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Generate impression based on findings. | 64 year old male with abdominal pain, nausea, pain-unclear etiology, eval for sbo vs renal stone. CHEST:LUNGS AND PLEURA: Interval increase in groundglass opacities in the lung bases, right greater than left. Bronchial wall thickening and bronchiectasis are noted, most prominently in the lung bases. Minimal basilar sca... | 1.Groundglass opacities in the lung bases with bronchial wall thickening and bronchiectasis. Findings may relate to aspiration or infection.2.Slightly hydropic gallbladder morphology, nonspecific. If gallbladder pathology is suspected, right upper quadrant ultrasound may be considered. |
Generate impression based on findings. | Female, 27 years old, with epistaxes, enlarged adenoids, deviated nasal septum, and a lymph node on the right at the angle of the mandible. The paranasal sinuses are clear and the major sinus ostia are patent. The nasal septum is intact and demonstrates a very slight S-shaped curvature in the coronal plane. The nasal t... | 1.No evidence of significant paranasal sinus inflammatory disease.2.No significant abnormalities of the soft tissues of the neck and no evidence of cervical lymphadenopathy. |
Generate impression based on findings. | Shortness of breath. Concern for infection. Status post left below the knee amputation. In-111 WBC: Physiologic activity is present in the liver, spleen, and bone marrow. No abnormal leukocyte accumulation is identified to indicate an active infectious or inflammatory process. Tc-99m Sulfur Colloid: The patient is stat... | No scintigraphic evidence of active infection or inflammation. |
Generate impression based on findings. | 65-year-old female. History of left mastectomy in 2012 for IDC and DCIS. History of multiple benign right breast biopsies. No current breast complaints. 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 fibroglandula... | Stable multiple clips from benign right breast biopsies. 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: 2 - Benign finding.RECOMMENDATI... |
Generate impression based on findings. | NSCLC. CHEST: Motion artifact grades image quality, limiting evaluation.LUNGS AND PLEURA:Circumferential right pleural thickening with right hemithorax volume loss. The reference right upper lobe pleural thickening is 8mm, previously 11 mm, (series 3, image 54). Reference pleural thickening adjacent to the right brachi... | Slight improvement in reference measurements. No conclusive new sites of disease identified. |
Generate impression based on findings. | 58-year-old female with metastatic renal cell carcinoma-evaluate for progression. CHEST:LUNGS AND PLEURA: Increase in size and number of previously reported bilateral pulmonary nodules consistent with metastases are seen. The prior referenced left upper lobe nodule (series 5, image 19) measures 2.3 x 2.1 cm, previously... | 1. Substantial increase in metastatic disease burden in the pulmonary parenchyma.2. New hypodense lesion in liver most likely new metastatic deposit. 3. Continued increase in size of left sixth rib lytic lesion with soft tissue mass. 4. Increasing periaortic left retroperitoneal adenopathy. |
Generate impression based on findings. | 55-year-old female patient with metastatic lung cancer, ALK positive, on Crizotinib past 4 years. Compare with previous. ABDOMEN:LUNG BASES: Please refer to the CT of chest report from the same date.LIVER, BILIARY TRACT: No focal hepatic lesion is identified. Diffuse low hepatic parenchymal hypoattenuation raises the q... | 1. No specific evidence of metastatic disease or significant interval change.2. Question of hepatic steatosis. |
Generate impression based on findings. | 66 years, Male. Reason: obstruction History: ostomy with air Nonobstructive bowel gas pattern. Percutaneous gastrostomy tube overlying the gastric body. Foley catheter in place overlying the bladder. Degenerative changes of the visualized spine are noted.Please refer to dedicated chest radiograph from the same day for ... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Relapsed neuroblastoma. Pre-MIBG therapy. There is abnormal increased radiotracer uptake in the vertex of the skull (right greater than left), right sphenoid bone (as correlated with the prior MRI), bilateral proximal humeri, multiple thoracic vertebral bodies, sacrum, bilateral iliac bones, right acetabulum, and bilat... | Osseous MIBG avid tumor, as described above. |
Generate impression based on findings. | CT CHEST ABDOMEN PELVIS WO, 5/13/2015 1:33 PM CHEST:LUNGS AND PLEURA: Interval appearance of multifocal patchy airspace opacity most prominent within the right upper lobe.MEDIASTINUM AND HILA: Calcified subcarinal and right hilar lymph nodes.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: No significant abnormality no... | Interval appearance of multifocal patchy airspace opacity most prominent within the right upper lung; would favor infectious/inflammatory etiology.Interval improvement in degree of multifocal long segment distal ileal wall thickening. Submucosal fat observed suggestive for chronic inflammatory changes. Multifocal mildl... |
Generate impression based on findings. | 54 years, Male. Reason: assess for ileus obstruction History: 54 y.o. with celiac disease and abdominal pain, vomiting on a gluten free diet Above average stool burden. Nonobstructive bowel gas pattern without evidence of intraperitoneal free air. Lung bases are clear. | Nonobstructive bowel gas pattern with above average stool burden. |
Generate impression based on findings. | 16 year old female with metastatic colon cancer (peritoneal mets visualized during surgery), on chemotherapy, please eval for interval change since prior CT. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious pulmonary nodules. MEDIASTINUM AND HILA: Heart size is normal with no pericardia... | Interval development of mediastinal lymphadenopathy, hepatic lesions, and new or increased mesenteric and adnexal masses, highly concerning for progression of metastatic disease. |
