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Generate impression based on findings. | Reason: altered mental status, looking for acute intracranial abnormality History: altered mental status The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present. Since the prior exam the lateral ventricles have mildly enlargedThere is a subtle hyperdensity present along the right frontal lobe measuring approximately 15 mm in diameter .No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Since the prior examination the patient has developed periventricular white matter hypodensities of a moderate degree it is clinically appropriate MRI of brain with helpful in further evaluating this as it is rather unusual progression in the past 4 months especially given the patient's age of 20. 2.There is a subtle hyperdensity in the right frontal lobe anteriorly which is of uncertain significance. If clinically appropriate an MRI of the brain may be of further benefit. 3.Interval enlargement of lateral ventricles is likely related to atrophy. If clinically appropriate MRI of the brain may be useful to further evaluate this4.CT is insensitive for the early detection of nonhemorrhagic CVA |
Generate impression based on findings. | Reason: h/o CVA; POD #1 interval debulking from ovarian cancer History: altered mental status Since the prior exam in the 2004 the patient developed a right temporal and occipital lobe encephalomalacia with associated vacuum effect along the left lateral ventricle. A smaller focus of encephalomalacia is present along the left occipital lobe.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Encephalomalacia involving the right temporal lobe, right occipital lobe and left occipital lobe has developed since 2004.3.CT is insensitive for the early detection of nonhemorrhagic CVA. |
Generate impression based on findings. | Male 53 years old; Reason: Re-Staging; metastatic Bladder Cancer; Patient on Clinical Trial History: Re-staging post chemotherapy CHEST:LUNGS AND PLEURA: Mild emphysematous changes. New right lower lobe subpleural nodule measures 5mm (image 50/series 6)The pleural spaces are clear.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy. Pericardial effusion is slightly decreased..CHEST WALL: Left body wall probable sebaceous cyst. ABDOMEN:LUNGS BASES: LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland is nodular, unchanged.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Intra-aortic caval lymph node measures 1.3 x 0.5 cm (image 111/series 8) previously, 1.1 x 0.7 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Post operative changes in the left inguinal region from lymph node dissection.Left inguinal lymph node measures 1.2-cm (image 200, series 8), unchanged.Reference left external iliac lymph node measures 1.3 x 1.2 cm (image 174/series 8) previously, 1.4 x 1.1 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.New right subcentimeter right lower lobe pulmonary nodule. 2.No change in the reference lymph node measurements. |
Generate impression based on findings. | Reason: h/o NHL, now with progressive fatigue and recent abdominal pain History: NHL CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is normal. Mild coronary artery calcification. No pericardial effusion.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Lobulated kidneys with a right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Nonspecific mild mesenteric stranding is unchanged. No evidence of bowel obstruction or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No acute intra-abdominal abnormality. 2.No evidence of recurrent disease. |
Generate impression based on findings. | Female; 67 years old. Reason: r/o PE; h/o CVA ; currently POD#1 from tumor debulking from peritoneal cancer History: hypotension; tachycardia. PULMONARY ARTERIES: No evidence of pulmonary embolism. LUNGS AND PLEURA: Small bilateral pleural effusions with overlying dependent atelectasis, right greater than left. No focal airspace opacity. No suspicious pulmonary masses or nodules. Upper lobe predominant centrilobular emphysema. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. There are mild aortic valve, aortic arch, and coronary calcifications.CHEST WALL: Mild degenerative changes in the visualized spine. Right central venous catheter tip in SVC. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Postsurgical changes compatible with recent tumor debulking, including intraperitoneal free air and ascites. Feeding tube tip in the stomach. Cholecystectomy clips. | 1.No evidence of pulmonary embolism. 2.Postsurgical changes s/p peritoneal tumor debulking as described above. 3.Small bilateral pleural effusions with overlying dependent atelectasis, right greater than left. |
Generate impression based on findings. | Reason: hx of pulmonary nodules reassess History: above LUNGS AND PLEURA: Stable multiple bilateral nodules: The original index left lower lobe nodule remains stable when using similar measurement technique. On series 6 image 65, it measures 7 x 8 mm, previously 8 x 8 mm on 12/7/12, 5 x 5 mm on 12/7/11.A second reference left lower lobe nodule remains stable, 6 x 7 mm (series 6 image 51), previously 7 x 6 mm. This appears similar in density when compared to 2011.No interval pulmonary nodule calcification is identified.No new suspicious pulmonary nodule or pleural effusion.Postsurgical findings are stable within the right lower lobe from prior wedge resection. MEDIASTINUM AND HILA: Strands of mucous occupying the trachea.The heart size remains normal. No interval pericardial effusion. Minimal aortic valvular and coronary arterial calcification. No mediastinal or hilar lymphadenopathy.Small hiatal hernia.CHEST WALL: Stable multilevel degenerative of the thoracic spine. Stable superior left chest wall deformity.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Previously described abnormality within the superior pole of the right kidney is not included in this field of view. Based on the prior appearance, if interval cross-sectional imaging has not been performed, recommend further evaluation of the right kidney with cross-sectional imaging. | 1. Stable multiple pulmonary nodules. No interval calcification or new pulmonary nodule.2. The lesion in the superior pole of the right kidney is not included in this field of view. If interval outside sectional imaging has not been performed, recommend further evaluation of the right kidney with either dedicated renal CT or MRI. |
Generate impression based on findings. | Female, 48 years old, facial weakness. Evaluate for stroke. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.The bones of the calvarium and skull base are intact. | No acute intracranial abnormality. |
Generate impression based on findings. | Reason: Grade 3 endometrial ca History: pelvic pain CHEST:LUNGS AND PLEURA: Pulmonary micronodules, some of which are calcified. Mild basilar scarring. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy. Heart size is normal. No pericardial effusion.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without diverticulitis. No evidence of obstruction. The appendix is normal.BONES, SOFT TISSUES: Status post L4-L5-S1 fusion.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Soft tissue mass distends the endometrial cavity, which measures 1.9 cm in AP dimension (series 3, image 181).BLADDER: No significant abnormality noted.LYMPH NODES: Asymmetrically prominent right external iliac lymph nodes measure up to 1.4 x 1.0 cm (series 3, image 174).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Soft tissue mass in the endometrial cavity with asymmetrically prominent right external iliac lymph nodes suspicious for local metastasis. |
Generate impression based on findings. | Female, 29 years old, history of breast cancer status post chemo, now with fever of unknown origin. The frontal sinuses and frontoethmoidal recesses are clear. The ethmoid air cells are well pneumatized and unremarkable. The sphenoid sinuses are clear. The sphenoethmoidal recess are not well visualized but this may be technical.The maxillary sinuses are clear and the maxillary outflow pathways are patent.The nasal cavity is clear. The nasal turbinates are within normal limits. The septum is intact. | No evidence of active sinus infection. |
Generate impression based on findings. | Lungs he is status post chemo and resection CHEST:LUNGS AND PLEURA: Large left pleural fluid collection occupying the greater than two thirds of the left hemithorax and partially loculated at the lung apex. The lingula and remaining upper lobe are collapsed. A mass at the left apex is not readily distinguishable from adjacent atelectasis, measuring 27 x 27 mm (coronal image 41) at the reference level, previous the 33 x 29-mm.Nodular focus containing internal calcifications in the lingula measures 17 mm, previously 15-mm (5/39).Small micronodules in the right lung are unchanged.MEDIASTINUM AND HILA: Small volume of pericardial fluid, but the same. Left hilar and interlobar lymphadenopathy difficult to discern from adjacent vasculature and atelectatic lung but unchanged in retrospect.CHEST WALL: Apical tumor extending to the chest wall on the left unchanged. Unchanged soft tissue stranding left in the lower neck which are extends along the proximal right subclavian and axillary artery. New 13 x 15 mm nodular density in the left breast (4/46) is slightly higher density than simple fluid, of unclear etiology. This could be complex cyst however a metastatic or primary lesion cannot be ruled out. Numerous small enhancing lymph nodes in the left axilla are unchanged. Asymmetric skin thickening and subcutaneous fat stranding in the left breast is new from previous.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Motion artifacts causes slice misregistration and degrades sensitivity for detection of solid organ pathology.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions too small to characterize, not conclusively change lung for motion.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney located in the pelvis. Significant artifact from motion makes assessment of the U. right kidney limited; subcentimeter cortical lesions are too small to characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Decrease in measurement of left apical mass.2. Lingular nodule not significantly changed.3. Lymphadenopathy at the left hilum stable.4. Interval development of soft tissue stranding and skin thickening of the left breast as well as an internal nodular lesion. Although the findings could reflect sequelae of radiation therapy, the apparent nodule is incompletely assessed and metastatic or primary lesion cannot be ruled out. Recommend correlation with mammography. |
Generate impression based on findings. | Reason: carcinoid tumor compare to last Ct \T\ measure 1) left base nodule, 2) left hilum nodule, 3) paraspinal mass T10, 4) left pleural nodule \T\ 5) paratracheal node History: post 2 cycles of therapy CHEST:LUNGS AND PLEURA: Stable centrilobular emphysema and pulmonary cysts. Confluent dense air space opacities in the peripheral left upper lung (series 4 image 23 ) has demonstrated progressive increased density and new cavitation involving the medial component (series 4 image 24). The wall of this cavity is relatively thin, up to 4 mm in thickness. Immediately inferior and posterior to this is a new nodular opacity (series 4 image 34) that may be continued extension of this process. Given the progressive increased density and new cavitation, malignancy such as squamous cell carcinoma or cavitary infection are considerations.The previously referenced anterior pulmonary lesion abutting the pleural surface in the upper lobe (series 3 image 45 remains stable at 12 x 23 mm. Slightly superior and lateral to this in the left upper lobe (series 4 image 40), there is a new ground glass nodule that is difficult to measure.The second referenced left lower lobe nodule in the anteromedial basal segment (series 4 image 85) is stable, measuring 9 x 11 mm.The remaining scattered solid nodules are stable in size and number. No new pleural effusion.MEDIASTINUM AND HILA: Index left hilar mass which encases and narrows the left upper lobar bronchus (series 3, image 45) measures 21 mm in short axis, unchanged. Index left paratracheal lymph node (series 4 image 42) measures 19 mm in short axis, stable.Paraspinal soft tissue mass at the level of T10 (series 3 image 78) measures slightly smaller at 15 x 23 mm, as compared to 17 x 23 mm.CHEST WALL: Right port remains in stable position.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypodense lesions in the left hepatic lobe are unchanged from 2011, likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts and nonobstructing calculi are unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Increased hazy soft tissue attenuation of the mesentery is nonspecific, but similar toprior. This can be seen with carcinoid. Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Dense sclerotic focus occupies the left femoral neck which was not included in the field-of-view on prior studies.OTHER: Minimal prostatic calcification. | 1. Progressive left upper lobe airspace density with new cavitation. Considerations include a malignancy (such as squamous cell carcinoma) or cavitary infection.2. New ground glass nodule left upper lobe.3. Stable size reference left anterior upper lobe and lower lobe nodules. Additional non-referenced pulmonary nodules are stable in size and number.4. Stable size of mediastinal lymph nodes and left paraspinal mass. |
Generate impression based on findings. | 52 year old female. Follicular lymphoma. Reason: NHL restaging History: None CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: Stable right thyroid subcentimeter nodule. Stable mediastinal adenopathy; reference sub-carinal lymph node measures 1.5 x 1.0 cm (image 39; series 3), unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Stable mild splenomegaly PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant change in extensive, confluent retrocrural, retroperitoneal, and mesenteric adenopathy. Reference left periaortic lymph node mass (image 125; series 3) measures 3.2 x 2 .9 cm, roughly stable compared to priorBOWEL, MESENTERY: No change in extensive, confluent mesenteric adenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality identified.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant interval change in extensive, confluent retrocrural, retroperitoneal, and mesenteric adenopathy. |
