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Generate impression based on findings. | Transcranial Doppler sonogram was attempted but an adequate sonographic window was not identified and no arterial tracings were found. | Unable to perform exam due to inadequate sonographic windows. |
Generate impression based on findings. | Male 71 years old; Reason: history of hydrocele; seroma from paracentesis. Complaining of swelling History: swelling of scrotum RIGHT TESTIS: The right testis measures 4.3 x 2.1 x 2.8 cm and has normal echogenicity and internal vascularity. No intratesticular mass is identified.LEFT TESTIS: The left testis measures 4.2... | 1.Significant amount of scrotal edema without increased vascularity suggests this may be due to volume/fluid overload state as seen on recent CT rather than acute inflammatory process.2.Left-sided hydrocele. |
Generate impression based on findings. | Male 57 years old Reason: Hx of ankylosing spondylitis, preop, rule out neck instability. History: fixed neck, history of difficult intubation Bone mineralization is normal. There is straightening of the cervical spine. There are anterior marginal syndesmophytes between adjoining vertebral bodies. The disc spaces are n... | Findings of ankylosing spondylitis of the cervical spine without definite underlying fracture. If patient has persistent pain, consider MRI. |
Generate impression based on findings. | Female 33 years old Reason: nausea vomiting h/o diabetes rule out gastroparesis History: nausea vomiting Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 73 ... | Gastric emptying within normal limits. |
Generate impression based on findings. | 62-year-old male with left greater trochanter fracture AP view of the pelvis reveals no acute fracture. The bones are demineralized. Again seen is irregularity of the left greater trochanter superiorly which likely represents sequela of prior fracture in this region. Degenerative changes of the hip joints and sacroilia... | Degenerative changes with no new fracture identified.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 85-year-old female patient with history of fall while taking warfarin. CT HEAD: There is soft tissue swelling over the anterior midline convexity and a subgaleal hematoma over the left parietal convexity. No acute intracranial hemorrhage or extra-axial collection. Gray-white matter differentiation is maintained. There ... | 1.Soft tissue swelling and subgaleal hematoma without evidence of skull fracture or intracranial hemorrhage.2.Multilevel degenerative changes in the cervical spine as described above without acute fracture.3.Hypoattenuating right thyroid nodule is incompletely evaluated. |
Generate impression based on findings. | Female 74 years old Reason: back pain History: breast cancer history No abnormal osseous foci are identified to indicate metastatic disease. Minimal degenerative activity in the lumbar spine, most notably at the left L5-S1 facet joint. No significant osteoblastic focus identified as cause for back pain. | No evidence of osseous metastases. No significant osteoblastic focus identified to explain the patient's symptoms. |
Generate impression based on findings. | PICC pulledVIEW: Abdomen AP Left lower extremity PICC with tip at the left mid thigh. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Left lower extremity PICC has been retracted with tip at the left mid thigh. |
Generate impression based on findings. | DecompensationVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. The umbilical venous catheter tip at the IVC/RA junction. Cardiothymic silhouette normal. Bilateral pulmonary interstitial emphysema not significantly changed. Right upper lobe atelectasis new from prior stud... | Right upper lobe atelectasis new from prior study. |
Generate impression based on findings. | Female 54 years old Reason: metastatic breast cancer, new bone pain over hips, compare to prior History: hip pain Numerous new bilateral rib metastases, right greater than left. There is also new right ischial lesion. Multiple suspicious foci in the lower thoracic and upper lumbar spine are again noted. Note that sever... | 1.Somewhat mixed response, but overall progression of osseous metastatic disease, most notably involving rib lesions.2.Prominent upper renal collecting systems, right greater than left, which may be physiologic but raises question of obstruction. CT or ultrasound may be obtained for further evaluation if clinically ind... |
Generate impression based on findings. | Cognitive abnormalities with rapid onset memory disorder, personality disorder; concern for frontotemporal dementia.RADIOPHARMACEUTICAL: 9.1 mCi F-18 fluorodeoxyglucose (FDG)BLOOD GLUCOSE (FASTING): 85 mg/dL Today's CT portion demonstrates diffuse cerebral atrophy, markedly progressed from comparison head CT.Today's PE... | PET findings are classic for severe Alzheimer's dementia. |
Generate impression based on findings. | 36 year old female with benign intracranial hypertension. There are postoperative findings related to interval placement of a right frontal approach ventriculostomy catheter terminating near the foramen of Monro with minimal pneumocephalus. The ventricles are somewhat slit-like but unchanged in size. There is no eviden... | Postoperative findings related to placement of a ventriculostomy catheter terminating near the foramen of Monro without evidence of intracranial hemorrhage. The ventricles remain somewhat slit-like but unchanged in size. |
