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Generate impression based on findings. | Male, 59 years old, with history of esophageal cancer status post failed gastric pull-up, status post jejunal interposition. Extensive postoperative findings are again seen compatible with esophagectomy and jejunal interposition, as well as evidence of median sternotomy and resection of the head of the left clavicle.Th... | Postoperative findings are demonstrated compatible with esophagectomy and jejunal interposition. The course of the jejunal graft as it passes from its anastomosis point at the pharynx/esophagus junction to the anterior mediastinum is unchanged.Pockets of intraluminal contrast are seen at several points along the course... |
Generate impression based on findings. | Female 70 years old; Reason: history of resected renal cancer, on surveillance History: history of resected renal cancer, on surveillance CHEST:LUNGS AND PLEURA: Biapical scarring. Groundglass soft tissue in the right upper lobe (image 20/series 4) as slowly increased in size and texture since 2008.MEDIASTINUM AND HILA... | 1.No significant change from prior study.2.Slight increase in the density of the right upper lobe lung lesion. Annual follow up is suggested. |
Generate impression based on findings. | 40 years Female Reason: Please rule out upper urinary tract lesions and calculi History: microhematuria LUNG BASES: No suspicious pulmonary nodules. No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: There are 2 hypoattenuating hepatic lesions measuring greater than water density and fill-in on delayed ph... | No focal renal or ureteral lesion or other findings to account for hematuria. (Please note that no delayed phase images of the distal ureters or bladder were obtained, and lesion in these locations cannot be excluded.) |
Generate impression based on findings. | Reason: h/o tongue cancer History: eval for lung mets LUNGS AND PLEURA: No change in numerous micronodules and small nodules, many of which are calcified and all likely benign.Middle lobe and lingular bronchiectasis with volume loss is stable consistent with atypical mycobacterial infection.No specific evidence of meta... | 1. No sign of metastases.2. Stable postinflammatory micronodules and evidence of mycobacterial infection. |
Generate impression based on findings. | Clinical question: Evaluate for ischemia. Signs and symptoms: Left-sided weakness and blurry vision. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are extensive periventricular and subcortical as well a... | 1.No acute intracranial process.2.Findings of extensive age-indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | 44-year-old female with pain after stepping on tack. 3 views of the right foot demonstrate no foreign body. There is no acute fracture or dislocation. Alignment is anatomic. | No fracture, foreign body, or other specific findings to account for the patient's pain. |
Generate impression based on findings. | Clinical question: Rule out ICH, stroke. Signs and symptoms: Status post heart transplant, AMS. Nonenhanced head CT:There is no evidence of acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cystogram cortex, cortical sulci, ventricular system... | No acute intracranial process. Please see above comments. |
Generate impression based on findings. | Syncope and collapse Examination is mildly compromised due to patient motion.The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.No abnormal mass lesions are appreciated intracranially. No intracra... | 1.No evidence for acute intracranial hemorrhage, mass effect or edema. CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Exam is mildly compro... |
Generate impression based on findings. | Unspecified sinusitis . Nasal congestion and discharge The patient is status post multiple craniotomies. Patient is also status post paranasal sinus surgery.The nasal septum is a perforated.The walls of the maxillary sinuses are thickened. There is associated mucosal thickening along the maxillary sinuses. The outlet f... | 1.The patient's orbits and paranasal sinuses and nasal cavity are deformed. The ostiomeatal complex units aren't deformed. The maxillary sinuses appear to be patent into the nasal cavity to medial along their walls as indicated above. There is mucosal thickening within the maxillary sinuses with suggestion of chronic s... |
Generate impression based on findings. | 59 -year-old male with a known esophageal leak and fluid collections. CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions, left greater than right, appearing symmetric and the prior study. There is bibasilar and lingular scarring/atelectasis. There is mild interlobular septal thickening. Note is made of centrilob... | 1. No significant interval change in size as a reference anterior mediastinal fluid collection adjacent to the jejunal interposition, suspicious for abscess formation. There is extravasation of administered oral contrast adjacent to this collection consistent with the stated history of neoesophageal leak.2. Persistent ... |
Generate impression based on findings. | Hyperthyroidism The thyroid images demonstrate asymmetrically increased activity in the right lobe relative to the left lobe of the thyroid gland. Though asymmetric, the activity is homogeneous where present, without distinct nodules noted. The 4-hour radioactive iodine uptake is 6% and the 24-hour uptake is 14.5%, wit... | Mildly asymmetric distribution of activity in the thyroid gland, with normal radioactive tracer uptake levels. This is non-specific for a definite etiology and may be secondary to technical factors, related to asymmetric anatomy, or possibly due to a metabolically active right-sided nodule. Correlation with thyroid ult... |
