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Generate impression based on findings. | Female 31 years old Reason: 31yo female with metastatic leiomyosarcoma and new abdominal pain, midline firm abdominal mass on exam, and constipation History: abdominal pain, constipation, midline abdominal mass on exam CHEST:LUNGS AND PLEURA: Index right middle lobe nodule measures 7 mm in diameter on image #42, series... | Interval progression of disease with interval development of new bilateral lung metastases and significant interval increase in the size of the left lower quadrant retroperitoneal mass. |
Generate impression based on findings. | 45-year-old female with history of right hip AVN, felt 'popping' sensation and now increased pain. Evaluate for joint changes. Pelvis: AP view of the pelvis reveals components of a total hip arthroplasty on the left side which appears in anatomic alignment. The right hip is unremarkable.Right hip: 2 views of the right ... | Unremarkable examination. No plain radiographic evidence of avascular necrosis. |
Generate impression based on findings. | 69-year-old male with hip pain Moderate joint space narrowing and osteophytosis compatible with moderate osteoarthritis. No acute fracture is evident. Alignment is anatomic. | Moderate osteoarthritis of the right hip. |
Generate impression based on findings. | Clinical question: 66-year-old with chronic headaches; evaluate for sinusitis. Signs and symptoms: Headaches. Nonenhanced maxillofacial CT:All paranasal sinuses are well pneumatized. Small retention cyst in the right maxillary sinus measuring at 17 x 11 mm is noted. Minimal mucosal thickening in the left maxillary sinu... | 1.Minimal bilateral maxillary chronic sinus disease and findings suggestive of mild acute sphenoid sinusitis as detailed.2.Unremarkable other paranasal sinuses.3.Well-pneumatized mastoid air cells and middle ear cavities. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 124 cm/sec.Right internal carotid artery: 109 cm/sec.Left middle cerebral artery: 96 cm/sec.Left internal carotid artery: 92 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 61-year-old male with rheumatoid arthritis, pain in joint, shoulder region 3 views of the right shoulder reveal no acute fracture. There is uniform narrowing of the glenohumeral joint consistent with rheumatoid arthritis with surrounding sclerosis representing secondary degenerative arthritic changes. | Rheumatoid arthritis with secondary degenerative changes of the right shoulder. |
Generate impression based on findings. | Clinical question: Evaluate intracranial hemorrhage. Signs and symptoms: Syncope. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Asymptomatic female presents for bilateral diagnostic mammogram. No family history of breast cancer. History of right breast cyst aspiration. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density uncha... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 31-year-old female with pleuritic chest pain. Recent transatlantic flight. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no evidence of right heart strain. The main pulmonary artery measures 1.8 cm in diameter within normal limits.LUNGS AND PLEURA: Incidental note is mad... | 1. No evidence of pulmonary embolus.2. Partially impacted bronchus/mucus plugging in the right lower lobe, raising the question of bronchitis or asthma. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 50-year-old male status post total elbow arthroplasty (9/14) and capsulectomy (3/30/2015) Hardware components of a hinge type total elbow arthroplasty device and radial head osteotomy are again seen. Again seen is a healing fracture in the distal humerus and proximal ulna. There is a stable lucency surrounding the prox... | Hinge-type total elbow arthroplasty and healing fractures as described above. |
Generate impression based on findings. | Reason: eval for PE History: 2wk post op, chest pain and sob; Laparoscopic completion proctectomy, construction of ileoanal reservoir (J-pouch), diverting loop ileostomy on 4/28/15 PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus.LUNGS AND PLEURA: No pleural effusions or pneumothorax. No... | No evidence of pulmonary embolus. No acute cardiopulmonary findings.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: kidney stone History: left flank pain. The absence of intravenous contrast limits evaluation of the solid organs and vasculature. Absence of oral contrast limits evaluation of bowel. Given those limitations, the following observations were made:ABDOMEN:LUNG BASES: Left basilar atelectasis/scarring.LIVER, BILIAR... | No renal or ureteral calculi. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 50-year-old female with fx tibia Feb 2013-plates persistent pain in knee Right tibia/fibula: 2 nonweightbearing views of the right tibia/fibula reveal a long side plate with 3 screws proximally and 3 screws distally affixing the tibia. There is no evidence of hardware complication. There is deformity at the mid diaphys... | Postoperative and degenerative arthritic changes as described above. |
