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Generate impression based on findings. | Malignant neoplasm, follow-up. squamous cell in lung LUNGS AND PLEURA: Scattered micronodules which remain nonspecific and unchanged. Many remain calcified and compatible with old granulomatous disease exposure. No new suspicious nodules or masses.Biapical fibrosis and consolidation compatible with old radiation change... | Essentially stable left upper lobe mass and post radiation changes yet without new findings to support interval new spread of disease. |
Generate impression based on findings. | Metastatic prostate cancer status post 3 cycles of investigational therapy. Please complete PCWG2 form. The numerous foci of increased radiotracer uptake throughout the ribs, entire spine, and pelvis compatible with metastatic lesions have decreased in size, uptake intensity, and number. No new lesions suspicious for m... | Interval improvement in the osseous metastatic disease. |
Generate impression based on findings. | Evaluate mediastinal mass. LUNGS AND PLEURA: Moderately severe centrilobular emphysema in the upper lobes with a large anteroinferior bulla occupying the position of the right middle lobe. This is not typos its originChestLarge bulla occupying the anteroinferior portion of the right hemithorax with adjacent compressive... | 1.Persistent focal nodular opacities in the right lower lobe with mild increase in pleural effusion. This could represent organizing pneumonia however a focal underlying low-grade adenocarcinoma in the posterior aspect of the right lower lobe cannot be ruled out given the lack of resolution and increase from 2014 study... |
Generate impression based on findings. | 48-year-old female with rheumatoid arthritis Right foot: 3 weightbearing views of the right foot demonstrate juxta articular osteopenia and cortical irregularity particularly at the head of the fifth metatarsal compatible with rheumatoid arthritis erosion. Mild cortical irregularity at the base of the third proximal ph... | 1.Findings compatible with rheumatoid arthritis as described above. 2.Hinge-type left elbow arthoplasty without evidence of hardware complication. 3.Other findings as above. |
Generate impression based on findings. | History of multiple lung nodules concerning for metastatic disease. CHEST: Respiratory motion artifact degrades image quality, significantly limiting the examination.LUNGS AND PLEURA: Bilateral pulmonary nodules, the majority are unchanged though some in the left costophrenic angle region have resolved. Largest lesion ... | 1. Large pulmonary embolus in the distal left main pulmonary artery extending into the left descending artery and lingular branches. Cardiac configuration indeterminate for the presence of right heart strain. Dr. James Wallace verbally notified.2. The remaining pulmonary nodules are stable to smaller, and a few lesions... |
Generate impression based on findings. | 64 year old female s/p chemotherapy for recurrent ovarian cancer. Evaluate for response. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious pulmonary nodules. MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. Caliber of the great vessels is normal. No significant me... | 1.Previously demonstrated small volume ascites and peritoneal nodularity are no longer appreciable.2.Stable mildly enlarged left para-aortic retroperitoneal lymph node.3.No specific evidence of remaining measurable metastatic disease. |
Generate impression based on findings. | 54-year-old female. Asymptomatic female. Diagnostic mammogram recommended in place of screening due to difficulty in positioning patient due to patient's body habitus and limited mobility. Two standard views of both breasts and additional bilateral MLO and CC views were performed digitally and reviewed with the aid of ... | Difficult and limited exam secondary to patient's body habitus and limited mobility. Given these limitations, no mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually due to difficulty in imaging this patient. Results an... |
Generate impression based on findings. | 56-year-old male with malignant neoplasm of connective and other soft tissues-evaluate for progression of metastatic disease. CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary parenchymal nodules consistent with metastatic disease. These subjectively all appear unchanged compared to 4/21/2015. Reference nodule in th... | 1. Multiple pulmonary metastatic lesions unchanged since 4/21/2015.2. Enlarged right internal mammary lymph node, slightly larger than previous exam as measured above. 3. Right adrenal gland mass unchanged in size. This may represent metastatic disease but adenoma cannot be excluded on this single contrast phase CT. 4.... |
Generate impression based on findings. | 7-year-old male with history of relapsed neuroblastoma, pre-MIBG therapy. CHEST:LUNGS AND PLEURA: No masses or pleural effusions.MEDIASTINUM AND HILA: No pericardial effusion or significant lymphadenopathy.CHEST WALL: Heterogeneous appearance of vertebral bodies, may represent tumor involvement and/or therapeutic respo... | 1.Several calcified retroperitoneal lymph nodes and surgical clips are seen, with subtle soft tissue prominence adjacent to the celiac axis that may represent postoperative changes although this is nonspecific and should be correlated with nuclear medicine scan.2.Heterogeneous sclerosis of the axial skeleton, correlate... |
Generate impression based on findings. | Left upper extremity sarcoma CHEST:LUNGS AND PLEURA: Interval decreased. Persistent small to moderate pleural effusions. Underlying atelectasis without suspicious nodules or masses. Moderate emphysematous changes similar to prior. Scarring again observed in the left lung base and apices remain unchanged.MEDIASTINUM AND... | Interval decreased pleural effusions without suspicious new abnormalities. Specifically no findings to suggest metastatic disease |
