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Generate impression based on findings. | 33-year-old female with mid finger lac sp repair Evaluation of fine detail is limited by overlying bandage material. Again seen is irregularity of the soft tissues. There has been interval resection of the tuft of the distal phalanx with a couple of small bone fragments noted just distal to the base of the distal phala... | Interval resection of tuft of the distal phalanx. |
Generate impression based on findings. | One year of lower leg pain. Tenderness over tibial tuberosity and mid shaft.VIEWS: Left tibia-fibula AP/lateral (two views) 05/05/15 The bones are normal in appearance. No fracture is seen. No soft tissue swelling is identified. | Normal examination. |
Generate impression based on findings. | Asthma exacerbation.VIEW: Chest AP (one view) 5/5/2015 at 2352 hours. Cardiac silhouette size is normal. Bibasilar opacities likely atelectasis or pneumonia. No effusions or pneumothorax. | Multifocal opacities as described. |
Generate impression based on findings. | 89-year-old female patient with history of biliary obstruction status post ERCP with metal stent placement on 4/30/2015.Readmitted with post-ERCP pancreatitis, now with leukocytosis, tachycardia, elevated lactate. Question of abscess and assess stent. ABDOMEN:LUNG BASES: Moderate bilateral pleural effusions with overly... | 1. Findings compatible with acute pancreatitis without evidence of complication or drainable fluid collection.2. Biliary stent appears to terminate just proximal to the ampulla of Vater.3. Mild right and moderate left intrahepatic biliary ductal dilatation.4. Right hydronephrosis with question of a UPJ obstruction. |
Generate impression based on findings. | Generalized abdominal pain. Abdominal distention and emesis.VIEW: Abdomen AP (one view) 5/6/2015 Normal abdominal gas pattern with no evidence of obstruction or free air. No pneumatosis intestinalis or portal venous gas. | Normal examination. |
Generate impression based on findings. | Bilateral pain over mid shaft of tibia and tibial tuberosity. Concern for stress fracture.VIEWS: Right tibia fibula AP/lateral (two views) 05/05/15 The bones are normal in appearance. No fracture is identified. No soft tissue swelling is seen. Normal variant anatomy is noted in the posterior distal femur. | Normal examination. |
Generate impression based on findings. | 25-year-old male with recent hemicolectomy, rule out GI bleed. ABDOMEN:LUNG BASES: No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: Few subcentimeter hypoattenuating hepatic lesions, too small to further characterize. Gallbladder is collapsed.SPLEEN: No significant abnormality notedPANCREAS: No signific... | 1.Postsurgical findings related to right hemicolectomy.2.Small amount of free fluid in the pelvis, nonspecific.3.Nonobstructing renal stones redemonstrated. |
Generate impression based on findings. | waxing and waning mental status Extensive vertebral basilar artery wall calcifications indicating atherosclerotic changes, no change since prior study.There is subtle low attenuation on the right basal ganglia indicating chronic ischemic infarction, no change since prior exam.There is no evidence of acute ischemic or h... | 1. No evidence of acute ischemic or hemorrhagic lesion.2. Chronic ischemic infarction on the right basal ganglia, otherwise unremarkable. If clinically indicated, brain MRI can be considered for further evaluation. |
Generate impression based on findings. | 20-year-old male with pain. Wrist pain for 4 days, minimal range of motion. Pain increases when the wrist is flexed down. We see no fracture or malalignment to account for the patient's pain. | No fracture is evident. |
Generate impression based on findings. | Female, 76 years old. Reason: s/p OG eval placement History: see above Enteric tube with distal side-port in the gastric body.The lower pelvis is excluded from the field-of-view.Partially visualized nonobstructive bowel gas pattern.Pulmonary congestion incompletely imaged. | Enteric tube with side-port in the gastric body. |
Generate impression based on findings. | Female, 71 years old. Reason: Dobbhoff not flushing ?kinked History: see above Interval adjustment of Dobbhoff tube, now curled in the gastric fundus. This tube is likely kinked at its tip, with the distal most portion visualized en-face.The pelvis is excluded from the field-of-view.Partially visualized nonobstructive ... | Dobbhoff tube curled in the stomach, likely kinked at its tip. |
Generate impression based on findings. | 69-year-old male with neck pain. Evaluate for acute process s/p trip/fall, hit neck onto curb. Patient fell yesterday and landed on curb, complains of neck and back pain. We see no fracture. Moderate to severe multilevel degenerative disc disease particularly affects the lower cervical spine. There is also multilevel n... | Degenerative arthritic changes without fracture. |
Generate impression based on findings. | Respiratory distress. Shunt evaluation.VIEWS: Skull AP/lateral (two views), chest AP/lateral (two views) 05/05/15 Ventriculostomy tube tip is to the right of the midline in the anterior cranial fossa. Shunt tubing exits via a right parietal burr hole and extends inferiorly along the right occiput and neck. The shunt tu... | Change in orientation of ventriculostomy in the interval. No shunt discontinuity. |