Generate impression based on findings. | ScoliosisVIEWS: Thoracolumbar spine supine PA and lateral Posterior spinal fusion rods again noted from mid thoracic spine to lower lumbar spine. Residual scoliosis not significantly changed. Ventriculoperitoneal shunt catheter in place. There is an orphaned catheter projected over the right supraclavicular region. | No evidence of hardware failure. |
Generate impression based on findings. | 40 year old male with history of hyperlipidemia and atypical chest pain who presents for coronary CTA to evaluate coronary diseaseCPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coro... | 1. There are no significant coronary artery stenoses present. 2. No coronary calcium is noted.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this rep... |
Generate impression based on findings. | Reason: 42 y/o woman with metastatic breast cancer with new dyspnea and tachycardia. Evaluate for PE. History: Dyspnea, tachycardia. PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolus.LUNGS AND PLEURA: Continued increase in size and number of bilateral pulmonary nodules. The prior referenc... | No evidence of pulmonary embolus. Compared to 4/1/2015 study, interval increase in thoracic metastases as described above. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | There are postoperative findings related to L2-S1 posterior lumbar interbody fusion with left hemilaminectomy at L3-L5, utilizing bilateral rods, pedicle screws at the right L2-L3 and L5-S1 and the left L2-L4 and S1 levels as well as a right iliac fixation screw and a left S2 screw traversing the sacroiliac joint. The... | 1.Postoperative findings related to L2-S2 fusion and pelvic fixation with left hemilaminectomy at L3-L5 and prior L2-L5 XLIF. 2.Hardware appears intact. There is mild subsidence of the interbody graft at the L2-L3 level with sclerosis and focal rounded changes/osteolysis, which may be related to bone morphogenic protei... |
Generate impression based on findings. | FractureVIEWS: Left wrist AP and lateral There is a healing fracture involving the distal diaphysis of the radius. There is minimal 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... | Healing distal radial fracture with minimal dorsal angulation of the distal fracture fragment. |
Generate impression based on findings. | CLL, compare to prior scans CHEST:LUNGS AND PLEURA: Calcified right lower lobe granuloma. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Moderate atherosclerotic calcification of the aortic arch and descending aorta. Prevascular lymph node measures 1.0 x 1.0 cm (series 3, image 29... | 1.Stable size of mesenteric mass and retroperitoneal lymph nodes. 2.Stable solid left renal mass; renal cell carcinoma is not excluded. |
Generate impression based on findings. | 54 year old male with subdural hematoma. There is no evidence of acute intracranial hemorrhage. The left cerebral convexity subdural hematoma has resolved. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is scattered paranasal sinus mucosal thickeni... | 1.Resolution of left cerebral convexity subdural hematoma as well as the midline shift.2.New partially imaged 5 mm subcutaneous nodule in the midline of the occipital scalp soft tissues at the level of C1 likely represents a epidermal inclusion cyst. |
Generate impression based on findings. | Female 68 years old Reason: left hip hemiarthroplasty History: left hip hemiarthroplasty Left hip: Components of a left hip hemiarthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. There is heterotopic bone formation about the left hip.AP view of the pelvis... | Left hip hemiarthroplasty without radiographic evidence of hardware complication. |
Generate impression based on findings. | Female 68 years old Reason: left hip hemiarthroplasty History: lefthip hemiarthroplasty Left hip: Components of a left hip hemiarthroplasty device are situated innear-anatomic alignment without radiographic evidence of hardware complication. There isheterotopic bone formation about the left hip.AP view of the pelvis sh... | Left hip hemiarthroplasty without radiographic evidence of hardwarecomplication. |
Generate impression based on findings. | Forearm fracture.VIEWS: Right forearm PA/lateral (two views) 05/14/15 A cast obscures bone detail. Both bones fracture of the distal forearm is noted. Minimal posterior displacement of the distal radial fracture fragment is seen. | Near anatomic alignment of the both bones fracture of the distal forearm. |
Generate impression based on findings. | 44-year-old male patient with right inguinal pain. Testicular pain. PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Subcentimeter inguinal lymph nodes are noted bilaterally.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There i... | Small fat-containing left inguinal hernia. |
Generate impression based on findings. | 55 year old female with VP shunt and headaches. There is a left frontal approach ventriculostomy catheter terminating in the region of the left frontal horn. The imaged portion is intact. There is also a right parietal approach ventriculostomy catheter that loops through the right lateral ventricular atria with a tatte... | 1.No change in size of the shunted ventricles. The catheters are unchanged in position.2.Further progression of marked global volume loss. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is a a hypoattenuating lesion extending from the periapical area of the second left maxillary molar and into the maxillary sinus. The lesion appears to be lifting... | Hypoattenuating lesion arising from the second molar periapical space is favored to represent a periapical cyst as opposed to a periapical abscess. |
