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Generate impression based on findings. | 70 year old male s/p NG tube placement. Lateral right hemiabdomen is excluded from the field of view. Feeding tube tip in the gastric body. Mild diffuse bowel loop dilatation is compatible with generalized ileus pattern. Surgical clips project over the right hemipelvis. | Feeding tube tip in gastric body. Mild ileus pattern. |
Generate impression based on findings. | 58-year-old male with shortness of breath, tachycardia, and hemoptysis. The study is suboptimal secondary to motion artifact.PULMONARY ARTERIES: No evidence of pulmonary embolism. Pulmonary artery size at the upper limits of normal. No evidence of right heart strain. There is decreased perfusion to the right upper lobe... | No evidence of pulmonary embolism. Findings suggestive of mild CHF and bronchial asthma.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative. |
Generate impression based on findings. | 66 years, Female. Reason: Check NJ Feeding Tube Placement History: Check NJ Feeding Tube Placement Limited view of the abdomen. Nonspecific paucity of bowel gas. NJ tube tip overlies the 2nd segment of duodenum. Oral contrast material seen in the rectum. Biliary stent and drain partially seen. | NJ tube tip overlies the 2nd segment of duodenum. |
Generate impression based on findings. | 13 year old female with trauma, lateral mid foot pain. VIEW: Left foot AP, oblique, lateral (3 views) 1/19/15 at 23:53. Normal alignment without fracture or dislocation. No soft tissue abnormalities. | Normal examination. |
Generate impression based on findings. | 70 year old male s/p Dobbhoff placement. Pelvis excluded from field of view. Dobbhoff tube tip in gastric body. Nonobstructive bowel gas pattern with residual contrast material noted in the colon. Midline surgical staples and bilateral nephroureteral stents are present. | Dobbhoff tube tip in gastric body. |
Generate impression based on findings. | 52-year-old male with hypotension, leukocytosis in setting of Clostridium difficile which is refractory to p.o. Flagyl. Evaluate for abdominal perforation. ABDOMEN:LUNG BASES: Interval increase in large left pleural effusion with associated basilar compressive atelectasis. Interval increase in right pleural effusion, n... | 1.No significant change in bilateral severe hydroureteronephrosis with bilateral ureteral wall enhancement and perinephric fat stranding. Given stability, chronic infection suspected with acute component not excluded. 2.New fluid collection with rim enhancement and gas at the base of the penis. Differential considerati... |
Generate impression based on findings. | 14 year old male with stab to left chest. VIEW: Chest AP (one view) 1/20/15 at 5:08. The aortic arch, cardiac apex, and stomach are left sided. The cardiac silhouette is normal in size. No airspace opacities, pleural effusions or pneumothorax. Gaseous distension of the stomach. Irregular linear densities along the left... | Normal chest. |
Generate impression based on findings. | 76-year-old female with recent craniotomy and meningioma resection, now with headache. Redemonstration of postsurgical findings related to recent bicoronal craniotomy and resection of large right frontal meningioma, including air, blood products, and surgical packing material subjacent to the craniotomy site. There has... | 1. Evolving postsurgical changes related to recent craniotomy and resection of large right frontal meningioma, including blood products and surgical packing material. There is increase in bilateral frontoparietal edema, more extensive on the right with slight increase in downward mass effect. No significant effacement ... |
Generate impression based on findings. | 7 month old female with cough, fever, tachypnea. VIEWS: Chest AP (one view) 1/20/15 at 5:54. There is mild peribronchial wall thickening and right upper lobe atelectasis with volume loss and mild rightward tracheal deviation. The right cardiac border is obscured by the right upper lobe opacity. Cardiac size is normal. ... | 1. Bronchiolitis/reactive airways disease pattern with right upper lobe atelectasis. 2. Gaseous distension of bowel loops partially imaged. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. Right maxillary mucus retention cyst/polyp, otherwise the visualized portions of the paranasal sinuses a... | No acute intracranial abnormality. Please note that CT is not sensitive for the early detection of acute ischemic stroke and if there is strong clinical concern, an MRI may be considered. |
Generate impression based on findings. | Male 52 years old; Reason: gastric mass on CT scan Oct 2014 History: gastric mass on CT scan Oct 2014 CHEST:LUNGS AND PLEURA: Interval improvement of basilar air space opacities. 6-mm nodule in the posterior right lung (3:69) could be postinfectious, but follow-up is recommended. Other micronodules at the same level in... | 1.Grossly stable calcified soft tissue mass along the gastrohepatic ligament, of which the differential remains GIST tumor (favored), carcinoid or a calcified node.2.Bilateral pulmonary nodules as described above could be postinfectious, but follow-up is recommended to ensure stability. |
Generate impression based on findings. | 7 year old male with cough, fever. VIEWS: Chest AP/lateral (two views) 1/20/15 at 0601. The aortic arch, cardiac apex, and stomach are left sided. Normal heart size. Patchy opacity in the superior segment of the right lower lobe is suspicious for infection. Subsegmental retrocardiac atelectasis. | Patchy opacity in the superior segment of the right lower lobe is suspicious for infection. |
