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Generate impression based on findings. | follow up, right frontal lobe acute ischemic infarction. Re-demonstration of the right frontal lobe pre central gyrus acute ischemic infarction, no change since prior exam.There is no evidence of hemorrhagic conversion.No evidence of new ischemic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable... | No interval change of the right frontal lobe pre central gyrus acute ischemic infarction.No evidence of hemorrhagic conversion.Otherwise unremarkable head CT scan. |
Generate impression based on findings. | 3-year-old female with NF1 for evaluation if there is a retroperitoneal lesion.EXAMINATION: MR of the abdomen and pelvis 1/16/15 No pleural effusion. No focal hepatic lesions. There is no hydronephrosis or perinephric inflammation. The spleen is within normal limits. The gallbladder is within normal limits. There is a ... | 1.No retroperitoneal mass as clinically questioned. 2.Large amount of stool within the rectum. |
Generate impression based on findings. | 51-year-old male with chest pain, subtherapeutic INR PULMONARY ARTERIES: No pulmonary embolus. Enlarged pulmonary arterial tree similar to previous may represent pulmonary arterial hypertension.LUNGS AND PLEURA: Subtle clustered nodular opacities in the left lung base may represent sequela of aspiration. Subsegmental a... | 1. No pulmonary embolism or other acute findings to account for the patient's symptoms. 2. Other chronic findings as described above. PULMONARY EMBOLISM: PE: NegativeChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 65 years, Male. Reason: NG tube placement Enteric tube tip in the gastric fundus. Incompletely imaged bowel loops. There appears to be mild distension of small bowel measuring up to 3.0 cm. Stool filled presumed transverse colon is also seen. Left lung base atelectasis/consolidation. Please see dedicated chest radiogra... | Enteric tube tip in the gastric fundus. Mild distension of small bowel measuring up to 3 cm, incompletely imaged. |
Generate impression based on findings. | Ms. Doke is a 71 year old female with a personal history of right breast lumpectomy in 2011 for DCIS. She also had a benign biopsy in the right breast in 2011 for fibroadenomatoid changes with microcalcifications and a benign biopsy in the left breast in 2013 for fibroadenomatoid changes with microcalcifications. Famil... | Scattered benign calcifications in both breasts and stable postsurgical changes in the right 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.BI... |
Generate impression based on findings. | History of cardiac arrest. Evaluation limited by patient motion artifact.PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Severe centrilobular emphysema. Lung volumes with basilar consolidation/atelectasis, and a small right subpleural effusion.MEDIASTINUM AND HILA: Endotracheal tube with tip above the carina... | 1.No pulmonary embolus.2.Severe centrilobular emphysema with low lung volumes and bibasilar consolidation/atelectasis.3.Support devices as described above. PULMONARY EMBOLISM: PE: NegativeChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 76-year-old female with dizziness. Assess the posterior circulation. CT HEAD: There is a right frontoparietal convexity arachnoid cyst that measures up to approximately 3 cm in width with associated mass effect upon the underlying brain parenchyma. There is no evidence of intracranial hemorrhage. The ventricles are nor... | 1. No evidence of acute intracranial hemorrhage or mass lesions.2. Marked decrease in the caliber of the left vertebral artery distal to the left AICA origin and mild narrowing of the distal right vertebral artery and proximal basilar artery. 3. Focal stenosis of the P2 segment of the left posterior cerebral artery and... |
Generate impression based on findings. | Neck pain, evaluate for fracture or dislocation. The cervical vertebral bodies are appropriate height. Alignment is maintained. No fractures are identified in the cervical spine. No suspicious bony lesions are identified in the cervical spine.Individual levels as below:C2-3: No significant compromise to the spinal cana... | 1. No evidence of fracture or subluxation within the cervical spine.2. Minimal degenerative changes including disk bulge at the C4-C5 level with partial effacement of the ventral thecal sac, which can be further assessed with MRI if clinically indicated. |
Generate impression based on findings. | 56 year old male with colon cancer. Follow-up examination. Lack of IV contrast enhancement limits evaluation of the organs.CHEST:LUNGS AND PLEURA: Again noted are multiple bilateral pulmonary nodules. Reference left upper lobe nodule measures 1.2 x 1.1 cm (series 5, image 48), previously measuring 1.4 x 1.2 cm. Referen... | 1.Mild interval worsening of pulmonary metastatic disease.2.Stable disease in the abdomen and pelvis. |
Generate impression based on findings. | Headache after craniotomy. There has been interval evolution of the postoperative findings related to left frontal craniotomy for resection of a left frontal lobe tumor, with interval layering of hyperattenuating material in the resection cavity. There is persistent edema in the left frontal lobe. There are mixed solid... | 1. Interval evolution of the postoperative findings related to left frontal craniotomy for resection of a left frontal lobe metastasis, with interval layering of hemorrhage in the resection cavity and persistent surrounding vasogenic edema. Otherwise, assessment for residual tumor is limited on non-contrast CT.2. Uncha... |
Generate impression based on findings. | Male 58 years old Reason: status of liver transplant History: volume overload LIVER: The liver contour is mildly nodular. Liver measures 16.4 cm in length. The parenchyma is moderately coarse and echogenic . No suspicious hepatic lesions.BILIARY TRACT: The gallbladder is absent. Common duct measures 4mm. PANCREAS: The ... | 1.Echogenic coarsened hepatic suggestive of chronic liver disease.2.Patent hepatic vasculature. |
Generate impression based on findings. | 11 year old male with known radial fracture. Evaluate healing.VIEWS: Right wrist AP lateral and oblique (3 views) 1/16/2015 Overlying cast material obscures fine bone detail. Incomplete transverse fracture identified through the distal radial metaphysis, with sclerotic margins consistent with healing. Focal lucency see... | Radial fracture and questionable ulnar fracture as above. |
