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Generate impression based on findings. | 48-year-old female with adrenal mass. Evaluate. ABDOMEN:LUNG BASES: Previously noted small right inferior breast nodularity is not as conspicuous on the current examination. Previously noted 3-mm peri-fissural right middle lobe nodule is not in the field of imaging.LIVER, BILIARY TRACT: Cholelithiasis. Few scattered su... | 1.Left adrenal nodule most consistent with a lipid rich adenoma. 2.Stable enlarged fibroid uterus with mass effect on the bladder. 3.Small amount of fluid in the endocervical canal. Correlation with menstrual history is recommended.4.Cholelithiasis. |
Generate impression based on findings. | Clinical concern for pneumatosis intestinalis or pneumoperitoneum.VIEWS: Abdomen AP and crosstable lateral (two views) 1/21/2015, 19:40 Nasogastric tube terminates in the body of the stomach, with the side port below the GE junction.Increased gaseous distention of multiple loops of bowel, with a paucity of distal bowel... | Increased gaseous distention of multiple loops of bowel, worrisome for distal obstruction. |
Generate impression based on findings. | 59-year-old male with question of gout There is mild soft tissue swelling about the PIP joints bilaterally without erosions or visualized tophi. Mild osteoarthritis affects scattered interphalangeal joints. | Soft tissue swelling and mild osteoarthritic changes without radiographic evidence of gout. |
Generate impression based on findings. | 33-year-old male, rule out signs of infection or malignancy The teeth appear grossly intact with one mandibular molar filling noted. The mandible appears unremarkable with no evidence of erosion to indicate infection or malignancy. | No specific radiographic evidence of infection or malignancy. |
Generate impression based on findings. | Multiple small osseous lesions are again seen in the cervical spine consistent with known multiple myeloma. Lesions involving the anteroinferior C2 and posterolateral and anteroinferior C5 demonstrate evolution compared to 6/4/2012 with decrease in size and STIR signal abnormality. No compression fractures. Lack of co... | 1. Multiple myeloma with small scattered osseous lesions in the cervical and thoracic cord. No large destructive osseous lesions or compression fractures.2. Extensive epidural tumor in the lower thoracic spine with the superior epidural extent to T9 suspected and can be further delineated with postcontrast imaging for ... |
Generate impression based on findings. | Respiratory distress, rule out pneumonia.VIEW: Chest AP (one view) 1/22/2015 Previously seen left upper lobe opacity is not identified on today's examination and may have been related to rotational artifact or possibly atelectasis. Interval improvement of the right lower lobe opacity, likely reflecting resolved atelect... | Previously seen left upper lobe opacity may have related to rotational artifact or atelectasis, and is not seen on today's exam. |
Generate impression based on findings. | Premature infant with clinical concern for necrotizing enterocolitis.VIEWS: Abdomen AP and crosstable lateral (two views) 1/22/2015, 08:38 The nasogastric tube has been retracted with the tip at the level of the GE junction and the side port above the GE junction. Significant interval improvement of the previously seen... | Misplaced NG tube, with interval improvement of the diffuse generalized bowel distention. |
Generate impression based on findings. | 61-year-old male, evaluate for elbow injury Alignment is anatomic. No joint effusion is noted. We see no fracture or radiographic evidence of gout. | No fracture or malalignment. |
Generate impression based on findings. | 58-year-old female with pain and limited mobility A well corticated ossicle is again noted along the medial aspect of the humeral neck, which may represent a loose body, appearing similar to the prior exam. Amorphous ossification along the medial humeral neck at the level of the inferior glenohumeral ligament may repre... | 1. Findings suggestive of a loose body within the joint as well as possible old injury to the inferior glenohumeral ligament. Further evaluation with MRI may be considered if clinically warranted.2. Moderate glenohumeral osteoarthritis. |
Generate impression based on findings. | History of subdural hematoma and right meningioma. The right cerebral convexity subdural fluid collection has resolved. There is an unchanged mildly hyperattenuating extra-axial right temporal convexity mass that measures up to approximately 10 mm in width. There is no evidence of intracranial hemorrhage. There is mild... | 1. The right cerebral convexity subdural fluid collection has resolved and there is no evidence of acute intracranial hemorrhage.2. A right temporal convexity mass is compatible with a meningioma, but it better delineated on the prior MRI. |
Generate impression based on findings. | 44 year-old female with left knee pain. Three non weight bearing and one weight-bearing views of the left knee are provided. Normal appearing left knee. No acute fracture or dislocation. No joint effusion. The right knee also appears normal as seen on the frontal view. | Normal left knee. |