Generate impression based on findings. | Head trauma on warfarin, neck pain Head: No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. There are mild ... | 1. No evidence of intracranial hemorrhage or skull fracture.2. No fracture or subluxation within the cervical spine |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (4/2/15), ultrasound images of both breasts (4/2/15) performed at Advocate Good Shepherd Hospital. DIGITAL MAMMOGRAPHIC IMAGES (4/2/15):The breast parenchyma is composed of scattered fibroglandular elements. An irregularl... | Biopsy proven left breast malignancy. Extensive pleomorphic calcifications are present in the left upper outer quadrant, including the site of proven malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: chest pain, sob, hx of sarcoidosis, heart failure History: chest pain, sob PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus. Main pulmonary artery measures 3 cm and is borderline enlarged.LUNGS AND PLEURA: Interval resolution of the patchy pulmonary opacities with residual reticu... | 1.No evidence of pulmonary embolus.2.No acute appearing parenchymal opacities.3.Mosaic attenuation of the parenchyma, compatible with small airways involvement by sarcoid.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. I p... |
Generate impression based on findings. | Female, 22 years old. Reason: gastroparesis History: abd pain Nonobstructive bowel gas pattern.Large stool burden.Status post cholecystectomy. | No evidence of obstruction. Large stool burden. |
Generate impression based on findings. | Male 2 months old Reason: interval changes History: intubatedVIEW: Chest AP (one view) 5/6/2015 at 0352 hours. ET tube tip terminates below thoracic inlet. NG tube tip is at the stomach. Left-sided neck PCVC terminates at the right subclavian vein.Cardiac silhouette size is normal. Right upper lobe and bibasilar opacit... | Multifocal opacities as described. |
Generate impression based on findings. | Female, 80 years old. Reason: 80 yo female with dysphagia to solids and a history of acid reflux. Please evaluate for anatomic or functional causes of dysphagia. Scout radiograph of the chest unremarkable.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the ... | Moderate to severe esophageal dysmotility as detailed above, without fixed narrowing or other anatomic abnormality. No gastroesophageal reflux. |
Generate impression based on findings. | Male 2 months old Reason: 2 mo M, status epilepticus s/p central line placement. Eval line placement History: central line placementVIEW: Chest AP (one view) 5/5/2015 at 2021 hours. ET tube terminates below thoracic inlet. Central line tip is at the SVC. NG tube terminates at the stomach.Cardiac silhouette size is norm... | Interval central line placement.Multifocal opacities as described. |
Generate impression based on findings. | 52-year-old male post fall. Evaluate for fracture. Patient fell yesterday, anterior knee pain and bruise. Mild anterior soft tissue swelling but we see no acute fracture. Again seen are postoperative changes of prior ACL reconstruction. There is a bandlike sclerotic density in the lateral femoral condyle that presumabl... | No acute fracture. Other findings as above. |
Generate impression based on findings. | 36 years Female with Reason: left PTA w/ neck swelling History: left PTA, neck swelling Extensive swelling of the palatine tonsils, which touch in the midline, with mild resultant airway narrowing. Hypoattenuation within the tonsillar soft tissues does not measure fluid density, and is therefore more consistent with in... | 1.Extensive inflammation of the tonsils, which results in mild airway narrowing, without evidence of acute abscess formation.2.Cervical lymphadenopathy, likely reactive. |
Generate impression based on findings. | Trauma two weeks ago with persistent tenderness.VIEWS: Right knee AP/lateral/oblique (three views) 05/05/15 There may be a small joint effusion. No fracture is seen. The bones are normal in appearance. | Possible small joint effusion. |
Generate impression based on findings. | Grunting and fever. Pneumonia versus empyema.VIEWS: Chest AP/lateral (two views) 5/5/2015 at 2320 hours. Cardiac silhouette size is normal. Left lower lobe opacity likely pneumonia or atelectasis. No effusions or pneumothorax. | Left lower lobe opacity, likely pneumonia or atelectasis. |
Generate impression based on findings. | Respiratory failure and intubation. History of respiratory failure and epilepsy.VIEW: Chest AP (one view) 05/05/15, 2254 Endotracheal tube tip is above carina. Ventriculoperitoneal shunt tubing is present. Feeding tube side-port is in the esophagus. Spinal fusion instrumentation is noted. The most superior laminar wire... | Development of left hemidiaphragm elevation. Differential considerations include diaphragmatic paralysis, subpulmonic pleural effusion, and consolidation. |
Generate impression based on findings. | 17-year-old male patient with infantile cerebral palsy. Evaluate shunt. Again seen is a right transparietal ventriculostomy catheter that terminates in the white matter the right frontal lobe, unchanged. The right ventricle is dysmorphic and is unchanged compared to prior examination. The left lateral and third ventric... | Shunted supratentorial ventricular system is stable compared to prior examination.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 56 years old; Reason: mets lung cancer. ON ABT-700 and Erlotinib. pls c/w previous study and evaluate tx response. Please provide measurement to all lesions. History: lung ca ABDOMEN:LUNG BASES: Please refer to CT chest same date.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Large splenic granulom... | 1.Stable examination. |
Generate impression based on findings. | 56-year-old female with intermittent cramping right-sided abdominal pain for 3 months, now worsening. Rule out bowel obstruction, ischemia. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. Gallbladder is unremarkable.SPLEEN: No significant ... | No specific findings to account for abdominal pain. |