Generate impression based on findings. | 42-year-old male patient with T4N3M1 HPV+ squamous cell carcinoma of the right tonsil status post treatment. There are post-treatment findings in the neck with diffuse marked supraglottic edema with airway narrowing and superficial areas of hyperenhancement in the right oropharynx, mildly improved compared to prior exa... | 1.Post-treatment findings in the neck with no significant change in the treated lymphadenopathy and no evidence of residual tumor in the oropharynx.2.Slightly decreased supraglottic edema, but persistent enhancement of the oropharyngeal mucosal, which may represent mucositis.I personally reviewed the Images and/or proc... |
Generate impression based on findings. | Reason: patient with history of lung nodule History: n/a - follow up of nodule LUNGS AND PLEURA: Study is limited by motion artifact. 4 mm right middle pulmonary nodule (series 4 image 55). Probable groundglass nodule in the right lower lobe (series 4 image 51). Mild dependent atelectasis. No pleural effusions or pneum... | 4 mm right middle lobe pulmonary nodule and probable right lower lobe ground glass nodule. Prior studies will be helpful to determine stability. In patients with a higher risk, such as smokers, follow-up is recommended in one year. |
Generate impression based on findings. | 21-year-old male with left tibia stress fracture, evaluate for healing Again seen is cortical thickening along the medial aspect of the distal tibial metadiaphysis with poorly defined intracortical lucency compatible with stated history of stress fracture. The cortex is perhaps thicker on current study compared to prio... | Stress fracture as described above. |
Generate impression based on findings. | 56 years, Female. Reason: Recent capsule endoscopy; evaluate for retention History: unable to view capsule Nonobstructive bowel gas pattern. The capsule from the recent capsule endoscopy is not visualized on the current study.Bilateral total hip arthroplasties are noted. Suture material overlies the right paraspinal re... | Endoscopy capsule is not visualized on the current study. |
Generate impression based on findings. | 78-year-old male patient with metastatic prostate cancer. Evaluation of disease after 3 cycles of investigational therapy. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules are identified. There is a peri fissural left lower lobe pulmonary micronodule which may represent a lymph node, unchanged. A punctate calcif... | 1. Marked interval decrease in size of retroperitoneal lymphadenopathy. Smaller lymph nodes within the mediastinum and inguinal region are not significantly changed.2. Increased conspicuity of widespread sclerotic osseous lesions. Please refer to concomitant bone scan performed today for additional findings. |
Generate impression based on findings. | 37-year-old female Reason: Renal Ultrasound to Evaluate 1.1 cm Lesion Seen on CT Scan - ? Cyst, etc. History: Renal Ultrasound to Evaluate 1.1 cm Lesion Seen on CT Scan - ? Cyst, etc. RIGHT KIDNEY: Right kidney measures 11.1 cm in length. No hydronephrosis or shadowing renal calculus.LEFT KIDNEY: Left kidney measures 1... | Left superior pole simple renal cyst. |
Generate impression based on findings. | RVP positive for MRSA, H. influenzae and rhinovirus/enterovirus with productive cough and congestion, evaluate for pneumonia. History of graft-versus-host disease and NHL. LUNGS AND PLEURA: No pleural fluid or pneumothorax. Multifocal airspace opacities bilaterally compatible with bronchopneumonia, these are predominan... | Multifocal bronchopneumonia. No evidence of abscess or cavitation. |
Generate impression based on findings. | 56-year-old female with pain, proximal humerus fracture. Evaluate right humerus. Right shoulder: There is mild periosteal bone formation along the surgical neck of the humerus and greater tuberosity that may represent a healing/healed fracture but currently we see no fracture line. Mild osteoarthritis affects the gleno... | Findings suggestive of healing/healed proximal humerus fracture but we see no fracture line at this time. |
Generate impression based on findings. | Prostate cancer status post brachytherapy in 2004 A small non-specific focus of increased radiotracer uptake at the left inferior orbit/maxilla is more prominent than before, though also visible on the 2012 study. This appears atypical for metastasis and may be related to sinus disease or orbital in etiology.No definit... | No definite evidence of osseous metastases. |
Generate impression based on findings. | 47-year-old male patient with lymphoma. Restaging. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy by CT size criteria. No pericardial effusion is identified.CORONARY ARTERY CALCIFICATION: No significant coronary artery cal... | 1. Enlarged axillary, pelvic, and inguinal lymph nodes.2. Focal skin thickening in the lower left abdominal wall; correlate with direct inspection. |
Generate impression based on findings. | Male, 52 years old. Reason: s/p buccal urethroplasty 4/22/15 check for extravasation of urine History: s/p buccal urethroplasty 4/22/15 check for extravasation of urine The scout film of the pelvis show a Foley catheter in place without abnormal calcification.Contrast was injected retrograde through the 6 French cathet... | 1.No evidence of contrast extravasation to suggest leak.2.Marked narrowing of the prostatic urethra as above.Findings were discussed by telephone with Dr. Bales at 10:30 PM a.m. on 5/13/2015. |
Generate impression based on findings. | Metastatic thyroid cancer to the lung status post thyroidectomy and chemotherapy. Neck: There are postoperative findings related to total thyroidectomy. There are unchanged subcentimeter nodules in the thyroidectomy bed bilaterally. There is no evidence of significant cervical lymphadenopathy. The salivary glands are u... | 1. Postoperative findings related to thyroidectomy with unchanged nonspecific subcentimeter nodules in the treatment bed. 2. No evidence of intracranial metastases.3. Nonspecific subcentimeter nodules within the imaged portions of the lungs. Please refer to the separate chest CT report for additional details.4. Multipl... |