Generate impression based on findings. | 81 year old female with hepatitis C cirrhosis. HCC screening. LUNG BASES: No suspicious pulmonary nodules. No focal consolidation or pleural effusion. Cystic changes in the lung bases may represent centrilobular emphysema; the absence of smoking history other causes of cystic lung disease can be considered.LIVER, BILIA... | Cirrhotic liver morphology without focal lesion identified. |
Generate impression based on findings. | Pre-lung transplant evaluation. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 61 % of peak activity (normal >70 %)1 hour: 30 % of peak activity (normal 30... | Gastric emptying within normal limits. |
Generate impression based on findings. | 44-year-old male with renal cell carcinoma. There are multiple new subtle foci of osseous radiotracer activity including the right posterior ischium, right mid sacrum, left mid sacroiliac joint, several lower thoracic levels, left anterior inferior ribs, and left inferior sternum. The left iliac lesions are slightly in... | Findings suspicious for progression of osseous metastases, though this is somewhat equivocal. |
Generate impression based on findings. | History of left lumpectomy in 2006 for DCIS followed by radiation therapy and tamoxifen. No new breast complaints. History of breast cancer in mother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure ... | 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. | 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 almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural di... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 68 year old female with HCV cirrhosis. HCC screening. LUNG BASES: No suspicious pulmonary nodules. No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: No suspicious hepatic lesions. A right subcentimeter hypoattenuating lesion is too small to further characterize. Calcified hepatic granuloma. Gallbladder f... | 1.No suspicious hepatic lesions.2.Cholelithiasis. |
Generate impression based on findings. | 27-year-old female with history of Crohn disease treated with Humira, initially developed sinusitis with eventual invasion into the clivus, skull base, and further into the left neck as well as epidural space in the cervical spine with abscesses that were drained at NorthShore Evanston Hospital. Per chart, most recent ... | 1. Again seen are findings of extensive skull base osteomyelitis. No significant change in osseous erosive changes described above compared to prior CT and MRI from February.2. Multiple peripherally enhancing fluid collections including the left jugular foramen, prevertebral space, and paraspinous soft tissues have ove... |
Generate impression based on findings. | Female 75 years old; Reason: hx bladder cancer, assess for mets History: hx bladder cancer, assess for mets ABDOMEN:LUNGS BASES: Calcification left AV valve. No effusions.LIVER, BILIARY TRACT: Cholecystectomy clips. No biliary dilatation. No focal liver lesions.SPLEEN: Capsular calcifications, unchanged.PANCREAS: No si... | 1.Multiple filling defects in the left upper pole collecting system. Differential diagnostic consideration includes multifocal urothelial neoplasia or blood clots or combination there of. This could be evaluated further with urine cytology and ureteroscopy.2.Discussed with Dr. Blake Alberts, pager 3024 |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional bilateral CC and MLO views as well as a cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. A few scattered benign right breast calc... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 52-year-old male patient with identification dysphasia status post meal of fish. Evaluate for foreign object. PHARYNX/LARYNX: There are secretions in the left vallecula and the left piriform sinus. No radiopaque foreign object seen. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass... | There are secretions in the left piriform sinus and left vallecula without soft tissue mass or radiodense foreign object seen. Recommend correlation with direct visualization. |
Generate impression based on findings. | Left knee pain 4 views of the left knee are provided. Severe osteoarthritis affects the knee with bone-on-bone apposition of the medial tibiofemoral compartment and tricompartmental osteophytes. This osteoarthritis has perhaps progressed slightly when compared with the prior study.Similar but slightly less pronounced o... | Osteoarthritis. |
Generate impression based on findings. | Reason: surveillance History: metastatic testicular cancer. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, unchanged. No new or suspicious nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Right central catheter tip at the cavoatrial junction. Residual thymic tissue within the anterior mediastinum... | 1.Interval right kidney and large retroperitoneal mass resection. 2.Small slightly hyperattenuating nodule at the aortic bifurcation may represent a postsurgical fluid collection, such as hematoma, seroma, or lymphocele.3.Multiple small external iliac chain lymph nodes. 4.L3 vertebral body sclerosis and superior end pl... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy yielding a fibroadenoma. 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... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Status post surgery with plate exposure. Again seen is a plate and screw device affixing fibular bone graft within a defect of the right mandibular body. This appears similar to that seen on the prior study. I see no specific radiographic features of hardware complication. Lucency within the remaining right incisor lik... | Fibular bone graft fixation appearing similar to the prior study, with poor dentition as described above. |
