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Generate impression based on findings. | Male; 67 years old. Reason: etiology of neutropenic fever History: CLL, severe pressure like headache. LUNGS AND PLEURA: Scattered pulmonary nodules are again noted bilaterally, most prominent at the lung bases. Reference nodule in the right lung base has decreased in size and measures 1.1 x 0.9 cm, previously 1.5 x 1.1 cm (series 4, image 61). No focal consolidation or pleural effusion. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Moderate coronary calcifications. Multiple mildly enlarged mediastinal and hilar lymph nodes are again noted, some of which are calcified. Reference right hilar lymph node has decreased in size and measures 10 mm in short axis, previously 16 mm (series 3, image 54). CHEST WALL: Significant interval decrease in supraclavicular and axillary lymphadenopathy. Reference lymph node measures 10 mm in short axis, previously 22 mm (series 3, image 14).UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Splenomegaly is again noted and compatible with history of CLL. | 1.No specific source of infection identified. 2.Significant interval improvement in pulmonary nodular disease and lymphadenopathy. |
Generate impression based on findings. | Reason: eval for any acute pulm process History: dyspnea, leukocytosis LUNGS AND PLEURA: Small bilateral pleural effusions with associated atelectasis and consolidation in the left lower lobe. This finding is nonspecific with a differential diagnosis that includes aspiration and infection.MEDIASTINUM AND HILA: No significant lymphadenopathy.Extensive and severe coronary arterial calcification.Pacemaker leads extending to the area of the right atrial appendage and the anterior right ventricular wall with a third lead in a left ventricular vein.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Thickening of the left adrenal gland, unchanged.Extensive vascular calcifications.Status post cholecystectomy. | Pleural effusions with a focal nonspecific consolidation and atelectasis in the left lower lobe that may be due to aspiration or infection. |
Generate impression based on findings. | Reason: sarcoidosis progressive History: radicular involvement with possible sarcoidosis CHEST:LUNGS AND PLEURA: Bilateral mainly subpleural areas with reticular interstitial opacities and traction bronchiectasis indicative of fibrosis, with a mild upper zone predominance. This is consistent with a history of sarcoidosis.MEDIASTINUM AND HILA: No significant lymphadenopathy.No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.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: Multiple small lymph nodes all less than 10 mm in diameter.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. | Relatively mild pulmonary abnormalities consistent with fibrosis, nonspecific but consistent with sarcoidosis. |
Generate impression based on findings. | Male; 72 years old. Reason: COP, r/o underlying malignancy History: SOB LUNGS AND PLEURA:Multifocal basilar predominant airspace/interstitial opacities are again noted and appear markedly improved since the prior CT. Previously noted mass-like area of consolidation in the posterior left upper lobe has decreased in size and measures 2.4 x 2.0 cm, previously 3.0 x 2.3 cm (series 4, image 43). Wedge-shaped area of dense consolidation in the peripheral left lower lobe is also less prominent (series 4, image 72). While areas of consolidation have markedly improved, there is still evidence of lower lung zone predominant chronic interstitial disease. Associated findings include reticular and ground glass opacities as well as traction bronchiectasis due to fibrosis. There are no suspicious lesions to suggest underlying malignancy. No pleural effusions or evidence of honeycombing. Postoperative changes in the left lower lobe are presumably secondary to prior biopsy. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications.CHEST WALL: Mild multilevel degenerative disease of the visualized spine. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. Right upper pole renal hypodensities, most likely representing benign cysts. | Marked interval improvement in multifocal areas of consolidation on a persistent background of chronic interstitial lung disease as described above. Imaging findings are compatible with resolving organizing pneumonia superimposed on chronic underlying lung disease, possibly fibrosing NSIP. |
Generate impression based on findings. | 62-year-old female patient history of bilateral intraventricular hemorrhage. There is stable intraventricular blood present involving the lateral ventricles, the third ventricle and fourth ventricle without sulcal effacement.A ventriculostomy tube courses through the right frontal lobe into the right lateral ventricle with tip in region of foramen of Monro, stable from prior examination. Ventricle size is stable from prior examination. Small air bubble in the right lateral ventricle is stable from prior.Stable subarachnoid blood products are present in the posterior fossa.No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses redemonstrate a retention cyst in the left maxillary sinus and opacities in the right ethmoid air cells and right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Stable intraventricular blood and subarachnoid hemorrhage in the posterior fossa. Ventriculostomy tube is stable in position. |
Generate impression based on findings. | 62-year-old female patient with interventricular hemorrhage. There is stable intraventricular blood present involving the lateral ventricles, the third ventricle and fourth ventricle without sulcal effacement.A ventriculostomy tube courses through the right frontal lobe into the right lateral ventricle with tip in region of foramen of Monro, stable from prior examination. Ventricle size is stable from prior examination. Small air bubble in the right lateral ventricle is stable from prior.Stable subarachnoid blood products are present in the posterior fossa.No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses redemonstrate a mucus retention cyst in the left maxillary sinus and minor opacities in the right ethmoid air cells and right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Stable intraventricular blood and subarachnoid hemorrhage in the posterior fossa. Ventriculostomy tube is stable in position. |
Generate impression based on findings. | 47 year old with tonsil cancer status post surgery and chemo radiation with jaw osteoradionecrosis. SOFT TISSUES: When compared to the prior exam, at the level of the arytenoid cartilage, there has been interval increase of soft tissue fullness measuring 6 mm within the left piriform sinus, contralateral to the original tumor site. This tissue demonstrates mild enhancement, similar to other surrounding soft tissues, and may represent postoperative scarring or change versus tumor. Posttreatment changes are present in the anterior and right neck, with decrease in soft tissue prominence as well as further atrophy of the right neck muscles, mucosal thickening, and swelling of the soft tissues in the right masticator space. Surgical clips are again noted along the right neck. There is no visible soft tissue mass or lymphadenopathy which can be identified in this post-treatment background. LYMPH NODES:No evidence of enlarged lymph nodes by CT criteria or enlarged lymph nodes.GLANDS:The right submandibular gland is small, otherwise the parotid, submandibular, and thyroid glands are unremarkable. BONES: There has been formation of bony bridging of interval healing of the previously identified osteonecrosis of the right mandible. Again noted are plate and screw fixation No hardware failure or lucency surrounding the screws to suggest loosening or infection. A defect is seen in the right lamina papyracea with focal fat herniation, likely secondary to remote trauma. Mild degenerative and is of the cervical spine without suspicious lesion.OTHER:Lungs apices are clear. Visualized brain demonstrates no enhancing mass. | 1.Interval development of soft tissue fullness within the left piriform sinus which demonstrates mild enhancement and may represent postoperative scarring or change. However new contralateral tumor cannot entirely be excluded. Direct visualization with laryngoscopy may be indicated.2.Interval formation of bony bridging of interval healing of plate and screw fixation of the previously identified osteonecrosis of the right mandible no evidence of hardware failure. |
Generate impression based on findings. | 9-year-old with LOC. 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.PARANASAL SINUSES AND MASTOID AIR CELLS:Minimal paranasal sinus mucosal thickening.ORBITS: Normal. | No acute intracranial process. |
Generate impression based on findings. | 4 year old with mass, operative planning. A stereotactic grid is in place.BRAIN PARENCHYMA:As demonstrated on the multiple recent prior exams, there is a large multilobed cystic mass with mass effect on the pons, vermis, midbrain, right temporal lobe and right cervical peduncle is demonstrated interval increase in size when compared to prior older exams.VENTRICLES/CSF SPACES:There is obstructive hydrocephalus of the lateral and third ventricles with transependymal CSF flow enlargement of the lateral and third ventricles.FLUID:No fluid collections. No evidence of hemorrhage.BONE:Postsurgical changes are identified from plate and screw fixation of an old right zygomatic arch fracture. There are multiple craniotomy clips identified along the right frontal, and parietal skull. | 1.Large multi-lobed cystic mass with mass effect on the pons, vermis, midbrain, right temporal lobe and right cerebellar peduncle as identified on recent MRI..\2.Obstructive hydrocephalus of the lateral and third ventricles with transependymal CSF flow as identified on recent MRI. |
Generate impression based on findings. | 4-month-old evaluate for hemorrhage status post elevation of depressed skull fracture. BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage.VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.FLUID:No fluid collections. No evidence of hemorrhage.BONE:Soft tissue swelling and gas is identified over the right frontal lobe with an underlying fractured piece of calvarium now in alignment the remainder of the skull. Adjacent punctate focus of pneumocephalus,PARANASAL SINUSES AND MASTOID AIR CELLS: ClearORBITS: Normal | 1.No evidence of acute intracranial hemorrhage.2.Soft tissue swelling and gas are identified over the right frontal lobe with an underlying fractured piece of calvarium now in alignment with the remainder of the skull. |
Generate impression based on findings. | 52-year-old with head and neck squamous cell carcinoma. CT brain: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.CT NECK:SOFT TISSUES:Stable irregular left paratracheal mass within the postsurgical bed again measuring 33 x 18 cm. This mass again extends cranially and caudally in a similar extent with more superiorly mass component again measuring 16 x 16 mm when measured at the same locations. dilation of the left piriform sinus, thickening of the left aryepiglottic fold, and medialization of the left vocal cords, unchanged in appearance.LYMPH NODES:No evidence of enlarged lymph nodes by CT criteria or enlarged lymph nodes. Previous level 2 lymph nodes which had demonstrated interval increase, unchanged in size and not pathologic by CT size criteria. Stable right level 6 lymph node measuring 18 x 11 mm.GLANDS:The parotid, submandibular, and thyroid glands are unremarkable. BONES:Multilevel degenerative changes without suspicious osseous lesions. OTHER:The carotid arteries and jugular veins are patent. Lung apices redemonstrate pulmonary opacities suggestive of metastasis. Please refer to dedicated CT chest report from the same date. | No interval change in size of left paratracheal mass. Stable appearance of reference lymph nodes. |
Generate impression based on findings. | 52-year-old with head and neck squamous cell carcinoma. CT brain: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.CT NECK:SOFT TISSUES:Redemonstration of postsurgical changes within the left neck including a rotational pectoralis flap over a left level III surgical defect with interval decreased thickening of the muscle flap. The superficial and deep fat planes are extensively infiltrated, similar to prior study. Within this abnormal background, no definite evidence of suspicious focal mass or enhancement is seen. Postsurgical change is also seen within the right neck including volume loss and infiltration of the fat planes, similar to prior study.Stable thickened left aryepiglottic fold and effacement of the right pyriform sinus, similar to prior study. Medial deviation of the left aryepiglottic and left vocal folds is also similar to prior study.LYMPH NODES:No evidence of enlarged lymph nodes by CT criteria or enlarged lymph nodes.GLANDS:There is atrophy of the bilateral submandibular glands. The parotid and thyroid glands are unremarkable. BONES:Multilevel degenerative changes without suspicious osseous lesions. Stable anterior wedging of the T1 vertebral body.OTHER:The left IJ vein is not identified otherwise the carotid arteries and right jugular vein are patent. Centrilobular emphysema. | 1.Stable postsurgical changes without evidence of residual or recurrent disease.2.No evidence of intracranial metastases. |
Generate impression based on findings. | 51 year old rule out stroke: Left upper extremity and lower extremity weakness. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. Mild periventricular and subcortical white matter hypodensity likely represents sequela of small vessel disease of indeterminate age. There are no CT findings of acute cortical infarct.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear.ORBITS: Normal. | Small vessel disease of indeterminate age. If there is ongoing clinical concern for an acute infarction, an MRI exam of the much more sensitive and specific. |
