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Generate impression based on findings. | Tympanic perforation. Rule out cholesteatoma. Right: There is a curvilinear density associated with the right pars tensa likely representing a tympanostomy tube. There is also mild retraction of the tympanic membrane. The ossicles are intact. The middle ear and mastoid air cells are well-developed and clear. There are ... | 1.No evidence of cholesteatoma.2.Mild thickening of the left pars flacida which may correspond to some focal sclerosis described on recent otoscopic exam. 3.A circular structure present within the right pars tensa may represent a tympanostomy tube. |
Generate impression based on findings. | Reason: RLL Nodule FU History: Non diagnostic path on bx of RLL nodule LUNGS AND PLEURA: 13-mm right lower lobe subpleural homogeneous nodule with a few micronodules unchanged and still benign appearing.Scattered benign appearing calcified and uncalcified micronodules are stable.A left pleural effusion is smaller than ... | Stable pulmonary nodule. Improving left pleural effusion. Upper abdominal findings discussed above could be better evaluated by a dedicated abdomen CT if clinically indicated. |
Generate impression based on findings. | 5-year-old with Chiari malformation and ataxia. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. There is no abnormal enhancement. There is no midline shift. The ventricles are stable in size and configuirattion. The cerebellar tonsils are rounded and extend approximately 7 mm inferior to... | Unchanged mild cerebellar tonsillar ectopia, but otherwise unremarkable head CT. |
Generate impression based on findings. | Reason: 85 year-old female with squamous cell lung cancer status post chemoradiation w/ worsening sob, re-eval tumor size, stage History: worsening sob CHEST:LUNGS AND PLEURA: Interval increase in left pleural effusion.Development of bilateral upper lobe patchy groundglass opacities and bronchial wall thickening.Interv... | 1.Interval increase in left pleural effusion with new patchy upper lobe ground glass air space opacities suggestive of infection/aspiration, hemorrhage, or atypical edema possibly secondary to radiation therapy.2.Interval decrease in the left upper lobe cavitary lesion. However, some of this is in part due to compressi... |
Generate impression based on findings. | Reason: h/o nasal vestibule cancer and lung cancer History: r/o lung mets/recurrence LUNGS AND PLEURA: Assess post left upper lobectomy with postsurgical volume loss.No evidence of pulmonary or pleural metastases.Moderate to severe upper lobe centrilobular emphysema is unchanged.Benign-appearing micronodules are stable... | Left upper lobectomy, without evidence of metastatic disease. Moderate to severe centrilobular emphysema is present. |
Generate impression based on findings. | Reason: SOB, ILD History: SOB LUNGS AND PLEURA: Both upper and lower lung zone subpleural reticular opacities with equivocal evidence of honeycombing in the right lung base is mild. There is no significant groundglass disease. Only mild traction bronchiectasis is present. Calcification in the periphery of the lung base... | Interstitial fibrosis, the pattern suggestive of UIP although there is not a classic basilar predominance. |
Generate impression based on findings. | Infection. There is near-complete opacification of the left maxillary sinus with extension into the infundibulum, which is similar to the prior CT. There is minimal mucosal thickening within the right maxillary sinus. There is mild circumferential mucosal thickening within the left sphenoid sinus and moderate opacifica... | 1.Near complete bilateral tympanomastoid opacification, which has increased since the prior head CT. This may be represent otomastoiditis in the appropriate clinical setting versus sequela of intubation.2.Persistent opacification of the left maxillary sinus, but increased opacification of the right sphenoid sinus with ... |
Generate impression based on findings. | Headache. Rule out hemorrhage. There is no intracranial mass, fluid collection or acute hemorrhage. The ventricles are slightly prominent, but there is no evidence of acute hydrocephalus including periventricular hypoattenuation. The midline is intact. The imaged portions of the orbits and paranasal sinuses are unremar... | No evidence of acute intracranial hemorrhage or mass. Mild prominence of the ventricles for the patient's age without evidence of hydrocephalus. |
Generate impression based on findings. | Reason: worsening cough, hemoptysis History: worsening cough, hemoptysis LUNGS AND PLEURA: Right upper lobe subpleural 3.4 x 2.9 cm mass, present on chest radiographs radiographs since 9/3/2013, but not on the most recent prior to that, 4/12/2013.Other scattered nodular opacities are present, as well as a right pleural... | Right upper lobe mass subpleural in location and could be tumor although might be an organizing infarct. Other subpleural nodules elsewhere and the right pleural effusion gives some support for this. Continued radiographic follow-up is recommended to check for resolution, otherwise if persistent a repeat CT could be pe... |
Generate impression based on findings. | 75-year-old male with history of neuroendocrine bladder cancer needing baseline scan prior to chemotherapy initiation. Motion limits sensitivityLUNGS AND PLEURA: Right lower lobe round, solid pulmonary nodule measures 7 mm in diameter (image 173, series 4).Multiple bilateral scattered pulmonary micronodules. Mild apica... | 1. Right lower lobe pulmonary nodule indeterminate for metastatic disease, as are other smaller micronodules.2. No mediastinal or hilar lymphadenopathy. |
Generate impression based on findings. | 76 year-old male. Questionable sepsis, concern for abscess. Evaluate for a fluid collection. EPIC history: CABG and right hepatectomy for HCC s/p sternal debridement. Lack of intravenous and oral contrast decreases sensitivity for detection of solid organ and bowel pathology. CHEST:LUNGS AND PLEURA: Bilateral moderate ... | 1. Status post CABG with an open sternal wound. 2. Small amount of abdominopelvic ascites without loculation.3. Status post right hepatectomy. Nonspecific fluid in the surgical bed with no internal foci of air or adjacent inflammatory changes to suggest infection. |
Generate impression based on findings. | Refractory metastatic papillary thyroid cancer with lung metastases treated with cediranib. Head: There is no mass, cerebral edema, or abnormal enhancement. The gray-white matter differentiation is preserved. The ventricles, sulci, and cisterns are symmetric stable in size and configuration. The orbits are unremarkable... | 1. No evidence for locoregional tumor recurrence or neck lymphadenopathy. 2. No evidence of intracranial metastasis. |
