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Generate impression based on findings. | Age: 55 years. Sex : Female. Reason for study: Reason: eval for ability to take PO History: prolonged period of time npo, has trach. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. A single im... | Positive for vestibular penetration and negative for aspiration. Please see separate speech pathology report for additional details. |
Generate impression based on findings. | Snuffbox pain, check for fracture A well aligned lucency is projected across the waist of the scaphoid with associated mild widening of the scapholunate articulation. Scapholunate ligamentous injury is suspected along with a nondisplaced navicular fracture despite the absence of overlying significant swelling. Follow-u... | Suspected navicular fracture with possible injury of the scapholunate ligament |
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 is no diffusion abnormality. No extra-axial fluid collection is identified. Grossly stable appearance of punctate periventricular and subcortical foci of FLAIR hyperintensity within the ... | 1.No diffusion weighted abnormality.2.Stable appearance of mild chronic small vessel ischemic disease. |
Generate impression based on findings. | 79-year-old male patient with history of ruptured AAA status post repair and bilateral common iliac artery aneurysms. Six-month surveillance, asymptomatic. CHEST:LUNGS AND PLEURA: Bibasilar scarring and upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: A saccular aneurysm arising off the aortic arch ... | 1. Stable size of the left common and internal iliac artery aneurysms.2. Slight increase in size of the saccular aortic arch aneurysm with progression in thrombosis. |
Generate impression based on findings. | FractureVIEWS: Right thumb AP and lateral There is a comminuted fracture involving the tip of the distal phalanx of the right thumb. The distal fracture fragment is dorsally angulated and there is associated soft tissue swelling. | Comminuted fracture distal phalanx of the right thumb. |
Generate impression based on findings. | Thumb fusion Essentially unchanged appearance of the first MCP with a traversing screw and minimal evidence of actual fusion. Degenerative changes persist with a distinct lucency surrounding the screw and the threads both proximally and distally. Suspected loosening remains of concernTrapezium excision with associated ... | Unchanged screw fixation and appearance |
Generate impression based on findings. | 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 collections or subdural hematomas. Other than minimal foci of mucosal thickening in the max... | No acute intracranial abnormality to explain the patient's altered mental status. |
Generate impression based on findings. | FractureVIEWS: Left tibia and fibula AP and lateral Again noted oblique fracture involving the distal tibia not significantly changed from prior study. Minimal posterior angulation of the distal fracture fragment not significantly changed. The overlying cast obscures fine bony detail. | Fracture of the distal tibia not significantly changed from prior study. |
Generate impression based on findings. | FractureVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. Again noted an ossific density immediately adjacent to the lateral malleolus not significantly changed. No ankle joint effusion. The ankle mortise joint is normal. | No acute fracture or dislocation. |
Generate impression based on findings. | Male 4 months old Reason: is there reflux or fistula History: stool from penisVIEW: Abdomen AP (one view) 5/4/2015 at 1013 hours. Contrast material remains in the stomach fundus and to a lesser degree in the rectal ampulla. Persistent bowel distention with central distribution of bowel loops. | Residual contrast material in bowel loops as described. |
Generate impression based on findings. | 2 day old female with history of increased O2 requirementVIEW: Chest AP (one view) time 1001 Endotracheal tube tip approximately 1 cm above the carina. Nasogastric tube tip is in the area of the gastric body, however the side holes are at the GE junction. Umbilical venous catheter is at the level of the right atrium ju... | Endotracheal tube, and other findings as above. |
Generate impression based on findings. | Male 39 years old; Reason: 39 y/o male with colon ca on chemo. pls compare to prior CT. History: see above CHEST:LUNGS AND PLEURA: Right chest wall port with tip in distal SVC. Reference right middle lobe lung nodule, demonstrating interval decrease in size, measures 4 x 4 mm, image 48 series 5, previously measured 6 x... | 1. Status post left hemicolectomy. There is improving mesenteric soft tissue attenuation in the region of the postsurgical anastomosis in the left abdomen at the level of the left renal hilum. There is thickening and tethering of the adjacent stomach, small bowel and anastomosed large colon. 2. Persistent left ventral ... |
Generate impression based on findings. | 1-year-old male with history of left leg injury.VIEWS: Left tib-fib AP and lateral (2 views) time 0958 Overlying cast material limits evaluation of fine bone detail. Alignment is grossly anatomic, and there is no dislocation of the knee or ankle. No displaced fracture is seen, given these limitations. | Left lower extremity cast, and other findings as above. |
Generate impression based on findings. | There is a 3mm focus of enhancement along the left postcentral gyrus just medial to the hand area that is suspicious for an isolated metastatic focus. The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axi... | 1.Punctate lesion left post central gyrus is suspicious for an isolated metastatic focus. It is new since the prior exam. |
