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Generate impression based on findings. | Reason: evaluate ILD History: cough soboe fibrosis LUNGS AND PLEURA: Moderate reticulation distributed throughout both upper and lower lung zones without honeycombing.Mild groundglass opacities are present.Traction bronchiectasis is mild-to-moderate. There is no significant air trapping on expiration series.MEDIASTINUM... | 1. Moderate interstitial lung disease, a pattern consistent with NSIP, less likely hypersensitivity pneumonitis but inconsistent with UIP.2. Pulmonary arterial hypertension. |
Generate impression based on findings. | Female, 71 years old. Reason: nature of mid thoracic esophageal lesion/mass History: weight loss, cachexia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. Significant emphysematous changes in both lungs.Double contrast evaluation of the esophagus and gas... | 1.Moderate esophageal dysmotility.2.A heavily calcified aorta causes mass effect and narrowing of the esophagus at the level of the aortic arch.3.No obvious mass lesion identified. If concern persists, correlation can be made with endoscopy. |
Generate impression based on findings. | Male, 35 years old. Reason: please comment on stool burden History: new onset of abdominal pain and constipation Nonobstructive bowel gas pattern.Above average stool burden. | Above average stool burden. |
Generate impression based on findings. | Reason: evaluation preop for potential lung resection History: evaluation preop for potential lung resection CHEST:LUNGS AND PLEURA: Left upper lobe irregularly marginated solid nodule measuring 15 x 21 mm (series 6/24), not definitely changed since the previous scan allowing for differences in technique but possibly m... | 1.Left upper lobe 21 mm irregular pulmonary nodule, suspicious for neoplasm.2.Moderately enlarged nonspecific mediastinal lymph nodes. |
Generate impression based on findings. | 55-year-old male status post LVAD and high PVR. Evaluate for possible PE. The comparison chest radiograph performed on 5/7/2015 demonstrates no focal pulmonary opacities or pleural fluid. The ventilation images show diffusely decreased activity in the left lower lobe on single breath images, which fills in on wash-in i... | Matched left lower lobe ventilation/perfusion defect. Low probability for pulmonary embolus. |
Generate impression based on findings. | 61-year-old female with history of Hodgkin's lymphoma s/p 4 cycles with AVD in need of re evaluation. RADIOPHARMACEUTICAL: 11.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 108 mg/dL. Today's CT portion grossly demonstrates a right chest wall Port-A-Cath with catheter tip near the superior cavoatrial junc... | Interval complete resolution of abnormal hypermetabolic activity within lymph nodes, spleen, and bone with no suspicious FDG avid foci on the current exam. |
Generate impression based on findings. | Reason: Small cell lung cancer- Please provide bi-dimensional measurements per RECIST 1.1 criteria and compare to prior exam. History: Small cell lung cancer CHEST:LUNGS AND PLEURA: Moderate paraseptal predominant emphysema. Status post wedge resection of the left lower lobe. Stable paramediastinal radiation fibrosis i... | Interval progression of hepatic metastases. |
Generate impression based on findings. | History of lung cancer CHEST:LUNGS AND PLEURA: Centrilobular emphysema, stable. Postoperative changes of left upper lobectomy. 4mm RUL nodule unchanged (series 4, image 27). Remaining left lung medial radiation fibrosis is again seen. Mild bronchiectasis and tree-in-bud opacity in the bilateral lung bases, left greater... | 1.Left upper lobectomy. No evidence of recurrence or metastasis. 2.Interval development of tree-in-bud opacity in the bilateral lung bases, left greater than right, compatible with inflammatory etiology or aspiration. |
Generate impression based on findings. | 57-year-old male with history of non-Hodgkin's lymphoma status post stem cell transplant.RADIOPHARMACEUTICAL: 13.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 75 mg/dL. Today's CT portion of the neck grossly demonstrates no significant abnormality.Today's PET examination demonstrates increased radiotrace... | No convincing FDG tumor is evident. Increased activity diffusely in the right temporalis and masseter muscles as described above is most likely benign, less likely due to infiltrating tumor. Clinical correlation for this finding is requested.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's vis... |
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 are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major in... | Unremarkable contrast enhanced MRI of the brain. |
Generate impression based on findings. | 73-year-old male with left lung mass. Evaluate for metastatic disease.RADIOPHARMACEUTICAL: 14.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 87 mg/dL. Today's CT portion grossly demonstrates left upper lobe mass with additional left-sided interstitial opacities, suspicious for primary lung cancer with lym... | 1. Findings highly suspicious for left-sided lung cancer, as detailed above.2. Extensive supraclavicular, mediastinal, and bilateral hilar lymphadenopathy, compatible with metastatic disease.3. Hypermetabolic foci in both adrenal glands, right greater the left, very suspicious for additional metastases.4. Left scapular... |