Generate impression based on findings. | 39-year-old female with bilateral leg pain and signs and symptoms of consistent with stress fracture Left tib-fib: Mild/moderate periosteal reaction in the mid tibial diaphysis with circumferential cortical thickening. No acute fracture is evident. Alignment is anatomic.Right tib-fib: No acute fracture is evident. No p... | Findings compatible with left tibial stress fracture/reaction. |
Generate impression based on findings. | 75 years, Female. Reason: Pt. with abdominal pain History: 75 yo female with h/o ovarian cancer s/p TAH and chemoRT c/b radiation enteritis, multiple SBOs and SBRs on TPN, now complaining of abdominal pain. Please assess upright and flat xray to assess for SBO. Nonobstructive bowel gas pattern. There is air seen in the... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Reason: eval for evidence of PNA History: RLL abnormality on CT abd; sepsis in immunocompromised patient LUNGS AND PLEURA: Bilateral small pleural effusions. Mild lung base scarring. Left lung base nodule measuring 16 x 8 mm (series 4 image 84). Resolution of previously seen right lower lobe opacity. Mild tree-in-bud o... | 1.Bilateral small pleural effusions with shifting aspiration.2.Left lung base nodule. Prior imaging is recommended to determine stability. If prior imaging is not available, PET scan is recommended. |
Generate impression based on findings. | Patient is asymptomatic. History of convulsions. Evaluate for nodule noted on CXR. LUNGS AND PLEURA: Hazy subsolid airspace opacity in the left upper lobe abutting the major fissure. Minimal, subtle groundglass opacity in the dependent left lower lobe. Dense 4 mm nodule in the right upper lobe too small to characterize... | Very faint, postinflammatory appearing opacities in the left lung suspicious for sequela of recent aspiration event. Additional small 4 mm right upper lobe nodule near the right hilum to small to accurately characterize; if the patient is at high risk a follow-up CT may be obtained in 12 months, otherwise no additional... |
Generate impression based on findings. | 55-year-old female with metastatic lung cancer, ALK+, on Crizotinib past 4 years. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. Reference right level V lymph node is grossly stable, measuring approximately 7 mm. The thyroid and major salivary glands are ... | No evidence of measurable mass lesions or significant lymphadenopathy in the neck to suggest tumor recurrence. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (1/29/15, 4/3/15), ultrasound images of left breast (4/3/2015) performed at J. Stroger Hospital. For comparison, digital mammographic images (1/2/2014) are available. DIGITAL MAMMOGRAPHIC IMAGES (1/29/15, 4/3/15):The brea... | Two suspicious masses in the left breast; one at the periareolar area and the other at far posterior 5:00 position. Ultrasound-guided biopsy for both lesions is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 31-year-old female. Left breast palpable lump 1 x 1/2 months. Patient reports mild associated tenderness. DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and three spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely de... | Palpable small lump in the left breast inner lower quadrant with no sonographic or mammographic correlate. Recommend consultation with a breast surgeon for clinical management.BIRADS: 1 - Negative.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 76-year-old female with shoulder pain 3 views of the right shoulder show no acute fracture or malalignment. Small amount of calcification at the greater tuberosity may represent calcific tendinopathy (calcium hydroxyapatite deposition disease). Inferior osteophyte from the acromioclavicular joint. | Findings suggestive of calcific tendinopathy (calcium hydroxyapatite deposition disease). |
Generate impression based on findings. | 48-year-old male with pain and erythema, evaluate for osteomyelitis No osseous erosions are evident. Mild degenerative changes with osteophytes at the second MTP joint. Interval healing of soft tissue defect along the plantar surface of the foot. Small amount of periosteal reaction along the lateral aspect of the neck ... | No specific evidence of osteomyelitis. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 57-year-old with history of right mastectomy for multicentric DCIS in 2012. 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 elements, unchanged in pattern and distribution. A linear marker was placed... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 68 year old male with mitral regurgitation who is being considered for robotic mitral valve repair. He is referred to evaluate cardiovascular structures.CPT: 75572 Left Ventricle: The left ventricular end diastolic volume is mildly dilated (LVEDV 221 mL) The left ventricular end-systolic volume is normal (LV volume 77 ... | 1. Severe mitral valve prolapse of the posterior leaflet. 2. Mild LV dilation with normal systolic function. 3. Normal RV size and systolic function. 4. Severe left atrial dilation. 5. Mild calcification and tortuosity of thoracic aorta. 6. No coronary calcification. 7. Minimal sclerocalcific changes of the aortic valv... |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are multiple patchy areas of abnormal low density within the deep cerebral white matter, corresponding to areas of previously seen diffusion restriction on MRI. These do not appear si... | No acute intracranial hemorrhage. Areas of scattered patchy abnormal low density corresponding to focal areas of abnormal diffusion restriction on prior MRI. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended. |
Generate impression based on findings. | Uni-phasic upper GI examination was performed in a limited single contrast technique. Radiation was minimized by use of screen capture and fluoroscopy cancer. Newly all static images are screen capture.Contrast evaluation of the esophagus is unremarkable without evidence of mucosal or mural wall abnormalities. Additio... | Morphologically normal upper GI examination. To-and-fro peristalsis within the duodenum without dilatation to the level of the SMA (despite the atypical history). |