Generate impression based on findings. | 55 year old with recurrent head and neck cancer. CT brain: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.CT NECK:Evaluation is limited by streak artifact from dental hardware.SOFT TISSUES:Post-surgical changes are seen adjacent to the left tonsil with adjacent soft tissue thickening.LYMPH NODES:Level 2 lymph nodes are partially obscured secondary to extensive streak artifact from dental amalgam, however there is definite loss of the fat planes suggesting presence of lymphadenopathy on the left level 2, 3, 4 and 5. There is also left axillary lymph node which measures 1.4 cm.GLANDS:The parotid, submandibular, and thyroid glands are unremarkable. BONES:Multilevel degenerative changes without suspicious osseous lesions. PARANASAL SINUSES AND MASTOID AIR CELLS:There is mucosal thickening of the right maxillary sinus, and ethmoid and frontal sinuses. The mastoid air cells are clear and well pneumatized.OTHER:The carotid arteries and jugular veins are patent. Scattered bilateral fibrosis and pulmonary opacities. Please see CT chest performed at the same day. | 1.Obscuration of the normal fat planes with soft tissue density on the left secondary to extensive lymphadenopathy in the left level 2, 3, 4 and 5 stations. There is also left axillary lymph node which measures 1.4 cm.2.Postsurgical changes are identified adjacent the left tonsil, however there is no definite evidence of recurrent tumor not the primary site only soft tissue thickening.3.Pulmonary opacities, please see the separately performed chest CT.4.No intracranial metastases. |
Generate impression based on findings. | 30 year-old with 8 month history of bilateral lacrimal gland and orbit swelling. There is symmetric mild enhancement with enlargement of the lacrimal glands bilaterally. The preseptal soft tissues are otherwise unremarkable. The globes are symmetric. The intraocular lenses demonstrate appropriate position. The optic nerves and retrobulbar fat are unremarkable.There is near complete opacification of the left maxillary sinus. The also sinus disease is also identified within the ethmoid sinuses, right maxillary sinus, sphenoid sinus, and left frontal sinuses. The mastoid air cells and mastoid vessels are well pneumatized and clear. The visualized brain parenchyma is unremarkable.There is mild enhancement and nodularity to the parotid glands bilaterally. Mild prominence to the nasopharyngeal adenoid tissue.The visualized intracranial contents are unremarkable. | There is symmetric mild enhancement with enlargement of the lacrimal glands bilaterally, mild enhancement and nodularity of the parotid glands bilaterally, and mild prominence of the nasopharyngeal adenoid tissue. The differential diagnosis would most likely include Sjögren's syndrome, scleroderma, lupus, Mikulicz's disease, sarcoidosis, and lymphoproliferative diseases. |
Generate impression based on findings. | Follow-up lung incidental AVM on CT chest in 9/2013 PULMONARY ARTERIES: No pulmonary embolus. LUNGS AND PLEURA: Nodular/tubular density in the left lower lobe is unchanged likely representing a thrombosed AVM. No consolidation or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart is normal size and there is no pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Scarring of the right kidney is partially visualized consistent with right kidney atrophy seen on prior ultrasound. | No pulmonary embolus. No change in left lower lobe thrombosed AVM. |
Generate impression based on findings. | Status post ortho procedure 9/27, persistent tachycardia, evaluate for PE. PULMONARY ARTERIES: Left lower lobe segmental pulmonary embolus is seen.LUNGS AND PLEURA: Dependent atelectasis is present, right greater than left. Debris is seen within the trachea and right mainstem bronchus.7 mm scarlike nodule is seen in the right upper lobe. No pleural effusion. Upper lobe predominant centrilobular emphysema is noted. MEDIASTINUM AND HILA: Right supraclavicular and right paratracheal enlarged lymph nodes measuring up to 3.2 cm. The heart is normal in size and there is no pericardial effusion.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Left lower lobe segmental pulmonary embolus.2.Debris within the trachea with dependent atelectasis likely related to aspiration, right greater than left.3.7 mm scarlike nodule in the right upper lobe. If the patient is at high risk for lung malignancy, follow-up CT at 3 to 6 months is recommended, otherwise follow-up CT in 6 to 12 months recommended.4.Right supraclavicular and right paratracheal enlarged lymph nodes, which may relate to an underlying malignancy, especially given the known left femur lesion. |
Generate impression based on findings. | 39-year-old male with history of pilocytic astrocytoma s/p ventricular catheter insertion status post RT and several rounds of chemotherapy, now experiencing headache. Redemonstrated is the patient's right transfrontal Ommaya catheter that terminates in the medial right lateral ventricle, unchanged in position. Previously demonstrated pneumocephalus has resolved. There has been slight interval increase in size of lateral and third ventricles. There is no evidence of acute intracranial hemorrhage. Patchy areas of periventricular white matter hypoattenuation are again noted and stable in appearance. There is no midline shift of herniation. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Slight interval increase in size of lateral and third ventricles. |
Generate impression based on findings. | Large compressing hematoma to left lower extremity, hypercoagulable state, now short of breath and tachy, evaluate for pulmonary embolus PULMONARY ARTERIES: Technically adequate study without pulmonary embolus.LUNGS AND PLEURA: Subpleural perifissural right middle lobe nodule is unchanged from the prior study likely representing an intrapulmonary lymph node. Left lower lobe subpleural nodule is also unchanged from the prior study. Additional scattered pulmonary micronodules and ground glass opacities have not significantly changed compared to 7 years ago.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. Several scattered mediastinal lymph nodes are unchanged from the prior study. The heart is normal in size and there is no pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense left exophytic renal lesion is greater density than expected for a simple cyst, however this has not significantly changed in size from the prior study and likely represents a hemorrhagic cyst. | 1.No pulmonary embolus. 2.Stable pulmonary micronodules and ground glass opacities. This may be due to a chronic interstitial lung disease and is unchanged compared to 7 years ago. If further evaluation is clinically indicated, dedicated interstitial lung disease CT protocol with expiration and prone sequences should be considered. |
Generate impression based on findings. | Short of breath, evaluate for pulmonary embolus PULMONARY ARTERIES: Technically adequate study without pulmonary embolus.LUNGS AND PLEURA: Right basilar atelectasis/scarring is present. Right basilar bronchiectasis is also present. These may be chronic findings, potentially related to chronic aspiration. No acute consolidation or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. The heart is normal in size and there is no pericardial effusion.CHEST WALL: Mild to moderate degenerative changes are seen throughout the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Nonobstructing left renal stone partially visualized. Status post cholecystectomy. | No pulmonary embolus. |
Generate impression based on findings. | Female 30 years old Reason: appy History: pain, n/v ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Other surgically absent. No intrahepatic or extra hepatic biliary dilatation. No focal liver lesions. Possible fatty liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate calcification consistent with nephrolithiasis right kidney. No hydronephrosis hydroureter.Punctate calcification left dropout consistent with nephrolithiasis. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid. Diverticulosis no evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: 3 x 2.9 cm cyst or cystic lesion left adnexa. Correlate clinically.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No bowel wall thickening or dilatation.. No free or loculated fluid. No evidence of appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Cyst or cystic lesion left adnexa maximal dimension 3.8-cm. This could be evaluated further with ultrasound if clinically indicated. Possible fatty liver. Nephrolithiasis bilaterally without hydronephrosis.No evidence of appendicitis.Moderate allergic reaction with hives as detailed above treated with IV Benadryl. |
Generate impression based on findings. | 9-month-old with skull fracture and cardiac arrest. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:There is edema, and loss of sulcal differentiation overlying the posterior parietal lobe, findings may represent effacement from adjacent subdural hematoma, however acute ischemia versus contusion cannot be excluded.EXTRA-AXIAL SPACE:Associated with the fracture overlying the posterior parietal lobe, is a hyperdense fluid collection that measures approximately 7 mm in its maximal diameter and likely represents a subdural hematoma.BONE:There is a comminuted, obliquely oriented, minimally posteriorly displaced, acute fracture of the right posterior parietal calvarium that extends to the sagittal and lambdoid sutures with a portion extending into the right temporal bone.SOFT TISSUES:There is a hematoma in overlying soft tissue swelling overlying the right posterior scalp.PARANASAL SINUSES AND MASTOID AIR CELLS: There is near complete opacification of the right mastoid air cells. There is near complete opacification of the ethmoid and maxillary sinuses. The sphenoid and frontal sinuses have not pneumatized.ORBITS:Normal. | Comminuted, obliquely oriented minimally posterior displaced fracture of the right posterior parietal calvarium with overlying soft tissue swelling and underlying subdural hematoma.There is edema and loss of sulcal differentiation, involving the underlying posterior parietal lobe, findings may represent effacement from adjacent subdural hematoma but acute ischemia versus contusion cannot be excluded. |
Generate impression based on findings. | Female 56 years old Reason: Rectal Cancer: Restaging History: none CHEST:LUNGS AND PLEURA: Demonstration of multiple pulmonary nodules. No new nodules seen. Mild cavitation in some of the nodules is redemonstrated.Reference right lower lobe cavitary nodule, series 3 image 70 measures 1.8 x 1.2 cm. Previously 1.6 x 1.2 cm.No effusions. MEDIASTINUM AND HILA: Central venous catheter unchanged in position. Coronary calcifications. No pathologic size nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Gallbladder is surgically absent. No biliary dilatation. Punctate hypodensity medial segment left lobe unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Small lipoma in the region of the uncinate process, unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ileostomy. No evidence of ascites or carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes rectum. No evidence of ascites or carcinomatosis. Small nonobstructive incisional hernia.BONES, SOFT TISSUES: Surgical changes anterior abdominal wall.OTHER: No significant abnormality noted. | Minor change in size of pulmonary nodules. No new nodules. |
Generate impression based on findings. | Male 42 years old history lower abdominal pain. 60-pound weight loss. Family history gastric malignancy (mother). Abdominal pain. GI/GU pain c/b trouble urinating. Would like evaluation for GI/GU malignancy 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: Hydronephrosis right kidney with hydroureter proximally. The distal ureter appears collapsed. Etiology uncertain. An underlying ureteral lesion cannot be excluded. No obvious nephrolithiasis seen. Renal contour is normal. Perinephric fat as well.The left kidney is normal.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: Not well distended. Possible mild bladder wall thickening.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Unexpected finding of hydronephrosis and proximal hydroureter that may or may not be explained by the small ureteral stone. Underlying ureteral lesion should be excluded.Findings communicated to Aaron Wolfson, pager 3479 covering Cathryn Lee pager 2786, 10:30am 9/29/13 who will plan to call Dr. Waldman tomorrow. |
Generate impression based on findings. | 60 -year-old with altered mental status and AML, neutropenic fever. Rule out hemorrhage in setting of thrombocytopenia. CT brain: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.CT maxillofacial:No evidence of sinusitis. Globes are normal. No acute fractures. There is minimal, stable opacification of the left mastoid air cells. | Unremarkable head CT and maxillofacial CT. There is minimal, stable opacification of the left mastoid air cells. |
Generate impression based on findings. | Female 41 years old Reason: assess for metastatic disease History: vaginal lesion positive for recurrent cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Possible fatty liver, diffuse. Hepatomegaly 21.5 cm cephalocaudad coronal image 41. No focal lesions. Cholelithiasis. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild hydronephrosis and mild proximal hydroureter. Small stone is seen in the proximal right ureter see coronal image 51. This may not be the cause of the hydronephrosis is there is mild hydroureter below this level. No evidence of nephrolithiasis in the kidney. No perinephric fluid or fat stranding. Normal renal contour.The left kidney is normal.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, ADNEXAE: Surgically absent. No definite measurable tumor at the vaginal cuff although there is loss of fat plane between the vaginal cuff and the urinary bladder. Involvement of the right ureterovesical junction cannot be excluded I see no distal hydroureter.BLADDER: No significant abnormality noted.LYMPH NODES: Small nodes nonpathologic in size. For baseline purposes largest node is in the distal right external iliac distribution measures 1.3 x 0.8 cm series 3 image 176.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hydronephrosis and proximal hydroureter on the right. Nephrolithiasis within the proximal ureter may not completely explain these findings. Further evaluation is recommended.Fatty liver. Hepatomegaly Cholelithiasis.Findings discussed with the Dr. Yamada by telephone 9:15 a.m., 9/29/13. |