Generate impression based on findings. | Reason: hx of lung CA, pls compare to previous and measure History: none CHEST:LUNGS AND PLEURA: Patchy upper and lower lobe groundglass and airspace opacity, slightly improved from previous.Right middle lobe atelectasis and consolidation without evidence of bronchial obstruction, unchanged.Multiple micronodules and a ... | Resolving groundglass and airspace pulmonary opacities. Lymphadenopathy stable or slightly decreased. |
Generate impression based on findings. | 88-year-old female with metastatic lesion to the right humerus for evaluation of additional metastatic lesions from breast cancer There is generalized demineralization of the bone suggestive of osteopenia. Mild-to-moderate osteoarthritic changes affect the left glenohumeral joint, left acromioclavicular joint, bilatera... | Diffuse degenerative changes and demineralization images of osteopenia. No suspicious osseous lesions are evident. |
Generate impression based on findings. | 89-year-old female with left foot and ankle swelling Soft tissue swelling over the dorsum of the foot and over the medial malleolus. We see no fracture. Alignment is anatomic. | Soft tissue swelling without evidence of fracture. |
Generate impression based on findings. | 43-year-old female with neck sprain Six views of the cervical spine show no acute fracture. Anterior disc osteophytes are noted at C4-C5, C5-C6, and C6-C7. Vertebral body heights, disc spaces, and alignment are preserved. The neural foramina are patent bilaterally. | No acute fracture or subluxation is evident. Mild degenerative changes as described above. |
Generate impression based on findings. | Restaging head and neck cancer status post remote radiation therapy. Recent CT demonstrated progression of pulmonary micronodules.RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 109 mg/dL. Today's CT portion grossly demonstrates numerous bilateral small pulmonary nodules as well as ... | 1.No FDG avid metastatic disease. Specifically, none the pulmonary nodules are significantly FDG avid and remain of uncertain etiology. They could represent postinflammatory nodules. Conceivably, non-FDG avid tumor is also a possibility. Larger triangular right middle lobe hypermetabolic focus more likely benign inflam... |
Generate impression based on findings. | Cervical instability and fusion. History of abnormal x-rays.VIEWS: Cervical spine AP, lateral neutral/extension/flexion (four views) 05/07/15 Rods, plates, screws, and cerclage wires extending from the occiput to C3. The appearance of the hardware is unchanged. The bone graft material in the midline posteriorly is abou... | Continued instability at the atlantodens interval. |
Generate impression based on findings. | 55 year old obese man with Wilson's disease and cirrhosis. He has episodes of chest tightness while shoveling snow in the winter. He is referred to rule out severe coronary artery disease prior to liver transplant.CPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus o... | 1. There are no severe coronary artery stenoses present. 2. There is a partially calcified plaque in the mid LAD resulting in a 25-50% stenosis. 3. Mild circumferential left ventricular hypertrophy.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and uppe... |
Generate impression based on findings. | Left knee pain.VIEWS: Left knee AP/lateral/oblique (three views) neck are today A joint effusion is not identified. The bones are normal in appearance. No fracture is seen. | Normal examination. |
Generate impression based on findings. | Celiac disease and fecal swelling. Evaluate for extent of fecal retention.VIEW: Abdomen AP (one view) 05/07/15 A moderate to large amount of feces is present in the colon. No dilated bowel loops are seen. The spine appears intact. | Moderate to large fecal burden. |
Generate impression based on findings. | PICC placement. Respiratory failure and obesity.VIEW: Chest AP (one view) 05/07/15, 1758 Feeding tube tip is in gastric fundus. Endotracheal tube tip is just above carina. Ventriculoperitoneal shunt tubing is present. Spinal fusion instrumentation is noted with fracture of the most superior left laminar wire. Left uppe... | Left upper extremity PICC tip in right ventricle. |
Generate impression based on findings. | Sickle cell anemia. Pain, bruising and swelling of left ankle.VIEWS: Left ankle AP/lateral/oblique (three views) 05/07/15 A joint effusion is not identified. The bones are normal in appearance. No fracture is seen. No significant soft tissue swelling is noted. | Normal examination. |
Generate impression based on findings. | Wrist fracture.VIEWS: Left forearm PA/lateral (two views) 05/07/15 A cast obscures bone detail. Fractures of distal radius and ulna are again seen. Angulation at the radial fracture site is almost completely resolved. No angulation is identified at the ulna fracture. The rest of the forearm is normal in appearance. | Near-anatomic reduction of both bones fracture of distal forearm. |
