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Generate impression based on findings. | Mucosal thickening is present within the maxillary sinuses, mild on the right, minimal on the left. Otherwise the remaining paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels. The bilateral maxillary sinus ostia are patent as are the bilateral f... | 1.Mucosal thickening is present within the maxillary sinuses, mild on the right, minimal on the left. Otherwise the remaining paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels.2.The nasal septum is deviated leftward and there is a left-sided sep... |
Generate impression based on findings. | Altered mental status, right sided neglect. There is ventriculomegaly present with. Biventricular diameter has increased from 38 to 43 mm when compared to the prior exam from 2012 .Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuse... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.There is ventriculomegaly out of proportion with the sulci. This has progressed since the 3/4/2012 exam. The possibility of normal pressure hydrocephalus cannot b... |
Generate impression based on findings. | 28-year-old male with distal fibular fracture Oblique fracture through the distal fibular metaphysis with minimal lateral displacement of the distal fracture fragment. On stress views, there is mild widening of the medial tibiotalar gutter. | Oblique fractures of the distal fibular metaphysis with mild widening of the medial tibiotalar gutter. |
Generate impression based on findings. | TachypneaVIEWS: Chest AP and lateral Cardiophrenic silhouette normal. Cardiac apex and stomach are left-sided. The stomach is dilated. Minimal peribronchial wall thickening with patchy atelectasis in the right upper lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Reason: R/O ICH or fracture History: Pediatric Trauma There is a comminuted fracture of the right frontal bone, with less than 1 mm of depression. This is associated with a large overlying subgaleal hematoma, measuring up to 8 mm, and underlying parenchymal hemorrhage. There is no midline shift or evidence of herniatio... | Comminuted fracture of the right frontal bone with large subgaleal hematoma and underlying parenchymal hemorrhage. |
Generate impression based on findings. | 77-year-old male patient with known gastrointestinal bleeding, looking at changes in adenocarcinoma preoperatively. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: A hypodense segment 7 hepatic lesion measures 1 x 1 cm (image 40, series 3), unchanged.SPLEEN: No significant abnormality noted.P... | 1. Gastric antrum mass with direct extension into the liver and gallbladder with adjacent lymphadenopathy.2. Post-surgical changes of cystoprostatectomy with ileal-conduit formation. |
Generate impression based on findings. | 50-year-old female with abdominal pain, intolerance to by mouth. Evaluate for obstruction, evaluate for pyelonephritis. ABDOMEN:LUNG BASES: Interval development and growth of multiple nodules in the lung bases. The previously noted 3 mm left lower lobe nodule now measures 7 mm (series 4, image 12). A new right lower lo... | 1.Increased size of right colon mass, causing partial small bowel obstruction.2.Marked progression of metastatic disease as evidenced by increased size and number of hepatic, omental, cul-de-sac, splenic, adrenal, lung, and body wall metastases, as well as increased gastrohepatic, portacaval, omental, and other retrope... |
Generate impression based on findings. | Male 23 months old Reason: please eval for foreign body or anatomical obstruction History: wheezing, diminished breath soundsVIEWS: Chest AP/lateral (two views) 5/3/2015 The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. Peribronchial thickening, large lung volumes,... | Peribronchial thickening, with superimposed multifocal opacities. Reactive airway disease versus viral infection are considerations. |
Generate impression based on findings. | 12-year-old female, evaluate fracture.VIEWS: Right foot AP and lateral (2 views) 5/4/2015 time 8:17 There is a healing fracture of the base of the fifth metatarsal. The fracture line is less distinct indicating at least some interval healing. | Healing fracture of the base of the fifth metatarsal. |
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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable 5 mm mass in the left retroareolar regio... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Thumb edema and erythemaVIEWS: Left hand AP, oblique and lateral No acute fracture or dislocation. There is prior amputation involving the tip of the distal phalanx of the fourth digit. No evidence of bony erosion involving the thumb. | No evidence of bony erosion involving the thumb. |
Generate impression based on findings. | Male 17 years old Reason: r/o fracture History: pain ,swellingVIEWS: Right hand AP, lateral and oblique 5/4/2015 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | CVA. Altered mental status. Since the prior exam subacute infarction in the left middle cerebral artery territory has evolved and there is now encephalomalacia present in the same territory. There is no evidence for acute intracranial hemorrhage.The visualized portions of the paranasal sinuses are clear. The visualized... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.Encephalomalacia in the left middle cerebral artery territory is a likely related to a recent cerebral infarction. |
