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Generate impression based on findings. | . Female 63 years old Reason: evaluate for common bile duct dilation History: RUQ abdominal pain ABDOMEN:LIVER, BILIARY TRACT: There is intra and extra hepatic biliary dilatation. Common bile duct is dilated throughout its course and measures 1.2 cm in diameter. There is a 9 x 7 mm hyperintensity at the level of the am... | 1.Moderate to severe intra and extra hepatic biliary dilatation with dilated pancreatic duct. There is a hypointense lesion at the level of the ampulla suspicious for neoplasm. Further evaluation of this lesion with ERCP is recommended. Lack of intravenous contrast limits optimal evaluation. |
Generate impression based on findings. | 63-year-old female with left humerus pain. Rule out fracture, lytic lesion. 2 views of the left humerus reveal minimal osteoarthritis of the AC joint with no evidence of acute fracture or lesions within the humerus. Alignment is anatomic. | No acute fracture or lesions affect the humerus. |
Generate impression based on findings. | 25-year-old male with finger swelling/redness. Evaluate for osteo 3 views of the left third finger reveal soft tissue swelling with no evidence of acute fracture or malalignment. No evidence of cortical disruption to suggest osteomyelitis. | No radiographic evidence of osteomyelitis. |
Generate impression based on findings. | 70-year-old male with finger injury, evaluate fracture/dislocation 3 views of the right thumb reveal a comminuted transverse fracture of the distal phalanx of the right thumb with minimal displacement.3 views of the right index finger reveal a comminuted intra-articular fracture of the middle phalanx of the index finge... | Multiple comminuted fractures involving the phalanges of the thumb and indexfinger as described above. |
Generate impression based on findings. | 57-year-old male with bleeding from stoma. Evaluate for bleed. LUNGS AND PLEURA: The reference left lower lobe subpleural mass with internal dilated bronchioles measures 5.9 x 3.6 cm, previously 5.7 x 3.6 cm (85; series 6)Reference right lower lobe irregular solid nodule measures 10 mm, previously 10 mm (image 66; seri... | 1. Foci of subcutaneous gas density, fat stranding, and encapsulated fluid collections in the soft tissues of neck at the level of the thoracic inlet extending inferiorly within the mediastinum, along the trachea to the level of the T6 vertebral body, as described above. These findings are highly suspicious for descend... |
Generate impression based on findings. | Female 29 years old Reason: please characterize new periumbilical fistula. History: umbilical drainage ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significan... | No communication is noted between patient's known perirectal fistula and bowel loops. |
Generate impression based on findings. | Male 54 years old Reason: Crohn's r/o residual abscess History: abd pain, elevated CRP/WBC ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: There is a 1.5 cm in diameter cystic lesion in the mid body of the pancre... | No inflammatory changes at the previous location of the abscess without any drainable collection.There is a 1.5 cm cystic lesion with thick rim enhancement in the body of the pancreas. Further evaluation of this lesion with EUS is recommended. |
Generate impression based on findings. | Reason: acute path? History: head trauma, headache, fell down stairs Head: There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracran... | 1.No evidence of intracranial hemorrhage or mass effect. 2.No evidence of acute fracture or malalignment. |
Generate impression based on findings. | Female, 71 years old, with intracerebral hemorrhage. The left parietal approach ventriculostomy catheter is in stable position terminating just to the right of midline in the right frontal horn. The ventricles remain dilated and are perhaps 1 to 2 mm larger than on the prior examination.The quantity and distribution of... | 1.Stable appearance of the evolving left thalamic hematoma including stable degree of edema and mass effect.2.Stable quantity and distribution of intraventricular blood product.3.Ventricular dilatation persists and ventricular caliber is perhaps 1 to 2 mm increased from prior.4.No new intracranial abnormalities. |
Generate impression based on findings. | 14-year-old female with right lateral ankle pain and swelling and refusal to bear weight.VIEWS: Right ankle AP, oblique, and lateral (3 views) 5/8/2015 at 14:36 Small joint effusion and minimal widening of the fibular-talar space on the AP view. No fracture. | No fracture. |
Generate impression based on findings. | 7-year-old male status post forearm reduction.VIEWS: Right wrist PA and lateral (2 views) 5/8/2015, 17:15 Overlying cast material limits evaluation of fine bone detail. The both bones fracture of the distal forearm is redemonstrated and has been reduced. Angulation is resolved and alignment is anatomic. | Reduction of both bones fracture of the distal forearm. |
Generate impression based on findings. | 70-year-old male with finger pain, evaluate fingers for fracture. 2 portable views of the right hand reveal a comminuted intra-articular fracture of the middle phalanx of the index finger with radial displacement of the distal fracture fragments. Additional comminuted transverse fracture of the distal phalanges of the ... | Multiple comminuted fractures involving the phalanges of the thumb and index finger as described above. |
Generate impression based on findings. | 57-year-old male with hip fracture, better characterize the fracture 2 views of the right hip reveal an impacted subcapital right femoral neck fracture with slight cephalad displacement and varus angulation of the distal fracture fragment. | Slightly displaced subcapital right femoral neck fracture as above. |
