instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Female; 57 years old. Reason: eval for interstitial lung disease History: Abnormal CXR and PFTs, chronic dyspnea on exertion. LUNGS AND PLEURA: Extensive areas of consolidation have resolved since the prior study. No new focal air space opacities or pleural effusions. There are multifocal areas of ground glass opacity, as well as septal thickening and mild basilar predominant bronchiectasis. No honeycombing, centrilobular nodules, or evidence of air trapping on expiration views. Mild basilar scarring/discoid atelectasis, left greater than right. While these findings are nonspecific, differential considerations include atypical pulmonary edema, hypersensitivity pneumonitis, or drug reaction. MEDIASTINUM AND HILA: Mild cardiomegaly without pericardial effusion. Multiple small subcentimeter mediastinal lymph nodes are not significantly changed. Mild coronary and aortic calcifications. Enlarged and calcified thyroid gland is compatible with goiter. Enlargement of the main pulmonary trunk is compatible with pulmonary arterial hypertension. Small hiatal hernia.CHEST WALL: Median sternotomy hardware. No axillary lymphadenopathy. Superior vena cava occlusion with multiple chest wall collateral vessels again seen. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodensity in the peripheral right hepatic lobe most likely represents a benign cyst. | 1.Multifocal ground glass opacities, septal thickening, and mild basilar predominant bronchiectasis. Differential considerations include atypical pulmonary edema, hypersensitivity pneumonitis, and drug reaction. 2.Interval resolution of extensive lower lung zone and right middle lobe consolidation.3.Findings compatible with pulmonary arterial hypertension. |
Generate impression based on findings. | Male 53 years old Reason: metastatic thyroid ca, eval for dz progression History: as above CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules the majority of which are unchanged in size and extent.Reference pulmonary nodule measurements are as follows:Right lower lobe reference nodule measures 0.8 cm (series 5, image 74), previously 0.8 cm. Lingular lesion measures 2.0 cm (series 5, image 54), previously 1.2 cm. Left lower lobe nodule measures 0.7 cm (series 5, image 65), previously 0.6 cm.Subcentimeter soft tissue density endophytic tracheal nodule appears unchanged.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy unchanged. Reference subcarinal lymph node measures 1.5 cm (series 3, image 48), previously 1.6 cm. Reference left hilar lymph node measures 2.7 cm (series 3, image 49), previously measured 2.7 cm.Postsurgical changes compatible with thyroidectomy and tracheostomy. Tracheostomy cannula and phonation device in place.Normal heart size and no evidence of pericardial effusion.CHEST WALL: Lytic/sclerotic lesion in the T8 vertebral body unchanged. Lytic lesion in the left anterolateral T11 vertebral body slightly increased in size.There is a lytic lesion in the right anterior clavicular head which demonstrates posterior cortical disruption an irregular margin, and is compatible with metastasis.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: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Enlarged lingula reference nodule, and otherwise stable pulmonary nodules.2. Stable hilar and mediastinal lymphadenopathy.2. Interval increase in size of the lytic lesion in the T11 vertebral body.3. Newly identified right clavicular head lytic lesion compatible with metastasis. |
Generate impression based on findings. | History of chordoma CHEST:LUNGS AND PLEURA: Left upper lobe cavitary lesion measures 2.4 by 1.6-cm on image number 17, series number 4, slightly smaller compared to previous study.Lobulated referencing the liver mass abutting the pericardium measures 5.1 x 3. 6 cm number 58, series number 4, increasedin size compared to previous study. Index left lower lobe measures 5.2 by 3.9-cm on image number 75, series number 4, increased in size compared to previous study.Other numerous nodular densities in the liver are also stable to minimally increased in size compared to previous study.MEDIASTINUM AND HILA: Index right hilar lymph node measures 2.7 by 2.1-cm image number 43, series number 3. Index left hilar lymph node measures 3.2 x 2.4 cm image number 39, series number 3, increased in size compared to previous studyCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable small hepatic hypodensities of unknown etiology and significance.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: Mixed sclerotic/lytic lesion involving the sacrum, again noted. Left femur lesion, unchanged.OTHER: No significant abnormality noted. | Interval increase in most of the parenchymal and mediastinal index lesions as described above. |
Generate impression based on findings. | Male, 26 years old, worsening headache for one month, evaluate for ventricular enlargement. Right frontal approach shunt catheter is redemonstrated, tip in stable position within the left frontal horn. The caliber of the ventricles has not significantly changed compared to the recent prior MRI (the CC dimension of the lateral ventricles is 4 mm on both), and there has been only a mild increase in caliber when compared to the older CT.Suboccipital craniotomy changes are demonstrated with a clip and other surgical material at the foramen magnum. No intracranial hemorrhage or abnormal extra-axial fluid collections. No evidence of focal edema or generalized mass effect. | Stable positioning of the ventriculostomy catheter. Ventricular caliber is stable when compared to a recent MRI, and only minimally increased compared to a more remote CT. The ventricles are by no means enlarged. |
Generate impression based on findings. | Male; 48 years old. Reason: r/o PE History: pleuritic chest pain, cough. PULMONARY ARTERIES: No evidence of pulmonary embolism. Normal main pulmonary trunk diameter. LUNGS AND PLEURA: Minimal dependent scarring/atelectasis. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary embolism. There is bilateral basilar scarring/discoid atelectasis. |
Generate impression based on findings. | 57-year-old male needs coronary assessment for liver transplant. Coronary calcifications noted on chest CT and multiple risk factors for coronary artery disease with associated reduced exercise capacity. The aortic arch is left sided. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows: 2.5 x 3.2 cm.The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is no significant plaque in the left main coronary artery.LAD: The LAD gives rise to five diagonal and several septal branches. There is no significant plaque in the LAD or its branches. Three is a faint calcification at the mid LAD which was visualized on the previous noncontrast CT thorax, which does not contribute to significant stenosis. Minimal, noncalcified plaque is present in the distal LAD contributing to only mild stenoses. The first three diagonal branches are of normal caliber and are nonstenotic. D4 at the apex and D5 at the inferoapex are diminutive.LCx: The left circumflex artery gives rise to three obtuse marginal branches. The first OM arises high and is small. OM2 is large and nonstenotic. OM3 is small but unremarkable. There is no significant plaque in the LCx.RCA: The RCA arises normally from the right sinus of Valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and two, nonstenotic posterolateral branches. There is no significant plaque in the RCA or its branches.Few scattered calcified nodules in the right lower lobe. | No significant coronary artery plaque. |
Generate impression based on findings. | Female 84 years old; Reason: Residual subcutaneous fluid collection? NO IV and NO ORAL CONTRAST PLEASE. History: drainage from fistula site PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Left iliac lymph nodes.BOWEL, MESENTERY: The device in the sigmoid colon. A there is a tract extending to the skin surface which contains less gas. Portion of a tract extends to the left iliac fossa.BONES, SOFT TISSUES: Skin thickening in the left lower abdominal wall. The soft tissue gas is slightly decreased.OTHER: No significant abnormality noted. | 1.Persistent track to the skin although the amount of gas has decreased. There is a new focus of gas in the left iliac fossa. |
Generate impression based on findings. | Female 53 years old; Reason: incarcerated hernia History: abd pain, periumbilical ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small retro-peritoneal lymph nodes.BOWEL, MESENTERY: Mild cecal wall thickening with small adjacent lymph nodes. Scattered colonic diverticula involving the sigmoid colon. No bowel obstruction.BONES, SOFT TISSUES: Radiopaque density anterior to the left rectus muscle in the subcutaneous tissues with an associated fluid collection and inflammation that extends to the skin surface. Differential considerations include a hernia mesh with associated fluid collection or a radiopaque foreign body. The area of concern of the mass measures 5.2 x 2.5 cm on image 107/series 3. The soft tissue thickening that extends to the skin surface is best imaged on image 85/series 80293OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent or atrophicBLADDER: 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.Surgical mesh or radiopaque foreign body in the left abdominal subcutaneous tissues adjacent to the left rectus muscle. Possible track to the skin.2.Cecal wall thickening and sigmoid diverticulosis. Follow up is suggestedI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 32 years old Reason: Rule out PE History: Chest pain, SOB PULMONARY ARTERIES: Technically adequate study with no evidence of pulmonary embolism or right heart strain.LUNGS AND PLEURA: Minimal dependent basilar predominant atelectasis. Low normal lung volumes.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis. | 1. No evidence of pulmonary emboli.2. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Reason: follow up small bowel ileus History: abd pain, N/V ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Nonspecific right hepatic lobe hypodensity is too small to further characterize, but likely benign.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: Multiple dilated small bowel loops measuring up to 3.3 cm with air-fluid levels and associated small bowel feces sign (coronal image 66). A transition point is present at the left adnexal lesion. No pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Rim enhancing cystic left adnexal lesion measures 2.7 x 2.1 cm (series 3, image 96) with associated mesenteric inflammatory changes and free fluid.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Enhancing cystic left adnexal lesion compatible with tubo-ovarian abscess.2.Small bowel obstruction with a transition point in the left hemipelvis.Findings discussed with Dr. Bos of OB/GYN by telephone on 10/9/2013 at 9:15 a.m. |
Generate impression based on findings. | 44-year-old male with history of relapsed arch and lymphoma CHEST:LUNGS AND PLEURA: Subcentimeter nodule in the right middle lobe previously is no longer visualized. New small left pleural effusion with overlying compressive atelectasis.MEDIASTINUM AND HILA: Conglomerate anterior mediastinal adenopathy has increased in size since the prior exam and currently measures 16.2 x 14.3 cm (image 34; series 3). Extensive mediastinal adenopathy extends throughout the mediastinum.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Fatty infiltration of the liver, stable.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: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerosis in the L1 vertebral body appears stable compared to prior; continued surveillance advised.OTHER: No significant abnormality noted | Interval increase in the size of the conglomerate anterior mediastinal adenopathy. Stable sclerosis in the L1 vertebral body. Fatty infiltration of the liver. |