Generate impression based on findings. | 78-year-old female with knee pain, tenderness on exam Right knee: No acute fracture is evident. Alignment is anatomic. Moderate joint effusion. The extensor mechanism is intact. A fabella is noted. Atherosclerotic calcification of the vessels is present.Left knee: No acute fracture is evident. Alignment is anatomic. No... | Mild osteoarthritis of bilateral basilar joints. Knees are within normal limits for age. |
Generate impression based on findings. | 62-year-old male with lung cancer-evaluate for progression for metastatic disease. CHEST:LUNGS AND PLEURA: Radiation change and scarring in the right perihilar region is seen unchanged in the lung parenchyma. Enlarging right upper lobe, peri fissural nodule (series 5, image 37) which measures 1.7 x 1.0 cm, previously 0... | 1. Increasing metastatic disease burden in the lung parenchyma, mediastinal adenopathy, abdominal adenopathy, liver, and right adrenal gland.2. Stable appearance to distal lumbar aortic aneurysm with internal endovascular stent.. |
Generate impression based on findings. | Lung cancer presenting with fever and cough. Evaluate for advancing disease versus infection. LUNGS AND PLEURA: Redemonstration of severe background pulmonary fibrosis with honeycombing and traction bronchiectasis compatible with the patient's known scleroderma related interstitial lung disease. There are multiple regi... | 1.Interval increase in size of necrotic right lower lobe mass compatible with the biopsy proven malignancy. No significant interval change in additional left lower lobe mass which is also highly suspicious for malignancy.2.New near complete right lower lobe atelectasis with increasing right pleural effusion likely cont... |
Generate impression based on findings. | 68-year-old female with history of posterior and frontal headache after motor vehicle collision. Head: There is no evidence of intracranial hemorrhage. The gray-white matter differentiation appears to be maintained. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herni... | 1.No evidence of intracranial hemorrhage or mass effect.2.No acute cervical spine fracture or subluxation.3.Degenerative spondylosis of the cervical spine, most significant at C5-6, as detailed above. |
Generate impression based on findings. | Reason: follow up lung cancer. History: cough, right chest wall pain CHEST:LUNGS AND PLEURA: Interval increase in size of the right upper lobe mass (image 33 series 3) now measuring 3.9 cm x 3.2 cm previously measuring 2.5 cm x 2.2 cm. This mass now involves the adjacent pleura .There is now a large loculated right ple... | Interval progression of this patient's right upper lobe neoplasm with extension to the pleural surface and development of a large loculated right pleural effusion. Stable mediastinal and hilar lymphadenopathy. No new sites of disease identified. |
Generate impression based on findings. | 40-year-old male patient with diffuse abdominal pain, leukocytosis. Evaluate for pancreatic pseudocyst or other abdominal pathology. Streak artifact from a metallic clip in the left upper quadrant limits evaluation of surrounding structures. Additionally, motion limits evaluation.ABDOMEN:LUNG BASES: Motion limits evalu... | Hepatic steatosis without other specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Right lower quadrant pain and nausea; multiple myeloma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable segment 3 left lobe hepatic cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bil... | Extensive stool throughout the colon without evidence for acute inflammatory process, neoplasm, or obstruction. Fatty lesion arising from the uterus; favor benign etiology such as lipoleiomyoma |
Generate impression based on findings. | History of CLL with Richter's transformation. Known large retroperitoneal mass. Evaluate for lymphoma staging. Abdominal pain.RADIOPHARMACEUTICAL: 9.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 94 mg/dL. Today's CT portion grossly demonstrates a medium right and small left pleural effusion. Triangular s... | 1.Markedly hypermetabolic thoracic lymph nodes in the right paratracheal and subcarinal locations, very suspicious for lymphoma tumor activity.2.Enlarged lymph nodes elsewhere in the neck, chest, abdomen, and pelvis including a large retroperitoneal lymph node mass are only slightly FDG avid and considered more likely ... |
Generate impression based on findings. | 62-year-old female with history of bursitis, inability to walk, bilateral leg pain, no trauma. Lumbar spine: The bones appear slightly demineralized but we see no acute fracture. Moderate degenerative disc disease affects the lower lumbar spine and moderate to severe facet joint osteoarthritis affects the lower lumbar ... | Arthritic changes as described above. |
Generate impression based on findings. | Pain. Evaluate fracture. Again seen is a comminuted bicondylar fracture of the head of the proximal phalanx with slight lateral displacement of the lateral condylar fracture fragment appearing similar to the prior study accounting for slight positional and technical differences. Moderate osteoarthritis affects the firs... | Proximal phalangeal fracture appearing similar to that seen on the prior study. |
Generate impression based on findings. | 66-year-old male status post left total hip arthroplasty AP view of the pelvis demonstrates hardware components of a right total hip arthroplasty device situated in near anatomic alignment without evidence of hardware complication. Interval placement of a left total hip arthroplasty device situated in near-anatomic ali... | Interval placement of a left total hip arthroplasty device without evidence of complication. |
Generate impression based on findings. | Neutropenia and radiographic findings of pneumonia. Evaluate infection and pleural effusions. LUNGS AND PLEURA: Small region of tree-in-bud opacities in the right upper lobe (series 4 image 37). This may reflect trace aspiration or a small focus of developing infection. No significant parenchymal consolidations. Trace ... | 1.Trace bronchiolitis in the right upper lobe may related to aspiration or early developing infection. The more notable airspace opacity noted on recent chest radiograph correlates with basilar compressive/dependent atelectasis in the right lower lobe. No discrete consolidation of pneumonia.2.Small right and trace left... |