Generate impression based on findings. | 57-year-old male with right hip pain. Evaluate for right hip/pelvic fracture 3 views of the hips reveal an impacted subcapital right femoral neck fracture with slight cephalad displacement and varus angulation of the distal fracture fragment. | Impacted slightly displaced subcapital right femoral neck fracture as above. |
Generate impression based on findings. | 37-year-old female with ankle pain. Evaluate for fracture, dislocation. 3 nonweightbearing views of the left ankle reveal mild soft tissue swelling about the ankle with no evidence of acute fracture or malalignment. | Mild soft tissue swelling about the ankle with no acute fracture or malalignment. |
Generate impression based on findings. | 36-year-old male with traumatic back pain, rule out fracture 2 views of the lumbar spine reveal no acute fracture. Mild anterior osteophyte formation at L3. Alignment is anatomic and the disc spaces are preserved. | No acute fracture or malalignment. |
Generate impression based on findings. | 41-year-old female with pain, swelling. Rule out fracture 2 nonweightbearing views of the right tibia/fibula reveal a well corticated ossicle adjacent to the medial malleolus most likely a normal variant. Slight medial joint space narrowing of the knee as well as medial and lateral osteophyte formation compatible with ... | Joint effusion and osteoarthritis with no evidence of acute fracture or malalignment. |
Generate impression based on findings. | 11-year-old male status post reduction of distal both bones fracture of the wrist.VIEWS: Right wrist PA and lateral (2 views) 5/8/2015, 18:34 Cast material obscures fine bone detail. Again seen are fractures of the distal radius and ulna. There has been interval reduction with almost complete resolution of angulation a... | Reduction and casting of distal both bones fracture. |
Generate impression based on findings. | 65 year old male with metastatic thyroid cancer. HEAD: There is unchanged global volume loss. There are multiple hyperattenuating and presumably enhancing lesions within the brain. A left post central gyrus lesion is unchanged, measuring approximately 7 mm, however, a left superior parietal lobule lesion is slightly in... | 1.A left superior parietal lobule metastasis is increased in size with increased surrounding edema. The remaining intracranial metastases are unchanged or decreased in size.2.Metastatic lesions within the neck are mainly unchanged with one slightly decreased in size. |
Generate impression based on findings. | 57 years Male with Reason: s/p bronch med with drainage History: drainage Multiple foci of subcutaneous and mediastinal air, tracking from the level of the aortic arch to the mandible, which is likely related to recent bronchoscopy. Multiple pockets of fluid track along the trachea, extending inferiorly, out of field o... | 1.Multiple pockets of fluid and gas tracking from the mediastinum to the level of the mandible, with significant inflammatory changes in the mediastinum, extending out of field of view, which may represent evolving hematoma versus infection with developing abscess.2.Foci of gas and soft tissue density in the subcutaneo... |
Generate impression based on findings. | 17-year-old male with a history of sickle cell disease now with crisis, new onset cough and shortness of breath. Evaluate for acute chest syndrome.VIEWS: Chest PA/lateral (two views) 5/8/2015 at 17:42 Heart size is top normal and there is mild prominence of the pulmonary vasculature, unchanged. Linear opacities in the ... | No pneumonia or evidence of acute chest. |
Generate impression based on findings. | 41-year-old female with tachycardia and history of DVT. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no evidence of right heart strain. The main pulmonary artery measures 2.0 cm in diameter.LUNGS AND PLEURA: Fine emphysema pattern. Additionally, multiple subcentimeter c... | 1. No evidence of pulmonary embolus.2. Moderate fine pattern of emphysema diffusely. Superimposed cystic lung disease cannot be excluded due to small size and appearance of additional lesions. Differential considerations include lymphangioleiomyomatosis or much less likely LCH or LIP.PULMONARY EMBOLISM: PE: Negative.Ch... |
Generate impression based on findings. | 11-year-old male with swelling and pain left wrist.VIEWS: Left wrist PA, oblique, and lateral (3 views) 5/8/2015 at 17:58 Soft tissue swelling seen about the wrist and there is a small wrist joint effusion. A nondisplaced fracture through the growth plate of the distal radius extends to the anteromedial metaphysis. | Nondisplaced Salter-Harris type II fracture of the distal radius.Findings discussed with Dr. Brendan Devine by Dr. Kayleen Jahangir at 09:35 on 5/9/2015. |
Generate impression based on findings. | Male, 60 years old, history of T2 N2 M0 squamous cell carcinoma of the base of tongue. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Neck:Artifact from dental amalgam obscures visualization of som... | 1.No significant interval change in the appearance of an ulcerated lesion involving the right oral tongue.2.No pathologic adenopathy in the neck.3.No evidence of intracranial metastases. |
Generate impression based on findings. | 60-year-old female with base of the tongue cancer status post induction chemotherapy. Follow-up examination. CHEST:LUNGS AND PLEURA: New cluster of centrilobular nodules and tree-in-bud opacities in the right upper lobe. Interval resolution of the previously described groundglass opacities in the left lower lobe. No pl... | Focal nodular and tree-in-bud opacities in the right upper lobe are atypical in location for aspiration and most consistent with for acute infection. Given the upper lobe location, atypical etiologies should be ruled out clinically, including mycobacterial infection. No evidence of metastatic disease.These findings wer... |