Generate impression based on findings. | 62-year-old female patient history of bilateral intraventricular hemorrhage. There is stable intraventricular blood present involving the lateral ventricles, the third ventricle and fourth ventricle without evidence of interval new hemorrhage.A ventriculostomy tube courses through the right frontal lobe into the right lateral ventricle with tip in region of foramen of Monro, stable in position. Ventricle sizes are stable. Small air bubble in the right lateral ventricle has resolved.Subarachnoid blood products in the posterior fossa are less conspicuous and decreasing in density.No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses redemonstrate a retention cyst in the left maxillary sinus and opacities in the right ethmoid air cells and right maxillary sinus unchanged. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Stable intraventricular blood2.Subarachnoid blood products in the posterior fossa are less conspicuous and decreasing in density. 3.Ventriculostomy tube is stable in position. |
Generate impression based on findings. | CT P HEAD WO, 9/28/2013 6:45 PM 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.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear.ORBITS:Normal. | No acute intracranial process. |
Generate impression based on findings. | 51-year-old with pain. CT maxillofacial:SOFT TISSUES:Minimal right premaxillary soft tissue swelling.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS:Minimal mucosal thickening of the paranasal sinuses. The visualized mastoid air cells are clear.ORBITS:The globes are symmetric. The optic nerves appear normal. The lenses are in appropriate position. There is no preseptal soft tissue swelling. There is no retro-bulbar mass or hematoma. Lenses are in appropriate position and symmetric bilaterally.CT cervical spine:There is no prevertebral soft tissue swelling.There is a mild reversal of the normal cervical lordosis centered over C6-7.Vertebral body heights are maintained without evidence of fracture.There are multilevel degenerative changes including anterior osteophytes and loss of disk height at C6-7.There is a nodular thyroid. | No evidence of maxillofacial or cervical spine fracture.Nodular thyroid. |
Generate impression based on findings. | 59-year-old with LOC and mechanical fall. VENTRICLES/CSF SPACES:Prominence to the ventricles and sulci is consistent with moderate age related volume loss. No midline shift.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. Mild to moderate hypodensity within the periventricular and subcortical distribution likely represents mild to moderate chronic small vessel diseaseFLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear.ORBITS:Normal. | No acute intracranial process. Small vessel disease, mild/moderate, stable. |
Generate impression based on findings. | 33-year-old with headache and altered mental status. 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.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear. ORBITS:Normal. | No acute intracranial process. |
Generate impression based on findings. | 51 year-old with altered mental status, rule out acute intracranial abnormality. 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.PARANASAL SINUSES AND MASTOID AIR CELLS:Mild mucosal thickening of the paranasal sinuses. The mastoid air cells are clear.ORBITS: Normal. | No acute intracranial process. |
Generate impression based on findings. | 46-year-old with seizures, evaluate for mass. 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.PARANASAL SINUSES AND MASTOID AIR CELLS:Mucosal retention cyst within the right maxillary sinus. Mild opacification of the mastoid air cells. Paranasal sinuses and mastoid air cells are otherwise clear.ORBITS:Normal. | No acute intracranial process. |
Generate impression based on findings. | 42 year old with unilateral headache and hypertension. Rule-out acute subarachnoid hemorrhage. History of 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.PARANASAL SINUSES AND MASTOID AIR CELLS: Mild mucosal thickening of the ethmoid sinuses. Paranasal sinuses and mastoid air cells are clear.ORBITS: Normal | Mild mucosal thickening of the ethmoid sinuses. No acute subarachnoid hemorrhage. |
Generate impression based on findings. | 4-year-old with drooling and throat pain, evaluate for retropharyngeal abscess. SOFT TISSUES:There is no evidence of a peripherally enhancing fluid collection to suggest abscess.LYMPH NODES: There is prominence of the adenoids commonly seen in a patient of this age. Otherwise there is no evidence of enlarged lymph nodes by CT criteria or enlarged lymph nodes.GLANDS:The parotid, submandibular, and thyroid glands are unremarkable. BONES:Normal.OTHER:The carotid arteries and jugular veins are patent. Clear lungs. | No evidence for retropharyngeal abscess. |
Generate impression based on findings. | 10-year-old with vomiting and hydrocephalus status post shunt placement. Evaluate for change in ventricular size. VENTRICLES/CSF SPACES:Ventricular shunt catheter terminates in the region of the mid third ventricle. Third ventricle is smaller in size than the prior exam, imaging 11.8 mm where on the prior exam it measured 16 mm. bottle ventricles are unchanged in size. There is persistent effacement of the fourth ventricle.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. There is tectal beaking, interdigitation of gyri, and crowding at the level of foramen magnum consistent with Chiari 2.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear. ORBITS:Normal. | Mild interval decrease in size of third ventricle. Size of lateral ventricles is unchanged. |
Generate impression based on findings. | Female 71 years old Reason: evaluate for cause of bleeding History: anemia of unknown etiology ABDOMEN: Exam is significantly limited particularly in the abdomen the respiratory motion.LUNG BASES: Small to moderate bilateral pleural effusions with bibasilar atelectasis or consolidation.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: Percutaneous gastrostomy tube. Diverticulosis. No evidence of diverticulitis. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Atrophic or surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No bowel thickening or dilatation. No free or loculated intraperitoneal fluid. Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Exam is limited in the abdomen to the respiratory motion. No obvious cause for the patient's symptoms found. |
Generate impression based on findings. | 62 year old left-sided swelling and neck mass. Evaluation is limited by streak artifact.SOFT TISSUES:Within the left neck, extending from level of the TMJ to the hyoid bone is a 4.3 x 4.2 x 8.8 cm soft tissue mass in the demonstrates multifocal areas of low central attenuation concerning for necrosis. The adjacent left parotid gland is not clearly demarcated on this noncontrast examination, and this mass may actually be arising from or displacing the parotid gland.There is soft tissue asymmetry of the oropharynx which extends to the level of the left vallecula. The pre-epiglottic fat is maintained. This is incompletely evaluated without intravenous contrast and may represent a site of primary tumor.LYMPH NODES:There are too numerous to count, bilateral, level 2, 3, 4, lymph nodes many of which demonstrate central hypoattenuation concerning for necrosis.GLANDS:The right parotid, submandibular, and thyroid glands are unremarkable. The left parotid gland is not clearly visualized separate from, as detailed above.BONES:Multilevel degenerative changes without suspicious osseous lesions. There is an old right mandibular condylar deformity, likely from prior trauma.OTHER:There is atelectasis and lung opacity within the right upper lobe. Dedicated chest CT could provide additional information if clinically warranted. There is diffuse cerebellar atrophy. | 1.Evaluation is limited secondary to streak artifact and lack of intravenous contrast; there is a incompletely characterized mass originating along the left neck and extending from the left TMJ to the hyoid bone, it is unclear whether the mass arises from the left parotid gland or displaces it. Asymmetric irregularity of the oropharynx extending to the level of the left vallecula, is incompletely evaluated in the absence of intravenous contrast and may represent a site of primary tumor. 2.Extensive bilateral lymphadenopathy as detailed above. |
Generate impression based on findings. | Male 64 years old Reason: r/o obstruction History: pain, vomiting The exam is not sensitive detecting lesions in the solid organs due to lack of intravenous contrast. Given that limitation, the following observations are made: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: Exophytic 1.4 x 1.1 cm fluid density lesion lateral aspect left kidney, unchanged likely renal cyst.No evidence of nephrolithiasis. No evidence of hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Enteric tube terminates at EG junction and should be advanced. No evidence of bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid.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 findings to explain pain or vomiting. NG tube tip at EG junction.Findings communicated to clinical service by the radiology resident on call at the time of the examination. |
Generate impression based on findings. | Female 85 years old Reason: r/o obstruction History: pain, constipation, irreducible hernia ABDOMEN:LUNG BASES: A 0.8-cm nodule left lower lobe series 5 image 4. No effusions. 4-mm nodule right middle lobe. Scarring. Other micronodules possible.LIVER, BILIARY TRACT: Gallbladder is surgically absent. Intra-and extra hepatic biliary dilatation is seen without obvious etiology. This could be evaluated further with MRCP or ERCP if clinically indicatedSPLEEN: No significant abnormality notedPANCREAS: Focal calcifications anterior aspect pancreatic body seen separate from the splenic artery. Correlate for history pancreatitis. No evidence of pancreatic atrophy. No perinephric fat stranding or fluid.Small hypodense probably cysts the lesion in the tail of the pancreas measures about 1.1 x 0.9 cm series 4 image 32. This may be consistent with an IPM or other cystic neoplasm of the pancreas.ADRENAL GLANDS: Mildly thickened, no focal nodules.KIDNEYS, URETERS: Several large and small hypodensities in both kidneys likely cysts.RETROPERITONEUM, LYMPH NODES: Tortuosity and moderate atherosclerotic changes in the aorta. Mild bulging left aspect of distal abdominal aorta. Maximal dimension 2.3-cm coronal image 51.BOWEL, MESENTERY: Fat stranding in the perianal fat. Sinus tract or fistula to the skin cannot be excluded correlate clinically.There is also fluid and fat stranding in the perirectal fat. Moderate amount of stool in the rectum. Correlate for possible stercoral colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Multiple large calcifications likely fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall. Mild nonobstructive present incisional hernia a ventral hernia containing omentum only. Series IV image 73OTHER: Extensive atherosclerotic changes. No evidence of aneurysm. | Unexplained intra-and extra hepatic biliary dilatation concerning for obstruction of the distal common bile duct. This should be evaluated further.Small cystic lesion pancreatic tail. This could be evaluated further with M.R.C.P.Fluid and fat stranding perirectal and perianal area. Correlate clinically for colitis and for enterocutaneous fistula.Micronodules lungs. |
Generate impression based on findings. | 85 year-old with lung cancer, evaluate for brain metastases. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. Mild chronic small vessel disease. There are no enhancing intracranial masses to suggest metastases.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS: Clear. ORBITS: Normal. | No evidence of intracranial metastases. |
Generate impression based on findings. | 7 year old removed knife from head. Soft Tissues:Postsurgical changes and soft tissue swelling is identified over the left temporalis muscle and left anterior frontal lobe. There is a focus of subcutaneous gas that extends subdural space.VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. EXTRA-AXIAL SPACE:No fluid collections. No evidence of hemorrhage. Focus of left frontal subdural gas and scattered minimal foci of admixed hemorrhage products without evidence of frank hematoma, postsurgical in nature.BONE:No fractures. Visualized bony structures are normal. Craniotomy defect overlying the left frontal lobe is seen site at which the knife was likely removed.PARANASAL SINUSES AND MASTOID AIR CELLS: The sinuses are hypoplastic otherwise paranasal sinuses and mastoid air cells are clear.ORBITS: The orbits are normal. | Postsurgical changes and soft tissue swelling identified over the left temporalis muscle and left anterior frontal lobe with a focus of subcutaneous gas and scattered minimal foci of admixed hemorrhage products without evidence of frank hematoma that extends into the left frontal subdural space. No evidence of intraparenchymal hemorrhage. |
Generate impression based on findings. | Female 62 years old Reason: 62 F with LLQ hematoma with worsening abdominal distension, no improvement in Hgb despite blood, concern for intraabdominal bleeding History: abdominal distension Limitations: The exam is not sensitive for detecting lesions in the bowel vasculature or solid organs due to lack of oral or intravenous contrast.Due to body habitus skin and subcutaneous fat anterior abdominal particularly in the pelvis is partially cut off the field-of-view.ABDOMEN:LUNG BASES: Basilar 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: Dobbhoff tube tip in region of the gastric antrum. No free or loculated intraperitoneal fluid. No bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Incompletely visualized large subcutaneous lesion in the left anterior abdominal wall consistent with the patient's known hematoma. On coronal image 34/157, I estimate its greatest oblique length at about 30 cm by 12 cm .Due to the lack of IV contrast active bleeding cannot be excluded.Surgical hardware lower lumbar spine.OTHER: No significant abnormality noted | Incompletely visualized a large left low anterior abdominal wall hematoma. |
