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Generate impression based on findings. | Reason: follow up for urothelial cancer History: hx of urothelial cancer LUNGS AND PLEURA: Scattered benign appearing micronodules, but no evidence of pulmonary metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Only mild coronary artery calcifications are present, the heart and pericardi... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | Osteoarthritis Severe osteoarthritic changes are observed bilaterally including bone-on-bone narrowing involving all 3 compartments and moderate lateral subluxation. Sclerosis, osteophytes and subchondral cysts are also observed. No appreciable left effusion, however a small fluid collection in the right is noted.In ad... | Severe tricompartmental osteoarthritic changes with suspected loose bodies on the right |
Generate impression based on findings. | Lymphoma status post stem cell transplant now admitted for fever of unknown origin. Restaging exam for possible recurrent lymphoma.RADIOPHARMACEUTICAL: 14.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 127 mg/dL. Today's CT portion grossly demonstrates shotty bilateral jugular adenopathy. Small bilateral ... | Widespread markedly hypermetabolic lymph nodes in the neck, chest, abdomen and pelvis as well as enlarged diffusely markedly hypermetabolic spleen are all new from previous and compatible with recurrent lymphoma. |
Generate impression based on findings. | Reason: assess for effusion/empyema, infection History: sob LUNGS AND PLEURA: Large bilateral pleural effusions with underlying compressive atelectasis, greater on the left, markedly increased from previous. Absence of intravenous contrast material precludes evaluation for pleural thickening and enhancement, such as ma... | Large bilateral pleural effusions with underlying pulmonary edema and atelectasis. No specific evidence of infection on this nonenhanced scan. |
Generate impression based on findings. | Lumbago Severe osteoarthritic changes of the left hip with bone-on-bone narrowing and minimally interval increasing subchondral cysts observed especially superiorly. Gross preservation of femoral head shape remains, however increased density which may represent superimposed fractures, raises concern for possible early ... | Severe osteoarthritis minimally progressed |
Generate impression based on findings. | Check fracture healing Interval continued healing of the humeral neck fracture with gross anatomic preservation of alignment and interval increasing callus formation. Diffuse demineralization limits sensitivity. No new superimposed acute or interval abnormalities | Healing right humeral neck fracture |
Generate impression based on findings. | The right portal vein was embolized using 500-700 micron Embospheres until near stasis was achieved. A post-embolization venogram confirmed these findings.The distal right portal vein was then embolized using three 10 mm push-able coils and two 12 mm push-able coils. The catheter was then repositioned in the main port... | Successful embolization of the right portal vein. |
Generate impression based on findings. | Follow-up of NHL. There is interval enlargement of the bilateral lower neck cervical lymphadenopathy. For example, a left supraclavicular lymph node measures 25 x 19 mm, previously 17 x 14 mm and a right paratracheal lymph node measures 15 x 9 mm, previously 13 x 7 mm. Bilateral axillary lymph nodes appear to have incr... | 1. Interval progression of the lower neck cervical and axillary lymphadenopathy related to lymphoma. 2. Nonspecific subcentimeter hypoattenuating right thyroid nodule. |
Generate impression based on findings. | Reason: lung CA, headaches, evaluate for brain mets History: headaches, and left eye "Floater" The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain par... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.No abnormal mass lesions are appreciated intracranially. |
Generate impression based on findings. | Reason: hx of head and neck cancer/ per protocol follow up History: see above CHEST:LUNGS AND PLEURA: Numerous metastatic pulmonary nodules bilaterally.Index left lower lobe nodule (series 6/58) measures 11 x 17 mm, not significantly changed from 12 x 16 mm previously.Index right lower lobe nodule (series 6/64) measure... | Stable disease. |
Generate impression based on findings. | Altered mental status No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.There is moderate opacificati... | 1. No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. Moderate pansinus disease, worse since 11/4/2014. |
Generate impression based on findings. | Male 77 years old Reason: prostate cancer, restaging History: Castrate resistant prostate cancer CHEST:LUNGS AND PLEURA: Dependent atelectasis at the lung bases.MEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. Index subcarinal node measures 2 x 1.2 cm image number 50, series number 3.CHEST WALL: No si... | Extensive bone metastases, retroperitoneal and pelvic and possibly mediastinal metastatic adenopathy. |
Generate impression based on findings. | Elbow pain Extensive osteoarthritic degenerative changes throughout the elbow with poor visualization of the olecranon notch. Bulky osteophytes with sclerosis and subchondral cysts are observed in questionable mild deformity of the radial head representing possible old prior remote injury and/or fracture with deformiti... | Extensive deformity and bulky osteophytes and degenerative changes, suggesting old prior remote injury and repair. See detail and recommendation above |
Generate impression based on findings. | 30 year-old female with hydrocephalus and ventriculostomy shunt catheter, evaluate for change in ventricular sizes Redemonstrated is a left parietal approach ventriculostomy shunt catheter which is unchanged in position. There is also a right parietal burr hole and tract extending from the burr hole into the right late... | 1.The lateral ventricles remain near slitlike, unchanged.2.The third and fourth ventricles as well as the foramina of Luschka and cerebral aqueduct remain dilated, yet stable. |