Generate impression based on findings. | Female 12 years old Reason: r/o fracture History: painVIEWS: Right shoulder AP in internal and external rotation 5/4/2015 (2 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Reason: interval change History: subgaleal hemorrhage, s/p trauma Redemonstration of a minimally depressed comminuted fracture of the right frontal bone and underlying parenchymal hemorrhage, without significant interval change. Slight interval improvement in the size of the overlying subgaleal hematoma. There is no mi... | Slight interval decrease in the size of the subgaleal hematoma, otherwise, no significant interval change. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach are left-sided. Right middle lobe opacities with patchy atelectasis left lower lobe. Right lung volume is minimally smaller in comparison to the left. No pleural effusion or pneumothorax. | Right middle lobe opacity concerning for pneumonia. |
Generate impression based on findings. | Left hand swelling and pain.VIEWS: Left hand AP, lateral and oblique 5/4/2015 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 58 years old; Reason: 58 yo F history of distal pancreatectomy with subsequent pancreatic duct leak with peripancreatic fluid collection treated with pancreatic duct stent, also with percutaneous drains. CT to reassess fluid collections History: peripancreatic fluid collections ABDOMEN:LUNG BASES: Minimal left b... | 1.No drainable fluid collections.2.No bowel obstruction.3.Nephrolithiasis without hydronephrosis.4.Postsurgical changes in the pancreatic tail with minimal fluid in the surgical bed tracking to the spleen.5.Infiltration of the omental fat with a small fat containing midline hernia. The infiltration suggests omental inf... |
Generate impression based on findings. | Female 9 months old Reason: intubated, interval follow up History: intubated for pentobarb comaVIEW: Chest AP (one view) 5/4/2015 at 0359 hours. ET tube terminates below thoracic inlet. Central line is unchanged. Gastrostomy tube again noted. Cardiac silhouette size is normal. Persistent right upper lobe subsegmental a... | Persistent right upper lobe subsegmental atelectasis. |
Generate impression based on findings. | Constipation left lower quadrant painVIEW: Abdomen AP There is moderate amount of fecal burden. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Moderate amount of fecal burden without obstruction. |
Generate impression based on findings. | Reason: Bleed? History: Fall, possible head trauma 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. Patchy areas of periventricular hypoattenuation compatible with chronic ischemic small vessel disease, appear... | 1. No evidence of intracranial hemorrhage or mass effect. 2. Stable appearance of left posterior fossa mass, compatible with a meningioma. |
Generate impression based on findings. | Male 2 months old Reason: r/o obstruction History: abdominal painVIEW: Abdomen AP (one view) 5/4/2015 at 0834 hours. Disorganized, featureless bowel loops. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Featureless loops with no evidence of obstruction or free air. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts as well as an additional right MLO view 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 dis... | 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: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 2 days old Reason: Evaluate UVC placement History: Newborn w/ abnormal neurological exam requiring coolingVIEW: Abdomen and chest AP (2 views) 5/3/2015 Esophageal temperature probe terminates at the lower esophagus. NG tube tip is at the stomach. UVC terminates at the right atrium.The aortic arch, cardiac apex and... | Esophageal temperature probe, NG tube and UVC positioning as described.Minimal diffuse lung haziness consistent with TTN versus RDS.Disorganized, likely age-related and nonspecific abdominal gas pattern. |
Generate impression based on findings. | FractureVIEWS: Left wrist AP and lateral Again noted buckle fracture involving the distal radius in near anatomic alignment. The overlying cast obscures fine bony details. | Buckle fracture distal radius not significantly changed. |
Generate impression based on findings. | 18-year-old male patient with history of seizure. 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. Minimal mucosal thickening in the left sphenoid sinus. The remaining paranasal sinuses and mastoid air cells a... | No evidence of acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral Again noted acute fracture involving the distal radius. The distal fracture fragment is dorsally angulated increased from prior study. The overlying cast obscures fine bony detail. | Radial distal fracture fragment dorsally angulated increased from prior study. |