Generate impression based on findings. | Left knee pain 4 views of the left knee reveal some deformity and sclerosis in the proximal tibia from a healed fracture. There is a side plate with multiple screws. The bones appear in anatomic alignment. There is a small projection from the medial condyle that may be secondary to an old medial collateral ligament inj... | Healed proximal tibial fracture |
Generate impression based on findings. | 18-year-old female patient with headache and history of migraines. There is no evidence of intracranial hemorrhage. Gray-white matter differentiation is maintained. There is bilateral cerebellar tonsillar herniation, with tonsillar tips extending 7-8 mm below the foramen magnum. There is crowding of the foramen magnum ... | 1.There is severe crowding at the foramen magnum with cerebellar tonsillar herniation measuring 7 to 8 mm. There also appears to be diffuse effacement of the suprasellar cistern; combination of findings raises suspicion for brain sagging versus supratentorial mass-effect with downward herniation. No intracranial hemorr... |
Generate impression based on findings. | History of thoracic compression fracture. Back pain. Evaluate healing. There is equivocal mild concavity of the superior endplates of a couple of upper thoracic vertebrae, perhaps T4 and T5, that appears similar to that seen on the prior studies. I otherwise see no frank compression fracture on this study. Small verteb... | Minimal superior endplate concavities as above. |
Generate impression based on findings. | 78-year-old male with history of prostate cancer, assess for disease progression. Increased radiotracer uptake along the posterior aspect of the L5 vertebral body greater on the left correlates with extensive hypertrophic facet degenerative changes on prior CT and MRI examinations, consistent with degenerative disease.... | 1.No evidence of osseous metastatic disease.2.Degenerative radiotracer uptake in the lumbar and thoracic spine and healed left 9th rib fracture correlate with findings from prior CT and MRI examinations. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. 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. A linear... | 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. | Female, 37 years old. Reason: distended abd A singe prominent bowel loop in the midabdomen is newly identified from the prior exam.Enteric contrast within the colon from recent prior examination. | Air seen likely within a redundant sigmoid colon. If there is continued clinical concern, followup radiography may be useful. |
Generate impression based on findings. | Frontal sinus: There is mild mucosal thickening of the anterior frontal sinuses near the frontoethmoidal recesses.Maxillary sinuses: There is near complete opacification of the bilateral maxillary sinuses with layering fluid. The bilateral ostiomeatal complexes are obscured. Ethmoid air cells: There is patchy opacific... | Moderate paranasal sinus disease as described above. |
Generate impression based on findings. | 65-year-old male former smoker with a history of lung nodule. LUNGS AND PLEURA: Again seen is a dense area of consolidation in the left paramediastinal region with associated fibrosis and left upper lobe volume loss, which appears similar to the prior study. Adjacent measured consolidation is unchanged and measures 12 ... | 1. No significant interval change in reference dense consolidation in the left apex which was preceded by a prior pneumonia in 2012. This likely represents scarring/atelectasis with a component of organizing pneumonia as a consideration. Annual surveillance is recommended to evaluate for interval change given the low s... |
Generate impression based on findings. | Newly diagnosed mantle cell lymphoma. Initial staging.RADIOPHARMACEUTICAL: 12.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates a mucous retention cyst or polyp in the right maxillary sinus. Right chest Port-A-Cath with tip in the SVC. Multiple borderline-enl... | 1.Extensive hypermetabolic pelvic activity involving loops of bowel and adjacent lymph nodes, very suspicious for tumor activity.2.No suspicious FDG avid lesion within the neck, chest, or upper abdomen. Multiple borderline enlarged lymph nodes within the upper abdominal mesentery are not FDG avid. These could represent... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of a benign left breast core biopsy. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. A biopsy clip is present in the ... | A 14 mm focal asymmetry at the 12 o'clock position is noted in the left breast, for which spot compression views and possibly ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male, 49 years old. Reason: obstruction History: intestinal obstruction Multiple mildly prominent loops of bowel.New surgical staples and thoracic/lumbar spinal fixation hardware in place. | Multiple mildly prominent bowel loops, likely representing ileus given the post-op state. |
Generate impression based on findings. | 57-year-old female with right hip pain status post orthopedic fixation in 1996. 2 views of the right hip demonstrate a dynamic hip screw affixing a healed proximal femoral fracture in near-anatomic alignment. Findings appear similar to those seen on prior study from 2012. No acute findings are identified to account for... | Orthopedic fixation of healed proximal femoral fracture without acute findings to account for the patient's pain. |
Generate impression based on findings. | Male, 49 years old. Nausea/vomiting, abdominal pain, distention. Nonobstructed bowel gas pattern. Enteric contrast within the colon from recent prior examination. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 52 years old Reason: lymphoma, never treated (and breast CA in remission) History: lymphadenopathy CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Subjectively the mediastinal nodes are all slightly increased.Extensive mediastinal, hilar, subcarinal, prevascular, periaortic and sup... | Progression of disease based on marked increase in retroperitoneal adenopathy. Other index lesions as above. |