Generate impression based on findings. | Male 45 years old Reason: pe? History: pleuritic cp, prior pe PULMONARY ARTERIES: Technically adequate study. The pulmonary trunk is enlarged measuring 36 mm. Small subsegmental filling defects are seen in the left lower lobe (image 143, series 8) and anterior right upper lobe 98/131).LUNGS AND PLEURA: Basilar predominant atelectasis and fibrosis with associated bronchiectasis unchanged. Mild apical predominant paraseptal emphysema.Right lower lobe subpleural nodule (image 106, series 9), unchanged since 6/2010. Left upper lobe micronodule unchanged (image 36, series 9). MEDIASTINUM AND HILA: Enlarged right hilar node and small prevascular lymph nodes unchanged. Cardiomegaly. Patulous esophagus and small sliding type hiatal hernia.CHEST WALL: Mild symmetric gynecomastia unchanged. Small right subpectoral nodes unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis. Stable splenomegaly.Hypodense lesion in splenic parenchyma likely a hemangioma, lymphangioma or splenic cyst. Well-circumscribed hypodense region in the right renal sinus incompletely visualized/characterized on this examination, refer to CT abdomen and pelvis dated 10/1/2013. | 1. Bilateral small subsegmental pulmonary emboli.2. Enlarged pulmonary artery trunk consistent with pulmonary hypertension.3. Pulmonary nodules and mild lymphadenopathy unchanged. |
Generate impression based on findings. | Reason: r/o worsening dissection History: persist ant low back pain CHEST:LUNGS AND PLEURA: Left inferior lobe atelectasis. Bilateral apical bulla, right greater than left.MEDIASTINUM AND HILA: There are penetrating atherosclerotic ulcers of the thoracic aorta. Atherosclerotic calcifications of the aortic arch. Mural thrombus on the descending thoracic aorta. Atherosclerotic calcification of the coronary arteries. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable round, hypodense lesion in the liver. Gallbladder sludge without gallbladder wall thickening. No evidence of intrahepatic or extrahepatic ductal dilatation.SPLEEN: Splenule is adjacent to spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Two hypodense lesions in the right kidney of water density, likely representing renal cysts.RETROPERITONEUM, LYMPH NODES: Redemonstration of a type B aortic dissection originating above the level of the celiac axis. The celiac axis, superior mesenteric artery, renal arteries , inferior mesenteric arteries and iliac arteries are patent. The false lumen contains thrombus.The aorta at the level of the celiac axis is larger in diameter compared to prior exam measuring 3.8 cm, previously measuring 3.3 cm. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroid in the uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticula of the sigmoid and descending colon without evidence of diverticulitis.BONES, SOFT TISSUES: Coarsening of trabecula of the sacrum suggestive of Paget's disease.OTHER: No significant abnormality noted. | 1.Type B aortic dissection.2.Increase in size of abdominal aneurysmal component of aortic dissection.3.Multiple penetrating ulcers of the thoracic aorta. |
Generate impression based on findings. | Female; 32 years old. Reason: r/o SAH History: headache 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 significant intracranial stenosis is appreciated.4 x 5 mm aneurysm with a relatively narrower neck of the right superior hypophyseal artery located slightly above the optic strut at the medial aspect of the paraclinoid segment of the right ICA. No additional aneurysms are evident. The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:No significant interval change since prior study without evidence of acute intracranial hemorrhage. | 1. 4 x 5 mm right superior hypophyseal artery aneurysm as detailed above. No additional aneurysms are evident. If the clinical workup is negative for acute hemorrhage, please refer the patient to neurointerventional clinic for further management discussions.2. No acute intracranial hemorrhage is evident.These findings were discussed with the ER attending at 0950 hours on 10/9/2013. |
Generate impression based on findings. | Female, 17 years old, headache and vision changes status post VP shunt. Right parietal approach shunt catheter is in stable position, tip in the vicinity of the left foramen of Monro.Caliber of the ventricular system has not significantly changed. The frontal and temporal horns are completely decompressed. The atria are not dilated and are unchanged in caliber.The brain parenchyma is unremarkable. No mass effect or focal edema is seen. No intracranial hemorrhage or abnormal extra-axial fluid is detected.No bony lesions are detected. Mastoid air cells and middle ear cavities are clear. | Stable positioning of the ventriculostomy catheter. Stable caliber of the ventricular system. No acute intracranial abnormality. |
Generate impression based on findings. | Nodular lymphoma. Stem cell transplant. CHEST:LUNGS AND PLEURA: Nodular scarring at the right lung apex is stable compared to the prior examination. Minimal subpleural scarring and mild interstitial scarring. Scattered bulla.MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes. Coronary artery calcifications.CHEST WALL: Scattered subcentimeter axillary lymph nodes. Right chest port.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Spleen measures 17.1 cm in craniocaudal dimension. No focal lesions.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral, nonobstructive renal calculi.RETROPERITONEUM, LYMPH NODES: Ill-defined, retroperitoneal lymphadenopathy. For reference purposes, a left para-aortic lymph node (image 140; series 4) measures 1.8 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerosis and partial collapse of the L2 vertebral body.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Ovarian varices may reflect pelvic venous congestion syndrome. Correlate clinically.BLADDER: No significant abnormality noted.LYMPH NODES: Small pelvic lymph nodes. For reference purposes, a right common femoral lymph node (image 197; series 4) measures 1.0 x 1.2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Small lymph nodes in the chest, abdomen, and pelvis with reference measurements given above. Splenomegaly. Sclerosis and partial collapse of the L1 vertebral body. Bilateral, nonobstructive renal calculi. Ovarian varices; consider pelvic venous congestion syndrome. |
Generate impression based on findings. | Female, 27 years old, headache status post shunt removal in July. Since the prior CT examination, 3 previously seen right-sided intracranial catheters have been removed.A region of CSF density is identified within the right inferior frontal lobe measuring approximately 2.0 x 1.2 cm (image 16 series 3). This is increased in size from the CT examination, but not significantly changed from the more recent MRI.Mild parenchymal encephalomalacia is also demonstrated adjacent to this lesion, and more superiorly along the tract of a prior ventriculostomy catheter.Caliber of the lateral ventricles is also increased relative to the prior CT, but again, is not changed when compared to the more recent MRI. The lateral ventricles are at the upper limits of normal for age. The third ventricle is minimally prominent. The fourth ventricle is normal.No mass effect or focal parenchymal edema is seen. No intracranial hemorrhage is seen.No bony lesions are detected. Right-sided burr hole defects are again seen as well as mild dural calcification in the right frontal region. Congenital fusion anomaly of the posterior arch of C1 noted. Paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. No significant change in the size of a cystic region within the right inferior frontal lobe, or of the ventricular caliber, when comparison is made to an MRI examination from 08/08/13. |
Generate impression based on findings. | Reason: r/o abscess History: perirectal pain, fevers UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Decompressed due to Foley catheter.LYMPH NODES: Small pelvic lymph nodes.BOWEL, MESENTERY: Perirectal fat stranding without loculated fluid collections. Small amount of free fluid in the pelvis. BONES, SOFT TISSUES: Mild right gluteal fat stranding.OTHER: No significant abnormality noted. | 1.Perirectal and right gluteal inflammatory changes without evident loculated fluid collection. 2.Recommend MRI pelvis to evaluate for perianal fistula. |
Generate impression based on findings. | Male 72 years old; Reason: patient with questionable right nonfunctional adrenal mass, please characterize History: right sided mass, renal vs adrenal vs testicular vs retroperitoneal ABDOMEN:LUNGS BASES: Atelectatic changes at the lung bases.LIVER, BILIARY TRACT: Liver contour is smooth. The posterior aspect of the liver is compressed by the right fatty mass mass. Hepatic and portal veins are patent. No suspicious hepatic lesions. No biliary ductal dilatation.SPLEEN: Spleen is normal in size. There are multiple subcentimeter well defined hypodense lesions.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland is unremarkable. In the region of the right adrenal gland there is a mixed fatty mass/soft tissue mass with areas of calcification the excerpts Mass effect upon the liver. The mass measures at least 13.1 x 8.4 cm (image 43/series 8). The the lesion appears separate from the kidney. The fatty portions of the mass have enhancing septations.KIDNEYS, URETERS: Bilateral renal cysts. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Brachytherapy seeds within the prostate.BLADDER: No significant abnormality noted.LYMPH NODES: Small pelvic and inguinal lymph nodes.BOWEL, MESENTERY: Left inguinal hernia containing loops of small bowel without obstruction.BONES, SOFT TISSUES: Large left inguinal hernia containing loops of small bowel without evident obstruction.Postoperative hernia repair in the right inguinal canal.OTHER: No significant abnormality noted. | 1.Fat containing right retroperitoneal mass in the location of the right adrenal gland. Differential considerations include a complex adrenal myolipoma or right retroperitoneal liposarcoma. 2.Left inguinal hernia containing loops of small bowel. |
Generate impression based on findings. | Reason: r/o appy History: lower abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is not definitely identified. No evidence of bowel obstruction. No pneumoperitoneum. Small fat containing umbilical hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Distended.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. The appendix is not definitely identified.2. Small amount of free fluid in the pelvis is abnormal in a young male. Follow up is recommended. |
Generate impression based on findings. | Female, 47 years old, headache. Evaluate for sinusitis. The distal basilar artery, and perhaps the origin of the right PCA, are markedly hyperdense. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The frontal sinuses are hypoplastic. The frontoethmoidal recesses, ethmoid air cells, sphenoethmoidal recesses and sphenoid sinuses are clear. The maxillary sinuses are clear the maxillary outflow pathways are unobstructed. The nasal cavity is clear. Pneumatization of the right middle turbinate is seen. Nasal septum is intact with a leftward pointing bony spur. The mastoid air cells and middle ear cavities are clear. Debris is present within the left external auditory canal.The bones of the calvarium and skull base are intact. | 1. The distal basilar artery is hyperdense which is highly concerning for the presence of a potentially occlusive thrombus, much less likely atherosclerotic disease given the relatively normal appearance of the other vessels. Further evaluation with CT angiography is suggested.2. No CT evidence of acute ischemia is seen at this time. No additional acute abnormalities are detected.3. No evidence of paranasal sinus inflammatory change is seen.Findings discussed with Dr. Elliott at 0900 hrs on 10/9/13. |
Generate impression based on findings. | Reason: eval diverticulitis History: BRBPR, dark stools, TTP LLQ ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. The hepatic and portal veins are patent. No suspicious hepatic lesions given the single phase of contrast.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: Multiple dilated small bowel loops in the right hemi abdomen measuring up to 3.3 cm with associated small bowel feces sign and transition point in the mid abdomen (coronal image 62). No pneumoperitoneum or mesenteric free fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mesenteric varices.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.Small bowel obstruction with transition point at a jejunal loop in the midabdomen.2.Cirrhotic morphology of the liver with evidence of portal hypertension.Findings discussed with Dr. Carter in the ED by telephone on 10/9/2013 at 9:10 a.m. |