Generate impression based on findings. | 49-year-old male with metastatic renal cell carcinoma, needs new surveillance scan. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified and most likely related to prior inflammatory disease are unchanged. No new nodules or masses are seen to suggest metastatic disease. No pleural abnor... | 1. Increasing size of multiple adrenal gland nodules with measurements provided above. 2. Minimal change in scattered lytic skeletal lesions -- nuclear medicine bone scintigraphy is a more accurate indicator of extent of metastatic disease. 3. No new foci of metastatic disease identified. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 122 cm/sec.Right internal carotid artery: 111 cm/sec.Left middle cerebral artery: 134 cm/sec.Left internal carotid artery: 101 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 88 year old female with history of C.diff and abdominal pain, evaluate for free air. Interval resolution of rectal fecal impaction. Nonspecific rectangular radiodensity is noted which projects over the rectum. Nonobstructive bowel gas pattern. Spinal degenerative disease and vascular calcifications again seen. No free ... | 1.Nonobstructive bowel gas pattern with interval resolution of rectal fecal impaction. No free air. 2.Rectangular radiodensity of uncertain etiology and clinical significance projects over the rectum. Please correlate with patient's history. |
Generate impression based on findings. | NHL and GVHD. Follow up on fungal sinusitis and cough. There are postoperative findings related endoscopic sinonasal debridement. There is near-complete opacification of the left frontal sinus. There is apparent thinning of portions of the porsterior wall of the left frontal sinus. There is diffuse partial opacificatio... | 1. Postoperative findings related to sinonasal debridement with pansinus opacification that may represent acute upon chronic rhinosinusitis and apparent thinning of portions of the posterior wall of the left frontal sinus, which may represent inflammatory erosions. A brain MRI may be useful for further evaluation if cl... |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 120 cm/sec.Right internal carotid artery: 94 cm/sec.Left middle cerebral artery: 126 cm/sec.Left internal carotid artery: 97 cm/sec. | 1.Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec).2.Occasional heart rate irregularities with sporadic slightly increased diastolic times. |
Generate impression based on findings. | Ms. Hibbs is a 60 year old female with a personal history of left breast lumpectomy for breast cancer in 1997 followed by chemoradiation therapy. BRCA1 positive. Family history of breast cancer in sister and niece. Three standard views of both breasts along with a cleavage view were performed digitally and reviewed wit... | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnos... |
Generate impression based on findings. | CT HEAD: Right medullary infarct better seen on MRI. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses an... | 1. Atherosclerotic disease involving the intra- and extracranial vessels. Moderate multifocal stenoses is seen involving the V1 and V4 segments of the right vertebral artery. There is also short segment narrowing at the V1 segment of the left vertebral artery. 2. Moderate narrowing of the right P1 segment with patent r... |
Generate impression based on findings. | 64-year-old male -- pre-kidney transplant evaluation, patient with severe peripheral vascular disease. Within the limits of a non-IV contrast-enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: No signific... | 1. Gallstones without other biliary tract complication. 2. Minimal calcifications in the aorta and right common iliac artery with detailed descriptions above. |
Generate impression based on findings. | History of altered mental status, weakness, and speech disturbance. Remote history of left CVA with residual right-sided weakness. There is no evidence of intracranial hemorrhage. There is encephalomalacia and volume loss involving the left frontal, parietal, and occipital lobes, as well as ex vacuo dilatation of the l... | 1. Findings suggestive of chronic left middle cerebral artery territory infarction and perhaps the left posterior cerebral artery territory, although superimposed acute or subacute infarction in this region cannot be excluded. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI sh... |
Generate impression based on findings. | 74 year old male with progressive dysphagia to solids who reports history of similar episodes and esophageal dilation at outside hospital in 2010 and 2011. Scout radiograph of the chest unremarkable.Single contrast evaluation of the esophagus and gastric cardia/fundus demonstrated significant retention of ingested mate... | 1.Imaging findings compatible with achalasia as described above, also consistent with patient's reported history. If clinically indicated, further evaluation with endoscopy to assess for stricture or underlying partially obstructing lesion may be considered. 2.Moderate to marked esophageal motility disorder.3.Spontaneo... |
Generate impression based on findings. | Status post grand mal seizure, now intubated.VIEW: Chest AP (one view) 1/22/2015 Endotracheal tube tip is just above the carina. The right upper extremity PICC is in the high right atrium. A gastrostomy tube is in place. Slightly increased bibasilar airspace opacities likely reflecting atelectasis. | Bibasilar atelectasis. Endotracheal tube tip just above the carina. |
Generate impression based on findings. | BRAIN: There is extensive encephalomalacia involving the right frontal lobe, right basal ganglia, right thalamus and to a lesser extent the right temporal and parietal lobes with associated ex vacuo dilatation of the right lateral ventricle, consistent with chronic infarct. There is also evidence of chronic infarct in... | 1. No acute infarct. 2. Chronic large right frontotemporoparietal infarct including the right basal ganglia and thalamus. Chronic right cerebellar infarct also seen. 3. Evidence of intracranial and extracranial atherosclerotic disease with irregularity and up to moderate stenosis of the right M1 segment. There is atten... |
Generate impression based on findings. | Status post right upper extremity PICC placement. Evaluate location.VIEW: Chest AP (one view) 1/21/2015, 19:25 Endotracheal tube tip is below the thoracic inlet and above the carina. New right upper extremity PICC is in the high right atrium. A gastrostomy tube is in place and the epidural catheter has been removed. Un... | Bibasilar atelectasis. New right upper extremity PICC with tip in the right atrium. |