Generate impression based on findings. | Female 32 years old Reason: hx L UPJ obstruction s/p stent for hydro History: flank pain, dysuria This study is limited due to lack of intravenous contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No signif... | Interval placement of left-sided double-J catheter with interval decrease in the amount of left-sided hydronephrosis. Left upper pole collecting system dilatation persists.Chronic hydronephrotic changes involving the right kidney. Right nephrolithiasis.Transvaginal ultrasound is recommended for for the evaluation of th... |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the mastoids/middle ears are grossly clear. There is moderate-severe opacific... | No acute intracranial abnormality. Prominent paranasal sinus opacification with aerated secretions. Please correlate clinically for possible acute sinusitis. |
Generate impression based on findings. | Male 64 years old; Reason: Hep C, eval for radiologic evidence of cirrhosis History: Hep C. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cirrhotic liver morphology. Patent hepatic vasculature. Scattered hypoattenuating lesions are too small to characterize but may represent cysts. There is... | 1.Cirrhotic liver morphology without suspicious lesion. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular st... | Unremarkable noncontrast MRI brain. |
Generate impression based on findings. | 17-year-old male with right knee laceration, evaluate for retained foreign body.VIEWS: Right knee AP, oblique, and lateral (3 views) 5/14/2015 at 01:09 No acute fracture or dislocation. The bones are normal. No radiopaque foreign body. | No radiopaque foreign body. |
Generate impression based on findings. | Male, 81 years old. Reason: esophageal stricture s/p stent placement History: surveillance Scout radiograph of the chest showed an esophageal stent which extends from the level of the aortic arch to the diaphragm. Healed right 6th rib fracture redemonstrated. The left shoulder is excluded from the field-of-view. Again ... | 1. Esophageal irregularity with focal stricturing of the distal esophagus as above. 2. Posterior flow of contrast seen adjacent to the stent which appears similar to prior study and may represent a markedly irregular esophageal wall, however, a contained leak cannot be excluded.3. Persistent column of contrast to the m... |
Generate impression based on findings. | Clinical question: Encephalopathy status post cardiac arrest with likely anoxic brain injury, now with labile hemodynamic and discordant gaze. Nonenhanced head CT:There is no evidence of acute intracranial hemorrhage, midline shift or hydrocephalus.There is however interval generalized decreased size of cortical sulci ... | 1.Interval development of diffuse cerebral edema as detailed above.2.No evidence of hemorrhage or midline shift. |
Generate impression based on findings. | 38-year-old female patient with chest pain, postop. Evaluate for abscess. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Again seen is a subcentimeter hyperdense focus within the tail of the pancreas.ADRENAL ... | 1. Interval ileal pouch-anal anastomosis following completion proctocolectomy.2. Nonspecific right presacral fluid collection.3. Subcentimeter hyperdense focus within the tail of the pancreas; this appears similar to the prior study and further evaluation with a repeat pancreas MRI is recommended. |
Generate impression based on findings. | 46-year-old male with tachycardia and metastatic cancer. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. No evidence of right heart strain. The main pulmonary artery measures 2.5 cm in diameter, within normal limits.LUNGS AND PLEURA: There is interlobular septal thickening and fain... | 1. No evidence of pulmonary embolus.2. Interlobular septal thickening and basilar groundglass opacity consistent with acute pulmonary edema. Lymphangitic spread of tumor is considered less likely. No pleural effusion is evident.3. Interval development of patchy consolidation and faint groundglass opacity in the right u... |
Generate impression based on findings. | Chronic sinusitis, FESS. There are postoperative findings related to endoscopic sinus surgery, including bilateral uncinectomy, sphenoidotomy, and internal ethmoidectomy. There is also evidence of septoplasty without significant nasal septal deviation. There is persistent diffuse mucosal thickening within the bilateral... | 1. Postoperative findings related to endoscopic sinus surgery with pansinus opacification, which has increased in some portions of the sinuses and decreased other portions of the sinuses compared to March 2015.2. Postoperative findings related to cerebral aneurysm clipping. 3. Degenerative changes involving the left te... |
Generate impression based on findings. | Abdominal pain with history of diverticulitis and multiple abdominal surgeries, evaluate for obstruction; additional history obtained from path report in January states the vulvar carcinoma ABDOMEN:LUNG BASES: Basilar atelectasis. Mild coronary artery calcifications.LIVER, BILIARY TRACT: No significant abnormality note... | Small bowel obstruction with a transition point in the right lower quadrant, likely secondary to adhesions given history of multiple abdominal surgeries. No pneumoperitoneum or free fluid. |
