical fistula. History: Dysuria, blood in the urine. Also blood in the stool and mucus. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSP... | No bowel obstruction. No definitive evidence of an enterovesicular fistula. Circumferential thickening of the urinary bladder could be due to a nonspecific cystitis.Prominent left adnexa can be further evaluated with ultrasound, as described above. |
Generate impression based on findings. | Reason: pt with met melanoma s/p 6 cycles Pembro please assess response to therapy and compare to previous imaging History: met melanoma CHEST:LUNGS AND PLEURA: Right lower lobe nodule unchanged at 4 mm (series 4, image 67), previously 4 mm. Postsurgical findings are redemonstrated in the lingula. Asymmetric soft tissu... | Stable metastatic disease without evidence of disease progression. |
Generate impression based on findings. | Female 32 years old; Reason: neuroendocrine cancer s/p 3 cycles of chemo compare to last CT History: see above CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multifocal masses with... | Slight progression of disease in the liver as above. Retroperitoneal lymph nodes are more prominent on today's exam as well. |
Generate impression based on findings. | Reason: r/o stenosis or occlusion History: stuttering left sided weakness Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there ... | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease3.Findings raise the question of FMD or other connective tissue disease involving the distal ICAs. |
Generate impression based on findings. | Reason: Post Liver Transplant. Please evaluate all vessels for patency History: Liver Transplant PORTAL VENOUS: The portal vein is patent with normal hepatopedal flow, with peak systolic velocities ranging between 41 and 74 cm/s.HEPATIC ARTERIES: The common, left, and right hepatic arteries are patent with normal bipha... | Patent vasculature without evidence of stenosis, occlusion, or flow reversal.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 60-year-old female for evaluation of malignancy or signs of pulmonary infection LUNGS AND PLEURA: Large left pleural effusion measuring slightly greater than simple fluid density. Complete collapse of the left lung with hypoattenuating lesion in the collapsed left lower lobe measuring 1.5 x 1.1 cm (series 80352, image ... | Hypodense lesion in a collapsed left lower lobe may represent a malignancy. Large left pleural effusion with complete collapse of the left lung and mild pleural nodularity compatible with malignant effusion. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 60 year-old female with history of thyroid cancer, follow-up examination. Neck:Postoperative changes of carotid endarterectomy are again noted on the right. In the right sternocleidomastoid muscle anterior to the right common carotid artery a hypoattenuating peripherally enhancing collection is again seen. This collect... | 1.Stable appearance of reference lesions. No evidence of progression of metastatic disease in the neck.2.Status post right carotid endarterectomy. Hypoattenuating collection in the operative bed has decreased in size since the prior study and is most compatible with a resolving chronic hematoma/seroma.3.No evidence of ... |
Generate impression based on findings. | Female 60 years old; Reason: eval for malignancy, signs of pulm infxn History: white out of L hemithorax. Concern for mass ABDOMEN:LUNG BASES: Please see separately dictated CT chest report.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormali... | 1.No CT findings of abdominal or pelvic malignancy. |
Generate impression based on findings. | 57-year-old female with sepsis, elevated biliary enzymes. Evaluate for cholecystitis. Exam is slightly limited by patient's body habitus; decubitus positioning was not attainable.LIVER: Liver demonstrates normal size and echotexture, measuring 16 cm in length. No focal hepatic lesion is detected.GALLBLADDER, BILIARY TR... | Limited exam without specific evidence of cholecystitis. If there remains clinical concern for cholecystitis, HIDA scan may be considered. Splenomegaly.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 65-year-old male with recurrent laryngeal cancer status post laryngectomy (3/15/2015) CHEST:LUNGS AND PLEURA: No suspicious nodule or mass. Calcified and noncalcified subcentimeter micronodules are nonspecific. No pneumothorax or pleural effusion. Mild bronchial wall thickening, the central airways are patent. Basilar ... | No specific evidence of metastatic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 71-year-old male with fever LUNGS AND PLEURA: No pneumothorax or pleural effusion. Central airways are patent.Nodular airspace opacities and focal consolidation in the left lower lobe and lingula. Specifically, there is a focal nodular opacity in the left upper lobe (series 4, image 51) measuring 10 x 12 mm. Two additi... | Nodular and focal airspace opacities in the lingula and left lower lobe suspicious for atypical infection although malignancy cannot be entirely excluded. Follow-up examination after treatment is recommended to ensure resolution. |
Generate impression based on findings. | 68-year-old female with right-sided chest pain, history of recurrent DVTs with subtherapeutic INR PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolism. The main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Subsegmental atelectasis/scarring lung bases.Mild mos... | 1.No evidence of pulmonary embolism. 2.Mosaic attenuation suggestive of small airways or small vessel disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I personally reviewed the Images and/or procedure with the Resid... |