Generate impression based on findings. | 29 year-old female status post colectomy with primary anastomosis. Patient now with bilious NG tube output, tachycardia. There is concern for leak or abscess. Evaluate. ABDOMEN:LUNG BASES: New small right pleural effusion with associated atelectasis. Mild left basilar atelectasis.LIVER, BILIARY TRACT: Post operative ch... | 1.Findings consistent with small bowel obstruction with transition point in the left lower quadrant. 2.Interval development of small volume ascites, which is nonspecific.3.Postoperative changes of colectomy including small pneumoperitoneum without evidence of anastomotic leak. 4.New small right pleural effusion with as... |
Generate impression based on findings. | Female, 64 years old, with esophageal cancer, staging exam. Extensive treatment related findings are again seen including infiltration of the fascial planes, thickening of the platysma, supraglottic mucosal edema and a retropharyngeal effusion. These findings are not significantly changed. Note is made of mild asymmetr... | 1. Although the appearance of an infiltrative lesion involving the lower right neck remains much improved relative to the examination of 6/19/14, since the immediate prior study a subcentimeter nodule of enhancement has recurred at level 4.2. No definite evidence of additional lesions is seen. Extensive treatment relat... |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Minimal bibasilar atelectasis. No significant pleural effusion or consolidation. Left apical pulmonary nodule measuring approximately 8 mm (5/17), with an additional right lower lobe peripheral nodule, which should be followed on subsequent low dose CT lung without contrast according to Fleisch... | 1.Limited evaluation of the aorta, with subtle ascending arch ectasia as above.2.Pulmonary nodules, for which follow-up is recommended. |
Generate impression based on findings. | 38-year-old female with right lower quadrant and right upper quadrant pain. Evaluate for appendicitis versus kidney stones. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: Numerous hypoattenuating foci in both lobes of the liver are too small to characterize. There is a hypoattenuating focu... | 1.No evidence of appendicitis or nephrolithiasis as clinically questioned. 2.Nonspecific bilateral mildly enlarged pelvic and pericecal lymph nodes without associated inflammatory changes.3.Multiple diffuse hepatic hypoattenuating lesions are too small to characterize. Differential considerations include benign biliary... |
Generate impression based on findings. | There post-treatment findings in the neck, without definite evidence of tumor in the tongue base. PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postco... | 1. No evidence of locoregional tumor recurrence of significant lymphadenopathy.2. Stable heterogeneous appearance of the thyroid gland. |
Generate impression based on findings. | 60 year-old female with altered mental status, evaluate for acute intracranial process. Mild motion artifact and patient positioning slightly limit evaluation. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No mass, midline shift or uncal herniation. Gray-white differentiatio... | No evidence of 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. |
Generate impression based on findings. | ConstipationVIEW: Abdomen AP 1/19/15 Moderate amount of fecal burden without obstruction. Disorganized nonobstructive bowel gas pattern. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum. | Moderate amount of fecal burden. |
Generate impression based on findings. | Increasing oxygen requirementVIEW: Chest AP and abdomen AP 1/19/15 NG tube tip in the stomach. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. Mildly distended bowel loops without obstruction. No pneumatosis or pneumoperitoneu... | Minimal atelectasis in the left lower lobe. |
Generate impression based on findings. | 59-year-old female with history of bilateral breast cancers, now with right breast upper outer quadrant thickening. Ultrasound findings suggestive of mass versus necrosis/scarring. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic area measuring 2.3 x 1.5 cm at the 1... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | CVA, muscle weakness No intracranial hemorrhage is identified. There is extensive encephalomalacia involving the right frontal and to a lesser extent the right temporal and parietal lobes as well as the basal ganglia consistent with prior infarct. Hypoattenuation seen extending into the right centrum frontal centrum se... | 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. Chronic right frontotemporoparietal infarct including the right basal ganglia. Chronic right cerebel... |
Generate impression based on findings. | Evaluate ET tubeVIEW: Chest AP 1/20/15 ET tube tip immediately above the carina. Esophageal temperature probe tip at the GE junction. The umbilical venous catheter tip in the umbilical vein. The umbilical arterial catheter tip at T4. Cardiothymic silhouette normal. No focal lung opacity. No pleural effusion or pneumoth... | Endotracheal tube immediately above the carina. |
Generate impression based on findings. | Evaluate pneumothoraxVIEW: Chest AP and abdomen AP 1/20/15 ET tube tip immediately above the thoracic inlet. NG tube tip in the stomach. Umbilical lines unchanged. The two right chest tubes are unchanged. Cardiothymic silhouette normal. There is a small right subpulmonic pneumothorax unchanged. Diffuse atelectasis bila... | Right small subpulmonic pneumothorax unchanged. |
Generate impression based on findings. | 15-year-old male with chest wall tenderness in patient with cerebral palsyVIEWS: Chest AP/lateral (two views) 01/19/15 Spinal fixation rods are again noted. Cardiothymic silhouette is normal. No pleural effusions or pneumothorax. Left retrocardiac atelectasis. | Left retrocardiac atelectasis. |