Generate impression based on findings. | Left knee pain Severe to moderate tricompartmental osteoarthritic changes, greater on the left with bone-on-bone narrowing most pronounced within the medial compartment. Suspected multiple loose bodies are observed both posteriorly and in the lateral aspects of the left joint space. | Near severe osteoarthritic changes with probable loose bodies |
Generate impression based on findings. | There is a lesion in the anterior left frontal lobe with peripheral susceptibility artifact and heterogeneous T2 hyperintensity, compatible with an isolated cavernoma. The lesion measures 9 x 8 mm on axial T2 imaging appears to have an associated venous anomaly and does not have perilesional edema. There is a 6mm focu... | 1.Findings suggest an isolated cerebral cavernous malformation in the left frontal lobe associated with a developmental venous anomaly. 2.A small lesion in the posterior left frontal lobe subcortical white matter is non-specific. Although it could be vascular related or related to prior injury other pathologies cannot ... |
Generate impression based on findings. | 74-year-old female with anemia, acute kidney insufficiency, hypercalcemia for evaluation of multiple myeloma SKULL: No significant abnormality noted.CERVICAL SPINE: Loss of vertebral body height of C5 with severe degenerative disc disease affecting C5-C6. Moderate degenerative disc disease affects C3 C4 C4 C5 C6 C7 and... | 1.No suspicious myelomatous deposits.2.Severe degenerative disc disease of the cervical spine as described above. |
Generate impression based on findings. | 72-year-old male with history of bladder cancer status post radical cystectomy with ileal conduit urinary diversion, evaluate for metastatic disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant... | No specific evidence of disease recurrence or metastases. |
Generate impression based on findings. | 65-year-old female with pain, evaluate for fracture. Pain in left wrist along the medial aspect, patient states she feels a bump, possible injury when she injured her knee 3 views of the left wrist reveal mild osteoarthritis of the wrist with no joint effusion, fracture or dislocation. IV tubing noted along the medial ... | Mild osteoarthritis with no evidence of fracture or dislocation. |
Generate impression based on findings. | 27-year-old female with foot pain, base of fifth metatarsal as well as lateral malleoli ttp. Right plantar foot pain, no injury. Patient is a runner and plays basketball. 3 views of the right ankle reveal no joint effusion, fracture or dislocation. Posttraumatic subcutaneous density about the anterior soft tissues of t... | No fracture or dislocation. |
Generate impression based on findings. | Reason: Abd CT suggested central obstruction History: collaterals in body LUNGS AND PLEURA: Mild dependent atelectasis. Minimal atelectasis and scarring in the lingula. MEDIASTINUM AND HILA: No evidence of thrombus of the thoracic or cervical major veins. Cardiac size is normal. No pericardial effusion. No mediastinal ... | SVC widely patent. There is a nonocclusive partially calcified residual fibrin sheath in the right brachiocephalic vein and SVC from an old HD catheter. This is usually not clinically significant though if there is continued clinical concern a dedicated left arm shunt venogram can be obtained.I personally reviewed the ... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis 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 benign right breast ma... | Stable right breast mass, most likely a fibroadenoma. 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. | Male 59 years old; Reason: Hodgkin lymphoma, s/p HSCT, RESTAGING History: as above CHEST: LUNGS AND PLEURA: Scattered groundglass and nodular opacities throughout the right upper lobe, new from prior study, and also in the right lower lobe (4:62) likely represent infection.MEDIASTINUM AND HILA: Chest port line tip in t... | 1.New pulmonary airspace opacities as described above are suspicious for multifocal infection.2.New mild prominence of the pancreatic duct at the head with associated interval increase in atrophy. If indicated, MRCP can obtained for further evaluation.3.Otherwise, stable exam. |
Generate impression based on findings. | There has been progression of hypodensity within the subcortical white matter, centrum semiovale, and right insular cortex of the right frontal lobe corresponding with recent diffusion restriction consistent with involving stroke. There are no CT findings to suggest hemorrhagic transformation. Hypodensities are presen... | There has been progression of hypodensity within the subcortical white matter, centrum semiovale, and right insular cortex of the right frontal lobe corresponding with recent diffusion restriction consistent with involving stroke. There are no CT findings to suggest hemorrhagic transformation. |
Generate impression based on findings. | 33-year-old male with trauma. Someone stepped on ankle while playing basketball 5/3/2015, pain along lateral area of the ankle. 3 nonweightbearing views of the left ankle reveal a moderate joint effusion about the lateral malleolus of the ankle with no evidence of fracture, dislocation or malalignment. | Moderate joint effusion about the lateral malleolus with no evidence of fracture or dislocation. |
Generate impression based on findings. | 45 years, Female. Reason: dka, now with nausea and abdominal pain, assess for sbo History: as above Nonobstructive bowel gas pattern with above average stool burden. Lung bases are clear. | Nonobstructive bowel gas pattern. Above average stool burden |