Generate impression based on findings. | Male 62 years old; Reason: sp lapchole with cb bile leak and mutiple drains History: as above ABDOMEN:LUNGS BASES: Large bilateral effusions and lower lobe consolidation/atelectasis has not changed substantially compared to prior.LIVER, BILIARY TRACT: Large perihepatic abscess with gas fluid collection measuring 11.5 x 2 .1 cm has decreased in size since repositioning of percutaneous drain (image 44; series 3). There are two perihepatic drains. Pneumobilia. Metallic stent in the common bile duct. Hepatic vasculature are patent.SPLEEN: Peri-splenic wall enhancing fluid collection measures 10.4 x 4 .2 cm, similar compared to priorPANCREAS: Pancreatic stent. Pancreatic atrophy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A new double pigtail stent is in the transverse portion of the duodenum and distal common bile duct stent.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large pelvic wall enhancing fluid collection measuring 9.5 x 6.3 cm (image 145), slightly smaller compared to prior. | Decrease in size of perihepatic fluid collection. Pelvic collection slightly smaller. Peri-splenic collection stable. Unchanged bilateral pleural effusions with lung consolidation/atelectasis. |
Generate impression based on findings. | Lymphoma and aspergillus. Last CT worsening opacities concerning for fungal pneumonia. Bronchoscopy negative. LUNGS AND PLEURA: Significant improvement in the acute right upper lobe but opacities seen on the most recent previous scans, now with minimal residual scarring (6/24, 6/26). Solid nodule the right lower lobe (6/50) unchanged compared to recent studies and smaller than 4/24/12. Severe emphysema.MEDIASTINUM AND HILA: Chest port tip in the SVC. Hiatal hernia.CHEST WALL: Stabilization devices in the spine. Hyperattenuating presumed cement extruded into the spinal canal on the right at the level of at the level of T8 unchanged. Right chest port.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Incompletely visualized cystic lesions arising from the kidneys appear unchanged. Lesion on the left on the last image (4/104) the has an appearance similar to the last exam and probably reflects the top of a cyst but is incompletely visualized. | Significant improvement in right upper lobe pneumonia with residual scarring. |
Generate impression based on findings. | Male 63 years old; Reason: Cholangiocarcinoma: restaging History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Right hilar lymph node measures 1.2 x 1.2 cm (image 40/series 4) previously, 1.4 x 0.9 cm.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour. The reference lesion near the hepatic dome (segment 4) has resolved.The right inferior hepatic lobe lesion is stable measuring 2.2 x 1.2 cm (image 11/series 4). No new lesions. Intrahepatic expected pneumobilia with a common bile duct metallic stent.SPLEEN: No significant abnormality notedPANCREAS: Mild pancreatic atrophy with mild dilatation of the pancreatic duct andADRENAL GLANDS: Stable left adrenal nodularity.KIDNEYS, URETERS: Bilateral renal cyst and renal scarring. Calcifications in the left kidney are unchanged.RETROPERITONEUM, LYMPH NODES: Ectasia the intrarenal abdominal aorta.Reference portacaval lymph node measures 2.9 x 0.6 cm (image 109/series 4), unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Unchanged right sacrum sclerotic focus.OTHER: No significant abnormality noted | 1.Resolution of the segment 4 hepatic lesion. No new lesions.2.Stable exam otherwise. |
Generate impression based on findings. | Female 61 years old; Reason: Metastatic CRC - Restaging History: Completed 6 cycles chemo CHEST:LUNGS AND PLEURA: Subcentimeter pulmonary nodule along the right minor fissure (image 38/ series 6). No dominant or suspicious pulmonary lesions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall port terminates in the right atrium.ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour. Hypodense segment 7 lesion measures 1.1 x 1.1 cm (image 67/series 401). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic wall thickening involving the sigmoid colon. Left upper abdominal omental/peritoneal nodule measures 1.1 x 1.0 cm (image 85/series 401). BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic mass.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Solitary liver lesion and a left upper abdominal peritoneal deposit. |
Generate impression based on findings. | History of small cell (cured) now with growing groundglass opacities. Cough. LUNGS AND PLEURA: Architectural distortion, groundglass opacity and scarring in the lung adjacent to the right mediastinum most consistent with evolving radiation fibrosis. Scattered subpleural and intrapulmonary nodular opacities are most consistent with lymph nodes given their location, shape and proximity to the pleural surface or adjacent septa (right lower lobe images 5/50, 5/52, 5/77 and 5/80). On the left there is minimal paramediastinal scarring at the level of the main pulmonary artery in the left upper lobe proper. Minimal paravertebral pleural thickening on the right.4 x 4 mm mm septal nodule right lower lobe (5/58) unchanged in size compared to 8/28/13 but slightly larger in size and density compared to 5/3/13. This area was obscured on 11/7/12 study. MEDIASTINUM AND HILA: Lower right paratracheal lymph node measures 10-mm (4/32) probably present previously but difficult to confirm due to artifact in this region on the prior scans. Residual soft tissue between the right middle lobe bronchus and the right superior pulmonary vein were it enters the left atrium, difficult to measure but estimated to be approximately 8-12-mm (4/47), previously 7-mm.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Subtle apparent growth of 4-mm micronodule right lower lobe; metastasis cannot be excluded. Three month CT follow-up recommended.2. The remaining paramediastinal opacities have an appearance most compatible with evolving radiation pneumonitis and fibrosis over the last 3 scans. 3. Residual soft tissue in the mediastinum near the right middle lobe bronchus could be active or treated tumor. Given the lack of IV contrast, growth from the prior study cannot be verified with any degree of certainty, though it is suspected. PET scan may be of use for further characterization.4. Mild low right paratracheal lymphadenopathy. |
Generate impression based on findings. | Female 29 years old; Reason: hx breast cancer, now with FUO x 3 wks History: breast cancer, fever CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Left breast thickening with soft tissue mass in the left breast.ABDOMEN:LIVER, BILIARY TRACT: Fatty infiltration of the liver which limits evaluation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Post operative changes with fusion of the L5/S1 vertebral bodies. OTHER: Trace pelvic ascites. | 1.No evident metastatic disease.2.Fatty liver which limits evaluation for solid hepatic lesions.3.No drainable fluid collections in the chest, abdomen or pelvis. |
Generate impression based on findings. | Female 33 years old; Reason: eval acute intraabd process History: upper abd pain, vomiting, prior abd surgeries ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Hepatic and portal veins are patent. Intrahepatic pneumobilia.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post operative changes in the stomach and small bowel. A loop of small bowel is dilated in the left lower abdomen measuring up to 6 cm. Mild wall thickening involving the loop of bowel in the left upper abdomen adjacent to its gastric anastomosis.The colon is not distended.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: As aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Focal dilatation of a loop of bowel in the left lower abdomen adjacent to a suture anastomosis. This may represent a focal partial bowel obstruction.2.Wall thickening of the small bowel in the left upper abdomen.3.No drainable fluid collections. |
Generate impression based on findings. | 60 suture woman with abdominal pain, nausea and vomiting. Evaluate for diverticulitis or abscess. ABDOMEN: LUNG BASES: Bibasilar subsegmental atelectasis. Centrilobular emphysema.LIVER, BILIARY TRACT: Unchanged scattered hypoattenuating foci, which are too small to fully characterize, possibly representing cysts. Status post cholecystectomy.SPLEEN: Unchanged nonspecific hypodense foci.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged bilateral renal cysts, left greater than right.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aneurysmal dilatation of the infrarenal abdominal aorta to 2.5 cm with an ulcerated plaque (series 3; image 46). Unchanged near complete occlusion of the left common iliac artery with plaque. The celiac axis, SMA, and IMA are patent.BOWEL, MESENTERY: No significant abnormality.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Ovaries not visualized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant abnormality identified. No evidence of abscess or diverticulitis. Note that mild diverticulitis may be occult on imaging. |
Generate impression based on findings. | Female 23 years old; Reason: appy, bladder stone/clots? History: right sided abd pain, fever ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild bilateral hydronephrosis, worse on the right due to obstruction of the right ureter from the pelvic mass.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber. Contrast is not reached the cecum. The appendix is not identified.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Large left adnexal mass measuring at least 11 x 15 cm with fat and calcium components compatible with a large dermoid. The right adnexa measures 7.9 x 5.7 cm located in the upper right abdomen also with possible dermoid components.BLADDER: Decompressed by Foley catheterLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix is obscured.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Ascites. | 1.Large left ovarian teratoma2.Probable right ovarian teratoma3.Abdominal and pelvic ascites. Differential includes ovarian torsion vs ruptured dermoid4.Mild right hydronephrosis due to compression of the right ureter by the mass.5.Appendix is not visualized. |
Generate impression based on findings. | Male, 78 years old, history of metastatic thyroid cancer, compare to prior. No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Evidence of thyroidectomy is redemonstrated. No significant change is seen within the thyroid bed to suggest recurrent disease. A partially calcified nodule on the left side of the thyroid bed is unchanged (image 82 series 8). A previously referenced small left level 4 nodule is very difficult to distinguish but is no larger than on the prior exam measuring approximately 0.4 x 0.4 cm (image 70 series 8). Also unchanged is a right supraclavicular nonenhancing nodule which measures 1.7 x 1.6 cm (image 81 series 8).Effacement of the fascial planes of the neck is unchanged and likely related to prior therapy. The aerodigestive mucosa is within normal limits. The parotid glands are small. The submandibular glands are unremarkable. The cervical vessels remain patent. Lung apices are clear. No concerning bony lesions are demonstrated. | Stable postsurgical and posttreatment change. No evidence of progressive disease in the neck or intracranial metastatic disease. |
Generate impression based on findings. | Malignant neoplasm of the kidney. Secondary malignant neoplasm of the lung. Metastatic renal cell carcinoma. Evaluate for progression. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules are overall stable in size. A reference left lower lobe nodule measuring 1.2 x 1.2 cm (image 97; series 5) appear stable. Stents in the right mainstem bronchus with a small amount of debris is unchanged. Right lower lobe linear atelectasis.MEDIASTINUM AND HILA: Mild mediastinal lymphadenopathy is unchanged. A reference AP window node measures 1.1 x 0.9 cm (image 42; series 3), unchanged. Heart size is normal. Small pericardial effusion is stable.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Scattered subcentimeter hepatic hypodensities are unchanged and too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal mass is unchanged measuring 2.1 x 1.2 cm ((image 109; series 3) is stable.KIDNEYS, URETERS: Heterogeneous left kidney mass is unchanged in size measuring 8.5 x 8.9 cm (image 57; series 80220 coronal). There is compression of the left renal vein without evidence of thrombosis. The left renal artery appears patent. No hydronephrosis. The left ureter is patent taking an ectatic course around the mass.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal nodes are unchanged.BOWEL, MESENTERY: Small umbilical hernia containing a loop of bowel. No obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted.PELVIS: PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Overall unchanged exam. Reference measurements given above. |
Generate impression based on findings. | Acute shortness of breath and chest pain in the setting of DVT and been bed bound. Motion artifact degrades image quality, limiting assessment for detail.PULMONARY ARTERIES: Infusion was adequate. New filling defect in the left upper lobe pulmonary artery (13/79). Residual filling defects in a subsegmental branch of the right lower lobe (13/159), present on the prior study but difficult to visualize. The main pulmonary artery is enlarged measuring 3.3-cm in transverse dimension, compatible with pulmonary arterial hypertension.LUNGS AND PLEURA: No pleural fluid or pneumothorax. No focal air space opacities. Punctate granuloma left lower lobe.MEDIASTINUM AND HILA: Moderate to severe enlargement of the left atrium and left ventricle. No convincing evidence of right heart strain.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Dobbhoff tip in the gastric antrum. Cholecystectomy. | 1. Acute pulmonary embolus in the left upper lobe pulmonary artery. Referring resident of the neurology service verbally notified at 1:15 p.m. on 9/27/13.2. Small nonocclusive subacute embolus in a subsegmental branch of the right lower lobe.3. Left-sided cardiomegaly but no signs of right heart strain or pulmonary edema.4. Main pulmonary arteries and large, compatible with pulmonary arterial hypertension. |