Generate impression based on findings. | PICC placementVIEW: Chest AP Midline sternal wires are present. Left upper extremity PICC with tip at the confluence of the brachiocephalic veins. Cardiothymic silhouette normal. Patchy atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Left PICC with tip at the confluence of the brachiocephalic veins. |
Generate impression based on findings. | 59-year-old male with foot pain. There is mild to moderate hallux valgus deformity with mild osteoarthritis of the first metatarsophalangeal joint. Mild osteoarthritis affects the interphalangeal joint of the great toe as well as the midfoot articulations. There are also enthesophytes along the base of the fifth metata... | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 82-year-old male with pain Marked hallux valgus deformity is again noted. Hammertoe deformity of the second toe. Limited examination of the ankle demonstrates resection of the distal fibula and fusion of the tibiotalar joint fixed with multiple screws. Extensive vascular calcifications are noted. | Marked hallux valgus and hammertoe deformity as described above. Postsurgical changes as above. |
Generate impression based on findings. | 29 year old male with tuberous sclerosis, renal angiomyolipoma, intractable epilepsy. Evaluate Renal angiomyolipoma for change, compare with previous. Evaluation is limited by streak artifact from anterior spinal orthopedic fixation hardware extending from T11 to L3.LUNG BASES: No focal consolidation or pleural effusio... | 1.No significant interval change in bilateral renal lesions within the limitations noted above.2.Marked dilation of the rectum measuring up to 11 cm in diameter. Correlate clinically for fecal impaction. |
Generate impression based on findings. | Trauma to the fifth digitVIEWS: Right hand AP, oblique and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | Metastatic breast cancer The diffuse abnormal uptake in the spine and pelvis is similar to prior, compatible with metastatic disease. The additional foci of increased activity in the right seventh rib, right scapular tip, bilateral mid humeri, and bilateral femoral metadiaphyses are not significantly changed, also comp... | Stable appearance of the osseous metastatic disease throughout the axial and appendicular skeleton. |
Generate impression based on findings. | 67-year-old female with hip pain, fall at home 2 views of the right hip show 3 orthopedic screws affixing a healing/healed fracture of the femoral neck with slight valgus alignment. We see no acute fracture. Mild osteoarthritis affects the right hip and sacroiliac joint. Small surgical clips overlying the right groin. | Orthopedic fixation of a healing/healed femoral neck fracture and osteoarthritis. We see no acute fracture. |
Generate impression based on findings. | Malignant neoplasm of esophagus status post chemotherapy CHEST:LUNGS AND PLEURA: Paramediastinal opacities most likely evolving radiation pneumonitis.MEDIASTINUM AND HILA: Circumferential proximal esophageal wall thickening has significantly improved, for reference at the level of the great vessels right lateral esopha... | Significant improvement in size of proximal esophageal mass. Small mediastinal lymph nodes are nonspecific and a be correlated with outside FDG PET scan which was not available at the time of dictation. Low left cervical lymphadenopathy is present however, suspicious for nodal metastases. No evidence of pulmonary or up... |
Generate impression based on findings. | Patient with new left breast cancer, check for metastatic disease LUNGS AND PLEURA: A suspicious spiculated left lower lobe mass is observed adjacent to and indistinguishable from the descending aorta and posterior cardiac margin. This 3.6 x 3.8 cm lesion (image 75 series 5) also is associated with a small to moderate ... | 1. Questionable left lower lobe paramediastinal mass concerning for primary malignancy with associated moderate effusion. Service contacted, Dr. Baron2. Left breast mass correlating with known breast cancer. |
Generate impression based on findings. | Lung cancer. Follow-up exam. CHEST:LUNGS AND PLEURA: Redemonstrated postsurgical changes from left lower lobectomy. Nonspecific bilateral pulmonary micronodules are not significantly changed. The calcified nodules in the right middle and lower lobe compatible with prior granulomatous infection. No new or suspicious pul... | Stable examination without evidence of recurrent or metastatic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Triplane fracture.EXAMINATION: CT left ankle 3-D reconstruction 05/11/15 The comminuted triplane fracture is again seen. | Comminuted triplane fracture as previously described. |
Generate impression based on findings. | Metastatic Ewing sarcoma status post induction chemotherapy. Evaluate response.RADIOPHARMACEUTICAL: 7.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 102 mg/dL. Today's CT portion grossly demonstrates a left PICC line with tip in the SVC. Extensive periostitis is seen involving the left iliac wing.Today's ... | Significant interval improvement with marked interval decrease in size, number, and activity of previous extensive hypermetabolic tumor. Residual tumor activity remains most notably involving the left iliac wing with several additional punctate scattered osseous sites. No new FDG avid lesion. |
Generate impression based on findings. | 29-year-old male with pain. Evaluate for fracture 3 views of the right ring finger again show a slightly comminuted and mildly displaced mallet fracture through the dorsal aspect of the base of the distal phalanx. This appears similar to prior study accounting for slight positional differences. | Mallet fracture as above. |