Generate impression based on findings. | Female 46 years old Reason: Colitis vs. hemorrhage (per KUB read) History: Abdominal pain Limited by lack of optimal oral contrast.ABDOMEN:LUNG BASES: Bibasilar atelectasis or consolidation.LIVER, BILIARY TRACT: Mild central intrahepatic biliary dilatation. No evidence of extrahepatic biliary dilatation. The is of questionable significance as I believe it was present and 5/14/08 but with limited evaluation due arterial phase only. This could be evaluated further with ultrasound of clinically indicated.Small hypodense lesions too small to characterize likely cysts.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: Given limitation of lack of oral contrast, no obvious bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid. Mesenteric vasculature enhances normally.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Corpus luteum cyst likely right adnexa.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 evidence of bowel abnormality. Other findings as above including mild intrahepatic biliary dilatation of uncertain significance but probably unchanged. |
Generate impression based on findings. | 75-year-old with altered mental status. 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.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear.ORBITS: Normal. | No acute intracranial process. |
Generate impression based on findings. | 9-month-old with skull fracture and cardiac arrest status post bolt placement VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:There is edema, and loss of sulcal differentiation overlying the posterior parietal lobe, findings may represent effacement from adjacent subdural hematoma, however acute ischemia versus contusion cannot be excluded. Recommend MRI exam as clinically indicated for further evaluation.EXTRA-AXIAL SPACE: There has been interval development of subdural right frontal air after placement of a bolt.Redemonstrated associated with the fracture overlying the posterior parietal lobe, is a hyperdense fluid collection which represents a subdural hematoma. There has been interval mild redistribution of hemorrhage to the adjacent falx and tentorium.BONE: There has been interval placement of a bolt through the right frontal bone. Redemonstrated is a comminuted, obliquely oriented, minimally posteriorly displaced, acute fracture of the right posterior parietal calvarium that extends to the sagittal and lambdoid sutures with a portion extending into the right temporal bone.SOFT TISSUES:There is a hematoma in overlying soft tissue swelling overlying the right posterior scalp.PARANASAL SINUSES AND MASTOID AIR CELLS: There is near complete opacification of the right mastoid air cells. There is near complete opacification of the ethmoid and maxillary sinuses. The sphenoid and frontal sinuses have not pneumatized.ORBITS:Normal. | Interval placement of a right frontal bolt with postprocedural pneumocephalus but no frank hematoma formation.Redistribution of right posterior subdural hemorrhage along the falx and tentorium.Unchanged fracture of the right posterior parietal calvarium extending to the sagittal and lambdoid sutures.Edema, and loss of sulcal differentiation overlying the posterior parietal lobe, findings may represent effacement from adjacent subdural hematoma, however acute ischemia versus contusion cannot be excluded. |
Generate impression based on findings. | 49-year-old with right-sided weakness. VENTRICLES/CSF SPACES:No midline shift. CSF spaces appropriate for patient age.BRAIN PARENCHYMA:No abnormal mass lesions, edema, or hemorrhage. Mild periventricular and subcortical hypodensity likely represents small vessel disease of indeterminate age.FLUID:No fluid collections. No evidence of hemorrhage.BONE:No fractures. Visualized bony structures are normal.PARANASAL SINUSES AND MASTOID AIR CELLS:Clear.ORBITS:Normal. | Mild periventricular and subcortical hypodensity likely represents small vessel disease of indeterminate age. |
Generate impression based on findings. | 57-year-old male with metastatic melanoma on chemotherapy, assess response to treatment and compared to prior imaging. HEAD: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. Again seen is mucosal thickening of the ethmoid air cells and sphenoid sinus, with a large mucus retention cyst in the left maxillary sinus, unchanged. The mastoid air cells are normally pneumatized.Unremarkable visualized portions of the orbits.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 new asymmetry of the left piriform sinus, however without abnormal enhancement nor a discrete mass.Within the visceral space the thyroid gland appears intact. The airway appears patent. The parotid and the submandibular glands appear intact.The visualized lung apices redemonstrate lung nodules.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. There are facet hypertrophic changes present at C5-6 on the right side | 1.No evidence for neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy.2.There is new asymmetry of the left piriform sinus, however without abnormal enhancement nor a discrete mass.3.Multiple lung nodules; please refer to CT chest dictation for discussion of thoracic contents. |
Generate impression based on findings. | 56-year-old man with history of left vocal cord cancer, left neck pain, and hoarseness SOFT TISSUES:There is an irregular appearance to the piriform sinus, right more full than left, without visualization of discrete mass and no measurable focus of enhancement is identified. There is also questionable anterior rotation of the left arytenoid cartilage. Findings may represent change from therapy. 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. OTHER:The carotid arteries and jugular veins are patent. Centrilobular emphysema. The visualized intracranial contents are unremarkable. No lytic or blastic osseous lesions. | 1.There is an irregular appearance to the piriform sinus, right more full than left, without visualization of discrete mass and no measurable focus of enhancement is identified. There is also questionable anterior rotation of the left arytenoid cartilage. Findings may represent change from therapy. 2.No clinically significant lymphadenopathy. |
Generate impression based on findings. | Evaluate for signs of trauma. ABDOMEN:LUNG BASES: Coarse opacities are seen in the dependent bases. The the blood pool appears less dense than the intraventricular septum.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: Healing rib fractures are as follows: Right fifth anterior, right sixth posterior, right seventh posterior, right ninth posterolateral, left sixth posterior.OTHER: Feeding tube tip is in duodenum. Central line tip is in superior vena cava. Free peritoneal fluid is seen in the left upper quadrant.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The urinary bladder is hugely distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subcutaneous emphysema is present anterior to the right ischium and femoral head and medial to the left iliac bone and acetabulum.OTHER: No significant abnormality noted | Multiple healing rib fractures, small amount of free peritoneal fluid, anemia.Pelvic subcutaneous emphysema is most likely due to line placement. |
Generate impression based on findings. | Non-accidental trauma. ABDOMEN:LUNG BASES: Dependent opacities are present bilaterally.LIVER, BILIARY TRACT: Perichordal edema is identified. A 1 cm laceration extending to the capsule seen in the posterior segment of the right lobe (image 34/77.SPLEEN: Intact and normal in appearance.PANCREAS: Intact and normal in appearance.ADRENAL GLANDS: Normal in appearance.KIDNEYS, URETERS: Symmetric enhancement with no pelvicaliceal dilatation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Duodenojejunal junction is normally positioned. The duodenal wall not thickened.BONES, SOFT TISSUES: Healing rib fractures are as follows: Right fifth anterior, right sixth posterior, right seventh posterior, right ninth posterolateral, left sixth posterior.OTHER: Perihepatic fluid is noted and fluid is seen around the gallbladder. Free fluid is present between the spleen, kidney, and pancreas. No free peritoneal air is identified. Feeding tube tip is in duodenum. Central line tip is in superior vena cavaPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Markedly distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subcutaneous emphysema is present anterior to the right ischium and femoral head and medial to the left iliac bone and acetabulum.OTHER: No significant abnormality noted | Grade 1 liver laceration. Small to moderate free peritoneal fluid. Multiple healing rib fractures. |
Generate impression based on findings. | Swelling around shunt site. Vague abdominal pain. ABDOMEN:LUNG BASES: Minimal dependent atelectasis is seen.LIVER, BILIARY TRACT: Normal enhancement. No biliary ductal dilatation. The gallbladder is distended.SPLEEN: Normal in appearance.PANCREAS: Normal enhancement. Not enlarged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Symmetric cortical enhancement. No pelvicaliceal dilatation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Duodenojejunal junction is normally positioned.BONES, SOFT TISSUES: Left paraspinal soft tissue mass at the T10 -- 11 level measures 4.5 x 1.5 x 2.0 cm.OTHER: Two ventriculoperitoneal shunts are present. One tip is in the right upper quadrant and the other tip is in the left upper quadrant..PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Incompletely distended and normal in appearance.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is retrocecal and normal in appearance.BONES, SOFT TISSUES: No significant abnormality noted. A few subcutaneous nodules are noted, likely neurofibromas.OTHER: Two loculated fluid collections are seen. No inflammatory changes are identified adjacent to either collection. The one in the left lower quadrant anteriorly measures 1.7 x 5.3 x 3.1 cm. The one in the right lower quadrant measures 3.3 x 2.0 x 2.0 cm. The fluid collections are remote from the tips of the shunts. The left sided one is in contact with shunt tubing.A small amount of free fluid is seen in the right paracolic gutter and between the urinary bladder and rectum. | Two loculated fluid collections in the lower abdomen/pelvis. Inflammatory changes are not seen adjacent to the collections however infection cannot be excluded. |
Generate impression based on findings. | Male; 60 years old. Reason: Does patient have a PE History: Hypoxia PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Multiple pulmonary nodules are stable in size and extent. Reference left lower lobe nodule measures 12 x 12 mm and is unchanged (series 9, image 136). Right mainstem bronchus stent position is unchanged. Internal debris at its distal aspect causes near-complete occlusion of the bronchus and is suggestive of metastatic endobronchial tumor. Dense right lower lobe atelectasis/consolidation has increased since the prior exam and is likely secondary to bronchial obstruction. Centrilobular and paraseptal emphysema. MEDIASTINUM AND HILA: Normal heart size with small pericardial effusion. Unchanged mild mediastinal adenopathy. Reference AP window node measures 9 mm in short axis and is unchanged (series 8, image 114). CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered subcentimeter hepatic hypodensities are unchanged and too small to characterize. Left adrenal and renal masses are incompletely imaged- please see dedicated CT abdomen report from 9/27/2013 for further details. | 1.No evidence of pulmonary embolism. 2.Interval increase in right lower lobe atelectasis/consolidation, likely secondary to near-complete occlusion of the distal right mainstem bronchus by endobronchial tumor. |
Generate impression based on findings. | Male, 41 years old, history of nasopharyngeal cancer, status post hospital study, evaluate response to previous treatment. Low density soft tissue thickening within the region of the left ethmoid air cells, and to a lesser degree in the region of the right ethmoid air cells, is unchanged relative to the prior exam. The larger focus of tissue on the left abuts the lamina papyracea without definite evidence of bony destruction or orbital invasion. This tissue also abuts the left lateral lamella and fovea ethmoidalis, the latter demonstrating an area of deficiency which is also unchanged.The nasopharyngeal mucosa remains only minimally thickened, at most 9 mm on sagittal images. The tissues are free of any evidence of focal soft tissue mass or discrete pathologic enhancement. The remainder of the aerodigestive mucosa is likewise free of any suspicious lesions.An enhancing mass at the tail of the left parotid gland has significantly reduced in size, now measuring 1.5 x 1.0 cm (image 40 series 6), previously 2.5 x 2.4 cm. An additional reference nodule superficially in the left parotid is also decreased in size measuring 0.6 to 0.6 cm (image 31 series 6), previously 0.8 x 0.8 cm. Bulky adenopathy in the mediastinum is better assessed on the accompanying chest CT.A few additional non-reference lymph nodes have also decreased in size in the left neck. No definite new or progressive adenopathy is seen. Paragraph the right parotid gland, the submandibular glands and thyroid are free of focal lesions. The cervical vessels remain patent. Lung apices are unremarkable.Mixed lytic and sclerotic change of the orbits is redemonstrated, similar to prior exam. Lytic change involving the left fourth rib is also redemonstrated. Bone density in this region seems to have mildly recovered which may reflect some interval healing. | 1. Stable nonenhancing soft tissue thickening involving the region of the ethmoid air cells, left side more so than right. The tissue on the left abuts the anterior skull base which is stably deficient as above. The possibility of intracranial soft tissue invasion would be better assessed on MRI if clinically warranted.2. Interval reduction in size of several presumed pathologic lymph nodes in the left neck. No evidence of any new or progressive adenopathy.3. Stable mild thickening of the nasopharyngeal mucosa. No discrete mass lesion is demonstrated.4. Stable mixed lytic/sclerotic change of the clivus.5. Possible mild healing of a destructive lesion involving the left fourth rib. This is better assessed on the accompanying dedicated chest CT. |