Generate impression based on findings. | Multiple myeloma. Dropping hemoglobin. Rule-out retroperitoneal or intra-abdominal hemorrhage. ABDOMEN:LUNG BASES: Bilateral pleural effusions with overlying compressive atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse bony changes compatible with history of multiple myeloma. Status post vertebroplasty. Mild subcutaneous edema.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter decompresses the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse bony changes compatible with multiple myeloma.OTHER: Trace fluid in the pelvic cul-de-sac. | No evidence of intra-abdominal or retroperitoneal hemorrhage. Multiple myeloma. Bilateral effusions with overlying compressive atelectasis. Findings discussed with the clinical service at the time of dictation. |
Generate impression based on findings. | Male 60 years old; Reason: hs follicular NHL compare to previous History: hx follicular ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Prostate is enlarged with calcifications.BLADDER: No significant abnormality noted.LYMPH NODES: Left external iliac lymph node measures 10-mm previously, 9 mm (image 130 /ser 6)BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable exam with no significant size change in the pelvic lymph node. |
Generate impression based on findings. | Female 39 years old; Reason: Rectal Cancer: Restaging History: none CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Anterior mediastinal soft tissue measures 2.2 x 0.9 cm (image 32/series 4) previously, 2.2 x 1.0 cm.Right chest wall port terminates at the cavoatrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour with patent vasculature. Post operative changes adjacent to the liver. No suspicious hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right pelvic kidney; no hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Right external iliac lymph node, partially calcified measuring 0.8 x 0.6 cm (image 159/series 4) previously, 0.9 x 0.9 cm.BOWEL, MESENTERY: Post operative changes in the rectum. Post operative changes in the small bowel in the left lower abdomen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No change in the size of the reference lesions. |
Generate impression based on findings. | Male 78 years old; Reason: h/o met thyroid ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: There are multiple pulmonary nodules. A reference left lower lobe nodule measures 6-mm (image 64/series 9), unchanged. The pleural spaces are clear.MEDIASTINUM AND HILA: Soft tissue nodule is anterior to the trachea measures 1.1 x 0.9 cm (image 17/series 5) previously, 1.0 x 0.7 cm.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Stable right hepatic lobe hypodensity. Cholelithiasis without biliary ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal gland measures 4.4 x 1.4 cm (image 105/series 8) previously, 5.6 x 2.4 cm.Calcified left adrenal nodule.KIDNEYS, URETERS: Bilateral renal cysts. Some of the lesions in the right kidney are hyperdense and do not meet the criteria for simple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostatectomy with clips.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Expansile lytic right acetabular/ileum mass measures 5.1 x 4.8 cm (image 186/series 8) previously, 4.3 x 4.0 cm.OTHER: No significant abnormality noted | 1.Further decrease in the size of the right adrenal lesion.2.Slight size increase in the right ilium lesion. |
Generate impression based on findings. | Male 50 years old Reason: RUL pulmonary nodule; had CT in Oct 2012 and one in Kuwait in march 2013; unchanged in size 8 mm History: none LUNGS AND PLEURA: Moderate-sized partially loculated right pleural effusion unchanged. Right lower lobe atelectasis and consolidation unchanged consistent with rounded atelectasis. Multiple punctate calcific foci within atelectatic lung unchanged.Interval decrease in size of right upper lobe nodule now measuring 6 mm (image 46, series 6), previously measuring 8 mm. Multiple calcified micronodules unchanged.MEDIASTINUM AND HILA: Moderate partially loculated pericardial effusion with water density fluid, unchanged. No evidence of mediastinal or hilar lymphadenopathy. Post surgical changes consistent with heart transplant again evident.Calcification in the left brachiocephalic vein unchanged.CHEST WALL: Anterior/inferior right chest wall subcutaneous soft tissue deformity unchanged, and likely represents fibrosis and scarring. Evidence of prior sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Mild prominence of hepatic veins unchanged prior examination. | 1. Interval decrease in size of the right upper lobe nodular opacity, likely infectious/inflammatory in etiology.2. Persistent loculated right pleural effusion with associated rounded atelectasis.3. Stable moderate partially loculated pericardial effusion. |
Generate impression based on findings. | Reason: r/o for lung path. abn chest xray History: paresthesia of the hands, feet, smoker with clubbing; on Cellcept for nephrotic syndrome LUNGS AND PLEURA: Mild centrilobular emphysema is present.Right lower lobe calcified granuloma.Previously seen bilateral effusions have resolved. MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes are present.Vascular calcifications affect the aortic arch.CHEST WALL: Degenerative abnormalities are present throughout the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic cystlike hypodensities are nonspecific, the upper abdomen otherwise unremarkable. | No significant abnormality. No abnormality to account for the reported chest radiograph findings. |
Generate impression based on findings. | Reason: evaluate for possible primary or distant melanoma History: evaluate for possible primary or distant melanoma. 52-year-old female CT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. There is a 6 x 10 mm lymph node in the left inferior jugular chain this does not meet size criteria for adenopathy small lymph nodes are also scattered throughout the soft tissues of the neck left at jugulodigastric node measures 8 x 14 mm right jugulodigastric node measures 11 x 7 mm. these do not meet size criteria for lymphadenopathy.Within the visceral space the thyroid gland appears intact. There is a hypodense focus present in the right thyroid gland lobe measuring 11 x 7 mm axial dimensions. Heterogeneous lesion is present in the left thyroid gland lobe measures 10 x 6 mmThe airway appears patent.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact. A the minor degenerative changes in the cervical spine. There is medial deviation of the carotid arteries bilaterally.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No acute intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.The cerebellar tonsils are low lying and there is crowding at the foramen magnum | 1.No evidence for neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.No evidence for brain metastases.3.Heterogeneous lesion is present in the left thyroid gland lobe and a hypodense lesion in the right thyroid lobe. Please note CT is not accurate in evaluation of thyroid gland.4.Low lying cerebellar tonsils |
Generate impression based on findings. | Female; 48 years old. Reason: evaluate ILD for changes History: worsening sob LUNGS AND PLEURA: The lung volumes are decreased. There is severe honeycombing with subpleural reticular opacities, architectural distortion, and traction bronchiectasis in the right middle lobe, both lower lobes, and posterior left upper lobe. Patchy ground glass opacities and centrilobular nodules are noted in the upper lung zones, where there is also some extension of traction bronchiectasis and peripheral honeycombing. The pleura also appears nodular but no suspicious pulmonary lesions are identified. Findings are most compatible with an atypical UIP or a fibrosing NSIP pattern and not significantly changed since the prior CT. MEDIASTINUM AND HILA: Marked cardiomegaly with enlarged right heart. While this is a non-infused study, there appears to be significant mediastinal and hilar lymphadenopathy with many densely calcified nodes. This was present on the prior exam and may be reactive in etiology. Enlarged pulmonary trunk diameter is compatible with pulmonary hypertension.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Severe lower lung zone predominant honeycombing and architectural distortion is most compatible with an atypical UIP or a fibrosing NSIP pattern, but not significantly changed. 2.Findings compatible with pulmonary arterial hypertension. |
Generate impression based on findings. | Reason: 59 yo with HCV/HIV cirrhosis please eval for lesions History: none ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver with cirrhotic morphology with with evidence of portal hypertension including portosystemic collaterals and splenomegaly. Atrophied left lobe of the liver. Small nonenhancing, hypodense lesion in the right lobe of the liver, segment 7 is likely a hepatic cyst and unchanged compared to prior study. No suspicious focal liver lesions. No evidence of cholelithiasis. No intrahepatic ductal dilatation. Hepatic arteries, hepatic veins, and portal veins are patent. A minimal amount of ascites surrounding the gallbladder.SPLEEN: No significant abnormality notedPANCREAS: Redemonstration of a nonenhancing, hypodense lesion in the head of the pancreas. Pancreatic duct is visualized extending to the tail with the normal caliber.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Simple renal cyst in the lower pole of the left kidney. A simple renal cyst in the upper pole of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interposed loops of bowel between the liver and the diaphragm.BONES, SOFT TISSUES: Three left femoral neck screws. Umbilical hernia filled with ascites.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted. OTHER: No significant abnormality noted | 1.Cirrhotic liver with atrophic left lobe without evidence of focal lesions.2.Portal hypertension with splenomegaly and splenorenal shunt with minimal amount of ascites.3.Indeterminate pancreatic head cystic lesion may represent intraductal papillary mucinous neoplasm (IPMN). |
Generate impression based on findings. | Reason: h/o lung nodule History: cough LUNGS AND PLEURA: New poorly marginated 16-mm right lower lobe nodule image 48 series 5.New poorly marginated 15-mm left lower lobe nodule image 53 series 5, with a smaller nodule posterior medial to this. Scattered benign appearing micronodules are stable.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is present.Aortic root and coronary artery calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Images of the upper abdomen are unremarkable for a limited noncontrast study. | Multiple ill-defined pulmonary nodules, many of which alone would be suspicious for primary lung cancer, more likely metastatic breast cancer given the patient's history. |
Generate impression based on findings. | Reason: hx of bladder cancer, evaluate for lung mets History: none CHEST:LUNGS AND PLEURA: Postsurgical changes in the right lung. Scattered pulmonary micronodules. No suspicious pulmonary nodules or masses. No pleural effusions. MEDIASTINUM AND HILA: Multinodular thyroid gland appears unchanged. No lymphadenopathy. Heart size is normal. No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Scattered nonspecific hepatic hypodensities are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Indeterminate left adrenal nodule is unchanged in size.KIDNEYS, URETERS: Stable renal cysts. The renal parenchyma enhances symmetrically and excretes contrast symmetrically.RETROPERITONEUM, LYMPH NODES: Reference gastrohepatic lymph node measures 1.3 x 0.8 cm (series 10, image 96), previously 1.5 x 0.9 cm. Reference mesenteric lymph node measures 1.6 x 0.7 cm (series 10, image 161), previously 1.7 x 0.7 cm.BOWEL, MESENTERY: Mucosal fat deposition throughout the colon compatible with chronic inflammation or prior infection. BONES, SOFT TISSUES: Small fat-containing infraumbilical hernia.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Status post cystectomy with intact neobladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of recurrent disease or metastatic disease. 2.Stable lymph nodes. |
Generate impression based on findings. | Hypoxia question expanding hemo-thorax LUNGS AND PLEURA: Loculated left hydro-hemo-thorax slightly larger overall though the hemothorax on of the collection is not occlusive changed, seen at the lung base.Background centrilobular emphysema with mild diffuse septal thickening consistent with edema. Subsegmental atelectasis at the right lung base and compressive atelectasis of the lingula and left lower lobe adjacent to the fluid collection.MEDIASTINUM AND HILA: Left jugular catheter tip low in the right atrium. Enlargement of right atrium and right ventricle similar to previous. Coronary artery calcifications. Calcifications of the aortic valve noted. small pericardial fluid collection, similar to previous. Enlargement of the main pulmonary artery, unchanged. Mild mediastinal lymphadenopathy, about the same. Enlargement of the thyroid gland with several calcifications in the left lobe, nonspecific by CT.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Left adrenal adrenal gland is thickened, unchanged. Subcentimeter hypoattenuating hepatic lesions are too small to characterize. | 1. Although the overall volume of fluid in the left pleural space is slightly larger, the dense hemothorax component appears similar. 2. Signs of pulmonary arterial hypertension, right heart enlargement and pulmonary edema; constellation of findings raises the question of pulmonary venoocclusive disease although distal arterial pruning is absent.3. Nonspecific enlargement of the thyroid gland with calcifications, suggestive correlation with ultrasound or nuclear scintigraphy for further characterization |