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 evidence of heterotopia. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the ma... | Unremarkable brain MRI without focal abnormality to account for the patient's seizures. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt. Personal history of thymoma. 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, unchang... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: Pleural mesothelioma Please provide bi-dimensional measurements per RECIST 1.1 criteria and compare to prior exam LUNGS AND PLEURA: Interval increase in the moderate to large left pleural effusion and small right pleural effusion with associated atelectasis.Bilateral lung base scarring unchanged. No pneumothora... | 1.Stable distal paraesophageal mass. 2.Interval increase in the bilateral pleural effusion. 3.No new pulmonary nodules or masses.4.Please see same day abdomen and pelvis CT report for pertinent disease evaluation. |
Generate impression based on findings. | Female 56 years old; Reason: metastatic colon cancer History: assess post 6 doses of chemotherapy CHEST:LUNGS AND PLEURA: 6mmr soft tissue pulmonary nodule is located in the right upper lobe (image 21/series 5). There is also a pulmonary nodule in the right middle lobe.MEDIASTINUM AND HILA: Heart size is normal. No per... | 1.Near stable size measurements of the hepatic lesion.2.Right upper lobe and right middle lobe pulmonary nodules may represent early metastatic disease to the lungs. |
Generate impression based on findings. | Evaluation is limited due to lack of intravenous contrast, due to iodinated contrast allergy. Extensive dental amalgam streak artifact again obscures most of the oral cavity contents, thus limiting the evaluation of the area of reported right tongue tumor. Again seen are surgical clips along the right anterolateral or... | The exam is stable. There is no significant interval change. There is redemonstration and stability of postoperative changes related to right partial glossectomy and right neck dissection without evidence of recurrence. Please note that the tongue base is partially obscured by artifact and best evaluated by direct visu... |
Generate impression based on findings. | 86-year-old female with right leg pain. 2 views of the right femur demonstrate mild trabecular prominence of the proximal femur suggesting Paget's disease of bone. There is no acute fracture or dislocation. Mild osteoarthritis affects the right hip. Moderate osteoarthritis affects the right knee. | Osteoarthritis and other findings as described above, without acute fracture evident. |
Generate impression based on findings. | 62-year-old male with a history of metastatic thyroid cancer now with a right-sided pneumothorax. Follow-up study to evaluate for interval growth. LUNGS AND PLEURA: Interval resolution of the previously described small right pneumothorax. There is minimal scattered pulmonary nodules and micronodules, unchanged when com... | 1. Slight interval increase in size and mediastinal lymphadenopathy and persistent lytic lesion in the sternum consistent with the stated history of metastatic disease.2. Interval resolution of the small right pneumothorax.3. No significant interval change in scattered bilateral pulmonary nodules. No new pulmonary nodu... |
Generate impression based on findings. | 21-year-old male with history of right UPJ obstruction status post pyeloplasty. Evaluate split renal function and rule out obstruction. The posterior abdominal radionuclide angiogram demonstrates prompt perfusion of the kidneys with slightly decreased amount on the right. Sequential renal images demonstrate prompt upta... | 1.Near symmetric renal parenchymal function, not significantly changed from previous.2.Dilated right pelvicaliceal collecting system but with rapid washout following Lasix administration and no evidence of current obstruction. This appearance is also unchanged. |
Generate impression based on findings. | Male 14 years old Reason: post-op History: post-op, prior femoral lengtheningVIEWS: Right femur AP and lateral (2 views) 5/12/2015 at 13:36 A side plate and screw device affixes the distal medial femur without radiographic evidence of hardware complication. Round lucencies with overlying periosteal reaction are seen wi... | Healing osteotomy of the right femur. |
Generate impression based on findings. | 74-year-old male with lower back pain. 3 views of the lumbar spine demonstrate moderate degenerative disc disease at L3/L4 and L5/L1 which appears to have progressed slightly since the prior study. Relatively mild disc disease affects the remaining lumbar levels. There is suggestion of neuroforaminal narrowing at L5/S1... | DJD as described above. |
Generate impression based on findings. | 65 year old male with vague voiding symptoms including postvoid dribbling and scrotal swelling concerning for sliding hernia; please assess for hernia or bladder abnormality. Lack of intravenous contrast limits evaluation of solid viscera.LUNGS BASES: No suspicious pulmonary nodules. No focal consolidation or pleural e... | Moderate distention of the bladder. No specific findings to account for patient's symptoms. If there is concern for scrotal pathology, ultrasound would be indicated. |
Generate impression based on findings. | FractureVIEWS: Left forearm AP and lateral Forearm fractures involving the mid radius and ulna again noted with metallic rods stabilizing the fractures. There are sclerosis and periosteal reaction reflecting interval healing. The alignment is not significantly changed from prior study. The overlying cast obscures fine ... | Healing forearm fractures as described above. |