Generate impression based on findings. | Aborted left lower lobe wedge resection for bleeding during intubation. History of T3 N0 squamous carcinoma of left tongue and T1N0 squamous cell carcinoma of right tonsil status post chemo RT. S.O.B. and fatigue. History of infiltrating lobular breast carcinoma. LUNGS AND PLEURA: Emphysema. Subpleural fibrosis anterio... | 1. Interval increase in size of poorly marginated lipid containing nodule in the left lower lobe, now 10-mm.2. No new nodules.3. No suspicious enlarging mediastinal lymph nodes. The index trachea esophageal lymph node has been stable over multiple prior studies, consistent with a benign lesion.4. Breast findings incomp... |
Generate impression based on findings. | Newborn male, status post UVC placement.VIEW: Chest and abdomen AP (two view) 1/16/2015, 08:44 The UVC catheter has been advanced, now at the level of the pulmonary veins, likely traversing a patent foramen ovale. UAC catheter position unchanged. New focus of gas in the peripheral right upper quadrant concerning for pn... | 1.New focus of gas in the peripheral right upper quadrant concerning for pneumoperitoneum, the etiology of which is uncertain. 2.UVC catheter, at the level pulmonary veins. 3.Increased right middle lobe opacity likely atelectasis.These findings were discussed with Dr.Lenus via telephone at 11:09 1/16/2015. |
Generate impression based on findings. | 50 year-old female with history of wrist fracture. There is a comminuted intra-articular fracture of the distal radius with approximately 20% dorsal angulation of the distal fracture fragment. There is a mildly displaced fracture of the ulnar styloid. | Distal radius and ulnar styloid fractures as above. |
Generate impression based on findings. | 17-year-old male with history of hip pain. Evaluation of the acetabulum is slightly limited due to patient rotation. There appears to be an acetabular crossover sign on the left and to a lesser extent on the right which can be seen with cranial acetabular retroversion. There is no acute fracture or cam deformity. There... | 1.Acetabular crossover sign suggestive of cranial acetabular retroversion which can be associated with pincer femoroacetabular impingement in the correct clinical context.2.Slight irregularity along the margins of the pubic symphysis of uncertain clinical significance.3.If patient care warrants further imaging, MRI may... |
Generate impression based on findings. | History of endocarditis, rule out septic emboli. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. There is hypodensity with volume loss and calcifications involving the right posterior inferior cerebellar hemisphere which may be related to ... | 1. No evidence of intracranial hemorrhage, abscess, or empyema. If there is continued suspicion for emboli, MRI would be more sensitive.2. Calcifications and hypodensity in the right cerebellum likely related to remote PICA infarct or other chronic injury. |
Generate impression based on findings. | Ms. Spornberger is a 65 year old female with a personal history of left breast lumpectomy in May 2013 for IDC followed by chemoradiation therapy and AI. Three standard views of both breasts and two left spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is c... | Stable postsurgical changes in the left breast with decreased skin thickening/trabeculation. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 ... |
Generate impression based on findings. | 39-year-old female with history of pain. Evaluate for fracture. There is no acute fracture or subluxation. Mild degenerative disc disease affects C3-4. Severe degenerative disc disease affects C4-5 and moderate degenerative disc disease affects C5-6 and C6-7. Osteophytes project from the anterior aspect of the cervical... | Degenerative disc disease and neuroforaminal narrowing as above. No evidence of acute fracture. If patient care warrants further imaging, MRI may be considered. |
Generate impression based on findings. | 58-year-old female with history of fall. Evaluate for acute fracture or dislocation. There is no acute fracture or dislocation. Tricompartmental osteophytes indicate moderate osteoarthritis. There is a moderate-sized joint effusion. | Osteoarthritis and joint effusion as above without acute fracture. |
Generate impression based on findings. | Pulmonary nodules, PTLD. NHL. LUNGS AND PLEURA: Interval improvement in size and number pulmonary nodules.Left upper lobe nodule at the level of the AP window (/33) measures 6 x 9 mm, previously 14 x 18 mm.Right lower lobe nodule abutting the fissure and right hilum (5/49) measures 6 x 6 mm, previously 9 x 9 mm.Previou... | Interval improvement in size and number of pulmonary nodules which were present previously. However, new and worsening groundglass opacity and small sub-solid nodular opacities are seen in the left lower lobe, nonspecific, and could represent additional sites of disease. |
Generate impression based on findings. | 42 year-old female with diffuse abdominal pain, UTI, CVA tenderness to palpation, as well as diffuse body pain. Evaluate for kidney stone versus diverticulitis. Lack of IV contrast enhancement limits evaluation of solid organs.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis with... | 1.No nephrolithiasis or ureteral calculus. No hydroureteronephrosis. 2.Cholelithiasis without pericholecystic inflammatory changes.3.No specific findings to account for patient's pain. |
Generate impression based on findings. | Ms. Jeffries is a 68 years year old female with a personal history of left breast lumpectomy in 2012 for IDC/DCIS followed by chemoradiation therapy. Personal history of lung cancer. Three standard views of both breasts and two left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3... | Stable postsurgical changes in the left 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.RECOMMENDATION: ND - Diagnos... |