Generate impression based on findings. | Female, 30 years old. Reason: infertility History: infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed an anteverted uterine cavity without mucosal irregularity or filling defects in the uterine cavity. Both fallopian tubes were freely opacified with initial free spillage on... | Normal uterine cavity and patent fallopian tubes. |
Generate impression based on findings. | Sarcoma, follow-up. Myxofibrosarcoma involving the left clavicle LUNGS AND PLEURA: Persistent mild basilar atelectasis and or scarring. No suspicious new pulmonary nodules or masses, other than calcified granuloma, benign in appearance. No effusions. Stable appearing post radiation changes largely observed in left apex... | Stable postsurgical changes without evidence of recurrent or metastatic disease |
Generate impression based on findings. | PainVIEWS: Left knee AP, oblique and lateral No acute fracture or dislocation. There is a small knee joint effusion. | No acute fracture or dislocation. |
Generate impression based on findings. | 42-year-old female with pain, bunion. Rule out bunion formation 4 views of the right foot show mild hallux valgus deformity. Mild osteoarthritis affects the first metatarsophalangeal joint and midfoot articulations. There are ossicles at the second metatarsophalangeal joint and adjacent to the medial cuneiform which ma... | Mild hallux valgus deformity and degenerative changes as above. |
Generate impression based on findings. | Non-small cell lung cancer, follow-up LUNGS AND PLEURA: Postoperative changes from left upper lobectomy with bilateral apical minimal scarring. No suspicious new nodules or masses. No effusions. Mild emphysematous changes. Scattered micronodules unchangedMEDIASTINUM AND HILA: Unchanged left mediastinal shift without su... | No specific evidence to suggest recurrent or metastatic disease |
Generate impression based on findings. | 41-year-old with palpable lump in the left breast. Thickening of the breast is vaguely palpated at 9:00 position in the left breast. Focused ultrasound shows ill-defined hypoechoic mass measuring 7 x 4 mm at 9:00 position, 4 cm from the nipple in the left breast. Color Doppler study detects at increased blood flow with... | Suspicious mass in the left 9:00 position. Subsequently, ultrasound guided biopsy was performed for this mass.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 55-year-old female with foot pain. 4 views of the left foot show a moderate hallux valgus deformity. Mild osteoarthritic changes affect the first metatarsophalangeal joint. Mild osteoarthritis affects scattered interphalangeal joints. Small linear metallic foreign body in the soft tissues plantar to the distal phalanx ... | Hallux valgus deformity and mild osteoarthritic changes as above. |
Generate impression based on findings. | 41-year-old with suspicious mass in the left breast. Left ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 7 x 4 mm at the 9 o’clock position with increased vascularity, 4 cm from the nipple. The lesion was readily visible.PROCEDURE: The procedure and its r... | Successful ultrasound-guided core biopsy of the left breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female 10 years old Reason: evaluate scoliosis out of brace History: scoliosisVIEWS: Thoracolumbar spine standing out of brace PA (1 views) 5/13/2015 40 degrees of dextroscoliosis as measured from the superior endplate of T6 to the inferior endplate of L1. 16 degrees of levoscoliosis as measured from the superior endpl... | Stable thoracolumbar scoliosis as described above. |
Generate impression based on findings. | 32-year-old female patient with progressive metastatic triple negative breast cancer with lung metastases. Compare to outside CT 1/2015. Postchemotherapy. CHEST:LUNGS AND PLEURA: Postsurgical changes of a left upper lobe wedge resection with interval resection of a subpleural pulmonary nodule. There is nonspecific soft... | 1. Status post left upper lobe wedge resection with non-specific soft tissue thickening about the suture line. New left lower lobe subpleural nodular opacity is suspicious for metastases.2. Subcentimeter hypodense hepatic lesion is indeterminate.3. Complex left renal lesions for which follow up would be helpful. |
Generate impression based on findings. | Female, 38 years old. Reason: infertility History: infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed revealed an anteverted uterine cavity without mucosal irregularity or filling defects in the uterine cavity. Both tubes were freely opacified with free spillage on on the r... | Normal uterine cavity and patent right fallopian tubes. Dilated fimbria on the left without free spillage of contrast suggesting peri-fimbrial adhesions. |
Generate impression based on findings. | Patient with cough. Intestinal C. difficile infection LUNGS AND PLEURA: New mixed and largely focal airspace abnormality observed in the right upper lobe along the major fissure as well as a smaller scattered foci in the superior segment and posteriorly throughout the right lower lobe. Small associated effusion. Minima... | In light of the patient's history, multifocal infection is most likely with questionable superimposed aspiration |
Generate impression based on findings. | 68-year-old male with pain. Evaluate for instability. There is mild to moderate degenerative disc disease at L3/L4 and L4/L5. Moderate facet joint osteoarthritis affects the lower lumbar spine. There is grade 1 anterolisthesis of L4. Vertebral body heights are preserved. | Degenerative arthritic changes as above. |
Generate impression based on findings. | 9-year-old female with hemoglobin SS, chest pain and shortness of breath. Evaluate for acute chest.EXAMINATION: Chest PA and lateral (2 views) 5/13/2015 at 15:15 The heart is enlarged and there is pulmonary over circulation. Linear opacity along the right hilum compatible with atelectasis. No focal pulmonary opacity, p... | Right perihilar atelectasis. No radiographic evidence of acute chest. |