Generate impression based on findings. | Pain, deformity, swelling. Fracture? There is diffuse soft tissue swelling, particularly along the lateral aspect of the ankle. There is a short oblique fracture of the distal fibula extending to the level of the tibiotalar joint, with minimal postero-lateral displacement of the distal fracture fragment. I see no addit... | Distal fibular fracture as above. |
Generate impression based on findings. | Lung cancer surveillance. CHEST:LUNGS AND PLEURA: Severe centrilobular emphysema. Multiple right sided pulmonary nodules are again identified. Right upper lobe nodule (4/47 difficult to measure approximately 14 mm, previously 11-mm when measured in similar fashion. The solid component of the nodules just above the refe... | 1.Increased size and number of solid nodular densities in the right lower lobe, highly suspicious for recurrent disease.2.Right upper lobe lesions increased in the size and density, compatible with neoplasm. |
Generate impression based on findings. | Shoulder pain Severe degenerative changes throughout the left shoulder with bone-on-bone narrowing and deformity observed along the glenoid and correlating humeral head. Specifically there is superimposed density along the medial aspect of the humeral head representing a suspected bulky large osteophyte given that clea... | Severe osteoarthritic changes with bulky osteophytes, see description and recommendation above |
Generate impression based on findings. | Male 71 years old Reason: Re-evaluation of metastatic pancreatic cancer, undergoing chemotherapy History: none CHEST:LUNGS AND PLEURA: Index left upper lobe nodule is enlarged measuring 1.3 x 1.2 cm on image number 20, series number 5. Index right upper lobe pleural-based lung nodule measures 1.2 by 1.1-cm image number... | Interval increase in the size of the lung nodules and retroperitoneal soft tissue.Bone scan may be helpful for further evaluation of the left iliac bone. |
Generate impression based on findings. | Pain. Fracture classification. There is a comminuted fracture of the proximal humerus. This consists of a fracture through the surgical neck with mild impaction but little if any displacement/angulation. Although a fracture of the greater tuberosity was suspected on the basis of the radiographs, I see no discrete verti... | Humeral head/neck fracture as described above. |
Generate impression based on findings. | Mandible pain along the right aspect Irregularity and suspected recent loss of the right lower first molar, please correlate with patient history. Otherwise diffuse demineralization is observed. Mild mottled appearance does appear in the mid right mandibular body underlying this recently suspected lost dentition, if th... | Suspected recent extracted or lost right lower molar, see detail provided |
Generate impression based on findings. | The thoracic spine is in normal alignment. The vertebral body heights are maintained. There is no definite disc pathology. Redemonstrated is hypertrophy of the posterior elements and thickening of the ligamentum flavum at several levels, most prominent at T6-T7, stable in appearance. There is no significant spinal can... | There is no significant spinal canal or foraminal stenosis within the thoracic spine. Specifically, there are no pathologic lesions at the T5/6 level to explain the patient's radicular symptoms. |
Generate impression based on findings. | Female 41 years old Reason: evaluate for sigmoid mass and any possible mets History: sigmoid mass on colonscopy CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnorm... | Complex left adnexal mass suspicious for cystic ovarian malignant neoplasm. There is also significant wall thickening of the sigmoid colon, an ill-defined right lower quadrant mass invading the cecum and extending into the right adnexa and anterior abdominal wall mass invading the surrounding small bowel loops. Exact e... |
Generate impression based on findings. | Reason: Eval for PE, SOB sudden onset History: SOB sudden onset PULMONARY ARTERIES: No evidence of pulmonary embolism. No evidence of pulmonary artery enlargement. No sign of right heart strain.LUNGS AND PLEURA: Basilar subsegmental atelectasis or scarring is nonspecific, and there is no evidence of infection or edema.... | 1. No evidence of pulmonary embolism, or other significant abnormality. 2. Left base scarring or subsegmental atelectasis is seen, and the patient has undergone splenectomy.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: lung nodule History: Hx cough /sob LUNGS AND PLEURA: Interval resolution of a small focal area of right lower lobe consolidation.Moderate bilateral pleural effusions, larger on the left, not significantly changed.Mildly spiculated nodule contiguous with the right inferior pulmonary vein, measuring approximately... | Indeterminate nodule in the right lower lobe, which remains moderately suspicious for primary lung carcinoma in spite of its stability since the previous scan. A follow-up CT scan is recommended in approximately 12 months to confirm continued stability. |
Generate impression based on findings. | Reason: L4-5 bipsy to assess for discitis History: low back painOPERATORS: Greg ChristoforidisEBL < 5ml Serial CT images obtained during the biopsy procedure demonstrate needle placement within the L4-5 vertebra. Following needle removal images obtained that demonstrate no complications. | L4-5 disk biopsy under CT guidance. A total of nine biopsy specimens were delivered to microbiology and pathology for analysis. |
Generate impression based on findings. | Reason: follow LLL nodule and PE History: dyspnea PULMONARY ARTERIES: No evidence of pulmonary embolism. Previously seen extensive thrombus has completely resolved without web formation or other residual findings. The pulmonary artery is of normal caliber, and previously seen right heart strain is no longer present. LU... | 1. Complete resolution of prior extensive pulmonary emboli without residual web formation, with resolution of prior right heart strain.2. Near resolution of the previously noted left lower lobe anterior segment subpleural nodule, which likely was a pulmonary infarct. PULMONARY EMBOLISM: PE: Chronicity: Not applicable.M... |
