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Generate impression based on findings. | 60 years, Male. Reason: eval for obstruction History: increased NGT ouput,decreased ostomy output Pelvis excluded from field-of-view. NG tube projects over the far left lateral abdomen. Correlate with surgical history.Multiple surgical clips and staple lines left abdomen. Drainage tube seen over the left abdomen. Skin ... | NG tube projects far laterally over the left abdomen correlate clinically. |
Generate impression based on findings. | Left wrist pain, known radial fracture. 3 views of the left wrist demonstrate a comminuted fracture of the distal radius, with intra-articular extension and mild volar displacement of the distal fracture fragment. No significant callus formation to suggest healing. Radiocarpal alignment appears grossly intact. Addition... | Distal radial and ulnar styloid fractures as above. |
Generate impression based on findings. | 63 years, Female. Reason: eval persistent colonic dilation for worsening/improvement/resolution History: abdominal pain Dilated loops of small bowel in the upper abdomen measuring up to 3.5 cm in diameter. Paucity of ileal and colonic gas. In this clinical context postop ileus is most likely although obstruction cannot... | Increasing jejunal dilatation. |
Generate impression based on findings. | 71 years, Male. Reason: check NG feeding tube placement History: checkMG feeding tube placement Pelvis excluded from field-of-view. Dobbhoff tube has advanced. The tip projects over the distribution of the proximal gastric antrum.Nonobstructive bowel gas pattern. Residual contrast throughout the colon unchanged. Left p... | Dobbhoff tube projects over gastric antrum. |
Generate impression based on findings. | Right elbow and wrist pain status post fall 4 views of the right elbow demonstrate normal anatomic alignment without evidence of acute fracture or significant joint effusion.3 views of the right wrist demonstrate an orthopedic screw affixing the scaphoid to the lunate. No evidence of acute fracture or malalignment. Ver... | No acute fracture or malalignment. |
Generate impression based on findings. | Left foot pain status post fall Chronic deformity of the fifth metatarsal diaphysis, likely secondary to remote trauma. Ossific density along the proximal/medial aspect of the fifth metatarsal is favored to be from remote injury, as no donor site is identified. Severe osteoarthritic changes are noted in the midfoot, mo... | Severe osteoarthritis as above, without evidence of acute fracture or malalignment. |
Generate impression based on findings. | 76 years, Male. Reason: assess bowel dilatation History: distention, obstipation Diffusely dilated jejunum and air scattered throughout moderately prominent colon. Less than average stool burden The pattern distention of jejunal loops was seen on the CT scan of 4/23/2015 and I believe this pattern is persisting. Althou... | Persistent bowel dilatation most marked in small bowel loops in the left abdomen concerning for incomplete obstruction or persistent ileus. |
Generate impression based on findings. | Tenderness to palpation over thoracic and lumbar spine. Suboptimal study secondary to severe scoliosis and degenerative changes. The bones appear demineralized. There is significant S-shaped scoliosis of the thoracolumbar spine. Lumbar vertebral body heights are maintained. Compression fracture of T4 vertebral body, of... | Scoliosis and degenerative changes, as above. Compression deformities of T4 and T6 of unknown chronicity. |
Generate impression based on findings. | 26 years, Female. Reason: free air History: severe AP post J-tube placement Percutaneous G-tube or J tube overlies gastric body. Nonobstructive bowel gas pattern with moderate amount of gas seen throughout a nondistended colon. No visible stool. Impression on hepatic flexure by the gallbladder.Supine view is not sensit... | Percutaneous tube presumably J-tube is reported by clinical history overlies left upper quadrant. |
Generate impression based on findings. | 59 years, Male. Reason: ileus History: distention Pelvis excluded from field-of-view. Nonobstructive bowel gas pattern. Surgical clips staples. Multi-sidehole catheter the left abdomen. Pigtail catheter left chest. Other findings unchanged. | No evidence for obstruction. |
Generate impression based on findings. | 32 years, Male. Reason: S/p ex lap with TAC History: gastric distention Persistent focally dilated loop of jejunum up to 3.4 cm the left upper quadrant. Minimal scattered bowel gas elsewhere. No intramural air or free air given limitation of supine view. Favor postop ileus.Surgical staples, surgical line overlies pelvi... | Favor postoperative ileus. |
Generate impression based on findings. | Right hand pain status post punching car window There is a subtle/nondisplaced lucency along the base of the fifth metacarpal, likely representing a nondisplaced "boxer" fracture. This is consistent with mechanism of injury and physical exam. Additional lucency at the medial metaphysis may represent additional fracture... | Nondisplaced fracture through the base of the fifth metacarpal as above.Imaging findings were discussed with the emergency department by the resident radiologist on call on 5/3/2015 at 9:53 AM. |