Generate impression based on findings. | Reason: r/o metastases, evaluate for coronary califications History: HCC noted on recent MRI, pre liver transplant evaluation LUNGS AND PLEURA: Scattered, calcified and noncalcified micronodules compatible with prior granulomatous disease.No suspicious pulmonary nodules or masses.No pleural effusions.Minimal apical par... | 1.No suspicious pulmonary nodules or masses.2.Cirrhotic morphology of the liver with moderate amount of ascites and gastroesophageal varices. |
Generate impression based on findings. | Reason: history of ILD, assess any progression History: fatigue LUNGS AND PLEURA: Moderate fibrotic lung disease with subpleural reticulonodular opacities in a patchy distribution with basilar predominance are unchanged. Areas of honeycombing are present as well as mild traction bronchiectasis. Dystrophic calcification... | No significant change in interstitial fibrosis, compatible with UIP. |
Generate impression based on findings. | 56-year-old female with history of large intraparenchymal hemorrhage, 4 weeks post op after right frontotemporal decompressive craniectomy for temporal hematoma resection and right Pcomm aneurysm clipping, also AVM resection and right MCA bifurcation aneurysm repair. Right frontotemporal craniectomy and aneurysm clip a... | Expected evolution of right MCA territory infarct with significant volume loss and associated new 6-mm midline shift to the right due to the volume loss.No acute intracranial hemorrhage. |
Generate impression based on findings. | Male 78 years old Reason: pt with a history of met urothelial cancer currently receiving Gemcitabine/Carboplatin chemotherapy. Please assess for disease progression History: met urothelial cancer Lack of IV contrast limits this examination.CHEST:LUNGS AND PLEURA: Scattered micronodules, several of which are calcified, ... | 1.Stable left hydroureter with interval resolution of the previously seen left-sided hydronephrosis.2.Stable masslike fullness to the pancreatic head, which has been very gradually increasing in size since 2007. Slow growth makes this likely a more benign process such as stromal wall tumor in duodenum and unlikely to b... |
Generate impression based on findings. | 64-year-old female with lower extremity edema, tachycardia, elevated d-dimer despite low pretest probability. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: Large left and small right pleural effusions.Left lower lobe consolidation.Suggestion of i... | 1. No evidence of acute pulmonary embolus.2. Large left pleural effusion and left lower lobe consolidation; differential includes infectious process with reactive lymphadenopathy however questionable soft tissue density raises question of underlying neoplasm.3. Diffuse mediastinal and hilar lymphadenopathy; differentia... |
Generate impression based on findings. | Male 20 years old Reason: crohns, s/p loop ileostomy w/KUB concerning for obstruction at level of ileostomy. Please eval. History: emesis, pain, air fluid levels and concerns for obstruction on KUB ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is no evidence of intrahepatic biliary duc... | 1.Diffusely dilated small bowel decompressed distal to the ileostomy, which is concerning for possible bowel obstruction at the level of ileostomy; however, decompression secondary to the tube in the ileum limits this examination as these findings - see above discussion.2.Long segment colonic wall thickening extending ... |
Generate impression based on findings. | 68-year-old female with history of left nasal vestibule squamous cell carcinoma status post radiation. There are stable postoperative findings related to left suprahyoid neck dissection. There is no enhancing mass lesion to suggest tumor recurrence. Indeed, the nasal vestibule appears unremarkable without erosive lesio... | Stable post-treatment findings without definite mass to locoregional tumor recurrence of significant cervical lymphadenopathy. |
Generate impression based on findings. | 77 year-old male with gastric cancer. Status post resection -- re-stage CHEST:LUNGS AND PLEURA: Calcific granulomata and a few noncalcified punctate micronodules unchanged. Cluster of small nodules with a tree and bud appearance in the superior segment left lower lobe (9/12/13) in a pattern most consistent with inflamm... | 1. Interval subtotal gastrectomy and partial colectomy. without evident complication. 2. No evidence of residual or recurrent tumor seen. 3. Slight thickening of the sigmoid colonin region of diverticular changes -- diverticulitis cannot be excluded. See above discussion. 4. Small amount of ascites. |
Generate impression based on findings. | 58-year-old male with history of follicular lymphoma with gluteal transformation complicated by fluid and infection. Recess mass sizes post antibiotics. Suboptimal image quality limits evaluation of fine detail on this examination.Interval placement of a surgical drain into the previously identified fluid collection al... | 1.Interval increase in size of soft tissue masses along the anterior thigh and left iliac region as described above compared to the recent study from 8/6/13 and highly suspicious for progression of malignancy given the patient's history of transformed follicular lymphoma.2.Interval near-resolution of fluid collection a... |
Generate impression based on findings. | 55 year old male. Reason: nondiagnostic echo, r/o cad History: Cirrhosis and ascites. Pre-orthotopic liver transplant evaluation. Height: 70"Weight: 173 lbsBSA: 1.96 m^2BMI: 24.8 kg/m^2Cardiac Morphology:Left Ventricle:EDV: 183 ml The left ventricle is normal in size, shape, wall thickness, and volume. Right Ventricle:... | 1. Normal ventricular volume and morphology.2. No critical coronary artery stenoses. Diffuse focal calcification in the mid- RCA is associated with minimal to mild stenosis. |
Generate impression based on findings. | Reason: H/O MZ Lymphoma with pulmonary lesions in need for High resolution CT without contrast. History: MZ Lymphoma with Pulmonary lesions LUNGS AND PLEURA: Right lower lobe nodule subjectively slightly larger but still measuring 12 x 7 mm, image 63 series 5.Scattered stable micronodules one calcified, and scarring or... | Unchanged right lower lobe nodule. No new abnormalities. |