Generate impression based on findings. | Recurrent cutaneous squamous cell carcinoma of left ear, status post multiple excisions and chemotherapy. There are postoperative findings in the left preauricular region. There is skin thickening in the left preauricular region that measures up to 10 mm in thickness. The underlying calvarium appears to be intact. Ther... | 1. Post-treatment findings in the left preauricular region with nonspecific skin thickening.2. No evidence of significant cervical lymphadenopathy. 3. Interval thrombosis of the catheterized right inferior internal jugular vein.4. Partial opacification of the left mastoid air cells. |
Generate impression based on findings. | NSCLC restaging XRT to left hilum CHEST:LUNGS AND PLEURA: Motion artifact degrades image quality. Left hilar mass appears smaller, measuring 10 x 12-mm (7/52), previously 21 x 25 mm.Postsurgical and post-therapeutic changes on the right. Small area of subpleural consolidation anteriorly on the right (4/29) unchanged an... | Decreased size of left hilar mass, small lymph nodes in the AP window and right supraclavicular region. Right antecubital fossa contrast extravasation, please refer to the separately reported safety report in the patient's chart. |
Generate impression based on findings. | Female 47 years old; Reason: abdominal left side/ hx lupus concern vasculitis History: pain ABDOMEN:LUNGS BASES: New small left pleural effusion with basilar atelectasis.New small pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Subcentimeter hypodensity in the spleen is too small to ... | Probable medium or small vessel vasculitis (presumably SLE) most prominent in the small bowel of the left upper quadrant. Unchanged pelvic lymphadenopathy. New left pleural effusion with overlying compressive atelectasis. New pericardial effusion. Findings discussed with Dr. Konda at the time of dictation. |
Generate impression based on findings. | Male 64 years old Reason: hx of bladder cancer s/p radical cystectomy, evaluate for metastatic disease with delayed imaging History: see above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver, not significantly changed. Cholelithiasis, unchanged. SPLEEN: ... | No significant change from previous study. |
Generate impression based on findings. | Male 63 years old Reason: Hx of FCL History: Evaluate extent of disease CHEST:LUNGS AND PLEURA: Mild paraseptal emphysema in the lung apices, unchanged. Scattered bilateral micronodules are unchanged.MEDIASTINUM AND HILA: Index mediastinal lymph node measures 10-mm image number 50, series number 3, not significant chan... | Interval progression of disease with interval increase in the size of index lymph nodes.Mild compression fracture of L2 vertebral body, new from previous study. |
Generate impression based on findings. | 65 years, Female. Reason: unspecified abdominal pain History: abdominal pain Residual contrast material noted in the colon. Nonobstructive bowel gas pattern. Status post cholecystectomy. Left iliac stent present. Elevated right hemidiaphragm noted. Degenerative disease of spine. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | There is a CSF density extra-axial collection just lateral to the left cerebellar hemisphere with mild flattening of the underlying folia, however without mass effect upon the fourth ventricle. This measures up to 8 mm in maximal depth.There is slight asymmetric atrophy of left frontal gyri, more prominently evident a... | 1.There is a CSF density extra-axial collection just lateral to the left cerebellar hemisphere with mild flattening of the underlying folia, however without mass effect upon the fourth ventricle. This measures up to 8 mm in maximal depth. The differential diagnosis most likely includes a chronic subdural hematoma versu... |
Generate impression based on findings. | 72-year-old male with history of a renal mass. Evaluate. CHEST:LUNGS AND PLEURA: Scattered pulmonary nodules and micronodules. Reference right lower lobe nodule measures 5 mm (series 8, image 55). Reference left upper lobe nodule measures 5 mm (series 8, image 60). No pleural effusions or pneumothorax.MEDIASTINUM AND H... | 1.Interval decrease in size of the right midpole lesion as described above with interval regression of the associated inflammatory changes. Findings are more consistent with inflammatory lesion such as an infection rather than a neoplastic process but continued imaging is suggested until resolution. Findings relayed to... |
Generate impression based on findings. | 64 years, Male. Reason: evaluate enteric tube placement History: extubation Interval removal of one of the enteric tubes. Tip of remaining tube seen near the duodenojejunal junction. | Enteric tube as above. |
Generate impression based on findings. | Seven month old female status post liver transplant.VIEW: Chest AP (one view) 1/16/2015, 12:51 Central line terminates at the right atrium. Feeding tube is noted, with the tip terminating out of the field of view. Right upper abdominal quadrant surgical clips and IVC stent again seen. ET tube terminates below thoracic ... | Improved right upper lobe atelectasis. |
Generate impression based on findings. | Multiple spot images demonstrated smooth transit of the contrast cephalad and caudad with patient repositioning. | Successful fluoroscopic guided intrathecal injection of contrast for subsequent CT myelogram. |
Generate impression based on findings. | Ms. Manuel is a 45 year old female returning for a short term followup for bilateral masses. Of note, she was scheduled to return on 10/2013 for the short-term followup, but did not show up. She has had a right nipple milky discharge for the past 18 years. Three standard views of both breasts were performed digitally a... | Stable fibroadenolipoma in the right breast and involuting cyst in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign f... |