Generate impression based on findings. | Headache after craniotomy. There has been interval left frontal craniotomy for resection of a left frontal lobe tumor. There is hyperattenuating material in the resection cavity and a small amount of extraaxial air and fluid deep to the craniotomy flap. There is persistent edema in the left frontal lobe, but decreased ... | 1. Interval to left frontal craniotomy for resection of a left frontal lobe metastasis, with a small amount of hemorrhage in the surgical bed and persistent surrounding vasogenic edema. Otherwise, assessment for residual tumor is limited on non-contrast CT.2. Unchanged right frontal lobe metastases and associated vasog... |
Generate impression based on findings. | 5-year-old male with Li-Fraumeni syndrome. LIVER: The liver measures 11.3 cm in length and demonstrates appropriate parenchymal echogenicity. No focal mass lesion or intrahepatic biliary duct dilatation is evident. The main portal vein is patent demonstrating hepatopetal flow with a velocity of 0.3 m/sec.GALLBLADDER, B... | Normal examination. |
Generate impression based on findings. | There is no diffusion abnormality to suggest acute infarct. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. No intracranial mass or mass effect. The ventricles and sulci are... | 1. No evidence of acute infarct, intracranial mass, or mass effect.2. Mild chronic small vessel ischemic changes.3. Mild bilateral proptosis. |
Generate impression based on findings. | BRAIN:There is a moderate degree of periventricular and subcortical white matter changes in a pattern suggestive of MS. A few of these lesions seen previously are slightly less prominent. There is a new lesion in the left posterior medulla which shows enhancement. No abnormal enhancement or diffusion is seen throughou... | 1.Multiple T2 hyperintense lesions involving the supra- and infratentorial white matter are consistent with known demyelinating disease. Compared to 10/16/2014, there is development of a new lesion in the left dorsal medulla with enhancement suggestive of active demyelination.2.Multiple T2 hyperintense lesions within t... |
Generate impression based on findings. | 77-year-old male with history of right radical nephrectomy and left partial nephrectomy. Evaluate for disease. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: Diffuse hepatic parenchymal calcifications are likely sequela of prior granulomatous disease.SPLEEN: Splenic calcifications, likely ... | 1.Postoperative changes of right radical and partial left nephrectomy without evidence of residual disease.2.Bladder wall thickening with a right-sided mass which may be a prominent prostatic median lobe; however, cystoscopy is recommended to exclude of primary bladder mass. |
Generate impression based on findings. | 14-year-old male with painVIEWS: Right hand PA, oblique and lateral (3 views) 01/16/15 No acute fracture or malalignment is evident. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 14 year old female with Li-Fraumeni syndrome. LIVER: The liver measures 13.4 cm in length and demonstrates appropriate parenchymal echogenicity. No focal mass lesions are identified. There is no evidence of intrahepatic biliary ductal dilatation. The main portal vein is patent, demonstrating hepatopetal flow with a vel... | Normal examination. |
Generate impression based on findings. | Male 51 years old; Reason: bone scan abnormalities with a history of RCC History: as above There is persistent increased radiotracer uptake in the posterior right and left sixth ribs, as well as the anterolateral seventh rib which correlate with the nonspecific sclerotic rib lesions seen on same day CT study, however a... | Right skull and bilateral ribs lesions are equivocal and may represent osseous metastatic disease or a benign process. However, the appearance is stable and there are no new suspicious osseous lesions. FDG-PET may be useful for further evaluation for potential osseous and soft tissue metastatic disease if clinically wa... |
Generate impression based on findings. | Ms. Graves is a 84 year old female with a personal history of left breast lumpectomy in 2001 for IDC followed by radiation therapy. Family history of breast cancer in her sister diagnosed at the age of 50. She has no current breast related complaints. Three standard views of both breasts were performed digitally and re... | Stable postsurgical changes of the left 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.RECOMMENDATION: ND - Diagnos... |
Generate impression based on findings. | Seven year old female status post corrective osteotomy.VIEWS: Left forearm AP and lateral (two views) 1/16/2015 Interval removal of the cast. Compression plate and screw devices again traverse bilateral osteotomies of the mid radial and ulnar diaphyses, with increasing indistinctness of the osteotomy lines and associat... | Interval removal of the cast with healing osteotomies in near anatomic alignment. |
Generate impression based on findings. | Alignment is lordotic. 5 lumbar type vertebrae are noted. There is slight increase in the grade 1 anterolisthesis of L4 on L5 compared to the previous exam. The marrow signal is benign. Diffuse disc desiccation is noted, most prominent at the L4-5 and L5-S1 levels where there is persistent slight decrease in disc heig... | Degenerative disease of lumbar spine as described above which has progressed slightly at the L4-5 level with a slight increase in the grade 1 anterolisthesis and slight progression of the spinal canal stenosis/neuroforaminal narrowing. |
Generate impression based on findings. | Reason: h/o lung and rectal ca, now s/p 6 cycles platinum therapy and 3 cycles "maintenance" therapy eval response to chemo, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Small nonspecific solid and non-solid nodules in the apical regions, unchanged from previous.Persistent right pleural e... | New masslike opacity medially at the right lung base suspicious for tumor recurrence, and less likely infection, with adjacent interstitial opacity compatible with lymphangitic spread of tumor. |
Generate impression based on findings. | Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate height. Alignment is maintained. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology. Degenerative changes are seen in the cervical spine as des... | 1. Degenerative changes in the cervical, thoracic, and lumbar spine as detailed above.2. Mild cervical spinal canal stenosis at C3-4 and C6-7. There is severe neural foraminal stenosis at C6-7 bilaterally.3. Mild narrowing of the spinal canal in the thoracic spine at T10-T11 on the right.4. Congenital spinal stenosis i... |