Generate impression based on findings. | BRAIN:There are multiple punctate subcortical and periventricular T2/FLAIR hyperintense foci that are perpendicular to the long axis of the ventricle. Some of these lesions demonstrate T1 hypointensity. Additionally, there is T2/FLAIR signal hyperintensity along the cortex of the right post central gyrus. There is a p... | 1.Increased T2/FLAIR signal intensity and thickening of the left optic nerve compatible with optic neuritis.2.T2/FLAIR hyperintense foci in the supratentorial periventricular white matter, juxtacortical white matter, and cortex are suggestive of demyelinating disease, such as multiple sclerosis. It is favored that a fo... |
Generate impression based on findings. | PHARYNX/LARYNX: The left base of tongue does appear slightly more prominent than the right, although no focal mass or fluid collection is identified. The left vallecula is not well aerated. On delayed images this appears to relate to asymmetric lymphoid tissue within the lingual tonsils. The nasopharynx, oropharynx, h... | 1. No significant soft tissue abnormality. Posterior left mandibular periodontal/endodontal disease as well as similar abnormalities along the right posterior maxillary alveolar process for which correlation with dental exam is recommended.2. Slight asymmetric prominence of soft tissue along the left base of tongue alt... |
Generate impression based on findings. | Increase oxygen requirementVIEW: Chest AP Tracheostomy tube in place. NG tube tip in the stomach within the omphalocele. Cardiothymic silhouette at the upper limits of normal. Patchy atelectasis bilaterally right greater than left. Right central line with tip in the SVC. | Bilateral patchy atelectasis right greater than left not significantly changed. |
Generate impression based on findings. | Clinical question: Atypical headache. Signs and symptoms: Occipital headache, new onset, elderly man. Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and grade-white ... | 1.Unremarkable unenhanced head CT.2.Well-pneumatized paranasal sinuses and mastoid air cells.3.Left posterior parietal subgaleal hemorrhage as detailed. Correlate with history. |
Generate impression based on findings. | Clinical question: Chronic sinusitis. Signs and symptoms: Fever and nasal congestion for 3 months. Nonenhanced maxillofacial CT:Frontal sinuses demonstrate extensive opacification on the right and mild diffuse mucosal thickening on the left.Ethmoid sinuses demonstrate extensive bilateral (left greater than right) sinus... | 1.Chronic pansinusitis as detailed.2.Occluded bilateral ostiomeatal units and sphenoethmoidal recesses.3.Increased soft tissue density without associated bony changes in the left nasal passage.4.Significantly smaller left nasal valve compared to right and mild leftward deviation of nasal septum.5.Well-pneumatized bilat... |
Generate impression based on findings. | PainVIEWS: Left foot AP, oblique and lateral There is a Salter II fracture involving the neck of the fifth metatarsal. There is soft tissue swelling about the fracture site. | Acute fracture involving the neck of the fifth metatarsal. |
Generate impression based on findings. | Persistent fevers on broad-spectrum antibiotics, evaluate for occult infection ABDOMEN:LUNG BASES: Pulmonary arterial catheter is noted. See dedicated CT chest for pulmonary findings.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality note... | 1.No acute abdominopelvic abnormality to account for the patient's symptoms. 2.See dedicated CT chest report for additional findings. |
Generate impression based on findings. | POD#5 of a left carotid endarterectomy, now with left neck pain, swelling, and coughing of "phlegm". There are postoperative findings related to recent left carotid endarterectomy with foci of emphysema and scattered areas of fluid within the surgical bed, including within the left parotid gland. There is also patchy s... | 1. Postoperative findings related to recent left carotid endarterectomy with foci of emphysema and scattered areas of fluid within the surgical bed, for which superimposed infection cannot be excluded.2. Paucity of left internal jugular vein opacification may represent thrombosis. Doppler ultrasound may be useful for f... |
Generate impression based on findings. | Clinical question: Status post tectal tumor ablation. Signs and symptoms: Status post tectal tumor ablation. Nonenhanced head CT:There is a low-density tectal plate mass measuring approximately 24.5 mm in transaxial dimensions. There is no evidence of hemorrhage and no detectable soft tissue density with this mass. Fin... | 1.Entirely low-density tectal plate mass measuring at 24.5 mm in size.2.Enlarged supratentorial ventricular system and a right frontal approach ventricular catheter remains similar to prior exam.3.Right-sided hemispheric low density subdural with subtle mass effect on the adjacent parenchyma demonstrate no appreciable ... |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 131 cm/sec.Right internal carotid artery: 97 cm/sec.Left middle cerebral artery: 134 cm/sec.Left internal carotid artery: 70 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 38-year-old male patient with perianal Crohn's disease of the fistula opening on the right and now with large perianal abscess that is tender and not draining currently. Evaluate abscess. PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant a... | Perianal abscess/fistula as described above. |