Generate impression based on findings. | Female; 73 years old. Reason: metastatic thyroid cancer on treatment. evaluate for disease progression with measurements History: as above Stable mild bilateral hypodensity involving the external capsule and overlying centrum semiovale is unchanged. No mass effect, focal edema, or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. Stable well-circumscribed lucency within the left occipital bone over numerous prior exams, likely a venous lake or pacchionian granulation. Small mucous retention cyst and/or polyp bilateral maxillary antra. No suspicious lesions in the calvarium.Prior thyroidectomy. Unchanged focus of hyperenhancing soft tissue along the left tracheoesophageal groove measuring 1.5 x 0.9 cm (image 57, series 4). Unchanged reference nodule of tissue along the right jugular chain measuring approximately 0.8 cm in short axis (image 40, series 4) and 2.2 cm in length (image 38, series 80356); this tissue again remains unclear in etiology. No definite suspicious lymphadenopathy in the neck or supraclavicular regions.Stable asymmetric thickening of the left aryepiglottic fold. Again the left vocal cord is asymmetric relative to the right, and the left piriform sinus and laryngeal ventricle are enlarged suggesting vocal cord dysfunction. Please refer to dedicated CT chest report from today for scattered pulmonary nodules seen in the partially visualized lungs.No suspicious osseous lesions. | 1. No intracranial metastatic disease.2. No definite metastatic disease in the neck. Consider nuclear medicine scan for further characterization of the stable enhancing soft tissue focus in the left tracheoesophageal groove if clinically indicated. |
Generate impression based on findings. | Reason: Please evaluate pulsative tinnitus in the right ear. History: Pulsatile tinnitus in the right ear There is a 5-mm well-circumscribed lesion adjacent to the incus of the right middle ear as well as the lateral wall of the middle ear . superiorly it is contiguous with the intracranial venous structures and enhances similar to the adjacent veins. The adjacent tegmen tympani is eroded.The external and internal auditory canals are symmetric in diameter and intact. The middle ear structures are intact. The courses of the facial nerves were followed and appear intact. The mastoid air cells are clear. The vestibular aqueduct is identified and is within normal limits. The course of the eustachian tube is intact. The jugular foramen is intact. The carotid canal is intact and appeared foramen spinosum is identified and is intact. | 1.There is a small vascular protrusion in the right temporal bone which is visually contiguous with an intracranial vein running across an eroded portion of the tegmen tympani which is adjacent to the incus, adjacent to the lateral wall of the middle ear superior to the tympanic membrane. It appears to be a continuation of an adjacent intracranial vein through a defect in the tegmen tympani which would make it concerning if a biopsy is planned. It is possible that this represents an arteriovenous fistula. A glomus tumor with associated involvement of an adjacent intracranial vein is also possible. Alternative diagnoses may include a hemangioma or a protrusion/diverticulum of the adjacent dural vein into the middle ear. If clinically appropriate a conventional angiogram may helps evaluate this further. Please note that the superior margin of this lesion extends intracranially into a dural vein.2.Findings were discussed with Dr Mhoon. |
Generate impression based on findings. | Female 69 years old; Reason: 69yo female history of high grade uterine sarcoma s/p debulking surgery for mesenteric mass in July 2013, now with constipation and cramping pain. assess for recurrent disease History: as above CHEST:LUNGS AND PLEURA: Left lower lobe pulmonary nodule measures 1.7-cm (image 70/series 5) previously, 5mm. The pleural spaces are clear. MEDIASTINUM AND HILA: Right chest wall port terminates at the cavoatrial junction. No mediastinal lymphadenopathy.CHEST WALL: Partially imaged right arm hypo-dense tissue within the muscle may represent a distended bursa from the shoulder.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Lesions about the tail of the pancreas have nearly resolved and are too small to accurately measure.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small bilateral renal cysts. No evident hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right abdominal mass measures 10.9 x 9.2 cm (image 118/series 3) previously, 14.2 x 10.5 cm. There are additional foci of tumor in the abdomen and retroperitoneum. There is mass effect upon the bowel loops. Portions of the bowel loops are completely encased by the mass.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: New right lower mesenteric mass measuring 6.0 x 5.2 cm (image 145/series 3) .BONES, SOFT TISSUES: Postoperative changes in the anterior abdominal wallOTHER: No significant abnormality noted. | 1.Increase in size of the left lower lobe pulmonary lesion.2.Decrease in the size of the dominant right abdominal mass but new satellite lesion in the pelvis. |
Generate impression based on findings. | Female 52 years old; Reason: evaluate for possible primary or distant melanoma History: evaluate for possible primary or distant melanoma CHEST:LUNGS AND PLEURA: No suspicious primary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Soft tissue in anterior mediastinum most likely representing thymic tissue. CHEST WALL: Small left axillary lymph nodes. Right thyroid nodule.ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour with patent vasculature. Multiple well marginated hypodense hepatic lesions may represent cysts and are unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable left renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged uterus with a rounded mass at the fundus which may represent a fibroid.BLADDER: No significant abnormality noted.LYMPH NODES: Post operative changes in the right inguinal area. Soft tissue which may represent postsurgical change measures 1.9 x 1.1 cm (image 176/series 3) .BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace pelvic fluid. | 1.Post operative changes in the right inguinal area. No evident distant metastatic disease. |
Generate impression based on findings. | Reason: please evaluate for etiology of hematuria History: patient with hematuria ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small nonobstructive stone in the left renal pelvis. No hydronephrosis. The kidneys enhance and excrete contrast symmetrically without evidence of mass.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Large fibroid uterus, some calcified.BLADDER: No evidence of wall thickening or filling defect.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid in the pelvis, likely physiologic. | Small nonobstructive stone in left renal pelvis. |
Generate impression based on findings. | Abdominal pain. History of kidney stones on the left. 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 evidence of hydronephrosis, hydroureter, or renal or ureteral calculi.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of hyperdense material is noted in the appendix without evidence of inflammation.PELVIS:UTERUS, ADNEXA: No significant abnormality noted. Intrauterine device.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No findings to explain abdominal pain. Hyperdense material noted in the appendix without evidence of appendiceal inflammation. No evidence of renal or ureteral calculi as clinically queried. |
Generate impression based on findings. | Female 73 years old Reason: metastatic thyroid cancer on treatment. evaluate for disease progression with measurements History: as above CHEST: Respiratory motion artifact degrades image quality and may affect measurements.LUNGS AND PLEURA: Pulmonary metastases reference lesions as follows:Left upper lobe measures 8 x 6 mm (image 19, series 4), previously 7 x 10 mm.Left lower lobe nodule measures 11 x 9 mm (image 36, series 4), previously 11 x 12 mm.Right lower lobe infrahilar nodule measures 36 x 12 mm (image 56, series 4), previously 35 x 14 mm.No new nodules identified; however, sensitivity significantly limited by motion artifact.MEDIASTINUM AND HILA: Streak artifact from the patient's left chest wall pacemaker limits evaluation of the thoracic inlet.Stable mediastinal lymphadenopathy. Prevascular lymph node now measures 21 mm (image 33, series 3), remeasured at 19 mm on the prior examination.Left subclavian pacemaker position unchanged. Mildly dilated right internal jugular vein without evidence of clot, unchanged.CHEST WALL: Left subclavian pacemaker position unchanged. There is no evidence of axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Exam is significantly limited by respiratory motion artifact.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland mass now measures 2.7 x 2.2 cm (image 87, series 3), previously 2.6 x 2.2 cm. KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate multilevel degenerative changes are seen in the cervical, thoracic and lumbar spine. No definitive evidence of metastasis to the osseous structures of the chest and abdomenOTHER: No significant abnormality noted. | 1. Pulmonary metastases unchanged.2. Mediastinal lymphadenopathy unchanged.3. Left adrenal nodule unchanged in size and incompletely characterize on this examination. |
Generate impression based on findings. | Reason: 61-year-old male with history of bladder cancer status post radical cystectomy, please check for metastasis History: none ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. No evidence of tumor recurrence in the right nephrectomy bed. The left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Prominent lymph nodes in the retrocrural region, upper abdomen and retroperitoneum, stable since 2009.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy with intact neobladder. LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable abdominal lymph nodes. 2.Postsurgical change of cystoprostatectomy with intact neobladder and right nephrectomy. |
Generate impression based on findings. | Lung cancer poorly differentiated adenocarcinoma) liver mets no therapy yet. CHEST:LUNGS AND PLEURA: Centrally necrotic mass at the right hilum has enlarged, now causing mass effect upon the bronchus intermedius (7-mm in short dimension). The mass measures 5.2-cm in greatest dimension (coronal image 33), previously 4.3-cm. On axial series, the mass measures 3.6 x 4.3 cm, previously 2.5 x 2.7 cm, larger (3/48). Borders are spiculated, with tumor extension cranially into the upper lobe encasing the right main bronchus and its proximal segmental branches and caudally into the superior segment of the right lower lobe and its proximal segmental branches. The mass is inseparable from the right major and minor fissures and causes extrinsic compression upon the right descending pulmonary artery.Development of localized thickening of the undersurface of the right major fissure suspicious for a very small infarct. Absence of beading of the leading vessel argues against tumor embolism.Apical emphysema. Subsegmental atelectasis left lung base. Subpleural micronodules right middle lobe too small to characterize, possibly an intrapulmonary lymph node. Subpleural lipoma on the right.MEDIASTINUM AND HILA: Normal heart size. No pericardial fluid. Right hilar lymphadenopathy 19 mm, previously 18-mm (3/45). Small but similarly enhancing lymph nodes in the lower paratracheal spaces bilaterally (3/35), unchanged but suspicious for nodal metastases. Subcarinal lymphadenopathy is now indistinguishable from adjacent tumor. Lobar level lymphadenopathy adjacent to the right middle and lower lobe airways, slightly larger but remain less than 1cm. Segmental level lymphadenopathy in the right lower lobe (3/60) is unchanged.Extrinsic compression of the right descending pulmonary artery by hypoattenuating tumor.CHEST WALL: Subcentimeter low right cervical lymph nodes. Hypoattenuating intramuscular metastasis in the right shoulder is larger (3/12). Right sixth rib metastasis visible on PET is not appreciated.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Metastases in the right hepatic lobe increased in size and number. Largest lesion measures 3.6 x 4.2 cm (3/27), previously 2.4 x 2.1 cm. Thickening and enhancement of the adjacent abdominal musculature noted (3/121).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Several metastatic nodules on the left adrenal gland increased in size. Largest lesion measures 2.4 x 1.6 cm (3/86), previously 2.7 x 1.2 cm. Right adrenal gland now appears slightly nodular (3/97), suspicious for an underlying metastasis.KIDNEYS, URETERS: Left renal cysts. Hypoattenuating lesions too small to characterize unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Eccentric mural thrombus in the abdominal aorta. Fascial planes in the adjacent to the liver and right colon are thickened and nodular. In addition, the bowel in the right lower quadrant has poorly defined margins; these findings are suspicious for peritoneal metastases.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Persistent localized thickening of the duodenum incompletely assessed but suspicious for an underlying mass (coronal image 52, axial image 116).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in size of right lung mass as detailed in the body of the report. Tumor now causes mass effect on the bronchus intermedius, consider Pulmonary Medicine consultation for stent placement if clinically warranted. Metastases in the abdomen have increased in size and number. |