Generate impression based on findings. | Back, pelvis, right hip, knee and ankle pain status post MVC. The exam is limited secondary to patient body habitus. Given this limitation, no acute fracture or malalignment is appreciated in the thoracolumbar spine, pelvis, right hip, right tib-fib, right ankle or right knee. Degenerative changes are noted at the righ... | Degenerative changes without acute fracture or malalignment. |
Generate impression based on findings. | 67 years, Female. Reason: Assess NGT placement and ileus pattern History: ileus vs sbo NG tube tip projects over gastric body. Focally dilated loop of jejunum left upper quadrant. Pelvis excluded from field-of-view. | NG tube projects over the distal gastric body. |
Generate impression based on findings. | Warm and painful left wrist, decreased range of motion of the left knee. No stated trauma. The bones appear demineralized. Ossific density within the radiocarpal joint space is suggestive of chondrocalcinosis. A well-corticated ossific density adjacent to the fourth metacarpal head may relate to old trauma as no donor ... | Chondrocalcinosis in the left wrist and knee joints, which is suggestive of calcium pyrophosphate deposition disease in the appropriate clinical setting. Osteoarthritis also affects the wrist and knee. |
Generate impression based on findings. | Abdominal distention, ileus. History distended abdomen. Massively dilated bowel in the upper abdomen presumably represents colon is seen on the prior exams. Cannot exclude a dilated stomach is well. A loop of bowel traversing the upper abdomen measures 18.9 cm. (Stomach and could be decompressed with an NG tube if this... | Distended loop of bowel upper abdomen stomach versus transverse colon. Discussed with Dr. Sarah Gaines pager 3344. |
Generate impression based on findings. | Pain and limited range of motion of the neck The cervicothoracic junction is obscured by overlying anatomy. The dens maintains a normal relationship with the arches of C1. Severe multilevel degenerative disease affects the cervical spine including joint space narrowing, most significant at C6-7. There is anterior verte... | Degenerative changes as above, without acute fracture or malalignment. |
Generate impression based on findings. | Trauma with intracranial hemorrhage and fractures. Compared to examination from 6 hours prior, there is mild increase in prominence of the multiple hemorrhagic contusions involving the left greater than right frontal lobes. There is also a left anterior temporal lobe hemorrhagic contusion which is more prominent in the... | 1. Compared to CT head from 6 hours prior, there is mild increase in prominence of the extensive hemorrhagic contusions involving the left greater than right anterior-inferior frontal lobes as well as the left anterior temporal lobe. There is minimal petechial hyperdensity involving the right posterior temporal lobe as... |
Generate impression based on findings. | Left sinus fullness with chronic headache. Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There are small mucous retention cysts within the bilateral maxillary sinuses. The ostiomeatal units are clear.Posterior ethmo... | 1.Small mucosal retention cysts within the bilateral maxillary sinuses. Otherwise, the paranasal sinuses are clear.2.Partial opacification of the bilateral mastoid air cells and middle ears. 3.There is prominence of the nasopharyngeal soft tissues which is present on prior CT from 10/6/2011.I personally reviewed the Im... |
Generate impression based on findings. | 80 years, Female. Reason: SBO vs Gas in large intestine History: Distension and abdominal pain Diffusely dilated jejunum and air scattered throughout moderately prominent colon. Less than average stool burden The pattern distention of jejunal loops was seen on the CT scan of 4/23/2015 and I believe this pattern is pers... | Persistent bowel dilatation most marked in small bowel loops in the left abdomen concerning for incomplete obstruction or persistent ileus. |
Generate impression based on findings. | 76 years, Male. Reason: assess bowel dilatation History: distention, obstipation Barium administered on prior small bowel series is now progressed slightly into what appears to be colon. The majority of the contrast remains in massively distended small bowel.NG tube tip projects over the pyloric area. | High-grade mechanical small bowel obstruction but may be minimally incomplete. |
Generate impression based on findings. | Female, 53 years old.RFO trigger:Organ TransplantSuspected RFO location:N/AName of suspected RFO:N/AAttending Surgeon name/pager:Dr. Renz 4214Body Mass Index (BMI):34.85 Surgical clips and catheters overlie the upper abdomen. No unexpected radiopaque foreign body.Discussed by radiology resident on call Shelby Bennett w... | No unexpected radiopaque foreign body. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. 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. There... | 1.No evidence of acute infarct, acute hemorrhage, intracranial mass, or mass effect. 2.Mild chronic small vessel ischemic changes. Brain parenchyma appears otherwise unremarkable for age. 3.MRA demonstrates the superior cerebellar arteries appear to contact the trigeminal nerve roots bilaterally without clear evidence ... |