Generate impression based on findings. | 39-year-old male with recent increase in seizures. There is no evidence of intracranial hemorrhage. The gray-white matter differentiation appears to be maintained. There is moderate prominence of the ventricles and sulci, with diffusely prominent subarachnoid spaces, consistent with volume loss. There is no mass effect... | 1.There is no evidence of intracranial hemorrhage or mass effect. 2.There is a grossly stable appearance of moderate ventriculomegaly and prominence of the subarachnoid spaces, compatible with volume loss. |
Generate impression based on findings. | Restaging breast cancer status post chemotherapy. Rising tumor marker.RADIOPHARMACEUTICAL: 9.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion grossly demonstrates a chronic appearing osseous lesion that the posterior occiput which is not FDG avid and may be benign. Right mastect... | Progression of hypermetabolic tumor most notably involving the right pleura, liver, carcinomatosis, and with a new bone metastasis at L5. |
Generate impression based on findings. | There is an large oval-shaped hyperdense mass based on the right greater wing of the sphenoid, measuring 2.8 x 4.5 cm in greatest axial dimensions x 2.6 cm CC, with associated periosteal reaction the floor of the right middle cranial fossa. The epidural component of the mass results in mass effect upon the right tempo... | 1. Large soft tissue mass based on the right greater wing of the sphenoid with right lateral extraconal involvement as well as epidural component which results in mass effect upon the right temporal lobe. Additional heterogeneity along the superior medial aspect of the mass with adjacent temporal lobe hypoattenuation s... |
Generate impression based on findings. | Reason: h/o met thyroid ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Innumerable lower lobe predominant metastatic micronodules in a miliary pattern unchanged from the prior exams.Subpleural lingular nodule (image 75 series 5) is unchanged measuring 12 mm x 11 mm.Left upper lobe nodul... | No interval change in the innumerable metastatic pulmonary nodules. No sites of disease identified. |
Generate impression based on findings. | 3-year-old male with history of pilocytic astrocytoma, of the tectum. Exam is limited secondary to intraoperative technique. The known tectal plate mass is not well appreciated on this study. The lateral and third ventricles appear enlarged, grossly similar to prior. Intraventricular contrast is layering within the rig... | 1.Limited intraoperative CT of the head demonstrates layering contrast material within the right lateral ventricle administered via a right frontal approach ventriculostomy catheter, which terminates along the lateral aspect of the right frontal horn. The left lateral, third, and fourth ventricles are not opacified.2.G... |
Generate impression based on findings. | Right lung mass. Follow-up exam. LUNGS AND PLEURA: Redemonstration of a left upper lobe mass extending into the hilum. The main body of the mass is not significantly changed measuring 5.6 x 4.5 cm (series 4 image 20), previously 6.1 x 5.3 cm.However, there is marked interval increase in the size and number of multiple ... | 1.Marked interval increase in peripheral nodules in the left upper and left lower lobes compatible with worsening lymphangitic tumor spread.2.New right lower lobe nodules compatible with additional metastatic lesions.3.Additional tumor in the right hilum with adjacent nodularity suggestive of lymphangitic spread is not... |
Generate impression based on findings. | 29-year-old female. Right inferior breast mass on ultrasound for which biopsy is recommended. Has a brain tumor and mediastinal/retroperitoneal/pelvic lymphadenopathy concerning for metastatic disease. Evaluating for a primary source. Right breast ultrasound re-identified the target lesion for biopsy. The lesion to be ... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. This is most likely a malignancy. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 68-year-old male patient with shortness of breath. Preoperative evaluation for mitral valve replacement. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Scattered subcentimeter hypodense hepatic lesions are too small to characterize. Cholelithiasis without CT evidence of acute cholecystitis. ... | 1. Arterial measurements as described above.2. Bilateral renal cysts and nonobstructing right nephrolithiasis. |
Generate impression based on findings. | Lymphoma subsequent treatment strategy. History of acute lymphoid leukemia. Also with fevers and bacteremia.RADIOPHARMACEUTICAL: 8.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 233 mg/dL. Today's CT portions of the neck, abdomen, and pelvis grossly demonstrate chronic appearing bilateral maxillary sinusi... | 1.Single medium-sized markedly hypermetabolic hepatic dome lesion, very suspicious for primary (benign or malignant) or metastatic hepatic neoplasm. Apparent lack of central necrosis argues against abscess although given the history, hepatic infection cannot be entirely excluded.2.No additional convincing suspicious FD... |
Generate impression based on findings. | 54 years, Female. Reason: dobhoff History: dobhoff Dobbhoff tube with tip overlying the proximal gastric body. Paucity of bowel gas is noted. Interval placement of 5 radiopaque surgical sponges. The clinical service was contacted and reported that these sponges were external to the patient within a wound VAC. Multiple ... | Dobbhoff tube with tip overlying the proximal gastric body.Findings, including the radiopaque sponges, were discussed by telephone with the ICU physician, Dr. Gordon at 4:30 PM on 5/13/2015. |
Generate impression based on findings. | Knee pain with sports.VIEWS: Knee standing AP/Notch, knees merchant, right knee lateral, left knee lateral (right knee-4 views, left knee-4 views) 05/13/15 A small right joint effusion is present. A well-corticated synovial ossicle measures approximately 0.9 cm on the right. Articular surfaces of the femurs and tibias ... | Right synovial osteochondromatosis. |
