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Generate impression based on findings. | Male 4 years old Reason: reassess pleural effusions History: recurrent R sided chylothorax and pleural effusionsVIEWS: Chest AP/lateral (two views) 5/12/2015 at 09:30 Right chest port with tubing in the left posterior costophrenic sulcus, the tip projects off the inferior margin of the image. Left central line, tip in ... | Interval decrease in size of right pleural effusion. |
Generate impression based on findings. | Male 74 years old; Reason: Pancreas cancer please to previous imaging and provide index lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: Areas of pleural-based scarring in the right lateral pleural surface mid and lower lung on the right.Focal scarring left lingula, unchanged from several prior ... | 1.Pancreatic lesion measures slightly larger. Possible new lesion in dome of right lobe of the liver. |
Generate impression based on findings. | Female 12 years old Reason: pain History: Coxa veraVIEWS: Pelvis AP and frog-leg (2 views) 5/12/2015 at 09:43 The femoral heads are well directed into the acetabula. The left femur is medially rotated. Bilateral coxa valga is again seen with mild lateral uncovering of both femoral heads. Postop changes with sclerosis a... | Bilateral coxa valga. |
Generate impression based on findings. | 62 year old male Reason: Patient with h/o leukemia and apparent splenomegaly on exam. Want to evaluate flow across spleen and liver and splenomegaly History: LUQ pain . LIVER: Liver is upper limits of normal in size and measures 19.5 cm in length. The parenchyma is normal in echogenicity. PANCREAS: Partially visualized... | 1.Splenomegaly.2.Patent inflow and outflow hepatic and splenic vessels with normal directional flow. |
Generate impression based on findings. | Follicular lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Near-complete resolution of previously noted superior mediastinal mass lesion. Small residual peritracheal soft tissue best seen on image 30 of series 3 now measures 1.2 x 1.3 cm; this is in comparison to 5.1 x 7.1 cm on ... | Near-complete resolution of superior mediastinal mass lesion with resolution of retroperitoneal and pelvic adenopathy. Significant reduction in mesenteric adenopathy. No new adenopathy. |
Generate impression based on findings. | Female 7 months old Reason: EVAL HIP DYSPLASIAVIEWS: Pelvis AP and frog-leg (2 views) 5/12/2015 at 09:56 The femoral heads are symmetric in size and well seated in normal appearing acetabuli. There is no fracture. | Normal examination. |
Generate impression based on findings. | Ms. Riley is a 46-year-old female with screen-detected abnormalities in the right medial breast. Sonographic correlates were identified and the largest correlate was chosen as the target lesion. Right breast ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a lobulated hypoechoic mass ... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Ms. Ksiazek is a 57 year-old female with known left breast cancer (in the left lower inner breast). Recent MRI demonstrated non-mass enhancement in the left upper outer breast with suspicious kinetics. This will be the target for today's biopsy.. On subtraction images, there was reidentification of nonmass enhancement ... | Successful MR guided core needle biopsy of the non-mass enhancement in the left upper outer breast. Successful clip placement. Pathology is pending.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female 76 years old Reason: ovarian cancer with liver, spleen and mesenteric mets. Compare to previous exam with bidimensional measurements per recist 1.1 History: rising tumor marker and abdominal cramping concerning for progressive disease The absence of intravenous contrast limits evaluation of the solid organs and ... | Increase in size of reference lesions and possible new area of implant along the medial aspect of the dome of the liver.Other findings as above. |
Generate impression based on findings. | Metastatic colon carcinoma CHEST:LUNGS AND PLEURA: Small bilateral pleural effusionsMEDIASTINUM AND HILA: No significant abnormality notedCORONARY ARTERY CALCIFICATION: None. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Slight interval decrease in several of the previously noted numerous bi... | Slight interval decrease in several of the previously noted numerous bilobar hepatic metastatic lesions associated with slight interval decrease in size of other reference metastatic foci. However, peritoneal/omental nodularity while stable is now associated with interval increase in mild ascites. |
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. |
Generate impression based on findings. | Clinical question: Evaluate for ventricular size, ICH. Signs and symptoms: Headache. Nonenhanced head CT:Examination demonstrates shunted supratentorial ventricular system with slight interval decreased size of the supratentorial ventricles since prior exam and with maintained midline. A right frontal approach ventricu... | 1.Slight interval decreased size of shunted supratentorial ventricular system since prior exam.2.Stable right frontal approach ventricular catheter with the tip in the left lateral ventricle.3.No acute intracranial process. |
Generate impression based on findings. | Pain and swelling status post gunshot wound The previously seen intramedullary rod and screw device has been removed and replaced with a new rod device. The rod traverses a comminuted fracture of the distal tibial diaphysis, with fracture fragments in near-anatomic alignment. New density at the fracture slight site lik... | Orthopedic fixation of distal tibial fracture status post gunshot wound, with mild soft tissue swelling as above. |