Generate impression based on findings. | Female; 28 years old. Reason: eval for PE and interval progression of airway compression History: dyspnea, tachycardia. PULMONARY ARTERIES: No evidence of pulmonary embolism. Top normal main pulmonary trunk diameter.LUNGS AND PLEURA: Innumerable pulmonary nodules of varying size are consistent with metastatic disease. These appear to be mildly decreased in size and extent since the prior dedicated chest CT. Specifically, right upper lobe subpleural nodule in right costophrenic angle measures 1.1 cm, previously 1.5 cm (series 12, image 58). Additional subpleural nodule in right costophrenic angle now measures 0.6 cm, previously 0.9 cm (series 12, image 83). No focal airspace opacity or pleural effusion. MEDIASTINUM AND HILA: Extensive confluent mediastinal and hilar lymphadenopathy has mildly regressed since the prior study. Specifically, mass like lymphadenopathy to the right of the aortic arch now measures 3.8 x 3.0 cm, previously 6.3 x 5.5 cm, with resultant interval expansion of the airway (series 9, image 72). There is persistent mild narrowing of the distal left mainstem bronchus secondary to hilar lymphadenopathy (series 80868, image 48). Normal heart size without pericardial effusion. CHEST WALL: Right IJ venous catheter tip at the cavoatrial junction. No suspicious osseous lesions. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Several hypodense liver lesions are compatible with additional metastatic disease. Perisplenic fluid and nodular soft tissue between the spleen and abdominal wall are poorly characterized but again noted and also suggestive of additional metastatic disease. | 1.No evidence of pulmonary embolism. 2.Mild interval improvement in pulmonary and lymph node metastases as detailed above, with resultant expansion of the affected airway. Persistent residual narrowing of the distal left mainstem bronchus secondary to lymphadenopathy is noted. |
Generate impression based on findings. | Male 27 years old; Reason: 27 yr old male with h/o NHL; re-evaluation History: Evaluate CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Partially calcified anterior mediastinal and mediastinal lymph nodes are unchanged. The reference node measures 1.8 x 1.4 cm (image 34/series 3) previously, 1.8 x 1.8 cm.CHEST WALL: No new lymphadenopathy is evident.OTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal scarring and lobulations are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right acetabular lesion larger on the left is unchanged.OTHER: No significant abnormality noted | 1.Slight decrease in the partially calcified mediastinal nodes.2.No evident change in the left superior acetabular lesion. |
Generate impression based on findings. | Male; 59 years old. Reason: recurrent skin cancer History: s/p surgery and RT Post surgical change is redemonstrated in the left neck including soft tissue volume loss, partial resection of the left parotid gland, and infiltration/scarring of the fat planes. Evidence of a left neck dissection is also seen as well as mild scarring in the submental and anterior neck soft tissues. Within the residual left superior parotid gland, previously described focus of soft tissue is no longer seen. No new soft tissue mass or pathologic enhancement is seen within the surgical bed.No pathologic adenopathy is identified in the neck. Reference left subclavicular node is no longer discretely seen. Right level 2 lymph node measures 5 x 4 mm, previously 6 x 5 mm (image 64, series 4).The right parotid gland and submandibular glands are unremarkable. The thyroid is unremarkable. Cervical vessels remain patent. Lung apices are unremarkable with the exception of mild cystic change. Numerous calcified mediastinal lymph nodes are redemonstrated. No suspicious osseous lesions. | 1. Stable postsurgical change in the neck without evidence of residual or recurrent disease.2. No pathologic adenopathy in the neck. |
Generate impression based on findings. | Reason: h/o recurrent skin cancer History: r/o lung mets LUNGS AND PLEURA: Benign-appearing pulmonary micronodules are unchanged.Pleural thickening with calcification is consistent with prior asbestos exposure. Adjacent consolidation in the left lower lobe has improved and may be related to the pleural thickening such as evolving rounded atelectasis.Status post bilateral lung transplant. MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes are present, but there is no other sign of lymphadenopathy.Surgical clips are seen in the mediastinum and hila. Bilateral bronchial stents are seen.Right jugular central line terminates in the SVC.CHEST WALL: Clamshell sternotomy for lung transplant.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Pancreatic mass and calcifications are present as well as atrophic kidneys with cysts. | Improving left lower lung zone consolidation. There is no evidence of metastases. Status post bilateral lung transplant. |
Generate impression based on findings. | Reason: intra-abd bleed History: same ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: Bilateral pleural effusions. Right lower lobe consolidation and alveolar opacities. Left lower lobe patchy interstitial disease.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Hyperdense focus in the mesentery with fluid fluid levels consistent with new bleed. Mesenteric hematoma measures 12.3 x 5.8 cm. Large amount of ascites. Postoperative changes of the bowel in the right hemiabdomen.BONES, SOFT TISSUES: Extensive osseous lytic lesions with vertebral compression factors.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Decompressed bladder with Foley catheter.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Hyperdense blood suggesting layering of acute blood product. There is also moderate to large amount of pelvic ascites. Mild amount of intraperitoneal air may be residual air from recent surgery.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.New mesenteric hematoma with fluid fluid levels and layering of blood in the pelvis. 2.Free intraperitoneal air likely secondary to recent surgery.3.Large volume of ascites.4.Right lower lobe consolidation with alveolar opacities likely aspiration pneumonia. Small bilateral pleural effusions.Findings were discussed with the clinical service over phone by Dr. Alexander. |
Generate impression based on findings. | Pancreatic cancer. Status post Whipple. New baseline scan. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Small mediastinal lymph nodes reference purposes, precarinal and measures 1.5 x 1.0 cm (image 34; series 3). Coronary artery calcifications. Small hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Two subcentimeter hypodense liver lesions probably represent cysts but should be followed. These have not changed since the prior examination. One is located in the caudate and the second adjacent to the right portal vein (image 9; series 3). Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Presumed ventral hernia repair.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Iliac stents appear patent. 7.6 x 6.7 cm cystic nodule in the region of the left adnexa is unchanged. 1.5-cm right adnexal cyst is unchanged. | Small mediastinal lymph nodes. Unchanged fluid collection in the left pelvis, possibly representing a lymphocele or adnexal cyst. |
Generate impression based on findings. | Male 65 years old Reason: eval for PE History: dyspnea, tachycardia, malignancy PULMONARY ARTERIES: Technically adequate study. No filling defects to suggest PE.LUNGS AND PLEURA: Bibasilar atelectasis right greater than left with a small amount of associated right basilar consolidation. No pulmonary nodules or masses suspicious for metastatic disease. Minimal emphysema.MEDIASTINUM AND HILA: No evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest wall Port-A-Cath.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Innumerable hypodense hepatic lesions consistent with metastatic disease better characterized on the dedicated abdominal CT from the same day.Several prominent retroperitoneal lymph nodes unchanged. | 1. No evidence of pulmonary embolism.2. Bibasilar atelectasis with a small amount of associated right-sided consolidation.3. Innumerable hepatic metastases unchanged. |
Generate impression based on findings. | Male, 66 years old, status-post fall. Subdural hemorrhage along the right frontal lobe has progressed mildly in craniocaudal extent. For example, this collection now measures 27 mm in the CC dimension, previously 20 mm. The collection is stable in thickness at 5 mm.Subdural hemorrhage along the left frontal lobe has not significantly changed in quantity or extent.Subarachnoid hemorrhage is more prominent within the right sylvian fissure. Subarachnoid hemorrhage along the cerebral peduncles may be minimally more prominent, but this could also be related to technique.Otherwise, no new parenchymal abnormalities are detected. There is no evidence of significant generalized mass effect or midline shift. No intraventricular hemorrhage is seen at this time. The ventricular caliber is within normal limits.Lucency is evident within the right parietal bone immediately adjacent to one of the sites of subdural hemorrhage. | Mild interval expansion of a right frontal subdural hematoma. It also appears that subarachnoid hemorrhage within the right sylvian fissure has increased as well. Subarachnoid blood at the level of the cerebral peduncles is questionably more prominent. A subdural hematoma along the left frontal lobe is stable.Lucency within the right parietal bone likely reflects myelomatous disease. This lesion is immediately adjacent to one of the sites of subdural hemorrhage.Findings discussed with Dr. Levin at 1544 hrs on 9/27/13. |
Generate impression based on findings. | Male, 66 years old, status-post fall. History of multiple myeloma per the medical record. Mild straightening of the cervical lordosis is demonstrated. There is a grade 1 anterolisthesis of C7 relative to T1. This is secondary to advanced facet hypertrophy at these levels. Alignment is otherwise anatomic.There is mild degenerative loss of height of the C5 and C6 vertebral bodies. No evidence of any acute fracture is seen.Central compression and sclerosis of the T3 vertebral body is a stable finding. Areas of lucency are demonstrated through most of the cervical and upper thoracic vertebral bodies and posterior elements. Lucency is also present within the T4 spinous process with lysis and expansion of the right T4 transverse process and significant expansion/destruction of the proximal right T4 rib. There is a large chest wall based mass at this location which is incompletely evaluated. Most of the other visualized ribs demonstrate some degree of mottling, though none is as frankly destroyed as the right T4 rib.A disk-osteophyte complex is present at C5-6 which at least partially effaces the thecal sac. Scattered foraminal narrowing is demonstrated, most severely affecting the C5-6 and C6-7 levels.A pleural effusion is demonstrated on the right. Emphysema is seen in the lung apices.The right thyroid lobe is significantly enlarged and heterogeneous, containing small areas of calcification. | 1. No evidence of acute cervical spine fracture or dislocation.2. Numerous bony lesions consistent with a history of multiple myeloma are demonstrated through the visualized spine. In addition, there is a large pleural-based right chest wall mass with significant associated destruction of the right fourth rib.3. Enlargement and heterogeneity of the right thyroid, which could be better assessed on ultrasound if clinically warranted.Findings discussed with Dr. Levin at 1544 hrs on 9/27/13. |
Generate impression based on findings. | Male; 74 years old. Reason: T4N0M0 laryngeal SCC s/p CRT with salvage laryngectomy 7/6/2005 now with tonsillar/BOT SCC s/p resection. Now s/p adjuvant TFHX 4.5/4.5 cycles completed 5/8/13. CHEST:LUNGS AND PLEURA: There are no suspicious pulmonary nodules or masses. 3-mm right lower lobe micronodule is unchanged (series 5, image 85). Mild apical and basilar scarring without focal air space opacity or pleural effusion.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Calcified mediastinal lymph nodes indicate prior granulomatous infection. Left central venous catheter tip in SVC. Mild aortic arch and coronary calcifications.CHEST WALL: Previously noted right axillary and subpectoral lymphadenopathy is less prominent than on prior CT and likely reactive in nature. Healed fracture of lateral right 10th rib.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Scattered splenic granulomata.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large exophytic right lower pole renal cyst is unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild multilevel degenerative disease affects the visualized spine. OTHER: Dense abdominal aortic calcifications. | No evidence of metastatic disease. |
Generate impression based on findings. | Renal cell carcinoma Restaging scans 1.5 years after nephrectomy. Assess for metastatic disease. CHEST:LUNGS AND PLEURA: Mild upper lobe predominant centrilobular paraseptal emphysema. Chronic appearing interstitial thickening, unchanged. Mild basilar predominant bronchiectasis. Left apical ground glass opacity, not significantly changed. Previously described pleural effusions have resolved.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy, not significantly changed. Reference high right paratracheal lymph node measures 2.0 x 1.5 cm (series 4, image 32), unchanged. Left ICD and leads, unchanged. Cardiomegaly, unchanged. Post surgical changes of coronary artery bypass. Extensive aortic valvular, native coronary artery, and thoracic aortic calcifications.CHEST WALL: Sternotomy hardware.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of acute cholecystitis. Heterogeneous enhancement of the liver. Small amount of suprahepatic free fluid.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy. Left inferior pole renal cyst has decreased in size.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the spine. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the spine. OTHER: Small amount of free pelvic fluid has resolved. Left inguinal surgical clips. Atherosclerotic calcification of the abdominal aorta and its branches. | Resolved bilateral pleural effusions. Otherwise stable examination with measurements given above. |