Generate impression based on findings. | altered mental status 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate Minimal irregularities of intracranial distal arteries may indicate atherosclerotic changes. However, it needs to be noted that small distal arterial luminal c... | 1. No evidence of significant luminal stenosis or irregularity on both intracranial and extracranial carotid and vertebrobasilar arterial system.2. Precise evaluation with TOF technique for extracranial carotid arterial system especially left carotid bifurcation was not possible due to anatomical configuration (90 degr... |
Generate impression based on findings. | 56-year-old male patient with unexplained fevers. Question of mass or infection. CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions with overlying compressive atelectasis. Patchy opacities are noted in the right middle and right lower lobes.MEDIASTINUM AND HILA: Endotracheal tube tip is above the carina. No medi... | Small bilateral pleural effusions with right middle lobe and right lower lobe opacities which likely represents infection. |
Generate impression based on findings. | 35-year-old female with TMJ with concern for right joint tissues No acute fracture or malalignment is evident. No periapical lucencies. The temporal mandibular joints appear within normal limits without evidence of dislocation bilaterally. | No acute fracture or malalignment. |
Generate impression based on findings. | 14-year-old male patient status post epidural washout for epidural abscess, now with altered mental status. No acute intracranial hemorrhage. Gray-white matter differentiation is maintained. Again seen are extensive postoperative changes from right perimedian epidural abscess evacuation and drain placement as well as f... | No significant change in extensive postoperative changes from right paramedian epidural abscess evacuation and drain placement and frontal sinus and right ethmoid sinus washout. Minimal extra-axial collection along the right convexity is again seen and better appreciated on recent MRI. No new hemorrhage or mass effect ... |
Generate impression based on findings. | 73-year-old female with right AC joint pain No acute fracture is evident. Alignment is anatomic. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | Avascular necrosis 2 views of the right hip reveal patchy sclerosis in the femoral head. This is somewhat more conspicuous than on the previous exam. This clearly represents avascular necrosis. | Avascular necrosis right hip |
Generate impression based on findings. | Female 13 years old Reason: right proximal tibia fracture. There is a comminuted slightly medially and inferiorly displaced intra-articular fracture of the medial tibial plateau. The longest fracture line is traversing from the medial physis of the tibia obliquely up to the lateral intercondylar tubercle. The absence o... | Comminuted intra-articular and slightly displaced fracture of the medial tibial plateau. |
Generate impression based on findings. | 61-year-old female. History of right mastectomy in 2002 for breast cancer with adjuvant radiation and chemotherapy. No current breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular densit... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: bilateral ICH History: comatose Evolving hematoma centered in the right thalamus, which appears slightly smaller in dimension when compared to recent prior, measuring approximately 31 x 21 mm in axial dimension (series 4, image 16); there also appears to be slight interval reduction in the size of the hematoma ... | 1.Evolving hematomas in the right thalamus and left basal ganglia, which both appear slightly smaller when compared to previous exam.2.Slight interval reduction in the degree of intraventricular blood products.3.Stable appearance of left frontal ventriculostomy, with interval decompression of the ventricles.4.Persisten... |
Generate impression based on findings. | 47-year-old female with pain Right tib-fib: No acute fracture or malalignment is evident. No evidence of stress fracture. Chronic appearing ossicle along the anterior tibial tuberosity within the patellar tendon is likely of no clinical significance. Small ossicle distal to the fibular tip may reflect old traumaLeft ti... | Small amount of periosteal reaction along the posterior aspect of proximal left tibial diaphysis may represent a stress fracture. |
Generate impression based on findings. | Reason: Concern for PE History: shortness of breath, chest pain, hemoptysis PULMONARY ARTERIES: Adequate contrast bolus, but exam is severely limited by respiratory motion artifact. 2-3 subsegmental branches of the right lower lobe pulmonary arteries are diminutive in size and poorly opacified for short segments with d... | Exam is severely limited by motion artifact. Subsegmental branches of the right lower lobe pulmonary arteries are suspicious in appearance for pulmonary emboli but of unclear chronicity. Consider a follow up PE CT if patient is now able to breath hold.Findings discussed with Dr. Ann Hong on 5/6/15 10:10AM.PULMONARY EMB... |
Generate impression based on findings. | 2-year-old male with a history of ARDS, intubated.VIEW: Chest AP (one view) 5/6/2015 at 03:36 Endotracheal tube tip terminates at the thoracic inlet. Right central venous catheter tip in the right atrium, unchanged. Gastrostomy tube and thoracolumbar levoscoliosis again noted.Cardiothymic silhouette is normal. There is... | Complete right upper lobe collapse. |