Generate impression based on findings. | Reason: eval for fx History: fall w/ neck pain Head: 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. There is evidence of previous right mastoidectomy, with soft tissue density material within the mastoid bow... | 1.No evidence of intracranial hemorrhage or mass effect. 2.No evidence of acute facial bone or cervical spine fracture.3.Severe multilevel degenerative changes as detailed above, most severely at C5-C6, but not significantly changed from previous study. |
Generate impression based on findings. | 77-year-old female with shortness of breath, positive D dimer and intermediate probability VQ scan. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no evidence of right heart strain. The main pulmonary artery measures 1.9 cm in diameter.LUNGS AND PLEURA: T... | 1. No evidence of pulmonary embolus.2. Persistent patchy groundglass and nodular opacities in the right upper lobe which remains suspicious for acute infection. Post therapy reaction could be considered if there has been recent radiation therapy.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: ... |
Generate impression based on findings. | CT HEAD:There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are unchanged in size and configuration. There is mild global volume loss is slightly more prominent the parietal lobes. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is mild mucosal thic... | 1.No evidence of significant steno-occlusive lesion within the head or neck.2.No evidence of acute intracranial hemorrhage.3.Mild global volume loss that is slightly more prominent in the parietal lobes.4.Cervical spine degenerative changes most severe at C5-C7 where there is reversal of the normal cervical doses and a... |
Generate impression based on findings. | Newborn 28 week gestational aged patient with placement of multiple lines.VIEWS: Chest and abdomen AP (two views) 05/08/15, 1951 The endotracheal tube tip is above the thoracic inlet. Umbilical venous line tip is at junction of right atrium and superior vena cava. Umbilical arterial line has its tip at T7/8.Cardiothymi... | Changes from surfactant deficiency. Normal bowel gas pattern. |
Generate impression based on findings. | 25-year-old female with leg pain/swelling, evaluate for fracture 2 nonweightbearing views of the right tibia/fibula reveal distal fibular and medial malleolus fractures. 2 nonweightbearing views of the right ankle reveal spiral fracture of the distal fibula with the fracture line extending anterior to the joint space. ... | Acute fractures of the distal fibula and medial malleolus as described above. |
Generate impression based on findings. | 59-year-old female with pain. Evaluate for fracture 4 views of the right knee reveal an amputation through the proximal tibia/fibula. There is narrowing of the patellofemoral joint space with no joint effusion or acute fracture noted. Vascular calcifications. | Narrowing of the patellofemoral joint space with no acute fracture. |
Generate impression based on findings. | 69 year old male with PA during cardiac catheter procedure. HEAD: There is no evidence of intracranial hemorrhage. The scattered patchy foci of low attenuation throughout the supratentorial white matter that are most compatible with small vessel ischemic disease. There is mild global volume loss. The ventricles and bas... | 1.No evidence of intracranial hemorrhage.2.Severe pulmonary emphysema and infiltrates within both upper lobes concerning for pneumonia or edema. 3.Mild age indeterminate small vessel ischemic disease. If there is concern for acute ischemia, an MRI is suggested.4.Chronic appearing left orbital deformity with direct comm... |
Generate impression based on findings. | Female, 63 years old, history of metastatic thyroid cancer, assess response to Lenvatinib. Head:An expansile erosive lesion is redemonstrated centered within the left frontal bone. This lesion extends both into the overlying scalp and the underlying epidural space. Since the prior examination, the lesion has decreased ... | 1.Interval decrease in size of bilateral frontal bone metastatic deposits. No evidence of brain parenchymal metastases.2.Interval decrease in size of circumferential infiltrative tumor involvement of the larynx, as well as of at least 2 other soft tissue nodules in the neck.3.No new or progressing neck lesions. |
Generate impression based on findings. | 43-year-old male with back pain. Evaluate for fracture, dislocation. 4 views of the lumbar spine reveal no fracture. Alignment is anatomic and the disc spaces are preserved. | No fracture or dislocation. |
Generate impression based on findings. | 90-year-old female with decreased mobility, fall, pain. Evaluate for fracture. The right hip reveal no acute fracture. Severe degenerative changes affect the hip with bone-on-bone apposition of the femoral head and acetabulum as well as subchondral cyst formation and sclerosis. | Severe degenerative changes of the right hip with no acute fracture. |
Generate impression based on findings. | 90-year-old female with decreased mobility, fall, pain. Evaluate for fracture 3 views of the right shoulder reveal no acute fracture. There are severe degenerative changes about the shoulder with marked narrowing of the joint space as well as subchondral cyst formation and sclerosis. High riding humeral head compatible... | Severe degenerative changes of the shoulder with no acute fracture. |