Generate impression based on findings. | 36-year-old female patient with right lower quadrant pain, tender. Question of appendicitis. ABDOMEN:LUNG BASES: The lung bases are clear.LIVER, BILIARY TRACT: No focal hepatic lesion is identified. The gallbladder is surgically absent. There is prominence of the intra and extrahepatic biliary system which is non-speci... | 1. No evidence of acute appendicitis or other acute abnormality to explain the patient's symptoms.2. Prominence of biliary system may be due to a post-cholecystectomy state; if there is concern for biliary pathology, correlation with LFT's and a MRCP may be considered.2. Small amount of fluid in the pelvis is likely ph... |
Generate impression based on findings. | Metastatic lung cancer status post chemotherapy PELVIS:UTERUS, ADNEXA: Calcified fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable diffusely sclerotic L5 vertebral body. There is an additional nonspecific scl... | Nonspecific sclerotic focus in the intertrochanteric region of the left femur could be further evaluated by bone scan. Additional findings are unchanged. |
Generate impression based on findings. | Age: 58 years. Sex : Female. Reason for study: Reason: Eval Swallow History: Aspiration Pneumonia. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. Single static image was obtained. The exam wa... | Positive for deep vestibular penetration and negative for aspiration.Please refer to speech pathologist's full report for additional details. |
Generate impression based on findings. | Female 43 years old Reason: metastatic breast cancer History: spine pain Foci of increased uptake in the T6 and T7 vertebral bodies consistent with metastatic disease. No new foci of abnormal uptake identified. | Stable T6 and T7 vertebral body osseous metastases. No new osseous metastatic disease. |
Generate impression based on findings. | 13-year-old male with a history of left wrist fracture. Evaluate for healing.VIEWS: Left wrist PA and lateral (2 views) 5/14/2015 Overlying cast material limits evaluation of fine bone detail. Distal radius fracture in anatomic alignment with increasing density of periosteal reaction indicating interval healing. The ul... | Healing fractures as above. |
Generate impression based on findings. | 56-year-old female patient with CKG, left lower quadrant pain/vomiting/diarrhea. Question of diverticulitis. Lack of IV contrast limits evaluation of vascular structures and solid parenchymal organs.ABDOMEN:LUNG BASES: There is nodular groundglass opacities within the left lower lobe and lingula suggestive of infection... | 1. Left lower lobe nodular ground glass opacities likely represents pneumonia.2. No CT evidence of diverticulitis or other acute abnormality in the abdomen or pelvis. |
Generate impression based on findings. | Status post orthotopic liver transplant in 11/2013 for HCC, evaluate for lesions, assess hepatic vessel patency ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Stable appearance of the transplant liver. Hepatic artery is patent. Previously noted hepatic artery dilation has resolved. The porta... | Stable appearance of transplant hepatic parenchyma and vessels. |
Generate impression based on findings. | Right parotid gland adenopathy and cervical nodes. There is an ill-defined mass in the right parotid gland that measures up to 32 mm. There is also an ill-defined lesion in the left parotid gland that measures up to 12 mm. These lesions have decreased in size since February 2015. There is otherwise no significant lymph... | Decrease in size of the bilateral parotid lymphadenopathy. |
Generate impression based on findings. | Lung cancer metastasis workup. Previous chemotherapy. No evidence of acute ischemic or hemorrhagic lesion on this scan.No evidence of abnormal enhancement.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, i... | Normal contrast enhanced brain CT scan. |
Generate impression based on findings. | Neck pain The cervical vertebral bodies are appropriate height. There are nonspecific scattered areas of osseous lucency which may be related to osteopenia. Degenerative changes are seen throughout the cervical spine with moderate loss of disc height at the C4-C5 and C5-C6, levels. Vacuum phenomena is noted at the C6-C... | Multilevel degenerative changes in the cervical spine including prominent ventral disc protrusion at the C3-C4 level which indents the ventral cervical cord. Otherwise no high-grade spinal canal or neural foraminal stenosis is appreciated. MRI can be considered as clinically indicated. Prominent facet arthropathy is al... |
Generate impression based on findings. | Female 68 years old Reason: r/o acute fracture History: pain Bone mineralization is decreased. It is an acute vertical fracture with associated impaction injury of the tibial plafond near the medial malleolus. Ankle alignment remains near-anatomic.There is cortical irregularity of the medial talar dome most suggestive ... | Ankle fracture as detailed above. |
Generate impression based on findings. | 7-year-old male with almost daily crampy abdominal pain. Evaluate for constipation.VIEW: Abdomen AP (one view) 5/14/2015 at 13:03 Nonobstructive bowel gas pattern with moderate stool burden. No evidence of portal venous gas, pneumatosis intestinalis, or free air. | Moderate stool burden. |
Generate impression based on findings. | 44-year-old male patient for prekidney transplant evaluation. Evaluate aorta and iliac vessels for kidney transplant. Lack of IV contrast limits evaluation of vascular structures and solid organs.ABDOMEN:LUNG BASES: Left basilar atelectasis/scarring with pleural thickening and calcification, appearing similar to the pr... | 1. Post-transplant changes in the right lower quadrant.2. Moderate atherosclerotic disease of the aorta and its branches. |