Generate impression based on findings. | Female; 7 years old. Reason: fall from > 10 ft w/ neck flexion vs axial load History: midline C5-C7 tenderness Straightening of normal cervical lordosis is likely positional. The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are evident. No compromise to the spinal canal or neural foramina. The visualized intracranial compartment and paraspinal soft tissues are unremarkable. There is no abnormal prevertebral soft tissue swelling. | No acute fracture or malalignment of the cervical spine. |
Generate impression based on findings. | Female 58 years old; Reason: stone History: L flank pain, hematuria ABDOMEN:LUNGS BASES: Partially imaged lower lung with bullous changes.LIVER, BILIARY TRACT: Liver is normal morphology. There are multiple gallstones in the gallbladder. Common bile duct is dilated measuring up to 2.8-cm. There are multiple calcified filling defects within the gallbladder representing stones.SPLEEN: Calcified splenic granulomata.PANCREAS: Multiple clips about the pancreatic tail.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts. Internal complexity cannot be characterized without contrast.Mild left ureter thickening and dilatation due to a 12 x 7 mm calculus in the pelvis (image 114/series 3) there is a probable second calculus measuring 8 x 4 mm (image 102/series 3).RETROPERITONEUM, LYMPH NODES: Calcified upper abdominal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent or atrophic.BLADDER: No bladder calculi. LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the hips and lumbar spine.OTHER: No significant abnormality noted. | 1.Two left calcifications in the course of the left ureter likely representing obstructive a partially obstructive calculi. Follow-up is recommended.2.Cholelithiasis and extensive choledocholithiasis which M.R.C.P. is recommended to evaluate the common bile duct and head of the pancreas. |
Generate impression based on findings. | Hypoxia, tachycardia, newly diagnosed AML, a valid for pulmonary embolism PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Multifocal consolidation is seen throughout the lungs. Bilateral pleural effusions are seen. Diffuse groundglass opacities are also present.Perifissural right middle lobe nodule likely represents an intrapulmonary lymph node.MEDIASTINUM AND HILA: Right jugular central venous catheter tip lies in the SVC. Left PICC tip also lies in the SVC. No mediastinal or hilar lymphadenopathy. Endotracheal tube tip is above the carina and below the thoracic inlet. The heart is normal in size and there is no pericardial effusion.CHEST WALL: Bilateral axillary lymphadenopathy. Body wall edema is noted.UPPER ABDOMEN: Nasogastric tube tip is seen in the stomach. Hepatosplenomegaly. | 1.No pulmonary embolus.2.Multifocal consolidation consistent with infection.3.Bilateral pleural effusion and diffuse ground glass opacities which may represent pulmonary edema. Body wall edema.4.Bilateral axillary lymphadenopathy. |
Generate impression based on findings. | Female; 80 years old. Reason: pt with recurrent lung ca s/p 3 cycles of chemo History: now needs disease evaluation compare to previous scans and comment. Mild motion artifact limits diagnostic sensitivity. CHEST:LUNGS AND PLEURA: Extensive right upper lobe scarring and atelectasis are again noted, with associated small loculated pleural effusion that has decreased in size. The right suprahilar mass is unchanged in size and measures 51 x 40 mm (series 7, image 21). The mass surrounds and partially constricts the right upper lobe bronchus, not significantly changed from the prior study. Mild basilar atelectasis is also present. No focal airspace opacity or suspicious pulmonary nodules. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Small superior mediastinal lymph nodes are again noted and unchanged. Moderate aortic arch and coronary artery calcifications.CHEST WALL: Thoracic kyphosis and severe multilevel degenerative disease of the thoracolumbar 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: No significant retroperitoneal lymphadenopathy. 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: Atherosclerotic calcifications of the abdominal aorta and its major branches. | 1.Right suprahilar tumor is stable in size and continues to constrict the right upper lobe bronchus and cause post-obstructive atelectasis. 2.No additional suspicious lesions are identified. 1. |
Generate impression based on findings. | Kidney stones. Low-back pain with hematuria. The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or renal calculi.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No findings to explain low back pain. No evidence of renal or ureteral calculi. |
Generate impression based on findings. | Reason: s/p G tube insertion from 10/2/13 History: G-tube site erythema, purulent drainage, tenderness ABDOMEN:LUNG BASES: Right mild pleural effusion with overlying minimal atelectasis.LIVER, BILIARY TRACT: No suspicious focal liver lesions. No intrahepatic or extrahepatic ductal dilatation. Minimal gallbladder sludge within the gallbladder.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and bilateral iliac arteries. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is soft tissue inflammation of the anterior abdominal wall at the G-tube entry site. There are no discrete drainable fluid collections. The hyper enhancing soft tissue measures 5.7 x 1.8 cm. G-tube appears to be within the lumen of the stomach.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: No significant abnormality notedOTHER: No significant abnormality noted | Soft tissue thickening in the anterior abdominal wall about the G-tube without discrete drainable fluid collection.Findings were discussed with Miranda Dellert via phone at 9:30 p.m. on 10/8/2013 by Dr. Jahangir.Contrast extravasation description:Supervising radiologist: Dr. David JangirMinor or major extravasation: MinorContrast type:120 cc of Omnipaque 350 were administered.Amount extravasated: 15 ccLocation of extravasation: Right forearmSigns and symptoms: Patient denies pain, numbness, tinglingTreatment given: Warm compressDischarge instructions given: Yes |
Generate impression based on findings. | Clinical question: Metastases? Signs and symptoms: New onset of vertigo. Nonenhanced head CT:There is no detectable acute intracranial process.Ectopia of cerebellar tonsils with flattening deformity of the inferior poles of tonsils and complete effacement of subarachnoid space is noted. Findings concerning for Chiari malformation.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF cisterns and gray -- white matter differentiation otherwise.Calvarium and soft tissues of the scalp are unremarkable.Limited images through the orbits are unremarkable.Visualized paranasal sinuses demonstrate minimal right posterior ethmoid air cell opacification and unremarkable otherwise.Unremarkable bilateral mastoid air cells and middle ear cavities.Small soft tissue density in the left external auditory canal to represent debris/Max. | 1.Ectopia of cerebellar tonsils with resultant tonsillar deformity and complete effacement of subarachnoid space at the level of foramen magnum concerning for Chiari malformation.2.Unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | Male, 30 years old, seizures, postop grid placement. A left parietotemporal craniotomy has been performed. Electrode grid has been placed intracranially along the left temporal, parietal and frontal lobes. Scalp swelling, subcutaneous air and pneumocephalus are within expected postoperative limits.Mild generalized mass effect is present in the left hemisphere with mild effacement of sulci and of the left lateral ventricle, likely reflecting effects of recent surgery. No focal parenchymal edema or large parenchymal hematoma seen. There may be a small of extra-axial blood product subjacent to the craniotomy which is within expected limits. | Expected postoperative findings subsequent to placement of a grid along the left frontal, parietal and temporal lobes. |
Generate impression based on findings. | Female 49 years old; Reason: R/o diverticulosis/diverticulitis History: Rectal Bleed ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver has a smooth contour. Status post cholecystectomy. Note suspicious hepatic lesions. Hepatic vasculature are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes.BOWEL, MESENTERY: Small bowel is normal in caliber. Focal area of inflammation with focal area of colonic wall thickening at the level of the hepatic flexure. The inflammation extends to the liver capsule. No discrete fluid collections are drainable. There are other diverticula involving the splenic flexure.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: Please see aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Focal area of colonic wall thickening and inflammation at the level of the hepatic flexure. Differential considerations include focal diverticulitis, colitis or possible mass causing the inflammation. Recommend colonoscopy and follow up to resolution.2.Scattered colonic diverticula involving the splenic flexure.3.Status post cholecystectomy. |
Generate impression based on findings. | Lymphoma, pre-stem cell transplant evaluation. There are small retention cysts within the bilateral maxillary sinuses, left greater than right. There is also a small retention cyst within the left sphenoid sinus as well as suggestion of an air-fluid level. Otherwise, the ethmoid and frontal sinuses are clear. The nasal cavities are clear. The mastoid air cells are clear. There is a 3 mm diameter enostosis within the left clivus. There is extensive loss of bilateral temporomandibular joint space as well as subchondral cyst formation, sclerosis, flattening, and irregularity of the bilateral mandibular condyles. The orbits and imaged portions of the intracranial structures are grossly unremarkable. | 1. Small retention cysts within the bilateral maxillary sinuses and left sphenoid sinus and suggestion of an air-fluid level that can represent acute sinusitis in the appropriate clinical setting.2. Advanced bilateral temporomandibular joint degenerative changes. |
Generate impression based on findings. | Reason: eval abscess History: severe pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No focal hepatic lesions.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 evidence of bowel obstruction. No pneumoperitoneum or mesenteric free fluid. No drainable fluid collections.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Air-fluid level in the rectum compatible with a diarrheal state.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evident localized inflammatory process in the abdomen or pelvis. |
Generate impression based on findings. | Apparent bony defect of right tegmen tympani on MRI and continued leaking from right nostril after car accident. On the right, the external auditory canal is clear and patent. The mastoid air cells are underpneumatized, but clear. The middle ear cavity is also clear. The ossicular chain is intact. The posterior incudal ligament appears slightly hyperdense, although this may represent normal variation. There is apparent thinning and perhaps dehiscence of the anterior wall of the epitympanum medially that measures up to 2 mm without associated encephalocele. The inner ear structures are unremarkable without evidence of semicircular canal dehiscence or pneumolabyrinth. The facial nerve describes a normal course, but may be dehiscent along portions of the tympanic segment.On the left, the external auditory canal is clear and patent. The mastoid air cells and middle ear cavity is also clear. The ossicular chain is intact. The posterior incudal ligament appears slightly hyperdense, although this may represent normal variation. The inner ear structures are unremarkable without evidence of semicircular canal dehiscence or pneumolabyrinth. The facial nerve describes a normal course, but may be dehiscent along portions of the tympanic segment.There is mild left sphenoid sinus and posterior ethmoid sinus mucosal thickening.There is patchy faint hypoattenuation in the medial right temporal lobe and right middle cerebral peduncle, as well as thickening of the trigeminal nerves that correspond to the presumed demyelinating lesions, which are better depicted on the prior brain MRI for additional findings. | 1. Apparent thinning and perhaps dehiscence of the anterior wall of the epitympanum medially that measures up to 2 mm without associated encephalocele or middle ear fluid and thus may represent a normal variant. 2. Patchy faint hypoattenuation in the medial right temporal lobe and right middle cerebral peduncle, as well as thickening of the trigeminal nerves that correspond to the presumed demyelinating lesions, which are better depicted on the prior brain MRI for additional findings. |