Generate impression based on findings. | Knee pain.VIEW: Left knee lateral (one view) 05/12/15 No joint effusion is present. The patella is normally positioned. The patellar ligament is slightly thickened at the level of the tibial apophysis. No fracture or bone destruction is noted. | Slight thickening of the patellar ligament at the level of the tibial apophysis. |
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. |
Generate impression based on findings. | Male, 61 years old, history of spindle cell neoplasm of the glottis. Findings related to prior treatment and surgery are again seen including asymmetry of the false and true focal folds, asymmetry of the aryepiglottic folds, and generalized laryngeal mucosal edema. New from the prior examination is an area of apparentl... | 1.Redemonstration of treatment related findings and evidence of prior surgery at the level of the glottis.2.New from the prior examination is a small area of apparently polypoid tissue projecting from the right glottis. The differential would include adherent secretions, treatment related granulation, and recurrent tum... |
Generate impression based on findings. | 36-year-old female with right hip pain. There is no acute fracture or dislocation. Alignment is anatomic. Moderate degenerative changes are noted about the right hip, including joint space narrowing and subchondral sclerosis. Mild left hip osteoarthritis on the AP view. | Moderate right and mild left hip osteoarthritis without acute fracture. |
Generate impression based on findings. | 54-year-old male with history of head and neck carcinoma and chemoradiation therapy. Compared to previous measurements. CHEST:LUNGS AND PLEURA: No pleural fluid or pneumothorax. No new nodules or masses are identified.Nodule in the lingula has irregular margins and is inseparable from the mediastinal pleural surface, u... | 1. No significant change in size of pulmonary nodules since the prior study. No new pulmonary nodules or masses are identified.2. Hypoattenuating nodules in the pancreas are nonspecific and may represent interdigitating peripancreatic fat or IPMN's. Further characterization with a dedicated MRI/MRCP could be considered... |
Generate impression based on findings. | Please note that there are only 11 rib bearing vertebral bodies. However, to maintain consistency with prior imaging studies and the operative report, the vertebral body numbering scheme from prior exams will be propagated which assumes 12 thoracic and 5 lumbar vertebral levels.There is posterior spinal fusion from T1... | 1. Please note for the purposes of numbering there are 11 thoracic ribs and numbering is performed as per prior report. Postoperative findings related to posterior spinal fusion extending from T10 through L5 and decompressive laminectomies from L2 through L5 with interval removal of posterior segmental instrumentation ... |
Generate impression based on findings. | Female 45 years old; Reason: pelvic pain History: pelvic and rlq pain ABDOMEN:LUNGS BASES: 8 mm nodule right lung base series 4 image 4.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality no... | 1.No signs of appendicitis. Enlarged lobular uterus consistent with fibroids. Single focal calcification in the region is likely a phlebolith.2.8mm nodule right lung base. Follow-up per Fleischner criteria. |
Generate impression based on findings. | 52 years, Male. Reason: eval NGT History: eval NGT Interval placement of enteric tube with side-port and tip projecting over the mid and distal esophagus, respectively. Paucity of bowel gas without definite obstruction. Degenerative changes of the visualized spine are noted. Midline surgical staples, IVC filter, and 2 ... | Enteric tube with tip overlying the distal esophagus. Recommend advancing the enteric tube. |
Generate impression based on findings. | Pain with ambulation to anterior aspect of knee. Small osteophytes indicate mild osteoarthritis. There is also chondrocalcinosis of the menisci and articular cartilage of the knee, as well as streaky calcification within the gastrocnemius tendons. There is a small joint effusion. A 1 cm ossicle in the posterior soft ti... | Arthritic changes as described above. |
Generate impression based on findings. | Prostate carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCORONARY ARTERY CALCIFICATION: None. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter low-attenuation focus within the right hepatic dome best seen on i... | Negative for acute, inflammatory, or metastatic focus. |
Generate impression based on findings. | Male 50 years old; Reason: 50 yo male with hx of appendiceal cancer; pt s/p HIPEC; please evaluate for recurrence History: appendiceal cancer CHEST:LUNGS AND PLEURA: Fibrosis and atelectasis left lower lobe is unchanged from prior exam. No suspicious nodules. No effusions.MEDIASTINUM AND HILA: Small nonpathologic size ... | 1.Small changes in index lesions. No new sites of disease. |
Generate impression based on findings. | Right trapezial mass. Fluctuates clinically and is painful. I see no abnormality to account for the painful trapezial mass. The musculature of the right shoulder and upper back is unremarkable. The scapula and remaining bones of the shoulder are unremarkable. There is mild depression of the anterior aspect of the super... | No mass is evident. If further imaging evaluation is clinically warranted, ultrasonography may be considered. |