Generate impression based on findings. | Injury to right occiput with soft tissue swelling.EXAMINATION: Skull AP/lateral (two views) 05/14/15 The lateral view is not a true lateral and obliquity is present. No definite depressed skull fracture is seen. | No definite depressed skull fracture. CT may be helpful if further evaluation is necessary. |
Generate impression based on findings. | History of breast cancer with lytic lesions reported on CT cervical spine CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CORONARY ARTERY CALCIFICATION: None. CHEST WALL: Hiatal hernia with enteric contrast suggestive of reflux.ABDOMEN:LIVE... | Multiple lytic lesions in the ribs, thoracic, and lumbar spine compatible with metastatic disease. |
Generate impression based on findings. | Metastatic lung cancer treated with MPDL3280A. There is apparent interval increase in size of an ill-defined conglomerate of right level 4 lymph nodes, which measures up to 22 x 30 mm, previously 22 x 28 mm. There is also interval increase size of the necrotic right paratracheal lymph node, which measures 26 x 19 mm, p... | 1.Overall slight interval increase in size of the metastatic right cervical and upper mediastinal lymphadenopathy.2.Multiple nodules within the partially imaged lungs. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Female 54 years old Reason: eval for evidence of OA History: acute on chronic knee pain Right knee: Bone mineralization is normal. Joint spaces are near normal. Alignment is anatomic. There is mild sharpening of the tibial spines. No acute fracture or malalignment. No joint effusion.Left knee: Bone mineralization is no... | Mild sharpening of the right tibial spines suggestive of very early osteoarthritis. |
Generate impression based on findings. | Female 55 years old Reason: left tibia fracture History: left tibia fracture Status post intramedullary nail placement affixing a tibial fracture with the fracture fragments in near-anatomic alignment. There is some callus formation about the fracture site indicating ongoing healing.No hardware complication is evident.... | Healing distal tibial fracture. |
Generate impression based on findings. | 69-year-old female with a history of hypoxia and shortness of breath. Personal history of metastatic GE junction adenocarcinoma and known PE. PULMONARY ARTERIES: Technically adequate study to the level of the segmental branches without evidence of pulmonary embolus. No evidence of right heart strain. The main pulmonary... | 1. No evidence of pulmonary embolus.2. Interval increase in large bilateral pleural effusions. Associated groundglass opacities are suggestive of a component of pulmonary edema.3. Marked thickening of the distal thoracic esophagus consistent with the patient's known history of adenocarcinoma.4. Multiple nonspecific pul... |
Generate impression based on findings. | 54-year-old male status post hardware removal Interval removal of sideplate and screw device affixing a distal clavicular fracture. Defects are noted from the previous fixation screws. The fracture line is seen with mild callus formation suggestive of interval healing. No retained radiopaque foreign bodies. No acute fr... | Interval removal of sideplate and screw device affixing a healing distal clavicular fracture. |
Generate impression based on findings. | 82-year-old male with tenderness along right lower lateral ribs Diffuse demineralization suggestive of osteopenia. Minimally displaced right 5th through 8th rib fractures appear are chronic in etiology. | Multiple chronic appearing right sided rib fractures. |
Generate impression based on findings. | 21 years, Female. Reason: Determine size of abscess History: Psoas abscess s/p IR drain Scout radiograph of the pelvis showed a right lower quadrant percutaneous pigtail catheter. Residual contrast was present in the distal colon and rectum presumably from prior contrast enhanced CT study.Contrast opacified a right pso... | Fistulae related to Crohn's disease intervening between the right psoas muscle and cecum with measurements of the right psoas abscess cavity as above. |
Generate impression based on findings. | Ms. Harris is a 48 year old female with a personal history of bilateral breast cysts. She has no current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, uncha... | Bilateral benign morphology masses, likely representing cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually, given that the patient has been recalled from screening mammogram multiple times. All results and r... |
Generate impression based on findings. | 18 years, Male. Reason: eval for ileus History: abdominal pain Dilated loops of small bowel measuring up to 6 cm in the mid abdomen with air distally in the colon and rectum which may represent a partial small bowel obstruction. Moderate to large stool burden, particularly in the ascending and descending colon.Lung bas... | Dilated loops of small bowel which may represent a partial small bowel obstruction. If prior imaging is available, would be helpful for comparison. Correlate clinically for constipation. |