Generate impression based on findings. | TachypneaVIEW: Chest AP 1/20/15 NG tube tip in the stomach. Cardiothymic silhouette at the upper limits of normal. Increased atelectasis in the left lung new from prior study. No pleural effusion or pneumothorax. | Interval increase in the atelectasis in the left lung. |
Generate impression based on findings. | 15-year-old female for evaluation of pelvic ring injuryVIEWS: Pelvis AP (4 views) 01/20/15 Minimally displaced oblique fracture through the left superior pubic ramus. Buckling of the left sacral arcuate lines is suggestive of a fracture through the left sacrum. | Minimally displaced oblique fracture through the left superior pubic ramus. Buckling of the left sacral arcuate lines is suggestive of a fracture through the left sacrum. |
Generate impression based on findings. | 59 years, Male. Reason: 59M w pSBO by CT but no prior surgery, please evaluate for location and etiology of obstruction. History: abdominal pain Distended loops of small bowel are again seen centrally. There is oral contrast material in the decompressed small bowel in the left hemipelvis.Enteric tube tip overlies the g... | Distended loops of small bowel are again seen centrally. There is oral contrast material in the decompressed small bowel in the left hemipelvis. |
Generate impression based on findings. | 15-year-old female status post traumaVIEWS: Pelvis AP (one views) 01/19/15 There is a minimally displaced fracture of the superior left pubic ramus. Buckling of the left sacral arcuate lines is suggestive of a fracture through the left sacrum. | Minimally displaced fracture of the superior left pubic ramus. Buckling of the left sacral arcuate lines is suggestive of a fracture through the left sacrum. |
Generate impression based on findings. | Male; 45 years old. Reason: ILD History: Assess type and extent LUNGS AND PLEURA: Low lung volumes with severe lower lobe predominant interstitial lung disease. Moderate reticular opacities, architectural distortion, severe traction bronchiectasis and bronchiolectasis, and some honeycombing, in a pattern consistent wit... | Severe interstitial lung disease in a pattern consistent with UIP. Patulous esophagus could indicate scleroderma. |
Generate impression based on findings. | Ms. Boodro is a 61 year old female with a personal history of right breast mastectomy in 2009 with implant based reconstruction for IDC/DCIS followed by chemoradiation and hormonal therapy. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is... | Scattered benign calcifications in the left breast. 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... |
Generate impression based on findings. | Female, 57 years old, status post basilar tip aneurysm coiling with elevated PTT, assess subarachnoid hemorrhage. A large basilar tip coil mass is redemonstrated obscuring visualization of the brain on several slices.A small amount of intraventricular blood product layering within the occipital horns demonstrates inter... | 1.Evolution of intraventricular blood product which appears less dense and perhaps slightly reduced in quantity.2.No significant enlarging or new areas of extraventricular subarachnoid blood.3.Redemonstrated are findings of basilar tip aneurysm coiling. Patchy parenchymal hypoattenuation is unchanged. |
Generate impression based on findings. | PainVIEWS: Right hand AP, right middle finger oblique and lateral There is a cortical buckle fracture involving the base of the proximal phalanx of the middle finger. There is associated soft tissue swelling at this location. The remainder of the examination is normal. The alignment is normal. | Cortical buckle fracture base of the proximal phalanx of the middle finger. |
Generate impression based on findings. | 14-year-old female for evaluation of fractureVIEWS: Right shoulder internal/external rotation, right humerus AP/lateral, right elbow AP/oblique/lateral (7 views) 01/19/15 No acute fracture or malalignment is evident. No elbow joint effusion. | Normal examination. |
Generate impression based on findings. | Female 58 years old; Reason: 58yo F w/ cirrhosis and rising TBili, evaluate for cholecystitis History: as above Angiographic images are unremarkable. There was persistence of radiotracer in the blood pool with eventual uniform accumulation in the liver. There was no gallbladder activity identified at one hour, with per... | No obstruction of the cystic duct suggesting no scintigraphic evidence of acute cholecystitis. Delayed blood pool clearance of the activity suggesting hepatocellular dysfunction. |
Generate impression based on findings. | 11 month old male with fever.VIEWS: Chest AP (one view) 1/20/15 at 7:53. Right upper lobe atelectasis unchanged. Lingular airspace opacity may represent atelectasis or pneumonia with obscuration of the left heart border.Cardiomediastinal silhouette obscured by lingular and right upper lobe opacities. No pneumothorax. | 1.Lingular airspace opacities may represent atelectasis or pneumonia.2.Persistent right upper lobe atelectasis. |
Generate impression based on findings. | Female; 67 years old. Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema. Scattered pulmonary micronodules are unchanged. No suspicious pulmonary nodules or masses. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Mild calcif... | No evidence of metastatic disease in the chest and abdomen. |
Generate impression based on findings. | Tibia fractureVIEWS: Right tibia and fibula AP and lateral There is an oblique fracture involving the distal diaphysis of the right tibia. The distal fracture fragment is displaced laterally. The overlying cast obscures fine bony detail. | Acute oblique fracture distal diaphysis of the right tibia. |
Generate impression based on findings. | Fracture.VIEWS: Left ankle AP/lateral/oblique (3 views) 01/20/15 Three screws continue in place in the distal fibula. The fractures have healed. Alignment is anatomic. | Healed ankle fractures. |