Generate impression based on findings. | Thymic neuroendocrine carcinoma, status post resection. There are postoperative findings in the upper mediastinum and subtotal thyroidectomy. There is a right lower paratracheal lymph node that measures approximately 8 mm in short axis. The salivary glands are unremarkable. There are tonsilloliths. The major cervical v... | 1. Postoperative related to thymic tumor resection and subtotal thyroidectomy with an unchanged lower right paratracheal lymph node that corresponds to the pathology-proven metastatic lymph node. 2. Interval consolidation of the lung apices suggestive of radiation fibrosis. Please refer to the separate chest CT report ... |
Generate impression based on findings. | Ms. Bell is a 55 year old female with a personal history of right breast lumpectomy in 2011 for IDC followed by radiation and hormonal therapy. She has no current 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 composed o... | Stable postsurgical changes of the right 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.RECOMMENDATION: ND - Diagno... |
Generate impression based on findings. | Female 17 years old; Reason: bone scan of lumbar. Per patient, has chronic low back pain, repetitive stress from competitive dancing. No abnormal osteoblastic activity was identified to suggest significant osseous pathology; specifically no abnormal activity was identified in the lumbar spine.Thank punctate focus in th... | Unremarkable exam. No evidence of spondylolysis or other explanation for the patient's low back pain. |
Generate impression based on findings. | Pain. Rule out fracture. There is swelling of the soft tissues of the lateral aspect of the ankle. I see no underlying fracture. Small spurs project from the talus, likely degenerative in etiology. There may be a small tibiotalar joint effusion. There is a large os peroneum, a normal variant. | Soft tissue swelling and other findings as above, without fracture evident. |
Generate impression based on findings. | Cough, shortness of breath LUNGS AND PLEURA: Subtle reticulonodular subpleural opacities with slight basilar predominance. Very small subpleural cysts consistent with traction bronchiectasis secondary to fibrosis. No focal air space opacities or pleural effusions. No significant air trapping. MEDIASTINUM AND HILA: Seve... | 1.Mild subpleural reticulonodular opacities with small subpleural cysts consistent with traction bronchiectasis secondary to fibrosis. These findings are suggestive of mild UIP and less likely fibrosing NSIP. 2.Hepatomegaly and hepatic steatosis partially imaged. |
Generate impression based on findings. | 3-year-old female with NF1 for evaluation if there is a retroperitoneal lesion.EXAMINATION: MR of the abdomen and pelvis 1/16/15 No pleural effusion. No focal hepatic lesions. There is no hydronephrosis or perinephric inflammation. The spleen is within normal limits. The gallbladder is within normal limits. There is a ... | 1.No retroperitoneal mass as clinically questioned. 2.Large amount of stool within the rectum. |
Generate impression based on findings. | 55-year-old male with history of metastatic renal carcinoma. Evaluate for progression of disease. Additional history of VATS and left chest exploration with mediastinal dissection. Left lower lobe resection. CHEST:LUNGS AND PLEURA: Right lower lobe reference nodule (5/64) is unchanged in size, currently 5 x 6 mm. Post ... | Progression of disease, with left lung base enhancing pleural nodules, and chest wall invasion as above. |
Generate impression based on findings. | Female 26 years old; Reason: subclinical hyperthyroidism and thyroid nodules, evaluating for toxic nodules The thyroid images demonstrate mild uniform inappropriately elevated uptake in a gland of normal size and configuration. The 4-hour radioactive iodine uptake is 14.4% and the 24-hour uptake is 34.1% (normal range ... | 1. Uniform mildly increased uptake in the thyroid gland, which particularly in the setting of suppressed TSH levels is inappropriately elevated and suggestive of mild Graves' disease.2. No hot or cold nodules are visualized, therefore the known nodules seen on prior ultrasound remain indeterminate for malignancy. |
Generate impression based on findings. | Pain after ski injury Four views of the left knee are provided. I see no fracture, malalignment or joint effusion.The right knee appears normal as seen on the frontal views. | No findings to account for patient's pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Right facial swelling, pain, blurry vision, 1 month of sinus drainage. There are caries involving ADA # 2, 4, 12, 15, 29, 30, 31, many of which have associated periodontal lucencies. The salivary glands are unremarkable. There is no significant lymphadenopathy in the upper neck. There are small probable retention cysts... | 1. Multiple dental caries many of which are associated with periodontal disaease, but no evidence of soft tissue abscess.2. Small probable retention cysts in the left maxillary and right frontal sinuses. The paranasal sinuses are otherwise clear. |
Generate impression based on findings. | History of movement disorder. Evaluate for thymoma. LUNGS AND PLEURA: Left basilar scarring/atelectasis. No focal air space opacities, suspicious nodules/masses, or pleural effusions.MEDIASTINUM AND HILA: Small amount of nodular soft tissues present in the anterior mediastinum has significantly decreased in comparison ... | Fatty involution of the thymus since the prior examination from 2010, with minimal residual thymic tissue. No evidence of thymic hyperplasia or thymoma. |
Generate impression based on findings. | Status post prostalac for infected left total shoulder. Evaluate hardware. Components of a left total shoulder arthroplasty device are situated in near anatomic alignment. Thin lucency at the interface of the glenoid component with the underlying bone appears similar to that seen on prior studies and is of doubtful cli... | Total shoulder arthroplasty as above. |