Generate impression based on findings. | Reason: h/o met medullary thyroid ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Bilateral pulmonary metastases are not significantly changed in size or number. Reference lesions in the posterior right upper lobe measuring 7 x 5 mm (series 4 image 41) and spiculated lesion in the right ... | 1. Interval increase in size of mediastinal lymphadenopathy with compression of SVC and bronchus intermedius, though they remain grossly patent. 2. Stable appearance of pulmonary metastases. |
Generate impression based on findings. | 30 day old male evaluate pneumothorax.VIEW: Chest AP (one view) 1/16/2015, 13:00 Three chest tubes are again seen. The chest tube previously directed most superiorly on the prior examination is now directed more inferiorly, crossing the midline. The two additional chest tubes are unchanged.Persistent large right anteri... | 1.Anterior right pneumothorax unchanged. 2.The chest tube previously directed most superiorly on the prior examination is now directed more inferiorly, crossing the midline. The two additional chest tubes are unchanged. |
Generate impression based on findings. | Please note that FLAIR sequences are degraded by motion and therefore the evaluation for FLAIR signal abnormalities is unreliable. A small enhancing focus is seen within the left tegmentum at the pontine midbrain junction near the expected location of the medial longitudinal fasciculus (1001/19). There is suggestion o... | A small enhancing focus within the expected location of the left medial longitudinal fasciculus may account for the patient's reported internuclear ophthalmoplegia. There is perhaps a small vessel associated with this focus. The differential for this small lesion would include vascular, inflammatory or demyelinating et... |
Generate impression based on findings. | Male 65 years old Reason: pt with a history of renal cell cancer please assess for disease progression History: renal cell cancer CHEST:LUNGS AND PLEURA: Left lower lobe linear atelectasis, not significantly changed from previous study.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abn... | Stable to minimally increased left nephrectomy bed, peripherally enhancing hypodense lesion. The fluid adjacent to this lesion has slightly decreased within the interval. |
Generate impression based on findings. | Reason: S/p roux en y gastric bypass, evaluate j-j anastomosis through g tube History: abdominal pain s/p s/p roux en y gastric bypass Scout radiograph showed a nonobstructive bowel gas pattern with postoperative changes. Small amount of residual contrast material seen in right abdomen.Fluoroscopic evaluation showed co... | Patent biliopancreatic limb/jejunojejunal anastomosis, see above. |
Generate impression based on findings. | Male, 9 years old, with increased ICP, assess for hydrocephalus or herniation. Hyperdense blood product is redemonstrated layering dependently within the occipital horns. The quantity of blood on the right is approximately unchanged, while on the left it is reduced. A small amount of blood product remains vaguely disce... | Evolution of intracranial blood product is seen with reduction in blood in the left occipital horn as well as the interpeduncular and suprachiasmatic cisterns, and stable blood product in the right occipital horn. Findings compatible with subarachnoid blood product in the occipital sulci have also not significantly cha... |
Generate impression based on findings. | Ms. Lestikow is a 70 year old female presenting for routine mammography. Family history of breast cancer in mother and maternal cousin. 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, u... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually (rather than screening given that she comes from a long distance away for this imaging). Results and recommendation were discussed with the patient.BIRADS: 2 - Ben... |
Generate impression based on findings. | Reason: 72 y/o male with HCC and recent imbalance. Please exclude brain metastases. History: imbalance The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the b... | 1.No evidence for intracranial mass lesion. 2.No evidence for acute intracranial hemorrhage mass effect or edema.3.Please note that MR is more sensitive in the detection of intracranial metastases than CT. |
Generate impression based on findings. | Female 19 years old Reason: Follow-up scan. S/P right nephropexy History: right hydronephrosis BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echoge... | Grade 2 right-sided hydronephrosis. Right kidney in the expected anatomic location.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Gra... |
Generate impression based on findings. | Head:Enhancing lesion within the left superior frontal gyrus is increased in size with increasing surrounding edema. No new enhancing lesions are evident. A blush of contrast in the left basal ganglia is unchanged from the prior exam and likely represents vessels as seen on prior MRI. Old left basal ganglial lacunar i... | 1.Metastatic lesion in the left superior frontal gyrus has increased in size with increasing surrounding edema. This would be better assessed on MRI.2.Treatment related findings within the neck without evidence of recurrent disease or significant lymphadenopathy.3.For findings in the lungs, please see dedicated chest C... |
Generate impression based on findings. | Male 77 years old; Reason: prostate cancer, castrate resistant History: prostate cancer, assess for disease response There are numerous osteoblastic lesions involving the bilateral ribs, cervical/thoracic/lumbar spine and pelvis. | Multiple osseous metastatic foci as described above. |
Generate impression based on findings. | Redemonstration of a left frontal parenchymal hematoma which is unchanged in size measuring 3.7 x 2.6 x 3.3 cm (oblique AP x TR x CC) with similar edema and local mass effect compared to prior exam. There is 5 mm of rightward subfalcine herniation measured at the level of the foramen of Monro. Within this hematoma the... | 1.Left frontal hematoma as described above with no significant change in the size, mass effect and edema. 2.Round low-attenuation nodule within left frontal hematoma; malignancy is not excluded. Correlate with outside MRI. |