Generate impression based on findings. | 36 year old female. History of right breast palpable area for which ultrasound was performed, showing simple and complicated cysts in the medial breast, a probably benign finding. Short interval follow-up was recommended. DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and two spot compression views of the r... | Right breast benign cysts in the upper inner quadrant, similar to prior study. New small mass in the right breast at the 10 o'clock position correlates to a 4 mm simple cyst sonographically. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, routine scre... |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 115 cm/sec.Right internal carotid artery: 85 cm/sec.Left middle cerebral artery: 116 cm/sec.Left internal carotid artery: 76 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Chronic lymphocytic lymphoma status post treatment and left renal oncocytoma. There is no definite cervical lymphadenopathy. The Waldeyer ring structures are not enlarged. The airway appears patent. The thyroid gland and major salivary glands are unchanged. The major cervical vessels are intact. There is a right subcla... | No significant lymphadenopathy in the neck to suggest recurrent lymphoma in this region. |
Generate impression based on findings. | 79-year-old female with left rib lateral pain Radiopaque BB markers are placed over the left lower ribs. No acute displaced rib fractures are evident. Moderate to severe cardiomegaly. Large lung volumes suggestive of COPD. A tri lead AICD is unchanged in position. | No acute displaced rib fractures are evident. |
Generate impression based on findings. | 69-year-old female with pain, evaluate for rheumatoid arthritis Right hand: 3 views of the right hand show a small cyst in the head of the third metacarpal head. No osseous erosions. No acute fracture or malalignment is evident.Left hand: 3 views of the left hand show no osseous erosions. No acute fracture or malalignm... | No radiographic evidence of rheumatoid arthritis. |
Generate impression based on findings. | Female 47 years old Reason: breast cancer; surgery 5/15/15 at 8am-Left axilary SNBx and bilateral mastectomy History: breast cancerRADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 1.0 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased ac... | Sentinel node identified in the left axilla. |
Generate impression based on findings. | 68-year-old male with pain including low back. Evaluate for fracture/dislocation 3 views of the right shoulder reveal no acute fracture or malalignment.5 views of the lumbar spine reveal 5 nonrib-bearing lumbar vertebra. Mild anterior osteophyte formation of the lower spine, otherwise alignment is anatomic with preserv... | No acute fracture or malalignment. |
Generate impression based on findings. | Multiple transaxial images of the lower abdomen and pelvis were assess.The previously described loculated fluid collection was no longer as evident, following placement of Foley catheter as well as bilateral nephroureterostomy catheters.Contrast was injected through bilateral nephroureterostomy catheters and additiona... | Likely long-standing, confined urinary bladder rupture, well controlled by drainage from Foley catheter and nephroureterostomy catheters. |
Generate impression based on findings. | 69-year-old female with metastatic breast cancer receiving therapy. History of bone metastases. Evaluate treatment response. CHEST:LUNGS AND PLEURA: Subpleural fibrosis along the anterior aspect of the right upper lobe, consistent with prior radiation therapy, unchanged. Relatively hyperlucent left lower lobe with low-... | Stable osseous metastatic disease. There is interval development of numerous hypoattenuating lesions with a peripheral rim of edema in the right lobe of the liver, which are suspicious for metastatic disease. Differential considerations include pyogenic hepatic abscesses, in the correct clinical setting. |
Generate impression based on findings. | Metastatic breast cancer status post chemoradiation. Restaging exam.RADIOPHARMACEUTICAL: 13.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion of the neck and pelvis demonstrates scattered sclerotic lesions most notably in the pelvis without additional significant pathology. Pleas... | 1.Numerous new hypermetabolic hepatic metastases.2.Additional findings suspicious for carcinomatosis throughout the thecal sac. Spine MRI may be useful for further evaluation.Diagnostic CTs of the chest and upper abdomen also performed at today's visit will be reported separately. |
Generate impression based on findings. | There is moderate dilatation of the lateral and third ventricles, but unchanged from the outside exams. The posterior aspect of the third ventricle measures 12 mm transverse. The fourth ventricle is small to normal in size. There is a punctate calcification likely relates to choroid near the foramen of Magendie. On th... | 1. Moderate lateral and third ventricular dilatation, not significantly changed since outside exam, secondary to caudal tectal mass resulting in distal aqueduct obstruction and more proximal dilatation. The mass is better delineated on the outside MRI.2. No significant pineal cystic lesion. 3 mm rounded cystic structur... |
Generate impression based on findings. | Female 82 years old Reason: eval for fracture History: fall, R flank pain; right shoulder plain Right shoulder: Bone mineralization is decreased. Severe osteoarthritis affects the right shoulder with bone-on-bone apposition. There are inframedial humeral head osteophytes.Mild osteoarthritis affects the right acromiocla... | 1.Multilevel thoracolumbar degenerative disc disease without evident compression fracture.2.Severe osteoarthritis of the right shoulder. |
Generate impression based on findings. | 43 years, Female. Reason: assess for obstipation History: 43 y.o. woman with a history of gas/bloating, urgency Nonobstructive bowel gas pattern with large stool burden throughout the colon. Intrauterine device projects over the pelvis.Lung bases are clear. | Nonobstructive bowel gas pattern with large stool burden |