Generate impression based on findings. | 76 year-old male with history of intraparenchymal hemorrhage, new anticoagulation. There is been interval decrease in size and attenuation of the left thalamic parenchymal hemorrhage since the prior study. There remains mass effect on the third ventricle and left lateral ventricle, otherwise the ventricles are not sign... | 1. Continued interval improvement in left thalamic intraparenchymal hemorrhage and intraventricular hemorrhage.2. No new intracranial hemorrhage.3. Increased paranasal sinus opacification since the prior study.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Neck swelling. Evaluate for abscess and lymphadenopathy. There is a septated rim-enhancing fluid collection in the infra hyoid region at the midline measuring approximately 9 x 15 x 10 mm (AP by TR by CC) with adjacent fat stranding and a reactive lymph node measuring 9 x 7 mm. There is no evidence significant cervical... | A septated rim-enhancing fluid collection in the midline infra hyoid region measuring up to 15 mm with adjacent fat stranding and reactive lymph node is most compatible with an abscess or superinfected thyroglossal duct cyst.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this ... |
Generate impression based on findings. | 50 year-old male with metastatic melanoma please assess response to therapy and compared to previous imaging. Again seen are postoperative findings related to left neck dissection. There is no significant interval change in the reference cervical lymph nodes. For example, a left level 1B lymph node measures 14 x 11 mm ... | 1. Mild increase in size of a small right paratracheal lymph node, which should continue to be followed on subsequent examinations. 2. Otherwise stable reference mildly enlarged lymph nodes and postoperative changes. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
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 scattered punctate foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes. Pa... | 1.No acute intracranial hemorrhage or mass effect. Mild chronic small vessel ischemic changes.2.3 to 4 mm aneurysm at the communicating segment of the right internal carotid artery. 1 to 2 mm aneurysm or infundibulum at the communicating segment of the left internal carotid artery. 2 mm aneurysm at the right MCA bifurc... |
Generate impression based on findings. | History of recurrent T4N2b supraglottic laryngeal squamous cell carcinoma status post laryngectomy on March 15. Please evaluate postoperative baseline study. Streak artifact from dental amalgam somewhat limits evaluation. There are postoperative changes related to laryngopharyngectomy with free flap placement at the ri... | 1. Postoperative changes related to laryngopharyngectomy, bilateral neck dissection, and right thyroid lobectomy with free flap placement at the right aspect of the pharynx with effacement of the supraglottic airway. A tracheostomy is in place. 2. A left level 5B lymph node and necrotic small right level 3 lymph node a... |
Generate impression based on findings. | 58 year old female with shunt, headache, neck pain. Head CT: There is no acute intracranial hemorrhage, mass effect, or midline shift. The ventricles appear decompressed and unchanged in size and configuration. The brain parenchyma appears within normal limits with preserved gray-white differentiation. There is no intr... | 1. No acute intracranial abnormalities. No intracranial shunt catheter is present. Rather, there is a lumboperitoneal shunt as seen on shunt series radiographs.2. Multilevel cervical spine degenerative changes as describe above. No evidence of fracture or traumatic subluxation. 3. Fibrotic changes in the right greater ... |
Generate impression based on findings. | Altered mental status, found down on bus stop. Head CT: There is no acute intracranial hemorrhage, mass effect, or midline shift. The ventricles and sulci are unremarkable in size and configuration. There is preserved gray-white differentiation. The calvarium, orbits, and paranasal sinuses appear unremarkable.Cervical ... | 1. No acute intracranial hemorrhage or mass effect.2. Mild cervical spine degenerative changes without fracture. 3. Mildly prominent partially imaged cervical lymph nodes are nonspecific. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 71-year-old female with syncope. There is no acute intracranial hemorrhage, mass effect, or midline shift. The ventricles and sulci appear unremarkable in size and configuration. Brain parenchyma appears within normal limits with preserved gray-white differentiation. There are atherosclerotic calcifications of the inte... | 1.No acute intracranial hemorrhage or mass effect.2.Hyperdense and mildly prominent pituitary gland. Finding may be related to Rathke's cyst with proteinaceous material or less likely hemorrhage within an adenoma. No associate mass effect. Comparison with prior CT if available or further evaluation with pituitary MRI c... |
Generate impression based on findings. | There are postoperative changes related to a left translabyrinthine lateral skull base approached resection of a left cerebellopontine mass with placement of a fat graft. There is residual tumor in the left cerebellopontine angle predominantly at the anterior margin with a portion of the mass extending into the left i... | Postoperative changes related to a left translabyrinthine lateral skull base approached resection of a left cerebellopontine mass and fat graft placement. Evidence of small residual tumor in the left cerebellopontine angle, predominantly at the anterior margin, with extension into the left internal auditory canal. Ther... |
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