Generate impression based on findings. | Male 63 years old Reason: evaluate hepatic vasculature, evaluate for lesions History: Cirrhosis, pre liver transplant eval, hx splenorenal embolization. LIMITED ABDOMENLIVER: 12.6 cm in length. Extremely echogenic limiting sensitivity for focal lesions in limiting the Doppler exam as well.BILIARY TRACT: Gallbladder sur... | Exam limited by markedly echogenic liver. Right portal vein and hepatic veins could not be visualized on this exam or on the prior exam. Other vessels a patent. |
Generate impression based on findings. | Lower back pain for one year, evaluate for spondylolysis.VIEWS: Lumbar spine AP oblique and lateral (4 views) 1/21/2015 No acute fracture, malalignment or spondylolysis is evident. A large stool burden is distributed throughout the colon. | No findings seen to account for the patient's lower back pain. |
Generate impression based on findings. | Status post PICC placement, evaluate location.VIEW: Chest AP (one view) 1/21/2015, 18:35 Interval placement of a right upper extremity PICC with the tip terminating in the right atrium. New bibasilar opacities suggestive of atelectasis. Previously seen contrast within the renal collecting systems is no longer evident. | Basilar atelectasis. Right upper extremity PICC terminates in the right atrium. |
Generate impression based on findings. | 58 year old female with inflammatory pain right hand, family history of RA. Evaluate for RA, inflammatory arthritis, crystalline arthritis. Left hand:Three views of the left hand are provided. Osteoarthritis affects the DIP joints. No evidence of erosions.Right foot:Three weight bearing views of the right are provided.... | No specific evidence of inflammatory arthritis. Additional findings as above. |
Generate impression based on findings. | 11-year-old male with cough/chest painVIEWS: Chest PA/lateral (two views) 01/21/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Minimal peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern. | Mild reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Reason: rule out pneumonia as well as evaluating back pain History: wheezing, back painVIEW: Chest AP (one view) 01/21/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Mild to moderate peribronchial cuffing compatible with reactive disease/bronchiolitis pattern. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Dysphagia and 90 pound weight loss. There is apparent mild asymmetric thickening of the left palatine tonsil, extending slightly into the left soft palate. However, the pterygoid muscles are intact and there is no evidence of significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary gl... | Apparent mild asymmetric thickening of the left palatine tonsil, extending slightly into the left soft palate is nonspecific and may represent anatomic variation or inflammatory process, although neoplasm cannot be entirely excluded. Endoscopy may be useful for further evaluation. |
Generate impression based on findings. | Reason: obstruction History: nausea vomitingVIEW: Abdomen AP (one view) 01/21/15 Gastrostomy tube, surgical sutures, and surgical clips are present and unchanged. Ascending colonic enema catheter is unchanged.Moderate to large amount of amorphous stool throughout the rectum and colon, increased since the prior exam. No... | Moderate to large stool burden. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | CLINICAL DATA: Age: 70 years. Sex : Male. Indication: Reason: eval for progression History: metastatic RCC, on bevacizumab. CHEST:LUNGS AND PLEURA Right middle lobe nodule (6/60) is unchanged in size, at 4 mm. No additional suspicious nodules or masses are seen.Right hilar reference lymph node (80410/68) measures 27 x ... | 1.Adrenal metastases are similar in size to prior.2.Mediastinal and hilar lymphadenopathy, similar in size to prior. |
Generate impression based on findings. | History of chronic constipation and anal duplication, evaluate stool burden status post clean-out.VIEW: Abdomen AP (one view) 1/22/2015 An average stool burden is distributed predominantly throughout the right colon, improved from the prior examination. The bowel gas pattern is nonobstructive. No portal venous gas, pne... | Average stool burden distributed predominantly throughout the right colon, improved from the prior exam. |
Generate impression based on findings. | Reason: Assess for cecal bleeding source/mass History: GI bleed; incomplete colonoscopy due to tortuosity The scout film shows a nonspecific bowel gas pattern without any evidence of obstruction or ileus. Barium flowed freely from the rectum to the cecum. There is no evidence of an obstructing or constricting lesion. S... | 1.Multiple colonic diverticula as above.2.No cecal mass is noted. 3.Significant tortuosity and redundancy of the colon. |
Generate impression based on findings. | Fever, cough, hypoxia, L-sided chest painVIEWS: Chest PA/lateral (two views) 01/21/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Mild to moderate peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern. Left-sided aortic arch, cardiac ... | Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | Ms. Roginski is a 75 year old female with a personal history of right breast lumpectomy 1997 for DCIS followed by radiation. Personal history of benign right breast biopsy in 2001. Family history of breast cancer in mother and maternal aunt. Three standard views of both breasts were performed digitally and reviewed wit... | 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. | History of large T waves on EKG, concerning for hemorrhagic conversion of CVA. There has been interval appearance of small patchy areas of hypoattenuation and loss of gray-white differentiation in the right middle cerebral artery territory, including the right postcentral gyrus, suggests edema related to evolving acute... | Findings consistent with evolving acute infarcts in the right middle cerebral artery territory superimposed upon chronic infarct in the right occipital lobe and chronic small vessel ischemic disease, without evidence of hemorrhagic transformation. I personally reviewed the Images and/or procedure with the Resident/Fell... |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (12/15/14) performed at Jackson Park Hospital. For comparison, mammographic images (11/6/12) are available. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A ... | No mammographic evidence of malignancy. BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 16-year-old female with right knee patellar dislocation. Four views of the right knee are provided. No joint effusion. No acute fracture or dislocation. The trochlea appears shallow. | The trochlea appears shallow, otherwise, normal appearing knee. |
Generate impression based on findings. | 91-year-old female left week and landed on her wrist; now with pain and swelling. Three views of the left wrist are provided. The bones appear demineralized. Arterial calcifications. Complete fracture through the distal radial metaphysis with slight dorsal displacement of the distal fracture fragment. Tiny fragment dis... | Distal radial metaphyseal and ulnar styloid fractures as described above. Findings discussed with Dr. Zmuda at 10:45 AM. |
Generate impression based on findings. | 32 year-old female with right knee pain. Three nonweightbearing and one weight-bearing views of the right knee are provided. No joint effusion. No acute fracture or malalignment. | Normal appearing right knee. |
Generate impression based on findings. | Ankle pain, evaluate for fracture.VIEWS: Left ankle AP lateral and oblique (3 views) 1/22/2015 Moderate soft tissue swelling is seen about the ankle, and there is a small joint effusion, but no underlying fracture or malalignment is evident. | Moderate soft tissue swelling and joint effusion without underlying fracture or malalignment. |
Generate impression based on findings. | Male; 76 years old. Reason: nature of right upper lobe mass on CT scan History: weakness, weight loss, failure to thrive. LUNGS AND PLEURA: Right apical mass compatible with primary lung cancer measuring 4.8 x 2.9 cm (series 4/18). The mass is largely contiguous with the pleural surface, which raises the question of pl... | Right apical mass compatible with primary lung cancer with possible pleural invasion and marked mediastinal and bilateral supraclavicular lymphadenopathy. |
Generate impression based on findings. | 62-year-old male with increased abdominal girth. Evaluate for cirrhosis. LIVER: The liver measures 18.5 cm in length with mild nonspecific coarse hepatic echotexture. No evidence of nodularity of the liver capsule or asymmetric left hepatic lobe enlargement to suggest cirrhosis. Again noted is an anechoic lesion in the... | 1.No sonographic evidence of cirrhosis as clinically questioned.2.Stable cyst in the liver and the right kidney. |
Generate impression based on findings. | There is a focal oval low-density structure within the right lateral retropharyngeal space, measuring 1.3 x 1.5 cm in greatest axial dimensions. This measures 37 Hounsfield units. There is additional extensive abnormal low density, right greater the left side. Along the retropharyngeal space, extending from the clivus... | 1. Focal right lateral retropharyngeal low density collections suspicious for abscess versus phlegmon, with adjacent extensive retropharyngeal fluid and edema, extending from clivus to C7-T1 level. Associate localized mass effect upon adjacent structures including slight rotation and displacement of the airway, which i... |
Generate impression based on findings. | Redemonstrated are postoperative changes related to a left frontal craniotomy for tumor resection and hematoma evacuation from the left frontal lobe. There is an unchanged mixed density extra-axial collection underlying the craniotomy flap, representing postoperative fluid and blood products. There are residual scatte... | Postoperative changes related to evacuation of left frontal lobe metastatic lesion. No significant change in residual blood products and edema in the left frontal lobe. Unchanged mass effect including 5 mm left to right midline shift. |
Generate impression based on findings. | 42 year-old female with a strong family history of breast cancer, including breast cancer in her mother, maternal grandmother, and maternal and paternal great grandmothers. Prior questionable left breast skin lesion seen. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD ... | 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: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 132 cm/sec.Right internal carotid artery: 130 cm/sec.Left middle cerebral artery: 142 cm/sec.Left internal carotid artery: 115 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Left true vocal cord lesion at the anterior commissure and persistent hoarseness, path consistent with SCCA, s/p microlaryngoscopy with re- excision of left true cord lesion in December 2014. There is no discernible vocal cord tumor. The paraglottic fat and laryngeal framework appear to be intact. There is no evidence ... | 1. No discernible vocal cord tumor. 2. No evidence of significant cervical lymphadenopathy based on size criteria or other tumors in the neck3. Carious tooth # 29 with periodontal disease. |
Generate impression based on findings. | Patient with tibia and fibular fractures, evaluate healing.VIEWS: Left knee AP and lateral (two views) 1/22/2015 The lines of the proximal tibial and fibular diaphyseal fractures appear less distinct. Callus formation and periosteal reaction is seen, increased from the prior exam. Alignment is near anatomic. | Healing tibial and fibular fractures as above. |