Generate impression based on findings. | 66 year old male with history of metastatic prostate cancer, evaluate response to therapy. CHEST:LUNGS AND PLEURA: Minimal bibasilar dependent atelectasis. Left upper lobe (5/122) groundglass opacity is stable, nonspecific. No pleural effusion or consolidation.MEDIASTINUM AND HILA: Scattered mediastinal and hilar calci... | 1.Unchanged findings of metastatic prostate cancer, without evidence of new metastases.2.Left upper lobe ground glass opacity is nonspecific, and unchanged since 2012, so indolent process such as atypical adenomatous hyperplasia is on the differential. |
Generate impression based on findings. | 52-year-old male with history of prostate cancer and PSA of 125. Assess for metastatic disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Few scattered right hepatic lobe subcentimeter hypoattenuating lesions are too small to characterize but statistically likely cysts.SPLEEN: No signifi... | 1.Heterogeneously enhancing prostate gland consistent with stated history of prostate cancer. 2.Retroperitoneal and pelvic lymphadenopathy. 3.Mild nonspecific rectal wall thickening. Evaluation with colonoscopy is recommended if patient has not had a colonoscopy.4.No CT evidence of osseous metastases. Please refer to c... |
Generate impression based on findings. | Metastatic renal cancer assess for progression. CHEST:LUNGS AND PLEURA: Severe emphysema. Smoothly marginated 16 x 13 mm solid nodule in the left lower lobe posterior to the descending thoracic aorta (4/45).No pneumothorax or fluid.MEDIASTINUM AND HILA: Left interlobar lymph node appears prominent (4/53), not reliably ... | 1. Single indeterminate pulmonary nodule in the left lower lobe measuring 16mm; a metastasis cannot be ruled out, consider PET scan for further characterization unless the referring clinical service can obtain and submit outside prior studies for comparison.2. Assessment of the patient's known renal tumor or characteri... |
Generate impression based on findings. | pT3N0 left parotid high grade salivary duct carcinoma status post treatment. There are postoperative findings related to left parotidectomy with persistent ill-defined stranding in the region of the surgical bed, but no discrete measurable mass lesion. The previously demonstrated right parotid mass is now inconspicuous... | 1. Postoperative findings related to parotidectomy without discernible discrete measurable mass lesion, within the limits of CT.2. A previously demonstrated right parotid lesion is now inconspicuous. |
Generate impression based on findings. | Initial staging of newly diagnosed mid-esophageal cancer. Past history of laryngeal cancer status post chemoradiation.RADIOPHARMACEUTICAL: 11.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates right apical consolidation with bronchiectasis. Bilateral emphysema... | 1.Two focal hypermetabolic mid and distal esophageal lesions which could represent primary esophageal tumor versus inflammatory sites.2.Numerous fairly symmetric hypermetabolic bilateral hilar and mediastinal lymph nodes suggestive of inflammation although metastatic lymph nodes is also a possibility.3.Hypermetabolic r... |
Generate impression based on findings. | Reason: lung cancer 7 yrs ago, s/p chemo and RT. Pls c/w previous study and evaluate dz status. History: lung ca CHEST:LUNGS AND PLEURAMEDIASTINUM AND HILA: Moderate coronary arterial calcifications. Unchanged small mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contras... | 1. Stable postradiation changes without evidence of recurrent or metastatic disease. 2. Other chronic findings as described above. |
Generate impression based on findings. | Male 65 years old; Reason: Lung Transplant Evaluation History: as above 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: 50.8 % of peak activity (normal >70 ... | Gastric emptying within normal limits. |
Generate impression based on findings. | 31-year-old male with right chest pain. Evaluate for pulmonary embolism. PULMONARY ARTERIES: No evidence of pulmonary embolism. The pulmonary artery measures 28 mm without right heart strain.LUNGS AND PLEURA: Left lower lobe atelectasis. No focal opacities or suspicious lung nodules. No pleural effusion.MEDIASTINUM AND... | 1. No evidence of pulmonary embolism.2. Cardiomegaly with pericardial thickening consistent with pericarditis. Further characterization with an echocardiogram is recommended.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Mildly increased peripheral subpleural basilar predominant reticulonodular opacities. Focal pleural-based nodular density measuring 1.0 x 1.0 cm (series 5 image 65) is new. No pleural effusions.MEDIASTINUM AND HILA: Scattere... | 1. 1.0 cm left lower lobe nodular opacity is new since the prior study. While it does not have an appearance typical of metastatic disease, a 3 month CT follow up is recommended to confirm stability to exclude a new primary lung neoplasm. 2. Increased subpleural reticulonodular opacities since the prior study, which ar... |
Generate impression based on findings. | Left otalgia. Left: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Right: The external auditor... | 1. Unremarkable temporal bones.2. Degenerative changes of the left temporomandibular joint. |
Generate impression based on findings. | 2-year-old male for assessment of osteomyelitisVIEWS: Left and right ankle AP, oblique, lateral (6 views) 01/16/15 Right ankle: Wrap or skin staples are seen along the lateral aspect of the ankle with associated soft tissue swelling. No cortical erosions to suggest osteoarthritis. Left ankle: No cortical erosions to su... | Lateral soft tissue swelling about the right ankle without evidence of osteomyelitis. |