Generate impression based on findings. | PainVIEWS: Left wrist AP, oblique and lateral No acute fracture or dislocation. No evidence of soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 65-year-old female with pain The bones appear demineralized suggestive of osteopenia/osteoporosis. Slight rightward curvature of the lumbar spine. There is multilevel facet joint osteoarthritis severely affecting the lower lumbar spine. There is grade 1 anterolisthesis of L4 and L5. Mild to moderate degenerative disc d... | Degenerative arthritic changes as above. |
Generate impression based on findings. | Reason: re-eval pulm nodules History: immunosuppressed heart transplant patient with persistent upper respiratory sx and prior pulm nodules LUNGS AND PLEURA: Interval resolution of right middle lobe and left lower lobe patchy groundglass opacities. Small pleural effusions or pneumothorax. No suspicious pulmonary nodule... | Interval resolution of a patchy pulmonary opacities. No specific evidence of pneumonia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Prostate cancer Increase uptake identified in the right hemipelvis. Focal increased uptake in the T10 and T11 vertebrae are non-specific though may represent degenerative changes. Bilateral increased signal at the shoulder joints and knees likely represents degenerative changes. | 1. Increased uptake in the right hemipelvis. Though this appears atypical for metastatic disease, continue attention to this region on follow up examinations is recommended. Radiograph of the pelvis may be considered to exclude Pagetoid changes. 2. Increase foci of uptake in the thoracic spine may represent degenerativ... |
Generate impression based on findings. | 11-year-old female, evaluate scoliosis.VIEWS: Thoracolumbar spine PA standing out of brace (1 views) 5/13/2015 at 14:47 Dextroscoliosis of 42 degrees as measured from superior endplate of T6 to the inferior endplate of T12. Levoscoliosis of 27 degrees as measured from the superior endplate of L1 to the inferior endplat... | Stable thoracolumbar scoliosis as described above. |
Generate impression based on findings. | Sarcoidosis, COPD, and chest radiograph concerning for interstitial lung disease. LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema with a slight upper lobe predominance compatible with the stated history of COPD. No honeycombing, traction bronchiectasis, or other evidence of fibrosis.No dominant or suspi... | Severe emphysema without specific evidence of interstitial lung disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Low-dose protocol, tobacco use. Screening exam LUNGS AND PLEURA: Minimal scarring and/or atelectasis with scattered small 3 mm nodules bilaterally, some are calcified most compatible with granulomatous disease exposure. No suspicious nodules or masses. No effusions. Mild centrilobular emphysema.Mild bronchial wall thic... | Suspected granulomatous disease exposure given bilaterality and partial calcification of scattered micronodules. |
Generate impression based on findings. | Reason: head and neck cancer evaluate for tx, please provide measuremtns History: as above LUNGS AND PLEURA: Scattered calcified noncalcified micronodules compatible with a prior granulomatous disease.No suspicious pulmonary nodules or masses.No pleural effusions.Minimal scarring/discoid atelectasis at the left lung ba... | No evidence of metastatic disease. |
Generate impression based on findings. | Lung transplant workup, SOB, COPD. LUNGS AND PLEURA: Severe centrilobular emphysema. No pleural fluid or pneumothorax. Mild mucous plugging of the airways in the lung bases, left greater than right. Stable scarlike opacity at the right apex (5/10).New 6 x 6 x 8 mm mm nodule in the posterior aspect of the left upper lob... | New 6 x 6 x 8 mm lipid-containing left upper lobe nodule- differential considerations include a postinflammatory focus of endogenous lipoid pneumonia or an intrapulmonary lymph node. Though the lesion is most likely benign, three-month follow-up CT is suggested. The additional lesions appear stable, also favoring benig... |
Generate impression based on findings. | 44 year old male with hx of intraabdominal and epidural abscess. R/o abscess intraabdominal. LUNG BASES: No focal consolidation or pleural effusion. No suspicious pulmonary nodules. Micronodule along the right major fissure likely represents an intrapulmonary lymph node (series 6, image 50).LIVER, BILIARY TRACT: Subcen... | 1.No findings to suggest intra-abdominal abscess.2.Stable soft tissue thickening anterior to the L4-S1 vertebral bodies, likely postsurgical in etiology -- infection in this region is therefore unlikely. |
Generate impression based on findings. | Reason: h/o tonsil cancer and CRT, PET+ lesions, compare to previous, eval for growth, measurements pls LUNGS AND PLEURA: Right upper lobe calcified granuloma. No pleural effusions or pneumothorax. No suspicious nodules or masses.MEDIASTINUM AND HILA: Mild thickening of the tracheal wall. Mild increase in the size of a... | Small but enlarging right paratracheal lymph node and development of ipsilateral enlargement of the thymus. These findings are indeterminant however early or indolent metastatic disease cannot be entirely excluded. Consider PET scan. |
Generate impression based on findings. | Right breast cancer and uterine adenosarcoma No definite abnormal osseous foci are identified to indicate metastatic disease.There is mild soft tissue uptake in the right breast, likely reflecting treatment changes. | No definite evidence of bone metastases. |
Generate impression based on findings. | Progressive metastatic breast cancer assess for brain metastases. There is no evidence of intracranial mass or abnormal enhancement. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major ce... | No evidence of intracranial metastases. |
Generate impression based on findings. | 42-year-old female with breast cancer-compare to last CT scan provide tumor measurements. Status post 2 cycles of chemotherapy. CHEST:LUNGS AND PLEURA: Continued increase in size and number of bilateral pulmonary parenchymal lung nodules. The prior referenced right lower lobe nodule (mistakenly referred to as left lowe... | Progressive metastatic disease seen in lung parenchyma, mediastinal and axillary lymph nodes, subcutaneous tissues, liver and skeletal system with increasing size and number of lesions seen as described above. |