Generate impression based on findings. | Reason: tremors History: tremors 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 ventricles and sulci are prominent, consistent with moderate age-related volume loss. No extra-axial collect... | 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. | 27-year-old female with pain, limited ROM. While playing soccer 5/3/2015, patient twisted right knee while pivoting, now with general right knee discomfort and unable to fully extend. 4 nonweightbearing views of the right knee reveal no joint effusion, fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | Male 3 years old Reason: evaluate lung fields History: respiratory failure post traumaVIEW: Chest AP (one view) 5/4/2015 at 0647 hours. ET tube tip is above the carina. NG tube tip terminates at the antropyloric region. Central line tip is at the right atrium. Cardiac silhouette size is normal. Persistent right lung ba... | Persistent right lower lobe atelectasis or contusion with possible superimposed pleural effusion. |
Generate impression based on findings. | Female, 34 years old. Reason: dysphagia, h/o SLE History: dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus was limited secondary to incomplete mucosal coating, but revealed no ... | 1. Large volume spontaneous gastroesophageal reflux to the level of the thoracic inlet. 2. Moderate esophageal motor abnormality as detailed above.3. Probable small hiatal hernia. |
Generate impression based on findings. | 89-year-old female patient with slurred speech. Evaluate for bleed versus mass. Personal history of known metastatic breast cancer. Note that dental amalgam mildly limits evaluation of the skull base. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration... | 1.No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the early detection of acute non-hemorrhagic cerebral infarcts.2.Multiple bilateral probable age indeterminate lacunar infarcts in the basal ganglia. 3.White matter hypoattenuation may represent age-indeterminate small vess... |
Generate impression based on findings. | Reason: evaluate for PE vs acute chest History: chest pain, HbSS with VOC PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus.LUNGS AND PLEURA: Bilateral dependent pulmonary opacities, which appear new from prior abdominal CT. MEDIASTINUM AND HILA: Moderate cardiomegaly. No pericardial effu... | 1.No evidence of pulmonary embolus.2.Bilateral nonspecific lung base pulmonary opacities, compatible with dependent atelectasis.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 w... |
Generate impression based on findings. | A right frontal convexity subdural low attenuating collection now measures up to 5 mm in maximal thickness (previously 7 mm) with minimal, if any, mass effect on the adjacent gyri. There is no new intracranial hemorrhage, mass effect, or cerebral edema. Redemonstrated is mild periventricular and subcortical white matt... | 1.Interval slight decrease of the previously demonstrated small right frontal convexity subdural collection with minimal, if any, mass effect. 2.No new intracranial hemorrhage3.No abnormal enhancing foci. |
Generate impression based on findings. | Male 3 years old Reason: PICC placed - check tip location History: PICC placedVIEW: Chest AP (one view) 5/3/2015 at 1338 hours. ET tube and NG tube unchanged. Interval left upper extremity PICC placement, tip is at the right atrium. Cardiac silhouette size is normal. No change in right lung base opacity either atelecta... | No change in right lower lobe opacity after central line placement. |
Generate impression based on findings. | Reason: r/o intracranial mass, other History: asymmetric pupils Again seen are postsurgical changes related to left frontal calvarial craniotomy/plasty, including side plate and screws, without significant interval change. Dehiscence of the left orbital wall to superior lateral aspect is unchanged. Mild sclerosis of th... | 1. No evidence of new or recurrent mass.2. Stable post-surgical/treatment changes, as above. |
Generate impression based on findings. | 57-year-old female inability to ambulate. Evaluate for fracture. Patient fell twice 5/3/2015, left hip pain 5 views of the hips reveal mild to moderate degenerative changes of the sacroiliac joints as well as bilateral hips. No fracture or dislocation.Surgical clips in the pelvis. | Mild to moderate degenerative changes of the sacroiliac joints and bilateral hips with no fracture or dislocation. |
Generate impression based on findings. | 19-year-old female, struck by car. Evaluate for fracture. Pain at shaft of fifth metatarsal 3 nonweightbearing views of the right foot reveal no fracture or dislocation. Alignment is normal.4 views of the right ankle reveal no fracture or dislocation. Alignment is normal. | No fracture or dislocation. |
Generate impression based on findings. | DesaturationVIEW: Chest AP ET tube tip immediately above the carina. NG tube tip in the stomach. UVC tip in the right atrium. Cardiothymic silhouette normal. Diffuse atelectasis increase from prior study. No pleural effusion or pneumothorax. | Low-lying ET tube with increasing atelectasis bilaterally. |
Generate impression based on findings. | Images are limited due to extensive susceptibility artifact from indwelling dental hardware, which distorts the anterior aspect of the images especially on diffusion-weighted and susceptibility weighted imaging. Within these limitations, there is a prominent right paramedian frontal epidural collection which is T1 hyp... | 1. Prominent right paramedian cerebral convexity epidural abscess and smaller right cerebral convexity and right parafalcine subdural abscesses. Localized mass effect with midline shift to the left measuring 4-5 mm.2. Limited exam due to dental hardware artifact, although visualized right-sided paranasal sinuses are co... |