Generate impression based on findings. | 30-year-old male patient with left upper quadrant/left flank pain. History of splenomegaly. Evaluate for splenic pathology. ABDOMEN:LUNG BASES: There is patchy left lower lobe consolidation which likely represents infection.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: The spleen is mildly enlarged, si... | 1. Left lower lobe pneumonia.2. Stable splenomegaly without evidence of infarct. |
Generate impression based on findings. | 71-year-old female with left-sided posterior 11th rib pain No acute fracture is evident.Monitor cardiomegaly with dual-lead ICD.Chronic appearing interstitial changes at the lung bases bilaterally. | No displaced rib fractures are evident. |
Generate impression based on findings. | Reason: PE, hx ca with SOB and LE edema History: SOB, LE edema PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus.LUNGS AND PLEURA: Bilateral dependent atelectasis/scarring. Mild bronchiectasis predominantly in the lung bases. Solid 6 mm left lower lobe pulmonary nodule noted (8/135), whic... | 1.No evidence of pulmonary embolus.2.Scattered new indeterminate pulmonary nodules. 3 month CT follow up recommended.3.Calcifications in the right thyroid lobe. Correlate with thyroid function test if clinically indicated.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Prox... |
Generate impression based on findings. | Female, 74 years old, with history of pharynx cancer. Assess for recurrence. The pharyngeal mucosa is free of any suspicious masslike lesion. The supraglottic larynx is mildly but diffusely thickened, likely a reaction to therapy. No focal lesions are detected. A clustering of pretracheal nodes is again seen within the... | 1.Redemonstration of treatment related findings with no definite evidence to suggest recurrent mucosal tumor.2.Stable clustered lymph nodes in the superior mediastinum, none of which individually meets imaging criteria for pathologic enlargement. |
Generate impression based on findings. | 50-year-old female patient with right upper quadrant pain, vomiting, diarrhea, PO intolerance. Evaluate for cholecystitis, liver pathology, pancreatitis. ABDOMEN:LUNG BASES: No significant abnormality.LIVER, BILIARY TRACT: No focal hepatic lesion is seen. The main portal vein is patent. Cholelithiasis without CT eviden... | 1. Mild prominence of extrahepatic biliary system without intrahepatic dilatation or evidence of distal obstructing lesion.2. Cholelithiasis without CT evidence of cholecystitis.3. Subcentimeter, non-obstructing nephrolithiasis. |
Generate impression based on findings. | 32-year-old male acute onset hematuria, LLQ abdominal pain, hx of bowel resection 2003 s/p impaled in llq by rusty screw driver, chronic worsening LLQ abd pain. Rule out kidney stone, bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver enhances homogeneously without focal... | No specific findings to account for patient's left lower quadrant abdominal pain. |
Generate impression based on findings. | Mild thickening is noted in the left eyelid and minimal left proptosis, compatible with history of preseptal cellulitis. The extraocular muscles and optic nerves are normal in size and density. No enhancing fluid collections, retrobulbar inflammation, or evidence of subperiosteal abscess. No bone destruction or fractu... | 1.Findings compatible with left preseptal edema/cellulitis without evidence of postseptal extension.2.Nonspecific partial opacification of the paranasal sinuses and bilateral middle ears. |
Generate impression based on findings. | Reason: evaluate for PRESS History: altered, hypertension 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 are prominent, which could represent mild age-related volume loss. No ex... | 1.No evidence of intracranial hemorrhage or mass effect. 2.No convincing evidence of posterior reversible encephalopathy syndrome. Please note, CT is somewhat insensitive in the detection of PRESS, MRI may be considered if there is strong clinical suspicion. 3.Chronic deformity of the right frontal bone with subjacent ... |
Generate impression based on findings. | 84-year-old female with vomiting, epigastric pain. Concern for cholecystitis. ABDOMEN:LUNG BASES: Scarring, bronchiectasis, and emphysema. Right lower lobe nodule measures 7 mm.LIVER, BILIARY TRACT: The liver enhances homogeneously. Single subcentimeter hypoattenuating hepatic lesions, too small to further characterize... | 1.Nonspecific biliary findings; if gallbladder pathology is suspected, right upper quadrant ultrasound would be indicated.2.7 mm right lower lobe pulmonary nodule. Follow-up in 6 months is recommended to ensure stability. |
Generate impression based on findings. | 67-year-old female. History of focal right asymmetry. Six-month follow-up study. Personal history of right cyst removed in 2009 and colon cancer diagnosed at the age of 58. 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 scatter... | Right breast asymmetry has been stable for a year, most likely benign. 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.RECOM... |
Generate impression based on findings. | 57-year-old male with hip pain Mild osteophytosis compatible with mild osteoarthritis of the left hip. No acute fracture or malalignment is evident. | Mild osteoarthritis affects the left hip. |
Generate impression based on findings. | 61-year-old female with antalgic gait, avoiding the right ankle with history of remote injury 6 months ago Significant soft tissue swelling is noted about the ankle. Plantar calcaneal spur is noted. Moderate osteoarthritis affects the talonavicular and navicular cuneiform joints. No acute fracture is evident.Extensive ... | Significant soft tissue swelling and degenerative changes as described above without evidence of acute fracture. |