Generate impression based on findings. | Breast cancer. Follow-up exam. LUNGS AND PLEURA: Compressive atelectasis in the left lung base secondary to the patient's scoliosis. No dominant or suspicious pulmonary nodule. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Right chest port with tip at the cavoatrial junction. No mediastinal or hilar lymphad... | 1.Interval decrease in size of left breast mass, left axillary lymphadenopathy, and left supraclavicular lymphadenopathy.2.No definite internal mammary lymphadenopathy or focal osseous lesion in the sternum. Previously noted hypermetabolism in this region may be related to the patient's postsurgical changes or tumor wh... |
Generate impression based on findings. | 35 years, Female. Reason: assess for constipation History: 35 y.o. with abdominal pain and history of constipation Nonobstructive bowel gas pattern with average stool burden. Lung bases are clear. | Average stool burden. |
Generate impression based on findings. | 32 years, Male. Reason: dobhoff History: dobhoff Dobbhoff tube with tip overlying the proximal gastric body. Nonobstructive bowel gas pattern. Status post median sternotomy with mediastinal surgical clips. | Dobbhoff tube with tip overlying the proximal gastric body. |
Generate impression based on findings. | 65 years, Male. Reason: ngt place,ent History: see above NG tube with tip projecting over the second portion of the duodenum. Nonobstructive bowel gas pattern. Catheter overlying the right pelvis, which is unchanged. Please refer to dedicated chest radiograph from the same day for additional details. | NG tube with tip projecting over the second portion of duodenum. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (12/10/14, 12/17/14), ultrasound images of left breast (12/17/14) performed at Dreyer Medical Clinic. DIGITAL MAMMOGRAPHIC IMAGES (12/10/14, 12/17/14):The breast parenchyma is heterogeneously dense. There is a 7 mm round ... | A mass in the left breast at 5-6:00 position. Repeat ultrasound of the left breast with possible ultrasound guided biopsy is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 87-year-old male with mmp w/fall on outstretched left hand, radial tenderness w/wrist swelling There is a nondisplaced, transverse fracture through the distal radius with possible extension to the articular surface. The distal ulna appears intact. Severe osteoarthritis affects the basilar joint. The bones appear demine... | Distal radius fracture as above.Findings were discussed with Dr. Justin Boike by phone on 5/13/2015 at 4:40 PM. |
Generate impression based on findings. | 31-year-old female with metastasis question of impending fracture Mixed lytic and sclerotic lesions in the greater trochanter and mid and distal femoral diaphysis are compatible with osseous metastasis. Additional sites are also noted within the right iliac wing and partially visualized proximal fibula. | Mixed lytic and sclerotic metastatic lesions as described above. |
Generate impression based on findings. | JRA and pain between the third and fourth toes bilaterally, evaluate for neuroma.EXAMINATION: Left foot AP, lateral, and oblique (3 views) 5/13/2015Right foot AP, lateral, and oblique (3 views) No joint space narrowing or bone erosion. No acute fracture or malalignment. | Normal examination. |
Generate impression based on findings. | Staging newly diagnosed Hodgkin's lymphoma.RADIOPHARMACEUTICAL: 9.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 66 mg/dL. Today's CT portion grossly demonstrates multiple enlarged lymph nodes in the left neck and bilateral supraclavicular regions. Additional enlarged bilateral axillary and anterior media... | 1.Extensive markedly hypermetabolic tumor involving lymph nodes of the left neck and throughout the thorax.2.Several additional subtle but abnormal foci in the upper abdomen involving lymph nodes and spleen, very suspicious for abdominal tumor involvement. |
Generate impression based on findings. | Chest pain LUNGS AND PLEURA: No focal parenchymal opacity. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Heart is normal in size. No pericardial effusion.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: Multilevel degenerative changes within the lower thoracic spine.U... | 1.No findings in the chest to account for the patient's pain.2.Poorly defined lesion within the liver as described. This is nonspecific, but in the absence of a known history of malignancy and occurring in a normal background liver, this is statistically most likely benign. Ultrasound can be considered as clinically wa... |
Generate impression based on findings. | Male, 56 years old. No unexpected radiopaque foreign object. Skin staples project over the mid-abdomen and bilateral hips. Bilateral common iliac stents and bypass graft material is noted. Excretion of contrast is noted in the bilateral renal collecting systems and bladder presumably from recent aortofemoral bypass pro... | No expected radiopaque foreign object.The findings were discussed by telephone with the attending surgeon, Dr. Babrowski, by the radiology resident on call at 7:00 PM on 4/20/2015. |
Generate impression based on findings. | History brain metastasis, possible intracranial hemorrhage. There is a diffuse swelling of right temporal occipital lobe with a subtle masslike lesion indicate possible metastasis with surrounding edema based on clinical history. However, possibility of primary intra-axial mass lesion or acute ischemic infarct may not ... | Right temporal occipital brain swelling with subtle increased masslike attenuation indicate possible brain mass with the surrounding edema such as metastatic lesion more likely.No definitive evidence of intracranial hemorrhage.Brain MRI with and without contrast enhancement is recommended for further evaluation.I perso... |