Generate impression based on findings. | Reason: angiosarcoma History: angiosarcoma LUNGS AND PLEURA: Bronchial/bronchiolar wall thickening with tree in bud opacities are again left lower lobe compatible with aspiration bronchiolitis and loculated fluid within the left fissure similar appearance the prior exam.Peripheral left lower lobe cavitary lesion with wall thickening (image 82 series 5) is unchanged.Right apical consolidation and intrathoracic extension of the large right chest wall mass.New right basilar nodular opacity with irregular margins and surrounding groundglass (image 88 series 5) most likely is inflammatory in origin although a metastatic lesion cannot be entirely excluded.Small left apical micronodule (image 20 series 5) probably inflammatory in origin.MEDIASTINUM AND HILA: Demonstration of occlusion of the SVC with increased soft tissue in the right paratracheal region. Stenosis of the left innominate vein. Mildly enlarged left hilar lymph nodes unchanged.Cardiac size is normal with mild pericardial thickening.Aortic and coronary artery calcifications with mural plaques identified within the descending aorta.CHEST WALL: Large necrotic mass with foci of calcification are and irregular contrast enhancement in the right upper posterior chest wall is grossly unchanged in size but demonstrates increasing air collections presumably representing ongoing necrosis and ulceration. There is associated bony destruction of multiple ribs posteriorlyUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Again identified is focal perfusion abnormality involving the liver .Renal hypodensities too small to characterize.Stable periaortic and gastrohepatic enlarged lymph nodes. | 1.Large right posterior chest wall mass with associated rib involvement and intrathoracic extension demonstrates increasing necrosis and foci of air which may represent post therapeutic changes and accompanying ulceration.2.New right basilar nodular opacity with surrounding groundglass most likely is inflammatory/infectious in origin. Continued follow up examination is recommended.3.Changes of aspiration bronchiolitis in the left lower lobe.4.Stable left lower lobe peripheral thick walled cavitary lesion and associated focal pleural thickening.5.Periaortic and gastrohepatic adenopathy unchanged. |
Generate impression based on findings. | Female; 63 years old, presents with cough. Reason: prior CT scan here shows abnormal T12 lesion and lung nodule. LUNGS AND PLEURA: The well circumscribed left lower lobe nodule containing central lipid attenuation is unchanged in size, measuring 13 x 10 mm. Imaging findings are most consistent with a benign lesion such as hamartoma. No focal air space opacity or pleural effusion. No suspicious pulmonary lesions are identified.MEDIASTINUM AND HILA: Postsurgical changes compatible with PFO closure. Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Small right cardiophrenic lymph node measures 8 mm in short axis and is unchanged (series 3, image 69).CHEST WALL: Poorly defined sclerotic focus in the T12 vertebral body is unchanged . No significant axillary lymphadenopathy. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Subcentimeter hypoattenuating focus adjacent to the gallbladder fossa is again seen and most likely a benign hepatic cyst. | 1.Left lower lobe pulmonary nodule is unchanged in size and most likely represents a benign lesion such as hamartoma.2.Sclerotic focus in T12 vertebral body is unchanged .3.No interval change or evidence of metastatic disease. |
Generate impression based on findings. | Reason: r/o aortic dissection History: chest pain CHEST:LUNGS AND PLEURA: Apical bulla bilaterally.MEDIASTINUM AND HILA: Mild atherosclerotic calcification of the aortic arch.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No focal suspicious hepatic lesions. No intrahepatic or extrahepatic duct dilatation. Porcelain gallbladder.SPLEEN: Hypodense and nonenhancing lesion in the spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small subcentimeter hypodense lesion in the right kidney likely represent benign renal cysts. Small subcentimeter hypodense lesion in the left kidney likely represents a benign renal cyst.RETROPERITONEUM, LYMPH NODES: Ulcerating plaque on the anterior wall of the descending aorta at the level of the diaphragmatic crux. There is a degree of narrowing at the origin the celiac artery with post stenotic dilatation. Fusiform aneurysmal dilatation of the abdominal aorta below the level of the renal arteries, measuring 3.9 x 4.2 cm (series 15, image 182), with associated mural thrombus. Because the aorta at this level is ectatic and measurements on axial images may overestimate the diameter, the diameter of the aorta measures 3.9 cm on coronal series 8126, image 48. Atherosclerotic calcification of the descending aorta and bilateral iliac arteries. The aneurysm descends and approaches the bifurcation of the iliac arteries without involvement of the iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Ulcerating plaque on the anterior wall of the descending aorta at the level of the diaphragmatic crux.2.High-grade narrowing at the origin of the celiac artery with poststenotic dilatation.3.Fusiform aneurysmal dilatation of the abdominal aorta below the level of the renal arteries extending to but not involving the bifurcation of the iliac arteries.4.Porcelain gallbladder. |
Generate impression based on findings. | Reason: assess for toxic megacolon History: hx of cdiff, abd pain and distention ABDOMEN:LUNG BASES: Basilar atelectasis/scarring. Mild peri-fissural nodularity compatible with history of sarcoidosis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Accessory splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypo-enhancing solid mass in the right upper pole does not meet the criteria for simple cyst. There are additional indeterminate right renal lesions. Absent left kidney is possibly congenital.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: Mild colonic wall thickening without evidence of toxic megacolon. No pneumoperitoneum or drainable fluid collections.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mild colonic wall thickening compatible with history of colitis. 2.No evidence of toxic megacolon or drainable fluid collections.3.Indeterminate right renal lesions. Recommend MRI abdomen for further characterization. |
Generate impression based on findings. | Reason: eval mass suprapubic/LLQ History: abd pain, mass palpated just L lateral to midline ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Multiple subcentimeter, hypodense lesions in the right lobe of liver are too small to further characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodense, Subcentimeter lesion in the right kidney likely represents a benign renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is focal colonic wall thickening of the ascending colon (series 3, image 68) may be collapse of the bowel wall.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple large heterogeneously enhancing masses which appear contiguous with the uterus most likely representing large necrotic uterine fibroids. The largest mass measures 9.0 x 8.0 cm (series 3, image 111). There is associated mass effect on adjacent structures.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subcutaneous soft tissue nodule of unclear etiology in the left buttock measuring 2.6 x 2.5 cm (series 2, image 142).OTHER: No significant abnormality noted | 1.Multiple large necrotic appearing uterine fibroids with associated mass effect on adjacent structures.2.Subcutaneous soft tissue nodule of unclear etiology in the left buttock.3.Multiple subcentimeter, hypodense lesions in the liver are too small to further characterize, but likely represent hepatic cysts.4.Focal ascending colon wall thickening may be due to collapse of the bowel wall. |
Generate impression based on findings. | Male; 45 years old. Reason: Hx of Hodgkin's Disease History: Evaluate extent of disease Male; 45 years old. Reason: Hx of Hodgkin's Disease History: Evaluate extent of disease Reference lymph nodes measurements are detailed below: Reference group of right level II lymph nodes have increased in size and measure approximately 18 x 17 mm , previously 10 x 16 mm (series 4, image 28); these nodes appear suspicious based on size.Right level IIb lymph node has mildly decreased in size and measures 8 x 6 mm, previously 11 x 9 mm (image 37).Right carotid space lymph node with retropharyngeal extension has mildly increased in size and measures 7 x 7 mm, previously 7 x 4 mm (image 31). Right supraclavicular (labeled level IV on prior exam) lymph node has mildly decreased in size and measures 8 x 4 mm, previously 9 x 5 mm (series 48).Multiple non-reference lymph nodes particularly in the left supraclavicular region and left level III/IV are increased in size, some now enlarged, with a more rounded and suspicious appearance. For example, a left level Vb/supraclavicular lymph node measures 13 x 12 mm, previously 4 x 3 mm (image 34).The visualized aerodigestive tract is unremarkable without exophytic lesion or focal effacement. Aside from mildly increased size of a right intraparotid lymph node, the salivary glands and thyroid gland are unremarkable.Cervical arterial vascular structures are patent with mild atherosclerotic plaque at the carotid bifurcation. In addition, there is mild retropharyngeal course of the right internal carotid artery. There is poor contrast opacification of the left internal jugular vein throughout its course, possibly due to obstruction at the level of the known anterior mediastinal mass.The orbits are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.Stable mild cervical spondylosis without evidence of suspicious osseous lesion.Conglomerate/mass-like anterior mediastinal adenopathy is partially visualized. Please see the dedicated CT chest for further thoracic findings. | 1. Interval increased size in bilateral cervical and left supraclavicular lymph nodes, several of which are now suspicious based on size and/or morphology.2. New poor contrast opacification of the left internal jugular vein, likely due to obstruction at the level of the patient's known anterior mediastinal mass.3. Please refer to today's dedicated CT chest for further thoracic findings. |
Generate impression based on findings. | CLL. History of fungal pneumonia. A follow-up scan. LUNGS AND PLEURA: Continued improvement in bilateral groundglass opacities consistent with fungal pneumonia. Residual patchy foci of ground glass as well as subtle areas of nodularity which may reflect persistent foci of infection. No pleural fluid. Subpleural nodular opacities left lower lobe suggestive of subpleural lymph nodes are unchanged.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the aorta and its branches. Several small lymph nodes are unchanged. Severe coronary artery calcifications. Aortic valvular calcifications also noted.CHEST WALL: Diffuse skeletal demineralizationUPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Hepatosplenomegaly. Poorly defined low density lesion in the left hepatic lobe (3/84), unchanged. Severe atherosclerotic calcification of the abdominal aorta and visualized portion of the superior mesenteric artery. | Continued improvement in fungal pneumonia with near complete resolution of the ground glass and nodular opacities. |