Generate impression based on findings. | 67-year-old patient with acute mental status change. Evaluate for intracranial bleed. There is an arachnoid cyst at the anterior pole of the left temporal lobe in the middle cranial fossa which demonstrates a catheter with its tip in unchanged position adjacent the left superior orbital fissure. The cyst causes minimal stable midline shift and is roughly stable in size when compared to exams from 2005 accounting for differences in acquisition angle.There is prominence of extra-axial CSF spaces when compared to the degree demonstrated within sulci and ventricles. This is not an acute finding, though in the right clinical context sequela of chronic subdural hemorrhage could be one potential etiology. Within the limitations of exam technique, there are no acute abnormalities including new mass, acute hemorrhage, hydrocephalus or evidence of acute ischemia. Gray-white matter differentiation is maintained bilaterally.There are secretions within all sinuses. Mastoid air cells and orbits are unremarkable. | 1. No visualized acute intracranial pathology.2. Stable, prominent extra-axial CSF spaces which could potentially reflect sequela of chronic subdural hemorrhage or effusion.3. Stable shunted arachnoid cyst in the left middle cranial fossa. |
Generate impression based on findings. | Reason: eval PE History: weakness, hypoxia, tachypnic PULMONARY ARTERIES: No evidence of a pulmonary embolus.LUNGS AND PLEURA: Moderate upper lobe predominant paraseptal and centrilobular emphysema.Mild bronchial wall thickening more prominent at the bases with scattered nodular opacities suggesting inspissated mucus/atelectasis.No suspicious pulmonary nodules or masses. No pleural effusions. MEDIASTINUM AND HILA: No mediastinal lymphadenopathy.Cardiac size is normal without evidence of the pericardial effusion.Marked aortic calcification.CHEST WALL: Degenerative changes in the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of a pulmonary embolus. Redemonstration of paraseptal and centrilobular emphysema. |
Generate impression based on findings. | 63 year old male. Reason: Please evaluate cause for RUQ, R flank pain. History: Esophageal ca. ABDOMEN:LUNG BASES: Status post gastric pull up. Stable post-operative changes. No infiltrates, nodules or effusions. LIVER, BILIARY TRACT: Multiple hypodense lesions are scattered through the hepatic parenchyma consistent with hepatic cysts. These lesions are unchanged since the prior examination. There is no intra- or extra-hepatic biliary duct dilatation and the hepatic vasculature is patent. Status post cholecystectomy. SPLEEN: No significant abnormality notedPANCREAS: There is marked celiac and peripancreatic adenopathy, which encases the celiac axis, SMA, SMV, splenic vein and head of the pancreas. This infiltrating adenopathy is stable since the prior exam.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There is marked retroperitoneal lymphadenopathy at the level of the celiac axis that extends inferiorly to the head of the pancreas. This lesion is infiltrating in nature and appears to encase the celiac axis, SMA, confluence of the SMV and splenic vein and the head of the pancreas. This adenopathy appears to extend superiorly across the diaphragm. Stable since the prior exam. BOWEL, MESENTERY: No significant abnormality noted. Small amount of barium contrast in the normal appearing RLQ appendix. 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 | 1.Peripancreatic lymphadenopathy encasing the celiac axis, SMV, splenic vein, head of the pancreas and SMA, extends superiorly across the diaphragm. This lesion is stable since the 9/10/2013 examination.2.No acute change to explain right sided pain. |
Generate impression based on findings. | Male; 47 years old. Reason: Fall + Progression of R MCA infarct History: L side weakness Redemonstration of large acute infarction involving the right MCA distribution, which demonstrates increasing edema, sulcal effacement, and mass effect on the body of the right lateral ventricle. There is 3 mm leftward midline shift at the level of the third ventricle, slightly increased since prior study (image 44, series 80253). No evidence of hemorrhagic conversion. Hyperdense right MCA sign is noted.The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. The calvarium is intact. | Large non-hemorrhagic acute infarction within the distribution of the right MCA with increasing edema and mass effect. |
Generate impression based on findings. | Female 91 years old; s/p MVC with knee pain, XR concerning for L tibial fracture, please evaluate further. The bones are diffusely demineralized indicating osteopenia. A linear lucency extends from the anterior articular surface of the tibial plateau and runs vertically with a slight posteroinferior angle and with minimal displacement, representing a tibial plateau fracture (series 80265, image 22). The fracture is superimposed on a pronounced depression and microfracture throughout the lateral tibial plateau. Severe tricompartmental osteoarthritis is present with bone-on-bone apposition of the lateral compartment. A moderate to large joint effusion is present. A focus of fat is noted in the joint capsule of uncertain etiology. Vascular calcifications are again noted. | 1.Nondisplaced lateral tibial plateau fracture. 2.Moderate to large knee joint effusion.3.marked osteoarthritis of the knee. |
Generate impression based on findings. | Reason: r/o cholecystitis History: abdominal pain ABDOMEN:LUNG BASES: Bibasilar atelectasis and/or scarring.LIVER, BILIARY TRACT: A distended gallbladder with no definite gallbladder wall thickening or pericholecystic fluid. Slight hyperattenuating areas in the dependent portion of the gallbladder are questionable for gallstones. No focal intrahepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate hyperdense foci in the left kidney may represent very small nonobstructing calculi or vascular calcification. No evidence of hydronephrosis or hydroureter bilaterally.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: There is a 2.8 x 2.2 cm right adnexal cystic lesion, not significantly changed compared to prior exam. There is mild amount of fluid within the endometrial cavity.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes and vacuum disk phenomenon involving the L4-L5 and L5-S1 disk spaces.OTHER: No significant abnormality noted | 1.Questionable gallstones visualized without intrahepatic or extrahepatic ductal dilatation. No gallbladder wall thickening or pericholecystic fluid. If there is a strong clinical concern for acute cholecystitis, right upper quadrant ultrasound is recommended.2.Redemonstration of a benign-appearing, unilocular right adnexal cystic lesion, not significantly changed compared to prior exam.3.Increase in intrauterine fluid since prior exam. Stenosis and/or obstruction of the cervical canal cannot be excluded. |
Generate impression based on findings. | Reason: eval thoracic aneurysm History: chest pain, known aneurysm CHEST:LUNGS AND PLEURA: Large bilateral pleural effusions with overlying passive atelectasis. Upper lobe predominant septal thickening compatible with edema.MEDIASTINUM AND HILA: Cardiomegaly with mild coronary artery calcification. No pericardial effusion. Aortic arch aneurysm as described below.VASCULATURE: Ectatic ascending aorta measures 4.3 cm in diameter. Scattered calcification of the great vessels, which are patent. Aortic arch aneurysm originating distal to the left subclavian artery measures 7.4 cm in diameter. There is extensive mural thrombus. The descending thoracic aorta is normal in caliber measuring 3.4 cm in diameter. The main pulmonary artery is enlarged measuring 4.2 cm, which can be seen in pulmonary arterial hypertension.The celiac axis and SMA are patent. There is calcification at the renal artery origins bilaterally with mild narrowing on the right. The left renal artery is not completely evaluated.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Bilateral renal cysts. | 1.Aortic arch aneurysm as described above. 2.CHF.3.Pulmonary arterial hypertension. |
Generate impression based on findings. | 78-year-old male with history of IBD and admitted with multiple abscesses on outside CT. Unclear etiology. ABDOMEN: LUNG BASES: Bilateral small pleural effusions, decreased in size compared to previous study.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: Multiple midline anterior pelvic abscesses are somewhat smaller since the prior examination of 9/26/2013. The abscess in the left lower quadrant adjacent to the sigmoid colon is smaller. The second collection adjacent to the sigmoid colon on the left side is smaller.A third abscess is found on the right side of the sigmoid colon more inferiorly. The wall of the adjacent sigmoid colon is thickened. Adjacent small bowel loops also demonstrate mild wall thickening without evidence of obstruction. There are smaller interloop collections between the small bowel loops.Given the hypodense enteric contrast of CT enterography, the exact location of fistulae is difficult to discern. There are multiple coalescent small bowel loops in the pelvic anterior midline region with thickened bowel wall, extending to the adjacent sigmoid colon. Multiple abscesses are present. Normal appendix in the right lower quadrant. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Anasarca. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Multiple abscesses surrounding the sigmoid colon in the anterior midline region are smaller since the prior examination. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Multiple abscesses adjacent to the sigmoid colon between the small bowel loops in the lower abdomen and in the pelvis, most on the left side. These are somewhat smaller since the 9/26/2013 examination. Adjacent coalescent midline pelvic small bowel loops and sigmoid colon demonstrate mild wall thickening consistent with inflammation.No other significant changes since 9/26/2013. |
Generate impression based on findings. | 76-year-old male with question of infection. History: fever, hypotension CHEST:LUNGS AND PLEURA: Bilateral moderate pleural effusions with underlying atelectasis. Interlobular septal thickening and patchy ground glass opacities are compatible with edema. No suspicious lung nodules or masses. Interlobular septal thickening compatible with pulmonary edema. Right middle lobe and lingular scarring/atelectasis. Calcified left upper lobe granuloma.MEDIASTINUM AND HILA: Cardiac enlargement with marked coronary artery calcification. Small pericardial effusion. ICD leads in the right atrium/ventricle. Severe coronary artery calcifications. No mediastinal or hilar lymphadenopathy. Mild substernal extension of the thyroid gland. Thoracic aorta and great vessel calcification with mural thrombus throughout the descending aorta. Aneurysmal dilatation of the ascending aorta measures 4.5 cm in diameter is unchanged. Scattered mediastinal lymph nodes, which are not pathologically enlarged by CT criteria.CHEST WALL: No significant abnormality noted.ABDOMEN: LIVER, BILIARY TRACT: Hemangioma at the dome, image 81 of series 3. Hydropic gallbladder. Multiple subcentimeter hepatic hypodensities and hyperdensities are too small to characterize. No biliary duct dilatation.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: Small amount of ascites is present. Diffuse atherosclerotic calcifications of the aorta and major branches.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Gas bubble in the urinary bladder, probably due to recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small fat-containing right inguinal hernia. Right femoral venous catheter is in the expected position. | Bilateral pleural effusions. Lower lobe atelectasis. Trace ascites. No abscess or abnormal fluid collection. Cardiomegaly. Other findings are stable. |
Generate impression based on findings. | Male; 55 years old. Reason: r/o pe History: pleuritic chest pain. PULMONARY ARTERIES: Small linear filling defect in a segmental artery of the left lower lobe is suspicious for pulmonary embolus of uncertain chronicity (series 7, image 156).LUNGS AND PLEURA: Mild basilar atelectasis/scarring. No focal air space opacity or pleural effusion. Upper lobe predominant mild centrilobular and paraseptal emphysema.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.Small pulmonary embolus of uncertain chronicity and clinical significance in a left lower lobe segmental artery.2.Saline extravasation into wrist- see details in technique section above. |
Generate impression based on findings. | Right parotid gland mucoepidermoid, high grade carcinoma, stage IVa, pT2N2b, s/p total parotidectomy with ipsilateral neck dissection on August 7, 2008 (9/50 lymph nodes were positive for metastatic carcinoma, the largest focus measuring 4.4 cm with multiple matted lymph nodes). The patient also underwent chemoRT with TFHX, completed October 31,2008. There are posttreatment findings related to right parotid and submandibular gland resection and neck dissection. There is no evidence of locoregional tumor recurrence or significant cervical lymphadenopathy by CT criteria. The remaining major salivary glands are unremarkable. There is an unchanged punctate hypodensity in the left lobe of the thyroid gland. The oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, and subglottic airways are unremarkable. The carotid arteries and jugular veins are patent. There is unchanged mild degenerative cervical spondylosis. There are no lytic or blastic lesions. There is minimal opacification of the right mastoid air cells. The imaged portions of the paranasal sinuses are clear. The imaged portions of the intracranial structures and orbits are unremarkable. There are mild emphysematous changes in the lungs. Please refer to separate chest CT report from for additional details. | Stable posttreatment findings in the right neck without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | 71-year-old female with history of bladder cancer post cystectomy. Reason: Does patient have evidence of abscess in pelvis? Please compare w/prior CT. History: SIRS and prior fluid collection, "cannot r/o abscess". ABDOMEN:LUNG BASES: Bibasilar atelectasis or scar. Coronary artery calcifications. LIVER, BILIARY TRACT: No intra- or extra-hepatic biliary duct dilatation. There is no focal hepatic abnormality. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst. Presumed small right renal cyst. Renovascular calcifications and punctate nonobstructing calculus in the lower pole of the right kidney. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No adenopathy. Inferior vena caval filter is in the expected position. Ectasia of the distal abdominal aorta.BOWEL, MESENTERY: Ostomy in the right lower quadrant. There is no bowel dilatation.BONES, SOFT TISSUES: Degenerative changes.OTHER: Small amount of ascites. Diffuse atherosclerotic vascular calcification. IVC filter is in the expected position. PELVIS:UTERUS, ADNEXA: Post hysterectomy.BLADDER: Post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: In the left pelvis, involving the iliopsoas muscle, there is a small irregular fluid collection associated with surgical clips at the lateral pelvic wall. (image 113, series 3) This is smaller since the prior exam. There is thrombosis of the adjacent iliac and common femoral veins. | Decreased size of the left pelvic fluid collection. Mild ascites. No other significant interval change. |