Generate impression based on findings. | Male 40 years old; Reason: leiomyosarcoma compare to last CT \T\ measure using RECIST criteria 1) RML nodule, 2) right hepatic lobe lesion \T\ 3) right paraspinal lesion History: post 2 cycles. CHEST:LUNGS AND PLEURA: Pulmonary masses consistent with metastases several of which are increased in size. The right middle l... | 1.Marked increase in size of pulmonary lesions. Liver lesions roughly stable. Enhancing soft tissue lesion] muscles the chest as measured above. Subcentimeter right renal lesion exophytic unchanged. No new sites of disease. |
Generate impression based on findings. | 76-year-old female status post right total knee arthroplasty. 4 views of the right knee demonstrate components of a total knee arthroplasty device in near anatomic alignment. There is no radiographic evidence of hardware complication. The patella is high riding, but evaluation of the patellar tendon is limited secondar... | Total knee arthroplasty as described above. |
Generate impression based on findings. | Ms. Cesarioprice is a 45 year old female presenting with suspicious findings in the right breast from outside MRI. An MR-directed US was performed at our institution, confirming the MR findings. She presents today for an ultrasound-guided biopsy of the right breast. Right breast ultrasound re-identified the target lesi... | 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. | FractureVIEWS: Right tibia and fibula AP and lateral The surgical drain has been removed in the interval. The external fixator in place not significantly changed. Comminuted fractures involving the distal tibia and fibula are again noted. Minimal periosteal reaction at the fracture sites with alignment not significantl... | Healing tibia and fibular fractures as described above. |
Generate impression based on findings. | New diagnosed lung cancer initial staging. Also history of prostate cancer metastatic to bone and a renal mass.RADIOPHARMACEUTICAL: 12.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 121 mg/dL. Today's CT portion grossly demonstrates a large approximately 7 cm left lower lobe lung mass. Small to medium hyp... | 1.Large markedly hypermetabolic lung mass in the left lower lobe, highly suspicious for primary lung cancer.2.Extensive hypermetabolic metastatic disease throughout the chest, abdomen, and pelvis including bilateral mediastinal, left pleural, mesenteric, retroperitoneal, body wall, and osseous metastasis as detailed ab... |
Generate impression based on findings. | Age: 71 years. Sex : Male. Reason for study: Reason: self reported history of aspiration and cough after swallowing liquids History: cough and possible aspiration. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was rec... | Negative for vestibular penetration and tracheal aspiration.Please refer to speech pathologist's report for additional details. |
Generate impression based on findings. | 63-year-old female with a history of esophageal cancer status post chemoradiation therapy, prior to surgery. CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema with upper lobe predominance, appearing similar to the prior study. Right basilar scarring/atelectasis. No pleural effusion or pneumothorax... | 1. Slight interval decrease in wall thickening of the distal esophagus/gastric cardia consistent with the stated history of esophageal carcinoma with reference measurements provided above.2. No evidence of metastatic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this ... |
Generate impression based on findings. | 87-year-old female with bilateral knee pain. 4 views of the right knee demonstrate chondrocalcinosis of the lateral meniscus. The knee otherwise appears normal for age. No acute fracture or joint effusion is noted.4 views of the left knee demonstrate chondrocalcinosis of the menisci and hyaline cartilage. Mild osteoart... | Mild degenerative arthritic changes as described above. |
Generate impression based on findings. | Age: 51 years. Sex : Male. Reason for study: Reason: h/o HNC and CRT, compare to baseline History: none. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. Single static image was obtained.The ex... | Negative for vestibular penetration or tracheal aspiration.Please refer to speech pathologist's report for additional details. |
Generate impression based on findings. | 68 years Male with Reason: h/o laryngeal ca and CRT, compare to previous, measurements pls History: none Again seen are extensive post-treatment findings in the neck, with diffuse pharyngeal space mucosal edema. The heterogeneous, poorly-defined supraglottic mass is not significantly changed when compared to immediate ... | 1.Stable appearance of heterogeneous poorly defined supraglottic mass when compared to immediate prior.2.Interval decrease in size of necrotic right level V levels.3.Other findings are unchanged, as above. |
Generate impression based on findings. | 60-year-old male with bilateral hip pain. Single AP view of the pelvis demonstrates mild cortical and trabecular prominence involving the right innominate bone. Findings are suggestive of Paget disease. Additional density over the right SI joint is likely secondary to osteophyte formation. Mild osteoarthritis also affe... | Paget disease and degenerative arthritic changes as described above. |
Generate impression based on findings. | Female 10 years old Reason: Nocturnal enuresis / to rule out KUB anomalies History: Nocturnal enuresis BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullar... | Normal exam.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter... |
Generate impression based on findings. | Age: 91 years. Sex : Male. Reason for study: Reason: assess for aspiration History: frequent throat clearing, possible aspiration pneumonia. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No ... | Positive for vestibular penetration and tracheal aspiration.Please refer to speech pathologist's report for additional details.Anterolisthesis of C4 on C5 noted on fluoroscopic images. Dedicated cervical spine radiographs can be obtained if clinically warranted. |