Generate impression based on findings. | Postop Again seen is deformity of the right hip joint with absence of the femoral head and neck and disarticulation of the proximal femur with respect to the acetabulum. Multiple foci of heterotopic bone are again noted in the right hip region, a couple of which may have been resected when compared with the prior study... | Right hip disarticulation with heterotopic bone formation and postoperative changes as described above. The margins of one fragment of heterotopic bone along the medial aspect of proximal femur are slightly indistinct and hence I cannot exclude the possibility of osteomyelitis of this fragment. If further imaging evalu... |
Generate impression based on findings. | Reason: Assess reported small aneurysm MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is a 3mm broad necked right PCOMA infundibulum present. It is stable since the 11/... | 1.60% focal narrowing of the distal right vertebral artery intracranially.2.There is a 3mm broad necked right PCOMA infundibulum present. It is stable since the 11/20/2013 CTA. The right PCOMA is tiny. |
Generate impression based on findings. | 51-year-old male with a history of renal cancer who presents for follow up. Evaluate. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Few scattered micronodules are unchanged. Mild bilateral basilar atelectasis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal withou... | No evidence of disease recurrence or metastatic disease. |
Generate impression based on findings. | 44-year-old female status post left shoulder revision. Overlying splint material limits fine osseous detail. Hardware components of a total shoulder arthroplasty are in gross anatomic alignment without radiographic evidence of hardware complication. There is a cortical step off along the proximal humerus which may refl... | Postoperative changes of total shoulder arthroplasty as above. |
Generate impression based on findings. | 24 years, Female. Reason: assess stool burden History: constipation Large stool burden, increased from prior study. Nonobstructive bowel gas pattern. Surgical clips noted at right abdomen. Degenerative changes of the symphysis pubis. | Large stool burden, increased from prior study. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 73 years old; Reason: Focal uptake? History: Multinodular goiter, tracheal deviation, low TSH The thyroid images demonstrate an enlarged gland with multiple hot and cold nodules bilaterally. No dominant suspicious cold nodule is seen. 4-hour radioactive iodine uptake is 10% and the 24-hour uptake is 15% (normal ... | 1. Findings consistent with toxic multinodular goiter.2. No dominant cold nodule is seen on scintigraphy, although correlation with ultrasound and physical exam is suggested if there is concern for malignancy. |
Generate impression based on findings. | 55-year-old male with cough, shortness of breath. Evaluate interstitial lung disease. LUNGS AND PLEURA: Innumerable small pulmonary nodules throughout both lungs in an overall random and uniform distribution. The vast majority of these nodules measure a few millimeters in diameter. There is some consolidation in both l... | 1. Innumerable small bilateral pulmonary nodules as described above with a wide differential diagnosis. Considerations include granulomatous infection including mycobacterial and fungal etiologies, sarcoidosis, and varicella pneumonia. Less likely possibilities include inhalational disease/pneumoconiosis or metastatic ... |
Generate impression based on findings. | Reason: Patient w/ fever, leukocytosis, ?aspiration, h/o pancreatic ca, eval for pneumonia vs mass History: sob, cough, fever, leukocytosis LUNGS AND PLEURA: Patchy bilateral basilar opacities, with consolidation containing air bronchograms in the lingula region of the left upper lobe, and in the left lower lobe.Subseg... | Basilar opacities suggestive of infection involving the lingula and left lower lobe, although aspiration could be another possible etiology. |
Generate impression based on findings. | Shoulder pain Mild osteoarthritis affects the glenohumeral joint, and moderate osteoarthritis affects the the acromioclavicular joint. There is spurring of the anterior aspect of the acromion process. The bones appear slightly demineralized. | Osteoarthritis. |
Generate impression based on findings. | 77 years, Male. Reason: Evaluate for gastric distention History: pain with tube feeds Gastrostomy tube noted overlying the gastric body without significant gaseous distention, minimal gas seen in the fundus. Small to moderate stool burden. Nonobstructive bowel gas pattern. Degenerative disease of the spine. | Gastrostomy tube in region of gastric body. |
Generate impression based on findings. | Hip pain status post total hip replacement Components of a total hip arthroplasty device are situated in near anatomic alignment without specific radiographic evidence of hardware complication. Mild cortical thickening along the tip of the femoral component is of doubtful significance, as is thin lucency along the tip ... | Total hip arthroplasty in near-anatomic alignment. |
Generate impression based on findings. | 6 year old male with pain and discoloration of the 3rd finger after car door slammed onto his handVIEWS: Right 3rd finger AP, oblique, lateral (3 views) 1/16/15 No acute fracture or malalignment is evident. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | Tx(3,4)N2cM0 supraglottic squamous cell carcinoma status post treatment. There are post-treatment findings in the neck, with diffuse mucosal edema and patchy enhancement at the site of the treated supraglottic tumor, with mild airway narrowing. However, there is no discernible measurable tumor in the supraglottic regio... | Post-treatment findings in the neck, but no evidence of measurable residual supraglottic tumor or significant lymphadenopathy in the neck. |
Generate impression based on findings. | There are no areas of abnormal signal. No intracranial mass or mass-effect. No evidence of heterotopic gray matter or cortical dysplasia. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or herniation. There is no diffusion abnormality. No extra-axial fluid... | MRI of the brain appears within normal limits for age. No findings to suggest seizure focus. |
Generate impression based on findings. | Status post fixation Again seen is an intramedullary rod and screw device affixing a comminuted oblique fracture of the distal femoral metadiaphysis in near anatomic alignment. There has been progression of callus formation along the fracture indicating some healing. I see no hardware complications. Moderate osteoarthr... | Fixation of healing distal femoral fracture. |