Generate impression based on findings. | Breakthrough seizures. Evaluate for etiology. There is encephalomalacia involving the right temporo-parietal region, which is likely from chronic infarct. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with moderate age-indete... | No acute intracranial abnormality. Unchanged chronic right temporo-parietal infarct and chronic small vessel ischemic disease. If there is suspicion for an alternate source of seizures, MRI may be helpful.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Evaluate for hemorrhagic conversion. There is no evidence of acute intracranial hemorrhage or mass effect. There is bilateral periventricular hypoattenuation compatible with chronic microvascular ischemic disease. There is no significant interval change in the ill-defined asymmetric hypoattenuation corresponding to kno... | No significant interval change in the appearance of the subacute infarction involving the left basal ganglia, left corona radiata and along the the left subcentral lobule. No evidence of hemorrhagic conversion. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 26-year-old male with relapsed ALL c/b fungal sinusitis, found to have significant left orbital swelling. Again seen are postoperative changes of sinonasal surgery and debridement. Compared to 4/20/2015, interval development of moderate opacification of the bilateral ethmoid sinuses and the sphenoid sinuses are seen as... | Interval development of moderate opacification of the bilateral ethmoid and sphenoid sinuses as well as new soft tissue thickening along the left medial orbit along the superior oblique muscle as well as thickening of the left medial rectus muscle. These findings are all highly concerning for progression of invasive fu... |
Generate impression based on findings. | 60 years, Male. Reason: eval for obstruction History: increased NGT ouput,decreased ostomy output Pelvis excluded from field of view.NJ tube tip overlies jejunum just distal to ligament of Treitz. NG tube also coiled in stomach.Other catheters overlie abdomen.Mild non-obstructive jejunal dilatation.Bilateral pleural ef... | NG and NJ tubes as above. |
Generate impression based on findings. | 59 years, Male. Reason: ileus History: distention Pelvis excluded from field-of-view. NG tube projects over the far left lateral abdomen. Correlate with surgical history.Multiple surgical clips and staple lines left abdomen. Drainage tube seen over the left abdomen. Skin staples over the right abdomen. Calcification an... | NG tube projects far laterally over the left abdomen correlate clinically. |
Generate impression based on findings. | Evaluate subdural, status post drain Compared to 5/1/2015, there is slight decrease in size of the mixed density large extra-axial collection along the right cerebral convexity. Collection measures 14 mm in the coronal plane previously 16 mm at similar level. There is more clear decrease in size compared to the prior s... | Compared to 5/1/2015, there is slight interval decrease in size of the mixed density subdural collection along the right convexity and slight improvement in associated mass effect. There is more noticeable decrease in size of the collection compared to the prior study from 4/28/2015. |
Generate impression based on findings. | 68 years, Female. Reason: assess for stool burden, signs of obstruction History: constipation, rectal pain Moderate stool burden, greater than average. No obstruction.Lung bases clear. | Above average stool burden. |
Generate impression based on findings. | There is hypoattenuation involving the left aspect of the splenium of the corpus callosum, corresponding to area of restricted diffusion seen on the prior MRI. 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 ... | 1.Hypoattenuation involving the left aspect of the corpus callosum splenium corresponding to site of restricted diffusion seen on recent MRI. No acute intracranial hemorrhage.2.Moderate chronic small vessel ischemic changes.3.Dense atherosclerotic calcifications of the intracranial and extracranial internal carotid art... |
Generate impression based on findings. | CT HEAD: There is no evidence of intracranial mass or abnormal enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. CT NECK: There are postoperative f... | 1. Stable post-treatment findings related to left thyroidectomy with mostly stable extensive metastatic cervical lymphadenopathy. There is however minimal interval increase in size of a few metastatic lymph nodes.2. Partially imaged superior mediastinal lymphadenopathy. Please see separate report for findings in the ch... |
Generate impression based on findings. | Reason: 62 yo with HCC please eval for METS History: none LUNGS AND PLEURA: New 15 mm subsolid nodule in right upper lobe (image 54/115). Stable 17 mm nodule in right lower lobe.New 7 mm nodule in left lower lobe (image 94/115). Punctate micronodule along the diaphragmatic surface in the left lower lobe (image 103/115)... | 1. New 15 mm subsolid nodule in right upper lobe which is nonspecific but not typical of metastatic disease. It could, however, represent atypical adenomatous hyperplasia or adenocarcinoma in situ. Continued follow up is recommended. 2. New 7 mm nodule in left lower lobe thought this is inseparable from an area of scar... |
Generate impression based on findings. | Reason: head and neck cancer compare to previoys with measurements. History: as above CHEST:LUNGS AND PLEURA: Innumerable subcentimeter pulmonary nodules are grossly stable in number and size. The reference right lower lobe pulmonary nodule measures 5 mm on image 38/57, unchanged. Aspirated debris in central airways.ME... | Stable pulmonary nodules and lymphadenopathy. |