Generate impression based on findings. | History of osteomyelitisVIEWS: Right tibia and fibula AP and lateral Again noted are multiple surgical clips along the medial distal aspect of the tibia. Bony deformity with sclerosis involving the mid diaphysis of the tibia again noted. Diffuse osteopenia noted. No acute fracture of the tibia and fibula. | Bony deformity with sclerosis involving the mid diaphysis of the tibia in a patient with known history of osteomyelitis not significantly changed from prior study. |
Generate impression based on findings. | Fracture.VIEWS: Left thumb PA/lateral (two views) 01/20/15 A buckling fracture of the posterior cortex of the distal phalanx metaphysis is noted. Minimal anterior subluxation of the proximal phalanx on the metacarpal is noted. | Fracture of the distal phalanx. Abnormal alignment at the metacarpophalangeal joint. |
Generate impression based on findings. | Male; 65 years old. Reason: Hx lung nodule 3 months History: cough LUNGS AND PLEURA: Interval resolution of nodular opacities including a 9-mm nodule in the right lobe, compatible with post infectious or inflammatory etiology. Stable bilobed nodule in the left upper lobe measuring 7 mm in the anterior lobe (image 159, ... | 1. Interval resolution of multiple nodular opacities including a 9-mm right upper lobe nodule, compatible with post infectious or inflammatory etiology.2. Stable bilobed nodule in the left upper lobe, for which continued follow-up is recommended in another 9 and 21 months per Fleischner Society recommendations.3. Stabl... |
Generate impression based on findings. | Male; 61 years old. Reason: lung Ca. s/p chemo and RT and resection for left, and RT for right side cancer. Followup scan. History: cough CHEST:LUNGS AND PLEURA: Status post left upper lobectomy. Increased atelectasis/consolidation of the superior segment of the left lower lobe, likely secondary to radiation changes. V... | 1. Increased atelectasis/consolidation of the superior segment of the left upper lobe, likely secondary to radiation changes.2. Right upper lobe endobronchial lesion has again slightly decreased in size.3. No new sites of disease in the chest and abdomen. |
Generate impression based on findings. | 21-year-old male with osteosarcoma off therapy. Assess for metastatic disease. LUNGS AND PLEURA: Interval resolution of groundglass opacity in the left upper lobe seen on the prior study. Scattered new micronodules in the superior segment of the left upper lobe (series 4 image 45), in the lingula (series 4 image 68), a... | 1.Interval resolution of left upper lobe opacity seen on the prior study.2.Scattered micronodules are new since the prior study and may be postinfectious/postinflammatory in etiology, but are nonspecific. |
Generate impression based on findings. | Reason: evaluate sinuses History: chronic nasal congestion and sinus pain/pressure The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. There is only mild nasal septum deviation towards the left.The frontal sinuses are clear.Maxillary sinuses are clear. E... | 1.There is no evidence for paranasal sinus obstruction.2.No evidence for active sinusitis at this time. |
Generate impression based on findings. | Female 77 years old; Reason: Please evaluate for stones, upper urinary tract lesions History: microhematuria ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No ... | 1.No CT findings to explain hematuria.2.6-cm mixed sclerotic and lucent lesion in the right femur is felt to be benign, and may represent a dysplasia versus a liposclerosing myxofibroma. If clinically indicated, MRI can be performed for further evaluation. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Scattered bilateral nonspecific pulmonary micronodules.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no significant pericardial effusion. Moderate coronary artery calcifications. Scattered small lymph nodes are seen at the mediastinum. Atherosclerosis affects the aorta and... | Marked splenomegaly and scattered small lymph nodes as above, related to known history of NHL, without findings of infection to explain the patient's fever. |
Generate impression based on findings. | Female 73 years old; Right breast mass seen on screening mammogram. Ultrasound findings suggestive of malignancy. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 12 x 12 x 12 mm at the 10 o’clock position with increased vascularity, 4 cm from the nip... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | toe walkerVIEWS: Pelvis AP No acute fracture or dislocation. Both the femoral heads are seated within the acetabula. Both the femoral epiphyses are symmetric in size. | Both the femoral heads are seated within the acetabula. |
Generate impression based on findings. | 78 year old with history of right lumpectomy for IDC in January 2012. Patient received radiation therapy. No new breast complaints. Three standard views of both breasts and two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is compos... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | FractureVIEWS: Left tibia and fibula AP and lateral Again noted a compression plate and multiple screws in the proximal tibia without evidence of hardware failure. There is interval healing of the comminuted fracture of the proximal tibia. There is periosteal reaction and sclerosis reflecting interval healing. Multiple... | Healing proximal tibial fracture as described above. |
Generate impression based on findings. | Reason: lung cancer History: lung cancer CHEST:LUNGS AND PLEURA: Right upper lobe mass in the posterior segment of the right upper lobe is unchanged measuring 4.1 cm x 6.3 cm (image 27 series 5). This mass is abutting the medial pleural surface and mediastinum. No other suspicious pulmonary nodules or masses.No pleural... | 1.Large right posterior upper lobe necrotic mass abutting the pleura and mediastinum is unchanged in size. No additional pulmonary nodules or masses identified.2.Mediastinal lymphadenopathy and large hepatic metastasis unchanged in size.3.No new sites of disease identified. |