Generate impression based on findings. | Alignment is anatomic. There are no fractures or subluxations. The visualized intracranial and paraspinal contents are unremarkable. Note is made of postsurgical changes from ACDF placement at the C3-4 and C4-5 level as well as intravertebral disk prostheses placement between the C5-6 and C6-7 levels which obscures fu... | 1.Exam is limited by hardware.2.Postsurgical changes from ACDF placement at the C3-4 and C4-5 levels and intravertebral disk prostheses placement at the C5-6 and C6-7 levels without complications or fracture3.Multiple persistent spondylitic changes with severe central spinal canal stenosis at the C5-6 level and moderat... |
Generate impression based on findings. | 50-year-old female with abdominal pain of unclear etiology. Evaluate. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hypoattenuating foci in segment 6 and dome of the liver are nonspecific. Additional subcentimeter hypoattenuating foci in the left hepatic lobe are too small to characterize.SP... | 1.No specific acute findings to account for patient's pain. 2.Hepatomegaly with a few nonspecific hypoattenuating foci. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. In retrospect, on the exam dated 12/12/2014, there was mild increased attenuation along the left tentorium which may have represented a small subdural hematoma or could have been related to artifact, however this finding is no... | 1.No acute intracranial abnormality.2.In retrospect, there was a small amount of density along the left tentorium on the prior exam which may have been due to a small subdural hematoma or artifact. This is no longer present on the current exam.3.An MRI may be considered if clinically warranted for a more sensitive eval... |
Generate impression based on findings. | 16-year-old male status post right derotational osteotomyVIEWS: Pelvis AP/lateral (two views) 01/16/15 Spinal stabilization rod and screw device is again seen affixing the lower lumbar spine and sacroiliac joints. Intrathecal pump device overlies the upper pelvis.A left proximal femoral plate and screw device is again ... | Posterior femoral dislocation with coxa valga deformity of the postoperative right femur. |
Generate impression based on findings. | 59-year-old male with history of foot fractures. The bones are demineralized. Again seen are transverse fractures through the necks of the second through fifth metatarsals with mild lateral angulation of the heads of the second through fourth metatarsals. New callus formation indicates some interval healing. There is a... | Healing metatarsal fractures as described above. |
Generate impression based on findings. | Fell down 17 steps today with brief LOC and dizziness. History of traumatic brain injury in 1993. There is no evidence of acute intracranial hemorrhage or mass. There is bilateral parieto-occipital encephalomalacia. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The ima... | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. Partially-imaged right nasal ala contusion and possible fracture of the right nasal skeleton.3. Bilateral parieto-occipital encephalomalacia is likely related to remote traumatic brain injury. |
Generate impression based on findings. | 31-year-old male with history of pain. There is moderate osteoarthritis affecting the left hip with osteophyte formation along the anterolateral femoral head/neck. The right hip appears normal. The remainder of the pelvis is unremarkable. | Osteoarthritis as above. |
Generate impression based on findings. | 2-year-old female first-time wheezerVIEWS: Chest AP (one views) 01/16/15 Cardiothymic silhouette is normal. No pleural effusions or pneumothorax. No focal pulmonary opacities. Mild peribronchial cuffing is suggestive of reactive airway disease/bronchiolitis pattern | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | 54-year-old female with history of humerus fracture. Again seen is a fracture through the greater tuberosity with mild superior displacement. There is adjacent callus formation indicating some interval healing. There is a band of sclerosis incompletely traversing the surgical neck of the humerus likely representing a h... | Proximal humerus fracture as above. |
Generate impression based on findings. | Esophageal cancer status post chemoradiation. CHEST:LUNGS AND PLEURA: No pleural fluid or pneumothorax. No suspicious pulmonary nodules or masses. Mild paramediastinal fibrosis consistent with history of radiotherapy. MEDIASTINUM AND HILA: Left paratracheal lymph node 14 mm, previously 15-mm (3/32). Small pericardial f... | 1. Unremarkable appearance of the thoracic esophagus.2. Decrease size of small left paratracheal lymph node.3. Increased volume of pericardial fluid which may be related to radiation therapy.4. Decreased size of right adrenal gland nodule and left adrenal gland thickening. PET scan was reviewed by Dr. Applebaum and it ... |
Generate impression based on findings. | Ms. Densmore is a 85 year old female presenting with a palpable left breast mass. Per patient's daughter, she had noticed left breast swelling/redness since Nov 2014. She was placed on a course of antibiotics which did improve the swelling, but the lump is still present. Three standard views of both breasts and two lef... | Asymmetric left breast skin thickening and edema with no mammographic/sonographic correlate for patient's area of concern. A surgical consultation is recommended at this time for further evaluation of these findings. Differential considerations include cellulitis/mastitis, unusual manifestation of CHF or potentially in... |
Generate impression based on findings. | 85-year-old female with history of colon cancer, evaluate disease status. CHEST:LUNGS AND PLEURA: Reference left upper lobe pulmonary nodule (4/23) measures 2.4 x 1.6 cm, increased from previous 1.6 x 1 cm.Other non-reference lesions have increased in size, and there is a new small right pleural effusion.MEDIASTINUM AN... | Findings consistent with progression of disease in the lungs, liver and lymph nodes, with reference measurements given above. |