Generate impression based on findings. | Female, 44 years old. Reason: 44F s/p lap sleeve gastrectomy on 4/3/15 with emesis History: emesis of solids and liquids The scout film shows a nonobstructive bowel gas pattern. Right upper quadrant surgical clips are noted. Surgical suture material is noted in the left upper quadrant. Contrast is visualized within the... | 1.Findings consistent with SMA syndrome.2.Postsurgical changes from gastric sleeve procedure. |
Generate impression based on findings. | Right tonsillar head neck cancer status post chemotherapy. Restaging exam.RADIOPHARMACEUTICAL: 11.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 111 mg/dL. Today's CT portion grossly demonstrates confluent abnormal soft tissue density and adjacent lymph nodes throughout the right neck, right supraclavicul... | 1.Extensive recurrent hypermetabolic tumor in the right neck and thorax.2.Several bilateral new benign-appearing rib fractures. |
Generate impression based on findings. | 72-year-old female with nasal trauma 3 views of the nasal bone show a depressed and likely comminuted fracture of the nasal bone. Tiny metallic density along the inferior margin of the nasal bone may represent a small foreign body. Embolization coils are noted to the left of the sella turcica. | Depressed nasal bone fracture as described above. These findings were relayed to Dr. Corey at the time of dictation. |
Generate impression based on findings. | Restrictive lung disease with mosaic pattern on outside study. LUNGS AND PLEURA: Mild parenchymal mosaic attenuation which becomes more pronounced on the expiratory images. No reticulation, nodularity, architectural distortion, or fibrosis. This is not significantly changed from prior.Unchanged regions of peripheral sc... | Stable mosaic attenuation in the lungs bilaterally. Given the patient's history of pulmonary embolism and evidence of pulmonary hypertension, this is most consistent with chronic thromboembolic disease. Overall, the findings are not significantly changed since 2004. |
Generate impression based on findings. | : 44 yo man with hx of asthma and adenopathy. now with new upper lobe reticular nodular changes. Eval for sarcoid vs ABPA History: shortness of breath LUNGS AND PLEURA: Upper lobe predominant bronchiolar wall thickening with tree-in-bud opacities, and both solid and groundglass nodules. The largest measures 12.5 mm (im... | 1.Demonstration of upper lobe predominant bronchiolar wall thickening, tree-in-bud opacities, and scattered groundglass and solid nodules. The differential diagnosis would include an eosinophillic bronchiolitis including Churg-Strauss syndrome as well as other eosinophillic lung diseases. In addition, sarcoidosis canno... |
Generate impression based on findings. | Right upper lobe lesion noted on chest radiograph. No additional history provided. LUNGS AND PLEURA: Post surgical changes from surgical resection of the left upper lobe proper. Cystic bronchiectasis in the right upper lobe may be postinfectious and chronic, some of the cystic lesions appear to intercommunicate. Consol... | 1.Right upper lobe consolidation, cystic nodules and ipsilateral pleural fluid/thickening and mild lymphadenopathy as described which has features most suggestive of active infectious process such as Mycobacterium Tuberculosis or other atypical mycobacterial infection, occurring in a patient with cystic bronchiectasis.... |
Generate impression based on findings. | Female, 58 years old. Reason: hx of dysphagia History: swallowing difficulty for solids and less for for liquids. Scout image on inspiration showed a lap band appropriately located close to the diaphragm with a normal angle of phi. There is no evidence of slippage. No focal lung opacity or pleural effusion. Bones appea... | 1.Stasis of contrast within the gastric fundus with cascading flow distally only upon deep inspiration. Delayed retention of contrast within the gastric fundus and esophagus despite being in the erect position for 15 minutes. 2.Normal appearance of the lap band without evidence of slippage.3.Severe esophageal dysmotili... |
Generate impression based on findings. | Pleuritic chest pain The comparison chest radiograph performed on 5/13/2015 demonstrates cardiomegaly with mild bibasilar opacities likely representing mildly increasing edema.The ventilation images show mildly heterogeneous activity in the bilateral lower lobes on single-breath and wash-in images. There is no abnormal... | Mild matched ventilation and perfusion heterogeneity in the bilateral lower lobes, compatible with a low probability of pulmonary embolism. |
Generate impression based on findings. | After fall, malaise and fatigue No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous str... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Altered mental status, report finding difficulty. No evidence of acute ischemic or hemorrhagic lesion.Multiple focal small left periventricular and left basal ganglia area calcifications.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Muscle spasm, history of septic shock with the C Triphasil, new right onset right-sided most twitching, bilateral upper extremity increased atone compared to yesterday. Mild diffuse brain atrophy which is age appropriate.There is a focal encephalomalacia seen on the right upper pons which likely represents chronic isch... | Mild diffuse brain atrophy, chronic ischemic infarct on the right pons, and nonspecific small vessel disease as described above.No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Seizure history, altered mental status. No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal s... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Other malaise and fatigue, rule out stroke NONCONTRAST CT HEADNo change of scattered deep white matter low-attenuation lesions since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The ... | Tortuous extracranial arterial system indicate atherosclerotic changes.No evidence of major vessel occlusion, significant stenosis or intracranial arterial stenosis or aneurysm. |