Generate impression based on findings. | Female 54 years old Reason: L lateral ankle/low extremity pain for 2 wks History: L lateral ankle/low extremity pain for 2 wks Bone mineralization is normal. Alignment is anatomic. No acute fractures or stress fractures are evident. Partially imaged is left knee osteoarthritis. | No evident fracture or stress fracture. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 133 cm/sec.Right internal carotid artery: 98 cm/sec.Left middle cerebral artery: 158 cm/sec.Left internal carotid artery: 98 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Reason: SCD with worsening tachycardia and hypoxia, he also has left clavicular head tenderness and concern for bone infarction vs. osteo History: as above, assess for PE vs. fibrosis PULMONARY ARTERIES: There is no evidence of pulmonary embolism. Although the main pulmonary artery measures upper normal, there is no ev... | No evidence of pulmonary embolism, or other acute abnormality. Mild dependent atelectasis or scarring and pleural thickening is unchanged. There is no specific evidence of clavicular osteomyelitis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV S... |
Generate impression based on findings. | Female 76 years old Reason: History of breast cancer with lytic lesions reported on 5/10/15 CT Cervical Spine WO. Evaluate extent of disease. Numerous osteoblastic metastases throughout the axial and appendicular spine including the skull, ribs, spine, as well as right proximal femur. | Numerous osseous metastases. |
Generate impression based on findings. | Evaluate for scoliosis status post spine fusion in 2011.VIEWS: Thoracolumbar spine AP (1 views) 5/14/2015 Posterior spinal fixation rods with hooks extend from T3 to L4 and appear unchanged without evidence of hardware complication. Dextro levoscoliosis appears similar to the prior study. An opacity in the left lower l... | Postsurgical changes without evidence of hardware failure. |
Generate impression based on findings. | 66 years, Female. Reason: assess for megacolon History: shock Interval placement of enteric tube with side-port projecting over the mid esophagus and tip overlying the distal esophagus. Mild gastric distention. No evidence to suggest toxic megacolon. Bowel gas pattern appears similar to prior study, however, the relati... | Enteric tube sidehole projecting over the mid esophagus. Recommend advancing at least 12 cm.No evidence of a markedly dilated colon to suggest toxic megacolon. Developing small bowel obstruction cannot be excluded given the relative paucity of gas in the colon and diffuse inflammatory changes seen within the bowel on r... |
Generate impression based on findings. | Reason: mets lung cancer, s/p multiple chemo, pls c/w previous study and evaluate tx response. Pls provide bi-dimensional measurment to all lesions per RECIST 1.1 History: lung ca LUNGS AND PLEURA:Right upper lobe elongated nodular opacity measuring 15 x 48 mm (series 6/36), not significantly changed when using compara... | Slight increase in pulmonary and mediastinal reference lesions and otherwise stable disease. |
Generate impression based on findings. | 3-year-old male evaluate left elbow fracture.VIEWS: Left elbow AP and lateral (2 views) 5/14/2015 Soft tissue swelling is seen along the proximal anterior forearm. There is a fracture of the radial neck with approximately 3 mm of anterior and 7 mm of medial displacement of the proximal fracture fragment. The distal hum... | Displaced radial neck fracture as above. |
Generate impression based on findings. | 9-year-old male with right shoulder pain after a fall.VIEWS: Right shoulder AP in internal and external rotation (2 views) 5/14/2015 No acute fracture or dislocation. The bones are normal. | No fracture or dislocation. |
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 paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial abnormality. |
Generate impression based on findings. | There is transitional lumbosacral anatomy with partial lumbarization of S1 vertebra. For the purposes of this exam, the last fully formed disc is at L5-S1, and the last rib-bearing vertebra is at T12. Postoperative changes are again seen from previous posterior surgical fusion of L4 and L5, with resultant susceptibili... | 1. Transitional lumbosacral anatomy. If further surgery is to be contemplated, please correlate with imaging of the entire spine.2. Redemonstration of postoperative changes at the L5-S1 level, with stable grade 1 anterolisthesis of L5 on S1. Persistent moderate-severe left foraminal narrowing.3. Mild interval progressi... |
Generate impression based on findings. | Left parotid mass, ulcerative: evaluate for extent of lesion. (Squamous cell cancer to the right parotid area 3 years ago (T4N2) with chemotherapy and radiation.) Neck: There is a bulky necrotic and ulcerative mass centered within the left parotid space with extension into the auricle and parapharyngeal and masticator ... | 1. A ulceronecrotic mass centered within the left parotid space with extension into multiple surrounding spaces that corresponds to the know squamous cell carcinoma deposit has increased in size since January 2015.2. Left neck and bilateral axillary lymphadenopathy at least in part likely represents metastatic disease,... |
Generate impression based on findings. | Reason: mets lung cancer, PD from Erlotinib. Pls c/w previous study and evaluate dx status.Pls provide bi-dimensional measurement to all lesions per RECIST 1.1 History: lung cancer CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules, several of which have cavitation, generally stable compared to the previous s... | 1.Slight increase in some reference nodules and otherwise stable disease.2. Sclerosis of T1 and L5, unchanged, consistent with metastases. |