Generate impression based on findings. | Reason: Assess for stricture/ adhesion History: abdominal pain, nausea, delayed gastric emptying, began after appendectomy Scout radiograph showed a nonobstructive bowel gas pattern. Double contrast visualization of the esophagus showed no morphologic abnormality. During the exam, no spontaneous or provoked gastroesoph... | Unremarkable exam, normal bowel transit time. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema.New atelectasis involving the lateral segment of the right middle lobe, probably from aspiration, since aspirated material was seen in the airways to this region.There is no evidence of pulmonary... | No evidence metastases, or other significant abnormality except for aspirated secretions on the right leading to partial right middle lobe atelectasis. |
Generate impression based on findings. | Reason: renal cancer with metastasis on therapy. Eval for change History: renal cancer on therapy The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowel. Given these limitations, the following observations were made:CHEST:LUNGS AND PLEURA: Reference right middle lobe nodule ... | Interval regression of disease with reference measurements given above. |
Generate impression based on findings. | Reason: HNSCC. Compare to previous. 13-0311 protocol. History: as above CHEST:LUNGS AND PLEURA: Redemonstration of multiple pulmonary masses with reference measurements as follows:Right upper lobe 7.2 x 6.3 cm (series 6 image 29) previously 7.1 x 6.2 cm.Left upper lobe 4.2 x 3.1 cm (image 39) previously 4.2 x 3.1 cm.li... | 1. No significant interval change in size of pulmonary metastases since the prior study. 2. Other chronic findings as described above. |
Generate impression based on findings. | Ms. Jackson is a 45 year old female presenting with a left breast mass that been present for several months. She denies any focal pain or history of trauma. Three standard views of both breasts with three left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma... | Two irregular solid masses in the left upper outer breast with suspicious sonographic features. An US-guided biopsy of the larger mass is recommended for histologic sampling. Recommendations for the second mass can be made pending the results from the biopsy.The patient is on daily aspirin for her multiple other comorb... |
Generate impression based on findings. | Fibular fracture Stress view demonstrates the oblique distal fibular fracture without evidence or change in alignment. Ankle mortise remains intact and symmetric. Minimal soft tissue swelling. | Distal fibular fracture in alignment |
Generate impression based on findings. | Fibular fracture Single projection again demonstrates the distal fibular fracture with minimal displacement laterally. Overlying moderate soft tissue swelling with Morse minimal diffuse swelling. Specifically the ankle mortise remains intact and symmetric under stress | Distal fibular fracture the absence of interval change or evidence of ligamentous injury involving the medial side |
Generate impression based on findings. | Olecranon fracture follow-up Two K wires with figure 8 fixation appears unchanged without evidence of interval new abnormality. Fracture planes are indistinct compatible continued and essentially complete healing. Soft tissues unremarkable. | Post fixation hardware without evidence of interval complication. Underlying healed olecranon fracture |
Generate impression based on findings. | Left knee pain Moderate tricompartmental osteoarthritic changes with narrowing, sclerosis and osteophytes greater in the medial aspects. Moderate knee effusion. Alignment otherwise preserved | Moderate osteoarthritis |
Generate impression based on findings. | Right knee pain Moderate tricompartmental osteoarthritic changes with fixation of the medial tibial plateau. No hardware complications. No change in alignment. No distinct effusion or additional soft tissue abnormality | Post tibial plateau fracture repair without evidence of new complication superimposed upon moderate osteoarthritis |
Generate impression based on findings. | Pain Oblique and mildly posterior displacement of a distal fibular fracture with a small additional adjacent linear fragment. Additionally a posterior tibial fragment minimally displaced and irregularities underlying the medial malleolus collectively suggests an SER 4 injury. No evidence of mid and distal hindfoot appe... | SER 4 injury and questionable talar dome AVN |
Generate impression based on findings. | History rheumatoid arthritis, evaluate for lung disease. LUNGS AND PLEURA: 7 x 5 mm pleural based left lower lobe nodule. There is mild subpleural basilar fibrosis and basilar predominant bronchiectasis without bronchial wall thickening. MEDIASTINUM AND HILA: Mildly enlarged main pulmonary artery measures 3.2 cm, which... | 1. 7 x 5 mm pleural based left lower lobe nodule, for which 6 month follow up is recommended. 2. Mild subpleural basilar fibrosis and basilar predominant bronchiectasis is nonspecific and may represent rheumatoid related interstitial lung disease. |
Generate impression based on findings. | Prostate cancer. Gleason 9. ABDOMEN:LUNG BASES: Minimal scarring at the lung bases. Coronary artery calcifications.LIVER, BILIARY TRACT: 1.7-cm indeterminate hypodense lesion in the inferior right lobe (image 73; series 3).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS:... | Solitary indeterminate 1.7-cm liver lesion. |
Generate impression based on findings. | 20-year-old female with history of pain. There is no acute fracture or dislocation. Alignment is anatomic. The soft tissues are unremarkable. | No radiographic findings to account for the patient's pain. |
Generate impression based on findings. | Right upper lobe mass rule out lung cancer. Tobacco use. LUNGS AND PLEURA: Irregularly marginated right apical nodule containing an internal air bronchogram measures 11 x 10 x 9-mm mm, previously 10 x 7 x 7 mm. Spiculated appearance of the borders could be due to an adjacent emphysema or cellular infiltration. The nodu... | 1. Interval enlargement of right apical nodule, suspicious for primary pulmonary neoplasm. Recommend correlation with PET scan. This was discussed with the referring clinical service (GI fellow) prior to time of dictation.2. Nonspecific 5-mm right lower lobe nodule is of unclear chronicity as the area was previously at... |