Generate impression based on findings. | Unspecified epilepsy without mention of intractable epilepsy Periventricular and subcortical white matter hypodensities of a moderate to marked degree are present. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. Ather... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.Periventricular and subcortical white matter changes of a moderate to marked degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Head injury, convulsions The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. Th... | No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | fall with hematoma on head The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a subgaleal hematoma present adjacent to the right frontal bone. There is no underlying coup or contrecoup injury appreciated and no underlying fracture appreciated.Periventricular and subcortical whit... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.. 2.Periventricular and subcortical white matter changes of a mild to moderate degree are nonspecific which have progressed since the prior exam. At this age they are most likely vascular related. |
Generate impression based on findings. | Type II or unspecified type diabetes mellitus with ketoacidosis, not stated as uncontrolled. Patient now has a headache. A small focus of encephalomalacia is present along the right inferior parietal lobule anteriorly reaching the supramarginal gyrus just behind the postcentral sulcus. This is stable and compared to th... | 1. No evidence for acute intracranial hemorrhage mass effect or edema.2.Old focus of encephalomalacia is present at the right inferior parietal lobule involving supramarginal gyrus. Most likely this is related to prior vascular event. |
Generate impression based on findings. | headache for a week No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are ... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | slurred speech, difficulty The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. ... | No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | altered mental status Re demonstration of the left frontal encephalomalacia with aneurysm clip around Acom or distal left ICA area and left pterional approach.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.Patchy low attenuations on bilateral periventricular white matter indicate non specific... | No evidence of acute ischemic or hemorrhagic lesion.Re demonstration of post surgical clipping with left frontal encephalomalacia, no change since prior exam. |
Generate impression based on findings. | 58 year old female with abdominal distention, lactatemia. Eval for mesenteric ischemia, sbo. ABDOMEN:Lack of oral contrast limits evaluation for bowel pathology.LUNG BASES: Minimal dependent atelectasis. No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: Liver enhances homogeneously without focal lesion. ... | 1.No evidence of bowel ischemia.2.Narrowing of the celiac axis without calcific atherosclerosis may be seen with median arcuate ligament syndrome. |
Generate impression based on findings. | 25-year-old female patient with left flank pain. Evaluate for left nephrolithiasis. 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 n... | 1. 3 mm stone at the left ureterovesical junction.2. Bilateral nephrolithiasis. |
Generate impression based on findings. | Crackles from left knee while running two days ago. Tender to palpation on left anterior tibial tuberosity.VIEWS: Left knee AP/lateral/oblique (three views) 05/07/15 No joint effusion is present. The bones are normal in appearance. No fracture is identified. | Normal examination. |
Generate impression based on findings. | Male, 55 years old. Reason: ro obstruction or free air History: abd pain post colonoscopy, no bms Nonobstructive bowel gas pattern. Moderate to large stool burden.No free air seen on upright imaging.Right hip prosthesis. Status post median sternotomy. | Nonobstructive bowel gas pattern. No free air.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 59-year-old male patient with altered mental status. Evaluate for hemorrhage. 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. 3 mm hyperattenuating focus in the anterior superior aspect of the third ventricle... | 1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts and MRI should be considered if there is continued clinical suspicion.2. 3 mm hyperattenuating focus in the anterior superior aspect of the third ventricle is favored to represent ... |
Generate impression based on findings. | 14-year-old female with history of traumaVIEWS: Cervical spine AP, lateral and swimmer's (3 views) 5/7/2015 at 2317 The cervical spine is visualized down to C6, with the C7 vertebral body and partially posterior to overlying soft tissue. No prevertebral soft tissue swelling or displaced fracture. No significant malalig... | No acute fracture or other significant abnormality. |
Generate impression based on findings. | Female 91 years old; Reason: abdominal pain, bloating History: LLQ and pubic tenderness The absence of intravenous contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:CHEST:LUNGS AND PLEURA: Left lower lobe atelectasis with a nodular focus meas... | 1.Small chronic/recurrent fluid containing ventral hernia. While nonspecific, this is in the region of patient's symptoms and therefore could be the source of the patient's pain.2.Nonspecific pulmonary micronodules, may represent prior granulomatous process but can be followed as per Fleischner guidelines.3.Atrophic le... |
Generate impression based on findings. | Pain on weightbearing.VIEWS: Right knee AP/lateral/oblique (three views) 05/07/15 No joint effusion is identified. The bones are normal in appearance. No fracture or bone destruction is seen. | Normal examination. |