Generate impression based on findings. | 65 years, Male. Reason: Evaluate prior to G-tube placement. History: As above Motion artifact makes evaluation suboptimal. Nonobstructive bowel gas pattern. Surgical clips are noted in the right upper quadrant and mediastinum.Opacity in the right lung base consistent with atelectasis with associated rightward mediastin... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 17-year-old male evaluate PICC placement.VIEW: Chest AP (one view) 5/14/2015, 16:23 A right upper extremity PICC has its tip at the SVC/RA junction. The cardiomediastinal silhouette is normal. There is no focal pulmonary opacity, pleural effusion, or pneumothorax. Oral contrast material is seen within the transverse co... | Right upper extremity PICC with tip at the SVC/RA junction. |
Generate impression based on findings. | 79-year-old male patient with newly diagnosed parotid cancer, squamous cell carcinoma versus myoepithelial carcinoma. Question of metastatic disease. ABDOMEN:LUNG BASES: Multiple pulmonary nodules are noted within the lung bases along with a pleural nodule in the right lung base. Please refer to CT chest report for fin... | 1. Bilateral pulmonary nodules and right lung base pleural nodule; please refer to the dedicated CT chest report for chest findings.2. Pelvic and inguinal lymphadenopathy.3. Right adrenal nodule and hypodense renal lesions are incompletely characterized on single phase CT. |
Generate impression based on findings. | Male 2 days old Reason: evaluate line placement History: central line placement, prematureVIEW: Chest AP (one view) 5/14/2015, 16: 29 The left neck PICC has its tip at the junction of the left internal jugular and left subclavian veins. Umbilical artery catheter tip is at the level of T9. Enteric tube tip is in the gas... | Left neck catheter tip at the left IJ and subclavian vein junction. |
Generate impression based on findings. | 19-year-old female with sickle cell disease and venoocclusive crisis with new focal left hip/pelvic pain The bones appear within normal limits without evidence of sclerosis. No acute fracture is evident. Alignment is anatomic. | No radiographic evidence of avascular necrosis. |
Generate impression based on findings. | 87 year-old female with history of metastatic renal cell carcinoma with recent onset sharp back pain, right lateral aspect, around T4 Thoracic spine: Multilevel anterior osteophytes and lateral syndesmophytes represent degenerative disc disease. Vertebral body heights and alignment are preserved.Lumbar spine: Multileve... | 1.No acute compression fracture is evident. 2.Patient's known L1 lytic lesion is better characterized on recent CT. 3.Degenerative disease as described above. Grade 1 anterolisthesis of L4 on L5, unchanged. |
Generate impression based on findings. | 27-year-old female with left dorsal pain 3 weightbearing views of the left foot show no acute fracture or malalignment. No evidence of stress reaction or stress fracture. | No evidence of stress reaction or stress fracture. |
Generate impression based on findings. | Images are slightly limited by patient motion. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are scattered punctate and confluent areas of abnormal low density in the periventricular and sub... | 1. No acute intracranial hemorrhage. Mild-moderate age-indeterminate small vessel ischemic changes.2. Smooth area of ossific density along the lateral right temporal bone inner table which may represent a benign exostosis versus less likely a small dural based meningioma. |
Generate impression based on findings. | 3-year-old male with left forearm injury, right forearm images provided for comparison.VIEWS: Left forearm AP and lateral (2 views) 5/14/2015 at 16:42Right forearm AP and lateral (2 views 5/14/2015 at 14:40 Left forearm: Overlying splint material limits evaluation of fine bone detail. Again seen is soft tissue swelling... | Displaced proximal radial neck fracture and buckle fracture of the ulna as above. |
Generate impression based on findings. | Lung nodule. Evaluate for malignancy.RADIOPHARMACEUTICAL: 9.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 107 mg/dL. Examination is limited by patient body habitus. Today's CT portion grossly demonstrates multiple bilateral groundglass and semisolid pulmonary lesions, similar to recent diagnostic CT. The... | Multiple bilateral mild to moderately hypermetabolic subsolid lung nodules are suspicious for multiple primary lung cancers, possibly indolent. Of these, the most metabolically active are seen in bilateral lower lobes. |
Generate impression based on findings. | Female 42 years old Reason: rule out recurrent follicular thyroid cancer - rising TG and no obvious lesions in neck on ultrasound RADIOPHARMACEUTICAL: 11.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates post therapy changes in the neck. Cholecystectomy clips... | 1.No convincing FDG avid thyroid cancer. Slightly avid supraclavicular lymph nodes which may be due to inflammation, however low-grade thyroid cancer cannot be entirely excluded. Correlate with radioiodine scan as clinically indicated.2.Nonspecific focus in the right sacrum which may be benign osseous lesion. Correlati... |
Generate impression based on findings. | Male 8 months old Reason: Evaluate for interval changes History: respiratory distressVIEW: Chest AP (one view) 5/14/2015 at 16:50 Tracheostomy tube in place with tip at the thoracic inlet. Right central line tip in the SVC. NG tube tip in the stomach within the omphalocele.The cardiothymic silhouette is upper limits of... | Bilateral patchy atelectasis greater on the right and not significantly changed. |