Generate impression based on findings. | 31-year-old female with history of pain and stiffness. Left foot: There is a mild hallux valgus deformity. Mild pes planus. There is no evidence of inflammatory arthritis.Right foot: There is a mild hallux valgus deformity. Mild pes planus. There is no evidence of inflammatory arthritis.Left knee: There are tricompartm... | 1.Constellation of findings suggestive of rheumatoid arthritis in the hands, left greater than right.2.Mild bilateral hallux valgus and pes planus deformities.3.Mild osteoarthritis at the knees. |
Generate impression based on findings. | 65-year-old male with altered mental status Redemonstrated are stable periventricular and subcortical low attenuation white matter foci most likely reflecting age indeterminate small vessel ischemic stroke without CT evidence of acute territorial, cortical infarct. There is no acute no hemorrhage, mass, mass effect, or... | No acute intracranial process. |
Generate impression based on findings. | History of systemic lupus erythematosus, tongue dysplasia, and new enlarged fixed lymph nodes right cervical chain. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid appears unremarkable. The submandibular glands appear to be atrophic. The paroti... | 1. No evidence of measurable mass lesions or significant cervical lymphadenopathy.2. Findings suggestive of acute sinusitis.3. Nonspecific micronodules in the partially-imaged lungs. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | History of rheumatoid arthritis, evaluate for lung disease. LUNGS AND PLEURA: Scattered benign appearing calcified micronodules. Basilar atelectasis/scarring. No focal airspace opacities, pleural effusions, or evidence of fibrosis. No evidence of bronchiectasis, although there is mild basilar bronchial wall thickening.... | 1. No evidence of rheumatoid related lung disease as clinically questioned.2. Other findings as described above. |
Generate impression based on findings. | Male 66 years old; Reason: prostate cancer History: evaluate the right ribs as pt had a fall, r/o mets. Patient, history of multiple recent falls. Patient also noted falling today in the parking lot of the hospital, landing on his right knee, denies head trauma, dizziness or pain. Exam was unremarkable, with mild skin ... | 1. Benign fractures of the right anterior 3rd-6th ribs.2. A single additional focus in the left posterior 10th rib with somewhat more suspicious features on both bone scan and comparison CT could represent a single focus diastasis. However, given history of recent fracture and multiple recent falls, an atypical appeara... |
Generate impression based on findings. | Reason: follow up for prostate cancer History: prostate cancer CHEST:LUNGS AND PLEURA: Apical scarring. Previously described nodular opacities in the right lower lobe (series 4, image 59) and right middle lobe (series 4, image 72) are unchanged. Right upper lobe granuloma unchanged. Reference subpleural nodule in the l... | Most of the reference lesions are stable although the left acetabular and left femoral bone lesions appear larger on today's examination. Correlate with bone scan. |
Generate impression based on findings. | Male, 59 years old, with stroke. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The visual... | No acute intracranial abnormality. |
Generate impression based on findings. | Reason: s/p 4 yrs after s/p LUL for management of T1aN0 stage IA adenocarcinoma History: annual f/u LUNGS AND PLEURA: Severe paraseptal and centrilobular emphysema with surgical changes consistent with left upper lobectomy. Basilar scarring/atelectasis unchanged. No new suspicious nodules or masses. No pleural effusion... | Stable postoperative changes of left upper lobectomy with emphysema and basilar scarring/atelectasis. No evidence of recurrent disease. |
Generate impression based on findings. | 26 year old female with sacral pain. Evaluate for fracture. There are postsurgical changes in the lumbar spine and left sacrum with bone graft material present . Pedicle screws extend through the L4 and L5 vertebral bodies with additional hardware in the right sacrum, right ilium, and left ilium. Additionally, there is... | Postsurgical changes without evidence of acute abnormality. |
Generate impression based on findings. | There are no acute fractures. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation is present throughout with significant disc height loss at L2/3, mild disc height loss... | 1.L2/3: Mild to moderate right lateral recess and moderate right neural foraminal stenosis.2.L3/4: Moderate left lateral recess and mild to moderate right neural foraminal stenosis.3.L4/5: Mild central, mild bilateral lateral recess, and moderate left neural foraminal stenosis. |
Generate impression based on findings. | 65-year-old male with history of L3/4 radiculopathy. There is lumbarization of S1. There is no acute fracture or subluxation. There is moderate degenerative disk disease especially at L5-S1. There is moderate facet hypertrophy most notably in the lower lumbar spine. | Degenerative arthritic changes as above. If patient care warrants further imaging, an MRI may be obtained. |
Generate impression based on findings. | History of mantle cell lymphoma status post chemotherapy, last in 1998. Recent CT showed a mildly enlarged lymph nodes, stable. Undergoing heart transplantation evaluation. Restaging exam to define disease activity and possible biopsy planning.RADIOPHARMACEUTICAL: 14.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (F... | 1.No significantly FDG avid tumor currently. There are symmetric mildly hypermetabolic lymph nodes in the axilla, mediastinal, and inguinal locations which, while slightly more pronounced than previous, are still mild and considered more likely a manifestation of systemic inflammation. Tumor activity cannot be entirely... |
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