Generate impression based on findings. | Female, 56 years old. Reason: post NGT placement History: post NGT placement NG tube tip overlies the gastric antrum.Nonobstructive bowel gas pattern. Moderate to large stool burden.Round, peripherally calcified density in the right upper quadrant, compatible with a gallstone as seen on prior CT imaging.IVC filter. | NG tube terminates in the stomach.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Laceration on palm of hand.VIEWS: Left hand PA/lateral (two views) 05/07/15 No foreign body is identified. No fracture is seen. The bones are normal in appearance. | No foreign body. |
Generate impression based on findings. | acute intracranial abnormality? Mass?Signs and Symptoms: worsening of chronic headache The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.... | No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | 54-year-old female patient with headache and known brain metastases. Evaluate for new metastatic disease, CVA, or intracranial hemorrhage. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no herniation. There are small areas of hypoattenua... | 1.No evidence of intracranial hemorrhage or significant mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts and evaluation of metastatic disease and MRI should be considered if there is continued clinical suspicion.2.Small foci of hypoattenuation in the right matter in the lef... |
Generate impression based on findings. | Female, 81 years old. Reason: S/p UGI with contrast today - please assess to see if contrast has passed through stomach yet History: s/p gastric resection The majority of the enteric contrast from the recent upper GI exam remains in the stomach. Minimal contrast has passed through to the small bowel.Nonobstructive bowe... | Minimal contrast has passed into the small bowel on this exam.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Blunt head trauma 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.The visualized portions of the paranasa... | No evidence of acute intracranial hemorrhage or mass effect. No skull fracture. |
Generate impression based on findings. | Female, 81 years old. Reason: sp transgastric antral mass resection, UGI performed today, eval gastric motility History: none The enteric contrast from the recent upper GI exam has now passed from the stomach, no mostly in the small bowel.Nonobstructive bowel gas pattern.Surgical changes of the stomach.Surgical staples... | Interval passage of enteric contrast from the stomach into the small bowel.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 77-year-old male patient with shortness of breath. Evaluate for PE. CHEST:LUNGS AND PLEURA: Status post left pneumonectomy with coarse peripheral calcifications, a small amount of pleural fluid, and deformity of the left chest wall. There is a right apical scarring with a thin-walled cavitary lesion within the apex mea... | 1. Study inadequate for the evaluation of pulmonary emboli. 2. Post-surgical changes of a left pneumonectomy with associated left chest wall deformity.3. Cavitary lesion within the right upper lobe likely represents sequela from prior infection.4. No acute findings in the abdomen/pelvis. |
Generate impression based on findings. | Dizziness and giddiness. Evaluate for ischemia The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No ... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Female, 79 years old. Reason: Initial placement of DHT History: Initial placement of DHT The lower abdomen and pelvis are excluded from the field-of-view.Dobbhoff tube tip projects over the gastric body.Partially visualized nonspecific bowel gas pattern.Pleural effusion/retrocardiac opacity better evaluated on recent c... | Dobbhoff tube tip projects over the gastric body.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 77-year-old female with shortness of breath, history of cancer, history of chemotherapy and radiation. LUNGS AND PLEURA: There is patchy groundglass opacities in the right upper lobe. Note is made of scattered bilateral pulmonary micronodules. Biapical scarring/atelectasis. There is mild apical bronchiectasis.MEDIASTIN... | 1. Patchy groundglass and nodular opacities in the right upper lobe are suspicious for infection. Alternatively, post therapy reaction could be considered if radiation therapy to the right neck was completed within the last 6 months. 2. Irregular wall thickening of the gallbladder is nonspecific. Clinical correlation a... |
Generate impression based on findings. | Other musculoskeletal symptoms referable to limbs. BLE numbness and weakness 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 are identified in the thoracic spine. The thyroid gland a... | 1.The exam is markedly limited due to x-ray attenuation from the patient's large body habitus. There is no obvious fracture or subluxation appreciated in the lumbar spine or in the thoracic spine. Please note that more subtle lesion such as a mass within the thecal sac or a less obvious disc protrusion may be masked as... |
Generate impression based on findings. | 13 year old male with interval tibial fracture casting and reductionVIEWS: left knee ap/lateral (2 views) 5/8/2015 at 0320 The overlying cast material obscures fine bone detail. Previously seen medial tibial epiphysis longitudinal fracture is again seen in anatomic alignment. Large joint effusion. No dislocation or add... | Interval casting of previously seen medial tibial plateau fracture in anatomic alignment. |