Generate impression based on findings. | 13 mm left adrenal adenoma on outside CT, 6 month follow-up study ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Probable left hepatic lobe hemangioma. Additional hepatic hypodensities are too small to further characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abno... | Probable left adrenal adenoma. Correlate with outside imaging. |
Generate impression based on findings. | Hip dysplasia.VIEWS: Pelvis AP/frog leg (two views) 05/14/15 The right femoral head ossification center is slightly smaller than the left. Minimal lateral uncovering of the left femoral head is present. Both femoral heads are well directed into normally formed acetabula. | Normal examination. |
Generate impression based on findings. | 35 year old female who is a high-risk individual with strong family history of breast cancer. Mother diagnosed with breast carcinoma at the age of 39 and died at age 40. No breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is ... | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female, 72 years old. Reason: assess sb given hx of multiple SBO History: s/p sigmoidectomy in 2001, w/ recurrent pSBO Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 30 minutes. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus trac... | Normal examination of the small bowel and proximal colon. |
Generate impression based on findings. | High probability benign calcifications in the left breast for which six-month follow-up is recommended. Patient presents today for bilateral diagnostic mammogram. No breast related complaints. Three standard views of both breasts and 2 spot magnification views of left breast were performed digitally and reviewed with t... | Multiple clusters of benign morphology calcifications in both breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMM... |
Generate impression based on findings. | History of significant surgeries, including lysis of adhesions and various abscess drainages presents with generalized weakness, evaluate for new abscesses or foci of infection. Additional history obtained from path report on 4/23 states metastatic urothelial cancer. ABDOMEN:LUNG BASES: Right middle lobe collapse, unch... | Near interval resolution of loculated fluid collections along the undersurface of the anterior abdominal wall associated with the midline wound. There is no measurable fluid. |
Generate impression based on findings. | The ventricles and sulci are slightly prominent suggestive of mild volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the m... | Essentially unremarkable noncontrast MRI of the brain. |
Generate impression based on findings. | 72-year-old female patient with right flank pain. Evaluate aorta, for kidney stone, mild right lower quadrant pain. ABDOMEN:LUNG BASES: Bibasilar atelectasis.LIVER, BILIARY TRACT: Subcentimeter hepatic hypodensities are too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormal... | 1. No specific findings to account for the patient's symptoms.2. Focal aneurysmal dilatation of the left common iliac artery. |
Generate impression based on findings. | 73 years, Male. Reason: Septic shock with known C diff infection and worsening abdominal distension and persistent lactate History: see above Persistent ppaucity of bowel gas which is stable or possibly slightly less compared to prior exam. No definite evidence of obstruction. Percutaneous gastrostomy tube overlies the... | Stable examination. |
Generate impression based on findings. | Male, 77 years old. Reason: rule out duodenal obstruction History: abdominal pain; jaundice Scout abdominal radiograph showed mildly dilated bowel loops, suggestive of ileus pattern, with enteric contrast within the colon from recent prior examination. Biliary stent/drain and percutaneous cholecystostomy tube in place.... | 1.Mild luminal narrowing and wall irregularity involving the third portion of the duodenum near the level of the patient's pancreatic mass, without obstruction.2.Patent biliary stent and cystic duct. |
Generate impression based on findings. | T1N0M0 left ventral tongue squamous cell carcinoma resected on 7/3/2014 and status post CRT completed 10/29/14. There is streak artifact related to dental amalgam, which obscures portions of the oral cavity contents. Within these limits, there is a no discernible measurable mass in the left anterior oral tongue, amidst... | Streak artifact related to dental amalgam, which obscures portions of the oral cavity contents. Within these limits, there is a no discernible evidence of recurrent tumor in the left anterior oral tongue or significant lymphadenopathy in the neck amidst post-treatment findings. |
Generate impression based on findings. | 19 year old female with a history of lupus and tachycardia, evaluate for pulmonary embolism. PULMONARY ARTERIES: No pulmonary embolism to the subsegmental level. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: There is no pleural effusion, pulmonary opacity, or pulmonary nodule. No pneumothorax.MEDIAST... | No evidence of acute pulmonary embolism. |
Generate impression based on findings. | Surgery for slipped capital femoral epiphysis.VIEWS: Pelvis AP/frog leg (two views) 05/14/15 One screw on the right and two screws on the left are again seen. The screws are intact and remain in place. The screw on the right has its tip in the epiphysis. The more superior screw on the left has its tip in the epiphysis.... | No evidence of complication after bilateral pinning of slipped capital femoral epiphysis. |