Generate impression based on findings. | Reason: 50 pack year smoking history, dyspneic on exertion, r/o nodule, assess for emphysema History: SOB LUNGS AND PLEURA: Mild to moderate upper lobe centrilobular emphysema.Left anterolateral subpleural fibrosis from prior radiation treatment for breast cancer.No pulmonary nodules identified, except for scattered benign appearing punctate micronodules. MEDIASTINUM AND HILA: Surgical clips are present in the thyroid region.There is no mediastinal or hilar lymphadenopathy.CHEST WALL: Left axillary surgical clips are present.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Prominent adrenal glands and a small accessory splenule. | Mild/moderate centrilobular emphysema, but no pulmonary nodules. |
Generate impression based on findings. | Female; 51 years old. Reason: assess disease progression History: lung cancer. CHEST:LUNGS AND PLEURA: Postsurgical changes compatible with right upper lobe wedge resection and left lower lobectomy are again noted. Dense right apical consolidation measures 6.5 x 3.0 cm and is not significantly changed in size, previously measuring 6.0 x 2.9 cm (series 5, image 29). There is a new convexity in the anterior/inferior aspect of this consolidation. However, there has been mild interval decrease in surrounding ground glass opacity in a previously seen solid component anterolaterally at the level of the arch.Consolidation within the right middle lobe with central cavitation demonstrates mild interval decrease in solid component which measures 4.2 x 1.2 cm, previously 4.1 x 2.4 cm (series 5, image 47). MEDIASTINUM AND HILA: Normal cardiac size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant interval change in enhancing lesions in the right hepatic lobe, most suggestive of hemangiomas.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted. | Mixed response in right hemithorax disease. |
Generate impression based on findings. | Abdominal or pelvic swelling, mass, or lump, generalized The lack of intravenous contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Status post left hepatic lobe wedge resection.SPLEEN: Top normal size.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction. Appendix is unremarkable. No pneumatosis intestinalis, free intraperitoneal air, or free fluid in the abdomen/pelvis.BONES, SOFT TISSUES: Small fat containing umbilical hernia. Soft tissue density in the anterior subcutaneous soft tissues compatible with injection sites.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: Eval left adrenal and adnexal nodules seen in Feb, 2013 History: 64F with breast cancer and indeterminate findings on initial workup CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules.No suspicious nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Reference right paratracheal lymph node measures 1.1 x 0.7 cm (series 8, image 31), previously 1.6 x 1.0 cm. Heart size is normal. Coronary artery calcifications.CHEST WALL: Status post left mastectomy and axillary dissection. No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Accessory splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Indeterminate left adrenal nodule measures 1.6 x 1.4 cm (series 8, image 94), unchanged.KIDNEYS, URETERS: Left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Left adnexal lesion measures 5.6 x 4.4 cm (series 8, image 176), previously 5.7 x 4.6 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Status post left mastectomy and axillary dissection.2.Indeterminate left adrenal nodule, unchanged.3.Left adnexal lesion, unchanged. Pelvic ultrasound should be considered as clinically warranted. |
Generate impression based on findings. | Reason: T4N0M0 laryngeal SCC s/p CRT with salvage laryngectomy 7/6/2005 now with tonsillar/BOT SCC s/p resection now s/p adjuvant TFHX 4.5/4.5 cycles completed 5/8/13. History: as above The patient is status post laryngectomy and tracheostomy placement with stoma. The sternocleidomastoid muscles are atrophic bilaterally. The trapezius muscles are atrophic bilaterally. There are surgical clips along the right neck and. There is soft tissue thickening surrounding the right and the left carotid space especially in the suprahyoid neck the patient is status post right-sided myocutaneous flap placement a periodWithin the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses demonstrate opacification of the left maxillary sinus with thickening of the walls of left maxillary sinus compatible chronic sinusitis . The mastoid air cells demonstrate minor opacities in the right mastoid air cells.The parotid and the submandibular glands appear intact. The submandibular glands are atrophic.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. The patient is status post laminectomies at C3, C4, C5, C6 and is status post anterior fusion at C5 and C6. There are endplate osteophytes and uncovertebral osteophytes at C3-4 there is bilateral neural foramen encroachment. To a lesser degree there is neural foramen encroachment at C4-5 due to uncovertebral osteophytes. This is relatively stable compared to prior exams. | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.teslas head and neck surgery with soft tissue thickening in the right neck related to post treatment change compared3.chronic sinusitis |
Generate impression based on findings. | Reason: Eval right frontal bone lesion on bone scan History: 64F with breast cancer and indeterminate findings on initial workup There is a 5 x 6 mm sagittal dimension and the 5 x 60 mm coronal dimension lesion along the inner aspect of the right frontal calvarium. It is somewhat expansile and has an ill-defined inner margin.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is a right frontal bone calvarial lesion present . Given the patient's clinical history, metastasis cannot be excluded2.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: please evaluate for subdural hemorrhage, hematoma. and evidence of icp History: R parietal skull fracture The CSF spaces are appropriate for the patient's stated age with no midline shift. There is subcutaneous soft tissue thickening present along the right parietal scalp tissues measuring 4 mm in thickness. There is no evidence for associated coup or contra coup injury. There is an underlying linear calvarial fracture present involving the right parietal boneNo abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is right parietal bone nondisplaced calvarial fracture present without associated intracranial hemorrhage2.Findings were discussed with resident Dr Jermain from the ER at the time of this interpretation |
Generate impression based on findings. | Pain. Prior right talar neck fracture with resulting subtalar joint arthritis. There is increased density with associated linear components along the lateral aspect of the talar dome. Otherwise, the talar dome is intact without evidence of fracture or collapse with a symmetric mortise. Early AVN is suspected.There is severe degenerative arthritic changes of the subtalar joint including near bone on bone apposition, bulky osteophytes, and subchondral cysts extending into the talus, most prominently at the middle and posterior calcaneal facets. The anterior facet is mostly spared. Note is a made of a small bone island in the anterior calcaneus. The remaining visualized bones of the anterior foot are unremarkable. There is mild, diffuse soft tissue swelling and fat stranding without a discrete fluid collection or effusion. No additional soft tissue abnormalities are observed. | Findings most suspicious for early AVN of the talus with hindfoot degenerative changes as described above. Specifically, there are no findings to support coalition. |
Generate impression based on findings. | Male 61 years old; Reason: recent surgery with abd pain, partial obstruction? History: abd pain, anorexia ABDOMEN:LUNGS BASES: Calcifications in the right lung base. These might be in the pleural space.LIVER, BILIARY TRACT: Liver has a smooth contour. Hepatic vasculature are patent. No biliary ductal location.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Post operative changes in the colon. No bowel obstruction is evident. BONES, SOFT TISSUES: Anterior abdominal scar.OTHER: No upper abdominal fluid collections.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic anastomosis in the pelvis. Fluid fluid levels within the colon indicate a diarrheal state.BONES, SOFT TISSUES: Nonspecific lucent foci in the ileum bilaterally.OTHER: No pelvic fluid collections. | 1.Fluid levels in the colon indicate a diarrheal state.2.No bowel obstruction or fluid collections.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 35 years old; Reason: LLQ palpable, very mobile mass not seen on ultrasound - please take liberty to change exam to CT abdo/pelvis if warranted to image the area where mass is. History: palpable mass, tender ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver has a smooth contour. Hepatic vessels are patent. No suspicious hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis or focal renal mass.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Right adnexal cystic lesion is thin-walled measures 3.8-cm. A more thicker wall left adnexal cystic lesion measures 2.9-cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course ; colon is not distended. No colonic diverticulitis is evident.BONES, SOFT TISSUES: No body wall hernia.OTHER: No pelvic fluid collections. | 1.Bilateral cystic adnexal lesions may be physiologic cysts in a premenopausal female. |
Generate impression based on findings. | Female 42 years old; Reason: evaluate acute right lower quadrant pain (14 days post-ob from endometrial ablation) History: acute right lower quadrant pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No nephrolithiasis or hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes. No retroperitoneal hematoma is evident.BOWEL, MESENTERY: Small bowel is normal in caliber. Terminal ileum is unremarkable. Appendix is normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Heterogeneous uterus is suboptimally evaluated by noncontrast CTBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No pelvic fluid. | 1.Etiology for the patient's right lower quadrant pain is not evident.2.No fluid collections. |
Generate impression based on findings. | Female 66 years old; Reason: pt with colon cancer, please evaluate for metastasis History: pt with colon cancer, please evaluate for metastasis CHEST:LUNGS AND PLEURA: Chronic changes in the right lung with volume loss and subpleural fibrotic changes anteriorly.No dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion . Extensive calcified hilar lymph nodes.CHEST WALL: Calcification of the right breast prosthesis. Elevation of the right hemi-diaphragm. Extensive lytic lesions throughout the thoracic spine and ribs.ABDOMEN:LIVER, BILIARY TRACT: Large left hepatic lobe metastatic deposit measuring 8.5 x 6.0 cm (image 84/series 3). Hepatic vasculature are patent. Mild left hepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple cysts in the right kidney. Some of these cysts are complex. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive small lytic foci in the osseous structures. Hemiatrophy of the left body wall musculature.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient's colonic malignancy is not evident by CT. No bowel structureBONES, SOFT TISSUES: Extensive osseous lytic lesions.OTHER: No significant abnormality noted. | 1.Large left hepatic lobe metastases.2.Extensive lytic lesions throughout the osseous structures. The findings are more suggestive of multiple myeloma or an infiltrative malignancy although uncommonly extensive colonic metastatic disease can have a similar appearance. A bone marrow biopsy may be needed for diagnosis. |
Generate impression based on findings. | Male 63 years old; Reason: eval liver pathology, diaphragmatic involvement History: intractable hiccups, n/v ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver has a smooth contour. It is unremarkable for unenhanced technique. No perihepatic fluid collections are evident.Status post cholecystectomy.SPLEEN: Spleen is normal in size. No peri-splenic collections.PANCREAS: Fatty atrophy of the pancreas. No peripancreatic fluid collections.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy in the pelvis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No perihepatic or perisplenic collections to account for the patient's hiccups. |
Generate impression based on findings. | Female 33 years old; Reason: h/o mitotic leiomyoma History: new right lower quadrant pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No suspicious hepatic lesions. Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Small bowel is normal in caliber and course. Copious amount of fecal matter within the distended rectum suggests constipation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Probable left adnexal corpus luteal cyst. The large mass emanating from the uterus has been resected.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evident metastatic disease.2.Findings suggestive of constipation with distention of the rectum. |
Generate impression based on findings. | Male 49 years old; Reason: punctate lesions in spleen on ultrasound, please evaluate further History: punctate lesions in spleen on ultrasound, please evaluate further ABDOMEN:LUNGS BASES: Please see chest exam.LIVER, BILIARY TRACT: Liver is enlarged measuring over 20 cm in craniocaudal dimension. The hepatic veins are dilated likely from heart failure.Gallbladder wall is edematous likely from heart failure The portal vein is patent. No biliary ductal dilatation.SPLEEN: Spleen is enlarged measuring 16 cm in greatest, dimension. Subcentimeter hypodense lesion (image 35/series 12) is too small to characterizePANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys with multiple cysts.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymph nodesBOWEL, MESENTERY: Small bowel is normal in caliber. No significant ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Hepatic and splenomegaly.2.Gallbladder wall edema possibly from heart failure as there is no significant pericholecystic fluid.3.Dilated hepatic veins likely from heart failure. |