Generate impression based on findings. | Female 1 day old Reason: evaluate lung fields, UVC placement History: Term infant with respiratory distress and FIO2 requirementVIEW: Chest and abdomen AP (2 views) 5/3/2015 UVC terminates at the left atrium or left superior pulmonary vein. The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette si... | Misplaced UVC.Multifocal streaky opacities on a background of diffuse lung haziness.Small bilateral pleural effusions.Disorganized, likely age related and nonspecific abdominal gas pattern. |
Generate impression based on findings. | 65-year-old female with pain. Evaluate for fracture. Patient felt pop in right knee a few days ago while on medication, now has swelling in knee joint with pain in anterior and posterior knee joint. 4 weightbearing views of the right knee reveal a small anterior joint effusion about the knee as well as mild osteoarthri... | Small anterior joint effusion about the knee and mild osteoarthritis with no evidence of fracture or dislocation. |
Generate impression based on findings. | 68-year-old female patient with diffuse abdominal pain. Question of intra-abdominal process. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abno... | Right colonic/distal terminal ileum wall thickening with mild surrounding inflammatory changes; these findings likely represent a colitis possibly ischemic, infectious, or inflammatory in etiology. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral The buckle fracture involving the metaphysis of the distal radius again noted and not significantly changed. The alignment is not significantly changed. The overlying cast obscures fine bony detail. | Buckle fracture distal radius not significantly changed. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in a paternal aunt. Two standard digital views and tomosynthesis of both breasts and additional bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may o... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | MCP joint painVIEWS: Right thumb AP, lateral and oblique 5/3/2015 (3 view/s) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Tachypnea and feverVIEWS: Chest AP 5/3/2015 (1 view/s) Port-A-Cath central line and skeletal deformities are again noted. Cardiac silhouette size is normal. Right lung base opacity, likely atelectasis or pneumonia. No effusions or pneumothorax. | Right lower lobe opacity as described. |
Generate impression based on findings. | Reason: PCXR 5/2 shows a prominent soft tissue density History: s/p CABG x 4, ASD Repair, LAA Ligation on 4/20/2015 LUNGS AND PLEURA: Large left pleural effusion and small right effusion, with associated atelectasis/consolidation. MEDIASTINUM AND HILA: Cardiac size is normal. High-density fluid collection along the per... | 1.High-density fluid collection along the pericardium, upper mediastinum, and sternotomy incision compatible with postoperative hematoma.2.Diastasis of the sternum by 2cm.3.Large left and small right pleural effusions with associated atelectasis/consolidation. Findings discussed with Mark Myren, PA on 5/4/15 11:05 AM. |
Generate impression based on findings. | Follow-up scan for multicystic kidney KIDNEYS Cortical Echogenicity: Right cortical echogenicity is within normal limits. The left kidney is composed of 6 cysts of varying size arranged randomly, without interconnection. Medullary Echogenicity: Right side within normal limits. The left kidney is composed of 6 cysts ... | Right kidney within normal limits, left kidney with grossly unchanged multicystic dysplastic appearance.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices a... |
Generate impression based on findings. | Male, 77 years old. Reason: sp LAR, now with recurrent anastomotic strictures, sp enema, red rubber instertion History: improvement in abd distention, advancement of diet Markedly dilated colonic loops are again seen, similar in extent from the prior exam. No gas seen within the rectum. Status post LAR.Surgical clips i... | Persistent massive dilation of the visualized colon, suggesting chronic ileus or obstruction at the surgical anastomosis. |
Generate impression based on findings. | Brain: The ventricles and sulci are unchanged in size and configuration. The 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 ischemi... | 1.Mild chronic small vessel ischemic changes. No acute infarct, hemorrhage or mass effect.2.Multilevel degenerative changes of the cervical spine with mild to moderate spinal canal stenosis superimposed upon congenital narrowing of the spinal canal and variable multilevel foraminal stenosis as described above. |
Generate impression based on findings. | Reason: increased ICP History: pain 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 skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Female, 52 years old. Reason: assess for obstruction History: abd pain, bloody diarrhea, hx of SBO Postsurgical changes, deformity, and hardware about the right pelvis, similar in appearance to prior exam. Right upper quadrant cholecystectomy clips and multiple additional abdominal clips appears similar to prior.Nonobs... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | There is bilateral enlargement of the vestibular aqueduct (left greater than right). This is associated with mild dysplasia of the cochlea (left more so than right).The bilateral external auditory canals, middle ear cavities and mastoid air cells are completely clear. There is no evidence for congenital atresia of the... | There is bilateral enlargement of the vestibular aqueduct (left greater than right). This is associated with mild dysplasia of the cochlea (left more so than right). |