Generate impression based on findings. | 66-year-old male with left hip fracture repair AP view of the pelvis demonstrates interval placement of a left total hip arthroplasty device situated in near-anatomic alignment without evidence of hardware complication. No acute fracture or malalignment. Replacement of right total hip arthroplasty device is noted lacki... | Bilateral total hip arthroplasty devices as described above. The right arthroplasty device lacks a femoral head component. |
Generate impression based on findings. | Postoperative changes are seen from interval anterior cervical fusion of C4 through C6. Disc height has been expanded at C4-C5 and C5-C6 with interbody spacers and associated bone graft material. Streak artifact from the indwelling is rotation limits evaluation of surrounding structures.the scout lateral view and the ... | 1. Interval expected postoperative changes from anterior surgical fusion of C4-C6, with interval increased disc space heights at these levels. No acute fracture or instrumentation complication. Decreased focal disc pathology at C4-C5.2. Small triangular-shaped ossific density anterior to the mid C2 vertebra which is of... |
Generate impression based on findings. | 66-year-old female patient with abdominal pain. Evaluate for colitis. Motion limits the evaluation.ABDOMEN:LUNG BASES: Mild coronary artery calcifications are noted. No pericardial effusion. Minimal basilar atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion is identified. No intra- or extrahepatic biliary ductal... | 1. Questionable perirectal edema which may represent a proctitis, possibly secondary to an infectious etiology.2. New moderate ascites.3. Diffuse osseous metastases. |
Generate impression based on findings. | Metastatic RCC on pazopanib, evaluate for response CHEST:LUNGS AND PLEURA: Bilateral calcified pulmonary nodules consistent with granulomas. New small left pleural effusion.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy. Reference prevascular lymph node measures 9 mm in short axis (series 3, image 51), pre... | 1.Supraclavicular, mediastinal, and retroperitoneal lymphadenopathy are slightly increased compared to the prior exam.2.Nonspecific right ninth rib lesions are unchanged. |
Generate impression based on findings. | There are no areas of abnormal attenuation or pathological enhancement. There are mild atherosclerotic changes in the bilateral cavernous and supraclinoid portions of the internal carotid arteries, right greater than left, with associated minimal narrowing on the right.The intracranial internal carotid arteries are no... | 1.Chronic occlusion of the proximal V1 to distal V2 segment of the right vertebral artery with reconstitution from the thyrocervical trunk. The V4 segment of the right vertebral artery is dominantly diminished and there is additional irregularity and moderate narrowing of the distal V4 segment distal to the PICA.2.Rede... |
Generate impression based on findings. | 55-year-old male with red, warm, swollen left foot and leg. Evaluate for osteomyelitis 2-3 metatarsal left 3 views of the left foot reveal interval amputations through the distal 3rd and 4th metatarsals. Again seen are amputations through the proximal phalanges of the great toe and 2nd digit and proximal 5th metatarsal... | Findings are worrisome for osteomyelitis involving the osteotomy site of the distal third metatarsal. |
Generate impression based on findings. | Former smoker with recurrent/metastatic supraglottic laryngeal cancer completed XRT 2002, status post supraglottic laryngectomy, with subsequent right neck recurrence, now status post total laryngectomy. There are post-treatment findings related to total laryngectomy with flap reconstruction and tracheostomy, bilateral... | 1. Extensive post-treatment findings in the neck without definite evidence of locoregional recurrent tumor. 2. Multiple nodules in the partially-imaged lungs. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 62-year-old female patient with hypoxia. Evaluate for malignancy. CHEST:LUNGS AND PLEURA: Bibasilar atelectasis/scarring with interlobular septal thickening in the left lung base, similar to the prior study . No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: No significant mediastinal or hilar lympha... | 1. Moderate to large stool stool in the rectum with rectal wall thickening may be seen in the setting of stercoral colitis.2. Distal SVC stent in place with stenosis of the proximal SVC and numerous chest and abdominal wall collateral vessels.3. Cholelithiasis without CT evidence of acute cholecystitis.4. Atelectasis/s... |
Generate impression based on findings. | Ms. Lee is a 74 year old female presenting with right lateral breast tenderness for the past 2 months that has resolved on today's exam. Patient's primary care physician thought this pain was likely due to a musculoskeletal etiology. She denies a discrete mass, overlying skin changes, or nipple discharge. Three standar... | No mammographic evidence of malignancy. Patient's right breast pain should be managed clinically if it persists. 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: 1 - Negative.RECOMMENDA... |