Generate impression based on findings. | 61-year-old male with history of laryngectomy for SCCA with new recurrence left neck. History of HIV LUNGS AND PLEURA: Mild centrilobular and paraseptal emphysema.Left lower lobe ground glass and tree-in-bud opacities and bronchiectasis compatible with chronic aspiration. Reference right lower lobe reference pulmonary ... | 1. Increased size of right upper lobe pulmonary micronodule and new right middle lobe micronodule.2. Left lower lobe findings suggestive of chronic aspiration.3. Decreased size of reference mediastinal lymph node. |
Generate impression based on findings. | Reason: metastatic thyroid cancer on treatment. evaluate for disease progression with measurements History: as above CHEST:LUNGS AND PLEURA: Calcified pulmonary micronodules.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy seen.Aberrant right subclavian artery... | No evidence of metastases, or interval change. |
Generate impression based on findings. | 41 year old female with headache and syncope. NONCONTRAST CT HEAD:The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection, or acute hemorrhage. The osseous structures are un... | 1.No acute intracranial abnormality.2.Unremarkable CTA head. |
Generate impression based on findings. | 17 year-old female with history of recurrent osteosarcoma status post thoracotomy. End therapy evaluation. LUNGS AND PLEURA: Postsurgical changes of prior wedge resections involving the right lower lobe and left upper lobe, similar to prior. Pulmonary micronodule along the right minor fissure is unchanged, and may repr... | Postsurgical changes and stable probable intrapulmonary lymph node in the right minor fissure. No new pulmonary nodules. |
Generate impression based on findings. | 32 year old female. Pain and mass. Lack of intravenous contrast decreases sensitivity for detection of solid organ pathology. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Calcified splenic granulomata. PANCREAS: No significant abnormality notedADRENAL... | 1. Unchanged right adnexal dermoid.2. punctate right renal stone. |
Generate impression based on findings. | 51-year-old female with history of cerebral aqueductal stenosis status-post third ventriculostomy, now with chronic headaches. There is no evidence of acute intracranial hemorrhage. The ventricles are mildly increased in size compared with the prior study. There is a right frontal approach extraventricular drain in pla... | 1. Interval increase in size of ventricular system indicative of hydrocephalus. The imaged portions of the ventricular shunt catheter appear intact.2. Stigmata of mild corpus callosum dysgenesis and associated lipoma.3. No evidence of acute intracranial hemorrhage.Findings were related to Dr. Thomas Kelly at 5:08 p.m. ... |
Generate impression based on findings. | 57 year-old male. Aortic dilatation. Aortic aneurysm. Shortness of breath. CHEST:LUNGS AND PLEURA: Calcified micronodules. No focal airspace consolidation or pleural effusion.MEDIASTINUM AND HILA: Dilated ascending aorta with luminal diameter of 4.9 cm (9/40), not significantly changed. Dilated main pulmonary artery me... | Stable aneurysmal dilation of the ascending aorta. |
Generate impression based on findings. | Headache and breast cancer. There is no evidence of intracranial hemorrhage. There is a subcentimeter nonenhancing hypoattenuating focus demonstrated within the posterior limb of the right internal capsule (axial image 15). There is no significant associated mass effect. The ventricles are within normal limits in size ... | A 4 mm hypoattenuating nonenhancing focus within the right internal capsule may represent an age indeterminate lacunar infarct. A metastases is less likely. However, an enhanced MRI examination may be of benefit in further characterization.This result was communicated verbally to Dr. Yasmin Hasan at the time of reporti... |
Generate impression based on findings. | 58-year-old female with cough for 10 days, shortness of breath, and intermittent fever to 101. LUNGS AND PLEURA: Diffuse bronchial wall thickening and areas of mucous plugging. Patchy areas of tree-in-bud opacities with more confluent areas bilaterally in the mid-lungs. MEDIASTINUM AND HILA: Enlarged mediastinal lymph ... | 1. Findings suggestive of an atypical infection such as mycobacterium avium intracellulare or other mycobacterial infection. Other etiologies might include follicular bronchiolitis and atypical sarcoid or remotely the possibility of cryptogenic organizing pneumonia.2. Mediastinal and axillary lymphadenopathy.Findings d... |
Generate impression based on findings. | Venous clot vs abscess vs hematoma. There is an expansile filling defect within the the right internal jugular vein extending from the near the junction with the maxillary vein to the confluence with the subclavian and brachiocephalic veins. There is diffuse stranding of the surrounding fat planes. There is no evidence... | A large filling defect within the right internal jugular vein is compatible with acute thrombosis. Stranding of the surrounding fat planes may represent a hemorrhage or cellulitis, but there is no evidence of abscess. Discussed with Keningsberg at 5:30 PM on 9/12/13. |
Generate impression based on findings. | History of laryngectomy for scca with new recurrence left neck. History of HIV as well. Head: There is no abnormal intracranial enhancement. No mass lesions are identified. The ventricles are within normal limits in size and configuration. There is no midline shift. The mastoid air cells and paranasal sinuses are clear... | Interval increase in size of the heterogenously enhancing mass that measures approximately up to 29 mm (previously up to 24 mm in March 2011) in the left neck with ill-defined borders that infiltrate the overlying sternocleidomastoid muscle, likely representing to a metastatic level 4 lymph node with extracapsular spre... |
Generate impression based on findings. | Metastatic thyroid on treatment. Evaluate for disease progression. Head: There is no mass effect, edema, or abnormal enhancement to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. The ventricles are stable in size and configuration. There is re partially opacified und... | 1.No significant interval change in the recurrent tumor in the right tracheoesophageal groove that measures up to 14 mm.2.No significant cervical lymphadenopathy. 3.No evidence of intracranial metastatic disease. |
Generate impression based on findings. | Right hip pain after fall. Femoral neck fracture? There is a nondisplaced fracture of the femoral neck with mild valgus impaction. I see no additional fracture. Moderate osteoarthritis affects the hip joint. Subcentimeter ossicles along the inferior margin of the femoral neck may represent loose bodies within the joint... | Right femoral neck fracture and other findings as described above. |