Generate impression based on findings. | 59 year old female status post l tha revision Portable views of the pelvis, left hip and left femur reveal postoperative changes of left total hip arthroplasty with long femoral stem with the diaphyseal component centered within the medullary space. Alignment is anatomic with no evidence of hardware complication or acu... | Postoperative changes of left total hip arthoplasty in anatomic alignment with no evidence of hardware complication. |
Generate impression based on findings. | 63-year-old male, car accident 2 weeks ago, ongoing point tenderness on posterior cervical spine. Rule out fracture. 4 views of the cervical spine reveal mild disc space narrowing at C3/C4 with mild anterior osteophyte formation. Otherwise alignment is anatomic with no evidence of acute fracture. | Mild degenerative changes of the cervical spine with no acute fracture. |
Generate impression based on findings. | Pain. Rule out fracture.VIEWS: Left forearm AP/lateral (two views) 05/08/15 The bones are normal in appearance. No fracture is identified. No soft tissue swelling is seen. | Normal examination. |
Generate impression based on findings. | 87-year-old female s/p hemi. Postoperative changes of right bipolar hemiarthroplasty in anatomic alignment with no evidence of hardware complication. No acute fracture. | Right bipolar hemiarthroplasty in anatomic alignment with no evidence of hardware complication. |
Generate impression based on findings. | Pain. Rule out fracture.VIEWS: Left wrist PA/lateral/oblique (three views) 05/08/15 The bones are normal in appearance. No fracture is identified. No soft tissue swelling is seen. A joint effusion is not identified. | Normal examination. |
Generate impression based on findings. | Laceration of distal phalanx of middle finger.VIEWS: Right hand PA/lateral/oblique (three views) 05/09/15 A soft tissue defect in the nail bed and ulnar aspect of the distal middle finger is present. The bones are normal in appearance. No foreign body is identified. | Soft tissue defect in distal middle finger. No foreign body or fracture. |
Generate impression based on findings. | Tenderness of proximal interphalangeal joint of index finger.VIEWS: Right hand PA, right index finger oblique/lateral (three views) 05/09/15 Soft tissue swelling is identified around the proximal interphalangeal joint of the index finger. A transverse nondisplaced fracture at the level of the condyles of the proximal p... | Nondisplaced fractures of the proximal and middle phalanges of the index finger. |
Generate impression based on findings. | Pain.VIEWS: Left elbow AP/lateral/oblique (three views) 05/08/15 A joint effusion is not present. The bones are normal in appearance. A fracture is not seen. | Normal examination. |
Generate impression based on findings. | 20 year old female with head and face trauma after fall. HEAD: There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull is unremarkable. There ... | 1.No evidence of intracranial hemorrhage or skull fracture.2.Extensive soft tissue along the calvarium and induration of the subcutaneous fat of the head and upper neck that was not present on the prior exam. There are also scattered cervical lymph nodes that are slightly increased in number. These findings are nonspec... |
Generate impression based on findings. | 63-year-old female with a history of metastatic thyroid cancer. Evaluate response to Lenvatinib. Compare to prior study. CHEST:LUNGS AND PLEURA: Reference left lower lobe nodule measures 4 mm, previously 8 mm (67; series 6). There is interval decrease in size of multiple bilateral pulmonary nodules. There is interval r... | Interval decrease in size of the reference anterior chest wall masses. There is also interval decrease in size and number of numerous bilateral pulmonary nodules suspicious for metastatic disease. Please see the CT soft tissue neck report for additional details regarding the reference thyroid mass.I personally reviewed... |
Generate impression based on findings. | 7 year old male with vomiting and history of neuroblastoma. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is paranasal sinus mucosal thickening and secretions... | 1.No evidence of intracranial hemorrhage. If there is a concern for intracranial metastases, contrast enhanced MRI is recommended.2.Paranasal sinus mucosal thickening and secretions may represent sinusitis in the proper clinical setting. |
Generate impression based on findings. | 4-year-old female holding arm and flexion with good strength and range of motion after a from a slide. Repeat radiocapitellar view to evaluate for fracture.VIEWS: Left elbow radiocapitellar (1 view) 5/9/2015, 00:52 The radiocapitellar view is more of a lateral view than radiocapitellar thus a subtle radial head fractur... | No fracture. |
Generate impression based on findings. | Mandible hypoplasia and mandibular distraction.VIEWS: Skull AP/lateral (two views) 05/09/15 The mandibular distractors are intact. Nasotracheal tube has been removed. Nasogastric tube remains in place. A scalp IV is seen.Osteotomies of the mandible are noted. The distances between the plates of the distractors have inc... | Increase in bilateral mandibular distraction. |
Generate impression based on findings. | 63-year-old female with a history of metastatic thyroid cancer. Compared to previous examination CHEST:LUNGS AND PLEURA: Stable scattered pulmonary micronodules, some of which are calcified. 7 mm left lower lobe pulmonary nodule appears unchanged, previously 7 mm (71; series 4). No new pulmonary nodules or masses. No p... | 1. Persistent enhancing nodule within the anterior left sternocleidomastoid muscle. The second reference nodule at the midline at the mid clavicular level also appears similar to the prior study. No significant interval change in reference left axillary lymph nodes. Given the increased metabolic activity in these locat... |