Generate impression based on findings. | Other malaise and fatigue, rule out stroke NONCONTRAST CT HEADNo change of scattered deep white matter low-attenuation lesions since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The ... | Tortuous extracranial arterial system indicate atherosclerotic changes.No evidence of major vessel occlusion, significant stenosis or intracranial arterial stenosis or aneurysm. |
Generate impression based on findings. | Pain. Injured foot in ballet. History of Crohn's disease.VIEWS: Left foot AP/lateral/oblique (three views) 05/13/15 No significant soft tissue swelling is present. The bones are normal in appearance. A fracture is not identified. | Normal examination. |
Generate impression based on findings. | 77-year-old female with pain. Rule out fracture 2 views of the right hip reveal no fracture or malalignment. Osteophyte formation at the acetabulum compatible with moderate osteoarthritis. | Osteoarthritic changes without fracture. |
Generate impression based on findings. | Clinical question: Headache in patient with AP shunt. Nonenhanced head CT:There is no detectable acute intracranial process. Shunted supratentorial ventricular system demonstrate no appreciable change in size or the position of catheter since prior study. Calcified subdural on the right and low-attenuation subdural on ... | 1.No evidence of an acute or new finding since prior study. 2.Stable exam since prior study. |
Generate impression based on findings. | Male 72 years old; Reason: eval for acute appy History: RLQ pain The absence of intravenous and contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Bibasal atelectasis/scarring. Scattered pulmonary micronodules are nonspecif... | 1. Uncomplicated appendicitis.2. Pulmonary micronodules as described above. These can be followed as per Fleischner guidelines. |
Generate impression based on findings. | Known protein S deficiency patient with Coumadin for history of sinus venous thrombosis. INR is 2.1 at this point. Follow-up of known intracranial aneurysm. NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.There is evidence of left frontotemporal autonomy with a surgical clip indicati... | Posterior clipping status of the left distal ICA aneurysm such as recurrence or residual sac cannot be evaluated with a CT angiogram due to metallic artifact.No evidence of other intracranial aneurysm, or significant luminal stenosis on this scan.Normal extracranial cranial cervical arterial system. |
Generate impression based on findings. | 66 years, Female. Reason: eval for free air, colonic distension History: abd pain Nonobstructive bowel gas pattern without intraperitoneal free air or portal venous gas. Diffuse osseous metastatic disease as seen on the prior CT study. Patchy airspace disease and small pleural effusions. Please refer to concomitant che... | Nonobstructive bowel gas pattern without evidence of intraperitoneal free air. |
Generate impression based on findings. | Fracture reduction.VIEWS: Left forearm PA/lateral (two views) 05/14/15, 0723 and 0726 The radial fracture has been reduced. Alignment is near-anatomic. A cast has been applied. | Fracture in cast. |
Generate impression based on findings. | 15-year-old male with swelling over PIP of right third digit. Evaluate for fracture.VIEWS: Right hand PA, oblique, and lateral (3 views) 5/13/201, 23:43 Mild soft tissue swelling around the PIP joint of the third digit. The bones are normal in appearance. No acute fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | Pain. Rule out fracture.VIEWS: Left forearm AP/lateral (two views), left wrist PA/lateral/oblique (three views) 05/14/15, 0451, 0453, 0441, 0443, 0446, 0449 A large wrist joint effusion is present. Moderate soft tissue swelling is seen around the distal forearm.The radial epiphysis is displaced posteriorly by one quart... | Both bones fracture of the distal forearm. |
Generate impression based on findings. | Female, 72 years old. Reason: Dobbhoff History: Dobbhoff Dobbhoff tube curled within the stomach, with tip overlying fundus.The lower pelvis is excluded from the field-of-view. Increased presence of gas within the bowel in the right abdomen. No evidence of obstruction on this nondedicated exam.Cardiac pacer leads in ri... | Dobbhoff tube curled within the gastric fundus. |
Generate impression based on findings. | 6-year-old female status post ET tube adjustment, evaluate placement.VIEW: Chest AP (one view) 5/14/2015, 05:48 The ET tube has been adjusted, its tip is at the carina. NG tube tube tip is in the gastric antrum. Chest tube projects over the left hemithorax.The cardiomediastinal silhouette is normal. Interval improvemen... | 1.ET tube adjusted, tip at the carina.2.Interval improvement in aeration of the left lung. Persistent opacity in left medial lower lobe segments likely a combination of atelectasis and consolidation. |
Generate impression based on findings. | 76 years, Male. Reason: Abdominal distension History: distension Suboptimal exam secondary to motion artifact. Feeding tube overlies the proximal gastric body. There is a paucity of bowel gas without definite evidence of bowel obstruction. Rectal tube is in place. Hyperdense material in the right lower quadrant and pel... | Paucity of bowel gas without definite evidence of obstruction. |
Generate impression based on findings. | 72-year-old female with knee pain and swelling 2 views of the right knee demonstrate her progress of a total knee arthroplasty device situated in near-anatomic alignment without evidence of hardware complication. No fracture or malalignment is evident. No joint effusion. The bones appear demineralized suggestive of ost... | Total knee arthroplasty as described above. |