Generate impression based on findings. | 62-year-old female with history of multiple myeloma now presents with neck pain. 6 views of the cervical spine demonstrate mild nonspecific demineralization but no definite focal lytic lesions. Moderate multilevel DJD is present in the mid and lower cervical spine. There is also moderate multilevel facet joint osteoart... | Degenerative arthritic changes as described above without fracture. |
Generate impression based on findings. | Reason: Pleural mesothelioma please provide bi-dimensional measurements per RECIST 1.1 criteria History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: Nodular pleural thickening of the left hemithorax consistent with mesothelioma.Reference measurements as follows:1. At the level of the aortic arch (series/40), 54 mm at ... | Progression of disease in the left hemithorax, chest wall, contralateral lung, liver and retroperitoneum. |
Generate impression based on findings. | Male, 57 years old.RFO trigger: Organ Transplant Suspected RFO location: abdomenName of suspected RFO: Count correctAttending Surgeon name/pager: Dr. Becker?Body Mass Index (BMI): 32.74 No expected radiopaque foreign object. There is a paucity of bowel gas without definite evidence of obstruction.Surgical clips overlie... | No expected radiopaque foreign object.Findings were discussed by telephone with the attending surgeon, Dr. Becker at 2:15 PM on 5/12/2015. |
Generate impression based on findings. | History of right mastectomy in 2000 for carcinoma. Patient received radiation therapy. No new breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distr... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 65-year-old male with HCC. The patient was positively identified. The risks, benefits, and alternatives were explained. 51.2 mCi Y-90 Thera Spheres were administered via the right hepatic artery by the interventional radiology service in the angiography suite. This was supervised by Dr. Appelbaum. | Successful administration of Y-90 Thera Spheres. |
Generate impression based on findings. | 55-year-old female status post right total knee arthroplasty. 4 views of the right knee demonstrate components of a total knee arthroplasty device in near anatomic alignment. There is no radiographic evidence of hardware complication. Large joint effusion and anterior soft tissue swelling limit evaluation of the extens... | Right total knee arthroplasty as described above. |
Generate impression based on findings. | 74 year old male with hx of bladder cancer s/p radical cystectomy, evaluate for metastatic disease with delayed imaging. LUNG BASES: No suspicious pulmonary nodules. No focal consolidation or pleural effusion.LIVER, BILIARY TRACT: Liver enhances homogenously without focal lesion. Gallbladder is unremarkable. Distal com... | Postsurgical findings of cystectomy and neobladder formation, without specific evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 68-year-old male with neck pain. The cervicothoracic junction is not well visualized on lateral views secondary to overlying anatomy. 5 views of the cervical spine demonstrate severe degenerative disk disease affecting C4/C5, C5/C6, and C6/C7. Moderate to severe DDD affects C3/C4. Anterior and posterior vertebral body ... | Degenerative arthritic changes as described above without frank instability. |
Generate impression based on findings. | Female, 63 years old, with right hand weakness and poor balance. Evaluate for cervical abnormality. The procedure, indications, benefits, risks/complications and alternatives were described to the patient and informed consent was obtained. The patient was placed in the prone position and the inferior back was prepped w... | Successful fluoroscopic guided lumbar puncture for cervical myelogram without immediate complications. |
Generate impression based on findings. | 68-year-old female. Patient presents with a palpable right breast lump in the upper outer quadrant felt by her OB/GYN physician; patient herself does not feel the lump. Personal history of head and neck cancer. Diagnostic mammogram: Three standard views of both breasts, an exaggerated lateral right CC view, and two spo... | No suspicious abnormality corresponding to referring physician palpable lump in the right breast. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the... |
Generate impression based on findings. | 61 years, Male. Reason: dobhoff History: dobhoff Feeding tube with tip in the distribution of the gastric antrum. Limited evaluation of the bowel gas pattern with gaseous distention of the stomach and few loops of dilated bowel. Degenerative changes of the lower lumbar spine are noted. | Feeding tube with tip in the distribution of the gastric antrum. |
Generate impression based on findings. | Reason: surveillance of lung nodule History: shortness of breath LUNGS AND PLEURA: Severe centrilobular emphysema. Right major fissure nodule measures 5mm and appears flattened on this study (series 6 image 65). A subpleural left lower lobe nodule appears stable from prior study. Other micronodules along the major fiss... | No significant change of the pulmonary nodules. Given the stable study since 2013, these nodules are likely benign representing intrapulmonary lymph nodes. However, given patient's smoking history and emphysema, consider low-dose annual screening in the future. |
Generate impression based on findings. | 67-year-old female status post left total hip arthroplasty. 3 views of the left hip demonstrate a total hip arthroplasty device in near anatomic alignment, without radiographic evidence of hardware complication. Previously identified skin staples have been removed.Single AP view of the pelvis shows the aforementioned l... | Total left hip arthroplasty as described above. |