Generate impression based on findings. | Lung cancer, follow-up CHEST:LUNGS AND PLEURA: The posterior right upper lobe mass remains similar in overall size given slight differences in patient positioning and gantry angle. The mass remains 5 x 7 cm (image 39 series 6) with a new moderate pleural effusion layered posteriorly. Surrounding atelectasis and extensi... | Stable reference measurements as described, however a new interval moderate right pleural effusion superimposed upon the previously measured scattered bilateral metastatic disease and right sided mass |
Generate impression based on findings. | Lung cancer. Follow-up exam. CHEST:LUNGS AND PLEURA: Demonstration of a right middle lobe mass compatible with the patient's known primary tumor. Another measures 4.6 x 3.3 cm (series 5 image 62), previously 3.7 x 3.1 cm. Multiple additional right upper and left upper lobe nodular opacities ranging from partially groun... | 1.Interval increase in size of right middle lobe primary malignancy. Multiple additional solid and some solid nodular opacities in the upper lobes are not significantly changed and may represent metastases or synchronous primary malignancies.2.Interval increase in size of confluent right mediastinal/hilar lymph node me... |
Generate impression based on findings. | Scoliosis and surgery.VIEWS: Spine standing PA/lateral (two views) 05/13/15 Spinal fusion instrumentation extends from T3 to L1. Rods, hooks, and pedicle screws are intact.A residual right thoracic curve is seen.A moderate amount of feces is present in the colon. | Postoperative changes with no evidence of complication. |
Generate impression based on findings. | 59 year old female s/p ERCP and IR embolization. Abd pain. Assess fluid collection. LUNG BASES: Small right and trace left pleural effusions with overlying compressive atelectasis. LIVER, BILIARY TRACT: Liver enhances homogenously without focal lesion. Status post cholecystectomy.SPLEEN: No significant abnormality note... | Known pancreatic pseudocyst measures up to 8.9 cm, status post cystoduodenostomy drainage. Few other smaller loculated peripancreatic fluid collections are also present. |
Generate impression based on findings. | Provided history: MAI on therapy, COPD, assess stability of lung nodules. History per pathology report states right lung upper lobe adenocarcinoma. LUNGS AND PLEURA: Severe emphysema. No pneumothorax or pleural fluid.Interval right upper lobectomy. No signs of localized recurrence. New subpleural scarring at the right ... | Postsurgical changes of a right upper lobectomy with no signs of recurrent or metastatic disease. Pulmonary nodules/lymph nodes are stable and likely benign. Signs of pulmonary hypertension. |
Generate impression based on findings. | Reason: 60 yo male with hx of GIST; pt has LLL chest nodule; please evaluate for abnormalities a History: chest nodule; laparoscopic transgastric wedge resection of posterior gastric fundus, completion upper endoscopy for GIST on 04/24/15 LUNGS AND PLEURA: Left lower lobe nodule decreased in density and now appears to ... | 1.Left lower lobe lesion appears decreased in density, now a cluster of small nodules. This may represent primary pulmonary neoplasm as it appears atypical for a metastasis. Lesion would be difficult to percutaneously biopsy. Follow-up CT suggested in 3 months. An additional diagnostic consideration could be a cluster ... |
Generate impression based on findings. | Head neck cancer, follow-up CHEST:LUNGS AND PLEURA: There continues to be no suspicious nodules or masses. Mild diffuse emphysematous changes without effusions. Scattered micronodules unchanged including a slightly focal larger nodule in the apical segment of the right lower lobe (image 49 series 5).MEDIASTINUM AND HIL... | No distinct intrapulmonary findings to suggest metastatic disease, however mild increasing compression wedge deformities of 2 vertebral bodies, see detail provided |
Generate impression based on findings. | Delayed gastric emptying. Nausea and vomiting with food contents 8 hours status post meals. Visually there was morphologic abnormality related to the patient's gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 m... | Gastric emptying within normal limits. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Stable scattered nonspecific micronodules. No new suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of pericardi... | No evidence of metastatic disease. |
Generate impression based on findings. | Hyperparathyroidism There is physiologic distribution of the radiopharmaceutical. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. NM PARATHYROID IMG W/SPCT AND CT ANTMCL LCLZTN, 5/13/2015 12:40 PMCLINICAL INFORMATION:HyperparathyroidismTECHNIQUE: 21.5 mCi Tc-99m sestamibi was inject... | Findings compatible with ectopic parathyroid tissue in the left paratracheal soft tissues. |
Generate impression based on findings. | 45-year-old female with mid point tenderness in the C-spine Cervical spine: Mild straightening of the usual cervical spine lordosis may be secondary to positioning or muscle spasm. Vertebral body heights and disc spaces are preserved. No acute fracture or traumatic subluxation is evident. The neural foramina are intact... | 1.No acute fracture or traumatic subluxation.2.Bilateral total hip arthroplasty devices without evidence of hardware complication as described above. |
Generate impression based on findings. | 36-year-old male patient with history of bilateral complex renal cysts. Evaluate for concerning RCC lesions. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: There is a 1.4 x 1.4 cm enhancing lesion in segment 8 of the liver (image 28, series 6) which likely represents a flash filling hemangio... | 1. Multiple bilateral renal cysts, some of which are complex and others which are new from an OSH MRI from 2012, without specific radiographic features to suggest malignancy.2. Scattered foci of enhancement within the liver likely represent flash filling hemangiomas or transient hepatic attenuation differences. |