Generate impression based on findings. | Clinical question: Status post skull lesion biopsy. Signs and symptoms headache. Nonenhanced head CT:Examination demonstrates no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system,... | 1.No acute intracranial process.2.Expected postoperative changes of right frontal calvarial surgery and unremarkable calvarium otherwise.3.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities are well pneumatized. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are pre... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Metastatic colon carcinoma CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: Stable reference subcarinal lymph node best seen on image 42 of series 3 measuring 1.1 x 1.2 cm.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable peripheral se... | Slight interval increase in size of reference pericecal lymph node. Other reference lesions stable. |
Generate impression based on findings. | 67 years Male Reason: Response to Chemotherapy Treatment. Compare to Last - 3/21/14 Scan \T\ 10/10/2014 Scan. History: Pancreas Cancer LUNG BASES: No suspicious pulmonary nodules. Calcified left basilar granuloma. No focal consolidation or pleural effusion. Small hiatal hernia.LIVER, BILIARY TRACT: Multiple right hepat... | 1.Postsurgical findings related to Whipple are redemonstrated.2.Increased soft tissue thickening in the resection bed is concerning for tumor recurrence/progression |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts and repeat right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses.Benign morphology oval mass in the... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then these can be used as ... |
Generate impression based on findings. | Reason: h/o nasopharyngeal ca and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No evidence of metastases and no change.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.The heart and pericardium appear normal.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: Mild ... | 1. No evidence of metastases.2. Cholelithiasis. |
Generate impression based on findings. | 61-year-old male with laryngeal cancer. Restaging examination. CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema with an upper lobe predominance. Right apical and lingular scarring/atelectasis. Again seen is left basilar scarring and coarse left lower lobe pleural calcification likely related to the patient's histor... | 1. No evidence to suggest metastatic disease.2. Interval resolution of the previously described groundglass opacities. Subtle centrilobular nodules and tree-in-bud opacities in the left lower lobe are suggestive of chronic aspiration, given the debris within the trachea.3. Persistent intra and extrahepatic biliary duct... |
Generate impression based on findings. | Male 15 months old Reason: out-toeing History: out-toeingVIEWS: Pelvis AP (1 views) 5/12/2015 at 10:05 The left femoral epiphysis is slightly smaller than the right. The amount of ossification in both femoral epiphyses is disproportionate to the patient's age reflecting delayed ossification. No fracture is identified. | Marked delay in ossification of bilateral femoral epiphyses. |
Generate impression based on findings. | 45-year-old male with lower back pain status post motor vehicle collision. 5 views of the lumbar spine demonstrate no acute fracture or malalignment. However, it should be noted that the coccyx is not entirely included on this L-spine exam. Vertebral body heights are preserved. Mild DJD affects the L5/S1 disc space. Sm... | No fracture or other acute abnormality to account for the patient's pain. |
Generate impression based on findings. | Female 8 years old Reason: abdominal pain LIVER:The liver is normal in contour and echogenicity. It measures 12.5 cm in length. No focal hepatic masse is identified. The main portal vein demonstrates normal direction of flow with a velocity of 0.2 m/s. There is no ascites.GALLBLADDER, BILIARY TRACT: The gallbladder is ... | Normal examination. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema.Previous aspiration like opacities have resolved.No sign of metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.Prior port catheter removed.The heart and pericardium ap... | No sign of metastases, or other significant abnormality. |
Generate impression based on findings. | Female 57 years old Reason: Stem cell transplant admission found to have elevated LFT's on admission History: none LIVER: Liver measures 15.9 cm in length. The parenchyma is increased in heterogeneity with a coarsened echotexture which may reflect chronic liver disease or fatty liver infiltration. BILIARY TRACT: The ga... | 1.Cholelithiasis without evidence of cholecystitis.2.Increased heterogeneity of the liver with a coarsened echotexture may reflect chronic liver disease or fatty liver infiltration.3.Patent hepatic and splenic inflow and outflow vessels with normal flow. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are screening mammograms dated 4/25/2015 and right breast ultrasound dated 5/4/2015 performed at Community Healthcare System in Munster, IN. For comparison,OSH 4/28/2015 right breast ultrasound and prior mammograms (2/27/2014, 1/29/2013, 1/26/2013) are ... | 8 mm mass at the 5 o'clock position of the right breast biopsied to be invasive ductal carcinoma. A clip was placed per report; however, no post-procedure mammogram was submitted for confirmation.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: evaluate ILD History: sob cough fibrosis LUNGS AND PLEURA: Reticular opacities, right greater than left, predominantly lower lobes. No significant honeycombing. No pleural effusions or pneumothorax. No significant air trapping. Mild dependent atelectasis.MEDIASTINUM AND HILA: Cardiac size is normal. No evidence... | Possible UIP or NSIP pattern. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: ? Mass History: mass on CXR LUNGS AND PLEURA: Mild centrilobular emphysema.Mild nonspecific groundglass opacities with interlobular septal thickening, small pleural effusions and basilar compression atelectasis are suggestive of edema.MEDIASTINUM AND HILA: 3 x 3 cm rim calcified soft tissue lesion in the high l... | 1. Interstitial opacities with pleural effusions and basilar atelectasis suggestive of edema secondary to CHF.2. Upper mediastinal calcified soft tissue nodule could be due to etiologies include a calcified thyroid cyst, a foregut duplication cyst, or could be vascular. This was discussed with the consulting pulmonary ... |