Generate impression based on findings. | Male, 49 years old. Reason: ileus History: ileus NG tube with tip overlying the gastric fundus and sidehole at the level of the GE junction.The lower abdomen and pelvis are excluded from the field-of-view. Dilated loops of small bowel. Gas seen distally within the colon.Midline surgical staples along the chest and abdo... | NG tube with sidehole at the level of the GE junction. This can be advanced to be within the stomach. Persistent ileus pattern. |
Generate impression based on findings. | 67-year-old female status post revision of left total hip arthroplasty with liner exchange Hardware components of a total left hip arthroplasty device are seen near anatomic alignment without evidence of hardware complication. Small foci of gas and soft tissue drains reflect recent surgery. No acute fracture or malalig... | Left hip arthroplasty device as described above. |
Generate impression based on findings. | Female, 60 years old. Reason: eval ng tube placement History: ng placed NG tube with side port overlying the proximal gastric body.Possibility of bowel gas.Abdominal/pelvic surgical staples. Bilateral nephroureteral stents in place. Pelvic drain in place. Rectal tube or Foley catheter in place.Right upper quadrant surg... | NG tube side-port overlying the proximal gastric body. |
Generate impression based on findings. | 37 year old male with a history of cavitary lesion presents with cough. LUNGS AND PLEURA: There is minimal bronchial wall thickening. There is a thick walled 4.2 x 2.7 cm cavitary lesion with associated air-fluid level in the right upper lobe (37; series 4). There is a pulmonary nodule along the right minor fissure whi... | 1. Large right upper lobe cavitary lesion with associated air-fluid levels suspicious for intrapulmonary abscess formation highly consistent with a bacterial abscess. Differential considerations include atypical infection such as mycobacterial or fungal etiologies. Follow up examination to establish resolution is recom... |
Generate impression based on findings. | 69 years, Male. Reason: assess stool burden History: constipation+ diarrhea Large stool burden throughout the colon particularly the ascending colon and rectum. Nonobstructive bowel gas pattern with mild gaseous distention of the stomach. Degenerative changes affect the lumbosacral spine with mild scoliosis.Lung bases ... | Nonobstructive bowel gas pattern with large stool burden. |
Generate impression based on findings. | Abdominal distentionVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. Umbilical venous catheter tip at the IVC/RA junction. Cardiothymic silhouette normal. Bilateral pulmonary interstitial emphysema are present not significantly changed. No pleural effusion or pneumothorax. Absent bow... | Absent bowel gas without pneumoperitoneum. |
Generate impression based on findings. | Clinical question: ICH. Signs and symptoms: ICH, EVD clamped. Nonenhanced head CT:Acute hematoma in the right thalamus and its surrounding vasogenic edema is again identified. The hematoma is less defined and demonstrate decreased density compared to prior exam consistent with expected evolution. Surrounding vasogenic ... | 1.Subtle interval decreased density of the left thalamic hematoma and otherwise a stable.2.Hematoma and its surrounding vasogenic edema with resultant trace deviation of midline to the left remains stable.3.Stable size of ventricular system and ventricular catheter.4.Interval decreased intraventricular hemorrhage since... |
Generate impression based on findings. | Evaluate ETT placementVIEW: Chest AP ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. Cardiothymic silhouette normal. Bilateral pulmonary interstitial emphysema not significantly changed. Minimal patchy atelectasis right lower lobe. No pleural effusion or pneumothorax. | ET tube tip at the level of the thoracic inlet. |
Generate impression based on findings. | 6-year-old female status post ET tube adjustment, evaluate placement.VIEW: Chest AP (one view) 5/14/2015, 00:44 ET tube tip is in the right mainstem bronchus. NG tube tip is in gastric body. A chest tube projects over the left hemithorax.The left hemithorax is completely opacified which is new from the most recent prio... | Complete atelectasis of the left lung due to right mainstem bronchus intubation.Findings discussed with the pediatric resident caring for the patient at 04:46 5/14/2015 by Dr. Amin. |
Generate impression based on findings. | 82 years, Female. Reason: C.diff, r/o ileus History: see above Diffuse, air-filled small and large bowel with the appearance of a generalized ileus pattern. Cholelithiasis.Double lumen port with tip overlying the SVC.Patchy airspace opacities better characterized on recent chest CT study from 5/13/2015.The bones appear... | Generalized ileus pattern. |
Generate impression based on findings. | 31-year-old female with proximal foot pain. Evaluate for abnormality 3 nonweightbearing views of the left foot reveal no acute fracture or malalignment. No other findings are noted to account for the patient's pain. | No fracture or other findings to account for the patient's pain. |
Generate impression based on findings. | Female 48 years old Reason: sclerosing cholangitis History: pain NV ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is irregular, moderate to severe intrahepatic biliary dilatation affecting mostly the right lobe but also part of the left lobe. 2 plastic stents are seen extending from th... | Moderate to severe, irregular intrahepatic biliary dilatation despite the presence of 2 plastic biliary stents, compatible with history of primary sclerosing cholangitis. |
Generate impression based on findings. | Asthma exacerbationVIEW: Chest AP Cardiothymic silhouette normal. Cardiac apex and stomach are left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. The lung volumes are increased. No pleural effusion or pneumothorax. | Reactive airway disease without pneumonia. |