Generate impression based on findings. | Reason: stroke History: hemiplegia There is loss of gray white differentiation in the left temporal lobe, left parietal lobe, left insular cortex, left frontal lobe in the middle cerebral artery distribution as well as the lateral aspect of the anterior cerebral artery distribution associated with more sulcal effacemen... | 1.Since the prior examination left hemispheric infarction continues to evolve with slightly more mass effect on the current exam. No hemorrhagic conversion is appreciated |
Generate impression based on findings. | Reason: evaluate for signs of ICH History: 72yo M with h/o MDS evolved to AML s/p SCT with new confusion and possible hallucinations 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 ed... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. Exam is stable when compared to the prior exam2.CT is insensitive for the early detection of nonhemorrhagic CVA |
Generate impression based on findings. | Reason: s/p vp shunt History: same There is redemonstration of a ventriculomegaly and a shunt catheter which extends through the right parietal lobe into the right lateral ventricle across the midline with tip in frontal horn of the left lateral ventricle stable since the prior exam.The patient is status post aneurysm ... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. 2.There is a 2-mm right-sided subdural collection on the current exam which was not as evident on the prior exam this has appearance of a subdural effusion.3.Opacification of the mastoid air cells is a nonspecific finding |
Generate impression based on findings. | Reason: s/p VP shunt History: s/p VP shunt A new shunt catheter now extends through the right parietal lobe into the right lateral ventricle across the midline with tip in frontal horn of the left lateral ventricle stable since the prior exam. Patient status post a recent right sided burr hole placements for the ventri... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. 2.Since the prior exam the lateral ventricles have mildly decreased in size3.Opacification of the mastoid air cells is a nonspecific finding. |
Generate impression based on findings. | Female 19 years old Reason: hx hodgkins lymphoma, new pruritis and enlarging lymph nodes History: enlarging lymph nodes CHEST:LUNGS AND PLEURA: There is a single 4-mm (image 29, series 5) nodule seen in the left major fissure, which appears unchanged since the prior examination and likely represents a fissural lymph no... | 1.Stable cervical, supraclavicular, prevascular and retroperitoneal lymph nodes without evidence of new lymphadenopathy.2.Stable enlarged thymic tissue.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 31-year-old female with history of PE. PULMONARY ARTERIES: Technically adequate study demonstrating resolution of previous pulmonary emboli. No evidence of acute pulmonary embolus, although there may be a web where the prior embolus had been, image 121 series 7.LUNGS AND PLEURA: Right basilar linear subsegmental atelec... | Resolution of previous pulmonary emboli with a possible resulting web, but no evidence of acute pulmonary embolus. |
Generate impression based on findings. | 73-year-old female with history of chondrosarcoma CHEST:LUNGS AND PLEURA: Biapical scarring.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Incompletely and suboptimally evaluated 7 x 5.5 cm hypodense lesion in the right supraclavicular region. This lesion is best seen on image number 11, series numb... | Right supraclavicular hypodense lesion likely representing a postop collection, however, recurrent/residual tumor cannot be excluded with this single phase CT incompletely evaluating this area. MRI may be helpful for further evaluation, if clinically indicated.Right axillary adenopathy.Possible liver hemangioma. Intra-... |
Generate impression based on findings. | 41-year-old male with chest pain and shortness of breath. History of DVT and PE. PULMONARY ARTERIES: Technically adequate study. Note is made of large bilateral large filling defects in the main pulmonary arteries extending into the segmental branches of the left upper and lower lobes, as well as the right upper, middl... | 1. Large bilateral filling defects in the left upper, left lower, right upper, right, middle, and right lower lobes, consistent with extensive acute pulmonary emboli. There is straightening of the interventricular septum suggestive of right heart strain. There is dilation of the main pulmonary arteries suggestive of pu... |
Generate impression based on findings. | 40 year-old female with abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality ... | Normal study. |
Generate impression based on findings. | Headache, hypertensive emergency. There is patchy cerebral white matter hypoattenuation in the bilateral occipital lobes, with a more focal area of hypoattenuation on the right. There is no evidence of intracranial hemorrhage or mass. The ventricles and basal cisterns are normal in size and configuration. There is no m... | Patchy cerebral white matter hypoattenuation in the bilateral occipital lobes, right greater than left without evidence of intracranial hemorrhage, which may represent posterior reversible encephalopathy syndrome. MRI may be useful for further characterization. |
Generate impression based on findings. | 10-year-old male presenting with 6 month history of headache and vomiting that has worsened over the past month. There is prominent mucosal thickening within the frontal, maxillary, and sphenoid sinuses bilaterally. There is significant bilateral ethmoid air cell opacification. There is also opacification of the ostiom... | Sinus disease more so anteriorly than posteriorly. No other visualized pathology. |
Generate impression based on findings. | 59-year-old male with left-sided abdominal pain and diarrhea ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mildly dilated common bile duct, not significantly changed from previous study.SPLEEN: Status postsplenectomy.PANCREAS: Status post pancreatectomy.ADRENAL GLANDS: No significant abnorma... | Nonspecific mild dilatation of the left upper quadrant jejunal loops, not significantly changed from previous CT.Intra-or extrahepatic biliary dilatation and changes from total pancreatectomy are also unchanged. |
Generate impression based on findings. | 54-year-old male status post MVC more than one week ago, presents with severe neck pain and tingling in fingers. There are multilevel anterior flowing osteophytes consistent with diffuse idiopathic skeletal hyperostosis. There is severe multilevel facet joint hypertrophy and fusion. Several bridging osteophytes are not... | 1.No definite fracture of the cervical spine.2.Diffuse idiopathic skeletal hyperostosis and ossification of the posterior longitudinal ligament with mild spinal canal narrowing. Nevertheless, MRI may be useful for further characterization.3. Multilevel fusion of the bilateral facet joints and anterior C1 to the basicli... |