Generate impression based on findings. | Female, 68 years old, with history of myelodysplastic syndrome. Mild mucosal thickening and chronic osseous change is seen in the frontal sinuses. Elsewhere, the paranasal sinuses are clear. The major sinus ostia are patent and unobstructed. The nasal septum is intact demonstrating a mild S-shaped curvature. The turbin... | No evidence of significant sinus mucosal inflammatory disease. |
Generate impression based on findings. | History of left lumpectomy in 2004 for IDC and DCIS. Patient received radiation and chemotherapy. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern a... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 12 year old female with hypoxia, evaluate for pneumonia.VIEW: Chest AP (one view) 5/12/2015 at 10:30 Vagal nerve stimulator device in the left chest with leads extending into the left neck. Left thoracolumbar curve is again seen. The cardiomediastinal silhouette is normal. There are bilateral perihilar opacities and op... | Perihilar and left basilar atelectasis. No pneumonia. |
Generate impression based on findings. | Reason: Metastatic thyroid follicullar surveillance. History: none CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary metastases unchanged in size or number.Reference right middle lobe lesion (image 56 series 5) is unchanged measuring 18 mm.Reference left lower lobe lesion (image 68 series 5) measuring 14 mm unchange... | Numerous pulmonary metastatic nodules unchanged in size or number since the prior exam. No new sites of disease identified. |
Generate impression based on findings. | Rule out acute abnormality, fracture. Pain. I see no fracture, malalignment, or other acute abnormality to account for the patient's pain. The shoulder is within normal limits. | Normal-appearing shoulder without fracture or other acute abnormality to account for the patient's pain. |
Generate impression based on findings. | Clinical question: Hemorrhage. Signs and symptoms: AMS. Nonenhanced head CT:Examination demonstrates a new focus of ill-defined low attenuation of cortex and subcortical white matter of the medial aspect of the right posterior temporal and extending into the right occipital lobe. Findings results in subtle regional mas... | 1.Large focus of low attenuation involving the medial aspect of right posterior temporal lobe and with extension into the right occipital lobe corresponding to region of Falir/T2 hyperintensity on prior MRI exam. 2.No evidence of intracranial bleed or midline shift.3.New since prior exam is extensive opacification of b... |
Generate impression based on findings. | 50-year-old male with lower back pain. Limited study with single AP view of the lumbar spine demonstrates no acute fracture or gross malalignment. There is facet joint osteoarthritis at L4/L5 but the ability to analyze the intervertebral disks is limited. Mild degenerative disk disease is suspected at L5/S1. | Limited study demonstrates degenerative changes of the lower lumbar spine as described above. |
Generate impression based on findings. | Multiple myeloma, without mention of having achieved remission(203.00) Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment. There is mild loss of vertebral body height at L3, L2 and L1. There is mild loss of vertebral body height present at T12, T9 and T8 due to super... | 1.Status post anterior and posterior fusion in the lower thoracic spine as detailed above. There is no evidence for loosening of screws based on this exam.2.There are multilevel mild compression fractures present in the upper lumbar spine and visualized lower thoracic spine as described above.3.Multiple lytic lesions a... |
Generate impression based on findings. | Female, 43 years old. Reason: hx of dysphagia, Schatzki's ring, radiation in the past to chest/ abdomen/pelvis History: swallowing difficulty with solids and liquids Scout images obtained and showed surgical clips overlying the left axilla and the expected location of the thyroid. No focal pulmonary opacity was noted.D... | 1.Mild esophageal dysmotility disorder.2.Schatzki's Ring with patent esophageal lumen at that level as above. 3.Small hiatal hernia. |
Generate impression based on findings. | 7 year old male with knee painVIEWS: Left knee AP standing and lateral (2 views) 5/12/2015 at 10:22Right knee AP standing and lateral (2 views) 5/12/2015 at 10:22 No acture fracture or malalignment. There is a well circumscribed lucency in the medial aspect of the left proximal tibial metaphysis. | No fracture. Well circumscribed lucency in the left proximal tibia compatible with non-ossifying fibroma. |
Generate impression based on findings. | Reason: work-up for heart transplant History: biV heart failure, tetralogy of fallot LUNGS AND PLEURA: No significant abnormality noted. No pleural effusions or pneumothorax. No suspicious nodules or masses. MEDIASTINUM AND HILA: Marked cardiomegaly. Pulmonary valve prosthesis. Left predominant central pulmonary artery... | Marked cardiomegaly. Pulmonary valve prosthesis. Left predominant central pulmonary artery enlargement. |