Generate impression based on findings. | Reason: Long history of Bronchiolitis obliteranns from RA. Worsening over time. R/O ILD, emphysema etc. History: Progressive dyspnea and hypoxemia LUNGS AND PLEURA: Multifocal moderate to severe bronchial wall thickening with areas of mucous plugging and centrilobular nodules and minimal tree-in-bud opacity. Multifocal... | Multifocal moderate to severe bronchial wall thickening with areas of mucous plugging and centrilobular nodules and minimal tree-in-bud opacity. Multifocal air trapping on expiratory phase imaging. The findings are consistent with bronchitis obliterans.There are calcified and noncalcified micronodules (less than 4 mm) ... |
Generate impression based on findings. | Reason: h/o larynx cancer and prior smoking history History: as above LUNGS AND PLEURA: Scattered punctate micronodules are unchanged and presumably benign. Scattered punctate calcified granulomas are stable. Pleural and parenchymal scarring at the left base is unchanged.MEDIASTINUM AND HILA: No significant abnormality... | Stable CT with no evidence of pulmonary metastases. |
Generate impression based on findings. | Reason: sarcoma of mass near left lower molar s/p extraction, eval for spread History: sarcoma of oral cavity LUNGS AND PLEURA: Calcified granulomas but no suspicious pulmonary nodules.MEDIASTINUM AND HILA: Calcified mediastinal lymph nodes consistent with healed granulomatous disease.CORONARY ARTERY CALCIFICATION: Non... | No evidence of pulmonary metastases. |
Generate impression based on findings. | Per EPIC, patient presented initially to his oral surgeon in early April following a week of left lower molar tooth pain. He was diagnosed with caries of the tooth and had it extracted on 4/2/15. His oral surgeon noticed a soft tissue mass adjacent to his tooth and performed a biopsy. Review of the pathology demonstrat... | Status post extraction of ADA tooth #17 with cortical disruption of the adjacent alveolar process medially. Soft tissue adjacent to the area of cortical disruption measures up to 8 mm, unclear how much of this is residual tumor versus change related to recent extraction. Small bilateral cervical lymph nodes, which are ... |
Generate impression based on findings. | There is straightening of the cervical spine which is likely positional. There are no fractures or subluxations. The visualized intracranial and paraspinal contents are unremarkable. There are no significant degenerative changes or stenoses. | Negative cervical spine CT. Specifically, there are no CT findings to explain the patient's neck pain.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Headache 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.CT maxillofacial bones:There are no fractures identified involving the... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT of the maxillofacial bones does not demonstrate any fractures.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: eval IPH History: IPH 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 ventr... | 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. | 54 years, Male. Reason: 54M with reflux of gtube feeds. Please evaluate for distal obstruction vs ileus. History: reflux of gtube feeds Nonobstructive bowel gas pattern with air seen distally in the colon. Percutaneous gastrostomy tube overlies the left upper quadrant. Scattered postsurgical staples and suture material... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 53 years old; Reason: kidney stone History: hematuria spasmodic back pain Exam is not sensitive for detecting lesions in bowel due to lack of oral contrast and the solid organs and vasculature due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNGS BASES:... | 1.Nonobstructive nephrolithiasis right kidney, unchanged from prior exam. No specific findings to explain hematuria. If hematuria persists contrast-enhanced CT exam (nephrogram and excretory phases) should be obtained to rule out neoplasm (although note is made of contrast-enhanced CT angiogram in May 2013 given limita... |
Generate impression based on findings. | There is straightening of the cervical spine, likely secondary to degenerative changes. There is a normal relationship of the dens with the arch of C1. There is no acute fracture or pre-vertebral soft tissue swelling. The visualized intracranial structures and lung apices appear normal. C2-C3: No significant spinal ca... | 1.No acute fracture or malalignment.2.Multilevel degenerative changes with suspected moderate spinal canal narrowing at C3 through C5. Multilevel neuroforaminal narrowing, left greater than right. |
Generate impression based on findings. | 41 years, Female. Reason: evaluate NG placement History: NG placed Enteric tube is coiled in the stomach with tip in the distribution of the distal gastric body. Multiple loops of dilated small bowel with gas and stool in the colon likely represent a generalized ileus pattern. Contrast is noted in the collecting system... | NG tube with tip in the distribution of the distal gastric body. Postoperative changes with generalized ileus pattern. |
Generate impression based on findings. | 41-year-old female patient with abdominal pain, distention, obstipation status post ventral and inguinal hernia repair. Evaluate for abdominal obstruction 2 days postop ventral and inguinal hernia repairs. ABDOMEN:LUNG BASES: There is dependent basilar atelectasis.LIVER, BILIARY TRACT: Numerous cysts of varying sizes a... | 1. Postsurgical changes of umbilical and inguinal hernia repairs with anterior abdominal wall, rectus abdominus, and right inguinal hematomas.2. Near diffusely dilated small bowel and colon likely represents ileus given recent surgery, however, with presence of decompressed distal small bowel loops cannot exclude a dev... |