Generate impression based on findings. | 43-year-old female. Right breast calcifications. A standard ML view and two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There are a cluster of ... | High probability benign calcifications, for which a 6 month follow-up is recommended to confirm their stability. BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Reason: eval for pe History: new DVT RLE, now with SOB PULMONARY ARTERIES: Technically adequate study. Large central right pulmonary embolus with mild prestenotic dilatation. Main pulmonary artery measures 2.5 cm. No deviation or bowing of the septum. No reflux of contrast into hepatic veins. Smaller embolus attached t... | Large right central pulmonary embolus. Smaller left lower lobe pulmonary embolus which may be chronic.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute and chronicMultiplicity: BilateralMost Proximal: Main.RV Strain: None I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this re... |
Generate impression based on findings. | 19-year-old female struck by car. Evaluate for fracture. Pain to extend wrist, pain to medial condyle. 3 views of the wrist reveal mild ulnar subluxation as well as mild widening of the scapholunate ligament raising question of ligamentous injury. These findings do not appear acute with no associated joint effusion. No... | Findings raise the question of ligamentous injury. No acute fracture or dislocation. |
Generate impression based on findings. | 70-year-old female with elevated D dimer and dyspnea. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. The main pulmonary artery measures 2.5 cm in diameter. There is no evidence of right heart strain.LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules some of which are cal... | 1. No evidence of pulmonary embolus.2. Bilateral pulmonary micronodules and borderline intrathoracic nodes. These are nonspecific but given evidence of healed granulomatous infection elsewhere, are also likely post inflammatory. Typically nodules of this size do not require follow up unless the patient is a smoker.3. A... |
Generate impression based on findings. | Male, 71 years old. Reason: Checke feeding tube placement History: Check feeding tube placement The lower abdomen and pelvis are excluded from the field-of-view.Dobbhoff tube tip in the region of the duodenal bulb.Partially visualized nonobstructive bowel gas pattern. Enteric contrast material within the colon from rec... | Enteric tube tip in the region of the duodenal bulb. |
Generate impression based on findings. | 57 -year-old female. History of fibrocystic disease. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are scattered benign calcifications and small partially circumscribed m... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Chest pain PULMONARY ARTERIES: Technically adequate study. No pulmonary embolus is evident. LUNGS AND PLEURA: Multiple right lower lobe thin walled cysts supplied by anomalous feeding artery arising from aorta, compatible with pulmonary sequestration.MEDIASTINUM AND HILA: Cardiac size is unremarkable. No pericardial ef... | No pulmonary embolus. Right lower lobe pulmonary sequestration is noted.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. | Male, 55 years old. Reason: h/o heart transplant with diarrhea and abdominal pain, please evaluate Nonobstructive bowel gas pattern. Air-fluid levels noted.Moderate stool burden.No free air seen on upright imaging.Status post median sternotomy, right hip arthroplasty. | Nonobstructive bowel gas pattern. No free air. |
Generate impression based on findings. | 45-year-old female, leg ulcer. Concern for osteomyelitis. History of right tib/fib injury and infection many years. Open sore to lateral aspect of right tib-fib, patient states wound has history of opening and closing. Interval removal of orthopedic hardware.Shallow soft tissue ulceration overlies the right lateral asp... | 1. Shallow soft tissue ulceration along the right lateral aspect of the ankle. Marked cortical irregularity, periosteal reaction and questionable indistinctness of the distal fibula cortical margin, are nonspecific findings and although appears grossly intact and the post operative changes underlying the shallow soft t... |
Generate impression based on findings. | FractureVIEWS: Right foot AP and lateral There are healing fractures involving the first and second metatarsals with sclerosis and periosteal reaction. The alignment of the fracture is near anatomic. | Healing metatarsals fractures as described above. |
Generate impression based on findings. | 20-year-old female with lateral pain and pain in calcaneus No acute fracture is evident. No joint effusion. No malalignment. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 7-month-old female involved in pediatric trauma, evaluate for fracture and pneumothorax.VIEWS: Cervical spine AP and lateral views (2 views) 5/3/2015 time 21:19Chest PA view (1 view) 5/3/2015 time 21:17 Chest: The cardiothymic silhouette is unremarkable. The aortic arch, cardiac apex, and stomach are left-sided.There i... | Normal chest radiograph with no evidence of pneumothorax. Within the limitations of the cervical spine exam no acute fracture or subluxation is identified. |