Generate impression based on findings. | Right parenchymal hemorrhage. There has been slight interval evolution and decrease in size of the large intraparenchymal hematoma centered within the right basal ganglia and thalamus that extends into the ventricular system and along the right transfrontal ventricular shunt track and associated vasogenic edema. However, there has been redistribution and/or slightly increased intraventricular hemorrhage with slight interval increase in size of the temporal horn of the left lateral ventricle. There is no significant interval change in the small amount of intraventricular hemorrhage adjacent to the left transfrontal ventricular catheter. There is slightly reduced midline shift to the left, now 12 mm, previously 15 mm. However, there is persistent sulcal effacement, right uncal herniation, subfalcine, and transtentorial herniation. The imaged paranasal sinuses are clear. The extracranial structures are unchanged. | 1. Slight interval evolution and decrease in size of the large intraparenchymal hematoma centered within the right basal ganglia and thalamus that extends into the ventricular system and along the right transfrontal ventricular shunt track with associated vasogenic edema with redistribution and/or slightly increased intraventricular hemorrhage with slight interval increase in size of the temporal horn of the left lateral ventricle. Overall, the degree of midline shift appears slightly reduced. 2. No significant interval change in the small amount of intraventricular hemorrhage adjacent to the left transfrontal ventricular catheter. |
Generate impression based on findings. | Reason: pt history of ovarian cancer, currently in treatment. Please eval for response/progression using measurements if applicable and compare with previous History: see above CHEST:LUNGS AND PLEURA: Reference right lower lobe pulmonary nodule measures 5 mm, unchanged (series 5, image 57).Biapical and basilar scarring.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is normal. No pericardial effusion. Right chest Port-A-Cath tip terminates at the superior cavoatrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small serosal implant inferior to the left hepatic lobe is unchanged.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: Status post omentectomy. New mesenteric soft tissue nodule along the posterior margin of the stomach measures 9 mm (series 3, image 104). Reference mesenteric nodular density at the level of the iliac bifurcation is not discretely measurable. Minimal thickening of the terminal ileum, similar to the prior exam. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Reference perirectal soft tissue nodule measures 1.0 x 0.7 cm (series 3, image 171), previously 1.3 x 1.0 cm.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.New mesenteric soft tissue nodule along the posterior wall of the stomach compatible with progression of disease. |
Generate impression based on findings. | Multiple myeloma with pleuritic chest pain. Check for pleural disease LUNGS AND PLEURA: Mild basilar atelectasis, most dependent and posterior without discrete underlying focal additional abnormality. Mild central lobular emphysema with scattered subpleural micronodules bilaterally, likely post inflammatory. No superimposed suspicious intrapulmonary or additional pleural findings.MEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and pericardium are within limits.Questionable small hiatal herniaCHEST WALL: Mild scattered degenerative changes throughout the thoracic spine without discrete focal lytic or blastic lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Questionable small splenule. No additional abnormality observed in this limited evaluation of the upper abdomen | Basilar scattered atelectasis and nonspecific suspected subpleural nodules representing old postinflammatory findings. |
Generate impression based on findings. | Male, 62 years old, incontinence, off balance, mild dementia. Evaluate for normal pressure hydrocephalus. Vague hypoattenuation within the posterior limb of the right internal capsule may be artifactual or related to age indeterminate small vessel ischemic disease.Otherwise, the cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. The bones of the calvarium and skull base are intact. | No acute intracranial abnormalities. No evidence of normal pressure hydrocephalus as clinically questioned. |
Generate impression based on findings. | s/p right retrosigmoid craniotomy for resection of meningioma with micro dissection on 10/8/13. The images are degraded by patient motions. There are postoperative findings related to right suboccipital craniotomy and cranioplasty with a right posterior fossa resection cavity filled with fluid and a small amount of pneumocephalus, but no evidence of acute intracranial hemorrhage. Evaluation for residual tumor is limited on this non-contrast CT. There are mild nonspecific cerebral white matter hypoattenuating foci that are better depicted on the prior MRI. The ventricles appear to be stable in size and configuration. There is a small amount of lobulated soft tissue material within the opened right posterior mastoid air cells, which likely corresponds to surgical packing material. There is mild right parieto-occipital scalp swelling but no definite evidence of pseudomeningocele. | Expected postoperative findings related to recent right suboccipital craniotomy without evidence of acute intracranial hemorrhage. However, evaluation for residual tumor is limited on this non-contrast CT. |
Generate impression based on findings. | Female; 41 years old. Reason: enlarged thyroid Graves' Looking for how far down in the chest that the thyroid extends LUNGS AND PLEURA: No focal air space opacity or pleural effusion. Scattered pulmonary micronodules are present, the largest of which measures 8 mm (series 4, image 39). These nodules are nonspecific but possibly post-inflammatory.MEDIASTINUM AND HILA: The thyroid gland is diffusely enlarged and compatible with goiter. The most inferior aspect of the goiter involves the left thyroid lobe and extends just below the thoracic inlet to the the level of the left brachiocephalic vein. Mild compromise of the airway secondary to mass effect is noted.Normal heart size without pericardial effusion. There are scattered subcentimeter mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Large thyroid goiter exerts mild mass effect on the airway and extends inferiorly to the level of the left brachiocephalic vein just below the thoracic inlet.2.Scattered nonspecific pulmonary micronodules may be post-inflammatory in etiology. |
Generate impression based on findings. | Female, 57 years old, paralysis agitans, status post DBS placement. Bilateral parietal burr holes have been created through which bilateral stimulator leads are directed. These coarse inferiorly and medially to terminate at the inferior margins of the thalami.Pneumocephalus is an expected postoperative finding. No evidence of parenchymal hemorrhage or significant extra-axial blood product.Brain morphology is within normal limits. No mass effect is detected. The ventricular system remains patent and normal in size. | Expected findings status post placement of bilateral DBS leads. |
Generate impression based on findings. | Female 68 years old Reason: lung cancer s/p 14 cycles of chemo. please evaluate for disease and compare with previous scans History: lugn cancer CHEST:LUNGS AND PLEURA: Reference spiculated right lower lobe nodule measures 25 x 13 mm (image 62, series 5), previously 21 x 13 mm. nodular pleural thickening along the superior major and minor fissure unchanged. Reference pleural thickening adjacent to right lower lobe measures 4 mm thick (image 66, series 3), previously 4 mm.MEDIASTINUM AND HILA: Moderate interval increase in the prevascular lymphadenopathy. Reference prevascular lymph node measures 12 mm (image 21, series 3), previously 9 mm. Stable cardiophrenic lymphadenopathy. Calcified hilar and subcarinal nodes unchanged.CHEST WALL: Stable internal mammary chain lymphadenopathy.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: Small left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Right retrocrural lymph node now measures 13 mm (image 75, series 3), previously 12 mm.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No evidence of mesenteric lymphadenopathy or peritoneal carcinomatosis. Diverticulosis without evidence of diverticulitis.2BONES, SOFT TISSUES: Moderate degenerative changes of the thoracic and lumbar spine without evidence of osseous metastasis.OTHER: No significant abnormality noted. | 1. Moderate interval enlargement of reference pulmonary nodule and prevascular lymphadenopathy.2. Remaining lymphadenopathy and pleural nodularity unchanged.3. No new focus of metastatic disease identified. |
Generate impression based on findings. | Male, 54 years old, history of tracheostomy x 2 status post decannulation. Evaluate for tracheal stenosis with fine cuts of the larynx. The right anterolateral aspect of the maxilla is expanded by the presence of a complex appearing lesion. The lesion is composed of both soft tissue and highly mineralized structures resembling dysmorphic or dysplastic teeth.The bony rim of this lesion is non-sclerotic. The axillary cortex may be deficient in one or two places anteriorly. Posterior and medially, the maxillary cortex is also deficient with extension of soft tissue to the level of the nasal cavity. Also noted is an adjacent malpositioned tooth which projects horizontally from the right maxilla into the right nasal cavity.Poor dentition is evident throughout with numerous missing crowns and at least one periapical lucency.The palatine tonsils are mildly prominent for age. The tongue and floor of mouth are within normal limits. The epiglottis is thin and unremarkable. The right piriform sinus is effaced, probably by trapped secretions. The aryepiglottic folds are unremarkable. No definite laryngeal abnormalities are detected.At the level of the presumed prior tracheostomy, the trachea deviates toward the right and there is some mild enhancing soft tissue thickening along both sides of the trachea, more so along the left. The tracheal airway does, however, remained patent throughout and is at most mildly narrowed through this region. Scarring in the overlying soft tissues likely reflects prior tracheostomy.Scattered small lymph nodes are evident throughout the neck including within the subcutaneous tissues and the parotid spaces. None of these meets imaging criteria for pathologic enlargement. The salivary glands are otherwise unremarkable. The thyroid has been surgically divided at midline but is otherwise unremarkable. The cervical vessels are patent and normal. | 1. Mild tracheal deformity and paratracheal thickening at the level of the presumed prior tracheostomy. This likely reflects scarring and deformation from prior instrumentation. There is at most a very mild narrowing of the airway at this level, but overall, the airway remains patent throughout.2. Expansile lesion involving the right anterolateral maxilla containing both soft tissue and densely mineralized components. The differential for this finding includes an odontoma, with or without an associated lesion such as a keratocystic odontogenic tumor. There is an associated displaced tooth which projects into the right nasal cavity. |
Generate impression based on findings. | Tonsil cancer, follow-up CHEST:LUNGS AND PLEURA: Redemonstrated is the peripheral right lower lung nodule along the posterior costophrenic angle (image 78 series 4) with associated adjacent partially confluent additional nodules. Gross measurement remains 9 x 7 mm compared to 9 x 5 mm however the adjacent lesions with a new large additional nodule immediately superior measuring 9 x 8 mm (image 76 series 4) is of concern.New extensive perihilar ground glass opacities obscures the previously described changes adjacent to the major fissure and involves both the right middle and right lower lobes. Associated thickening of the associated fissures may represent mild fluid and or involvement.Left lung remains clear other than scattered micronodules. No effusions bilaterallyMEDIASTINUM AND HILA: Persistent small intravascular filling defect within the left inferior pulmonary vein (image 56 series 3) not dissimilar from prior exam.No lymphadenopathy. Specifically the previously described right hilar node is not currently well appreciated and measures under 6 mm, previously 9 mm (image 52 series 3).The cardiac and pericardial are otherwise within limitsCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Extensive cholelithiasis without associated hepatic abnormalitySPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild scattered degenerative changes unchangedOTHER: No significant abnormality noted. | 1. New right lower lobe peripheral nodules clustered with a prior peripheral nodular abnormality is indeterminant with stable appearing immediately adjacent pleural nodular findings previously described.2. New perihilar opacity concerning for infection and possible patient immunocompromise. Short term follow up to confirm resolution ( < 6 weeks) is suggested.3. Stable appearing venous thrombus |