Generate impression based on findings. | 55-year-old male with pain, rule out fracture. 2 views of the left hip reveal mild osteophyte formation at the left acetabulum, otherwise there is no evidence of fracture or dislocation. Injection granulomas in the soft tissues are noted. | No evidence of fracture or dislocation. |
Generate impression based on findings. | Hypodense foci are again noted in the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collecti... | Hypodense foci are again noted in the white matter without associated mass effect. This most likely reflects small vessel ischemic disease of indeterminate ages. Noncontrast CT is insensitive for the detection of metastases. Thus, if there is continued clinical concern for either metastases or acute ischemia, MRI with ... |
Generate impression based on findings. | 25-year-old female with bony tenderness Cervical spine: Evaluation of the cervicothoracic junction is limited by overlying anatomy. Vertebral body heights, disc spaces, and alignment are preserved. No acute fracture are traumatic subluxation is evident.Pelvis: Stimulator device projects over the abdomen and pelvis. No ... | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 33 years, Female. Reason: r/o SBO History: emesis Nonobstructive bowel gas pattern without evidence of pneumoperitoneum. Lung bases are clear | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Intracranial hemorrhage 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 the falx and superior sagittal sinus.A ventri... | 1.Since the prior exam from yesterday the patient's left frontal hematoma has not significantly expanded. There is associated midline shift, subarachnoid hemorrhage and intraventricular hemorrhage.2.A ventriculostomy tube is stable. The ventricles are stable. |
Generate impression based on findings. | 41-year-old male with nausea/vomiting. History of HIV, hepatitis B. ABDOMEN:LUNG BASES: Basilar scarring. No focal consolidation, pleural effusion, or suspicious nodularity.LIVER, BILIARY TRACT: The liver is not well opacified, likely owing to contrast filling numerous right body wall collaterals; this limits sensitivi... | 1.Secondary findings of central venous obstruction; CT of the chest with contrast may be considered for further evaluation.2.No specific findings to account for nausea/vomiting. |
Generate impression based on findings. | The study is limited by motion. Given this caveat:Redemonstrated is a stable appearing extensive area of hypoattenuation in the right cerebral hemisphere and encephalomalacia involving the periventricular white matter, the right parietal lobe, insula and temporal lobe, consistent with chronic infarct. There is ex vacu... | 1.The study is limited by motion.2.No acute intracranial hemorrhage or mass. 3.Extensive chronic right-sided infarct in the MCA distribution. 4.Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and there is no contraindication to MRI, MRI... |
Generate impression based on findings. | 87 years Female. Reason: assess for tracking of abscess History: tender, soft right posterior scalp lesion with purulence on aspiration. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The vent... | Enhancing fluid collection in the left posterior scalp, compatible with an abscess; no extension into the neck. |
Generate impression based on findings. | Rule out pulmonary embolus, shortness of breath PULMONARY ARTERIES: Technically adequate study. No pulmonary embolus is identified.LUNGS AND PLEURA: Mild lung base scarring and dependent atelectasis, unchanged from prior study. Pulmonary micronodules unchanged. Mild apical paraseptal emphysema.MEDIASTINUM AND HILA: LVA... | No pulmonary embolus identified. PULMONARY EMBOLISM: PE: NoneChronicity: 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. | 87 years, Female. Reason: obstruction History: abdominal pain Paucity of bowel gas however there are fluid-filled loops of bowel distally consistent with a nonobstructive pattern. Calcifications overly the spleen which may be the result of prior granulomatous disease. Calcifications in the pelvis likely represent uteri... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 83-year-old female with fall onto ribs, left-sided rib pain/lateral 6 views of the ribs reveal acute fractures involving the left lateral 8th, 9th and 10th ribs.Degenerative changes affect the right shoulder with calcific tendinopathy of the rotator cuff. | Left 8th, 9th, and 10th rib fractures. |
Generate impression based on findings. | 40-year-old female with hip pain after cleaning, lupus. Evaluate for fracture/dislocation. Left hip pain for 3 days, no known trauma. 2 views of the left hip reveal no fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | 48-year-old male with pain to rotator cuff with decreased ROM. Evaluate for abnormality. No injury, sudden pain after checking mail box 5/2/2015, pain at glenoid fossa. 3 views of the right shoulder reveal minimal osteophyte formation at the AC joint, otherwise there is no fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | 32-year-old female with MVC hit knee on dash, anterior medial pain. Evaluate tibial plateau fracture/other. 4 nonweightbearing views of the right knee reveal no joint effusion, fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | 64-year-old male with intracranial hemorrhage. Redemonstrated is a left temporal basal ganglia hematoma which is decreased in density when compared to most recent CT, and is relatively unchanged when compared to the more recent MRI (given differences in technique). Hemispheric mass effect has improved compared to the C... | No convincing evidence of an acute or significant new finding since prior exam. |