Generate impression based on findings. | History tonsil cancer, rule out lung mets. LUNGS AND PLEURA: Previously noted left lower lobe ground glass nodule now less dense but similar in size at 4 mm (image 43/99). A punctate left lower lobe micronodular (image 50/99) is unchanged. No new pulmonary nodules.MEDIASTINUM AND HILA: 6 mm right paratracheal lymph node unchanged. Other small subcentimeter nodes also unchanged.CHEST WALL: Healed rib fractures on the right. Stable presumed hemangioma in T12.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Retained gastropexy anchor in soft tissues of anterior abdominal wall, unchanged with no signs of surrounding inflammatory abnormality. | No evidence of metastatic disease. |
Generate impression based on findings. | Male; 76 years old. Reason: r/o subdural hematoma History: ams Stable extensive hypoattenuation in the subcortical, ventricular, and deep white matter with focus of hypodensity in the right thalamus, most compatible with small vessel ischemic disease and right thalamic lacunar infarct of indeterminate age. Stable appearance of encephalomalacia in the right parietal high convexity. Global parenchymal volume loss with ex vacuo dilatation of the ventricular and sulcal CSF spaces, commensurate for patient's age. The ventricles, sulci, and cisterns are symmetric. The gray-white matter differentiation is preserved. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. Vascular calcifications noted. The orbits are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear. The osseous structures are unremarkable. | 1. No CT evidence of acute intracranial abnormality. Please note that CT is not sensitive for early detection of nonhemorrhagic CVA.2. Stable small vessel ischemic disease and right thalamic lacunar infarct of indeterminate age.3. Stable right parietal high convexity encephalomalacia. |
Generate impression based on findings. | 57-year-old male. Metastatic melanoma on DTIC chemotherapy. Reason: pt with met melanoma on DTIC chemotherapy. Please assess response to treatment compared to previous imaging. CHEST:LUNGS AND PLEURA: Multifocal bilateral metastases. Index lesion right lower lobe series 5 image 71 measures 0.7 x 0.6 cm, smaller. A second index lesion is in the left lower lobe posteriorly series 5 image 67, measuring 1 x 0.9 cm. Several of the lesions have decreased in size. No effusions. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Redemonstration of old healed rib fractures and small nonpathologic sized axillary nodes.ABDOMEN:LIVER, BILIARY TRACT: Index hypodense lesion in segment 7, series 3 image 109, 1.2 x 0.9 cm is stable Reference lesion in the lateral segment of left lobe, series 3 image 139, measures 1.7 x 2.4 cm, smaller since the prior exam. Hypodense lesion in the dome of the left lobe is unchanged from baseline of 2/8/12, likely a cyst.Central hypodense lesion abutting the middle hepatic vein is unchanged but indeterminate. It was also seen on 2/8/12 where it appeared slightly smaller.Small hypoattenuating focus bulging the capsule of the lateral segment of the left lobe series 3 image 97, probably focal fat infiltration.Hypodense focus along the fissure for the ligamentum venosum in the medial segment of left lobe series 3 image 129 and represent vascular flow phenomenon focal fat and is unchanged from the prior scan.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: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Small pelvic lymph nodes are unchanged. An index distal left external iliac node measured on series 2 image 191, 1.8 x 0.8 cm. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No new sites of disease. Index lesions are stable or slightly smaller. No other significant change. |
Generate impression based on findings. | 41 year old male. Reason: h/o HNC, Dr. Vokes would like an eval s/p hospital stay and possible response to previous treatment. Compare to previous scans and measurements. LUNGS AND PLEURA: Stable multiple pulmonary nodules and micronodules, Reference right lower lobe nodule (series 9, image 118) measures 5.3 mm. The pulmonary nodule in the superior segment of the left lower lobe has changed in location (series 9, image 66), but is stable in size.MEDIASTINUM AND HILA: Stable bilateral mediastinal adenopathy. New patulous esophagus which is has a fluid-filled to the level of upper esophageal sphincter. There is concentric thickening of the esophageal wall.CHEST WALL: Gynecomastia. Mixed sclerotic lesion is seen in the T9 vertebral body.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly with cranio-caudal dimension of 24 cm. The numerous hyperattenuating lesions scattered throughout the liver mentioned on the prior exam are no longer seen. There are multiple larger hypoattenuating lesions with peripheral enhancement, which appear stable to larger in size and unchanged in number since the prior examination. There is no intrahepatic biliary ductal dilatation. The index lesion at the hepatic dome has increased from 3.2 cm diameter to 4 x 4 cm at image 83 of series 3. The index lesion in the left lobe medial segment is 3.6 x 4.2 cm at image 99 of series 3, larger. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There is diffuse peripancreatic, retroperitoneal, aortocaval, and paraaortic lymphadenopathy, with stable reference lesion measuring 2.3 x 2.0 cm, (image 104, series 3).BOWEL, MESENTERY: There is a gastrostomy tube in the expected position.BONES, SOFT TISSUES: The known mixed sclerotic lesion in the T9 vertebrae is stable. Cannot identify small hyperattenuating lesions in pelvis, sacrum and lower lumbar spine, mentioned previously. Degenerative changes in 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: Cannot identify small hyperattenuating lesions in pelvis, sacrum and lower lumbar spine, mentioned previously. Degenerative changes in the lumbosacral spine and pelvis. OTHER: No significant abnormality noted | 1.Stable to increased size of metastatic lesions throughout the liver with associated retroperitoneal lymphadenopathy consistent with metastatic disease.2.Cannot identify small hyperattenuating lesions in liver, pelvis, sacrum and lower lumbar spine, mentioned previously. 3.Stable retroperitoneal adenopathy. No new lesions. |
Generate impression based on findings. | Walking difficulty. Evaluate for intracranial mass. There is no intracranial mass, fluid collection, hemorrhage, hydrocephalus or evidence of acute ischemia. Gray-white matter differentiation is normal and the midline is intact. Incidental note is made of a cavum septum pellucidum and vergae.There are secretions in the sphenoid sinus which could represent sinusitis. Orbits and mastoid air cells are unremarkable. | No acute intracranial abnormality which would explain the patient's walking difficulty. Sphenoid sinus secretions which could suggest sinusitis. |
Generate impression based on findings. | Metastatic lung cancer status post 6 cycles chemotherapy. CHEST:LUNGS AND PLEURA: Reference right upper lobe mass measures 48 x 38 mm on image 31/111 (51 x 40 mm on prior). Reference left upper lobe nodule measures 15 x 13 mm on image 45/111 (15 x 13 mm in prior). Scattered ill-defined subcentimeter upper lobe nodular opacities are unchanged, bilaterally. Emphysema. No new pulmonary nodules. The previously referenced left lower lobe micronodule is not as well visualized on current study.MEDIASTINUM AND HILA: Reference left upper paratracheal/anterior mediastinal lymph node is stable 8 mm (image 18/145). Other small nodes are unchanged. The reference subcarinal lymph node is stable at 9 mm on image 37/145.CHEST WALL: Reference lymph node in the right lower neck is stable at 12 mm on image 6/145. Stable subcutaneous soft tissue lesion in left lower back of uncertain significance (image 95/145). Stable T10 compression fracture and mild compression deformities of surrounding vertebral bodies.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Punctate hypodensity in right lobe of liver (image 11/145) unchanged but too small to characterize. It is likely benign.SPLEEN: NegativeADRENAL GLANDS: Equivocal, previously referenced right adrenal nodule measures 10 x 7 mm (image 96/145) though some of this measurement includes the normal adrenal gland.KIDNEYS, URETERS: Stable left renal cyst. Stable small left renal calculus. Small subcentimeter hypodensities in right kidney are presumed cysts. These are unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches.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. Grossly stable pulmonary masses. 2. Stable lymphadenopathy.3. No new sites of disease. |
Generate impression based on findings. | Female; 25 years old. Reason: eval PE History: chest pain, back pain. PULMONARY ARTERIES: No evidence of pulmonary embolism. Upper normal pulmonary trunk diameter. LUNGS AND PLEURA: Minimal basilar scarring. No focal air space opacity or pleural effusion. Right lower lobe subpleural nodule is most likely post-infectious or embolic in etiology (series 10, image 64). MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Mildly enlarged left supraclavicular and axillary lymph nodes are nonspecific. 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. 2.No acute pulmonary or mediastinal abnormalities. |
Generate impression based on findings. | Reason: eval abscess/hydro History: abd pain, recent pyelo ABDOMEN:LUNG BASES: Basilar scarring/atelectasis.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. Evaluation for hepatic neoplasm is limited by single portal venous phase of contrast. Mild intrahepatic biliary ductal dilatation. Porta hepatis lymphadenopathy represents an expected finding in cirrhosis. No ascites. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis or nephrolithiasis. No perinephric collections or fat stranding. Right upper pole simple cyst.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta and its branches. Small retroperitoneal lymph nodes.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: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of renal abscess or hydronephrosis.2.Cirrhosis and nonspecific mild intrahepatic biliary duct dilatation. Evaluation for hepatic neoplasm is limited by the single portal venous phase of contrast. |
Generate impression based on findings. | Status post two cycles second line therapy for extensive stage small cell lung cancer. Oxygen dependent, COPD, pleural effusion. CHEST:LUNGS AND PLEURA: Emphysema.Significantly improved aeration of the left upper lobe though there is extensive residual interstitial and groundglass opacity and presumably some degree of lymphangitic tumor spread and/or radiation pneumonitis in this location. However, no measurable mass remains in this area. Interval decrease in left pleural effusion status post pleural drainage catheter placement. No suspicious pulmonary nodules on the right.MEDIASTINUM AND HILA: Large mediastinal mass has significant decreased in size now measuring 26 x 22 mm on image 32/164 (55 x 39 mm on prior image 17/86). Intrathoracic lymphadenopathy has also decreased. For continued reference a right paratracheal lymph node measures 12 mm on image 31/164 (19 mm on prior image 23/86).Atherosclerotic calcification of the aorta and its branches. Coronary calcification.CHEST WALL: Left supraclavicular lymphadenopathy has significantly decreased. Heterogeneous sclerosis in T9 vertebral body presumably metastatic disease is not significantly changed. Sclerotic lesion in the sternum is also presumably metastatic disease and was present on prior study. Similar areas of presumed metastatic disease are seen in T11 and L3 and 4. There is a compression fracture of L4. Small axillary lymph nodes unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.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: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Multifocal osseous metastases, unchanged.OTHER: No significant abnormality noted. | 1. Significant interval decrease in primary mediastinal mass. Left upper lobe now much better aerated with residual opacity presumably related to radiation pneumonitis and/or lymphangitic tumor spread but no measurable mass. Continued follow up is recommended.2. Interval decrease in widespread lymphadenopathy.3. Decrease in left pleural effusion s/p drainage catheter placement.4. Stable osseous metastases. |
Generate impression based on findings. | Female, 60 years old, with headache and subarachnoid hemorrhage. Evaluate for resolution. Continued interval decrease in conspicuity of several areas of subarachnoid hemorrhage is demonstrated. This includes within the right sylvian fissure, several frontal lobe sulci, and the left central sulcus. Hypodensity involving the right anterior temporal lobe, compatible with contusion, is redemonstrated. Parenchymal blood product at this site has also diminished in conspicuity.No areas of new intracranial hemorrhage are seen. Parenchymal morphology is otherwise unremarkable. The ventricular system is stable and normal in size. Mild hyperdense material along the right ventricular atrium is unchanged and may reflect choroid plexus calcification or perhaps a small amount of intraventricular blood product. | Continued evolution of intracranial hemorrhage. Subarachnoid blood product at several locations as described above is barely detectable on the current exam. No new areas of hemorrhage are seen. |
Generate impression based on findings. | Reason: eval abscess/infection History: LLQ abd pain, tachy, back pain ABDOMEN:LUNG BASES: Basilar atelectasis or scarring.LIVER, BILIARY TRACT: High density material in the gallbladder likely represents vicarious excretion of contrast from prior CT.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Retained contrast from prior CT compatible with renal dysfunction. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Asymmetric enlargement of the left iliopsoas with surrounding fat stranding of indeterminate etiology.BOWEL, MESENTERY: No evidence of obstruction. The appendix is normal. No pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Distended with contrast from prior CT.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. | 1.Nonspecific inflammation of the left iliopsoas of indeterminate etiology.2.Persistent nephrogram compatible with renal dysfunction. |