Generate impression based on findings. | 4-year-old female evaluate for fracture or dislocation after fall from slide.VIEWS: Left ankle AP, oblique, and lateral (3 views) 5/9/2015 at 01:44 There is mild soft tissue swelling about the ankle. No fracture or dislocation. | Soft tissue swelling. No fracture. |
Generate impression based on findings. | 4-year-old female with pain after fall from slide. Evaluate for fracture.VIEWS: Left foot AP and lateral (2 views) 5/8/2015, 22:48Right elbow AP, lateral, and oblique (3 views) 5/8/2015, 22:42Right forearm AP and lateral (2 views) 5/8/2015, 22:37 No soft tissue swelling or fracture in the left foot, right elbow or righ... | No fracture. |
Generate impression based on findings. | Respiratory failure. Intubated.VIEW: Chest AP (one view) 05/09/15, 0724 Endotracheal tube tip is below thoracic inlet. Right upper extremity PICC tip is at junction of superior vena cava and right atrium. A gastrostomy tube is present. There is a left thoracolumbar curve.Right upper lobe opacity is decreased. Left lowe... | Improved aeration of right upper lobe. Continued left lower lobe atelectasis, slightly worse. |
Generate impression based on findings. | 46-year-old female with a history of head and neck cancer and chemotherapy radiation therapy. Compared to previous measurements. CHEST:LUNGS AND PLEURA: Bilateral upper lobe scarring and subpleural linear and nodular scarring again seen, unchanged in appearance, compatible with post-radiation reaction. A previously des... | No significant interval change in biapical lung changes compatible with radiation reaction. No findings to suggest metastatic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: head injury, HA History: head injury, HA Head: There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are... | 1.No evidence of intracranial hemorrhage or mass effect. 2.No acute fracture or subluxation.3.Scattered degenerative changes of the cervical spine, most significant at C4-5 and C5-6. |
Generate impression based on findings. | 12-month-old male with previous radiograph showing rickets, evaluate for signs of rickets.EXAMINATION: Right humerus AP, left humerus AP, right forearm AP, left forearm AP, right femur AP, left femur AP, right tibia-fibula AP, left tibia-fibula AP (8 views) 5/9/2015, 09:40 Right lower extremity PICC is partially visual... | Changes of rickets with no fractures. Periosteal reaction is likely physiologic. |
Generate impression based on findings. | Cirrhosis and chronic hepatitis with TIPS placement. Is there primary sclerosing cholangitis? ABDOMEN:LIVER, BILIARY TRACT: The liver is small, has curvilinear borders and has decreased T2 signal intensity. Also, the signal intensity is slightly heterogeneous. No biliary ductal dilatation is present. The bile ducts hav... | Cirrhosis. Intrahepatic portosystemic shunt. Abnormal appearance of the biliary tree most likely related to cirrhosis however very advanced primary sclerosing cholangitis may have this appearance. |
Generate impression based on findings. | 46-year-old female with a history of squamous cell carcinoma of the head and neck and history of non-Hodgkin's lymphoma. Evaluate for disease progression. LUNGS AND PLEURA:Again seen are multiple pulmonary micronodules in the right middle lobe. There is interval increase in size of one of these nodules which now measur... | Interval increase in size of one of the previously described pulmonary micronodules in the right middle lobe with interval resolution of additional reference pulmonary micronodule in the surrounding area. Postinflammatory or postinfectious lesions are still favored over metastatic disease, however follow up in no longe... |
Generate impression based on findings. | Male, 43 years old, with history of CLL. Assess response for clinical trial protocol IRB 14-0881. Extensive cervical adenopathy has improved with reference measurements as follows:1. Left 1B (image 42 series 8): 21 x 18 mm, previously 32 x 20 mm.2. Left 2A (image 39 series 8): 24 x 22 mm previously 53 x 33 mm.3. Right ... | Interval improvement in extensive cervical adenopathy. |
Generate impression based on findings. | Reason: brain mets, stroke, Bleed History: AMS, acute onset generalized weakness hx of bladder cancer with mets. New severe left and moderate right hemispheric vasogenic edema involving the anterior left frontal lobe, left parietal lobe, and posterior right frontal lobe, which causes partial effacement of the anterior ... | 1.New hyperattenuating lesion in the posterior right frontal lobe with local mass effect and extensive new bilateral vasogenic edema is suspicious for metastatic disease. MRI is recommended for further catheterization.2.Partial effacement of the left lateral ventricle without evidence of herniation or significant midli... |
Generate impression based on findings. | 3-year-old male with right foot swelling and decreased weight bearing since falling on foot on 5/4/2015.VIEWS: Right foot AP, oblique, and lateral (3 views) 5/9/2015 at 09:59 Mild soft tissue swelling is seen along the dorsum of the foot. The lateral border of the proximal diaphysis of the great toe metatarsal is angul... | Torus fracture of the great toe metatarsal. Findings discussed by telephone with Dr. Summers by Dr. Kayleen Jahangir at 11:15 on 5/9/2015. |