Generate impression based on findings. | 75-year-old female with history of metastatic breast cancer. Pulmonary metastases and lymphadenopathy. CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules and micronodules are not significantly changed number and stable to slightly decreased in size. A reference left lower basilar nodule measures 9 x 6 mm (ser... | 1.Posttreatment changes in the right breast and axilla with stable postoperative seroma.2.Bone metastases not significantly changed. Please note that bone scan is more sensitive.3.Pulmonary nodules/micronodules stable to slightly decreased, pleural effusion, and small mediastinal nodes are nonspecific.4.Hepatic lesions... |
Generate impression based on findings. | Trauma and pain. Check great toe Diffuse demineralization limits sensitivityFoot: Mild scattered degenerative changes with marked atherosclerotic disease. No superimposed acute abnormality. Soft tissues are unremarkableL-spine: Bullet projects over the lateral soft tissues on the right. Underlying spine demonstrates mo... | Scattered degenerative changes without superimposed acute abnormality within limitations described |
Generate impression based on findings. | Male, 62 years old. Reason: NG tube placement History: NG tube placement The lower pelvis is excluded from the field-of-view.NG tube with tip overlying the gastric fundus.Nonobstructive bowel gas pattern. Average stool burden.Pancreatic and vascular calcifications are noted. | NG tube tip overlying the gastric fundus. |
Generate impression based on findings. | Male, 54 years old. Reason: s/p tracheo-colonic fistula speech prosthesis, complicated by enterotomy of colonic interposition History: s/p colonic interposition enterotomy Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Single contrast evaluation of the e... | Extensive postsurgical changes in the cervical esophagus with attenuated esophageal diameter above and end to side anastomosis and no evidence of focal stricture or contrast leak. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Right breast biopsy proven fibroadenoma. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distributio... | 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. | Age: 53 years. Sex : Male. Reason for study: Reason: evaluate for aspiration/penetration History: dysphagia. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. A single image was obtained for doc... | Positive for aspiration. Please see separate speech pathology report for additional details. |
Generate impression based on findings. | 69 year old with history of left mastectomy in 2014 presents for annual mammogram. No current breast complaints. Three standard 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 elements, unchanged in pattern and di... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Left foot injuryVIEWS: Left foot AP and lateral 5/4/2015 at 1120 hours. (2 views) There is a Salter-Harris II fracture of the first metatarsal. Alignment is anatomic. | Salter-Harris II fracture of the proximal first metatarsal as described. |
Generate impression based on findings. | Male 68 years old; Reason: Stage IV HCC please provide index lesions to include repeat measurement of all index lesions including the enhancing component of the liver as previously captured in the lateral aspect of the mass History: As above CHEST:LUNGS AND PLEURA: Basilar atelectasis. Interval resolution of bilateral ... | 1. Cirrhotic liver. Mild interval increase in size of reference hepatic segment 4 lesion (consistent with stated history of HCC). Referenced associated right superolateral enhancing lesional focus essentially unchanged. Previously visualized subcentimeter foci of arterial enhancement in hepatic segment 8 not well seen ... |
Generate impression based on findings. | Female 2 days old Reason: evaluate ETT post re-intubation History: 25 weeker with RDSVIEW: Chest AP (one view) 5/4/2015 at 1118 hours. ET tube tip is at the carina. NG tube terminates at the stomach. UVC tip is at the right atrium. Cardiac silhouette size is top normal. Bilateral diffuse lung haziness with pattern of P... | Interval repositioning of ET tube and NG tube as described. Bilateral diffuse lung haziness, right middle lobe subsegmental atelectasis and PIE pattern. |
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 extremely dense, which lowers the sensitivity of mammography. A few bilateral benign calcifications are present. No suspicious masse... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. The sensitivity of mammography for detecting breast cancer is decreased in patients with dense breasts such as this patient. Physical exam assumes a more important r... |
Generate impression based on findings. | FractureVIEWS: Right elbow AP and lateral, right forearm AP and lateral There is sclerosis involving the olecranon likely to represent a healing fracture. The alignment is anatomic. There is a small elbow joint effusion. | Likely healing olecranon fracture in anatomic alignment as described above. |