Generate impression based on findings. | Ms. Rucker is a 64 year old female with a strong family history of breast cancer in sister, mother, maternal aunt, and maternal grandmother. She has no current breast related complaints. Dense tissue noted on exam, but no focal palpable area of concern in stated. Three standard views of both breasts were performed digi... | 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. | 61 year-old male with history of thymic neuroendocrine cancer status post resection and chemoradiation two years ago. Recent recurrent disease with completion of proton radiotherapy and chemotherapy on 8/27/2014. CHEST:LUNGS AND PLEURA: Interval development of left upper lobe radiation fibrosis with associated volume l... | Expected progression of bilateral radiation fibrosis which obscures the previously seen bilateral upper lobe nodules.Postsurgical changes without definite evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.Right lower lobe micronodules remain unchanged.Mild apical scarring.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No coronary calcifications are seen, the heart ... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 55-year-old male with history of foot wounds. Evaluate for osteomyelitis. Left foot: Overlying bandage material is present which slightly limits evaluation. There is no specific radiographic evidence of acute osteomyelitis. There has been a fourth toe amputation. There are deformities at the bases of the second and thi... | No specific radiographic features of acute osteomyelitis. Postoperative/posttraumatic changes and other findings as above. |
Generate impression based on findings. | Reason: Eval new RUL pulmonary nodule History: CXR with new pulm nodule LUNGS AND PLEURA: Diffuse severe centrilobular emphysema, most severe in the right lower lobe.Spiculated subpleural right upper lobe nodule measuring 16 x 14 mm with adjacent pleural retraction, highly suspicious for primary lung carcinoma (series ... | 1.Highly suspicious 16mm subpleural right upper lobe spiculated nodule, most compatible with primary carcinoma. 2. More smoothly marginated indeterminate 13-mm nodule in the right upper lobe which is also moderately suspicious for primary carcinoma though the differential diagnosis includes hamartoma and metastasis.3. ... |
Generate impression based on findings. | Pain Three views of the right shoulder are provided. The glenohumeral joint appears normal. The acromioclavicular joint appears slightly widened, with small osteophytes along the distal end of the clavicle, appearing similar to prior studies. Cyst formation in the superior aspect of the humeral head is similar to that ... | Degenerative arthritic changes of the shoulders and other findings as described above. |
Generate impression based on findings. | Follow-up of metastatic thyroid carcinoma, BRAF +, on vemurafenib. Neck: There are stable postoperative findings related to total thyroidectomy. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy. The salivary glands are unchanged. The left internal jugular vein is absent, but the o... | 1. Stable findings related to thyroidectomy without evidence of measurable tumor recurrence or significant lymphadenopathy in the neck.2. Multiple micronodules in the partially-imaged lungs. Please refer to the separate chest CT report for additional details.3. No evidence of intracranial metastases. |
Generate impression based on findings. | Abnormal PFTs, evaluate for ILD. History of dyspnea. LUNGS AND PLEURA: Motion artifact degrades image quality, somewhat limiting evaluation. Within this limitation, no pulmonary masses or nodules are appreciated. Compressive atelectasis in the left lower lobe, both in the posterior costophrenic angle region (4/85) and ... | 1. No evidence of idiopathic interstitial lung disease. 2. Intermittent collapse of the distal airways on the expiration phase sequence may indicate bronchomalacia.3. Severe multichamber cardiomegaly with signs of pulmonary hypertension.4. Ventral hernia containing mesenteric fat.5. Nonspecific mild lymph node enlargem... |
Generate impression based on findings. | Reason: s/p 9 yrs after LUL for management of a T2N0M0 Stage IB adenocarcinoma History: annual f/u LUNGS AND PLEURA: Postoperative changes of left upper lobectomy. Scarlike opacity in the left apex (series 4 image 27) not significantly changed since 2011.Improved left lower lobe consolidation since the recent abdominal... | 1. Improved left lower lobe consolidation since the recent abdominal CT from 1/8/14 suggests resolving infection. Interstitial and mild nodular opacities are likely postinfectious or postinflammatory, however continued follow up is recommended to confirm stability. 2. 8 mm indeterminate subsolid right upper lobe nodule... |
Generate impression based on findings. | Ms. Flennoy is a 78 year old female with a personal history of right breast mastectomy in 1981 for cancer. She has no current breast-related complaints. Three standard views of the left breast (with additional left CC and MLO views) were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 12-year-old female with shoulder pain status post osteomyelitisVIEWS: Left shoulder, internal and external rotation; right knee AP, oblique, lateral; left humerus AP, lateral (7 views) 01/16/15 Left shoulder: No acute fracture or malalignment is evident. Deformity and periosteal reaction of the proximal humerus. Osseou... | Healing chronic osteomyelitis as described above. |
Generate impression based on findings. | Low back pain status post MVA For this study I will designate 5 lumbar vertebrae with small hypoplastic ribs at L1. Severe degenerative disk disease affects L5/S1. There is slight loss of height of the L5 vertebral body, but I suspect that this is chronic in etiology as I see no angular deformities to suggest an acute ... | Degenerative disk disease. |
Generate impression based on findings. | Pain Again seen is a comminuted fracture of the distal radius involving the metaphysis and radial styloid. The radial styloid fracture remains visible. Sclerosis along the distal metaphyseal fracture suggests an attempt at healing. There is also a minimally displaced fracture of the ulnar styloid that appears similar t... | Multiple fractures as described above. |