Generate impression based on findings. | There is a focus of diffusion restriction in the left posterior pons, compatible with an acute lacunar infarct. There are numerous foci of T2/FLAIR signal hyperintensity in the periventricular white matter, brainstem, and thalami. Additionally, there are numerous punctate foci of susceptibility in the bilateral basal ... | 1.Small acute lacunar infarct in the left posterior pons.2.Multiple microhemorrhages predominantly distributed in the thalami, brainstem, basal ganglia and to a much lesser degree cerebellum, and subcortical white matter are likely hypertensive in origin based on this pattern.3.Periventricular and subcortical white mat... |
Generate impression based on findings. | 62-year-old female with left hand pain status post fall. 3 views of the left hand show no acute fracture or dislocation. Mild degenerative arthritic changes affect the hand/wrist. | Mild degenerative arthritic changes without fracture. |
Generate impression based on findings. | Ms. Jackson is a 47 year old female with a personal history of right breast lumpectomy in September 2014 for IDC followed by chemotherapy, radiation, and hormonal therapy. Personal history of synchronous node positive cervical cancer. Family history of breast cancer in maternal aunt. Three standard views of both breast... | Expected postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diag... |
Generate impression based on findings. | 25-year-old female with lower back tenderness status post fall in mid April. 5 views of the lumbar spine demonstrate no acute fracture or malalignment. Vertebral body heights and disc spaces are within normal limits. No significant degenerative changes are identified. | No fracture or other specific findings to account for the patient's point tenderness. |
Generate impression based on findings. | Reason: Intrahepatic cholangiocarcinoma please assess and provide index lesion History: As above LUNGS AND PLEURA: Interval clearing of the right basilar atelectasis and small pleural effusion.No suspicious pulmonary nodules or masses can be identified.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal ... | No evidence of metastatic disease within the chest. See current CT abdomen/pelvis for evaluation of hepatic lesion. |
Generate impression based on findings. | 62-year-old female with right hip pain. 2 views of the right hip show no acute fracture or dislocation. The right hip joint appears normal for age. | Normal hip radiographs without specific findings to account for the patient's pain. |
Generate impression based on findings. | 36-year-old female with lower back pain. 3 views of the lumbar spine demonstrate mild degenerative disease at L1/L2 and also possibly involving the L5/S1 disc space. Possible mild posterior disc bulge is noted at L4/L5. The lumbar spine is slightly hyperlordotic. No acute fracture or malalignment is identified. The ver... | Mild degenerative changes as described above. |
Generate impression based on findings. | Male, 61 years old, with pT3 N0 left salivary duct carcinoma. Redemonstrated are postoperative findings related to left parotidectomy. Ill-defined soft tissue thickening and stranding within the operative bed is unchanged. No masslike lesions or concerning pathologic enhancement is detected.A mildly hyperattenuating le... | 1.Redemonstration of surgical findings related to left parotidectomy with no evidence of local tumor recurrence or pathologic adenopathy.2.Increased conspicuity of a right parotid lesion is likely due to differences in technique and does not imply increasing size. This lesion is nonspecific. |
Generate impression based on findings. | 62 year old female with a history of lumpectomy in November of 2011 followed by radiation and chemotherapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchange... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | PainVIEWS: Right hand AP, right fifth digit oblique and lateral There is a nondisplaced fracture involving the proximal phalanx of the fifth digit. There is associated soft tissue swelling at the fracture site. | Nondisplaced fracture of the head of the proximal phalanx of the fifth digit. |
Generate impression based on findings. | Male, 65 years old. Reason: s/p OGT placement Nonobstructive bowel gas pattern.Partially visualized central line, tip at the cavoatrial junction. No orogastric tube is seen on this exam. | Enteric tube not visualized. |
Generate impression based on findings. | Pancreatic cancer, evaluate for response to chemotherapy LUNGS AND PLEURA: No pleural effusions or pneumothorax. No suspicious nodules or masses.MEDIASTINUM AND HILA: Cardiac size is normal. No pericardial effusion. Subcentimeter mediastinal lymph nodes without significant change from prior study.CORONARY ARTERY CALCIF... | 1.No evidence of thoracic metastasis.2.Elliptical fluid collection in the lesser sac anterior to the pancreatic head appears increased compared to prior. Please refer to same day abdominal CT report for more details. |
Generate impression based on findings. | There is interval distraction osteotomy of the mandible with bilateral internal distractors noted. There is slight interval improvement in the mandibular hypoplasia. The partially imaged intracranial structures are within normal limits. There is mild prominence of the ventricles with prominence of the subarachnoid spa... | 1.Interval distraction osteotomy of the mandible with slight interval improvement in mandibular hypoplasia.2.Mild prominence of the ventricles with prominence of the subarachnoid space along the bilateral frontal convexities, likely representing benign enlargement of the subarachnoid spaces of infancy, which should res... |
Generate impression based on findings. | Increased work of breathingVIEW: Chest AP Cardiothymic silhouette normal. Marked scoliosis of the thoracic spine. Patchy atelectasis in the left lower lobe. No pleural effusion or pneumothorax. | Patchy atelectasis left lower lobe not significantly changed. |