Generate impression based on findings. | Female, 62 years old. Reason: recurrent small bowel obstruction History: nausea, vomit, low ostomy output, s/p total colectomy, end ileostomy Scout radiograph showed a nonobstructive bowel gas pattern. Below average stool burden. IVC filter in place.Transit time to the ostomy was approximately 45 minutes to one hour. F... | Suggestion of nonobstructive postoperative adhesions in the left lower quadrant, without focal stricture or evidence of active inflammation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her grandmother. 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 mass... | 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. | Reason: 79 yo M with known MRSA PNA/empyema + E. coli empyema s/p multiple chest tubes; febrile overnight History: see above LUNGS AND PLEURA: Multifocal bilateral lower lobe predominant areas of consolidation with some of these having cavitation similar in appearance to the prior exam.Bilateral loculated pleural effus... | 1.New somewhat high density fluid collection along the left superior mediastinum compatible with hemothorax and/or mediastinal hematoma.2.Stable appearance of the multifocal areas of consolidation, some with cavitation.3.Loculated pleural effusions. New pigtail catheter placed in the loculated effusion in the upper lef... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis 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. Scattered benign calcificatio... | 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. | Reason: Please evaluate subdural hematomas History: S/p crani for aneurysm repair; bilateral subdural hematomas seen on 4/21 CT scan Since the prior exam the patient's bilateral subdural collections which are similar in density to gray matter on the left side and similar in density to white matter on the right have mil... | 1.Since the prior exam the patient's bilateral subdural collections have enlarged and are associated with more mass effect. Most likely these represent subdural hematomas with recurrent hemorrhage. Please correlate with clinical findings. In the appropriate clinical setting, empyema can have a similar appearance. 2.The... |
Generate impression based on findings. | 56 years, Male. Reason: evidence of obstruction/stool burden History: constipation Nonobstructive bowel gas pattern with average stool burden. The lung bases are clear. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There is a 10 x 6 mm cavernoma within the right ventral lateral cerebellar hemisphere with associated blooming artifact, which appears increased in size since the exam from 5/20/2013 where it measur... | Comparing to more remote outside exams, no significant interval change in size or appearance of right cerebellar cavernoma. |
Generate impression based on findings. | 20-year-old male with lateral left foot, tender to palpation over proximal fifth metatarsal No acute fracture or malalignment is evident. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 54 year old female with a history of a benign right breast biopsy showing diabetic mastopathy. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern an... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 43 year-old female with an enhancing lesion in the right breast on the recent MRI (4/30/15). On subtraction images, an enhancing lesion is again seen in the right 12 o'clock position.This was chosen as the target.PROCEDURE:Coordinates of the central portion of the biopsy target were determined on the monitor with the a... | Successful MR guided core needle biopsy of the right breast 12 o'clock enhancing lesion. Successful clip placement. Pathology is pending.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 25-year-old female who suffered facial trauma and has facial contusions Soft tissue swelling is noted over the left forehead, right calvarium, right zygomatic arch, right infraorbital face, left cheek, and the mandible without underlying fracture.The orbits are unremarkable. The mastoids are clear. Limited view of the ... | Soft tissue swelling is noted over the left forehead, right calvarium, right zygomatic arch, right infraorbital face, left cheek, and the mandible without underlying fracture. |
Generate impression based on findings. | Great toe pain following trauma. Check for fracture Decreased demineralization limits sensitivityFoot: Scattered mild to moderate degenerative changes without superimposed acute abnormality. Limited evaluation and particular note is made of deformity of the distal ankle incompletely visualized compatible with old heale... | Scattered osteoarthritic changes without additional acute abnormality. See detail provided and limitations described |
Generate impression based on findings. | Trauma to the right elbowVIEWS: Right elbow AP, oblique and lateral, right forearm AP and lateral No acute fracture or dislocation. No elbow joint effusion. | Normal examination. |
Generate impression based on findings. | The ventricles and sulci are slightly prominent for the patient's stated age, which may relate to mild global volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.... | Essentially unremarkable noncontrast MRI brain. |
Generate impression based on findings. | Reason: repeat angio; pt has angio-negative SAH History: repeat angio; pt has angio-negative SAHOPERATOR: Greg ChristoforidisEBL < 5ccFLUOROSCOPY TIME: 18.4 minutesFrontal air karma: 1300.60 mGyLateral air karma: 639.94 mGy Left common carotid artery: No evidence for carotid stenosis on the basis of NASCET criteria. No... | 1.No evidence for cerebral aneurysm, AVM, arteriovenous fistula, carotid or vertebral dissection or vasculitis. |