Generate impression based on findings. | Male 17 years old with appendectomy complicated by abscess formation s/p drainage. Now with abdominal pain, elevated white blood cell count and sedimentation rate with recent completion of a course of antibiotics. ABDOMEN:LUNG BASES: The lung bases are normal.LIVER, BILIARY TRACT: The liver is normal in size, no liver ... | 1.4.1 x 1.6 x 2.7 cm abscess between the rectum and urinary bladder secondary to perforated appendicitis.2.Normal to small caliber distal ileal bowel loops dilated loops of small bowel more proximal compatible with a partial small bowel obstruction likely secondary to an inflammatory process in the right lower quadrant... |
Generate impression based on findings. | Male 19 years old; Reason: evaluating for testicular mass, varicocele, hydrocele, epididymal swelling History: acute testicular pain 3 d ago, intermittent bilateral testicular pain x 8 months. RIGHT TESTIS: Right testicle is normal and symmetric in size and echogenicity. No testicular lesion is identified.LEFT TESTIS: ... | 1.Normal-appearing and symmetric testes. No testicular lesions and no evidence of inflammatory changes.2.Complex cyst of the head of the left epididymis. |
Generate impression based on findings. | 67-year-old female with history of MS and many falls now presents with low back pain. 5 views of the lumbar spine demonstrate diffuse demineralization suggestive of osteoporosis. Moderate central loss of height of the L1, L2, and L3 vertebral bodies as well as mild superior endplate concavity of L5 are indicative of co... | Degenerative arthritic changes as described above, and multiple vertebral body compression fractures of indeterminate age. |
Generate impression based on findings. | 73-year-old male with met prostate cancer, bone pain, hip pain, increased left leg pain. Evaluate for mets from prostate cancer or fracture in hip and left femur 2 views of the left hip reveal no evidence of fracture or dislocation. No specific evidence of metastatic disease as clinically questioned. An os acetabuli is... | No evidence of fracture or metastatic disease as clinically questioned. |
Generate impression based on findings. | Large cell lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Peripheral perihepatic right lobe low-attenuation lesion no longer measurabl... | Interval decrease in size of reference lesions. No new adenopathy. |
Generate impression based on findings. | Female, 63 years old. Reason: eval dysphagia per speech recommendation History: dysphagia. Scout images was obtained demonstrating cardiomegaly with patchy bibasilar opacities which may represent atelectasis. AICD, cardiac valve replacement, and median sternotomy are noted. Adequate coating was not obtained using effer... | 1.Moderate esophageal dysmotility disorder.2.Anterior cervical esophageal web. 3.Spontaneous gastroesophageal reflux. Evaluation of the gastric mucosal was not well evaluated on the current study due to inadequate coating. 4.Small hiatal hernia. |
Generate impression based on findings. | 46 year old female with known thumen pelvic cystic mass with back pain and radicular component in it 3 views of the thoracic spine reveal minimal anterior osteophyte formation, otherwise alignment is intact with preservation of the disc spaces. No evidence of fracture.4 views of the lumbar spine reveal minimal anterior... | Mild degenerative arthritic changes with no evidence of fracture or malalignment. |
Generate impression based on findings. | 53-year-old female with pain. 4 weightbearing views of the left foot reveal a silastic implant at the first MTP joint. A small piece of hardware is noted within the second metatarsal head. A single screw is noted within the proximal phalanx of the first digit. The bones appear in anatomic alignment with no evidence of ... | Postoperative changes without an acute fracture. |
Generate impression based on findings. | 51-year-old female with right foot pain and swelling. 3 views of the right foot demonstrate a poorly defined linear lucency traversing the base of the fifth proximal phalanx, best seen on the oblique view. Findings likely represent a nondisplaced fracture at this site.Mild arthritic changes affect the foot. Posterior a... | Nondisplaced transverse fracture at the base of the fifth proximal phalanx.Findings were relayed to the ordering physician, Dr. Dua, via telephone message on 5/12/2015 at 17:40. |
Generate impression based on findings. | Female 10 years old Reason: Nocturnal enuresis - Rule out constipation History: rule out constipationVIEW: Abdomen AP (one view) 5/12/2015 at 14:19 Nonobstructive bowel gas pattern with a mild fecal burden. | Normal examination. |
Generate impression based on findings. | Clinical question: Evaluate paranasal sinuses, chronic ethmoid or sphenoid sinusitis. Signs and symptoms: Headache. Medtronic fusion sinus CT:Frontal sinuses are well-pneumatized and without evidence of disease.Ethmoid sinuses are well-pneumatized and without evidence of disease.Sphenoid sinus demonstrate mild bilatera... | 1.Mild sphenoid sinusitis with occluded left and compromises right sphenoethmoidal recesses.2.Unremarkable paranasal sinuses and nasal cavity otherwise.3.Well-pneumatized bilateral mastoid air cells and middle ear cavities and unremarkable images through the orbits. |
Generate impression based on findings. | 72 years female with colorectal ca. History of rectovaginal fissure; area of induration/pain along proximal right gluteal cleft. Evaluate right gluteal cleft for for fat stranding, fluid collection following IV antibiotics, other indication of infection. Lack of intravenous contrast limits evaluation of solid viscera.L... | 1.Limited exam due to lack of intravenous contrast.2.Rectovaginal fistula is redemonstrated with gas and fluid collection in the presacral space appearing slightly decreased from the previous exam.3.Right gluteal skin thickening and underlying inflammatory changes are not significantly changed. No drainable abscess. |