Generate impression based on findings. | Reason: evaluate for cholelithiasis, pancreatitis, patient s/p renal transplant History: RUQ abdominal pain 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: No significant abnormality noted. Severe coronary artery calcifications.LIVER, BILIARY TRACT: No intrahepatic focal lesions. No evidence of intrahepatic or extrahepatic ductal dilatation. Gallstones in a distended gallbladder, largest measuring 2.4 cm. There is associated gallbladder wall thickening measuring 4 mm without pericholecystic fluid.SPLEEN: No significant abnormality noted.PANCREAS: Atrophic pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral atrophic native kidneys with exophytic, probable cysts. Transplant kidney in the right iliac fossa.RETROPERITONEUM, LYMPH NODES: Scattered mesenteric lymph nodes.BOWEL, MESENTERY: Right lateral abdominal wall hernia containing small and large bowel along with the pole of the transplant kidney, increased in size compared to prior exam.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy with postsurgical changes.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis involving the sigmoid and descending colon. No fat stranding.BONES, SOFT TISSUES: Bilateral inguinal surgical clips.OTHER: No significant abnormality noted | 1.Large 2.4 cm gallstone within a distended gallbladder with gallbladder wall thickening may represent acute cholecystitis.2.Diverticulosis involving the sigmoid and descending colon without complications. Interval increase in size of right lateral abdominal wall hernia containing small and large bowel are along with the pole of the transplant kidney.3.Bilateral atrophic native kidneys with exophytic, probable cysts. |
Generate impression based on findings. | 74-year-old male. Restage lymphoma. Reason: Hx NHL lymphoma s/p 6 cycles of R-CHOP 11/2011; compare to previous. CHEST:LUNGS AND PLEURA: Right upper lobe pulmonary nodule is unchanged. No new or suspicious pulmonary nodule or mass. Mild upper lobe predominant centrilobular and paraseptal emphysema, unchanged. Biapical scarring unchanged.MEDIASTINUM AND HILA: Small nonenlarged mediastinal lymph nodes are not significantly changed. Stable reference aortopulmonary lymph node measures 7 x 5 mm (series 3 image 33). Coronary artery calcifications and lymph nodes are unchanged. Heart size is normal with no pericardial effusion.CHEST WALL: Postsurgical changes in the right chest wall. Elevation of the left hemidiaphragm, unchanged. ABDOMEN: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: Atherosclerotic calcification of the abdominal aorta and its branches. No enlarged retroperitoneal lymph nodes. Mild dilatation of the abdominal aorta is unchanged.BOWEL, MESENTERY: Colonic diverticulosis without evidence of acute diverticulitis.BONES, SOFT TISSUES: Mild degenerative changes of the spine. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: The bladder is distended but otherwise unremarkable.LYMPH NODES: No enlarged pelvic lymph nodes.BOWEL, MESENTERY: Colonic diverticulosis without evidence of acute diverticulitis.BONES, SOFT TISSUES: Sclerotic changes in the left iliac wing, acetabulum, pubis and left femoral head are unchanged and may be due to Paget's disease.OTHER: No significant abnormality noted | 1.Stable examination with no enlarged lymph nodes.2.Stable osseous changes in the left pelvis and femoral head. 3.No new lesions. |
Generate impression based on findings. | Reason: r/o hematoma post-fall History: fall, hit left forehead 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 demonstrates a mucosal thickening along the maxillary sinuses right more than left. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of nonhemorrhagic CVA |
Generate impression based on findings. | 74-year-old male h/o SDH, s/p burr holes History: surveillance A previously demonstrated left sided hypodense subdural hematoma now measures 6 mm (previously 7 mm). There are no residual findings of right subdural hematoma. The patient is status post left-sided craniotomy. A there is no acute intercranial hemorrhage. There is no mass, mass-effect, or midline shift. There are no CT findings to suggest acute territorial to a cortical infarct. The thecal thickening is present throughout the ethmoid air cells as well as within the right sphenoid sinus. Bilateral mastoid air cells and middle ear cavities remain clear. | 1.A previously demonstrated left sided hypodense subdural hematoma now measures 6 mm (previously 7 mm).2.There are no residual findings of right subdural hematoma. |
Generate impression based on findings. | Reason: evalutate for vascular stenosis History: TIA Neck CTA: There is opacification of the aortic arch, great vessels and carotid arteries and vertebral arteries. The origins of the innominate artery and left common carotid artery are not included on this exam. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. Atherosclerotic calcifications are present at the carotid bifurcations..There are some degenerative changes present in the cervical spine a mild degree. Paragraph there are pleural effusions present.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The anterior communicating artery is medium-sized. There is fetal origin of the posterior cerebral arteries bilaterally there the right P1 segment is small where as the left P1 segment is similar in size to the left posterior communicating arteryThere is extracranial origin of the left posterior inferior cerebellar artery. This vessel is a dominant cerebellar vessel. The anterior/inferior cerebellar arteries are non-dominantCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of multiple hypodense foci identified in the basal ganglia bilaterally Periventricular and subcortical white matter hypodensities of a mild to moderate degree are present. Atherosclerotic calcifications are present along the distal internal carotid arteries.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.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease3.there are multiple lesions in the basal ganglia which are compatible with lacunar infarcts age indeterminate.4.Periventricular and subcortical white matter changes of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. 5.pleural effusions |
Generate impression based on findings. | Question evidence of interstitial disease. Shortness of breath, low DLCO. LUNGS AND PLEURA: Though there is minimal nonspecific subpleural reticulation at the lung bases, the dominant abnormality is upper lobe predominant paraseptal and centrilobular emphysema. No evidence of honeycombing or groundglass opacity. Scattered punctate micronodules, largest is approximately 4 mm and is perifissural (image 51/106). Though these are nonspecific there most likely post inflammatory granulomas or intrapulmonary lymph nodes. Very mild airtrapping on expiratory phase imaging.MEDIASTINUM AND HILA: Calcified nodule left thyroid gland. Status post tricuspid valve repair. Old epicardial pacer leads are present. Small hiatal hernia.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Though there is minimal nonspecific subpleural reticulation at the lung bases, the dominant abnormality is upper lobe predominant paraseptal and centrilobular emphysema. |
Generate impression based on findings. | Female, 25 years old, status post hysterectomy with drainage catheters and headache. Surgical change is redemonstrated including evidence of a right hemispherectomy and right-sided craniotomies.Two drainage catheters are redemonstrated both of which terminate within the right-sided hemispherectomy defect. One of these enters from the right parietal bone, and the other enters from the left parietal bone. The two systems connect at a reservoir in the left parietal region. The radiopaque portions of the system are intact.Since the prior examination, intraventricular contrast has cleared. The left lateral ventricle remains small in caliber, similar to the prior exam. The right-sided hemispherectomy defect is also not significantly changed in caliber or morphology.Shift of midline to the right is stable. No new mass-effect, focal parenchymal edema, or other new lesions are detected. | Stable surgical change consistent with a right hemispherectomy. The hemispherectomy defect is unchanged in morphology. The shunted defect and left-sided ventricular system remain stable in caliber. |
Generate impression based on findings. | 80 year old female. Reason: Colon cancer please compare to previous scans and provide index lesion measurements for RECIST CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some calcified.No pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Coronary artery calcifications. Right chest wall Port-A-Cath tip at the cavoatrial junction. Large hiatal hernia.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Hepatic contour is smooth. No suspicious hepatic lesions. No biliary ductal dilatation. The hepatic vasculature is patent.SPLEEN: Scattered calcified splenic granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic kidneys. Heterogeneous enhancement of the kidneys may represent prior ischemic event.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta and its branches without aneurysmal dilatation.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: Sigmoid diverticulosis, similar in appearance to the prior exam, without evidence of diverticulitis.BONES, SOFT TISSUES: Stable L1 compression deformity.OTHER: No significant abnormality noted. | 1.Stable exam without evidence of recurrent or metastatic disease.2.Sigmoid diverticulosis, unchanged. |
Generate impression based on findings. | Reason: post-operative etv History: headache Since the prior examination a ventriculostomy tube has been placed which courses through the right frontal lobe into the right lateral ventricle with tip in the region of the foramen of Monro. The lateral ventricle biventricular diameter on the coronal imaging at the level of the foramen of Monro is approximately 34 mm. Since the prior exam the temporal horns of the lateral ventricles have significantly decreased in size. There is some intracranial air present.There is a hyperdense mass centered in the left precentral gyrus at the hand motor area which has a thin rim of hypodensity compatible with vasogenic edema. Deep to this in the peri-ventricular white matter there is a hyperdense lesion with similar imaging characteristics. There are multiple lesions scattered in both cerebellar hemispheres with a similar imaging characteristics to the above lesions which are partially obscured by artifact and better seen on recent MRI of the brain. Another lesion is present along the posterior aspect of the third ventricle . The cerebellar tonsils are low lying and and at the superior cerebellar cistern is effaced. There is associated ventriculomegaly.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 a ventriculostomy tube is in place and the lateral ventricles have decreased in size2. Multiple heterogeneous lesions scattered in the cerebellar hemispheres, third ventricle as well as the left hemisphere are compatible with metastatic disease given the patient's clinical history of metastatic adenocarcinoma.3.there is mass effect in the posterior fossa with tonsillar herniation as well as some superior transtentorial herniation. |
Generate impression based on findings. | Male, 35 years old, history of AVM with seizure. A partially calcified lesion is reidentified within the left frontal lobe compatible with patient's known AVM. The surrounding parenchyma demonstrates hypodensity and some degree of encephalomalacia, in a pattern similar to that seen on the prior examination. Large draining veins extend from the lesion, meandering around the brainstem to join with the deep venous system.No evidence of intracranial hemorrhage, new parenchymal edema or new intracranial lesions is seen. The left lateral ventricle remains smaller than the right, but the size and morphology are unchanged. No significant mass-effect or midline shift is demonstrated.The bony calvarium and skull base are intact. The paranasal sinuses and mastoid air cells are clear. | Stable CT appearance of the patient's known left frontal AVM with stable associated parenchymal abnormalities. No intracranial hemorrhage, new edema, mass effect or other acute findings are seen. |
Generate impression based on findings. | Reason: frame guidance hcp History: headache The examination was performed with a stereotactic frame in place which may obscure some abnormalitiesThere is a 23 x 16 mm axial dimension mass centered in the left precentral gyrus at the hand motor area which was is hyperdense relative to gray matter and has a thin rim of hypodensity compatible with vasogenic edema. Deep to this in the peri-ventricular white matter there is a 8mm enhancing hyperdense lesion with similar imaging characteristics. There are multiple lesions scattered in both cerebellar hemispheres with a similar imaging characteristics to the above lesions which are partially obscured by artifact and better seen on recent MRI of the brain. Another lesion is present along the posterior aspect of the third ventricle . The cerebellar tonsils are low lying and and at the superior cerebellar cistern is effaced. There is associated ventriculomegaly.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.Multiple heterogeneous lesions scattered in the cerebellar hemispheres, third ventricle as well as the left hemisphere are compatible with metastatic disease given the patient's clinical history of metastatic adenocarcinoma.2.Ventriculomegaly probably due to the above described metastatic lesions especially the one in the vermis and the one in the third ventricle3.there is mass effect in the posterior fossa with tonsillar herniation as well as some superior transtentorial herniation.4.This is a limited exam for the purpose of stereotactic guidance. |