Generate impression based on findings. | 38-year-old female with chronic back pain. 5 views of the lumbar spine show no acute fracture or malalignment. The vertebral body heights and disc spaces are within normal limits. | Normal lumbar spine radiographs without specific findings to account for the patient's pain. |
Generate impression based on findings. | 73-year-old male with history of kidney stones. RIGHT KIDNEY: Right kidney measures 11.5 cm in length. No renal stone, mass, or hydronephrosis is present.LEFT KIDNEY: Left kidney measures 12.0 cm in length. There is a 0.6 cm nonobstructing stone in the inferior left renal pole. No hydronephrosis is evident. No renal ma... | Nonobstructing 0.6 cm left inferior pole renal stone. |
Generate impression based on findings. | 66 year-old female with bilateral knee pain. 4 views of the right knee demonstrate prominent enthesophytes along the patella, particularly at its superior aspect. Mild osteoarthritis appears similar to the prior study.4 views of the left knee also demonstrate prominent enthesophytes along the patella, again most pronou... | Bilateral osteoarthritis as described above. |
Generate impression based on findings. | 65-year-old female with chronic back pain. 5 views of the lumbar spine demonstrate mild diffuse demineralization. Mild to moderate facet joint osteoarthritis affects the lower lumbar spine. There is grade 1 anterolisthesis of L4 on L5 as well as mild DJD involving the L4/L5 disc space. No acute fracture or malalignment... | Degenerative arthritic changes of the lower lumbar spine as described above. |
Generate impression based on findings. | 72-year-old female with pain and swelling in the feet. 4 views of the right foot demonstrate mild soft tissue swelling along the anterior aspect of the ankle. There is a bipartite accessory navicular bone but the foot otherwise appears normal for age. A small plantar calcaneal spur is noted.4 views of the left foot als... | Mild soft tissue swelling and degenerative arthritic changes as described above. |
Generate impression based on findings. | 65 years Female Reason: CARCINOID TUMOR SMALL BOWEL EVALUATE FOR INTERVAL CHANGE History: COLON CANCER CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules. Stable micronodule along the right minor fissure likely represents an intrapulmonary lymph node. No focal consolidation or pleural effusion. Left upper lobe gro... | 1.Prominent mesenteric nodes in the region of the small bowel anastomosis are not significantly changed, with reference measurements as above.2.Left upper lobe groundglass opacity is not significantly changed; indolent primary lung malignancy, such as minimally invasive adenocarcinoma, is not excluded; continued follow... |
Generate impression based on findings. | Reason: 81 y/o male with head/neck CA; please eval for metastasis History: see above CHEST:LUNGS AND PLEURA: Apical radiation fibrosis and mild emphysema are stable.Unchanged basilar opacities are suggestive of atelectasis or scarring.Groundglass nodular opacity remains 10 mm image 65 series 6 right lower lobe, which s... | 1. Incidentally noted pulmonary embolus left lower lobe segmental branch. This was discussed with Samantha Holsti of the referring service at the time of dictation 5/12/2015 at 11:18 AM.2. No evidence of metastases. 3. Right lower lobe groundglass nodule, which should be followed in 6-12 months as a potential lung canc... |
Generate impression based on findings. | 62-year-old male with history of multiple myeloma. SKULL: AP and lateral views of the skull show innumerable small round lucent lesions, compatible with multiple myeloma and appearing similar to the prior study.CERVICAL SPINE: AP and lateral views of the cervical spine demonstrate diffuse bony demineralization which li... | Findings compatible with multiple myeloma that appear similar to the prior study, except for progression of thoracic and lumbar spine compression fractures as described above. |
Generate impression based on findings. | Reason: lung nodule on CXR, weight loss, anorexia History: lung nodule on CXR, weight loss, anorexia LUNGS AND PLEURA: Pulmonary infarct of posterior right middle lobe corresponding to the distribution of the pulmonary embolus. Small right pleural effusion with associated atelectasis. 5 mm right middle lobe nodule (ser... | 1.Large right interlobar and smaller left lower lobe pulmonary embolus. There is associated subpleural infarct in the right middle lobe which cause the apparent nodule described on the previous chest radiograph, with a small pleural effusion.2.Nonspecific hepatic hypodensities and porcelain gallbladder as above.Finding... |
Generate impression based on findings. | Female, 58 years old, history of nasopharyngeal carcinoma status post CRT. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. Patchy white matter hypoattenuation is nonspecific but may reflect age indeterminate microvascular ischemic disease. Fluid levels... | 1. No evidence of recurrent primary tumor or pathologic adenopathy in the neck.2. A 9 mm groundglass nodule in the right lung apex appears to be new. This is nonspecific but will require imaging follow-up to exclude a neoplastic process.3. Stable permeative and lytic changes of the left central skull base. No new osseo... |