Generate impression based on findings. | 2-year-old female with altered mental status, seizure-like activity, after fall. Evaluate for hemorrhage. There is no evidence of intracranial hemorrhage. There is mild prominence of the ventricles and the anterior extra-axial space, presumably subarachnoid space. These findings were present on previous ultrasound of t... | 1. No evidence of intracranial hemorrhage or mass effect. If there is continued clinical concern for structural abnormality, consider MRI.2. Nonspecific prominence of the ventricles and extra-axial subarachnoid spaces likely relates to benign enlargement of the subarachnoid spaces of infancy. While this finding typical... |
Generate impression based on findings. | 45 year old for annual mammogram. 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 heterogeneously dense, unchanged in pattern and distribution. Scattered benign calcifications are unchanged in both breasts. No... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | FractureVIEWS: Right forearm AP and lateral Healing fractures involving the mid radius and ulna again noted. There has been interval healing as evidenced by bony remodeling. The alignment is near anatomic. | Healing forearm fractures as described above. |
Generate impression based on findings. | Male; 69 years old. Reason: AnCA positive LUL nodule? Surveillance History: none LUNGS AND PLEURA: Severe upper lobe predominant emphysema. Left apical scarring extending to a calcified nodular opacity in the left upper lobe, most likely due to prior granulomatous process. Additional scattered pulmonary micronodules, s... | Severe emphysema and findings suggestive of prior granulomatous process. No suspicious pulmonary nodules or masses. |
Generate impression based on findings. | Reason: GERD Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the mucosal surfaces or mural contours. Fluoroscopic evaluation of esophageal peris... | 1.Normal esophageal and gastric mucosa.2.Minimal dysmotility with trace proximal escape.3.One episode of gross reflux in erect position. Patient vomited twice during exam but denied nausea. |
Generate impression based on findings. | 9-year-old male with abnormal gait.VIEWS: Pelvis AP and frog leg, left foot standing AP, oblique, lateral, and right foot standing AP, oblique and lateral (8 views). Pelvis: Alignment is within normal limits. The femoral heads are round and well-seated in the acetabula. There is no fracture.Left foot: Mild flattening o... | 1. Findings consistent with bilateral treated clubfoot deformities as described above. 2. Normal pelvis. |
Generate impression based on findings. | 81 year-old female with metastatic colon cancer who present for follow-up. Evaluate. Motion artifact limits evaluation.CHEST:LUNGS AND PLEURA: There is a new 2.2 x 1.9 cm (series 3, image 60) nodule at the right lung base highly suspicious for metastatic focus. There is a new micronodule in the right upper lobe (series... | 1.New right basilar pleural based mass highly suspicious for metastatic disease.2.New nonspecific right upper lobe micronodule.3.Stable abdominal and pelvic exam. |
Generate impression based on findings. | Reason: pt w/ new onset facial/right hand numbess, c/f CVA History: see above The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular and subcortical white matter hypodensity is present.An asymmetrically hypodense focus is present at the right cer... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.There is a moderate to marked degree of periventricular and subcortical white matter lesions present which are rather unusual for the patient's stated age . These could be vascular in origin, related to a demyelinating process or vasculitis. Please ... |
Generate impression based on findings. | 59 year-old female with swelling and decreased range of motion following injury There are two approximately 5 mm rounded foci of mineralization within the soft tissues just lateral to the lateral condyle of the distal humerus. While we suspect these represent small foci of calcification within the extensor tendon perha... | 1. Densities lateral to the distal humerus we suspect represent chronic mineralization within the extensor tendon, although we can cannot exclude avulsion fracture fragments.2. Joint effusion without discrete fracture visualized. Repeat radiographs are recommended to exclude occult fracture.Findings were discussed with... |
Generate impression based on findings. | Ms. Williams is a 35 year old female with a recent biopsy performed at an outside hospital for a palpable abnormality in the left upper outer breast. Pathology report from outside hospital: cystic apocrine metaplasia, intraductal papilloma, and columnar cell change. She presents today for confirmation of appropriate pl... | Biopsy marker clip is in the appropriate location at site of previous palpable abnormality. The overall imaging is concordant with the pathology. Patient is to follow-up with Dr. Jaskowiak later today for final results and recommendations.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Lette... |