Generate impression based on findings. | 23-year-old female with posterior cervical pain. Cervical spine: No acute fracture or subluxation. There is mild straightening of the usual cervical lordosis which may be due to positioning or muscle spasm. The vertebral body heights and disc spaces are preserved. Anterior osteophyte at C6-C7. The neural foramina are p... | 1.No acute fracture or malalignment is evident. 2.Rightward curvature of the thoracic spine.3.Anterior osteophytes at C6-C7. |
Generate impression based on findings. | Reason: Status post robotic prostatectomy with Foley catheter in place. Had bladder injury repair and right ureteral reimplant during surgery on 4/27. Please evaluate for any contrast extravasation given repair. Scout film demonstrated no abnormal calcification. Right nephroureteral stent is in place.Cystografin was ad... | No evidence of contrast extravasation. Expected vesicoureteral reflux to the level of the right renal pelvis without evidence of hydronephrosis. |
Generate impression based on findings. | Altered mental status 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 bifurcatio... | 1.Left fusiform gyrus lesion. There is suspected to represent a focus of infarction along the territory of the left posterior temporal artery. If clinically appropriate MRI of the brain with help further assess this.2.Pseudoaneurysm along the right internal carotid artery distal cervical portion. Most likely this is a ... |
Generate impression based on findings. | 75-year-old male patient with right flank pain. Evaluate for stone. ABDOMEN:LUNG BASES: A 1 cm left lower lobe pulmonary nodule is unchanged in size.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL... | 1. Nonobstructing nephrolithiasis. No evidence hydronephrosis.2. Minimally complex right renal cysts. |
Generate impression based on findings. | Other malaise and fatigue The patient is status post right-sided parietal craniotomy. There is a partially cystic lesion present centered in the right parietal lobe and extending into the right temporal lobe associated with adjacent hypodensities in the right frontal, parietal and temporal lobes as well as the right in... | 1.The patient is status post right parietal surgery. There is a cystic lesion which extends from the right parietal lobe into the right temporal lobe. The possibility of underlying residual or recurrent tumor cannot be excluded on the basis of this exam. There is adjacent vasogenic pattern of edema or tumor infiltratio... |
Generate impression based on findings. | Reason: eval for cspine injury History: cspine ttp, fall from bed 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 visualize... | 1.No evidence for cervical spine fracture2.No evidence for acute intracranial hemorrhage mass effect or edema.3.A 6mm cystic lesion is present in the right thyroid gland. This is nonspecific. Please correlate with patient's clinical symptoms. |
Generate impression based on findings. | 87-year-old female with abdominal pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: Scarring and atelectasis is noted in the lung bases.LIVER, BILIARY TRACT: Calcified granulomata. Otherwise liver is unremarkable.SPLEEN: Calcified granulomata. Normal sized spleen.PANCREAS: Distal pancreatic body mass measures 4.4 ... | 1.Long segment bowel wall thickening in the mid to distal ileum with mild perihepatic/pelvic ascites suggests enteritis of infectious, inflammatory, or ischemic etiology.2.4.4 cm distal pancreatic body mass, suspicious for primary pancreatic neoplasm. Further evaluation with dedicated triple phase CT or MRCP is recomme... |
Generate impression based on findings. | There are no fractures or subluxations. The visualized intra-abdominal and paraspinal contents are unremarkable. For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. Again seen is minimal retrolisthesis of L5/S1. Otherwise, the spine alignment is anatomic. Degenerative c... | Slight interval progression of degenerative disease as detailed above, with the worst neural foraminal and central canal narrowing at L3-L4. |
Generate impression based on findings. | 40-year-old male with cough and severe asthma and possible tracheal compression. LUNGS AND PLEURA: Biapical scarring/atelectasis. Scattered bilateral pulmonary micronodules. Mild bronchial wall thickening can be seen in reactive airway disease. No pleural effusion or pneumothorax. There is no definite air trapping seen... | Mild bronchial wall thickening can be seen in reactive airway disease. No definite air trapping is seen on the expiratory sequence, although the lung bases are incompletely included in the field of view. No evidence of tracheal compression, as clinically questioned.I personally reviewed the Images and/or procedure with... |