Generate impression based on findings. | 28-year-old male with bilateral knee pain Right knee: The alignment is anatomic. No acute fracture is evident. No joint effusion. The extensor mechanism is intact. Sclerotic focus in the medial femoral condyle may represent a benign bone island.Left knee: The alignment is anatomic. No acute fracture is evident. No join... | Normal examination. |
Generate impression based on findings. | 48-year-old female with history of EtOH and tobacco induced chronic calcific pancreatitis status post ERCP 5/4 which showed pancreatic duct stricture was dilated and stented. Severe post procedure pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The liver enhances homogeneously without fo... | 1.Findings suggestive of acute on chronic pancreatitis.2.Gallbladder distension as well as intra and extrahepatic biliary ductal dilatation may indicate distal obstruction. If there is clinical concern for acute cholecystitis, right upper quadrant ultrasound would be indicated.3.Mild generalized ileus. |
Generate impression based on findings. | 68-year-old man with CLL undergoing treatment for worsening abdominal distention. Assess for ascites, infection, hepatosplenomegaly. LIVER: Liver remains enlarged measuring 20 cm in length. Echotexture remains coarsened. Perihepatic ascites again noted. Portal vein is patent with flow towards the liver. GALLBLADDER, BI... | Hepatosplenomegaly. Increasing ascites. Bladder stone. Status post cholecystectomy. |
Generate impression based on findings. | Reason: eval s/p R MCA aneurysm clipping History: eval s/p R MCA aneurysm clipping Interval pterional craniotomy and placement of a right lower cranial fossa clip. Extra-axial blood products and pneumocephalus are expected findings in the immediate postop period. There is relatively mild generalized mass effect with mi... | 1.Status post pterional craniotomy and clipping of right MCA bifurcation aneurysm, with expected postsurgical changes, causing mild generalized mass effect and minimal midline shift. No evidence of herniation. 2.Given slight limitation, no evidence of significant change or extension of known subarachnoid hemorrhage.3.N... |
Generate impression based on findings. | Prostate and kidney cancer. Right lower extremity edema. ABDOMEN:LUNG BASES: Left pleural thickening. Periosteal reaction on the left left lower rib could represent a metastasis (image 16; series 3); correlate with bone scan.LIVER, BILIARY TRACT:Cholelithiasis without biliary ductal dilatation.SPLEEN: No significant ab... | Possible left lower rib metastases. No finding to explain right lower extremity edema. |
Generate impression based on findings. | 70 year old with recent right breast biopsy revealed foci of ADH presents for seed localization. Right ultrasound re-identified the target lesion for localization. The lesion to be targeted is a hypoechoic mass measuring 13 x 8 mm at the 9 o’clock position without increased vascularity, 3 cm from the nipple. The lesion... | Successful needle localization of the right breast mass.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: ro CVA History: LUE weakness Large area of hypoattenuation involving the subcortical white matter, but sparing the cortex, in the posterior right frontal lobe extending from the vertex to the operculum, with questionable masslike lesions in the right paracentral lobule and a second smaller lesion slightly more ... | Extensive vasogenic edema with suggestion of associated masslike lesions, of which there are at least four. Contrast-enhanced MRI is recommended for further characterization. Given patient's clinical history, metastatic disease is suspected. |
Generate impression based on findings. | 49-year-old male patient with type B dissection. Evaluate for type A, right flank pain. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Redemonstration of a type B aortic dissection with an intimal flap beginning just distal to the left subclavian artery and extending to the level of the l... | No significant change in the extent of a type B aortic dissection. |
Generate impression based on findings. | 45-year-old female. History of a mass in the right lower outer breast on screening mammogram that sonographically corresponded to a simple cyst. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously d... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually; tomosynthesis would be particularly useful in this patient with heterogeneously dense breasts. Results and recommendation were discussed with the patient.BIRADS: 2... |
Generate impression based on findings. | Reason: Hx of HIV with cough & respiratory distress, AMS LUNGS AND PLEURA: Paraseptal emphysema predominantly of the upper lobes is again seen. Calcified nodule of the right upper lobe is again seen. Interval development of multifocal patchy opacities in the dependent aspects of the upper lobes and bilateral lower lobe... | Multifocal pneumonia, most likely related to aspiration based on distribution. Mild mediastinal lymph node enlargement. Mild emphysema.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Clinical question: On hep gtt. Signs and symptoms: Stroke. Nonenhanced head CT: Previously reported patchy foci of acute ischemic stroke in the right cerebellum are not as conspicuous on this exam. There is no evidence of hemorrhage and only subtle effacement of cerebellar folia as result of stroke is detected. Fourth ... | 1.No acute intracranial hemorrhage or any significant mass effect.2.Subtle patchy foci of low attenuation in the right cerebellum with subtle effacement of cerebellar folia consistent with patient's known acute right cerebellar strokes. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consis... | No acute abnormality. Mild chronic small vessel ischemic changes. |