Generate impression based on findings. | 59-year-old with history of recent benign right breast biopsy presents for bilateral diagnostic mammogram. Patient indicates interval increase in crusting and discoloration of the right nipple. Mammogram: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast p... | No mammographic evidence of malignancy. Patient notices right nipple itching, discoloration and crustiness for which surgical consultation is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | There is redemonstration of posttreatment changes in the neck, relating to prior right right lymph node dissection and post radiation effects. PHARYNX/LARYNX: There is a left-sided tonsillith. The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There... | 1. Stable post treatment changes within the neck without evidence of focal mass or cervical lymphadenopathy.2. Stable appearance of heterogeneous partially calcified left thyroid nodule. |
Generate impression based on findings. | Male 62 years old; Reason: metastatic apocrine adenocarcinoma with h/o mets to lung, mediastinum, vertebrae- eval for treatment effects- compare with 2/11/15 and 10/22/14 History: RUE lymphedema, L neck adenopathy CHEST:LUNGS AND PLEURA: Persistent moderate-sized right pleural effusion with increased areas of loculatio... | 1. Lymphadenopathy stable to mildly decreased in size as above.2. Persistent moderate-sized right pleural effusion with increased areas of loculation and with underlying atelectasis seen.3. Diffuse osseous metastatic disease without significant change. However, please note that nuclear medicine bone scintigraphy would ... |
Generate impression based on findings. | PainVIEWS: Left hand AP, left fourth digit oblique and lateral There is fracture and dislocation at the fourth PIP joint. The middle and distal phalanges of the fourth digit are dislocated posteriorly in relation to the proximal phalanx. Additionally there is a small fracture at the dorsal aspect of the middle phalanx ... | Fracture dislocation at the fourth PIP joint as described above. |
Generate impression based on findings. | CERVICAL SOFT TISSUES: There are postoperative findings related to osteoplastic laminoplasty from C2 to T2 for subtotal resection of the intraspinal extradural tumor. There remains bulky left anterior paraspinal tumor with epidural involvement at the left anterolateral aspect of the bony spinal canal, which extends th... | 1.Postoperative findings related to osteoplastic laminoplasty from C2 to T2 for subtotal resection of the intraspinal extradural tumor with residual bulky left paraspinal tumor, persistent left anterolateral epidural involvement and expansion as well as destruction of the left neural foramina at the C2-T2 levels. There... |
Generate impression based on findings. | Reason: history of head and neck cancer. Follow up. History: none CHEST:LUNGS AND PLEURA: Benign-appearing punctate micronodules, unchanged.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.The heart and pericardium appear normal.CORONARY ARTERY CALCIF... | No sign of metastases, or other significant abnormality. |
Generate impression based on findings. | Reason: Head and neck cancer; follow up scans History: as above CHEST:LUNGS AND PLEURA: Two new left lower lobe nodules consistent with metastases, the more inferior one 6 x 10 mm image 52 series 5.Stable scattered punctate micronodules.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.The heart an... | Two new pulmonary nodules consistent with metastases |
Generate impression based on findings. | Tube placementVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Mandibular distraction devices are present bilaterally. Cardiothymic silhouette normal. Cardiac apex and stomach are left-sided. No focal lung opacity. No pleural effusion or pneumothorax. | No focal lung opacity. |
Generate impression based on findings. | Open knee wound, check hardware Knee and lower leg: The proximal tibial side plate with interposed graft appears unchanged without evidence of new complications. Graft appears less distinct consistent with continued interval healing. Overlying soft tissues are also similar without new distinct wording defects or new ab... | Orthopedic fixation of the proximal tibia with interval continued minimal healing and no new superimposed complications |
Generate impression based on findings. | Mild mucosal thickening is present within the maxillary sinuses. Bilateral ostiomeatal units remain patent.Mucosal thickening is present within the sphenoid sinuses, mild on the left and minimal on the right, narrowing the ostium of the left sphenoethmoidal recess.Mucosal thickening can be found scattered in bilateral... | 1.Mild mucosal thickening is present within the maxillary sinuses. 2.Mucosal thickening is present within the sphenoid sinuses, mild on the left and minimal on the right, narrowing the ostium of the left sphenoethmoidal recess.3.Mucosal thickening can be found scattered in bilateral ethmoid air cells.4.Mild mucosal thi... |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none There is infiltration of the fat planes in the left submandibular space. This has not changed substantially since the previous exam. A an 8 x 9 mm axial dimension lymph nodeWithin the suprahyoid neck on the basis of size criteria for lymphadenopath... | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy. Some infiltration in the fat planes of the left submandibular space is likely posttreatment related. |
Generate impression based on findings. | 47-year-old female with biopsy-proven left breast DCIS. History of prior left lumpectomy for DCIS in October 2014. On review of the prior studies, an hourglass-shaped clip is present within the left lower inner breast. A faint cluster of residual calcifications is noted slightly posterior and lateral to the biopsy clip... | Successful needle localization of the left breast clip and residual calcifications.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Evaluation is somewhat limited due to lack of contrast. There are post-treatment changes of the left cheek and involving the upper left parotid gland and left masticator space. PHARYNX/LARYNX: The nasopharynx, oropharynx, and hypopharynx are unremarkable. The larynx is unremarkable The upper trachea and esophagus are ... | 1. Stable posttreatment changes. No definite evidence of local tumor recurrence, although evaluation again limited due to lack of contrast.2. Improved appearance of the paranasal sinuses.3. Persistent nonspecific fluid within the left mastoid and middle ear. Please correlate clinically. |