Generate impression based on findings. | Metastatic lung cancer status post chemo/RT CHEST:LUNGS AND PLEURA: Severe emphysema. Left upper lobe mass measures 18 x 12 mm (4/72), previously 18 x 16 mm. Right apical fibrosis. New nodular density in the right apex (4/58). Other lesions seen previously are otherwise stable. Micronodule in the lingula unchanged.MEDIASTINUM AND HILA: Small lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions in the right hepatic lobe unchanged. SPLEEN: Previously seen hypoattenuating lesion at site of prior mass is less well visualized.ADRENAL GLANDS: Left adrenal gland thickening unchanged. Nodular thickening of the right adrenal gland appears similar to remote earlier studies, appearance of the last examination may have been due to volume averaging.KIDNEYS, URETERS: Punctate cortical hypoattenuating lesions in the kidneys are too small to accurately characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal lymph nodes similar to previous. Gastrohepatic ligament lymph node on series 3 image 104 appears slightly larger but remains less than 1 cm in short axis.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. | Interval decrease in measurement of left upper lobe index lesion. Right adrenal gland nodule is less prominent and was likely artifactual on the prior examination. New nodular density right upper lobe indeterminate but could be a result of the involving radiation fibrosis, short-term follow-up may be of use. |
Generate impression based on findings. | Reason: bilateral renal mass, please compare to OSH infused study History: bilateral renal mass, hx of prostate ca 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: Small bulla in bilateral lung bases.LIVER, BILIARY TRACT: Hypodense, subcentimeter hepatic segment 8 lesion is too small to further characterize.SPLEEN: No significant abnormality notedPANCREAS: Hypodense, subcentimeter lesion in the tail of the pancreas is likely a lipoma.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large renal cyst in in the left kidney measuring 5.3 x 5.6 cm. There is a solid exophytic mass arising from the lower pole of the left kidney isodense to renal parenchyma measuring 2.6 x 2.5 cm. Small hypodense lesion in the right kidney likely representing a benign renal cyst.RETROPERITONEUM, LYMPH NODES: IVC filter. Mild atherosclerotic calcification of the descending aorta and iliac arteries bilaterally.BOWEL, MESENTERY: G-tube in appropriate location.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Small solid, exophytic mass arising the lower pole of the left kidney he is suspicious for renal neoplasm.2.Large left renal cyst.3.Small right renal cyst.4.Hypodense subcentimeter hepatic segment 8 lesion is too small to further characterize.5.Hypodense subcentimeter lesion in the tail of pancreas likely represents a lipoma. |
Generate impression based on findings. | Severe COPD and MAI infection. Cough and dyspnea. LUNGS AND PLEURA: Severe centrilobular emphysema. Debris in the dependent trachea and left greater than right mainstem bronchi.Septal thickening and masslike consolidation in the medial segment of the right middle lobe and anterior periphery of the lateral segment right middle lobe new from previous. D. right middle lobe bronchus is occluded shortly after its origin (5/62)Subsegmental atelectasis in the lingula..Stable appearing subpleural lymph nodes along the fissures.New focal nodular septal thickening right upper lobe (4/11) measuring 9-mm. 8mm subpleural nodule anterior right upper lobe (4/154) present previously, not conclusively changed in size. The previously seen adjacent nodule has resolved in the interim.2 -3-mm subpleural nodule right upper lobe (4/169) unchanged and present on the prior examinations. Subpleural nodule right lower lobe (4/27) present previously and may represent an intrapulmonary lymph node, unchanged.3-mm nodular opacity right lower lobe with surrounding groundglass opacity (4/251) present previously but increased in size and density, suspicious for active infection.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the aorta and its branches. Main pulmonary artery mildly enlarged at 31-mm (3/51), suggestive of pulmonary arterial hypertension. Coronary artery calcifications. Normal heart size.CHEST WALL: Severe endplate degenerative changes at the C7/T1, T2/T3, and L2/L3 with loss of disk space and endplate sclerosis.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Severe atherosclerotic calcifications of the aorta. | 1. Mixed response since the previous examination with resolution of one of the two nodules in the right upper lobe but development of new focal nodular opacities in the right lung suspicious for active infection. 2. New consolidation involving the peripheral aspects of the right middle lobe with filling defect in the right middle lobe bronchus nonspecific and may be secondary to aspiration or infection. Follow-up PA and lateral chest radiographs are recommended to assess for resolution as an endobronchial lesion cannot be excluded at this time.3. Debris in the airways consistent with aspirated secretions. |
Generate impression based on findings. | Female 59 years old Reason: hemothorax/fibrothorax History: shortness of breath and chest pain LUNGS AND PLEURA: Interval decrease in size of the loculated left pleural effusion and associated compressive atelectasis. New left apical predominant patchy ground glass opacities and interlobular septal thickening compatible with edema. Focal nodular ground glass opacity in the right middle lobe is likely inflammatory.Mild apical predominant centrilobular emphysema. Enlarged pulmonary artery compatible with pulmonary hypertension, unchanged.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy unchanged. Moderate coronary artery and thoracic aorta calcifications unchanged. Calcifications of the aortic valve. Enlarged right atrium, ventricle and pulmonary trunk. Stable to decreased pericardial effusion/thickening.Multinodular goiter with calcifications.Left internal jugular venous catheter with tip in the proximal IVC.CHEST WALL: Mild multilevel degenerative change of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Nonspecific enlargement of left adrenal gland unchanged. Moderate calcifications of the abdominal aorta and its branches. | 1. Interval decrease in size of the left pleural effusion and associated compressive atelectasis.2. New left patchy groundglass opacities and septal thickening compatible with edema. |
Generate impression based on findings. | Reason: history of known prostate cancer, please evaluate for mets. with delayed imaging. CT urogram. History: none ABDOMEN:LUNG BASES: Small punctate micronodule in the lower right lung.LIVER, BILIARY TRACT: Small subcentimeter hypodense lesion in the right lobe of the liver is too small to characterize (series 3, image 35). No evidence of cholelithiasis. No intrahepatic or extrahepatic ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign-appearing exophytic renal cyst in the left kidney. Benign appearing renal cyst in the right kidney. No filling defects of the ureters bilaterally.RETROPERITONEUM, LYMPH NODES: Scattered, subcentimeter lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged, heterogeneous enhancing prostate. No significant lymphadenopathy.BLADDER: Mild bladder wall thickening accentuated by incomplete distention of the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticula in the sigmoid and the descending colon without evidence of diverticulitis.BONES, SOFT TISSUES: Sclerotic focus in the L5 vertebral body.OTHER: No significant abnormality noted | 1.Small subcentimeter hypodense lesion in the right lobe of the liver too small to further characterize.2.Enlarged prostate without significant local lymphadenopathy. There is no evidence of metastatic disease.3.Diverticula of the sigmoid and descending colon without complications. |
Generate impression based on findings. | New slurred speech. hx of r sided weakness There are moderate patchy areas of cerebral white matter hypoattenuation. There is more focal area of encephalomalacia in the left basal ganglia and corona radiata. However, there is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. No dense vessel sign is apparent. The ventricles and basal and mildly prominent diffusely, reflecting brain parenchymal volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable, including a right lens implant. | Moderate patchy areas of cerebral white matter hypoattenuation, which may represent small vessel ischemic disease of indeterminate age. There is more focal area of encephalomalacia in the left basal ganglia and corona radiata, may represents sequela of chronic infarction, although acute infarction cannot be excluded. No evidence of acute intracranial hemorrhage. However, non-contrast CT is not sensitive for the detection of non-hemorrhagic and MRI is recommended if feasible. |
Generate impression based on findings. | Status post 4 months right thoracotomy parietal pleurectomy for management of epithelioid type malignant pleural mesothelioma and RML. for amyloidoma. CHEST:LUNGS AND PLEURA: Interval decrease in volume of partially loculated pleural fluid on the right. Right pleural thickness measurements as follows:Level of the horizontal portion of the left subclavian artery (3/14): 4 o'clock position 0 mm, previously 10-mm. 11 o'clock 0 mm, previously 4-mm. There is a small amount of residual fluid or thickening at the 3 o'clock position.Level of the great vessels (3/25): 3 o'clock position 3 mm, previously 5-mm. 6 o'clock position remains 0 mm.Level of the left atrium (3/54): 12 o'clock position 9 mm, previously 10-mm, 9 o'clock position remains 0 mm.Mild residual wall pleural thickening at the right costophrenic angle unchanged. Mild thickening of the right hemidiaphragm medially better seen on today's study, possibly due to differences in slice variation between exams. Postoperative changes of right middle lobectomy. Mild thickening of the right major and minor fissure is now visible due to resolution of pleural fluid in that region previously.MEDIASTINUM AND HILA: Minimal thickening or fluid along the lateral free wall of the left ventricle (3/69) not readily visible previously due to cardiac motion artifact but probably present previously. Stable mild pericardial thickening adjacent to the right atrial appendage.Large hiatal hernia. Multiple calcified mediastinal lymph nodes. Solid nodule in the anterior mediastinum measuring 17 x 12 mm (3/37), previously 16 x 10 mm, larger. This may represent a lymph node or thymoma.Stable lower right interlobar soft tissue adjacent to the suture line.CHEST WALL: Focal muscle thickening right lateral chest (3/119) indeterminate. Appearance of the right paraspinal musculature at the level of the thoracic inlet has improved.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: Renal cortical thinning bilaterally.PANCREAS: Pancreatic head calcification suggestive of chronic pancreatitis.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications 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. | Decreased volume of partially loculated pleural fluid on the right and decrease in reference level measurements. Thickening of the right hemidiaphragm and focal areas of pericardial thickening are better appreciated on today's study given scan variability and decreased amount of cardiac motion but may have been present previously. |