Generate impression based on findings. | 59-year-old female. Bilateral breast calcifications. History of breast carcinoma in maternal grandmother at age 80, maternal aunt at age 40 and paternal aunt at age 40. 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 ... | Stable bilateral breast calcifications. 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 Mammog... |
Generate impression based on findings. | Right upper quadrant pain associated with meals LIVER: The liver measures 17.5 cm in length. No intrahepatic biliary ductal dilatation or dominant liver masses. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Gallstones. No wall thickening or pericholecystic fluid.... | Cholelithiasis. |
Generate impression based on findings. | 67-year-old female patient with history of stem cell transplant. Needs follow-up abdomen CT to assess improvement in pneumatosis. ABDOMEN:LUNG BASES: Patchy groundglass opacities are noted in the right lower lobe. Severe coronary calcifications are noted.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of acute... | 1. Decreased, but persistent, colonic pneumatosis.2. Asymmetric right lower lobe ground glass opacities may represent an early infectious process. |
Generate impression based on findings. | Status post curettage/internal fixation for GCT of right proximal tibia, evaluate for local recurrence Again seen is a plate and screw device affixing cement within the proximal tibia representing the site of curettage and packing of a giant cell tumor of bone. Thin lucency along the margin of the cement appears slight... | Postoperative changes of giant cell tumor curettage/fixation without specific radiographic features of recurrence. |
Generate impression based on findings. | 58-year-old male with ttp/swelling wrist s/p fell off bike. Evaluate for acute process. There is a comminuted intra-articular fracture of the distal radius with the fracture fragment in near anatomic alignment. There is also a mildly displaced fracture through the ulnar styloid. | Distal radius and ulnar styloid fractures as above. |
Generate impression based on findings. | 72-year-old man with thrombocytopenia. Evaluate liver morphology. LIVER: The liver measured 16.4 cm in length. No focal liver lesions. Portal vein is patent with flow toward the liver on color Doppler imaging. Presumed bowel located posterior to the liver as noted on recent CT examination.GALLBLADDER, BILIARY TRACT: No... | No findings to explain from thrombocytopenia. End-stage kidneys with renal transplant. |
Generate impression based on findings. | Fall, evaluate for ICH There is a small extra-axial collection along the right frontoparietal convexity measuring up to 5 mm in thickness. There is minimal if any local mass effect. This collection is new since 1/15/2007.No definite evidence of acute intraparenchymal hemorrhage. There is global parenchymal volume loss,... | 5 mm low density extra-axial collection along the right frontoparietal convexity is compatible with a small chronic subdural hematoma or hygroma and is new since remote CT from 1/15/2007. There is minimal if any associated mass effect. |
Generate impression based on findings. | Male, 73 years old. Reason: eval Dobbhoff position, inadvertently displaced History: Dobbhoff adjusted Dobbhoff tube curled within gastric body.The pelvis is excluded from the field-of-view. Motion artifact limits evaluation. Partially visualized nonobstructive bowel gas pattern. See same day CT abdomen and pelvis for ... | Dobbhoff tube curled within the stomach. |
Generate impression based on findings. | 58-year-old male post reduction Evaluation of fine detail is limited by overlying cast. Comminuted intra-articular fracture of the distal radius with fracture fragments in near-anatomic alignment. Mildly displaced fracture of the ulnar styloid. | Distal radius fracture in near anatomic alignment. |
Generate impression based on findings. | 63-year-old male with a chronic cough. Quit smoking. Rule out lung cancer. LUNGS AND PLEURA: Note is made of centrilobular and paraseptal emphysema with an upper lobe predominance. Note is made of a mixed solid and groundglass nodular opacity in the right upper lobe (120; series 5). Bibasilar linear atelectasis/scarrin... | 1. Mixed solid and groundglass nodular opacity in the right upper lobe, abutting the major fissure, which may be postinflammatory in etiology, although an indolent adenocarcinoma in situ cannot be excluded. Follow-up examination in 3 months is recommended to evaluate for interval change. 2. Mild to moderate emphysemato... |
Generate impression based on findings. | 73-year-old male with rising WBC, and enterobacter bacteremia. Concern for abscess in pelvis or near kidney. ABDOMEN:Recommend intravenous contrast limits evaluation of solid abdominal viscera. Retained barium contrast in the colon produces streak artifact and further limits evaluation.LUNG BASES: Dependent atelectasis... | 1.Exam is limited by lack of intravenous contrast and by streak artifact from retained barium in the colon. Within these limitations, there are no obvious findings to suggest abscess.2.Diffuse bladder wall thickening may relate to chronic inflammation or obstruction. |
Generate impression based on findings. | 67-year-old male with ttp over L4-L5. Evaluate for acute process s/p MVC. We see no fracture. Mild degenerative disc disease affects the mid and lower lumbar spine. Osteoarthritis also affects both hips. | Degenerative arthritic changes without fracture. |
Generate impression based on findings. | 69-year-old female patient with non-Hodgkin's lymphoma status post chemotherapy in 2008. On observation. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules are identified. Punctate left lower lobe calcified granuloma.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. No pericardial effusion... | 1. Continued decrease in size of retroperitoneal soft tissue infiltration.2. Stable left paraspinal thoracic soft tissue lesion. |