Generate impression based on findings. | Male 65 years old Reason: 65yo with PBC cirrhosis, on coumadin for portal vein thrombosis. Requesting US to reassess for stability of thrombus History: ascites LIVER: The liver is shrunken coarsened in echogenicity with in nodular contour; it measures 13 cm in length. No focal hepatic lesions are identified, although s... | 1.Cirrhotic liver without portal venous blood flow compatible with portal vein thrombosis.2.Mild to moderate ascites.3.Splenomegaly.4.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Abdominal painVIEWS: Abdomen supine and upright Disorganized nonobstructive bowel gas pattern. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum. | Normal examination. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral Again noted healing fracture involving the distal radius with dorsal angulation of the distal fracture fragment not significantly changed. There is callus formation and periosteal reaction reflecting interval healing. The overlying cast obscures fine bony detail. | Healing distal radial fracture with dorsal angulation of the distal fracture fragment. |
Generate impression based on findings. | 57-year-old female with left hip pain No acute fracture or malalignment is evident. Moderate joint space narrowing of the left hip compatible with osteoarthritis. | Osteoarthritis as described above. No acute fracture or malalignment is evident. |
Generate impression based on findings. | Male, 37 years old. Reason: s/p Lap total gastrectomy for gastric cancer now w/ vomiting and feeling like food is getting stuck - please eval for stricture/obstruction at anastomosis. History: vomiting The right costophrenic angle is excluded from the field-of-view on the scout image, postsurgical changes in the upper ... | 1.Focal narrowing at the surgical anastomosis, worsened/decreased in caliber since prior study. No evidence of obstruction. 2.Preanastomotic outpouching which may represent weakening of the esophageal wall secondary to surgery or back pressure from the aforementioned focal narrowing.3.No evidence of contrast extravasat... |
Generate impression based on findings. | There is apparent slight asymmetric enhancement along the left inferior medial cavernous sinus, abutting the cavernous left internal carotid artery as seen on 1201/28. There is no significant corresponding T2 abnormality, and therefore this is favored to represent asymmetric venous enhancement rather than a true mass ... | 1. Limited exam as only dedicated cranial nerve imaging was obtained. Within these limitations, question subcentimeter nodularity of the proximal cisternal left oculomotor nerve without definite enhancement on available postcontrast imaging. Questioned mild atrophy of the distal cisternal oculomotor nerve. However, pat... |
Generate impression based on findings. | 61-year-old with cirrhosis, screen for HCC ABDOMEN:LUNG BASES: Calcified granuloma at the left base.LIVER, BILIARY TRACT: Cirrhosis. No arterially enhancing lesions to suggest HCC. Status post cholecystectomy. Ascites and esophageal varices.SPLEEN: Splenomegaly. Accessory splenule.PANCREAS: No significant abnormality n... | 1.No arterially enhancing lesions to suggest HCC. 2.Cirrhosis and portal hypertension. |
Generate impression based on findings. | 55 year old female who was recalled from screening mammogram for subtle architectural distortion in the central right breast . The technologist palpated a lump in the lower inner right breast which is marked with a triangular marker. Mammogram: An ML, full field MLO view and 3 spot compression views of the right breast... | Palpable mass in the right breast 3:00 position and another suspicious mass at right breast 9:00 position for which surgical consult and FNA is recommended. Patient will see Dr. Chhablani later today. Patient will participate in Allen Penn, MRI research study, scheduled for a breast MRI and ultrasound guided biopsy of ... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of intermittent bilateral breast pain for which diagnostic mammogram and ultrasound was previously done with no imaging abnormality. Two standard digital views and tomosynthesis of both breasts were performed 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Cognitive impairment with memory loss and behavioral changes. Possible frontotemporal dementia.RADIOPHARMACEUTICAL: 7.9 mCi F-18 fluorodeoxyglucose (FDG)BLOOD GLUCOSE (FASTING): 102 mg/dL Today's CT portion demonstrates no gross intracranial pathology.Today's PET examination demonstrates marked hypometabolism involving... | Findings very suspicious for frontotemporal dementia. |
Generate impression based on findings. | 43-year-old female patient with vomiting, diarrhea, elevated lipase. Lack of IV contrast limits evaluation of vascular structures and solid parenchymal organs.ABDOMEN:LUNG BASES: Small right pleural effusion with groundglass opacities may represent edema. Right middle lobe atelectasis/consolidation. The heart size is e... | 1. No CT evidence of acute pancreatitis.2. Small right pleural effusion with ground glass opacities may represent edema. Right middle lobe atelectasis/consolidation. |
Generate impression based on findings. | PainVIEWS: Left ankle AP and lateral No acute fracture or dislocation. There is tibiotalar slanting and underdevelopment of the talus more prominent medially. No evidence of ankle joint effusion. | Tibiotalar slanting and underdevelopment of the talus more prominent medially. |