Generate impression based on findings. | Evaluate opacities in right lung noted on recent MRI. LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Esophageal varices.CHEST WALL: The abnormalities noted on MR correlate with multiple bilateral subacute rib fractures.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cirrhotic liver status post TIPS. Please see recent MR for further details. | The abnormalities noted on MR correlate with multiple bilateral subacute rib fractures. |
Generate impression based on findings. | Reason: rule out obstruction vs appendicitis History: abd pain, n/v ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: A small subcentimeter, hypodense lesion in the right lobe of liver, segment 4 A is too small to further characterize. No intrahepatic or extrahepatic biliary ductal dilatation. No gallbladder wall thickening or pericholecystic fluid. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix measures up to 9 mm in without fluid collections. There is slight wall enhancement and minimal surrounding fat stranding.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 | 1.The diameter of the appendix is slightly greater than average measuring at 9 mm with slight enhancement of the wall and minimal fat stranding. These findings are indeterminate and could represent early appendicitis or be a variant of normal.2.Small hypodense lesion in the right lobe of the liver is too small to further characterize. |
Generate impression based on findings. | Reason: 60 male with AML, neutropenic fever, r/o infiltrate History: Neutropenic fever LUNGS AND PLEURA: Almost complete interval resolution of multiple nodular or focal air space opacities and micronodules.No new findings.MEDIASTINUM AND HILA: No significant lymphadenopathy.Mildly enlarged main pulmonary artery suggestive of pulmonary hypertension and low blood pool opacity consist with anemia.Catheter tip in the SVC.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. | Almost complete resolution of pulmonary nodules and focal consolidation, consistent with infection. |
Generate impression based on findings. | Recurrent head and neck cancer. LUNGS AND PLEURA: Scattered areas of bronchial thickening and bronchiectasis with centrilobular nodules are unchanged and likely related to chronic aspiration. Previously noted right lower lobe micronodule is no longer visible. No new pulmonary nodules.MEDIASTINUM AND HILA: Borderline right hilar lymph node is unchanged. Venous catheter tip at RA/SVC junction. Coronary calcification. Postop change involving the neck. Please see dedicated neck CT report for further details.CHEST WALL: Right chest wall port.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Gastrojejunostomy tube partially visualized. T12 compression deformity unchanged. | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: unruptured cerebral aneurysm incidentally found with family history of 2 family members with ruptured anerusym, evaluate for changes History: evaluate for changes, unruptured cerebral aneurysm Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The posterior communicating arteries are small. The anterior communicating artery is medium sizeCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense focus present in the left paracentral lobule which involves gray and white matter which is associated with hypodensity tracking down into the posterior limb of the left internal capsule and from there into the left cerebral peduncle and pons.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 lesion present involving the left paracentral lobule with extension into the internal capsule and left brain stem which is associated with some mass effect. It was not readily identified on MRA of the brain performed in July. If clinically appropriate an MRI of the brain may be of benefit to further evaluate this2.No evidence for cerebral vascular occlusive disease3.no evidence for intracranial aneurysm4.findings were discussed with Dr. Awad at the time of this interpretation. |
Generate impression based on findings. | 51 year old female. Reason: history of breast cancer, pt currently in treatment - scan for response/progression. please use measurements if applicable and compare with previous CHEST: LUNGS AND PLEURA: Suspicious nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Reference prevascular lymph node measures 1.6 x 0.9 cm (series 3, image 27), unchanged. No additional lymphadenopathy. Heart size is normal. No pericardial effusion. Right central venous catheter tip at the cavoatrial junction.CHEST WALL: Status post bilateral mastectomy. Bilateral chest wall skin thickening. Enhancing subcutaneous focus in the left anterior chest wall measures 2.3 x 1.2 cm (series 3, image 30), unchanged. Near simple fluid attenuating collection in the left chest wall is not significant changed in size from the prior exam and is compatible with postsurgical seroma. A smaller right chest wall fluid collection is unchanged. No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Indeterminate lesion at the hepatic dome measures 1.3 x 1.0 cm (series 3, image 66), previously 1.8 x 1.2 cm. Additional scattered hypodense lesions are too small to further characterize, but are likely simple cysts.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: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Indeterminate hepatic dome lesion is unchanged.2.Stable prevascular mediastinal lymph node.3.Stable left anterior chest wall nodule.4.Status post bilateral mastectomy with postsurgical fluid collections, unchanged in size. |
Generate impression based on findings. | Metastatic thyroid cancer on sorafenib CHEST:LUNGS AND PLEURA: Motion limits sensitivity.Multiple pulmonary nodules are stableReference right lower lobe nodule (image 47, series 4) is unchanged, measuring 11 mm x 10 mm.Reference right apical nodule (image 22 series 4) is unchanged measuring 7 mm x 6 mm.Reference left basilar nodule (image 48 series 4) is unchanged measuring 17 mm x 15 mm. (Note this was reported as 17 x 10 mm on prior but actually measured 17 x 15 mm as indicated on key images).MEDIASTINUM AND HILA: Mass at left thoracic inlet consistent with known malignancy. See neck CT report for further details.Extensive intrathoracic lymphadenopathy is not significantly changed. Lower right paratracheal lymph node is stable 18 mm (image 25/136). AP window lymph nodes stable at 15 mm (image 26/136). Subcarinal lymphadenopathy stable at 13 mm (image 34/136).CHEST WALL: Small axillary lymph nodes are unchanged. Degenerative change involving the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.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: Upper abdominal lymphadenopathy is unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving spine with superior endplate compression of L2.OTHER: No significant abnormality noted. | Stable lymphadenopathy and pulmonary metastases. |
Generate impression based on findings. | Reason: r/o obstruction vs colitis History: abdominal pain ABDOMEN:LUNG BASES: New right lower lobe linear atelectasis. Redemonstration of abnormal elevation of the right hemidiaphragm.LIVER, BILIARY TRACT: Cirrhotic liver morphology with evidence of portal hypertension. Atrophied left lobe liver, segment 2, 3, 4 with hypoperfusion. Redemonstration of the small, hypodense lesion in the right lobe of liver, segment 7 is likely hepatic cyst. No suspicious focal liver lesions. Redemonstration of gallbladder wall thickening with slight increase of surrounding fluid. This may represent an increase in previously demonstrated ascites surrounding the gallbladder or may represent a pericholecystic fluid. There is no evidence of gallstones although CT misses 20 to 30% of cholelithiasis. No evidence of gallbladder distention or intrahepatic or extrahepatic ductal dilatation. SPLEEN: Splenomegaly with portosystemic collaterals.PANCREAS: Redemonstration of a hypodense lesion in head of pancreas, grossly unchanged compared to prior exam.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Simple renal cysts in lower pole of the left kidney and 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 are again visualized. Umbilical hernia is filled with ascites.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: New thickening of the ball wall involving the descending and sigmoid colon with surrounding fat stranding.BONES, SOFT TISSUES: No significant abnormality notedOTHER: A minimal amount of ascites about the liver and gallbladder, slight interval increase compared to prior exam. | Increased fluid about the gallbladder may be accounted for by chronic liver disease but may also represent pericholecystic fluid to suggest cholecystitis. If there is concern for acute cholecystitis, a nuclear medicine or sonographic examination is advised.1.New bowel wall thickening involving the descending and sigmoid colon with fat stranding may represent colitis of indeterminant etiology, possibly inflammatory or infectious etiology.2.Cirrhotic liver with atrophic, hypoperfused left lobe, consistent with focal confluent fibrosis.3.Portal hypertension with splenomegaly and splenorenal shunt with slight interval increase in amount of ascites. |
Generate impression based on findings. | Reason: 84 y/o F with n/v eval for esophageal dysmotility, food impaction History: above CHEST:LUNGS AND PLEURA: Chronic reticulonodular interstitial disease with basilar honeycombing and traction bronchiectasis, with a predominantly subpleural and basilar distribution, not significantly changed. This finding is consistent with rheumatoid lung disease, possibly with a component of chronic aspiration.MEDIASTINUM AND HILA: Massively dilated esophagus containing a large amount of food material, consistent with a history of achalasia.Moderate coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. Dilated bile duct.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Moderately enlarged right adrenal gland, not significantly changed.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderately enlarged lymph nodes.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Retained contrast material in multiple colonic diverticula.Colostomy stoma in the left lower quadrant of the abdomen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Massively dilated esophagus with retained food material.2. Basilar predominant pulmonary fibrosis compatible with UIP, likely secondary to rheumatoid disease and possibly related to recurrent aspiration. |
Generate impression based on findings. | Sinus disease and septal/facial trauma s/p MVA. There is moderate bilateral maxillary sinus mucosal thickening, extending into the bilateral infundibula. There is moderate scattered ethmoid sinus opacification. There is Keros 2 configuration of the cribriform plate. The fovea ethmoidalis are symmetric. The ethmoid roof is intact. There is mild left and moderate right sphenoid sinus mucosal thickening. There is mild bilateral frontal sinus mucosal thickening. The olfactory recesses are clear. There is mild nasal septal deviation to the right. There is deformity of the bilateral nasal bone and frontal process of the maxilla fractures, compatible with prior fracture. There is left phthisis bulbi. The lamina papyracea are intact. The optic nerve canals and carotid grooves are covered by bone. There are carious ADA 5 and 13. The mastoid air cells are clear. The imaged portions of the intracranial structures are grossly unremarkable. | 1. Mild to moderate pan-sinus opacification in a sporadic pattern.2. Post-traumatic findings related to nasal bone and frontal process of the maxilla fractures and phthisis bulbi.3. Dental caries. |
Generate impression based on findings. | Female 80 years old Reason: hx of osteosarcoma, evaluation for mets History: hx of osteosarcoma, evaluation for mets LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules are unchanged in size and extent since the 2/19/2013 exam, and are likely benign in etiology. No new suspicious pulmonary nodules or masses identified. Minimal bibasilar atelectasis unchanged.MEDIASTINUM AND HILA: Moderate calcific changes in the wall of the thoracic aorta and mild calcific changes in the walls of the coronary arteries consistent with atherosclerotic disease. No evidence of mediastinal or hilar lymphadenopathy. Small sliding-type hiatal hernia.CHEST WALL: Mild multilevel degenerative changes seen in the thoracic and cervical spine, without evidence of metastatic disease. Wedge deformity of a lower thoracic vertebral body unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the right hepatic lobe appears unchanged and likely represents a hepatic cyst. Nodular lesion of the gallbladder fundus is incompletely visualized. Diverticulosis of the visualized descending and transverse colon. Atherosclerotic disease of the abdominal aorta and its branches. | No evidence of metastatic disease. |
Generate impression based on findings. | Recurrent head and neck cancer, pretreatment scan. CHEST:LUNGS AND PLEURA: Widespread bilateral pulmonary nodules consistent with metastatic disease. For continued reference a right lower lobe pulmonary nodule measures 9 x 9 mm on image 79/129 and a left lower lobe pulmonary nodule measures 9 x 7 mm on image 64/129. Apical emphysema and/or radiation pneumonitis.MEDIASTINUM AND HILA: Postop change involving the neck. Please see dedicated neck CT report for further details. Port catheter tip in SVC. Coronary calcification. Dilated left ventricle.CHEST WALL: Postop change involving the left axilla. Extensive residual lymphadenopathy. For continued reference a left axillary lymph node measures 15 mm on image 29/156. Postop change involving the left suprascapular area, incompletely visualized (image 1/156), please degenerative neck CT report for further details.Degenerative changes involving the spine but no definitive osseous metastases are evident.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypodensity in right hepatic lobe too small to characterize though continued follow-up is recommended (image 121/156). Ill-defined 1 to 2-cm hypodense nodule in hepatic dome (image 83/156) may be a hemangioma but is poorly visualized.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: Atherosclerotic calcification of the aorta and its branches.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. Pulmonary metastases.2. Left axillary lymphadenopathy.3. Left suprascapular soft tissue thickening, see neck CT report for further detilas.4. Nonspecific hepatic lesions which are more likely benign than malignant, though continued follow up is recommended. |
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