Generate impression based on findings. | 60-year-old male with history of ankle fractures. 3 views of the left ankle again demonstrate an oblique fracture through the distal fibula. Fracture fragments are in near-anatomic alignment and appear similar to the prior study. Transverse fracture through the medial malleolus also appears similar to the prior study. | No significant interval change in medial and lateral malleolar fractures. |
Generate impression based on findings. | Ms. Burgess is a 85 year old female with a personal history of right breast lumpectomy in September 2011 for IDC/DCIS treated with Femara. Family history of breast cancer in maternal cousin and maternal aunt. She has no current breast related complaints. Three standard views of both breasts were performed digitally and... | Stable postsurgical changes of the right breast. Left breast cyst with benign calcifications. 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... |
Generate impression based on findings. | 78-year-old male with lower back pain. 5 views of the lumbar spine show no acute fracture or malalignment. Vertebral body heights are within normal limits. There are small vertebral body osteophytes but the disc spaces are preserved. Mild facet joint osteoarthritis is noted in the lower lumbar spine. Note is made of pa... | Degenerative arthritic changes but no fracture or other acute findings to account for the patient's pain. |
Generate impression based on findings. | 81-year-old female patient with altered mental status and history of fall. Evaluate for intracranial hemorrhage and fracture. CT HEAD: There is no evidence of intracranial hemorrhage or mass effect. Again seen is global parenchymal volume loss with stable-appearing encephalomalacia in the left occipital and posterior p... | 1.No evidence of intracranial hemorrhage or mass effect. 2.Extensive age-indeterminate appearing small vessel ischemic changes. Chronic infarcts in the left occipital lobe, posterior parietal lobe and right cerebellar hemisphere. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts and MRI ... |
Generate impression based on findings. | Male, 64 years old. Reason: Patient w/ abd pain, diarrhea/constipation, eval fecal burden History: abd pain Nonobstructed bowel gas pattern.Average stool burden. | Average stool burden. |
Generate impression based on findings. | Male, 28 years old. Reason: evaluate for esophageal leak History: possible leak Single contrast evaluation of the esophagus and gastric cardia/fundus revealed:Postoperative changes of a gastric pull-up. The intrathoracic stomach is normal in size, with expected orientation, and containing a small amount of debris. No s... | Surgical changes of a gastric pull-up without evidence of leak. |
Generate impression based on findings. | Reason: Pleural mesothelioma please provide bi-dimensional measurements per RECIST 1.1 criteria and compare to prior exam. History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: Postoperative changes of a right pleurectomy and decortication with mesh in the right lung base. No pleural effusion or pneumothorax. Central a... | 1.Stable postoperative changes of a right pleurectomy and decortication.2.No definite evidence of residual tumor. Measurements of pleural thickening may be due to pleural scarring.3.Right major fissure soft tissue density continues to decrease size. |
Generate impression based on findings. | Female 24 years old Reason: 24F s/p total proctocolectomy with end ileostomy. Now with leukocytosis and purulence from perineal wound. Please eval for pelvic collection History: please eval for intra abdominal or pelvic process ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abn... | Minimal fat stranding in the perianal perirectal area. A few small bubbles of gas in the region where the drains located previously in the perianal area. No loculated fluid collections to suggest abscess. |
Generate impression based on findings. | Female, 67 years old. Reason: 67 yo female with history of intestinal bypass with an ileo-jejunal bypass in 1976 with reversal of bypass in 1979, now with recurrent abdominal pain and bilious vomiting. Please assess for partial SBO. Scout radiograph showed a nonobstructive bowel gas pattern. Scoliosis and degenerative ... | Normal examination of the small bowel. No evidence of bowel obstruction or adhesions. |
Generate impression based on findings. | Reason: T1N0 left retromolar trigone squamous cell carcinoma s/p WLE in 8/2012 and T4N2b left upper gingiva squamous cell carcinoma, stats post surgery and chemoradiation completed in 5/2014, now with a left palatal fistula. History: none CHEST:LUNGS AND PLEURA: Calcified granulomata are present, but no metastases.Para... | No evidence of metastases, or other significant abnormality other than emphysema. |
Generate impression based on findings. | Male 49 years old Polycystic kidney disease. Kidney transplant. History of intermittent nausea vomiting abdominal pain and abdominal distention. Prior CT with possible stranding at native left kidney and subcapsular hematoma transplanted kidney concerning for infected or hemorrhagic cyst. Exam is not sensitive for dete... | Enlarged multicystic kidneys with typical and atypical cysts. Evaluation limited by lack of intravenous contrast. Nonspecific fat stranding around and caudal to the lower pole of the left kidney.Subcapsular collection distorting the renal allograft consistent with a subcapsular hematoma. This scan conserve as baseline ... |
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