Generate impression based on findings. | 13-year-old male with history of fall. Evaluate for dislocation and fracture.VIEWS: Left knee AP, lateral and oblique (3 views) 5/7/2015 at 2353 A linear lucency of the medial tibial plateau extends from the articular surface to the underlying physis. Approximately 3 mm of depression and 1 mm of medial distraction is n... | Medial tibial plateau fracture in normal anatomic alignment, and large joint effusion as above. |
Generate impression based on findings. | Female, 64 years old. Reason: eval stool burden History: constipation Nonobstructive bowel gas pattern. Large stool burden.IVC filter. | Large stool burden.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | end stage renal disease, unspecified cerebral artery occlusion. 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate subtle luminal irregularities on bilateral MCA M1 segments as well as tortuous and ectatic basilar artery indicating ... | Atherosclerotic changes of intracranial arterial system as described above.No evidence of significant luminal stenosis. No aneurysm. |
Generate impression based on findings. | Female, 66 years old. Reason: please assess location of capsule History: gib Nonobstructive bowel gas pattern.Endoscopy capsule in the left midabdomen, overlying the descending colon.LVAD and AICD leads partially visualized. | Endoscopy capsule overlying the descending colon.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 2-year-old female with history of cough. Evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 5/8/2015 at 0347 Cardiomediastinal silhouette is within normal limits. Bronchial wall thickening is noted, consistent with reactive airway disease and/or bronchiolitis. No focal consolidation or pleural effusion. No pneu... | Findings consistent with reactive airway disease/bronchiolitis. |
Generate impression based on findings. | 31-year-old female with hypotension, nausea, vomiting, crackles on exam. Evaluate for pneumonia, worsening sacral mass, abscess. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. Pulmonary nodules are not significantly changed in size or number. Left upper lobe nodule measures 12 x 8 mm (series 4, ima... | 1.No significant interval change in pulmonary and hepatic metastases.2.Presacral soft tissue gas-containing mass continues to increase in size; infected tumor cannot be excluded. |
Generate impression based on findings. | 76-year-old female with respiratory distress, shortness of breath, and recent hospitalization. Evaluate for PE. PULMONARY ARTERIES: Technically inadequate study due to motion and mixing artifact. Pulmonary embolus cannot be excluded by this examination. The main pulmonary artery is dilated measuring 3.8 cm in diameter ... | 1. Technically inadequate study for evaluation for pulmonary embolus due to extensive motion and mixing artifact. PE cannot be ruled out by this exam.2. Persistent findings consistent with the patient's known history of scleroderma related interstitial lung disease. Interval resolution of the previously described pleur... |
Generate impression based on findings. | Male, 79 years old. Reason: F/U NG placement History: F/U NG placement Interval adjustment of NG tube, now with tip in the region of the antropyloric region.Nonobstructive bowel gas pattern. Multiple prominent loops of small and large bowel, nonspecific. The lower pelvis is excluded from the field-of-view.S-shaped scol... | NG tube tip in the antropyloric region. |
Generate impression based on findings. | Female 63 years old; Reason: new endometrial cancer, evaluate for metastatic disease. 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... | 1.No evidence metastatic disease.2.Mild asymmetric prominence of the right ureter to the level of the VUJ may reflect compression. |
Generate impression based on findings. | Respiratory distress of the newborn. Reassess for improvement in atelectasis.VIEW: Chest AP (one view) 5/8/2015 at 0426 hours. ET tube terminates below thoracic inlet. NG tube proximal side port is above the GE junction. Central line unchanged. Cardiac silhouette size is top normal. Interval resolution of right lung ba... | Interval resolution of right lung base atelectasis. |
Generate impression based on findings. | 54-year-old female with chest pain. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study. Note is made of multiple filling defects within the subsegmental branches of the right lower lobe consistent with pulmonary embolus (189; series 7). No evidence of right heart strain.LUNGS AND PLEURA: Note is made of ce... | 1. Findings consistent with pulmonary emboli in the subsegmental branches of the right lower lobe. No evidence of right heart strain.2. No significant interval change in the reference intracardiac mass with central necrosis or suprahepatic IVC reference lymph node.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Mult... |
Generate impression based on findings. | Fall, mild blunt head trauma, intoxicated 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 ar... | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. No acute fracture or subluxation in the cervical spine.3. Multiple areas of reticular thickening and nodularity in the bilateral lung apices which are incompletely characterized as well as mild prominence of the mediastinal lymph nodes. Suggest dedicate... |