Generate impression based on findings. | History of rhinorrhea, decreased sense of smell and taste. Assess for chronic sinusitis. There is minimal scattered ethmoid sinus mucosal thickening. The other paranasal sinuses are clear. There are minimal secretions within the nasal cavity. There is no significant nasal septal deviation. The lamina papyracea are inta... | minimal scattered ethmoid sinus mucosal thickening. The other paranasal sinuses are clear. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Altered mental status. DM, HTN, CAD, diastolic heart failure, paroxysmal AF, asthma, and treated breast cancer, childhood epilepsy, and shaking spells of unclear etiology. There is no evidence of intracranial hemorrhage or mass. There is diffuse cerebellar volume loss. The ventricles are otherwise normal in size and co... | 1. No evidence of intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Nonspecific diffuse cerebellar volume loss, which may be a manifestation of paraneoplastic syndromes, for example. I personally reviewed the Images and/or procedure with the R... |
Generate impression based on findings. | 62-year-old female with bilateral adrenal hyperplasia or adrenal nodule. Evaluate. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Too small to characterize segment 7 hypoattenuating focus. Cholelithiasis without associated inflammatory changes.SPLEEN: No significant abnormality notedPANCREAS:... | 1.Nonspecific mild adrenal gland thickening without evidence of hyperplasia by CT criteria or discrete nodule as clinically questioned.2.Cholelithiasis |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 82 cm/sec.Right internal carotid artery: Could not obtain because the patient was unable to cooperate fully for the entire examination.Left middle cerebral artery: 107 cm/sec.Left internal carotid artery: 85 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). However, the right internal carotid artery time average mean velocity could not be obtained because the patient was unable to cooperate fully for the entire examination. |
Generate impression based on findings. | History of colon cancer, pulmonary nodules, and cough. LUNGS AND PLEURA: Several pulmonary micronodules are present in both lungs, some of which are new since the prior study. For reference, a 4 mm micronodule in the right lower lobe (series 5 image 72) is new, as is a 4 mm subpleural nodule in the left lower lobe (ima... | Pulmonary micronodules which have waxed and waned since 2013 as described above would be an atypical presentation for metastatic disease and may be post-infectious or post-inflammatory in etiology. However continued follow up is recommended given the history of malignancy. |
Generate impression based on findings. | Ms. Greene is a 43 year old female with a personal history of left breast mastectomy in May 2011 for ILC/LCIS, followed by chemoradiation and hormonal therapy. Additional history of benign right breast biopsy in 2010. Family history of breast cancer in paternal grandmother and paternal aunt. Three standard views of the... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female; 64 years old. Reason: 64 y/o F with PMHx of OHT on immunosuppresion here with cough sob, concern for infection vs asthma History: sob, cough, sputum, chills LUNGS AND PLEURA: Interval improvement left lower lobe consolidation. Minimal bibasilar streaky subsegmental atelectasis persists. Mild right lower lobe br... | Interval improvement in left lower lobe consolidation. No specific evidence of pneumonia on the current exam. |
Generate impression based on findings. | 72-year-old female with history of endometrial cancer. Evaluate extent.Per pathology, endometrial adenocarcinoma. ABDOMEN:LUNG BASES: Nonspecific micronodule at right lung base (series 3, image 20)LIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: Nonspecific hypo... | 1.Mild heterogeneity of the uterus, most likely secondary to stated history of endometrial carcinoma.2.Nonspecific mildly prominent retroperitoneal, iliac chain, and inguinal lymph nodes.3.Mild T10 compression deformity. |
Generate impression based on findings. | There is no intracranial hemorrhage. The ventricles and sulci are mildly prominent, greater than expected for age. Volume loss also includes the cerebellum which may be related to chronic alcohol use. There is no midline shift or mass effect. There are no areas of abnormal attenuation. There is no extraaxial fluid col... | 1. No acute intracranial hemorrhage.2. Mild global parenchymal volume loss, greater than expected for age |
Generate impression based on findings. | Reason: difficulty swallowing in pt with hx of smoking. evaluate for obstruction, reflux History: difficulty swallowing Scout radiograph of the chest demonstrated mild diffuse increased interstitial markings and atherosclerotic calcification of the aortic knob. Double contrast evaluation of the esophagus and gastric ca... | 1.Moderate dysmotility, appearance consistent with presbyesophagus. 2.Prominent cricopharyngeus muscle and aortic knob impression without functional obstruction.3.No evidence of gastroesophageal reflux, no hiatal hernia.4.Transient hold up of pill near the gastroesophageal junction, which passed with liquid wash. |
Generate impression based on findings. | 24 year-old female with laceration over palmer PIP, evaluate for foreign body Soft tissue swelling about the PIP joint and mild soft tissue irregularity without evidence of radiopaque foreign body. No fracture is evident. | Mild soft tissue swelling without radiopaque foreign body visualized. |