Generate impression based on findings. | Redemonstrated are multiple oval foci as well as minimally confluent areas of abnormal FLAIR hyperintensity within the periventricular and to a lesser degree subcortical white matter, consistent with known demyelinating disease. As before, a subset of these areas demonstrate corresponding T1 hypointensity. Abnormal si... | Relatively stable findings consistent with known demyelinating disease. Although scattered lesions have increased or decreased in size, there are no definite new lesions. There is no associated abnormal enhancement. |
Generate impression based on findings. | Male 75 years old; Reason: metastatic prostate cancer, please provide bidimensional measurements per RECIST 1.1 CHEST:LUNGS AND PLEURA: Stable mild biapical nodularity/scarring.MEDIASTINUM AND HILA: Stable to mild interval decrease in size of reference subcarinal lymph node, measuring 1.5 x 0.7 cm, image 38 series 3, p... | 1. Essentially stable reference lymph nodes as above.2. Sclerotic osseous metastatic disease, please refer to concomitant bone scintigraphy from same day for additional findings. |
Generate impression based on findings. | Reason: History of metastatic breast cancer on treatment. Please compare to prior imaging, evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment. Please compare to prior imaging, evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: No significant abnormal... | 1. No evidence of pulmonary metastases.2. Small intrathoracic nodes are unchanged.3. Postoperative changes right breast and axilla with no residual measurable tumor.4. The patient developed a contrast reaction and was transferred to the ED. See separate notes.Contrast reaction description:Supervising radiologist: Amar ... |
Generate impression based on findings. | 42-year-old female with right chest wall abscess. History of right modified radical mastectomy February 2015 for invasive ductal carcinoma. Follow-up examination. A targeted right ultrasound was performed for the palpable area of concern. Along the right anterolateral chest wall, there is a fluid collection measuring a... | Fluid collection within the right anterolateral chest wall with a discrete pocket of fluid containing internal debris along the lateral margin. This findings are concerning for abscess. Results and recommendations were discussed with the patient. Additionally, these findings were discussed with Dr. Jaskowiak at the tim... |
Generate impression based on findings. | Pain Pelvis and hips: Minimally progressed and now moderate hip osteoarthritis since 2008. Changes include narrowing, sclerosis and osteophytes. Preserved femoral head shapes bilaterally. Of particular note is a small focal cortical thickening involving the proximal right femoral diaphysis laterally. Possible old stres... | 1. Old and grossly unchanged scattered bilateral iliac wing mixed sclerotic and lucent lesions. Possibly old metastatic foci correlating with prior MR imaging.2. Incompletely healed transverse fracture to the base of the second left metatarsal, please see description and recommendations provided |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Benign left breast biopsy in 2008. 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 den... | 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. | 68 year old female status post left lumpectomy in 2008 for breast carcinoma, and right lumpectomy in 2014 for high-grade DCIS with close margins, presents today for routine follow up. No current breast complaints. No family history of breast cancer. Three standard views of both breasts were performed digitally and revi... | High probability benign calcifications within the right breast. Six-month follow-up mammogram, with magnification views if the patient allows, is recommended to assess stability. Results, recommendations, and utility of magnification views were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATI... |
Generate impression based on findings. | Check left proximal humeral lesion, described as "neoplasm of uncertain behavior". Focal subcentimeter lucency projects in the proximal humeral diaphysis and only clearly seen in one projection. This lesion may be cortical and less likely an old screw tract from prior procedure or biopsy. Please correlate patient histo... | Focal nonspecific lucency in the proximal left humeral diaphysis. Correlation with prior imaging if available would increase sensitivity |
Generate impression based on findings. | Female 61 years old; Reason: 61 y/o female with colon ca on chemotherapy, compare to prior. History: see above CHEST:LUNGS AND PLEURA: Right-sided postsurgical sequela related to partial lower lobectomy. Decreasing small right pleural effusion. Unchanged small nonspecific right lower airspace disease or scarring.MEDIAS... | 1.Decreasing small right pleural effusion. Right-sided pulmonary embolism not seen. Dilatation of pulmonary artery trunk, suggestive of underlying pulmonary arterial hypertension. 2. Ventral abdominal subcutaneous nodularity and fluid, most likely reflecting postinjection sequela, largest focus measures 3.7 x 2.7 cm, l... |