Generate impression based on findings. | 58-year-old male with scrotal swelling PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Small nonspecific bilateral external iliac lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOT... | Significant scrotal wall thickening and bilateral hydroceles. No evidence of subcutaneous air to suggest necrotizing fasciitis. Further evaluation of testicles with ultrasound is recommended. |
Generate impression based on findings. | Female 56 years old Reason: eval for mets History: breast ca CHEST:LUNGS AND PLEURA: Streaky linear opacities with minimal associated ground glass opacities are seen in the right upper lobe, likely representing stable fibrotic changes from prior radiation therapy. Scattered micronodules are seen in the bilateral lung f... | 1.No evidence of metastatic disease.2.Stable right apical pulmonary scarring consistent with prior radiation therapy. |
Generate impression based on findings. | Reason: eval for DVT History: dyspnea. The medical record indicates a history of interstitial lung disease and Sjogren's. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolism. The pulmonary artery diameter is 36 mm consistent with pulmonary arterial hypertension, although still smaller ... | No evidence of pulmonary embolism. Pleural effusions and basilar consolidation are nonspecific, but could represent pneumonia especially in the lingular region. Enlargement of the main pulmonary arteries consistent with pulmonary arterial hypertension. Enlarged mediastinal lymph nodes are nonspecific and could be relat... |
Generate impression based on findings. | 71-year-old female status post ventriculoperitoneal shunt The study is limited due to lack of IV contrast.ABDOMEN:LUNG BASES: Bilateral small pleural effusions and dependent atelectasis. Mild cardiomegaly and small pericardial effusion.LIVER, BILIARY TRACT: There is intra-and extrahepatic biliary dilatation. High densi... | Limited study due to lack of IV contrast. Biliary dilatation with a presumed stone near the ampulla. M.R.C.P. may be helpful for further evaluation.Bilateral small pleural effusions and pericardial effusion.Patient's known ventriculoperitoneal shunt is noted in the right side of the abdomen with its tip coiled multiple... |
Generate impression based on findings. | Six year old patient with history of sickle cell anemia with headache and increased sleepiness. No intracranial mass, fluid collection or hemorrhage. There is no CT evidence of hydrocephalus or acute ischemia. Gray-white matter differentiation is appropriate and the midline is intact.There is mucosal thickening within ... | Sinus disease without any additional abnormality demonstrated. |
Generate impression based on findings. | Motor vehicle collision with pedestrian, injuring pedestrian. There is no evidence of intracranial hemorrhage, mass, or edema.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. There is perhaps a small defect in the lateral left orbital floor without herniation of the ext... | No evidence of intracranial hemorrhage, mass, or edema. |
Generate impression based on findings. | Fever and rash. Rule for possible lymphoma ABDOMEN:LUNG BASES: Borderline enlarged paracardiac lymph nodes.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. Spleen measures 12 cm in vertical dimension.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant ... | Enlarged retroperitoneal and pelvic lymph nodes. |
Generate impression based on findings. | 58-year-old male with decreased mental status, extensor posturing. Evaluate for cerebral edema. The exam quality is limited due to portable technique.Within these limitations, there is no definite evidence of cerebral edema or acute intracranial hemorrahge. There is no midline shift. The ventricles are stable in size a... | 1. Limited portable CT without definite evidence of acute intracranial hemorrhage, mass-effect, or cerebral edema.2. Pansinus opacification. |
Generate impression based on findings. | Weakness. There is no evidence of acute intracranial hemorrhage. There is hypoattenuation of the cortex and underlying whit matter of the right middle frontal gyrus with perhaps mild sulcal effacement. There is hyperdensity within the insular branches of the right MCA, suggestive of thrombus. There is encephalomalacia ... | 1. Hypoattenuation of the cortex and underlying whit matter of the right middle frontal gyrus with perhaps mild sulcal effacement likely represents an acute to early subacute infarct without hemorrhagic transformation or midline shift. Associated hyperdensity within the insular branches of the right MCA is suggestive o... |
Generate impression based on findings. | 70-year-old male presents with fever and pyelonephritis. Evaluate for interval change. Evaluate for renal fluid collection. Lack of intravenous contrast limits evaluation for lymphadenopathy, solid organ, and bowel pathology.ABDOMEN:LUNG BASES: Small right greater than left pleural effusions with adjacent consolidation... | 1. Compared to the prior study the hypoattenuation of the right renal parenchyma is stable to minimally increased with stable perinephric stranding and no perinephric loculated fluid collection. Differential includes pyonephrosis from obstruction versus xanthogranulomatous pyelonephritis.2. Short interval stability of ... |
Generate impression based on findings. | 42 year-old female with abdominal pain. Evaluate for renal stone This study is limited due to lack of IV contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No... | No evidence of renal stones or ureteral stones. |
Generate impression based on findings. | 55-year-old female with massive abdominal distention and hyperactive bowel sounds This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Gallbladder is significantly distended. Gallstones are present. Ultrasound may be helpful for further evaluation. No... | Limited study due to lack of IV contrast. Significant distention of the colonic segments and particular the cecum up to the level of the mid descending colon. These findings are most likely compatible with colonic ileus, however, colonoscopy may be helpful to exclude a colonic neoplasm.Distended gallbladder with gallst... |