Generate impression based on findings. | 71-year-old female with ankle pain along lateral malleolus There is deformity of the distal fibula consistent with old fracture. Moderate osteoarthritis affects the tibiotalar joint. No acute fracture is visualized. | Osteoarthritis and old fracture deformity of the distal fibula. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic s... | No acute abnormality. Mild chronic small vessel ischemic changes. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. Hypodensities within the right basal ganglia identified on the prior CT correspond to prominent peri-vascular spaces. There are a few scattered T2 hyperinten... | 1.No evidence of acute infarct.2.Mild chronic small vessel ischemic disease.3.T2 hyperintensities within the right basal ganglia and pons likely represent prominent perivascular spaces, with chronic lacunar infarcts considered much less likely. |
Generate impression based on findings. | Evaluate stool burden. Abdominal distention.VIEW: Abdomen AP (one view) 1/22/2015 A ventriculoperitoneal shunt catheter is in place, with the tip terminating in the right upper quadrant. A cecostomy tube is in place. There is a moderate/large stool burden distributed throughout the colon, predominantly affecting the de... | Moderate/large stool burden, with desiccated stool in the descending and rectosigmoid colon. |
Generate impression based on findings. | 64 years, Male. Reason: re-evaluate line placement History: as above Limited view of the abdomen with motion artifact. Pelvis is excluded from view. Enteric tube tip coiled in the gastric body. | Enteric tube tip coiled in the gastric body. |
Generate impression based on findings. | 64-year-old male with change in exam. Evaluate for changes in ICH. Re-demonstrated is an intraparenchymal hematoma centered at the left thalamus measuring 2.9 x 4.1 cm and approximately 3.9 cm in the craniocaudal dimension not significantly changed allowing for differences in measurement technique.There is surrounding ... | 1.No significant change in large left thalamic hemorrhage with intraventricular extension. Surrounding edema and mass effect including midline shift is not significantly changed. 2.Minimal interval enlargement of ventricular system compared to 1/21/2015 but not significantly changed since 1/19/2015. |
Generate impression based on findings. | 60 year-old male with bilateral knee pain Right knee: Ossified body superior to the patella may reside within the suprapatellar pouch. There is severe medial tibiofemoral and lateral patellofemoral joint space narrowing and tricompartmental osteophytes. Bone infarcts are noted within the distal femur and proximal tibia... | 1. Severe osteoarthritis, right greater than left.2. Bilateral joint effusions. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The... | 1. No MR evidence of demyelinating disease within the brain or cervical spine.2. Incidental probable pineal cyst.3. No significant cervical spondylotic changes. |
Generate impression based on findings. | Reason: Please evaluate for interval change in dysplastic nodules, presence of HCC/malignancy. History: Hep C Cirrhosis ABDOMEN:LIVER, BILIARY TRACT: Nodular, cirrhotic changes. Increased reticular T2 signal with delayed enhancement, compatible with areas of confluent fibrosis. No ductal dilatation. Cholelithiasis. Mil... | 1.Cirrhosis with sequela of portal hypertension. Multiple dysplastic and siderotic nodules. No enhancing lesion suspicious for hepatocellular carcinoma. |
Generate impression based on findings. | Clinical Female 42 years old Reason: 42 year female with incisional hernia; please evaluate for abnormalities History: hernia ABDOMEN: There is situs inversus.LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significan... | Situs inversus. Ventral hernias as described, the largest located in the midline containing small bowel with very mild wall thickening and prominent caliber. The proximal intraperitoneal bowel is not dilated. There is no fluid in the hernia sacs |
Generate impression based on findings. | 5-year-old male with right distal femur fractureVIEWS: Right knee AP/lateral (two views) 01/22/15 Overlying cast obscures fine bone detail. Again seen is a predominantly transverse fracture through the distal femoral metadiaphysis in near anatomic alignment with surrounding periosteal reaction and callus formation. | Healing right distal femoral fracture. |
Generate impression based on findings. | Reason: r/o pneumonia History: hypoxia, congential heartVIEWS: Chest AP/lateral (two views) 01/22/15 Cardiac silhouette is mildly enlarged. No pleural effusion or pneumothorax. Interval improvement of subsegmental atelectasis at the medial bases. Interval removal of epicardial leads. Round right lower lung opacity may ... | Round right lower lung opacity may represent infection. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 143 cm/sec.Right internal carotid artery: 147 cm/sec.Left middle cerebral artery: 143 cm/sec.Left internal carotid artery: 157 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | 79-year-old female with non-Hodgkin lymphoma. Reevaluation and compared to previous. CHEST:LUNGS AND PLEURA: Stable subcentimeter right middle lobe pulmonary nodule (series 4, image 48) measuring 0.8 x 0 .4 cm, previously 0.7 x 0.4 cm. No new nodules or evidence of air space disease is seen. No pleural disease.MEDIASTI... | 1. No significant adenopathy seen in theabdomen or pelvis with reference lymph node measurements made above to compare with 2009 examination. Stable mildly prominent pretracheal isolated thoracic lymph node unchanged since 2009. 2. Benign subcentimeter right middle lobe nodule unchanged since 2009. 3. Gallstones again ... |
Generate impression based on findings. | Chronic post nasal drip and cough. There is minimal scattered ethmoid sinus mucosal thickening. The paranasal sinuses are otherwise clear. The nasal cavity is clear. There is no significant nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bon... | Minimal scattered ethmoid sinus mucosal thickening. The paranasal sinuses are otherwise clear. |