Generate impression based on findings. | Female 5 months old Reason: is there pleural effusion History: CO2 retentionVIEW: Chest AP (one view) 5/8/2015 at 0750 hours. Central line tip is at the IVC/RA junction. NG tube is present. Cardiac silhouette size is normal. Right upper and lower lobe atelectasis with mediastinal shift. No effusions or pneumothorax. | Right upper and lower lobe atelectasis as described. |
Generate impression based on findings. | Respiratory failure.VIEW: Chest AP (one view) 5/8/2015 at 0548 hours. Left IJ and subclavian central lines terminates at the IVC. A gastrostomy tube is in place. Right mainstem bronchus intubation.Cardiac silhouette size is normal. Bibasilar opacities and streaky subsegmental atelectasis of the left upper lobe on a bac... | Multifocal opacities as described.Misplaced ET tube. |
Generate impression based on findings. | 94-year-old female patient with abdominal pain. Evaluate for intra-abdominal infection. Motion limits evaluation. ABDOMEN:LUNG BASES: Bibasilar atelectasis. Partially imaged calcified right hilar lymph nodes.LIVER, BILIARY TRACT: The gallbladder is surgically absent. There is mild intra and extrahepatic biliary ductal ... | 1. Stable mild intra- and extrahepatic biliary ductal dilatation, appearing similar to the prior study, with pneumobilia and an air-fluid level in the CBD. CT is insensitive for the detection of common bile duct stones; ERCP/MRCP is a more sensitive means of evaluation. 2. No additional acute findings to account for th... |
Generate impression based on findings. | Routine diagnostic mammogram to evaluate left breast skin changes and palpable mass. Mammogram: Three standard views of both breasts, additional left MLO and left axillary spot compression view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandula... | Left breast skin thickening with dilated ductal system and enlarged left axillary lymph node. Findings conveyed to Dr. Chhablani. Patient will undergo a skin punch biopsy and left breast core biopsy based on palpable guidance to rule out inflammatory breast cancer.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - ... |
Generate impression based on findings. | Female 76 years old; Reason: eval for pancreatitis complications History: elevated dimer / lactate The study is significantly limited by respiratory motion artifact.ABDOMEN:LUNG BASES: Please refer to dedicated CT pulmonary angiogram for chest findings. Cardiomegaly with severe right atrial hypertrophy. Severe mitral v... | 1.Trace peripancreatic fluid. The sensitivity of the peripancreatic fluid for acute pancreatitis is reduced given the associated perihepatic fluid however acute pancreatitis is not excluded, particularly in the context of the patient's elevated lipase.2.Cardiomegaly and evidence of right heart failure.3.Cholelithiasis. |
Generate impression based on findings. | 12-Year-old female with history of right wrist pain.VIEWS: right wrist ap, lateral and oblique (3 views) 5/8/15 at 0819 No displaced fracture or malalignment. No significant effusion. | Normal examination. |
Generate impression based on findings. | Other musculoskeletal symptoms referable to limbs. BLE numbness and weakness 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 are identified in the thoracic spine. The thyroid gland a... | 1.The exam is markedly limited due to x-ray attenuation from the patient's large body habitus. There is no obvious fracture or subluxation appreciated in the lumbar spine or in the thoracic spine. Please note that more subtle lesion such as a mass within the thecal sac or a less obvious disc protrusion may be masked as... |
Generate impression based on findings. | Female 58 years old; Reason: DHT placement History: as above Contrast now resides within the colon and rectum. Enteric tube projects over the mid abdomen with its tip about the ligament of Treitz. Portion of the tube is coiled within the stomach.There are postsurgical staples in the right hemiabdomen with a subdiaphrag... | 1.Enteric tube terminates about the ligament of Treitz |
Generate impression based on findings. | Male 59 years old; Reason: dht History: dht Possible lines tubes and support tubing project over the chest and abdomen. Enteric tube terminates in the region of the gastric body. | 1.Enteric tube terminates in the region of the gastric body |
Generate impression based on findings. | Male 35 years old; Reason: Check NJ site History: N/V There is an ongoing bowel obstruction with dilated small bowel loops measuring up to 4.5 cm.Enteric tube terminates in the region of the proximal jejunum. This gaseous distention of the small bowel. | 1.Small bowel obstruction.2.Enteric tube in the region of the proximal jejunum. |
Generate impression based on findings. | Male 79 years old; Reason: NG placement History: NG placement Distention of small bowel and colon most suggestive of an ileus. Enteric tube projects about the level of the carina and may reside within the airway or esophagus. | 1.Enteric tube projects over the chest and needs to be repositioned. |
Generate impression based on findings. | Left wrist pain after fallVIEWS: Left wrist AP, lateral and oblique 5/7/2015 (3 view/s) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 19 year old female with history of vomiting. Evaluate CSF shunt.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 5/8/2015 at 0801 Ventriculoperitoneal shunt catheter with intracranial tip slightly left of midline (unchanged), exits the skull through a right... | No kinks or discontinuity of the radiopaque portions of the shunt catheter. |