Generate impression based on findings. | Anemia orthopnea evaluate mediastinal mass LUNGS AND PLEURA: There is a small left-sided pleural effusion or pleural thickening. No evidence of large pulmonary nodules. The major airways are patent.MEDIASTINUM AND HILA: No evidence of mediastinal adenopathy. There are subcentimeter lymph nodes in the axillary regions b... | No evidence of mediastinal mass as clinically questioned. |
Generate impression based on findings. | 21-year-old female patient with 2 weeks right lower quadrant pain, now much worse with vomiting, peritonitic abdomen. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GL... | Possible wall thickening of the appendix without significant surrounding inflammatory changes, abscess, or perforation; this may represent an early appendicitis. |
Generate impression based on findings. | Male 5 days old with hemorrhagic liver mass noted on MRI and prior US. Patient had 40 mL of bloody fluid aspirated from the abdomen. LIVER:The liver contour is normal. The liver has decreased in size and measures 5.8 cm. Again seen within the right lobe of the liver is a heterogeneous but predominantly hyperechoic lame... | 1.No change in large heterogeneous mass in the right lobe of the liver.2.Resolution of upper abdominal ascites. |
Generate impression based on findings. | Female 74 years old Reason: right knee pain History: right knee pain Mild osteoarthritis affects the medial and lateral compartments with osteophytes.Moderate osteoarthritis affects the extensor compartment where there are changes in the undersurface of the patella. There is a joint effusion. No acute fracture or malal... | Mild to moderate right knee osteoarthritis. |
Generate impression based on findings. | 58-year-old female with ankle pain 3 weightbearing views of the right ankle reveal no soft tissue swelling, joint effusion, fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | 61 year old female with non-healing ulcer lateral aspect 5th MTB right foot. Evaluate charcot changes along 5th MTB region. 3 nonweightbearing views of the right foot reveal soft tissue swelling about the fifth metatarsal base with no evidence of bony destruction to suggest osteomyelitis. There is apparent fusion of th... | 1. No radiographic evidence of osteomyelitis. 2. Apparent fusion of the second, third and fourth metatarsal bases to the cuneiform bones suggestive of inflammatory arthritis. Other findings as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcificati... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male, 58 years old. Reason: migration of colonic stent History: was not in place during surgery, r/o migration to other places in colon No colonic stent is identified.Surgical clips in the pelvis and suture material within the upper abdomen. Midline surgical staples.A prominent left upper quadrant bowel loop measures u... | Colonic stent is not seen on this exam. |
Generate impression based on findings. | Scoliosis.VIEW: Spine standing PA out of brace (one view) 05/14/15 Right curve between T3 and T8 measures 31 degrees. Left curve between T9 and L1 measures 50 degrees.Laminectomies have been performed at the T10 and T11 levels. The sacral neuroforamina are enlarged. | Right thoracic and left thoracolumbar curves increased out of brace. |
Generate impression based on findings. | Metastatic renal cancer, on observation, assess for progression CHEST:LUNGS AND PLEURA: Left upper lobe pulmonary nodule measures 1.7 x 1.8 cm (series 5, image 26), previously 1.2 x 1.0 cm.No new pulmonary nodules or masses.MEDIASTINUM AND HILA: Left hilar lymph node measures 1.8 x 1.6 cm (series 3, image 34), unchange... | 1.Increasing left upper lobe pulmonary nodule.2.Stable hilar lymphadenopathy.3.No new sites of disease. |
Generate impression based on findings. | 71-year-old male patient with history of penile cancer status post partial penectomy and bilateral pelvic lymphadenectomy with enlarged inguinal nodes. PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant pelvic lymphadenopathy is noted by CT... | No specific evidence of metastatic disease. |
Generate impression based on findings. | Male, 62 years old. Reason: eval for free air History: severe abd pain Nonobstructive bowel gas pattern. No free air.Enteric contrast within central small bowel bowel loops from recent prior exam.Lung fields not well assessed. | No free air. No evidence of obstruction. |
Generate impression based on findings. | 40-year-old female with ankle pain 3 weightbearing views of the left ankle reveal no joint effusion, fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two paternal great aunts. Two standard digital views and tomosynthesis of both breasts and an additional right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattere... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 35-year-old female with right shoulder/arm pain 3 views of the right shoulder reveal no evidence of joint effusion, fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | 29-year-old female with hand pain 3 views of the right hand reveal no evidence of soft tissue swelling, fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | 20-year-old female with pain. Evaluate for fracture 3 weightbearing views of the right foot again reveal a nondisplaced oblique fracture of the body of the metatarsal of the great toe. Additional transverse fractures of the middle and proximal phalanx of the second digit are again seen with the intra-articular componen... | Healing fractures as described above. No new fractures. |