Generate impression based on findings. | Cerebral aneurysms, nonruptured. There is an unchanged superiorly directed ACOM saccular aneurysm that measures up to 6 mm in diameter with a 3 mm wide neck. There is an unchanged saccular aneurysm arising from the left MCA bifurcation that measures up to 5 mm in diameter with a 2 mm wide neck. There is an unchanged li... | 1. Unchanged ACOM saccular aneurysm that measures up to 6 mm in diameter with a 3 mm wide neck. 2. Unchanged left MCA bifurcation that measures up to 5 mm in diameter with a 2 mm wide neck. 3. Probable basilar artery fenestration, which appears unchanged. |
Generate impression based on findings. | Esophageal cancer CHEST:LUNGS AND PLEURA: Persistent and unchanged minimal bilateral and largely basilar dependent atelectasis superimposed upon a fine interstitial change, presumably chronic. No suspicious pulmonary nodules or masses. No effusions. Shifting mild tracheal debrisMEDIASTINUM AND HILA: Persistent moderate... | Distal esophageal adenocarcinoma with interval stability solitary mediastinal lymph node |
Generate impression based on findings. | 82-year-old female with chronic knee pain Left knee: 2 nonweightbearing views of the left knee show chondrocalcinosis and mild sharpening of the tibial spine suggestive of mild osteoarthritis. No joint effusion. The extensor mechanism appears intact. A fabella is noted.Right knee: 2 nonweightbearing views of the right ... | Degenerative changes as described above. |
Generate impression based on findings. | MRA HEAD: There is mild narrowing of the bilateral petrous segments, moderate narrowing of the right communicating segment, and severe narrowing of the left cavernous and distal left communicating segments of the internal carotid arteries. There is mild stenosis of the proximal left M1 segment and severe stenosis of t... | 1.Severe intracranial vascular disease with multifocal proximal and distal stenoses.2.Severe bilateral cervical vertebral artery disease with extensive stenoses.3.No significant cervical internal carotid artery stenosis. |
Generate impression based on findings. | Age: 56 years. Sex : Male. Reason for study: Reason: 56 y/o M with dysphagia, ? pharyngeal transport issue History: as above. 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. Two static images ... | Positive for vestibular penetration and negative for tracheal aspiration.Please refer to dedicated speech therapist's report for additional details. |
Generate impression based on findings. | 58 year old male with worsening chronic constipation, tenesmus, liquid stool, abd ttp, worst in llq, no peritoneal signs. Eval for diverticulitis, obstruction, stool burden, bowel wall pathology, colitis. LUNG BASES: No focal consolidation or pleural effusion. No suspicious pulmonary nodules. Minimal bilateral scarring... | 1.No specific findings to account for abdominal pain.2.Average colonic stool burden. |
Generate impression based on findings. | Follow-up of lung nodule. LUNGS AND PLEURA: Bilateral apical airspace opacity is unchanged, most consistent with scarring.Right lower lobe subpleural part solid nodule measures 13 x 9 mm, previously 10 x 6 mm. The anterior solid component has increased in size and density over the last 2 scans.Numerous subcentimeter gr... | 1. Continued enlargement of right lower lobe nodule, compatible with a primary pulmonary neoplasm. Further evaluation recommended.2. Mild ectasia of the thoracic aorta.3. Enlargement of the main pulmonary artery consistent with pulmonary arterial hypertension.4. Numerous groundglass density subcentimeter nodules may re... |
Generate impression based on findings. | Patient with stem cell transplant, now with cough. Check for infection. History of acute lymphoid leukemia LUNGS AND PLEURA: Persistent continued resolution of the multiple patchy airspace opacities greater in the right lower lobe. No distinct superimposed new focal airspace abnormalities, specifically no nodules or ma... | Continued improvement and decreased density in focal opacities observed in both lung bases, compatible with interval improvement and resolution of previously described multifocal infection in this immunocompromised patient. See details provided |
Generate impression based on findings. | 38-year-old female with ulnar right wrist pain 3 views of the right wrist show no acute fracture. Alignment is anatomic. Cysts are noted in the triquetrum near the lunotriquetral articulation. Although the ulna is not particularly long, this may represent ulnar abutment syndrome. | Cyst in the triquetrum may be due to ulnar abutment syndrome. This can be further evaluated with MRI. |
Generate impression based on findings. | Evaluate ETT placementVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. Cardiothymic silhouette normal. Patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. There is partial visualization of the G-tube. | ET tube tip below thoracic inlet and above the carina. |
Generate impression based on findings. | 76-year-old male for evaluation of gout Right hand: 3 views of the right hand demonstrate severe osteoarthritis at the radiocarpal joint with joint space narrowing. Severe osteoarthritis affects the triscaphe joint and basilar joint. No overhanging edges or erosions to suggest gouty arthritis. Ulnar styloid is enlarged... | 1.Severe degenerative disease as described above.2.Ankylosis of the left hand third DIP joint with surrounding soft tissue swelling may be due to an inflammatory arthritis.3.No specific evidence of gouty arthritis. |
Generate impression based on findings. | Breast cancer. There is left supraclavicular and axillary lymphadenopathy, which appears to have decreased in size since December 2014, accounting for differences in technique. For example, a left supraclavicular lymph node measures 8 x 14 mm. The thyroid and major salivary glands are unremarkable. The major cervical v... | 1. Metastatic left supraclavicular and axillary lymphadenopathy appears to have decreased in size since December 2014, accounting for differences in technique.2. Postoperative findings related to upper thoracic corpectomy, with evidence of loosening of the lower laminar screws. |
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