Generate impression based on findings. | Reason: reevaluation f/u for LLL cavitary lesion, pulm nodule History: no symptoms LUNGS AND PLEURA: Interval partial resolution of multiple small clustered subpleural nodular and groundglass opacities, likely secondary to infection.A small cavitary nodule at the left base has almost completely resolved with a small sc... | 1.Interval decrease or resolution of multiple subpleural nodular opacities, suggestive of infection.2.Stable left lower lobe nodule.3.No new findings. |
Generate impression based on findings. | 50 year old female unable to bear weight. There is mild soft tissue swelling along the lateral aspect of ankle, as well as a tibiotalar joint effusion. On the oblique view, there is slight cortical irregularity along the medial aspect of the distal fibular diaphysis which likely simply represent syndesmotic attachment ... | Equivocal hairline fracture of the distal fibular diaphysis as described above. This was discussed with Dr. Jones in the ED by phone at the time of dictation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 12-year-old male status post fracture, evaluate healingVIEWS: Left tibia-fibula AP/lateral (two views) 01/16/15 Interval removal of cast material. Again seen is a spiral fracture through the distal tibial diaphysis. Periosteal reaction and indistinctness of the fracture line is indicative of interval healing. There is ... | 1.Healing spiral fracture of the distal tibial metaphysis.2.Apparent bridging of the distal tibial physis. If this is true, this may cause leg length discrepancy. Close follow up is recommended. |
Generate impression based on findings. | 56 year-old female with history of lung CA, laryngeal CA, and IgG/lambda monoclonal proteinemia. SKULL: No evidence of lytic lesion.CERVICAL SPINE: No evidence of lytic lesion. There are surgical clips present within the lower neck.THORACIC SPINE: No evidence of lytic lesion. LUMBAR SPINE: No evidence of lytic lesion. ... | No lytic lesions are present to suggest osseous metastatic disease. Osteoarthritis and other findings as above. |
Generate impression based on findings. | Respiratory distress, unilateral effusion question pneumonia. LUNGS AND PLEURA: Bilateral pleural fluid collections, moderate on the right and large on the left. Air space opacities in the superior segment of the right lower lobe (series 5, image 41) consistent with pneumonia. There is a large volume of debris within a... | 1. Extensive endoluminal debris within with near complete occlusion of the left main bronchus and its branches.2. Bilateral areas of pneumonia, both within the right lower and left lower lobes, appearing more acute on the right.3. Masslike proximal to mid thoracic esophageal enlargement; an underlying esophageal neopla... |
Generate impression based on findings. | 62-year-old female with history of pain. Left hip: Mild osteoarthritis affects the left hip. There is no acute fracture.Pelvis: The bones are demineralized suggesting osteopenia/osteoporosis. Mild degenerative disc disease affects the visualized lower lumbar spine. There is a single surgical clip projecting over the le... | Osteoarthritis of the hip and knee. |
Generate impression based on findings. | Reason: 16 years s/p LUL History: 16 years s/p LUL LUNGS AND PLEURA: Postoperative changes of left upper lobectomy. Interstitial and nodular opacities throughout the residual left lung are not changed since the prior study and are most consistent with postoperative/postinflammatory etiologies. Previously measured nodul... | Status post left upper lobectomy with stable nodular and interstitial opacities which are most likely postinflammatory and/or postoperative in etiology. |
Generate impression based on findings. | Female 18 years old Reason: Liver with doppler, hepatic veins and portal vascular History: abnormal LFTs LIVER: The liver has a smooth contour. Liver measures 14.9 cm in length. The parenchyma is mildly echogenic. No focal hepatic lesions.BILIARY TRACT: The gallbladder has an anechoic lumen. Wall measures 3 mm in thick... | 1.Mild echogenic hepatic parenchyma possibly due to fatty infiltration. 2.Patent hepatic vasculature with appropriately directed flow. |
Generate impression based on findings. | Difficulty defecating, history of fibroid uterus There is prompt opacification of the rectum of normal static morphology. Apparent circumferential narrowing at level of rectosigmoid colon most likely normal peristalsis (series 5). Trial straining showed appropriate descent of the perineal floor; voluntary anal sphincte... | No significant rectal prolapse. |
Generate impression based on findings. | Reason: post op day 3 s/p duodenal fistula repair, please evaluate repair, assess for a leak Scout radiograph shows postsurgical changes. Nasogastric tube side port in first portion of the duodenum, tip located in third portion of duodenum. Bilateral nephrostomy tubes are partially seen. Prompt contrast opacification o... | Prompt contrast opacification of duodenojejunal junction, no evidence of leak or fistula. |
Generate impression based on findings. | 63-year-old male with history of pain. Right ankle: No acute fracture or dislocation. There is a small plantar calcaneal spur. There are scattered arterial calcifications. There is a small tibiotalar joint effusion.Pelvis: Mild osteoarthritis affects the left hip. There are arterial calcifications present within the pe... | Minimal degenerative changes as above, but otherwise we see no radiographic findings to account for the patient's pain. |
Generate impression based on findings. | 74-year-old male with history of ankle ulceration. Evaluate for osteomyelitis. There is mild soft tissue swelling about the ankle extending to the dorsum of the foot. There is no frank osteolysis to suggest acute osteomyelitis. There is a mild hallux valgus deformity. Mild osteoarthritis affects the first MTP and inter... | Degenerative changes and soft tissue swelling without radiographic findings of acute osteomyelitis. If there is clinical suspicion of medial or lateral malleolar osteomyelitis, dedicated ankle radiographs are recommended.Results text paged to pager number 6876 at 1130 on 1/16/15. |