Generate impression based on findings. | 43 years, Female. Reason: hx c.diff. abdominal pain. ro toxic megacolon History: abd pain Cardiomediastinal silhouette is unremarkable. No significant pulmonary or pleural abnormality noted. Nonobstructive bowel gas pattern. No free air identified. Average stool burden. | No acute cardiopulmonary process identified. Nonobstructive bowel gas pattern. No free air identified. Average stool burden. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images with tomosynthesis images (12/11/14) performed at St. Mary Hospital. For comparison, digital mammographic images (5/17/13, 5/31/13, 12/26/13) are available. The breast parenchyma is composed of scattered fibroglandular el... | No mammographic evidence of malignancy. No significant interval changes st the benign biopsy sites in the left breast. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: eval for ich, mass History: HA 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 parenchyma.The visualized portions of the paranasal sinuses... | No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: restaging for head and neck cancer History: head and neck cancer CHEST:LUNGS AND PLEURA: Redemonstration of apical and paramediastinal postradiation fibrotic changes and accompanying bronchiectasis. Upper lobe subpleural microcystic changes are similar in appearance to the prior exam.Increasing ground glass opa... | 1.Increasing ground glass opacities of the lung bases compatible with aspiration.2.Stable post radiation fibrotic changes in the upper lobes.3.Stable right lower lobe subpleural nodule may be related to subpleural lymph node. Stable mediastinal lymphadenopathy No new suspicious pulmonary nodules or new sites of disease... |
Generate impression based on findings. | 58-year-old male with pain Hardware components of a medial compartment arthroplasty device are again visualized without evidence of hardware complication. Severe osteoarthritis affects the lateral joint compartment. There is approximately 15 degrees valgus alignment of the knee relative to the neutral mechanical axis. | Osteoarthritis and a valgus deformity of the knee. |
Generate impression based on findings. | Male, 55 years old, status post posterior spinal fusion from C3 to T2. Posterior instrumented spinal fusion has been performed with bilateral lateral mass screws from C3 through C6, and bilateral pedicle screws at T1 and T2. The screws are affixed to bilateral stabilization rods. The screws are well seated. No instrume... | Expected findings subsequent to instrumented posterior spinal fusion and posterior spinal canal decompression. No instrument complications are suspected. |
Generate impression based on findings. | 66-year-old male with right shoulder pain Moderate osteoarthritis affects the glenohumeral and acromioclavicular joints. A high riding humeral head with narrowing of the acromiohumeral interval to approximately 4 to 5 mm suggests a chronic rotator cuff tear. Cysts are noted within the humeral head | Osteoarthritis with narrowing of the acromiohumeral interval suggestive of chronic rotator cuff tear. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 20 year-old female, evaluate for fracture Again seen is a transverse fracture through the distal fibula with fracture fragments in near anatomic alignment. The lateral aspect of the fracture line remains visible, although the medial aspect appears indistinct, which may reflect some interval healing. | Distal fibula fracture, as above. |
Generate impression based on findings. | Ms. Perkovich is a 75 year old female with a personal history of right breast lumpectomy for IDC in 04/2013 followed by chemoradiation therapy. No current breast related complaints. Three standard views of both breasts with two right spot magnification views were performed digitally and reviewed with the aid of R2 CAD ... | 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.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagno... |
Generate impression based on findings. | For the purposes of numbering, there are 5 lumbar type vertebral bodies. There is chronic compression fracture involving the L2 vertebral body with approximately 30% loss of height. No significant osseous retropulsion. Posterior elements are intact. Vacuum disk phenomena is noted at the adjacent L1-L2 level. Vertebral... | 1. Chronic compression fracture at L2 with 30 percent loss of height is stable to minimally worse compared to CT abdomen from 7/11/2014. 2. No significant osseous spinal canal stenosis at any level in the lumbar spine. Please note MRI would be more sensitive to evaluate for stenosis related to soft tissues.3. Epidural ... |
Generate impression based on findings. | Male 65 years old; Reason: evaluate portal vein thrombosis History: cirrhosis with new finding of PVT with no portal vein flow ABDOMEN:LUNG BASES: New trace left pleural effusion with adjacent compressive atelectasis.LIVER, BILIARY TRACT: Morphologic changes compatible with cirrhosis. Thrombosis of the main portal vein... | 1.Cirrhosis with multifocal thrombus involving the portal venous system, further detailed above. Ascites and sequela of portal hypertension, including splenomegaly. No suspicious hepatic lesion.2.New trace left pleural effusion.3.Cholelithiasis. |
Generate impression based on findings. | 37-year-old female with history of wrist pain after fall. There is equivocal widening of the scapholunate interval. There is mild osteoarthritis at the basilar joint. We see no fracture. | No fracture evident and other findings as above. |
Generate impression based on findings. | 41-year-old male with history of trauma. Evaluate for neck stability. The cervicothoracic junction is obscured on the lateral projection by overlying anatomy. There is no acute fracture or subluxation. Alignment is anatomic. There is no evidence of cervical spine instability. Tiny posterior osteophytes are present at C... | Minimal degenerative changes, but otherwise no evidence of fracture or instability. |