Generate impression based on findings. | Pain and swelling. Digital ulceration Moderate ulnar subluxation of the radiocarpal joint with associated deformity and questionable fracture or partial fragmentation through the waist of the navicular and proximal pole. Dedicated ventricular views are requested given patient's history and/or prior imaging if available... | Questionable left ventricular fracture and underlying degenerative changes of the radiocarpal joint. See detail provided |
Generate impression based on findings. | Male 15 years old Reason: s/p finger reduction History: painVIEWS: Left fourth digit lateral and oblique and left hand PA 5/4/2015 at 1304 hours (3 views) Interval reduction of PIP joint dislocation. Small fracture of the dorsal aspect of the proximal base of the mid phalanx is in anatomic alignment.. | Interval dislocation reduction as described. |
Generate impression based on findings. | 54 years, Male. Reason: s/p laparoscopic right nephrectomy. Has abdominal distension, abdominal pain, and nausea. Concerned for ileus or SBO. History: As above Mildly dilated, air-filled loops of small bowel and colon with air in the rectum likely represent a generalized ileus pattern. Curvilinear lucency beneath the r... | Generalized ileus pattern. |
Generate impression based on findings. | Postoperative changes are seen from left thyroidectomy. The heterogeneous right lobe of the thyroid gland appears slightly decreased in size, now measuring 4.9 x 3.9 cm in greatest axial dimensions, compared to previous 5.5 x 4.0 cm. The center appears slightly increased in heterogeneity which may relate to areas of n... | 1. Interval removal of tracheostomy tube.2. Slight interval decreased overall size of right thyroid gland heterogeneous nodule likely due to central areas of necrosis/cystic change. Similar degree of leftward deviation of the trachea with mild narrowing at this level.3. Previously noted anterior mediastinal mass is not... |
Generate impression based on findings. | Secondary malignant neoplasm of bone and bone marrow(198.5) Closed fracture of lumbar vertebra without mention of spinal cord injury thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. There is no compromise of thoracic spinal canal or exiting nerve roots. No bony lesions a... | 1.There is a large lytic lesion present within T9 which has progressed since the prior exam from March. It now extends further into the spinal canal and perivertebral space and to some degree impresses on the thecal sac and possibly compresses the spinal cord. There is an MRI from 4/28/2015 which demonstrate this bette... |
Generate impression based on findings. | 17 years old male. Reason: disease status evaluation. History of recurrent Hodgkin's lymphoma, s/p chemotherapy. This study was performed for restaging.RADIOPHARMACEUTICAL: 10.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 89 mg/dL. Today's CT portion grossly demonstrates multiple stable small lymph nodes... | 1.Interval improvement of FDG avid tumor in the axillary regions.2.Interval near complete resolution of hypermetabolic skin and subcutaneous soft tissue densities seen on prior study. |
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. No suspicious masses, microcalcifications or areas of architectural distortion are pre... | 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. | 62-year-old female with pain and cough. Evaluate for new lung nodules. CHEST:LUNGS AND PLEURA: Biapical scarring/atelectasis. Note is made of diffuse scattered groundglass opacities and nodular consolidation with associated tree-in-bud opacities most pronounced in the upper lobes. There has been interval decrease in le... | 1. Interval decrease in findings compatible with chronic aspiration/infectious bronchiolitis. 2. Persistent nonspecific mediastinal lymphadenopathy may be reactive.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | ScoliosisVIEWS: Thoracic and lumbar spine AP 5/4/2015 (1 view/s) 52 degrees thoracolumbar dextroscoliosis with no segmentation or fusion defects. | 52 degrees thoracolumbar dextroscoliosis. |
Generate impression based on findings. | 34-year-old female patient with abdominal distention. Question of obstruction. ABDOMEN:LUNGS BASES: Minimal bilateral dependent atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion is identified. No intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No peripancreatic... | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Male 64 years old; Reason: rule out metastatic disease History: prostate cancer 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 abnormality noted... | 1.No definite evidence of metastatic disease.2.Sclerosis of the vertebral bodies with fusion. Correlation with bone scan for activity is suggested. |
Generate impression based on findings. | 14 week old female patient with history of injury. There is soft tissue swelling in the scalp over the left forehead. No underlying skull fracture. 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 muco... | Soft tissue swelling over the left forehead without underlying skull fracture or intracranial hemorrhage. |
Generate impression based on findings. | [51-year-old female status post right hip pathologic fracture secondary to multiple myeloma treated with IM rod now with pain and drainage from incision. Evaluate for deep infection/nonunion of prior hip fracture] Postsurgical changes of right trochanteric femoral nail placement with a long diaphyseal component and scr... | 1. Findings most consistent with cellulitis with associated abscesses within the soft tissues of the proximal right lower extremity. There is no evidence of deep infection. 2. Postsurgical changes of right trochanteric femoral nail placement and screw device affixed into the femoral head with no evidence of bony union ... |