Generate impression based on findings. | 79-year-old male status post aortic femoral bypass in September 2007, evaluate native aorta for progression/aneurysmal change. Reason: eval graft History: dissection repaired 6 yr ago here, fall with blunt chest trauma CHEST:LUNGS AND PLEURA: Mild diffuse emphysematous change is seen. There is basilar atelectasis and scarring. Scattered calcified granulomas are noted in the lung.MEDIASTINUM AND HILA: The ascending thoracic aorta measures 4.2 x 3.8 cm. There is noncalcified and calcified atherosclerotic change of the descending thoracic aorta. No significant change since 2009. Diffuse coronary artery calcifications. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Few nonobstructive calculi are seen in the left kidney.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic change of the abdominal aorta is seen. There is patent aortobifemoral bypass graft. The infrarenal abdominal aorta aneurysmal sac is stable in size since 2009. The native distal aorta is occluded with reconstitution in the left common iliac artery and bilateral internal and external iliac arteries, all of which show extensive atherosclerotic change. Accessory right renal artery is redemonstrated as well as early branching of left renal arteryBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Scattered colonic diverticulosis is seen. Calcification in the appendix is seen, no surrounding inflammatory change is noted.BONES, SOFT TISSUES: Small fat containing left inguinal hernia.OTHER: No significant abnormality noted | No significant change since 2009. No aortic dissection. Status post aortobifemoral graft placement without endoleak. |
Generate impression based on findings. | 31 year old female. Reason: assess for clot. Status post right PCNL placement on 8/30/13. s/p R percutaneous stone removal. Dropping hemoglobin. Rule out retroperitoneal hematoma. 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: Radiodense collection in the dorsum of the right native kidney measures up to 2.7 x 4.2 cm at image 57 of series 3 compatible with a subcapsular hematoma. Nephroureteral double pigtail stent in the right renal collecting system. Punctate calcification in the left renal hilum is nonobstructing.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A percutaneous drain enters the peritoneum at axial image 95 of series 3 in the mid pelvis and extends cranially into the perihepatic region. A small amount of subcutaneous air is present in the anterior abdominal wall, compatible with history of a recent percutaneous nephrolithotomy procedure. There is a small air bubble and probable small subcutaneous extraperitoneal hematoma in the supraumbilical region at axial image as 63 of series 3.OTHER: No other evidence of retroperitoneal hematoma.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Right ureteral stent extends to the urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid is present, probably physiologic. | Expected PCNL postop changes. Subcapsular left renal hematoma. |
Generate impression based on findings. | 83 year old female. Reason: eval acute intraabd process History: upper abd pain, recent dx diverticulitis at OSH, distention ABDOMEN:LUNG BASES: Bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The uterus is absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis of the sigmoid and descending colon without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: Diffuse atherosclerotic calcifications of the aorta and major branches. | Diverticulosis without diverticulitis. |
Generate impression based on findings. | 82 year old female. Reason: ESRD patient s/p femoral line with hypotension and anemia. Eval for retroperitoneal bleed. History: hypotension ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Left lower lobe consolidation and volume loss. Transvenous pacemaker lead in the right ventricular apex.LIVER, BILIARY TRACT: A hydropic gallbladder measures more than 8 cm in length. Vicarious excretion of iodinated contrast in the gallbladder.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Diffusely ectatic abdominal aorta up to 2.5 cm in diameter. Diffuse atherosclerotic calcification of the aorta and major branches.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Wedge deformity of the L5 vertebral segment, probably osteoporotic fracture. No retroperitoneal hematoma.OTHER: Surgical dressing at the right groin. A large diameter right-sided catheter extends through the iliac veins to the IVC. | No retroperitoneal hematoma. Right femoral venous catheter terminates in the IVC. Moderate bilateral pleural effusions. Left lower lobe consolidation and volume loss. |
Generate impression based on findings. | 31 year old female. Reason: eval for evidence of appy History: RLQ abd 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 notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse colonic wall thickening involving the descending colon. The terminal ileum may be spared. The appendix appears normal (image 99 series 3). Differential considerations include infectious colitis or inflammatory bowel disease.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Descending colon and cecum wall thickening and adjacent fat infiltration compatible with infectious colitis or inflammatory bowel disease.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | The ascending colon and cecum wall thickening may be due to infectious colitis or inflammatory bowel disease. Normal appendix. |
Generate impression based on findings. | 65 year old male. Reason: Large clinically T3 invasive bladder mass, please assess for metastatic disease. ABDOMEN:LUNG BASES: Small amount of right sided dependent pleural thickening.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Fatty infiltration of the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in a decompressed urinary bladder. Questionable bladder wall thickening.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: Nodular ill-defined densities just anterior to the proximal common iliac arteries of unknown significance. No definite abnormality at this site on the outside 9/20/2013 exam. Otherwise, there is no definite adenopathy present. | No definite evidence of metastatic disease. |
Generate impression based on findings. | 32 year old male. Reason: stone vs appy History: 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 noted. No renal stones. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Normal appendix. No evidence of obstruction. No free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No acute abnormality to explain abdominal pain. No renal stone. Normal appendix. |
Generate impression based on findings. | 54 year old male. Reason: eval for abscess History: LLQ pain. Crohn's disease, perirectal fistulas. ABDOMEN:LIVER, BILIARY TRACT: Diffusely decreased signal of the liver likely represents iron deposition from prior blood transfusion.SPLEEN: Nonspecific splenic cyst.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Moderate right hydronephrosis is present with dilation of the proximal ureter up to where it crosses the right psoas muscle has been present since the prior MRI exam, without change. This is likely partially obstructed due to fibrosis/adhesions from the patient's Crohn's disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post subtotal colectomy. A network of enteroenteric fistulas is seen in the pelvis unchanged since the MRI exam. Diffuse inflammation in the adjacent small bowel. The bowel loops are dilated in this region indicating ongoing chronic partial obstruction.Persistent dilated small bowel loops are seen in the lower abdomen consistent with chronic partial small bowel obstruction.Abscess in the right abdominal side wall measuring 1.6 x 2.7 cm (image 113, series 3).Short segment stricture at the ileocolonic anastomosis is also noted. BONES, SOFT TISSUES: L1 and L2 spinal hemangiomas.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: A small amount of air is seen within the bladder. A fistulous tract is seen extending from the small bowel to the anterior bladder. There is a small abscess in the prevesical soft tissue at image 123 of series 3 that measures 1.4 x 1.7 cm. LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 2 cm diameter calcific density in the right lower quadrant at image 98 of series 3 may be retained barium contrast within a fistula that extends to the anterior prevesical space. This was present on the prior MRI examination. Small right perianal trans-sphincteric fistula seen ascending from 7 o'clock position to the right buttock crease skin surface.BONES, SOFT TISSUES: No significant abnormality noted. | 1.Perianal, enterovesical, enteroenteric, and right abdominal wall fistulas were seen on prior MRI and persist, compatible with diagnosis of Crohn's disease.2.Small perianal abscess along the tract of the right perianal fistula.3.Small right abdomen wall abscess 4.Moderate right hydronephrosis with dilation of the proximal ureter up to where it crosses the right psoas muscle, likely due to post-inflammatory adhesions.5.Ileocolonic anastomosis short-segment stricture.6.Most prominent abscesses are in the prevesical space and right lower quadrant anterior abdominal wall. 7. Dilated small bowel in the left lower quadrant is due to chronic partial obstruction. |
Generate impression based on findings. | 23 year old female. Reason: h/o Polycyctic Kidney disease, rule out Nephrolithiasis History: Pain. Hypertension. 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: Bilateral polycystic kidneys with multiple small atypical cysts and numerous hypodense cysts. Multiple punctate pedunculi bilaterally. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Multiple punctate nonobstructing renal calculi bilaterally in polycystic kidneys without hydronephrosis or hydroureter. |
Generate impression based on findings. | 37 year old male. Reason: r/o appy History: periumbilical / RLQ pain. HIV +. 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 notedRETROPERITONEUM, LYMPH NODES: There is diffuse retroperitoneal lymphadenopathy, especially in the periaortic region. For reference, there is a 1 x 1.8 cm lymph node in the left periaortic region at and image 65 of series 3. Some of this adenopathy may be reactive and related to the patient's diverticulitis and abscess.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulitis involving the sigmoid colon with an abscess that measures 2.2 x 2.5 cm at image 101 of series 3. No perforation. There is associated wall thickening and adjacent fat stranding.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Diverticulitis of sigmoid colon with abscess. No free air. Retroperitoneal lymphadenopathy. |
Generate impression based on findings. | 61 year old female. Reason: rule out aortic dissection. History: shoulder pain CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted. The aorta has normal caliber and taper. No aortic dissection. No aortic aneurysm.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Hypodense enlarged left adrenal is compatible with a benign adenoma measuring 3 cm in diameter.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. No bowel obstruction or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: The aorta has normal caliber and taper. There are diffuse atherosclerotic calcifications of the aorta and major branches. No aortic dissection. No aortic aneurysm.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: No aortic dissection. The iliac and femoral arteries are widely patent bilaterally. | No aortic dissection. No aortic aneurysm. Left adrenal adenoma. No bowel obstruction or free air. |
Generate impression based on findings. | Male; 49 years old. Reason: r/ o PE in the setting of severe pulm HTN History: SOB. PULMONARY ARTERIES: No evidence of pulmonary embolism. Enlarged pulmonary trunk diameter is compatible with pulmonary arterial hypertension.LUNGS AND PLEURA: Right upper lobe airspace/interstitial opacities are most compatible with infection, with asymmetric edema and hemorrhage being less likely. Small right pleural effusion.MEDIASTINUM AND HILA: Severe cardiomegaly with enlarged right heart. Moderate pericardial effusion. Mild coronary calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Reflux of contrast into the IVC is compatible with right heart strain. Cholelithiasis. Punctate right renal calculi. Atrophic kidneys. | 1.No evidence of pulmonary embolism.2.Findings compatible with pulmonary hypertension and right heart enlargement. 3.Pulmonary findings are most compatible with right upper lobe pneumonia; asymmetric edema and hemorrhage are secondary diagnostic considerations. |
Generate impression based on findings. | Male; 42 years old. Reason: PE? History: h/o pe, noncompliant with coumadin, tachycardic, hypoxic. Motion artifact and contrast dilution limits diagnostic sensitivity.PULMONARY ARTERIES: No evidence of pulmonary embolism to the lobar level. Filling defect within the right lower lobe branch artery is likely artifactual on series 8, image 178. Enlarged main pulmonary trunk diameter is compatible with pulmonary hypertension.LUNGS AND PLEURA: Mild basilar atelectasis/scarring. No focal air space opacity or pleural effusion. Calcified granuloma in the left upper lobe. Subpleural nodule in the left upper lobe is likely benign, representing an intrapulmonary lymph node or scarring (series 9, image 43). There is a small 1 cm nodule near a vascular bifurcation in the right upper lobe, most likely benign considering patient age (series 10, image 111). MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Calcified hilar lymph nodes indicate prior granulomatous disease. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mild reflux of contrast into the hepatic IVC. No other significant abnormality noted. | 1.No evidence of pulmonary embolism to the lobar level. 2.Findings compatible with pulmonary arterial hypertension. 3.Small nodule at a vascular bifurcation in the right upper lobe is most likely benign, but follow-up with low dose CT protocol is recommended in approximately 6 months to confirm stability or resolution. The findings were discussed with Dr. Corboy in the ED at the time of reporting. |