Generate impression based on findings. | Reason: history of SCLC; concern for mets History: AMS; EPS The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild degree are present.Biventricular diameter is 43 mm and previously was the same. No abnormal enhancing mass l... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.No abnormal mass lesions are appreciated intracranially to suggest brain metastases3.Mild enlargement of the lateral ventricles is a nonspecific finding. The possibility this related to normal pressure hydrocephalus cannot be excluded. |
Generate impression based on findings. | Female 13 years old Reason: fracture History: L ankle painVIEWS: Left ankle AP, lateral and oblique 5/3/2015 (3 views) Soft tissue swelling with no evidence of fracture, malalignment or joint effusion. | Soft tissue swelling but no fracture. |
Generate impression based on findings. | 57-year-old female with medial elbow pain status post fall Left elbow: Displacement of the anterior and posterior fat pads suggestive of effusion. No acute fracture or malalignment is evident. A radiographically occult fracture cannot be entirely excluded.Left knee: Minimal osteoarthritis affects the left knee. Moderat... | Displacement of the anterior and posterior elbow fat pads suggest a joint effusion although no acute fracture or malalignment is evident. A radiographically occult fracture is suspected and repeat radiographs are recommended in 7-10 days. |
Generate impression based on findings. | Swelling and pain. Rule out fracture.VIEWS: Left foot AP/lateral/oblique (3 views) 05/03/2015 The bones are normal in appearance. No fracture is identified. Soft tissue swelling is seen on the dorsum. | Soft tissue swelling with no fracture. |
Generate impression based on findings. | 24 years, Female. Reason: Distension History: fever. abd distension Gross pneumoperitoneum with both free and loculated air. The loculated air is in the expected position of Morison's pouch, outlining the right kidney, and in the left upper quadrant indicating retroperitoneal gas. High density material above the right ... | Gross pneumoperitoneum and retroperitoneal air. |
Generate impression based on findings. | Intracranial hemorrhage The patient is status post ventriculostomy tube placement. The ventriculostomy tube courses through the right frontal lobe to the right lateral ventricle through the foramen of Monro with the tip in the third ventricle.There is redemonstration of a ventriculomegaly. Biventricular diameter at the... | 1.There is no interval change in the size of the lateral ventricles. Ventriculomegaly remains. Periventricular hypodensities are suspected to be related to so-called subependymoma migration of cerebrospinal fluid. 2.Continued evolution of left thalamic and brainstem hemorrhage. |
Generate impression based on findings. | 55-year-old male with expressive aphasia, right upper extremity and left lower extremity spastic weakness. There is no evidence of intracranial hemorrhage or mass effect. There is stable marked confluent diffuse hypoattenuation in the periventricular and subcortical white matter. Areas of hypoattenuation within the tha... | 1.No evidence of acute intracranial hemorrhage.2.Stable extensive small vessel ischemic disease and multiple chronic infarcts including the left occipital lobe and right cerebellar hemisphere. |
Generate impression based on findings. | chest pain, evaluate for lung infiltrate and enlarged cardiac silhouetteVIEWS: Chest AP/lateral (two views) 5/3/2015 time 22:44 The cardiothymic silhouette is unremarkable. The aortic arch, cardiac apex, and stomach are left-sided.There is bronchial wall thickening and mild right middle lobe atelectasis. No consolidati... | Bronchial wall thickening compatible with reactive airway disease/bronchiolitis. |
Generate impression based on findings. | 61-year-old male patient with new left-sided weakness. Evaluate for stroke. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The bilateral internal... | 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. |
Generate impression based on findings. | 26-year-old female with pain Soft tissue swelling over the dorsum of the foot. No acute fracture or malalignment is evident. Mild degenerative changes affect the talonavicular and naviculocuneiform joints. Calcaneal spur is noted. | Soft tissue swelling over the dorsum of the foot without acute fracture or malalignment. |
Generate impression based on findings. | 42-year-old female with shortness of breath. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no evidence for right heart strain. The main pulmonary artery measures 2.4 cm in diameter. LUNGS AND PLEURA: Note is made of small bilateral pleural effusions, rig... | 1. No evidence of pulmonary embolus.2. Cardiomegaly with basilar groundglass opacities and bilateral pleural effusions suggestive of mild pulmonary edema.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative. I personally reviewed the ... |