Generate impression based on findings. | Neck: The exam is limited by streak artifact from posterior cervical spine hardware. There are postoperative findings related to lymph node dissection, supraglottic laryngectomy, and tracheostomy, as well as effects of radiation therapy. There is interval development of a conglomerate of mass lesions that overall meas... | 1. Extensive tumor recurrence in the right lower neck treatment bed with extension into the skin, aerodigestive track, with encasement of the right carotid artery and thrombosis or compression of the right internal jugular vein.2. No evidence of intracranial metastases.Discussed with Louann Shea at 2PM on 5/8/15. |
Generate impression based on findings. | 44-year-old female Reason: r/o growth of nodules, adenopathy History: multinodular goiter RIGHT LOBE MEASUREMENTS: 6.1 x 1.9 x 1.8 cm and previously measured 6.3 x 1.9 x 1.6 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.4 x 1.4 cm and previously measured 5.3 x 1.7 x 1.2 cm.ISTHMUS MEASUREMENTS: 0.3 cm. RIGHT LOBE: Multiple hypere... | Heterogenous appearing thyroid with multiple hyper and hypoechoic nodules as described above. Reference right and left lobe nodules are unchanged from the prior exam and do not demonstrate any internal vascularity or calcifications. Continued surveillance is recommended. |
Generate impression based on findings. | 36-year-old female with epigastric pain. Evaluate for pancreatitis or abscess. ABDOMEN:Lack of intravenous contrast limits evaluation of solid abdominal viscera.LUNG BASES: Small bilateral pleural effusions and associated compressive atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significa... | 1.No evidence of pancreatitis or loculated fluid collection. No specific findings to account for epigastric pain.2.Findings of volume overload include small bilateral effusions, small volume ascites and moderate anasarca. |
Generate impression based on findings. | Headache(784.0)Clinical question: ro chronic subduralSigns and Symptoms: fall with intermittent HAs The CSF spaces are appropriate for the patient's stated age with no midline shift. A focus of encephalomalacia is present along the medial aspect of the right parietal lobe and the smaller one is present along the right ... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.Small foci of encephalomalacia in the right parietal lobe and right frontal lobe are suspected represent old cerebral infarctions. The distribution suggests water... |
Generate impression based on findings. | Headache worsening, rule out bleed, ventriculomegaly 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 remain unchanged in size without evidence of hydrocephalus.The ... | No evidence of acute intracranial hemorrhage. No hydrocephalus. |
Generate impression based on findings. | Female, 77 years old. Reason: s/p esophageal dilatation (perf?) History: worsening dysphagia and odynophagia Scout image of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Fluoroscopic evaluation of the esophagus revealed no morphologic abnormalities of the mucosal surfaces ... | 1. No esophageal contrast leak or significant anatomic abnormality.2. Moderate esophageal dysmotility. |
Generate impression based on findings. | 50-year-old female patient with flank pain radiating to groin, hematuria. Evaluate for renal stone. ABDOMEN:LUNG BASES: Nonspecific left lower lobe pulmonary micronodule.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: An accessory splenule is noted.PANCREAS: No significant abnormality noted.ADRENAL GLAND... | 1. No obstructing ureteral calculus or hydronephrosis.2. Punctate, non-obstructing left renal stone is unchanged. |
Generate impression based on findings. | Evaluate for intracranial bleed/ subarachnoid hemorrhageSigns and Symptoms: Sudden onset headache, followed by right sided pain The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema i... | No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. CT is insensitive for the detection of meningitis. |
Generate impression based on findings. | 55-year-old female with shortness of breath and tachycardia. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. No evidence of right heart strain. The main pulmonary artery is dilated measuring 3.5 cm in diameter suggestive of pulmonary artery hypertension.LUNGS AND P... | 1. No evidence of pulmonary embolus.2. Right upper lobe lobar pneumonia and additional multifocal areas of pneumonia bilaterally, such as in the right middle lobe.3. Large right pleural effusion with associated compressive atelectasis.4. Percutaneous abdominal drains are incompletely visualized. The left percutaneous d... |
Generate impression based on findings. | 48-year-old male with left lower quadrant pain and tenderness. Also umbilical hernia. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: Left basilar scarring. No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: Hepatic steatosis. No focal lesion identified. Gallbladder is unremarkable.SPLEEN: Mild splenomeg... | 1.No evidence of diverticulitis or other findings to account for left lower quadrant abdominal pain.2.Hepatic steatosis and indeterminate bilateral adrenal nodules are noted incidentally. |