Generate impression based on findings. | 59-year-old male with altered mental status. Redemonstration of chronic infarcts in the right caudate, putamen, and globus pallidus as well as the posterior limb of the left internal capsule. Foci of hypoattenuation in the bilateral thalami are new from prior exam, and suggest age-indeterminate lacunar infarctions. Pro... | 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.Multiple regions of hypoattenuation, some of which are new when compared to prior exam, suggestive of worsen... |
Generate impression based on findings. | 79 year old female with breast cancer and headache. There is no evidence of intracranial hemorrhage. There is atherosclerotic calcification of the distal internal carotid arteries. There are a few scattered patchy foci of low attenuation within the supratentorial white matter. The ventricles and basal cisterns are norm... | 1.No evidence of intracranial hemorrhage. 2.A few scattered patchy foci of low attenuation within the supratentorial white matter most likely represent age-indeterminate small vessel ischemic disease, however, if there is concern for intracranial metastases, a contrast-enhanced MRI is recommended. |
Generate impression based on findings. | Reason: assess for causes of unresponsiveness History: totally unresponsive, not clearly protecting her airway No significant interval change. The ventricles and sulci are mildly prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There... | 1.No evidence of intracranial hemorrhage or mass effect. 2.Moderate age-indeterminate small vessel ischemic changes, without interval change. |
Generate impression based on findings. | Reason: altered mental status History: altered mental status Multiple subtle regions of hyperattenuation (at least 6), with subtle associated vasogenic edema, suggestive of masslike lesions in the right superior frontal gyrus, the right inferior parietal lobe, the right postcentral gyrus and the bilateral occipital lob... | Multiple subtle areas of hyperattenuation with associated edema, without significant generalized mass effect or midline shift, new from prior exam, concerning for multiple parenchymal mass lesions. Contrast enhanced MRI is recommended for further characterization.Findings discussed with emergency department by Dr. Coll... |
Generate impression based on findings. | Reason: acute mental status change with code sp OLT History: above Exam is limited secondary to portable technique. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air... | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. |
Generate impression based on findings. | Reason: eval for signs prior trauma, hx GSW to neck, now with chronic HAs History: HA There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull an... | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears ar... | 1.Homogeneously enhancing mass lesion situated in the crook of the right carotid bifurcation suggestive of a paraganglioma. 2.There is no evidence of flow-limiting stenosis or aneurysm in the head or neck.3.No intracranial hemorrhage or areas of abnormal attenuation in the head.4.Multiple thyroid cysts/nodules, which w... |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular st... | No evidence of acute ischemia. No findings to account for patient's symptoms. |
Generate impression based on findings. | Multiple (greater than 20), enhancing lesions are identified, with extensive surrounding T2 abnormality, compatible with vasogenic edema with resultant mild mass effect on the left lateral ventricle. The largest lesion on the right, in the posterior frontal lobe, measures 17 x 14 mm (series 11, image 25). The largest ... | Multiple new enhancing lesions in the bilateral cerebral hemispheres and cerebellum, compatible with metastatic disease. There is significant associated vasogenic edema and surrounding mass effect with resultant mild effacement of the left lateral ventricle. No evidence of midline shift or herniation. |
Generate impression based on findings. | Reason: CVA History: CVA 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. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to... | 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.Mild chronic small vessel ischemic changes, appearing similar to prior exam. |
Generate impression based on findings. | Hip dislocation reduction.VIEW: Pelvis AP (one view) 05/09/15, 1138 A cast obscures bone detail. The left femoral head remains well directed into the acetabulum. The right hip is normal in appearance. | Maintained reduction of the left femoral head. |
Generate impression based on findings. | Reason: AMS, h/o ETOH withdrawal, eval for bleed or stroke History: see above No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are within normal limits. No extra-axial c... | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. |
Generate impression based on findings. | Reason: 62M w/ PMHx schizophrenia who p/w altered mental status History: altered mental status/confusion 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 appear prominent, out of ... | 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.Extensive hypoattenuation in the periventricular and subcortical white matter consistent with age-indetermi... |
Generate impression based on findings. | 46 years Female with h/o HNC and CRT, compare to previous measurements Redemonstration of a centrally hypoattenuating, peripherally calcified nodule in the right thyroid lobe, measuring 12 x 8 mm (series 5, image 128), unchanged.There is no evidence of significant cervical lymphadenopathy. The referenced right level II... | 1.Stable right thyroid nodule, without evidence of locally progressive disease.2.Stable reference lymph nodes. |
Generate impression based on findings. | Female, 61 years old, with stroke. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The visu... | No acute intracranial abnormality. |