Generate impression based on findings. | 91-year-old male with remote history of motor vehicle accident now with pain AP view of the right shoulder demonstrate no acute fracture. The humeral head is high riding suggestive of a chronic rotator cuff tear. Moderate osteoarthritis affects the humeral joint.AP view of the left shoulder demonstrates no acute fractu... | Degenerative changes as described above. No acute fracture is evident. |
Generate impression based on findings. | 16-year-old female with tachypnea after extubation.VIEW: Chest AP (one view) 5/14/2015, 00:38 Interval extubation. Left upper extremity PICC tip is in the right atrium, VP shunt catheter is unchanged. Spinal fusion hardware is again seen.The cardiothymic silhouette is normal. There is persistent left lower lobe and lin... | Interval extubation. Left and right lower lobe and lingular atelectasis. |
Generate impression based on findings. | 26-year-old male with pain/swelling status post fall. Evaluate for fifth metacarpal fracture. 2 views of the right hand reveal no acute fracture or malalignment. | No fracture. |
Generate impression based on findings. | Reason: R/o PE History: 23 yo M with NICM with tachycardia, sob, fever PULMONARY ARTERIES: Study mildly limited by patient body habitus. No evidence of pulmonary embolus to the segmental arteries.LUNGS AND PLEURA: Patchy groundglass opacities of the right upper and right middle lobe, some of which appears new from prio... | 1.No evidence of pulmonary embolus to the segmental arteries.2.New right upper lobe and middle lobe patchy opacities and interval improvement of the left lower lobe opacities consistent with shifting aspiration or multifocal infection.3.Mild ground glass opacities that may represent edema.4.Right lung base subsegmental... |
Generate impression based on findings. | BiPAP increased work of breathingVIEW: Chest AP The endotracheal tube has been removed. Cardiothymic silhouette normal. Right upper lobe atelectasis has increased. There is improvement in the atelectasis at the right lower lobe and left lower lobe. Right upper extremity PICC with tip in the right atrium. Gastrostomy tu... | Right upper lobe atelectasis has increased from prior study. |
Generate impression based on findings. | Postoperative changes of a large left frontal cranioplasty are again seen. There is redemonstration of a prominent epidural collection underlying the cranioplasty flap measuring up to 20 mm in greatest thickness along the frontal parietal region and 25 mm along the left frontal lobe. There is slight increase in size o... | 1. Slight interval increased high attenuation in the more anteriorly located left frontal epidural collection with slight increased size as well as associated localized mass effect and midline shift.2. No significant interval change in appearance or size of more posterior located left-sided epidural collection.3. Stabl... |
Generate impression based on findings. | 4-year-old male with possible constipation, evaluate stool burden.VIEW: Abdomen AP (one view) 5/14/2015, 00:59 The cardiac apex and stomach are on the left. Nonobstructive bowel gas pattern with a moderate stool burden. No pneumatosis, portal venous gas, or free air. | Moderate stool burden. |
Generate impression based on findings. | 48-year-old male with right lower extremity ulcer, evaluate for osteomyelitis Tib-fib: Periosteal reaction along the medial aspect of the distal tibia. Small subtle subperiosteal lucencies. Small amount of soft tissue swelling is noted over this area. Foot: No acute fracture or malalignment is evident. No osseous erosi... | Chronic appearing periosteal changes over the medial aspect of the distal tibia and subtle lucencies in the bone. Overall the findings are suspicious for osteomyelitis. If further imaging is clinically warranted, MRI is recommended. |
Generate impression based on findings. | Female 64 years old; Reason: eval for obstruction vs ileus History: s/p open sacralcolpexy last week, vomiting/constipation. ABDOMEN:LUNG BASES: Bibasal scarring/atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL... | 1.Distal small bowel obstruction with a transition point in the pelvis. This may be secondary to a focal ileus due to postsurgical changes in the pelvis. |
Generate impression based on findings. | 38-year-old female patient with persistent nausea or vomiting, abdominal pain. Evaluate duodenal stent placement, obstruction, tumor progression-stage IV pancreatic cancer. ABDOMEN:LUNG BASES: Minimal right basilar atelectasis.LIVER, BILIARY TRACT: Redemonstration of numerous bilobar hepatic metastatic lesions. Many of... | 1. Progression of disease with increased size of pancreatic head mass and hepatic metastases.2. Interval placement of duodenal stent. No evidence of small bowel obstruction. 3. Intrahepatic biliary ductal dilatation with biliary stent in place.4. New small amount of ascites. |
Generate impression based on findings. | 54 year old female who was recalled from screening mammogram for focal asymmetry in the left upper outer quadrant best seen on the MLO view possibly a focally dilated duct or a mass . Mammogram: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3... | No mammographic 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 patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 56 years old Reason: eval for abscess, contained perf, cholangitis History: fever, jaundice, recent ERCP, has bili stent ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Again noted mild to moderate intrahepatic biliary dilatation despite the metallic stent. Pneumobilia noted in the left l... | Moderate intra and extrahepatic biliary dilatation despite the metallic and last extent. Soft tissue infiltration around the hepatic hilum may represent tumor infiltration.Significant wall thickening of the stomach is unchanged. |
Generate impression based on findings. | 33-year-old male with knee pain. Peds vs auto Right femur: 2 nonweightbearing views of the right femur reveal no fracture or malalignment.Right knee: 4 nonweightbearing views of the right knee reveal no fracture or malalignment. | No fracture or malalignment. |
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