Generate impression based on findings. | 39-year-old female with ttp LS. Evaluate for acute process s/p MVC. We see no fracture or malalignment. There is partial sacralization of L5 with hypertrophy of the left transverse process which articulates with the underlying sacrum. There is perhaps some minimal degenerative disc disease affecting the mid and lower l... | No fracture evident. |
Generate impression based on findings. | Healed fracture? Again seen are fractures through the necks of the fourth and fifth metacarpals with mild volar angulation of the distal fracture fragments. A small amount of callus has formed adjacent to both fractures, indicating an attempt at healing. Orthopedic fixation of a distal radius fracture is incompletely i... | Fourth and fifth metacarpal fractures as above. |
Generate impression based on findings. | 24-year-old with rare upper abdominal pain. Worse with eating. LIVER: The liver measures 16.5 cm in length. No focal liver lesions. Portal vein is patent with flow toward the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: No gallstones. The common duct measures 2 mm which is within normal limits.PANCREAS: N... | No findings to explain abdominal pain. If median arcuate ligament compression is suspected clinically, correlation with Doppler ultrasound of the celiac axis is advised. |
Generate impression based on findings. | 47-year-old female with history of cervical cancer, urinary retention. Elevated creatinine. Evaluate for hydronephrosis. RIGHT KIDNEY: Right kidney measures 11.0 cm in length and demonstrates minimal pelvocaliceal dilatation. A 10 mm simple cyst is present in the interpolar region. No renal mass or stone is identified.... | 1.Minimal bilateral hydronephrosis.2.Large cervical mass compatible with known primary cervical malignancy.3.Bladder wall thickening and associated large exophytic intraluminal mass may represent invasion by adjacent cervical mass. Correlation with prior imaging is recommended. |
Generate impression based on findings. | 79-year-old male with back pain, gait instability. Assess anatomy amid concern for worsening spinal stenosis. Evaluation of the lumbar spine is limited due to diffuse bony demineralization as well as extensive overlying bowel gas. Lumbar scoliosis and severe degenerative changes appear similar to prior study. Rightward... | Scoliosis and severe degenerative arthritic changes of the lumbar spine appear similar to prior study. If further evaluation/imaging is warranted, MRI can be obtained. |
Generate impression based on findings. | Healed fracture? An orthopedic screw affixes an intra-articular fracture of the base of the fifth metacarpal in near-anatomic alignment. The fracture line is indistinct and there is adjacent periosteal reaction, indicating some interval healing. | Healing fifth metacarpal fracture. |
Generate impression based on findings. | Right-sided weakness, slurred speech, rule out CVA. History of HIV. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or herniation. Gray-white differentiation is maintained. There are extensive confluent areas of hypoattenuation in the periventricular and subco... | 1. No evidence of intracranial hemorrhage or mass effect. 2. Extensive confluent areas of hypoattenuation in the periventricular and subcortical white matter, slightly worse on the left than the right, are nonspecific but compatible with advanced chronic small vessel ischemic disease. Given associated advanced parenchy... |
Generate impression based on findings. | 88-year-old female with night sweats for 3 to 4 weeks and unintentional weight loss. Evaluate for hilar adenopathy versus mass. LUNGS AND PLEURA: Scattered bilateral nonspecific pulmonary micronodules some of which are calcified. Bibasilar scarring/atelectasis. No pleural effusion or pneumothorax. No suspicious pulmona... | No suspicious pulmonary nodules or masses. No acute cardiopulmonary abnormality.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 38-year-old female with dry gangrene, evaluate for osteomyelitis. Diffuse soft tissue swelling as well as extensive vascular calcifications in the soft tissues. There is dense globular calcification in the soft tissues of the 5th toe which obscures the middle and distal phalanx limiting their evaluation, and we cannot ... | Dense calcification within the soft tissues of the 5th toe may be dystrophic in etiology or perhaps represent gout. The underlying distal and middle phalanx are not distinctly visualized and we cannot exclude the possibility of osteomyelitis. |
Generate impression based on findings. | Reason: Pulmonary embolism History: shortness of breath, tachycardia PULMONARY ARTERIES: No evidence of a pulmonary embolus. The pulmonary arteries enlarged measuring 3.5 cm and is compatible with pulmonary arterial hypertension.LUNGS AND PLEURA: Right chest tube in place with increasing loculated right pleural effusio... | 1.No evidence of a pulmonary embolus.2.Increasing pleural effusions bilaterally with extensive loculation and pleural thickening on the right suggestive of metastatic disease and/or infection.3.Increasing consolidation throughout the right lung may represent superimposed infection.4.Increasing nodular and groundglass o... |