Generate impression based on findings. | Alignment is anatomic. There are no fractures or subluxations. The visualized intracranial structures and lung apices are unremarkable. There is a normal relationship of the dens with the arch of C1. There is no significant spinal canal stenosis. C2/3: There is apparent fusion of the C2-C3 vertebral bodies with flowin... | Degenerative changes as above, without evidence of acute fracture or dislocation. |
Generate impression based on findings. | 11-year-old female with history of one week of abdominal pain. Evaluate for constipation.VIEW: Abdomen AP (one view) 5/3/2015, time 1517 Nonobstructive bowel gas pattern, with air and stool within the rectum. No dilated loops of bowel or other significant abnormality. Small amount of stool within the colon/rectum. | Nonobstructive bowel gas pattern, with a small amount of stool in the colon/rectum. |
Generate impression based on findings. | psychosis, question of change in speech The CSF spaces are appropriate for the patient's stated age with no midline shift. There are subdural effusions present in the posterior fossa which are likely related to some mild atrophy.Incidental note is made of partial empty sella.Incidental note is made of hyperostosis fron... | No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Scattered punctate foci of T2 hyperintensity demonstrated on prior brain MRI are not evident on noncontrast CT technique. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction.... | No acute intracranial hemorrhage or other acute abnormality identified. |
Generate impression based on findings. | 44-year-old male with pain Comminuted oblique fracture through the proximal phalanx with intra-articular extension to the MCP joint. Deformity of the fifth metacarpal likely represents an old healed fracture. | Comminuted fifth proximal phalanx fracture as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast cyst aspiration in 2010. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution... | Focal asymmetry in the right upper outer quadrant, for which spot compression views and possibly ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | stroke activation, R neglect Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bif... | 1.High-grade stenosis along the proximal left subclavian artery associated with what appears to be subclavian steal.2.There is 50% stenosis of the distal left vertebral artery at the vertebrobasilar junction3.There is ventriculomegaly out of proportion with the sulci. The possibility of normal pressure hydrocephalus ca... |
Generate impression based on findings. | 21 years, Female. Reason: dilated loops of bowel History: abdominal pain Nonobstructive bowel gas pattern. Lung bases are clear. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 36-year-old male with ankle pain, sports injury Oblique fracture through the proximal third of the fibula and spiral fracture through the distal third of the tibia with less than one half shaft width lateral displacement of the distal fracture fragments. The tibiotalar joint appears intact. | Tibial and fibular fractures as described above. |
Generate impression based on findings. | 66-year-old male with left-sided weakness status post TPA administration for stroke. There is no intracranial hemorrhage, mass effect, or midline shift. The ventricles and sulci appear normal in size and configuration. There is minimal periventricular hypoattenuation which is nonspecific but may represent age-indetermi... | 1.No acute intracranial hemorrhage or mass effect. 2.Well-defined hypoattenuation involving the right frontal periventricular white matter favored to represent a chronic infarct. 3.Chronic sinus disease involving the sphenoid sinus. |
Generate impression based on findings. | Reason: eval for cspine injury History: etoh intoxication, fall There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The skull and extracranial soft tissues are unremarkable. No acute facial bone fracture is ident... | 1. No fracture or other acute abnormality.2. Left maxillary sinus opacification. |
Generate impression based on findings. | 19 year old female with fever, leukocytosis and hypoxia. Concern for ACS. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no evidence of right heart strain. The main pulmonary artery measures 2.7 cm in diameter.LUNGS AND PLEURA: Note is made of bilateral lower lobe patchy ... | 1. No evidence of pulmonary embolus.2. Bilateral lower lobe patchy groundglass opacities and nodular consolidation. Differential considerations include multifocal infection as well as acute chest syndrome or aspirate.3. Bony changes consistent with sickle cell disease. 4. Incompletely visualized/characterized fluid aro... |
Generate impression based on findings. | DesaturationVIEW: Chest AP ET tube tip at the right mainstem bronchus. NG tube tip in the second portion of the duodenum. Cardiothymic silhouette normal. Minimal improved aeration left lung. Patchy atelectasis in the right lower lobe. | Malpositioned ET tube. |
Generate impression based on findings. | 57-year-old female with knee pain, effusion, hematoma, possible patellar defect No acute fracture or malalignment is evident. No joint effusion. The extensor mechanism appears intact. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 54 years Female with recent dental procedure and angioedema. Please evaluate for tooth infection. The patient is intubated with ET tube tip 2 to 3 cm above the carina and there is nasogastric intubation. There is enlargement of the tongue, compatible with known angioedema. Mild mucosal thickening in the bilateral maxil... | 1.Poor dentition with numerous dental caries and periapical lucency along the right central incisor compatible with periodontal disease. No evidence for abscess formation in the soft tissues of the neck.2.Intubated with enlarged tongue compatible with history of angioedema. |