Generate impression based on findings. | Reason: s/p rectal irrigation, evaluate for stool burden History: constipationVIEW: Abdomen AP (one view) 01/22/15 Gastrostomy tube, cecostomy tube, surgical staples and surgical clips are present. Small to moderate stool burden with amorphous stool within the descending colon. Nonobstructive bowel gas pattern. No pneu... | Decreased stool burden. |
Generate impression based on findings. | There is mild nonspecific prominence of the ventricles as well as the subarachnoid space especially along the frontal convexities. 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. There is scattered mild ... | No acute intracranial abnormality. Mild right lateral frontal supraorbital soft tissue swelling without fracture. |
Generate impression based on findings. | Reason: r/o pneumonia History: cough and feverVIEWS: Chest AP/lateral (two views) 01/22/15 Aortic arch, cardiac apex, and stomach are left-sided. Moderate peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern. There is mild tenting of the right hemidiaphragm suggestive of eventration. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is an... | No acute intracranial hemorrhage. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended. |
Generate impression based on findings. | 61-year-old female with a history metastatic breast cancer to lungs and retroperitoneal lymph nodes status post chemotherapy with complete imaging response. Currently not on treatment. Please evaluate for recurrent disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Scattered small n... | Slight increase in size of scattered pelvic lymph nodes. As these changes are small in size, there remain uncertain, howeverenhancement seen in these nodules not appreciated on 11/21/13 examination and is worrisome for recurrence. If further imaging characterization would be helpful, PET/CT would be recommended.. |
Generate impression based on findings. | Female, 79 years old, headache x 3 weeks and HTN, eval for mass, svd. Mild patchy periventricular hypoattenuation is seen, left side more than right, a non specific finding which most commonly reflects age indeterminate small vessel ischemic disease. The cerebral and cerebellar hemispheres and brainstem are otherwise n... | 1. Mild age indeterminate small vessel ischemic disease. 2. No evidence of intracranial hemorrhage, mass effect, or other findings which would account for the patient's symptoms.3. Uniformly hyperattenuating left vitreous probably reflects ophthalmologic intervention. Correlation with history of retinal detachment repa... |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is focal abnormal density in the left caudate body with associated mild ex vacuo dilatation of the anterior body of the left lateral ventricle, ... | 1. No acute intracranial hemorrhage. Chronic left caudate infarct. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended.2. No acute fracture or traumatic subluxation, with minimal grade 1 degenerative retrolisthesis of C4 on C5 and C5 on C6. Moderate scattered spondylotic chang... |
Generate impression based on findings. | Male 57 years old; Reason: PLease evaluate for liver malignancy or cirrhosis related changes History: 57 yo M with hepatitis C and EtOH history with ultrasound showing liver mass. ABDOMEN:LUNG BASES: Reticular opacities, likely atelectasis or scarring.LIVER, BILIARY TRACT: Vague 1.5-cm hepatic hypodensity seen on porta... | 1.Subtle changes suggestive of hepatic cirrhosis, particularly given findings seen in portal hypertension such as splenomegaly and gastroesophageal varices, further described above.2.Indeterminate hepatic lesions can be further characterized with MRI. Please obtain a hepatobiliary phase.3.Cholelithiasis. |
Generate impression based on findings. | Initial staging of Ewing sarcoma. Left hip pain.RADIOPHARMACEUTICAL: 7.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 83 mg/dL. Today's CT portion grossly demonstrates left PICC line with tip in the right atrium. Small bilateral pleural effusions are present. A permeative lesion of the left iliac wing wit... | 1.Large markedly hypermetabolic mass centered at the left iliac wing with significant extension into the soft tissues, compatible with the patient's diagnosis of Ewing sarcoma.2.Innumerable additional hypermetabolic widespread osseous tumor involvement throughout the axillary and proximal appendicular skeleton.3.Diffus... |
Generate impression based on findings. | Male 51 years old abdominal pain right upper quadrant. LIVER: 15.1 cm length. Normal echotexture. Punctate cyst in the dome of the liver which is also seen on CT. Flow in the portal vein is hepatopedal, peak velocity .2 m/secGALLBLADDER, BILIARY TRACT: Normal gallbladder. No intrahepatic or extra hepatic biliary dilata... | No findings to explain abdominal pain. Small left renal cyst and punctate hepatic cyst. Otherwise normal. |
Generate impression based on findings. | 68-year-old male with provided history of "enrolled in clinical trial". Further review of medical record reveals history of myelofibrosis. Within the limits of a non-IV contrast enhanced examination is limited due to thyroid solid parenchymal organs and vascular structures, the following observations can be made:CHEST:... | 1. Diffuse sclerosis of the skeleton and hepatosplenomegaly, compatible with diagnosis of myelofibrosis and are unchanged. 2. No change in appearance of nonspecific calcified right lobe liver mass. 3. No significant lymphadenopathy with no change in size of slightly prominent retroperitoneal lymph node. |