Generate impression based on findings. | Reason: PATIENT WITH STAGE IV NED COLON CANCER S/P RESECTION OF LEFT UPPER LUNG LESION IN APRIL 2013. eVALUATE FOR INTERVAL CHANGE History: MET COLON CANCER CHEST:LUNGS AND PLEURA: Surgical sutures are identified in where the previously noted left lower lobe nodule was noted. However there is now a 16 mm x 18 mm mass surrounding the suture line compatible with residual or recurrent tumor (image 36 series 5).Stable scattered nonspecific micronodules. No other suspicious pulmonary nodules or masses noted.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary artery and aortic calcification.CHEST WALL: Left hilar lymph node (image 25 series 3) stable to slightly increased in size.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Right hepatic lobe hemangioma unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Status post ileocolectomy.BONES, SOFT TISSUES: Fat-containing small anterior abdominal hernia.OTHER: No significant abnormality noted. | Status post wedge resection of a left lower lobe metastasis now demonstrating recurrent tumor at the surgical site. |
Generate impression based on findings. | Enlarged thyroid Graves' disease. There is marked diffuse enlargement of the thyroid gland that measures approximately 5.7 AP x 10.0 RL x 11.0 SI cm. The thyroid gland essentially extends inferiorly to the level of the clavicular heads and superiorly to the level of the oropharynx and there is retropharyngeal extension of the bilateral thyroid lobes such that these abut one another at the midline. The thyroid gland is somewhat heterogeneous with hypoattenuating and hyperattenuating areas that likely represent nodules. There is apparent narrowing of the hypopharyngeal airway at the level of the cricopharyngeus, measuring a minimum of 5 mm. There is mild diffuse narrowing of the trachea, measuring a minimum of 13 mm in transverse dimension. There is a cluster of coarse calcifications in the left posterior parotid space, along an incision site. There is no evidence of significant cervical lymphadenopathy. There is torus mandibularis internus. The imaged portions of the intracranial structures and orbits re unremarkable. The imaged portions of the lungs are clear. | Marked diffuse enlargement of the thyroid gland that measures approximately 5.7 AP x 10.0 RL x 11.0 SI cm. The thyroid gland essentially extends inferiorly to the level of the clavicular heads and superiorly to the level of the oropharynx and there is retropharyngeal extension of the bilateral thyroid lobes such that these abut one another at the midline. The thyroid gland is somewhat heterogeneous with hypoattenuating and hyperattenuating areas that likely represent nodules. Apparent narrowing of the hypopharyngeal airway at the level of the cricopharyngeus, measuring a minimum of 5 mm, may be partly attributable to physiological breath holding. Otherwise, there is mild diffuse narrowing of the trachea, measuring a minimum of 13 mm in transverse dimension. The thyroid gland is also mildly heterogeneous and ultrasound can be used for further characterization. |
Generate impression based on findings. | Male; 76 years old. Reason: pt with mesothelioma s/p resection History: doing well now needs disease evaluation. LUNGS AND PLEURA: No suspicious lesions or masses are identified to suggest recurrent disease. 7 mm pulmonary nodule adjacent to the right minor fissure most likely represents an intrapulmonary lymph node. No focal consolidation or pleural effusion. Focal area of ground glass opacity in the right upper lobe may represent mild infection. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Mildly enlarged right posterior tracheal lymph node(4/17). Small hiatal hernia with adjacent mildly enlarged lymph node near the GE junction is unchanged. Chronic small fluid collection adjacent to the distal esophagus is unchanged.CHEST WALL: No axillary lymphadenopathy. DISH and moderate multilevel degenerative changes affect the visualized spine. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Please refer to separately dictated abdominal CT report. | 1.No evidence of pleural disease. 2. Focal area of right upper lobe ground glass opacity may represent mild infection. Follow-up chest radiographs recommended in 6 weeks to assess for resolution.3. Small unchanged mediastinal lymph nodes and unchanged paraesophageal fluid collection of uncertain clinical significance.4. Please refer to separately dictated abdominal CT report. |
Generate impression based on findings. | Serous ovarian cancer. Reevaluate for tumor. 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: Focal hypoperfusion and atrophy presumably represents parenchymal scar at the upper pole of the right kidney.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: Status post TAH/BSO.BLADDER: No significant abnormality notedLYMPH NODES: Subcentimeter pelvic lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Left corona mortise is a normal variant. | No definite evidence of metastatic disease. Status post TAH/BSO. |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage or mass. Signs and symptoms: Seizures. Nonenhanced head CT:Examination demonstrates no evidence of any acute intracranial process including hemorrhage or mass as is questioned clinically. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.There are mild periventricular and subcortical low attenuation of white matter which considering patient's stated age of 67 there are suspected for age indeterminant small vessel ischemic strokes.Cerebral cortex, cortical sulci, ventricular system and CSF spaces remain within normal or patient's age.Mild bilateral cavernous carotid vascular calcification and minimally of the right vertebral artery is noted.Unremarkable images through the orbits.All paranasal sinuses and bilateral mastoid air cells /middle ear cavities are well visualized and unremarkable. | 1.Mild age indeterminate small vessel ischemic strokes.2.No acute intracranial hemorrhage or mass as is questioned clinically. |
Generate impression based on findings. | Recently completed CRT for a left base of tongue squamous cell carcinoma on 9/7/13. History of NHL CHEST:LUNGS AND PLEURA: Unchanged calcified nodules most consistent with granulomas. No new or suspicious nodules or masses.MEDIASTINUM AND HILA: Interval decrease in size of lower paraesophageal region lymph nodes. The GE junction appears unremarkable but is incompletely assessed.Right chest port tip at the SVC. Calcified right hilar lymph node, likely post infectious. No significant lymphadenopathy. Normal heart size.CHEST WALL: Right chest port. Focal sclerosis posterior aspect of the right humeral head present previously, incompletely assessed.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion at the dome of the diaphragm too small to accurately characterize but most likely a benign cyst.SPLEEN: Calcified nodules consistent with granulomas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval resolution of of lower paraesophageal lymphadenopathy and the appearance of the distal esophageal segment appears improved, this should be managed clinically. No signs of pulmonary or mediastinal nodal metastases. |
Generate impression based on findings. | Female 53 years old. Other diseases of lung, not elsewhere classified Abnormal weight gain Obesity, unspecified Tobacco use disorder. CHEST:LUNGS AND PLEURA: Mild diffuse paraseptal emphysema. Micronodule left lower lobe has increased in size and slightly lobular in contour measures about 0.9 x 0.9 cm is 5 image 67 previously 0.7 x 0.4 cm. There is also a0.5-cm pleural-based right upper lobe nodule series 5 image 33. No effusions.MEDIASTINUM AND HILA: Small scattered mediastinal nodes not definitely pathologic in size. Small elliptical shaped nodes in the prevascular space.CHEST WALL: Small bilateral axillary nodes questionable significance.ABDOMENLIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Increase in size of left lower lobe nodule with lobular contours. Recommend biopsy.Discussed by telephone with Dr. Geetha Govindarajan at the time of this dictation. |
Generate impression based on findings. | Male, 56 years old, history of tonsil cancer, follow-up exam. Again seen are treatment-related changes, more in the left neck than the right, including platysmal thickening, infiltration of the subcutaneous and deep fascial planes, mucosal edema and thin retropharyngeal effusion. There has been no substantial interval change. No evidence of recurrent tumor seen.Evidence of prior bilateral neck dissection is seen. No pathologic adenopathy is found on today's exam.The salivary glands and thyroid are free of focal lesions. The cervical vessels remain patent. No concerning bony lesions are detected. Small calcific density posterior to the T1 vertebral body is again seen which may reflect ligamentous calcification. | Stable treatment related change in the neck. No evidence of active disease. |
Generate impression based on findings. | Proptosis of left eye, possible orbital fracture right eye in 1970s. There is an inferiorly displaced right orbit wall fracture with a 5 mm defect adjacent to the inferior opthalmic nerve. There is no herniation of the orbital contents through the defect/ However, there is linear soft tissue that extends from the fracture site to the inferior aspect of the inferior rectus muscle, which demonstrates a tented morphology. There is also 3 mm of medial buckling of the right lamina papyracea. There is mild right enophthalmos. There is no retrobulbar hemorrhage. There is a left trochlear calcification. The left orbit is otherwise unremarkable. There is torus maxillaris internus. There are multiple dental caries. There is a 5 mm skin excrescence along the left nasal dorsum. The imaged intracranial structures are grossly unremarkable. | 1. Chronic right inferior and medial orbital blow out fracture with mild enophthalmos and scar tissue involving the right inferior rectus muscle, but no evidence of herniation.2. Multiple dental caries. |
Generate impression based on findings. | Evaluate for structural change after intracranial EEG lead placement. There are left cerebral electrode grids introduced via hemicraniotomy, which are in unchanged positions. Streak artifact form the hardware obscures regional anatomy. There is an unchanged postoperative air and fluid collection deep to the craniotomy that measures up to 10 mm in width. There is unchanged left cerebral hemisphere sulcal and left lateral ventricle effacement. Likewise, there is unchanged 5 mm of midline shift to the left. There is no definite evidence of acute intracranial hemorrhage. There is scattered paranasal sinus opacification. The mastoid air cells are clear. There is persistent air and fluid in the scalp overlying the craniotomy. | Stable postoperative findings related to left cerebral hemisphere grid electrode insertion without change in the position of the hardware and no definite evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | Female, 59 years old, with right submandibular lymph node and thyromegaly. A pathologically enlarged node or cluster of nodes is evident at level 2 on the right corresponding to an abnormal lymph node seen on prior sonogram. This lesion measures 1.8 x 1.8 cm transaxial (image 22 series 5). In the craniocaudal plane, the dimensions are similar to those seen on prior sonogram. No other pathologic adenopathy is detected in the neck by size criteria.The thyroid gland contains numerous hypodense lesions, more so on the right than on the left. These are better assessed on sonography.The salivary glands are free of focal lesions. The aerodigestive mucosa is within normal limits. Cervical vessels are patent. Lung apices are clear. No concerning bony lesions are detected. An ossific fragment at the site of the right C7 transverse process may represent a nonfused ossification center or chronic traumatic deformity. | 1. Right level 2 lymphadenopathy as discussed above. The fact that this lesion has not substantially changed in the several month interval since the prior sonogram increases concern for a malignant process.2. Heterogeneous, multi-nodular thyroid which is better assessed on sonography.3. In the absence of other specific findings, the possibility that one of the right-sided thyroid lesions is the source of right neck adenopathy should be considered. A radiographically occult mucosal lesion may also be considered. |