Generate impression based on findings. | 71-year-old female with history of bladder cancer post cystectomy. ABDOMEN:LUNG BASES: Bibasilar consolidation with small right effusion.LIVER, BILIARY TRACT: There is mild intrahepatic biliary dilatation and a not clearly identified on outside study from 7/18/13. Common duct it is mildly dilated to a level just above ... | Irregularly marginated left pelvic fluid collection involving musculature containing gas. Report wasSmall amount of thrombus in the inferior vena cava below filter tip.Thrombus in the left iliac and femoral veins.Mild biliary tract dilatation of uncertain etiology.No hydronephrosis.Report sent to the emergency room by ... |
Generate impression based on findings. | Physical assault. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. Thre is no midline shift. There is mild circumferential mucosal thickening within the right sphenoid sinus. The skull and extracranial soft tissues are unre... | No evidence of intracranial hemorrhage or fracture. |
Generate impression based on findings. | Bladder cancer. LUNGS AND PLEURA: Mild upper lobe predominant centrilobular emphysema is present.Scattered very small ground glass opacities, fluid-filled bronchi and bronchioles and patchy basilar consolidation are accompanied by minimal pleural effusions. MEDIASTINUM AND HILA: Numerous mediastinal lymph nodes are pre... | Basilar opacities with fluid filled bronchi/bronchioles and patchy consolidation, consistent with infection or aspiration.No reliable evidence of metastases. |
Generate impression based on findings. | 53 year old female with gastric cancer. Compare to prior. CHEST:LUNGS AND PLEURA: Stable nonspecific left upper lobe micronodule. Focal pleural nodularity in the right upper lobe is unchanged. No suspicious pulmonary masses or nodules. Minimal new left pleural effusion with adjacent compressive atelectasis.MEDIASTINUM ... | Stable reference nodes. No evidence of new metastatic disease. |
Generate impression based on findings. | Male 56 years old Reason: Pt is a 56 y/o male with h/o urothelial cancer, s/p radical cystectomy with neobladder, evaluate for recurrence, CT Urogram, delayed views, 3D reconstruction History: urothelial cancer ABDOMEN:LUNG BASES: There is evidence of minimal basilar atelectasis. LIVER, BILIARY TRACT: There is no evide... | There is no evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | 51 year old female with Hodgkin's disease presents with respiratory failure and inability to wean off ventilator. Evaluate for infection or cancer. CHEST:LUNGS AND PLEURA: Note is made of large bilateral pleural effusions. Note is made of diffuse groundglass opacities and interlobular septal thickening with associated ... | 1. Diffuse bilateral groundglass opacities and patchy consolidation, most pronounced in the upper lobes, with associated septal thickening, and bilateral pleural effusions. Appearance and distribution is most consistent with ARDS and acute interstitial pneumonia. Differential considerations include atypical infection, ... |
Generate impression based on findings. | 19year old female with Hodgkin lymphoma with new enlarging lymph nodes. Patient is experiencing pruritis and night sweats. No no clinically significant lymphadenopathy is appreciated. When measured at the same locations utilized on the comparison exam, previously measured reference lymph nodes are as follows:Right jugu... | 1.No new clinically significant lymphadenopathy.2.Reference lymph nodes appear stable to slightly decreased. |
Generate impression based on findings. | Physical exam findings suggestive of enlarging aortic aneurysm. Assess size of abdominal aortic aneurysm. The lack of oral contrast limits evaluation of the bowel. Evaluation of the abdominal solid organs is limited by the phase of contrast. The exam is protocoled for evaluation of the arterial system.CT angiography: T... | Enlarging infrarenal abdominal aortic aneurysm with a maximum axial dimension of 6.2 cm as described. Findings were discussed with the ordering physician Nikhil Bassi (p2633) at the time of dictation. |
Generate impression based on findings. | Reason: evaluate for mets. History: sarcoma There is a large mass in right supraclavicular region not seen entirely included on this exam. There are adjacent surgical clips present in There is an adjacent right axillary mass present measuring 58 x 53 mm axial dimensions It is included on CT chest exam performed at the ... | 1.There is a right supraclavicular mass and a right axillary mass present not entirely included on this examination. The possibility this represents metastatic lymphadenopathy is raised. Please refer to chest ct of the same date for further comments2. No evidence for neck lymphadenopathy on the basis of CT size criteri... |
Generate impression based on findings. | Reason: sarcoidosis? History: elevated ACE, neurological symptoms/signs suggestive of sarcoid LUNGS AND PLEURA: No change in basilar subpleural scarring or subpleural bands. There is no specific evidence of intrapulmonary sarcoid.MEDIASTINUM AND HILA: Apart from a calcified right paratracheal lymph node, there are no d... | Subpleural scarring lung bases, but no evidence of sarcoidosis or other significant abnormality. |
Generate impression based on findings. | Male 70 years old Reason: prostate cancer with rising PSA. eval for mets, nodes History: prostate cancer ABDOMEN:LUNG BASES: There is a 3-mm (image 20, series 5) right-sided pleural-based nodule in the right lower lobe. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Multiple nodules are seen adjacent to ... | 1.No evidence of metastatic disease or local recurrence.2.Several small retroperitoneal lymph nodes. |
Generate impression based on findings. | AMS this morning. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The grey-white matter differentiation appears preserved. The midline structures are grossly intact. The ventricles and basal cisterns are normal in size and configuration. No fracture of the skull is identified. The imaged porti... | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Female 76 years old Reason: restaging after Whipple for head of panc cancer History: none CHEST:LUNGS AND PLEURA: There is minimal dependent basilar atelectasis.MEDIASTINUM AND HILA: There is no evidence of significant mediastinal or hilar lymphadenopathy. Atherosclerotic calcifications of the thoracic aorta and corona... | 1.Evidence of new SMV thrombosis.2.The patient is status post Whipple procedure without evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | Facial pain after punched in nose. There is a 3 mm medially displaced fracture of the frontal process of the right maxilla. There is soft tissue stranding and swelling along the adjacent medial canthus region, overlying right nasal ala and dorsum. The nasal septum appears intact without significant deviation. There is ... | Fracture of the frontal process of the right maxilla with 3 mm of medial displacement and regional facial soft tissue contusions. |