Generate impression based on findings. | Restaging lymphoma.RADIOPHARMACEUTICAL: 12.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 81 mg/dL. Today's CT portion of the neck, abdomen, and pelvis grossly demonstrates small air-fluid levels in both maxillary sinuses consistent with sinusitis. Extensive atherosclerotic including coronary arterial cal... | 1.Hypermetabolic T11 lesion has progressed in size from previous, very suspicious for osseous tumor progression. Additional heterogeneous appearance to the spine raises the question of additional osseous tumor progression.2.Subtle new hypermetabolic nodular soft tissue foci involving the right iliacus muscle is suspici... |
Generate impression based on findings. | 6 month history of left throat/neck pain with mild dysphagia; current smoker. There appears to be mildly asymmetric prominence of the left palatine tonsil. There is no evidence of significant cervical lymphadenopathy by size criteria. The salivary glands are unremarkable. There is an elongated pyramidal lobe, which is ... | Apparent mildly asymmetric prominence of the left palatine tonsil, which is nonspecific, although neoplasm cannot be entirely excluded and endoscopy may be useful for further evaluation. Otherwise, no evidence of significant cervical lymphadenopathy by size criteria. |
Generate impression based on findings. | Reason: persistent epistaxis (both anterior and posterior) with epistat (anterior/posterior) balloon in place. Source of bleeding reported from the left posterior nasal cavity. Right common carotid artery: No stenosis at the carotid bifurcation on the basis of NASCET criteria. Venous and parenchymal phases were within ... | 1.Successful bilateral sphenopalatine artery embolization for epistaxis. |
Generate impression based on findings. | Assess fractures Three views of the right foot with weight-bearing reveals fractures of the second third and fourth metatarsals proximally. The fracture lines are indistinct consistent with healing. The bones are in anatomic alignment. | Healing metatarsal fractures in anatomic alignment |
Generate impression based on findings. | There is a right parietal approach ventriculostomy catheter, which courses through the right parietal lobe into the trigone of the right lateral ventricle with its tip along the frontal horn of the right lateral ventricle, unchanged in position. There is hypoattenuation within the brain parenchyma adjacent to the vent... | 1. No findings to suggest residual or recurrent cholesteatoma. 2. Evidence of prior suboccipital craniectomy and pronounced volume loss in the cerebellum. Prior MRI also demonstrates extensive superficial siderosis in the posterior fossa. Presumably these findings are all related to prior posterior fossa hemorrhage. |
Generate impression based on findings. | There is a complete absence of the corpus callosum with a possible interhemispheric cyst, given possible differential flow related artifact along the expected course of the third ventricle. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. There is bilateral... | 1. Complete agenesis of the corpus callosum with questioned interhemispheric cyst, versus flow-related artifact.2. Findings suggestive of Dandy Walker spectrum, such as Dandy Walker variant versus Blake pouch cyst.2. Mild hydrocephalus is suspected.3. Findings compatible with developing benign enlargement of subarachno... |
Generate impression based on findings. | 54 year-old female with weight loss, abdominal discomfort and shortness of liver edge. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild hepatomegaly is seen. Benign perfusion defect is seen adjacent to the falciform ligament/round ligament (series 3, image 42) a common variant. No parenchy... | 1. Hepatomegaly without other diagnostic abnormality seen in the liver. 2. Myomatous uterus. 3. No other abnormalities seen. |
Generate impression based on findings. | Medial ankle pain Three views of the right ankle unremarkable. No fractures. | Negative right ankle examination |
Generate impression based on findings. | History of fracture October 2014 Three views of the left wrist reveal diffuse soft tissue swelling. There is a small ossicle dorsal to the carpal bones that most likely represents a triquetral fracture of indeterminate age. Incidental note is made of congenital fusion of the lunate and triquetrum. | Triquetral fracture of indeterminate age. No previous radiographs in our system |
Generate impression based on findings. | Pain for months. Evaluate for stress fracture Three views of the left foot reveal questionable widening between the first and second metatarsals suspicious for a Lisfranc subluxation. This widening is best seen on the oblique view This appears somewhat more conspicuous than on the previous exam. No acute fractures are ... | Questionable Lisfranc subluxation with widening of the space between the first and second metatarsals. |
Generate impression based on findings. | The exam is limited by a relatively weak arterial phase contrast bolus.CT HEAD: There is no evidence of intracranial hemorrhage. There is an unchanged small focus of low attenuation within the left putamen that may represent a chronic lacunar infarct. The ventricles and basal cisterns are normal in size and configurat... | 1. Extensive diabetic vasculopathy of the head and neck vasculature with up to moderate to severe right common carotid artery stenosis, severe proximal left internal carotid artery stenosis, and perhaps severe left vertebral artery stenoses, although the assessment is limited due to technical factors. 2. Postoperative ... |
Generate impression based on findings. | Reason: ET tube placement History: BradycardiaVIEW: Chest AP (one view) 01/22/15 ET tube tip is at the thoracic inlet. NG tube side-port is just below the GE junction with tip below the field of view.Cardiothymic silhouette is top normal. Large lung volumes. Increasing right upper and left lung opacities on background ... | Increasing right upper and left lung opacities. |
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