Generate impression based on findings. | 60-year-old with outside study demonstrated a benign-appearing mass at left 12:00 position which is stable since 2013, presents for ultrasound study. Focused ultrasound for the left breast 12:00 position was performed. No abnormal lesions including solid or cystic masses are detected. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Status post resection of right proximal fibula for osteosarcoma. Evaluate for recurrence. Again seen are postoperative changes related to resection of the proximal and mid fibula. I see no findings to suggest tumor recurrence. | Postoperative changes of fibular resection without radiographic evidence of tumor recurrence. |
Generate impression based on findings. | 67-year-old male with biochemically recurrent prostate cancer. Punctate focus of increased radiotracer activity in the inferior right sacroiliac region on the posterior whole body view is nonspecific and may be related to degenerative arthritic change or tumor. No definite osseous metastatic disease.Mild increased trac... | Punctate nonspecific focus in the inferior right sacroiliac region, for which attention on follow-up is recommended. No definite osseous metastatic disease. |
Generate impression based on findings. | Reason: metastatic prostate cancer, evaluation of disease during treatment with invetigational therapy. Please complete PCWG2 form History: metastatic prostate cancer No definite abnormal osseous foci are identified to indicate metastatic disease.Stable degenerative changes of the mid-cervical region, right sacroiliac ... | No significant interval change or definite osseous metastases. |
Generate impression based on findings. | Right lower extremity radicular pain. Rule out DJD. There are 6 nonrib-bearing lumbar vertebrae which for the purposes of the study will be labeled L1 through L6. I suspect that there is hypertrophy of the left transverse process of L6 which appears to articulate with the underlying sacrum. Moderate to severe degenerat... | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 23-year-old male with history of AML now, prestem cell transplant evaluation. Lack of intravenous contrast limits evaluation for mediastinal and hilar lymphadenopathy.LUNGS AND PLEURA: Scattered nonspecific bilateral pulmonary micronodules. No suspicious pulmonary nodules or masses. No focal consolidation, pleural effu... | No suspicious pulmonary nodules or masses. No evidence of lymphadenopathy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 40-year-old female. History of left breast papilloma status post excision. Mammogram to assess clip, which is not in the specimen. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in... | No biopsy clip is evident in the left breast. 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: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mamm... |
Generate impression based on findings. | 57-year-old male with foot pain, evaluate for osteomyelitis There is diffuse soft tissue swelling particularly about the ankle. We see no radiographic evidence of osteomyelitis. Mild degenerative arthritis affects the ankle and midfoot. | Soft tissue swelling without radiographic evidence of osteomyelitis. If further evaluation/imaging is warranted, MRI can be obtained. |
Generate impression based on findings. | 42-year-old female patient with findings on prior CT concerning for autoimmune pancreatitis although asymptomatic. Evaluate pancreas. Also to evaluate for liver findings on previous CT which were concerning for sinusoidal obstruction. CHEST:LUNGS AND PLEURA: Scattered punctate calcified granulomas are seen. No suspicio... | 1. Stable diffusely enlarged pancreas which can be seen with autoimmune pancreatitis. 2. Diffuse hepatic reticular pattern of enhancement remains non-specific. |
Generate impression based on findings. | 71-year-old male with calcaneal ulcer and elevated ESR, CRP. Assess for osteomyelitis. Foci of gas density in the soft tissues of the heel posteriorly are compatible with stated history of ulceration. Margins of the underlying calcaneus appear intact without radiographic evidence of osteomyelitis. Patient has undergone... | Soft tissue ulceration(s) as above without radiographic evidence of osteomyelitis. |
Generate impression based on findings. | 43-year-old male cigar smoker with cough x2 months. Photon starvation artifact limits evaluation of the upper posterior thorax. Lack of intravenous contrast limits evaluation for lymphadenopathy.LUNGS AND PLEURA: Note is made of multifocal areas of subpleural reticulation and traction bronchiectasis most pronounced in ... | Patchy bilateral fibrosis with a posterobasilar predominance compatible with atypical UIP. Differential considerations chronic hypersensitivity pneumonitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 48-year-old female with severe right ventricular performance reduction. Rule out pulmonary embolism. The comparison chest radiograph performed on 5/3/2015 demonstrates no focal pulmonary opacities or pleural fluid. The ventilation images show a uniform distribution of activity on single-breath and wash-in images, aside... | 1. Low probability for pulmonary embolism.2. Moderate abnormal xenon-133 retention during ventilation washout in both lower lobes. |
Generate impression based on findings. | Female 84 years old Reason: ? Enlarging pancreatic mass or venous occlusive disease History: jaundice, rising LFTs LIVER: The liver measures 17.0 cm in length. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. There is increasing intrahepatic and extrahepatic biliary ductal dilatation. The common duct is measure... | 1.Patent hepatic vasculature.2.Hypoenhancing pancreatic mass consistent with patient's known adenocarcinoma. Allowing for differences in imaging technique there is probably slight enlargement of the mass compared to prior MRI. 3.Increasing pancreatic duct and biliary duct dilatation. |
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