Generate impression based on findings. | Male, 57 years old, history of T4aN2c squamous cell carcinoma of the right tonsil/right base of tongue, status post induction chemotherapy and chemoradiation (completed July, 2014), status post bilateral neck dissection (October, 2014). Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain... | 1. Evidence of treatment related findings and interval bilateral neck dissection. Previously seen pathologic adenopathy is no longer apparent. No new pathologically enlarged lymph nodes are detected.2. No evidence of any discrete or measurable mass is seen at the right tongue base or tonsil.3. No evidence of intracrani... |
Generate impression based on findings. | 52-year-old male with history of pain. Left knee: Tricompartmental osteophytes and joint space narrowing worse in the medial tibiofemoral compartment compatible with moderate osteoarthritis. Bony excrescence on the medial aspect of the proximal tibial metadiaphysis is likely the site of tendon insertion. Moderate osteo... | Osteoarthritis at the hips and knee and other findings as above. |
Generate impression based on findings. | 54-year-old male with history of pancreatitis in 2012 and 2014. Endoscopic ultrasound with signs of chronic pancreatitis. No masses. Evidence of fullness in the head of the pancreas and adjacent lymph nodes. Evaluate. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal arterially enhancin... | 1.Mild to moderate diffuse pancreatic ductal dilatation without evidence of a mass in the pancreatic head. Further evaluation with MRCP is recommended.2.Two mildly enlarged peripancreatic lymph nodes.3.Mild nonspecific retroperitoneal lymphadenopathy. |
Generate impression based on findings. | 54-year-old female with history of right shoulder pain. Moderate osteoarthritis affects the acromioclavicular joint with prominent osteophyte production. Tiny glenohumeral osteophytes indicate mild osteoarthritis. | Osteoarthritis is above. |
Generate impression based on findings. | 31-year-old female with chest pain. History of pulmonary emboli. Evaluate for pulmonary embolism. PULMONARY ARTERIES: No acute pulmonary embolism. Pulmonary artery size is within normal limits.LUNGS AND PLEURA: Interval resolution of focal areas of increased density at the peripheral left lower lobe seen on previous ex... | No acute pulmonary embolism. No significant pulmonary or pleural abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Positive. |
Generate impression based on findings. | 39-year-old female with history of foreign object in foot. There is a 4-mm triangular ossicle dorsal to the navicular compatible with a minimally displaced avulsion fracture appearing similar to the prior study when accounting for positional differences. We see no evidence of a foreign body. | Tiny ossicle dorsal to the navicular compatible with avulsion fracture appearing similar to prior. We see no foreign body. |
Generate impression based on findings. | 66-year-old male with left hip pain Left hip: Severe osteoarthritis affects the left hip with near bone-on-bone apposition superiorly.Pelvis: Hardware components of a right total hip arthroplasty device are situated in near anatomic alignment, although the distal aspect of the prosthesis not visualized on this study. S... | Osteoarthritis, as described above. |
Generate impression based on findings. | 33-year-old female with neck pain post head injury The cervicothoracic junction is not well seen on the lateral view due to overlying anatomy. Given this limitation, no acute fracture is visualized. Small anterior osteophytes project from the vertebral bodies at C4/5 and C5/6. There is slight rightward curvature of the... | No acute fracture is evident. Non-segmentation anomalies of the upper cervical spine and skull base as described above. If there is high clinical suspicion for fracture, CT may be considered for further evaluation. |
Generate impression based on findings. | Reason: dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Limited exam due to patient not tolerating the high density barium. No gross obstructive lesion of the esophagus was identified. No evidence of esophageal web or cricopharyngeal bar. Fluoro... | 1.Fluoroscopic evaluation of esophageal peristalsis showed moderate dysmotility with hold up of contrast in the mid esophagus with irregular tertiary waves. 2.No evidence of reflux.3.Limited exam due to patient not tolerating high density barium. |
Generate impression based on findings. | Interval postoperative changes are seen from left frontal craniotomy for hematoma evacuation from the left frontal lobe. There is a mixed density extra-axial collection underlying the craniotomy flap likely representing postoperative fluid and blood products. There are residual scattered areas of hyperdensity in the l... | 1.Expected postoperative changes following evacuation of left frontal lobe parenchymal hematoma, with residual scattered areas of hemorrhage in the hematoma cavity. Similar degree of midline shift, with decreased mass effect on the left lateral ventricle.2.Incomplete assessment of suspected left frontal lobe nodule whi... |
Generate impression based on findings. | Ms. Buscar is a 62 year old female with a personal history of right breast lumpectomy for IDC/DCIS in August 2010 followed by radiation and Femara therapy. Family history of breast cancer in two sisters. She has no current breast related complaints. Three standard views of both breasts were performed digitally and revi... | 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. | Male 60 years old; Reason: kidney cancer History: kidney cancer There is focal uptake in the frontal bone on the right, lateral to the orbit.No uptake in the region of the right kidney compatible with patient's known history of right nephrectomy. Bilateral symmetric uptake in the metatarsophalangeal joints likely degen... | Uptake in the right frontal bone may be due to metastatic disease. Recommend continued follow-up. |