Generate impression based on findings. | 7-year-old female with tracheostomy for evaluation of lung expansion, concern for inadequate tidal volumeVIEWS: Chest AP (one views) 01/16/15 Tracheostomy tube is in position. Severe dextroscoliosis of the thoracic spine.Cardiothymic silhouette is enlarged. No pleural effusion. Left lower lobe atelectasis is likely chr... | Likely chronic left lower lobe atelectasis. |
Generate impression based on findings. | Abnormal ABR bilaterally. ABR test results indicate elevated neural synchrony to air conducted clicks and 4000 Hz in the left ear and at 4000 Hz in the right ear. Results indicate at least a severe hearing loss in the left ear and normal sloping to mild hearing loss in the right ear. Right: There are opacities in the e... | 1. No evidence of inner ear or ossicular chain structural abnormalities. However, please also refer to the concurrent temporal bone MRI report.2. Partial opacification of the bilateral mastoid air cells and an apparent air-fluid level in a pneumatized right petrous air cell may represent effusions or secretions related... |
Generate impression based on findings. | 59 year-old with clinical history of palpable retroareolar mass of the left breast. The patient cannot currently note any palpable area of concern. Three standard views of both breasts and right retroareolar spot views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed o... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Correlation with physical examination is recommended to ensure these benign findings are concordant. Results and recommendation were discussed with the patient.BIR... |
Generate impression based on findings. | Ms. Yancey is a 58 year old female with a personal history of right breast lumpectomy in 2006 for IDC followed by radiation and letrozole therapy. Personal history of benign right biopsy for sclerosing adenosis/apocrine metaplasia. Family history of breast cancer in paternal aunt and cousin. Three standard views of bot... | Stable postsurgical changes of the right 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.RECOMMENDATION: ND - Diagno... |
Generate impression based on findings. | "Metastatic lung cancer status post multiple chemo." Pathology record states additional history of mesothelioma. CHEST:LUNGS AND PLEURA: Diffuse pulmonary groundglass opacity with nodular thickening of the fissures and septa, consistent with edema due to lymphangitic tumor and vascular congestion, with resolution in pr... | 1. Increase in size of left lower lobe index nodule and nonindex nodules.2. Slight improvement in right pleural thickening, fluid and pulmonary edema.3. No significant change in diffuse thoracic/ abdominal lymphadenopathy. |
Generate impression based on findings. | 16-year-old male status post open reduction internal fixation of the volar plate fracture.VIEWS: Left fourth digit AP oblique and lateral (3 views) 1/16/2015 Interval removal of the fixation wires. There is indistinctness of the avulsion fracture line, compatible with healing, with persistent and unchanged deformity of... | Healing/healed volar plate avulsion fracture with interval removal of the fixation hardware. |
Generate impression based on findings. | Metastatic medullary thyroid carcinoma. Neck: There are postoperative findings related to thyroidectomy and neck dissection. There thyroidectomy bed appears unchanged. However, there has been continued interval increase in size of lower neck and partially-imaged mediastinum. For example, a left lower neck mass now meas... | 1. Continued tumor progression in the lower neck and upper mediastinum, as well as slight increase in size of metastases in the partially-imaged lungs. Please refer to the separate chest CT report for additional details.2. No evidence of intracranial metastases. |
Generate impression based on findings. | Male 9 years old Reason: eval femur healing History: s/p removal of implantVIEWS: Femur name of views (number of views views) AP and lateral Interval removal of the plate and screw device, with residual screw tracts evident. Periosteal reaction again seen, but the fracture line is indistinct compatible with healing. | Interval removal of the plate and screw fixation device, with healing/healed femoral fracture. |
Generate impression based on findings. | Adenocarcinoma of the lung. CHEST:LUNGS AND PLEURA: Postoperative changes of left lower lobe wedge resection and left apical posterior segmental resection Right paramediastinal and right lung base postradiation changes. Trace pleural effusions.Numerous 1 to 2-mm semisolid micronodules predominantly in the right upper l... | 1. Small new left lower paratracheal lymph node and slight enlargement of a right distal paraesophageal lymph node should be monitored on subsequent studies, of unclear clinical significance.2. Right upper lobe ground glass/sub-solid nodule minimally increased in size and density. Other numerous lesions without signifi... |
Generate impression based on findings. | Reason: lung cancer History: s/p LLL wedge and s/p LLL lobectomy LUNGS AND PLEURA: Left upper lobectomy and left lower lobe wedge resection.Left lower lobe well marginated nodule 5 mm, unchanged as far back as 8/8/2012.Scattered foci of scarring unchanged. MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphade... | Status post left upper lobectomy and left lower lobe wedge resection. Stable benign appearing left lower lobe nodule, with no evidence of metastases or other significant abnormality. |
Generate impression based on findings. | Morning headache. There is no evidence of intracranial hemorrhage or 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 paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tiss... | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Fall, atrial fibrillation and CVA, supratherapeutic INR, mechanical fall and struck face one week ago. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. No hydrocephalus. No extra-axial collections. Again seen are chronic infarcts involving ... | 1. No evidence of intracranial hemorrhage or mass effect.2. Multiple chronic infarcts involving the bilateral cerebellar hemispheres.3. Soft tissue hematoma in the right malar region. No fracture seen in the calvarium or visualized maxillofacial bones. |
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