Generate impression based on findings. | Right ear infection associated with ear pain, tinnitus, and intermittent mild headache. Recent ventricular shunt revision. History of pineal tumor status post resection in 4/2012 as well as radiosurgery. Head: There are postoperative findings related to suboccipital craniotomy with mesh cranioplasty. In addition, there... | 1. Findings compatible with right external otitis and otomastoiditis. Evaluation for abscess is otherwise limited on non-contrast CT.2. New intraventricular hemorrhage related to interval shunt revision. The ventricular system has increased in size along with new periventricular hypoattenuation that may represent trans... |
Generate impression based on findings. | Vomiting, evaluate for changes and hydrocephalus 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. Again seen is a right transfrontal approach ventricular shunt catheter which r... | No evidence of acute intracranial hemorrhage or mass effect. Mild increase in size of the dysmorphic lateral ventricles compared to 9/3/2014. |
Generate impression based on findings. | 55-year-old female patient with esophageal mass. Remote history of AML and breast cancer. Question of metastases. CHEST:LUNGS AND PLEURA: Minimal scarring in the lingula. No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy by CT size criteria. No pericar... | 1. Soft tissue thickening of the midesophagus.2. Prominent gastrohepatic lymph node is suspicious for nodal metastases.3. Unchanged lumbar vertebral body hemangiomas without specific evidence of osseous disease. |
Generate impression based on findings. | Female, 60 years old. Reason: trouble withe swallowing water without solid dysphagia History: as above for 3 months Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morpholog... | 1. Mild esophageal dysmotility.2. No gastroesophageal reflux or anatomic abnormality. |
Generate impression based on findings. | Unspecified intracranial hemorrhage Since the prior exam a left medial frontal lobe hematoma has not significantly enlarged. It extends to the medial left parietal lobe. It currently measures 73x32mm axial dimension and 72x59mm sagittal dimensions and is unchanged. It extends and abuts the falx and superior sagittal si... | 1.Since the prior exam from yesterday the patient's left frontal hematoma has not significantly expanded. There is associated midline shift, subarachnoid hemorrhage and intraventricular hemorrhage.2.A ventriculostomy tube is stable. 3.The ventricles are stable. |
Generate impression based on findings. | 63-year-old male with recurrent gastric cancer causing biliary obstruction, s/p PTC and 3 cycles of chemotherapy. Restaging - evaluate previous subcentimeter liver lesions, recurrent primary lesions, any definitive evidence of metastatic disease? CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules. No focal consoli... | 1.Interval placement of cholecystostomy tube.2.Otherwise stable exam without evidence of measurable disease in the abdomen or pelvis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with tomosynthesis 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. Loose cluster of calcificati... | 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. | Subdural hemorrhage. Headache(784.0)Clinical question: evaluate s/p subdural drain removalSigns and Symptoms: recent subdural evacuation The patient is status post bilateral frontal burr hole placement for subdural evacuations. Compared to the prior exam the amount of subdural air has mildly decreased. The left-sided s... | 1.Since the prior exam the patient's bilateral subdural collections have not changed significantly. The right subdural appears slightly larger whereas the left one is approximately the same in size. Please note the amount of air has decreased slightly.2.The patient is status post right-sided craniotomy from multiple an... |
Generate impression based on findings. | malignant neoplasm of prostate, word finding difficulty. No evidence of acute ischemic or hemorrhagic lesion.There is no evidence of abnormal enhancement either.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline sh... | No evidence of acute ischemic or hemorrhagic lesion.There is no evidence of abnormal enhancement either. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast biopsy 16 years ago Two standard digital views of both breasts and bilateral MLO views and cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern an... | 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. | Asymptomatic female presents for routine screening mammography. History of bilateral breast benign biopsies. 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. Clip identified in the ri... | 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. | 27-year-old female with a history of cellulitis/abscess of the neck and lung granulomas. History of Crohn's disease. LUNGS AND PLEURA: Scattered bilateral pulmonary micronodules. No masses are identified. No focal consolidation, pleural effusion or pneumothorax.Basilar dependent atelectasis. Suture lines from prior wed... | No evidence of intrathoracic abscess extension. |
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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Loosely clustered calcifications in th... | 9 mm asymmetry in the central left breast , best seen on the CC view. Spot compression views, rolled views and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or ar... | 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. |
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