Generate impression based on findings. | 67 year old male status post fall, evaluate for intracranial hemorrhage. VENTRICLES/CSF SPACES:Stable in size and appearance to the 2005 exam, is a prominent arachnoid cyst within the left middle cranial fossa resulting in a stable minimal rightward midline shift measuring approximately 6 to 7 mm. A drainage catheter extends into the arachnoid cyst from a small left temporal burr hole.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage.FLUID:No evidence of hemorrhage. No evidence of soft tissue hematoma.BONE:No fractures. Small left temporal burr hole for placement of drainage catheter is identified. There are small lucent lesions within the skull, given the patient's clinical history of multiple myeloma, these findings may represent myeloma lesions.PARANASAL SINUSES AND MASTOID AIR CELLS: The visualized paranasal sinuses and mastoid air cells are well aerated.ORBITS:The globes are intact. | 1.No evidence for acute intracranial hemorrhage, hematoma, or acute cortical stroke.2.Scattered ill-defined, poorly characterized lucent lesions within the skull which may be consistent with the clinical history of multiple myeloma.3.Stable appearing prominent arachnoid cyst within the left middle cranial fossa resulting in a stable minimal rightward midline shift measuring approximately 6 to 7 mm; stable from 2005. 4.A drainage catheter extends into the arachnoid cyst from a small left temporal burr hole. |
Generate impression based on findings. | 16-month-old with seizure. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal. Sinuses are clear. | No acute intracranial process. |
Generate impression based on findings. | 90 year-old with neck stiffness. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age. BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. There are calcifications of the basal ganglia bilaterally. There are moderate periventricular and subcortical hypodensities likely representing chronic small vessel disease.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS: Clear.ORBITS: Patient is status post bilateral intraocular lens change. | No acute intracranial process. |
Generate impression based on findings. | Male; 64 years old. Reason: PE? History: lung ca, tachycardic, sob. PULMONARY ARTERIES: Suboptimal exam due to motion artifact in the lower lung zones, but no reliable evidence of pulmonary embolism. LUNGS AND PLEURA: Postsurgical changes status post VATS and right upper lobe wedge resection, with small residual hydropneumothorax and loculated fluid extending into the fissures. Small bilateral pleural effusions, left greater than right. There remains a right upper lobe lesion which measures 2.4 x 2.3 cm and has the imaging appearance of the original right upper lobe mass (series 8, image 41). Left lower lobe nodule is unchanged and measures 10 mm (series 9, image 238). Previously seen right lower lobe nodule is not well visualized on this exam. MEDIASTINUM AND HILA: Normal heart size with small pericardial effusion. Mediastinal and hilar lymphadenopathy is not significantly changed since the prior CT. Specifically, right paratracheal lymph node is unchanged and measures 10 mm (series 7, image 74). Mild aortic and coronary calcifications.CHEST WALL: Stable appearance of osteolytic lesion causing partial collapse of T8 vertebral body, compatible with metastatic disease.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Bilateral renal cysts are again noted. There is thickening and nodularity of the left adrenal gland. Periaortic lymphadenopathy. | 1.Suboptimal exam due to motion artifact in the lower lung zones, but no reliable evidence of pulmonary embolism. 2.Postsurgical changes s/p VATS and wedge resection as described above, with persistent right upper lobe lung mass and thoracic lymphadenopathy. |
Generate impression based on findings. | 28-year-old with new onset seizure. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal. | Unremarkable head CT. |
Generate impression based on findings. | Male; 42 years old. Reason: chest pain, sob, and leg pain/swelling for 3 days. r/o PE. Suboptimal contrast opacification limits diagnostic sensitivity. PULMONARY ARTERIES: No evidence of pulmonary embolism to the first segmental level.LUNGS AND PLEURA: No focal air space opacity, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism to the first segmental level.2.No significant pulmonary or pleural abnormalities. |
Generate impression based on findings. | Male; 58 years old. Reason: PE? History: tachycardic, new hypoxia PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Mild upper lung zone predominant centrilobular emphysema. Streaky basilar opacities are new since the prior CT but most likely represent atelectasis/scarring and are less likely related to aspiration/infection. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Dense coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuating lesions in the left hepatic lobe likely represent benign cysts. Cholelithiasis. Hypodense left renal lesion is incompletely imaged but likely represents a benign cyst. | 1.No evidence of pulmonary embolism. 2.New streaky basilar opacities most likely represent atelectasis/scarring or may be related to aspiration/infection. |
Generate impression based on findings. | Male; 21 years old. Reason: Evaluate for cause of fever History: Persistent fevers, URI Sx LUNGS AND PLEURA: No focal air space opacity, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Low density blood pool compatible with anemia. CHEST WALL: Right chest port tip in SVC. No significant axillary lymphadenopathy. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No abnormal findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: 65 year old male with large clinically T3 invasive bladder mass, please assess for metastatic disease. LUNGS AND PLEURA: Diffuse dorsolateral right pleural thickening appears chronic. No acute infiltrates. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted. | No definite evidence of metastatic disease. |
Generate impression based on findings. | 30-year-old with new diagnosis of left laryngeal cancer, hoarseness. SOFT TISSUES:There is asymmetric soft tissue prominence involving the left true vocal cord with sclerosis of the adjacent arytenoid cartilage. LYMPH NODES:No evidence of enlarged lymph nodes by CT criteria or enlarged lymph nodes.GLANDS:The parotid, submandibular, and thyroid glands are unremarkable. BONES:Multilevel degenerative changes without suspicious osseous lesions. There is left maxillary sinus mucosal thickening.OTHER:The carotid arteries and jugular veins are patent. Centrilobular emphysema. | Asymmetric soft tissue prominence involving the left true vocal cord with sclerosis of the adjacent arytenoid cartilage. |
Generate impression based on findings. | 47-year-old with weakness and CVA. Noncontrast CT head:BRAIN PARENCHYMA:In the setting of underlying small vessel ischemic disease, there is a large acute infarction within the distribution of the right middle cerebral artery with effacement of the sulci. On the current study, there is no evidence of hemorrhagic conversion of this infarct.VENTRICLES/CSF SPACES:There is ex vacuo dilatation of the ventricles consistent with prior ischemic disease.EXTRA-AXIAL SPACE:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.CT angiogram of the head:The post bifurcation right internal carotid artery progressively decreases in lumenal flow enhancement through its distal cervical portion, into the skull base, and involving the cavernous segments, with irregularity of the vessel wall until it exits the cavernous sinus where it is no longer identified These findings are concerning for acute occlusion given the patient's clinical scenario. The right middle cerebral artery is not identified. The left internal carotid artery demonstrates mild atherosclerotic calcification, but otherwise is unremarkable. Contrast within the right anterior cerebral artery is likely from retrograde filling across the anterior communicating artery. The distal vertebral arteries, the basilar artery and the proximal left anterior, left middle, and posterior cerebral arteries are unremarkable. The anterior communicating artery is identified. The posterior communicating arteries are visualized and normal. The vertebral arteries are similar in size and unremarkable. | Large, non-hemorrhagic, acute infarction within the distribution of the right middle cerebral artery.Multifocal irregularity of the right internal carotid artery with absence of contrast within the distal right internal carotid artery and right MCA. Findings likely represent acute occlusion given the patient's clinical symptoms which may be from more inferiorly located dissection versus embolism. |
Generate impression based on findings. | 69 year old male. Reason: Metastatic adenocarcinoma: restaging CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesion. Scattered micronodules are unchanged. No pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Coronary artery calcification. CHEST WALL: Right chest wall port terminates at the distal SVC ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology. The hepatic lesions are less evident on the current exam. The right hepatic lobe reference lesion is not visible. Hepatic and portal veins are patent. The confluent mass extending from the gastric antrum to the liver across the gastrohepatic ligament is not definitely seen.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal lower pole cyst. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Reference retroperitoneal lymph node in the aortocaval region measures 1.1 x 0.7 cm (image 124/series 3).BOWEL, MESENTERY: Stable postoperative changes in the stomach from prior gastrojejunostomy. No bowel obstruction. The tumor in the antrum is not definitely seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No new lesions. Decrease in the size of the reference hepatic lesions and the gastric mass extending from the antrum to the liver. |
Generate impression based on findings. | 47 year-old with stroke. BRAIN PARENCHYMA:There is a large acute infarction involving the distribution of the right MCA as demonstrated on the prior CT angiogram and head CT. There is increasing edema, sulcal effacement, and mass effect on the body of the right lateral ventricle. No midline shift. VENTRICLES/CSF SPACES:Worsening mass effect on the body of the right lateral ventricle. No midline shift. FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal. | Large non-hemorrhagic acute infarction within the distribution of the right MCA with worsening edema, sulcal effacement, and mass effect on the body of the right lateral ventricle. |
Generate impression based on findings. | 67 year old male. Reason: Any evidence for metastatic disease from colon cancer? History: 1.5 cm sessile benign-appearing sessile polyp removed from the ascending colon at colonoscopy on 9-16-13 showed invasive adenocarcinoma. ABDOMEN:LUNG BASES: Status post median sternotomy. Coronary artery calcifications. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted. Probable splenules in the left upper quadrant. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large hiatal hernia. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral fat-containing inguinal hernias. | No measurable metastatic disease. |
Generate impression based on findings. | 56-year-old female with MGUS and lambda light chain amyloidosis. Reason: please evaluate for etiology of hematuria. please perform a CT urogram that includes non-contrast, arterial phase, and delayed images. History: 56 yo F who occasionally passes urinary clots ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Nonspecific hypodensity in the left lobe of the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted. No renal calculi. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Metallic density at the cecal tip. No appendix. No other significant abnormality. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No CT findings to indicate a lymphoproliferative disease process or to explain the patient's hematuria. No significant change since 2/12/2013. |
Generate impression based on findings. | Female; 48 years old. Reason: 48 y/o with lymphoma and sarcoidosis with persistent fevers of unknown origin, further imaging for infection v lymphoma progression v sarcoidosis. LUNGS AND PLEURA: Innumerable ground glass and solid nodules of varying size are noted, and are larger and predominate in the lung bases. Cavitation is present in at least one nodule measuring 22 x 19 mm (series 6, image 35). Thickening of interlobular septa is also seen. Lower zone predominance of nodules and presence of cavitation favor pulmonary lymphoma over sarcoidosis. Multifocal infection is also possible but seems less likely. MEDIASTINUM AND HILA: There is extensive mediastinal and hilar lymphadenopathy compatible with sarcoidosis and/or lymphoma. Low right paratracheal lymph node measures 25 mm in short axis (series 4, image 26). However, no significant airway compromise is noted. Normal heart size with mild pericardial thickening.CHEST WALL: Right central venous catheter in the SVC. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Mildly enlarged gastrohepatic and periaortic lymph nodes (series 4, image 93). | Severe lymphadenopathy and nodular pulmonary disease with cavitation and lower lobe predominance. The differential diagnosis for these findings includes both sarcoidosis and lymphoma, but lower zone predominance of nodules and presence of cavitation favor pulmonary lymphoma over sarcoidosis. Granulomatous infection is also possible but seems less likely. |
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