Generate impression based on findings. | Pain, decreased range of motion. Fracture? I see no fracture or malalignment. I see no specific findings to account for the patient's pain or decreased range of motion. | Normal-appearing shoulder without fracture or other findings to account for the patient's pain. |
Generate impression based on findings. | Assess for intra-articular calcaneus fracture. 3 views of the left foot and 3 views of the left heel show a large extra-articular avulsion-type fracture through the superior aspect of the posterior calcaneal tuberosity. The fracture fragment measures approximately 3 cm in greatest dimension and is displaced superiorly ... | Extra-articular avulsion-type fracture of the posterior calcaneus as described above. |
Generate impression based on findings. | 48-year-old with metastatic lung cancer, worsening back pain, known metastases. 3 views of the thoracic spine again show a posterior stabilization device with screws entering the T2, T3, T6, and T7 vertebrae. I see no hardware complications. Cement replacing the right half of the T4 vertebral body appears similar to th... | 1. Postoperative changes of the upper thoracic spine appearing similar to those seen on the prior study, with lytic destruction of the posteromedial aspect of the right fifth rib.2. Extensive stool in the colon. |
Generate impression based on findings. | Fell off a bike. Swelling left upper nasal area. Is there a fracture. I see no fracture. The facial bones are unremarkable. | No fracture evident. |
Generate impression based on findings. | Altered mental status with elevated troponin. No evidence of acute ischemic or hemorrhagic lesion.Patchy bilateral periventricular white matter and centrum semiovale low attenuations indicate mild to moderate nonspecific small vessel disease. No change since prior exam.The ventricles, sulci, and cisterns are symmetric ... | No evidence of acute ischemic or hemorrhagic lesion.Mild to moderate nonspecific small vessel disease, no change since prior exam. |
Generate impression based on findings. | Malaise and fatigue possible cerebrovascular accident No evidence of acute ischemic or hemorrhagic lesion.Bilateral periventricular and centrum semiovale patchy low attenuations especially white matter area indicate nonspecific small vessel disease, moderate degree.The ventricles, sulci, and cisterns are symmetric and ... | No evidence of acute ischemic or hemorrhagic lesion.Nonspecific small vessel disease. |
Generate impression based on findings. | Intoxicated, head injury, hematoma on forehead. There is subtle soft tissue swelling midline for forehead which extends slightly to the left side which is compatible with soft tissue hematoma. Otherwise, there is no evidence of acute ischemic or hemorrhagic lesion in the brain.The ventricles, sulci, and cisterns are sy... | No evidence of acute ischemic or hemorrhagic lesion in the brain.No evidence of bony abnormality, specifically no evidence of acute fracture. |
Generate impression based on findings. | Headache and dizziness, prior episodes of motor vehicle accident. 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... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Difficulty speaking No evidence of acute ischemic or hemorrhagic lesion.Bilateral patch low attenuations on periventricular white matter and centrum semiovale indicate nonspecific small vessel ischemic disease, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no ma... | No evidence of acute ischemic or hemorrhagic lesion.Moderate degree, nonspecific small vessel disease, no change since prior exam. |
Generate impression based on findings. | Muscle weakness, generalized, possible cerebrovascular accident 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/a... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Imaging evaluation There is encephalomalacia seen on the left especially inferior cerebellar hemisphere indicating chronic ischemic infarct. Patch low attenuations on bilateral trigone area and periventricular white matter indicating nonspecific small vessel disease. Linear low attenuation on the left anterior aspect o... | No evidence of acute ischemic or hemorrhagic lesion.Interval development of multifocal areas size chronic ischemic infarct as described above.Nonspecific small vessel ischemic disease, progressed since prior exam.Brain MRI can be considered for further imaging evaluation if clinically necessary. |
Generate impression based on findings. | 73 year old man with left ventricular assist device being considered for TAVR. He is referred to assess cardiovascular anatomy to guide procedure.CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic coarctation, dissection or aneurysm is ... | 1.Aortic anatomy as above. 2. LVAD inflow and outflow cannulas well positioned and without obvious obstruction. 3. Severe multivessel coronary calcification. 4. Severe right ventricular and right atrial dilation. 5. Moderate left atrial dilation. 6. Normal LV size with interventricular septum minimally displaced tow... |
Generate impression based on findings. | Lateral swelling and pain over lateral malleolus. Evaluate for fracture. There is soft tissue swelling along the lateral and anterior aspects of the ankle. There is also suggestion of a tibiotalar joint effusion. I see no acute fracture or malalignment. | Soft tissue swelling without fracture evident. |
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