Generate impression based on findings. | Ms. Cremins is a 66 year old female with a personal history of left breast mastectomy in 2010 for invasive mammary carcinoma with mixed ductal and lobular features treated with radiation, chemotherapy, and Arimidex. She has no current breast related complaints. Three standard views of the right breast were performed di... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: h/o tongue ca/CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Apical scarring unchanged.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Apart from mild aortic root calcification, the heart and pericardium appe... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | known unruptured right distal ICA aneurysm follow up 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate 4.6mm x 3mm sized right distal ICA, at the junction of the right ACA A1 segment aneurysm.Comparing to prior study, there is no s... | No change of right distal ICA right ACA A1 segment junctional aneurysm since prior exam.Non visualization of the right MCA aneurysm on this scan.No other aneurysm was seen. |
Generate impression based on findings. | Reason: assess interstitial infiltrates History: sob, hypoxi LUNGS AND PLEURA: Severe mainly upper zone centrilobular emphysema.Patchy bilateral airspace and interstitial opacities throughout both lungs, more severe at the lung bases. Nodular and masslike components at the lung bases are most likely due to confluent co... | Extensive bilateral airspace and interstitial pulmonary opacity, greatest at the lung bases, with nodular and masslike areas of consolidation superimposed on emphysema, most likely secondary to recurrent aspiration and infection. There is no specific evidence of recurrent tumor in the chest, though further follow-up is... |
Generate impression based on findings. | Six-month follow-up for high probability benign right breast fibroadenoma and simple cyst. Mammogram: Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. S... | Stable benign fibroadenoma and a new septated cyst in the right breast.No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RE... |
Generate impression based on findings. | Reason: 82-year-old male with history of HCC. Evaluate and compare to prior History: see above. CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant centrilobular and paraseptal emphysema. Diffuse bronchial wall thickening. Right middle lobe subsegmental atelectasis, unchanged. Scattered pulmonary micronodules/nodul... | 1.New 0.9 cm arterial enhancing lesion with washout in the right lobe of the liver. Other hepatic lesions are stable.2.Fluid collection along the left hepatectomy margin has slightly increased in size. |
Generate impression based on findings. | 52 years, Male. Reason: NGT placement History: NGT after advancement \R\6cm The enteric tube has been advanced with tip in the distribution of the gastric fundus and side port overlying the distal esophagus above the GE junction. Paucity of bowel gas without definite obstruction. Degenerative changes of the visualized ... | Enteric tube with side port overlying the distal esophagus above the gastroesophageal junction. . Recommend advancing the enteric tube. |
Generate impression based on findings. | Female, 56 years old, history of pT2 N2c Mx squamous cell carcinoma of the tongue. Again seen are posttreatment and surgical findings including evidence of bilateral neck dissection, partial glossectomy with flap repair, and diffuse infiltration of the fascial planes. Within this posttreatment background, and accountin... | Redemonstration of posttreatment and surgical findings with no evidence of primary tumor recurrence or pathologic adenopathy.Stable mixed lucent and sclerotic appearance of the mandible which may reflect radiation related effects. |
Generate impression based on findings. | Reason: airway obstruction? had bronchus cut-off sign on CXR History: c/f bronchial obstruction LUNGS AND PLEURA: Innumerable pulmonary nodules, appear to have slightly increased in size and number since the prior exam.However, reference right upper lobe lesion (image 25 series 4) is stable at 9 mm.Left pleural effusio... | 1.Numerable pulmonary metastases appear to increased in size and number since the prior exam.2.New right pleural effusion and persistent large loculated left pleural effusion most likely malignant in origin.3.Obstruction of the left lower lobe bronchus and redemonstration of left lower lobe collapse.4.Osteolytic lesion... |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The right lateral ventricle is slightly larger than the left, likely a normal variant. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. There is mild muc... | No acute intracranial abnormality. |
Generate impression based on findings. | Clinical question: Assess interval change in the status of hydrocephalus. Signs and symptoms: Concern for shunt malfunction. Nonenhanced head CT:There is evidence of interval increased size of supratentorial and infratentorial ventricular system since prior exam. There is however also complete resolution of previously ... | 1.Interval complete resolution of (L>R) hemispheric CSF density subdurals since prior exam.2.Interval increased supratentorial and infratentorial ventricular size since prior study however with a stable right frontal approach ventricular catheter.3.No acute intracranial hemorrhage, mass effect or midline shift.4.New si... |
Generate impression based on findings. | There are multiple stable non-enhancing periventricular and subcortical white matter lesions, accounting for differences in technique. Many of these are oriented perpendicular to the long axis of the lateral ventricles, consistent with known demyelinating disease. Stable lesions are also seen along the callosal septal... | Continued stable appearance of supratentorial demyelinating lesions, with overall mild T1 and mild-moderate T2 burden of disease. |