Generate impression based on findings. | Right lower quadrant pain. Nausea, vomiting, fever. ABDOMEN:LUNG BASES: No focal opacity is present. No pleural effusion is seen.LIVER, BILIARY TRACT: Normal enhancement. No biliary ductal dilatation. Gallbladder is distended and normal in appearance.SPLEEN: Normal enhancement. Normal size.PANCREAS: Normal in appearanc... | Appendiceal abscess. |
Generate impression based on findings. | Myxofibrosarcoma of right jaw status post chemoradiation. Prior resections included April 2009, recurrence resection July 2011, and recurrence resection March 2012. The March 2012 resection recovered myxofibrosarcoma and subsequently there was increased soft tissue in the right submental and submandibular region. There... | Extensive post-treatment findings without definite evidence of locoregional tumor recurrence or suspicious lymphadenopathy. |
Generate impression based on findings. | Reason: evaluate basilar consolidations for possible infectious source History: 69yo F w/ ISS stage II MM s/p 4 cycles CR admitted for autologous PBSCT with persistent fevers and basilar opacities on CXR LUNGS AND PLEURA: Small pleural effusions are present with adjacent mild compression atelectasis.Interlobular septal... | Small pleural effusions and a swimmer interstitial opacities are suggestive of mild edema from hypervolemia. Diffuse groundglass mosaic attenuation is nonspecific but can be seen in early viral infection or edema. No reliable evidence of fungal infection. |
Generate impression based on findings. | Status post renal biopsy with concern for post biopsy bleed on ultrasound. Evaluation of the bowel and abdominal solid organs is limited by the lack of oral and IV contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Postoperative changes from partial liver transplant. No intra-or extrahep... | Left perirenal hematoma as described. Results were discussed with nephrology. |
Generate impression based on findings. | Reason: pt with lung ca on Tarceva oral therapy History: doing well, now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Postoperative changes of the left apex demonstrates increasing nodularity (series 5 image 12). The nodular component measures 6 mm, as compared to 4 mm on the p... | 1. Nodularity associated with left apical scar increasing in size, now 6 mm, compared to 4 mm 3 months earlier. This is suspicious for focal recurrence.2. Stable size of previous referenced nodules |
Generate impression based on findings. | Reason: lung cancer History: lung cancer s/p resection LUNGS AND PLEURA: Previously described small left upper lobe nodule is no longer seen and may have represented a nidus of infection or atelectasis.Linear scarring or subsegmental atelectasis is unchanged.There is no evidence of pleural or pulmonary tumor.Status pos... | Status post right middle lobectomy without evidence of recurrent disease. Previously reported nodule no longer visible. |
Generate impression based on findings. | Reason: rule out lesion causing mass effect; midline shift; compression; ventricular outflow obstruction History: headache x 2 years but headache with emesis 3 weeks ago with relief of headache The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated in... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. Noncontrast CT of the head is within normal limits. |
Generate impression based on findings. | Status post resection and radiotherapy for tongue CA in 2009. Please reevaluate and compare to prior scans. Head: No intracranial mass, fluid collection or focus of pathologic enhancement. There is no CT evidence of acute hydrocephalus or ischemia. The midline is intact. Imaged portions of the orbits, paranasal sinuses... | 1.No intracranial abnormality, including findings which suggest metastatic disease.2.Extensive postoperative and postradiation changes within the neck related to prior glossectomy which are stable in configuration and do not suggest recurrence or metastatic disease.3.Stable or very slightly increased size of the previo... |
Generate impression based on findings. | Reason: h/o HNC, h/o CRT, compare to previous, measurements History: none There is asymmetry in the appearance of the tongue base which remain stable since the prior exam the fat planes adjacent to the left tongue base are mildly effacedWithin the suprahyoid neck on the basis of size criteria for lymphadenopathy no lym... | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.There is paranasal sinus opacification which remains in stable |
Generate impression based on findings. | Reason: 68 y/o female c/o chest tightness, need to rule out PE History: chest heaviness/tightness PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolism or right heart strain.LUNGS AND PLEURA: Apical and right subpleural radiation fibrosis is stable.Previously seen right lower lobe opacit... | No evidence of pulmonary embolism. New patchy left base opacity is consistent with infection or aspiration. |
Generate impression based on findings. | History of metastatic renal cell carcinoma. Evaluate for progression of disease. CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules compatible with metastatic disease the vast majority of which are new compared to the prior exam. A reference superior segment right lower lobe lesion has enlarged measuring 3.2 x 2.6 c... | Interval progression of disease as described. |
Generate impression based on findings. | Reason: Lung cancer and renal cancer History: followup exam compare to last CT CHEST:LUNGS AND PLEURA: Previously described cavitary lesion and groundglass opacities in the left lung are no longer present. Left paramediastinal traction bronchiectasis, progressive consolidation and architectural distortion compatible wi... | 1. Left paramediastinal consolidation, traction bronchiectasis and mild architectural distortion compatible with post radiation fibrosis. No evidence for recurrent disease.2. No interval mediastinal or hilar lymphadenopathy.3. Interval left partial nephrectomy with perinephric high-density collection favoring hematoma.... |
Generate impression based on findings. | Reason: pt with h/o lung ca s/p chemo and chest RT, also H/n ca too History: doing well now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Dense right upper lobe paramediastinal radiation fibrosis, unchanged.Status post left upper lobectomy.Mild centrilobular emphysema is present... | No evidence of recurrence. |