Generate impression based on findings. | Postoperative and posttreatment changes are seen from prior total thyroidectomy and radiation therapy. Pharyngeal mucosal edema is noted with poor visualization of the retropharyngeal fat plane. There is redemonstration of a small triangular-shaped area of enhancement measuring 5 x 6 mm just medial to the right common... | Stable appearance of small area of enhancement medial to the right common carotid artery at the level of the cricoid, retrospectively present dating back to the April 20, 2011 postoperative exam with interval decreased size. Differential diagnosis again includes posttreatment effects including a treated lymph node or l... |
Generate impression based on findings. | Altered mental status 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.Periventricular and subcortical white matter hypodensities of a m... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.Periventricular and subcortical white matter changes of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. 3.Air-fluid ... |
Generate impression based on findings. | A hypodense focus is redemonstrated in the right fusiform gyrus extending into the right occipital lobe. This is unchanged since prior exam in distribution. There is no evidence for hemorrhagic conversionThe visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are cl... | 1.Subacute phase infarction involving the right fusiform gyrus and adjacent occipital lobe without evidence for hemorrhagic conversion. |
Generate impression based on findings. | 53 -year-old female. Right breast lumpectomy for IDC and RT. Follow-up. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is stable architectural disto... | Post-surgical changes of the right breast and stable benign bilateral masses, asymmetries, and calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the ... |
Generate impression based on findings. | 35-year-old male with right lower quadrant pain. Evaluate for appendicitis. ABDOMEN:LUNG BASES: Moderate cardiomegaly.LIVER, BILIARY TRACT: Moderate periportal edema. The liver enhances homogeneously without focal lesion.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: N... | 1.No evidence of appendicitis.2.Findings of volume overload include cardiomegaly, periportal edema, anasarca, and mild ascites. |
Generate impression based on findings. | 78-year-old female with a history of anaplastic thyroid carcinoma status post chemoradiation therapy. LUNGS AND PLEURA: Persistent mild paramediastinal fibrosis/posttherapy changes in the lung apices. Persistent bilateral pulmonary nodules and micronodules, appearing similar to the prior study. Reference right lower lo... | No new or suspicious pulmonary nodules are identified.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 10-year-old male with history of pseudomonas infection and acute kidney failure. Recurrent urinary tract infection. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Norm... | No hydronephrosis, or other findings to explain the patient's recurrent urinary tract infections.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen... |
Generate impression based on findings. | Patient fell, pain Diffuse demineralization limits sensitivityShoulder: Mild osteoarthritic changes observed with sclerosis and small osteophytes. No distinct definite acute abnormality, specifically no fracture or malalignment however please consider serial follow-up imaging given limitations if suspicion remains high... | No acute osseous abnormalities, specifically no distinct fracture, however limitations are described. Please see above |
Generate impression based on findings. | PHARYNX/LARYNX: The nasopharynx, oropharynx, and hypopharynx are unremarkable. The larynx is unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The contrast-enhanced appearance of the submandibular, sublingual, and parotid glands bi... | No cervical lymphadenopathy except for enlarged right node of Rouviere which is nonspecific but may be reactive. In the left occipital scalp, there is a small normal-appearing lymph node although superficial in location which may correlate with the patient's area of palpable concern. |
Generate impression based on findings. | Bilateral knee pain Interval progression of now in near severe to moderate osteoarthritic changes greater on the right with changes greater in the medial compartment bilaterally. Changes include near bone on bone narrowing, sclerosis and small osteophytes. No definite effusions, however a small fluid collection on the ... | Progressing osteoarthritic changes greater on the right |
Generate impression based on findings. | Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.T12/L1: UnremarkableL1/2: UnremarkableL2/3: UnremarkableL3/4: Unremark... | L5/S1:Disc desiccation and mild disc height loss are associated with a left paracentral disc protrusion which abuts and flattens the left S1 nerve sheath origin. There are no stenoses. |
Generate impression based on findings. | Reason: Bleed? History: AMS There is a hypodense focus involving gray and white matter located in the left fusiform generous associated with the mild mass effect.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits ... | 1.Left fusiform gyrus lesion. There is suspected to represent a focus of infarction along the territory of the left posterior temporal artery. If clinically appropriate MRI of the brain with help further assess this and differentiate tumor from infarct. Findings were discussed with Dr Newey. |