Generate impression based on findings. | 49-year-old female with pain, evaluate for bigger osteophyte Severe osteoarthritis affects the tibiotalar joint with prominent anterior osteophytes appearing similar to the prior exam. Moderate osteoarthritis affects the midfoot and talonavicular articulations. Posterior and plantar heel spurs are noted. There is media... | Osteoarthritis, appearing similar to the prior exam. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Stable calcified and noncalcified micronodules. No new suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Right chest Port-A-Cath with its tip in the SVC.Mildly prominent right hilar lymph node... | 1.No evidence of pulmonary or pleural metastatic disease.2.Extensive sclerotic osseous metastases with many of the sclerotic lesions becoming osteolytic compatible with treatment response.3.No new sites of disease identified. |
Generate impression based on findings. | 68-year-old female, follow up examination Again seen is a fracture of the proximal diaphysis of the fifth metatarsal with fracture fragments in near anatomic alignment. There has been progression of callus formation along the fracture indicating some interval healing. | Healing fifth metatarsal stress fracture. |
Generate impression based on findings. | 55-year-old male with history of cervical spine fusion. There is an anterior plate device with screws entering the vertebral bodies of C3-4. A second anterior plate device is present with screws entering C5 and C7. The C6 vertebral body appears partially resected with spacer and bone graft material between C5 and C7. T... | Postsurgical and degenerative changes as above. |
Generate impression based on findings. | 70 year-old male with neck pain, evaluate for osteoarthritis Severe degenerative disk disease affects C7/T1. Moderate degenerative disk disease affects C5/6 and C6/7. Mild degenerative disk disease affects C3/4 and C4/5. Moderate to severe multilevel facet joint osteoarthritis is noted with neuroforaminal narrowing bil... | Degenerative disk disease and osteoarthritis as described above. |
Generate impression based on findings. | CLINICAL DATA: Age: 66 years. Sex : Male. Indication: Reason: Evaluate liver disease from metastatic colorectal cancer. Requesting triple phase CT scan. History: NA. LUNG BASES: Minimal subsegmental atelectasis at the lung bases. Left lower lobe pulmonary nodule (60/28) beasures 6mm, larger than the previously seen 4mm... | 1) Foci of heterogeneous hypoattenuation of the liver, consistent with given history of metastatic colorectal cancer, unchanged compared to prior PET/CT.2) Left lower lobe pulmonary nodule, nonspecific, recommend dedicated CT Chest to ensure resolution/stability. |
Generate impression based on findings. | 68-year-old female with metastatic breast cancer and DJD, right shoulder pain The bones are demineralized with small foci of sclerosis seen in the humeral head and proximal diaphysis consistent with metastatic breast cancer. Additional metastatic foci are better seen on prior CT and bone scan examinations. Surgical cli... | Metastatic disease and mild osteoarthritis as described above. |
Generate impression based on findings. | 60 year-old male with history of ORIF. There is a plate and screw device affixing a comminuted interarticular fracture of the calcaneus in anatomic alignment. There is no evidence of hardware complication. The fracture lines remain partially visible appearing similar to the prior study when accounting for projectional ... | Orthopedic fixation of calcaneus fracture appearing similar to prior. |
Generate impression based on findings. | 57-year-old female with medial eminence pain at first metatarsal head Two orthopedic screws affix the first tarsometatarsal joint in near-anatomic alignment. The articulation appears at least partially fused. There is no evidence of hardware complication. Flattening of the medial aspect of the first metatarsal head is ... | Postoperative changes of Lapidus procedure and osteoarthritis affecting the first metatarsophalangeal joint, appearing similar to the prior exam. |
Generate impression based on findings. | Male; 71 years old. Reason: 71 yo h/o indolent R pleural based adenocarcinoma with h/o pleurodesis for routine surveillance CHEST:LUNGS AND PLEURA: Stable nodular right pleural thickening. Post surgical scarring, atelectasis, and loculated effusion on the right is unchanged.MEDIASTINUM AND HILA: Redemonstration of medi... | Stable right pleural and mediastinal disease. No new sites of disease in the chest and abdomen. |
Generate impression based on findings. | 48-year-old female, evaluate for scoliosis There is approximately 35 degrees levoscoliosis of the upper thoracic spine measured from the superior endplate of T2 to the inferior endplate of T7. There is also approximately 55 degrees dextroscoliosis of the thoracolumbar spine, measured from the superior endplate of T7 to... | Scoliosis, as described above. |
Generate impression based on findings. | Male; 57 years old. Reason: HNSCC. 6mo post CRT FUP. Compare to previous. History: as above LUNGS AND PLEURA: New mild groundglass opacity in the right upper lobe (e.g. image 42, series 4), which may be due to aspiration. Otherwise, significant abnormality.MEDIASTINUM AND HILA: Interval removal of right chest Port-A-Ca... | 1. No evidence of pulmonary metastases.2. New mild groundglass opacity in the right upper lobe, which may be due to aspiration. |
Generate impression based on findings. | Confusion, heart failure, evaluate for CVA or other etiology No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus.... | 1. No evidence of 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. Mild chronic small vessel ischemic changes with probable chronic lacunar infarct in the right subinsular w... |
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