Generate impression based on findings. | HydronephrosisSONOGRAM KIDNEYS AND BLADDER 5/4/2015 BLADDER Wall Thickness: Normal Contents: Partially distended urinary bladder with no evidence of debris or filling defects. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal ... | Normal sonogram of the kidneys and bladder.*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. Grade 4: Grade 3 and parenchymal thinning. **SFU gra... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A stable benign calc... | 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. | Reason: r/o disease progression History: cough. Shortness of breath. Stable post-treatment findings, including mild pharyngeal edema and local mucosal thickening. No mass lesions or cervical lymphadenopathy are identified. Unchanged calcification of the left vocal fold and sclerosis of the bilateral arytenoid cartilage... | No measurable residual/recurrent laryngeal tumor or significant lymphadenopathy in the neck. |
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 left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses.Bilateral benign appe... | 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. | Note that susceptibility artifact from braces obscures significant portions of the frontal and temporal lobes including the periorbital gyri and rectus gyri.BRAIN:There are foci of susceptibility in the bilateral middle temporal gyri with associated surrounding edema, compatible with contusions. There is a focus of in... | 1.Findings of diffuse axonal injury in the bilateral frontal lobes as well as in the splenium of the corpus callosum.2.Bilateral contusions in the temporal lobes.3.Subarachnoid hemorrhage.4.Nondisplaced fracture of the left inferior articular process of C5.5.Edema in the interspinous spaces of C3-C6 compatible with inj... |
Generate impression based on findings. | Tachycardia, assess for pulmonary embolus. PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus.LUNGS AND PLEURA: Left apical subcentimeter pulmonary nodules are again seen. Moderate right and small left pleural effusions with associated atelectasis/consolidation, new from prior study. Lingu... | 1.No evidence of pulmonary embolus. 2.New moderate right and small left pleural effusions with associated atelectasis/consolidation.3.Prominent axillary, subpectoral, retrocrural, cardiophrenic, and perisplenic lymph nodes again seen.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Mo... |
Generate impression based on findings. | Male, 48 years old. Reason: evalaute for ileus History: abdominal pain Large amount of free intra-abdominal air is noted. Other abnormal areas of air in the upper abdomen which appear bubbly and may not be free. Possible retroperitoneal air. Nonobstructive bowel gas pattern. Above average stool burden.Jejunostomy tube ... | Large pneumoperitoneum and possible retroperitoneal gas and additional upper abdominal air which may be in a complex collection. This is greater than expected intra-abdominal gas 3 days post jejunostomy placement. Recommend followup CT imaging if clinically indicatedFindings discussed via telephone with Nina Gupta at 1... |
Generate impression based on findings. | Age: 55 years. Sex : Female. Reason for study: Reason: coughing with oral intake History: see above. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. Two images were obtained for documentation.... | Negative for penetration or aspiration. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of fibroadenoma and benign bilateral breast biopsies in 1991. 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 pat... | 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. | 14-week-old female with unspecified injury.VIEWS: Cervical spine AP and lateral views (2 views) 5/4/2015 time 1:07 PMChest AP and abdomen AP (2 views) 5/4/2015 1:11 PM Cervical spine: This vertebral bodies of C1-C5 are visualized, C6-T1 are obscured by overlying anatomy. The relationship of C1 and C2 is not properly vi... | 1.Normal chest radiograph. 2.Distended stomach with nonobstructive bowel gas pattern.3.Due to marked rotation, alignment of the cervical spine is incompletely evaluated. If clinical suspicion is high, repeat radiographs or CT of the cervical spine may be obtained for further evaluation. |
Generate impression based on findings. | 53-year-old male with history of head and neck cancer status post chemoradiation therapy. Compared to previous measurements. CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules, unchanged. No new pulmonary nodules identified. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: No evidence of lympha... | No findings to suggest metastatic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 57-year-old male with history of renal cell carcinoma. CHEST:LUNGS AND PLEURA: Extensive centrilobular and paraseptal emphysema with an upper lobe predominance. No pleural effusion or pneumothorax. The reference left lower lobe nodule measures 1.4 x 1.3 cm, previously 1.6 x 1.3 cm (51; series 5).MEDIASTINUM AND HILA: P... | 1. No significant interval change in the single reference indeterminate pulmonary nodule in the left lower lobe measuring 1.4 cm.2. No significant interval change in size of the reference renal lesions which are incompletely characterized on this noncontrast CT examination.I personally reviewed the Images and/or proced... |
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