Generate impression based on findings. | 54 year old female with metastatic lung cancer. There is streak artifact related to an endovascular coil in the region of the right cavernous carotid artery. There is no evidence of acute intracranial hemorrhage. There are unchanged subtle foci of low attenuation within the left frontal and parietal lobes that likely c... | 1.No evidence of acute intracranial hemorrhage.2.Unchanged subtle foci of low attenuation within the left frontal and parietal lobes likely corresponds to vasogenic edema seen on prior MRI from metastases. Please note that CT is insensitive in the evaluation of intracranial metastases. |
Generate impression based on findings. | 58 year old female with thyroid cancer. HEAD: There is no evidence of intracranial mass. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable... | 1.Unchanged postoperative findings related to total thyroidectomy and right neck dissection with unchanged enlarged right level 4 and high right paratracheal lymph nodes.2.No evidence of intracranial metastases.3.Numerous pulmonary metastases that will be further characterized on the report from CT chest performed conc... |
Generate impression based on findings. | Male, 49 years old, with squamous of carcinoma of the head and neck status post chemotherapy and radiation. Treatment related findings are redemonstrated including infiltration of the fascial planes, right side more than left, subcutaneous reticulation, and evidence of neck dissection. The supraglottic larynx remains e... | Treatment related findings with no evidence to suggest disease recurrence. |
Generate impression based on findings. | The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is no significant bony spinal canal stenosis. The paravertebral soft tissues are unremarkable. | No evidence of thoracic spine fracture. |
Generate impression based on findings. | Male, 60 years old, right-sided vision loss, history of TIA. Again seen is a combination of patchy ill-defined periventricular hypoattenuation with superimposed more focal hypoattenuating lesions appearing similar in distribution and severity to the prior examination. Also unchanged are focal lucencies within the deep ... | 1.No significant interval change in the appearance of mixed age-indeterminate and chronic small vessel and cortical ischemia.2.No new intracranial lesions. |
Generate impression based on findings. | Female, 75 years old, with metastatic thyroid cancer. Findings are seen compatible with prior thyroidectomy. A previously hypermetabolic lesion located at the level of the thyroidectomy bed along the right tracheoesophageal groove is not significantly changed in size measuring approximately 21 x 14 mm (image 49 series ... | Findings compatible thyroidectomy are seen. Soft tissue thickening along the tracheoesophageal groove at the level of the thyroidectomy bed, which correlates to hypermetabolism on the prior PET scan, has not significantly changed in size. Scattered small cervical and axillary lymph nodes are also visualized, none of wh... |
Generate impression based on findings. | Female, 22 years old, with headaches. Assess for sinusitis. The paranasal sinuses are clear with only minimal mucosal thickening along the maxillary sinus floors. The major sinus ostia are patent. The nasal septum is intact. The nasal turbinates are morphologically unremarkable. The mastoid air cells and middle ear cav... | No evidence of active sinus inflammatory disease. |
Generate impression based on findings. | Reason: Evaluate left lower lobe mass. History: Questionable mass seen on chest x-ray from outside hospital. LUNGS AND PLEURA: Subsegmental atelectasis/scarring of the left upper lobe and and left lower lobe. Scattered, nonspecific pulmonary micronodules stable versus 2012 and likely benign. No pleural effusion.MEDIAST... | Subsegmental atelectasis and scarring without evidence of acute pulmonary process or suspicious mass.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female, 48 years old, with dental caries, assess for dental abscess. Extensive periapical lucency is seen surrounding the right second mandibular molar such that the buccal cortex of the mandible is completely eroded. No discrete fluid collection is identified. The remaining dental structures are otherwise intact. The ... | Severe periodontal disease affecting the right second mandibular molar, but no evidence of any associated soft tissue abscess is seen. |
Generate impression based on findings. | Female, 71 years old, with intracerebral hemorrhage. The left parietal approach ventriculostomy catheter is in stable position terminating just to the right of midline in the right frontal horn. The ventricles remain dilated but are stable relative to the prior exam.The quantity and distribution of intraventricular blo... | 1.Stable appearance of the evolving left thalamic hematoma and associated mass effect.2.Stable quantity and distribution of intraventricular blood product.3.Stable ventricular dilatation. |
Generate impression based on findings. | Reason: Assess for PE, pulmonary hypertension. History: Hypoxia, chest pain. PULMONARY ARTERIES: No filling defect to suggest pulmonary embolus. The pulmonary artery is normal in caliber. No evidence of right heart strain.LUNGS AND PLEURA: Moderate centrilobular emphysema. Right basilar atelectasis/scarring. Scattered ... | 1.No evidence of pulmonary embolus.2.Emphysema with scattered calcified and noncalcified micronodules. These are nonspecific and far more likely benign than malignant though in smokers follow-up CT study in 12 months is recommended to confirm stability.3. Diffuse mild to moderate bronchial wall thickening which is nons... |