Generate impression based on findings. | Male 80 years old; Reason: eval for progression History: metastatic urothelial cancer CHEST:LUNGS AND PLEURA: There are multiple bilateral pulmonary lesions. The reference right middle lobe pulmonary lesion measures 1.2 x 1.1 cm (image 46/series 4) previously, 1.0 x 0.9 cm.Reference left lower lobe pulmonary lesion mea... | 1.Slight increase in the size of the reference pulmonary and liver lesions. |
Generate impression based on findings. | Female 43 years old; Reason: masses abnormal nodes? History: thyroid cancer s/p surgery I131 Integrated U" you do that at the lower follow-up isPatient is status post total thyroidectomy. Within the right thyroid bed, there is a 4 x 6 x 4 mm nodule with shadowing calcification.Within the left thyroid bed superiorly, th... | 1.6 mm nodule in the right thyroid bed with suggestion of calcification is suspicious. This may be amenable to percutaneous biopsy. |
Generate impression based on findings. | There is no midline shift or mass effect, areas of abnormal signal, or diffusion abnormality. No extra-axial fluid collection is identified.There is slight prominence of the subarachnoid spaces, especially anteriorly, as well as the ventricles. Normal flow-voids are demonstrated in the major intracranial vascular stru... | 1.No acute intracranial abnormality. 2.Findings suggestive of benign enlargement of the subarachnoid space in infancy which should resolve by 2 years of age; follow-up may be obtained, as clinically indicated.3.Mildly enlarged asymmetric left left 2a lymph node, likely reactive. |
Generate impression based on findings. | Pain Redemonstration of the nondisplaced and partially healing subacute fracture of the first proximal phalanx. No change in alignment. Soft tissues appears similar. | Healing first proximal phalanx fracture |
Generate impression based on findings. | Pain Interval subacute healing of a minimally impacted intra-articular distal radial fracture previously suspected. Mild callus formation is observed. No change in alignment or distal wrist/components. Soft tissues are unremarkable | Healing distal radial fracture |
Generate impression based on findings. | There is mild nonspecific prominence of the lateral ventricles. The ventricles and sulci are otherwise 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 collections or su... | Unremarkable unenhanced brain CT. |
Generate impression based on findings. | The ventricles and cerebral sulci are within normal limits for age. There is redemonstration of disproportionate prominent cerebellar and vermian folia consistent with focal volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is ... | 1. No acute intracranial abnormality.2, Redemonstration of diffuse cerebellar volume loss much greater than expected for the patient's stated age. Clinical correlation is recommended for possible chronic alcoholism history or neurodegenerative disorder. |
Generate impression based on findings. | 55-year-old male surveillance imaging for left cheek squamous carcinoma status post radiation therapy. LUNGS AND PLEURA: Interval resolution of the previously described subpleural consolidation/atelectasis. Probable intrapulmonary lymph nodes noted along the major fissures bilaterally, unchanged. Right basilar scarring... | 1. Interval resolution of the previously described subpleural consolidation/atelectasis and right pleural effusion.2. No new or suspicious pulmonary nodules or masses are identified.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Knee pain No distinct osteoarthritic or additional radiographic abnormalities. Alignment preserved. No effusion. | No radiographic abnormality or acute disease |
Generate impression based on findings. | Female 6 days old Reason: ETT placement History: ETT placementVIEW: Chest AP (one view) 5/4/2015 at 1033 hours. ET tube tip is above the carina. NG tube is present. UAC terminates at T8. UVC tip is at the ductus venosus. Cardiac silhouette size is normal. Diffuse lung haziness with pattern of PIE and left lower lobe at... | Diffuse lung haziness with pattern of PIE and left lower lobe atelectasis. |
Generate impression based on findings. | Lumbar stenosis. Left hip and back pain. Changes extend to the knee Lumbar spine: Scattered moderate osteoarthritic changes most pronounced involving L1 to with relative sparing of the lower levels. Lower facet sclerosis with preservation of vertebral body height and alignment. Small to moderate osteophytes. Posterior ... | Scattered moderate degenerative changes involving the spine, SI joints and hips |
Generate impression based on findings. | Reason: R/O ICH or fracture History: Pediatric Trauma There is a comminuted fracture of the right frontal bone, with less than 1 mm of depression. This is associated with a large overlying subgaleal hematoma, measuring up to 8 mm, and underlying parenchymal hemorrhage. There is no midline shift or evidence of herniatio... | Comminuted fracture of the right frontal bone with large subgaleal hematoma and underlying parenchymal hemorrhage. |
Generate impression based on findings. | 41-year-old female. Call back from screening for a right upper breast focal asymmetry. Two standard views and two spot views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution.... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
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