Generate impression based on findings. | 64 year old female with shortness of breath on exertion. Metastatic lung cancer, on chemo. Follow up. CHEST:LUNGS AND PLEURA: Spiculated right upper lobe nodule measures 8 x 10 mm (image 26, series 5), previously 9 x 10 mm.The solid portion of the previous mixed density reference lesion within the right middle lobe mea... | 1. Minimal decrease in size of reference pulmonary nodules which may represent metastases or synchronous primary lesions. No new suspicious pulmonary nodules. 2. No significant change in right lower lobe consolidation of biopsy proven adenocarcinoma with adjacent organizing pneumonia3. No change in mediastinal lymphade... |
Generate impression based on findings. | Female 66 years old Reason: Please eval for lung mets, hematuria workup. known bladder tumor s/p TURBT 9/12/13 History: bladder mass ABDOMEN:LUNGS AND PLEURA: Numerous solid and ground glass nodules are seen scattered throughout the pulmonary parenchyma, many of which appear new on this examination. There is a solid-ap... | 1.Numerous new pulmonary nodules which are likely inflammatory in etiology; however, metastatic disease cannot be entirely excluded.2.Developing mediastinal or hilar lymphadenopathy.3.Free air scattered on anterior wall of the bladder, clinical correlation required.4.Small amount of free air within the bladder consiste... |
Generate impression based on findings. | 66 year old female with a history of large cell carcinoma. Status post right upper lobectomy two years ago. LUNGS AND PLEURA: Status post right upper lobectomy. Biapical lung scarring/bronchiectasis is likely due to radiation treatment. Scattered pulmonary micronodules, some of which are calcified, appearing similar to... | Status post right upper lobectomy and chest wall resection without evidence of recurrent or residual disease. |
Generate impression based on findings. | Male 66 years old Reason: Gastric Cancer - restaging History: none CHEST:LUNGS AND PLEURA: There is evidence of minimal basilar atelectasis. Scattered calcified and noncalcified micronodules are again evident and appear grossly unchanged in size.MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphad... | 1.Slight thickening of the gastric wall which is nonspecific in nature2.Stable thickening of the distal esophagus.3.Stable pancreatic tail mass, which is concerning for a primary pancreatic mass.4.No evidence of new focus of metastatic disease. |
Generate impression based on findings. | Reason: right neck sarcoma History: r/o lung mets LUNGS AND PLEURA: Calcified granuloma right lower lobe, the lungs otherwise unremarkable.MEDIASTINUM AND HILA: No lymphadenopathy.Calcified lymph nodes are the sequela of prior granulomatous disease.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of ... | No change, and no sign of metastases. |
Generate impression based on findings. | History of upper extremity soft tissue sarcoma. Evaluate metastases. CHEST:LUNGS AND PLEURA: Unchanged left lower lobe calcifications likely represent granulomas.No new or suspicious pulmonary nodules.MEDIASTINUM AND HILA: Unchanged calcified subcarinal and left hilar lymph nodes. The stability favors prior granulomato... | Stable examination without specific evidence of metastatic disease. |
Generate impression based on findings. | Reason: lung nodule History: RLL lung nodule LUNGS AND PLEURA: 9 x 14 mm lobulated right lower lobe nodule image 64 series 4 has not significantly changed since an outside study of 12/2/2011. Peripheral to this is mild bronchiolitis with tree in bud opacities.Scattered punctate micronodules are stable. MEDIASTINUM AND ... | Right lower lobe nodule unchanged since our earliest available study 12/2/2011 and 18 a benign etiology highly likely. Annual or every other year CT follow-up is recommended. |
Generate impression based on findings. | CAD status post CRT 2009 CHEST:LUNGS AND PLEURA: Multiple pulmonary micronodules and subpleural/intrapulmonary lymph nodes are unchanged compared to 12/2008 with the exception of a 3-mm right lower lobe nodule (5/50) which has been stable since 2011, consistent with benign lesions. No new or suspicious nodules, pneumot... | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: r/o fx, abnormality on lateral Cspine ?fusion History: acute worsening of chronic lower CSpine pain 2/2 assault The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine. There is congenital anterior and posterior fusion of C6 on C7At C2-3 t... | 1.There is some minor general changes present in the cervical spine worse at C5-6 without significant compromise of spinal canal or exiting nerve roots2.no cervical spine fractures are appreciated.3.Congenital fusion of C6 on C7 |
Generate impression based on findings. | History of right middle lobe lung cancer with pelvic metastasis. Interval follow up exam. CHEST:LUNGS AND PLEURA: Severe apical predominant centrilobular emphysema.Focus of fibrosis and groundglass in the lateral segment right middle lobe is not significantly changed compared to prior and compatible with posttreatment ... | Posttreatment changes in the right middle lobe. There is a new right upper lobe nodule that is too small to characterize, but further follow up is recommended. No evidence of metastatic disease in the abdomen and pelvis. |
Generate impression based on findings. | 71 year-old female with a lung nodule. CHEST:LUNGS AND PLEURA: Spiculated left upper lobe nodule measures 14 x 14 mm (image 28, series 4), previously 16 x 15 mm and has spicules extending to the major fissure.No new pulmonary nodules identified. Numerous bilateral faint nodular groundglass opacities are not significant... | 1. Left upper lobe pulmonary nodule is minimally changed in size when measured comparably. This could represent a metastatic lesion vs a primary lung cancer. Numerous faint ground glass nodular opacities bilaterally are most compatible with adenocarcinoma metastases and would unlikely produce visible activity on PET du... |
Generate impression based on findings. | 63-year-old male with a history of invasive squamous cell carcinoma of the tongue. Status post chemoradiation therapy. CHEST:LUNGS AND PLEURA: 6-mm right upper lobe ground glass nodule (33; series 5) is unchanged dating back to the most remote examination in 8/2011. Additional scattered calcified and non-calcified pulm... | 1. A 6 mm right upper lobe ground glass nodule is stable dating back to 8/2011, likely representing atypical adenomatous hyperplasia versus noninvasive primary adenocarcinoma in situ. No new nodules or masses to suggest metastatic disease.2. Persistent nonspecific mesenteric fat stranding along the course of the SMA/SM... |
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