Generate impression based on findings. | 33-year-old female with Crohn's disease with pain and stiffness in the right sacroiliac joint Small focus of increased STIR signal and decreased T1 signal within the sacrum at the inferior aspect of the sacroiliac joint may represent degenerative changes or artifact. No fluid signal is noted within the sacroiliac joint... | No specific evidence of sacroiliitis. |
Generate impression based on findings. | Female 69 years old Reason: bilateral knee OA History: bilateral knee OA Right knee: Moderate to severe osteoarthritis affects the right knee worst in the medial and extensor compartments. There is bone-on-bone apposition in the medial compartment. There are tricompartmental osteophytesLeft knee: Moderate to severe ost... | Moderate severe bilateral knee osteoarthritis with severe right medial compartment osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast attempted aspiration in 2010. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, uncha... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Ankle painVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. There is a well-corticated ossicle immediately inferior to the lateral malleolus. The ankle mortise joint is normal. No evidence of ankle joint effusion. | No acute fracture or dislocation. |
Generate impression based on findings. | 64-year-old male patient history of HCC status post TACE/RFA. ABDOMEN:LUNG BASES: Bibasilar dependent atelectasis. A calcified left lower lobe granuloma is unchanged.LIVER, BILIARY TRACT: The liver has a cirrhotic morphology. There are expected post TACE/RFA ablation changes in the right hepatic lobe at a site of the p... | Status post TACE/RFA of a right hepatic lobe HCC without arterial enhancement on this examination or new suspicious lesion. |
Generate impression based on findings. | Invasive squamous cell carcinoma of the base of the tongue; screening exam prior to clinical trial. Head: There is no evidence of intracranial mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged parana... | 1. An infiltrative mass that measures up to approximately 35 mm that is centered in the right tongue base with extension posteriorly across the glossopharyngeal sulcus, extension laterally into the pterygoid musculature, and extension anteriorly into the oral tongue, but no evidence of extension across the midline, is ... |
Generate impression based on findings. | 70 years, Female. Reason: ngt placement History: sbo Enteric tube with sidehole overlying the proximal gastric body and tip overlying the distal gastric body.No evidence of bowel obstruction on plain film, however, this can be better delineated on CT examination from earlier on the same day.Retained contrast is noted i... | Enteric tube with tip overlying the distal gastric body. |
Generate impression based on findings. | PEA arrest: intact brain stem reflexes, but otherwise comatose. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter appears to be grossly intact. There is no midline shift. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. There are partially imaged ae... | No evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | Reason: PE? History: pleuritic chest pain, hypoxia, tachycardia, ddimer + PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus.LUNGS AND PLEURA: Mild subpleural thickening. No pleural effusions or pneumothorax. No suspicious mass or nodule.MEDIASTINUM AND HILA: Cardiac size is normal. No per... | No evidence of embolus. Small hiatal hernia and nonspecific mild thickening of the esophagus noted.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 55-year-old female with pain There is approximately 16 degrees of valgus angulation of the right knee with respect in neutral mechanical axis. Hardware components of a total right hip arthroplasty device are seen situated in near-anatomic alignment without radiographic evidence of hardware complication. Severe osteoart... | Right knee with 16 degrees of valgus angulation with respect in neutral mechanical axis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are pre... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 53 years old; Reason: hx of kidney cancer s/p right radical nephrectomy, evaluate for metastatic disease History: see above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Thickening of the gallbladder fundus suggestive of adenomyomatosis.SPLEEN: No significant abnormality noted.PANCRE... | 1.No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast pain on and off for years. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern a... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 65-year-old male with a history of thoracic aortic aneurysm. Please evaluate. LUNGS AND PLEURA: Left basilar scarring/atelectasis. No focal consolidation, pleural effusion or pneumothorax. Mild paraseptal emphysema with an upper lobe predominance.MEDIASTINUM AND HILA: Again seen is an ectatic ascending thoracic aorta m... | 1. Ectatic ascending thoracic aorta without evidence of aortic aneurysm, as clinically questioned.2. Interval resolution of the previously described bilateral upper lung groundglass opacities. |
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