Generate impression based on findings. | 67-year-old male with right lateral ankle pain, rule out fracture. 3 nonweightbearing views of the right ankle reveal soft tissue swelling about the ankle with no fracture or dislocation. Hyperostosis at the syndesmosis is noted which is of no clinical significance. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | Evaluate shuntVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 5/12/2015 Ventriculostomy tube tip is adjacent to the midline in the middle cranial fossa. The distal tubing courses along the right neck with the tip terminating at the right upper quadrant. Th... | No kinking or discontinuity in the radiopaque portions of the shunt catheter. |
Generate impression based on findings. | Evaluation is limited due to lack of contrast. As noted on the CT chest, there is a peripherally calcified 3.3 x 3.4 cm upper mediastinal soft tissue density structure to the left of the trachea, just below the level of the cricoid cartilage. There is associated deformity as well as rightward deviation of the mildly t... | 1. Redemonstration of previously seen superior mediastinal peripherally calcified oval soft tissue density structure with questioned contiguity with additional tapering soft tissue density located just inferiorly without calcification, in close proximity to the proximal brachiocephalic artery, which raises concern for ... |
Generate impression based on findings. | Reason: Hx lung nodule History: Shortness of breath LUNGS AND PLEURA: Left lingular subpleural nodule (image 70 series 5) measures 11 mm x 9 mm. Using corresponding measurements from the prior exam dated 3/14/2012 this measured 11 mm x 8 mm.No other pulmonary nodules or masses can be identified.Moderate upper lobe pred... | 1.Left lingular subpleural nodule without significant interval change over the 3 years.2.Moderate upper lobe predominant centrilobular emphysema. |
Generate impression based on findings. | PainVIEWS: Right foot AP, oblique and lateral No acute fracture or dislocation. The alignment is normal. | Normal examination. |
Generate impression based on findings. | PainVIEWS: Left foot AP, oblique and lateral No acute fracture or dislocation. The alignment is normal. | Normal examination. |
Generate impression based on findings. | FractureVIEWS: Right elbow AP and lateral Again noted healing fracture involving the distal humerus with periosteal reaction. The alignment is near anatomic. The overlying cast obscures fine bony detail. | Healing fracture of the distal humerus as described above. |
Generate impression based on findings. | Staging newly diagnosed left breast cancer.RADIOPHARMACEUTICAL: 15.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 87 mg/dL. Today's CT portion grossly demonstrates an approximately 2 cm soft tissue density nodule in the left breast. There is a small to medium-sized left pleural effusion. An approximately ... | 1.Small hypermetabolic left breast nodule, compatible with the history of breast cancer.2.Medium-sized hypermetabolic lung mass in the left lower lobe, compatible with additional tumor. Given the additional left lung and mediastinal findings (see below), a synchronous primary lung cancer is considered more likely altho... |
Generate impression based on findings. | FractureVIEWS: Right foot AP and lateral There is a healing fracture involving the neck of the fifth metatarsal. There is periosteal reaction and sclerosis reflecting interval healing. The alignment is not significantly changed from prior study. The overlying splint has been removed in the interval. | Healing fracture neck of the fifth metatarsal as described above. |
Generate impression based on findings. | Female 62 years old; Reason: r/o acute intra-abdominal process History: RLQ pain, RUQ pain ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis. No basilar pleural effusions.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Spleen is normal in size with a few scattered calcified granulomata.PANCREAS: No signi... | 1.No bowel obstruction.2.Appendix is normal.3.Etiology for the patient's right upper quadrant and right lower quadrant pain is not evident by CT.4.Suboptimal evaluation of the uterus and adnexa, if pain persists in the pelvis consider ultrasound.5.Indeterminate right adrenal lesion, further characterization with a dedi... |
Generate impression based on findings. | Male 44 years old; Reason: renal cell carcinoma History: renal cell carcinoma CHEST:LUNGS AND PLEURA: There are multiple small bilobar pulmonary nodules which are new. A new reference right upper lobe pulmonary lesion measures 4 mm on image 34/series 5.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion... | 1.Decrease in the size of the right renal mass and right body wall mass.2.Developing subcentimeter pulmonary nodules. These are suspicious for early pulmonary metastatic disease. |
Generate impression based on findings. | Polyp of nasal cavity. Assess extent of nasal polyposis The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. There is concha bullosa present on the left-sided and mild nasal septal deviation towards the right. There is a small polypoid lesion present at t... | 1.There is a left-sided nasal polypoid lesion at the left middle turbinate. 2.No evidence for paranasal sinus outlet obstruction. There is concha bullosa and nasal septal deviation to the right.3.Dental periapical lucencies along the maxillary dentition. This is a nonspecific finding but can be seen with periapical abs... |
Generate impression based on findings. | Female 55 years old; Reason: 55 y/o female Metastatic neuroendocrine carcinoma on treatment. pls compare to prior History: see above CHEST:LUNGS AND PLEURA: No dominant lung lesions of developed. The pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality n... | 1.Near stable size measurements of the metastatic deposits in the liver. |
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