Generate impression based on findings. | 4-year-old female with history of status asthmaticus, intubation.VIEW: Chest AP (one view) time 0414 Nasogastric tube tip projects over the stomach, with side holes near the GE junction. Endotracheal tube tip is approximately 2 cm above the carina.The stomach is markedly distended. Cardiomediastinal silhouette is uncha... | Nasogastric tube tip projects over the stomach, with side holes near the GE junction, without additional significant interval change. |
Generate impression based on findings. | NG tube placementVIEW: Chest AP Endotracheal tube tip is below thoracic inlet and above the carina.. NG tube tip at the GE junction. Cardiothymic silhouette normal. Patchy atelectasis in the perihilar region and in the right lower lobe. No pleural effusion or pneumothorax. The stomach is dilated. | Malpositioned NG tube.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 43-year-old with history of right mastectomy for invasive carcinoma in 2011 Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 89-year-old female with abdominal pain. Evaluate for diverticulitis. ABDOMEN:Lack of intravenous and oral contrast limits evaluation for solid organ and bowel pathology. Within these limitations, the following observations are made:LUNG BASES: Evaluation of lung bases is limited by respiratory motion artifact. Nonspeci... | 1.Findings consistent with acute pancreatitis. Evaluation for complications is limited by lack of intravenous contrast.2.Findings suggestive of intravascular volume depletion. |
Generate impression based on findings. | Evaluation is limited due to lack of intravenous contrast. Within these limitations, there is clear evidence of an extra-axial collection located along the anterior half of the superior sagittal sinus, greater to the right of midline anteriorly. Known additional extraaxial components along the right cerebral convexity... | 1. Incompletely evaluated epidural abscess at the right cerebral convexity along the anterior superior sagittal sinus which is not well delineated on this noncontrast exam. Known right cerebral convexity and parafalcine subdural collections not appreciated on the CT exam. Mild associated midline shift to the left.2. Di... |
Generate impression based on findings. | 67-year-old female with history of immune modulation medication for chronic autoimmune disease with back pain and gluteal soreness, evaluate for possible compression fracture There are 5 nonrib-bearing lumbar vertebrae. There is mild levoscoliosis of the lumbar spine. Vertebral body heights are preserved. There is grad... | Degenerative changes without evidence of acute compression fracture. |
Generate impression based on findings. | DesaturationVIEW: Chest AP NG tube tip in the stomach. Cardiothymic silhouette normal. Patchy atelectasis bilaterally without pleural effusion or pneumothorax. | Minimal patchy atelectasis bilaterally without pleural effusion. |
Generate impression based on findings. | 41-year-old male patient with nausea, vomiting, abdominal pain. Evaluate for possible partial obstruction. Motion limits evaluation.ABDOMEN:LUNG BASES: Minimal dependent basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormali... | Focally dilated loop of small bowel in the left upper quadrant with decompressed bowel proximally and distally; these findings are compatible with a small bowel obstruction with suspicion for a closed loop obstruction. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears ar... | 1.No acute intracranial hemorrhage or mass effect.2.No evidence of intracranial aneurysm or flow-limiting stenosis.3.Dense atherosclerotic calcifications at the right carotid bifurcation contributing to approximately 68% stenosis at the right internal carotid artery near the bifurcation. Mild atherosclerotic calcificat... |
Generate impression based on findings. | Reason: Post Liver Transplant. Please evaluate all vessels for patency History: Post Liver Transplant. Please evaluate all vessels for patency . PORTAL VENOUS: No significant abnormality noted. There is patent flow in the main , left, and right portal veins.HEPATIC ARTERIES: No significant abnormality noted. Right, lef... | Patent hepatic arteries, veins, and portal veins. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural di... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Evaluate pleural effusionVIEW: Chest AP NG tube tip in the stomach. Central line with tip in the IVC. Cardiothymic silhouette normal. Patchy atelectasis left lower lobe in a background of chronic lung disease. No pleural effusion or pneumothorax. | Patchy atelectasis left lower lobe in a background of chronic lung disease. |
Generate impression based on findings. | 28-year-old male with distal fibular fracture status post splinting Cast material obscures fine bone detail. Again seen is a minimally displaced oblique fracture through the distal fibula in near anatomic alignment. | Distal fibular fracture status post splinting in near-anatomic alignment. |
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