Generate impression based on findings. | Reason: PE. History: Shortness of breath, chest pain, history of recent prolonged immobilization, 14 hour bus ride x2 in last for 2 days. PULMONARY ARTERIES: No filling defect to suggest acute pulmonary embolus. The main pulmonary artery is normal in caliber. No right heart strain. LUNGS AND PLEURA: Nonspecific right l... | 1.No evidence of acute pulmonary embolus.2.Nonspecific right lower lobe pulmonary nodule, though much more likely benign than malignant. Recommend follow-up CT in 12 months if the patient is low risk, follow-up in 6 months if a high risk patient to confirm stability.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not appl... |
Generate impression based on findings. | 20 year old female with left tonsillar swelling. There is enlargement of the palatine and adenoid tonsils with mild narrowing of the nasopharynx but without evidence of rim-enhancing fluid collection. There is bilateral cervical lymphadenopathy as well as enlargement of a left retropharyngeal lymph node.The thyroid and... | Tonsillar enlargement and cervical lymphadenopathy without evidence of peritonsillar abscess. |
Generate impression based on findings. | 90 year old female with head injury. There is no evidence of acute intracranial hemorrhage. There is global volume loss that has mildly progressed since the prior exam, and atherosclerotic calcification of the distal internal carotid arteries. Multiple patchy foci of low attenuation throughout supratentorial white matt... | 1.No evidence of acute intracranial hemorrhage or skull fracture.2.Moderate age-indeterminate small vessel ischemic disease, worsened global volume loss, and multiple chronic appearing infarcts, some which are new or evolved since the prior exam. |
Generate impression based on findings. | Reason: Evaluate for PE. History: Persistent tachycardia, lower extremity pain/swelling. PULMONARY ARTERIES: The exam is limited by poor bolus timing, however within these limitations, there is no filling defect to the lobar level. Main pulmonary is normal in caliber. No evidence of right heart strain.LUNGS AND PLEURA:... | Technically limited study. No acute pulmonary embolus to lobar level. If further evaluation is needed a V/Q scan would likely provide better characterization.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative. I personally reviewed ... |
Generate impression based on findings. | CT HEAD:There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. CTA HEAD: There is atheroscle... | 1.Moderate atherosclerotic stenosis of the cavernous ICAs.2.No significant or high-grade intracranial stenosis. |
Generate impression based on findings. | Sickle cell anemia. Chest pain and hypoxia.VIEWS: Chest PA/lateral (two views) 05/09/15 Left central line tip is in superior vena cava. Cholecystectomy clips are present.Bone changes from sickle cell disease are seen.Cardiac silhouette size is upper limits of normal. No pleural effusion is present. No focal airspace di... | No pneumonia or evidence of acute chest. |
Generate impression based on findings. | 8-day-old former 25 week gestational age patient on high-frequency oscillating ventilator. Desaturations.VIEW: Chest AP (one view) 05/10/15, 0613 Endotracheal tube tip is at thoracic inlet. Feeding tube tip is in stomach with side port at level of GE junction. Umbilical venous line has its tip at junction of inferior v... | Decreased focal opacities. Continued interstitial emphysema. |
Generate impression based on findings. | Male, 60 years old, history of T1 N2 B squamous cell carcinoma of the right palatine tonsil. No evidence of any residual or recurrent tongue base or tonsillar mass is seen. Mild supraglottic laryngeal edema persists likely related to therapy.A right level IIa reference lymph node measures 4 mm short axis (image 29 seri... | No evidence of recurrent primary tumor or pathologic adenopathy. |
Generate impression based on findings. | Right lower quadrant pain. Unable to see the appendix on sonogram from 05/08/15. Increased abdominal pain. Gorlin-Goltz syndrome. ABDOMEN:LUNG BASES: No focal opacity is present. No pleural effusion is identified.LIVER, BILIARY TRACT: Liver enhancement is normal. The liver is not enlarged. The gallbladder is distended.... | Multiple pelvic cysts. These exert mass effect on the urinary bladder and on the rectum. These may be related to Gorlin-Goltz syndrome. Further evaluation with MR may be helpful. |
Generate impression based on findings. | Status post liver transplant, please evaluate all vessels for patency VASCULAR:Main portal vein patent with normal directional flow, velocity ranges from 40 to 70 cm/s.Patent right and left portal veins with normal direction of flow, velocity measures 30 cm/s and 20 cm/s, respectively.Common hepatic artery peak systoli... | Patent hepatic vasculature. |
Generate impression based on findings. | 56 year old female with left upper extremity weakness. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues a... | No evidence of intracranial hemorrhage. Please note that CT is insensitive in the detection of acute ischemia and if there is clinical concern, an MRI is suggested. |
Generate impression based on findings. | 26 year old female with head trauma. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | 67 year old male with head trauma. There is no evidence of acute intracranial hemorrhage. There are unchanged areas of encephalomalacia within the bilateral cerebellar hemispheres, and the right parietal and temporal lobes most compatible with chronic infarcts. There is atherosclerotic calcification of the distal inter... | 1.No evidence of acute intracranial hemorrhage or skull fracture.2.Unchanged chronic cerebellar and right parietotemporal infarcts with resultant encephalomalacia. |
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