Generate impression based on findings. | Nose to opponent shoulder injury with widening of nasal bridge and b/l infraorbital regions. There is mild stranding of the subcutaneous fat overlying the zygoma and along the nasal dorsum. However, there is no evidence of nasal fracture or other maxillofacial fracture. The nasal septum appears to be intact without significant deviation. The temporomandibular joints are intact. The orbital contents are intact. There is mild scattered paranasal sinus mucosal thickening without air-fluid levels. The imaged mastoid air cells are clear. The imaged intracranial structures are grossly unremarkable. | Mild contusion of the subcutaneous fat overlying the zygoma and along the nasal dorsum. However, there is no evidence of nasal fracture or other maxillofacial fracture. |
Generate impression based on findings. | Metastatic esophageal CA status post resection, chemo and RT. CHEST:LUNGS AND PLEURA: Right middle lobe intrapulmonary lymph node. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The proximal and mid thoracic esophagus is dilated with fluid and has mild circumferential wall thickening. Proximal to the anastomosis at the distal esophagus, the esophageal lumen is nearly obliterated to a slit-like appearance (3/87). Circumferential esophageal thickening extends to the level of the anastomosis, up to 14-mm (single wall thickness lateral right esophagus (3/88), consistent with recurrent tumor.Index retrocrural lymph node measures 21 x 16 mm, previously 21 x 13 mm (3/94). Slightly lower than on index retrocrural lymph node has significantly increased in size and its borders are less well defined suspicious for adjacent soft tissue infiltration.Subcarinal lymphadenopathy has increased in the interim (3/58). In addition, though not significantly enlarged, right hilar lymph nodes appears centrally hypoattenuating is suspicious for an internal necrosis (3/57). These appear minimally larger compared to the prior examination. Left and right lower paratracheal subcentimeter lymph nodes appear slightly increased in size and/or density. Upper normal heart size. Coronary artery calcifications.CHEST WALL: Degenerative change of the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic metastases, several of which have decreased in size or conspicuity. The index lesion at the dome of the liver measures 12 x 9 mm, previously 14 x 8 mm (3/88)..SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Pancreatic head calcifications suggestive of chronic pancreatitis.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches. Small retroperitoneal lymph nodes are similar to previous.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Postsurgical changes about the GE junction and proximal stomach with numerous surgical clips.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mixed response with newly visible recurrent tumor cranial to the distal esophageal anastomosis and intrathoracic lymphadenopathy consistent with nodal metastases. Continued improvement in appearance of hepatic metastases. Index and non-index retrocrural lymphadenopathy is worse. |
Generate impression based on findings. | Male 76 years old Reason: peritoneal mesothelioma s/p resection History: none. Additional history path report indicates history of colon cancer. ABDOMEN:LUNG BASES: Small hiatal hernia. No lung nodules or effusions. Calcific granuloma right perihilar area.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: Presumed a right paraesophageal lymph node is remeasured on series 7 image 12, 1.9 x 1.3 cm. Previously 2 x 1.5 cm.BOWEL, MESENTERY: Surgical changes. No evidence of free or loculated fluid of carcinomatosis.BONES, SOFT TISSUES: Osteophytes, osteoporosis, mild loss of height T11. T11 vertebral body has prominent central endplate depression less likely lytic focus, unchanged. No other discrete lytic or blastic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal suture line intact. No evidence of recurrent mass. No pericolonic nodes. No free or loculated intraperitoneal fluid or signs of carcinomatosis.BONES, SOFT TISSUES: Flowing osteophytes involving multiple levels. Osteoporosis. No discrete lytic or blastic disease.OTHER: No significant abnormality noted | Stable small noted in the right lower paraesophageal area. Possible lytic area T11 as described, unchanged. No evidence of recurrent peritoneal carcinomatosis. |
Generate impression based on findings. | Please evaluate glomus tumor in right middle ear. On the right, there is nearly complete opacification of the middle ear cavity with soft tissue density material and scattered faint amorphous calcific densities. There is mild irregularity of the cochlear promontory and tegmen tympani without frank dehiscence. There is also complete opacification of the mastoid air cells, which is otherwise well-pneumatized. The facial nerve described a normal course, although evaluation for dehiscence is limited by the presence of adjacent soft tissue. The jugular plate is intact. There is no aberrant or lateralized carotid artery. There is thinning and possible dehiscence of the superior semicircular canal. The inner ear structures are otherwise unremarkable. On the left, the external auditory canal is clear and patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The facial nerve describes a normal course. The inner ear structures are unremarkable. | 1. Right middle ear mass compatible with glomus tympanicum. No evidence of extension into the jugular canal.2. Thinning and possible dehiscence of the superior semicircular canal. 3. Complete opacification of the right mastoid air cells. |
Generate impression based on findings. | Male 45 years old Reason: mesothelioma s/p 3 doses of immunotherapy. please evaluate for disease and compare with previous CT scans History: mesothelioma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Gallbladder is surgically absent. No focal liver lesions or biliary dilatation.SPLEEN: Surgically absent.PANCREAS: No significant abnormality notedADRENAL GLANDS: Nodule in abutting the upper limb of the left adrenal gland reidentified measures 1.9 x 1.9 cm. Previously 1.5 x 1.7 cm.Right adrenal gland is normal.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index retroperitoneal and gastrohepatic nodes remeasured as follows:Gastrohepatic ligament node 1.4 x 1 cm series 3 image 36. Previously 1.2 x 0.6 cm.BOWEL, MESENTERY: Peritoneal implants. Index lesions are measured as follows:Soft tissue mass posterior to the stomach, series 3 image 45, measures 4.2 x 2.9 cm. Previously 4 x 3.1 cm.Pericecal mass or confluent masses a shunt series image 88, 7.8 x 5.5 cm. Previously 5.4 x 4 cm.Scattered small mesenteric nodes with reference noted in mesentery 0.6 x 0.5 cm series 2 image 86. Previously 0.7 x 0.6 cm.Distortion of bowel without evidence of frank obstruction.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: Small amount of ascites. In the peritoneal implant in the region of the cul-de-sac is poorly defined estimated at 1.4 x 1.1 cm on series 3 image 127. Previously 1.2 x 1.1 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Increase in size of index lesions as above. |
Generate impression based on findings. | Chronic airway obstruction. Shortness of breath and pulmonary hypertension LUNGS AND PLEURA: Mild centrilobular emphysema without associated definite additional changes of COPD or evidence of air trapping on expiration views.Scattered micronodules without discrete superimposed solitary abnormality. Many are subpleural and likely postinflammatory. Mild basilar atelectasis greater in the left and partially secondary to the cardiomegaly.MEDIASTINUM AND HILA: Portable line lymphadenopathy with measurements at the upper limits of normal yet demonstrating fatty hila.Coronary calcifications with moderate nonspecific cardiomegaly. Artifact from associated ICD leads. Pericardium unremarkable. Prominent enlarged pulmonary arteries consistent with known hypertension. For reference the pulmonary artery measures 3.7 cm in diameter (image 35 series 3).Moderate hiatal hernia.CHEST WALL: Artifact and ICD generator overlying the left chest upper wall. Extensive degenerative changes throughout the thoracic and upper lumbar spine with gassy sites recent question of diffuse idiopathic skeletal hyperostosis.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Extensive descending aortic primary branch atherosclerotic changes. A nodular left adrenal is also observed without a clear single measurable lesion. Right adrenal unremarkable. Visualized portions of the kidney, spleen and remaining upper abdomen otherwise unremarkable | Mild basilar atelectasis with minimal questionable scarring. See detail provided |
Generate impression based on findings. | T3N2 tonsil SCC s/p CRT 4/12. Dental amalgam produces streak artifact that obscures surrounding structures. There are unchanged post-treatment findings in the right tonsillar region without evidence of tumor recurrence. There is no significant lymphadenopathy. There is an unchanged configuration of the right vocal cord. The airways are patent. The major salivary and thyroid glands are unchanged. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. There is a retention cyst within the right maxillary sinus. The imaged portions of the intracranial structures and orbits are unremarkable. The imaged portions of the lungs are clear. | No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | Mesothelioma no therapy so far CHEST:LUNGS AND PLEURA: Right hemi-thorax posterior visceral and parietal pleural thickening and loculated fluid not appreciably changed. Reference level measurements as follows:Level of the main pulmonary artery (3/49) : 4 o'clock position is unchanged at 4-mm.Level of the right inferior pulmonary vein (3/63) 5 o'clock position unchanged 5-mm. 6 o'clock position 7 mm, previously 6-mm.Level of the heart base ((3/78): 4 o'clock position 5-mm, unchanged. 5 o'clock position 5 mm, unchanged.Subpleural reticulation consistent with fibrosis bilaterally, mild. Mosaic attenuation in the lung bases, unchanged. Scattered intrapulmonary lymph nodes and pulmonary nodules are unchanged.MEDIASTINUM AND HILA: Numerous bilateral mediastinal lymph nodes, abnormal in the multiplicity, stable to minimally larger measuring up to 11-mm in short axis (3/39, subaortic). Bilateral hilar and inferior interlobar lymphadenopathy. Right hilar lymphadenopathy 15 mm, previously 12-mm.Neri artery calcifications. Mild cardiomegaly.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: Fatty replacement of the pancreas.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. | No significant change in the right hemithorax pleural thickening. Mild pulmonary fibrosis. Lower mediastinal and bilateral hilar/interlobar level lymphadenopathy stable to slightly worse. |
Generate impression based on findings. | Head and neck cancer, follow-up CHEST:LUNGS AND PLEURA: Scattered micronodules unchanged without suspicious new superimposed nodules or masses. No effusions.MEDIASTINUM AND HILA: No lymphadenopathy.Moderate coronary calcifications. Cardiac and pericardium are otherwise unremarkable.Small hiatal herniaCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered subcentimeter hypodensities again likely simple cysts unchanged. Gallbladder unremarkableSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No findings to suggest metastatic disease or interval change |
Generate impression based on findings. | History of desmoplastic pleural mesothelioma status post left pleurectomy/decortication on 5/13 CHEST:LUNGS AND PLEURA: Left hemithorax volume loss, thickening of the left major fissure and parietal pleural thickening consistent with provided history of mesothelioma. Scattered calcified and noncalcified nodules most consistent with granulomas. Calcified pleural plaques. Scattered small foci of emphysema. Minimal dependent ground glass and bronchial opacities in the right lower lobe may be sequelae of aspiration and can be followed on subsequent examinations. Reference measurements on the left as follows:Level of the great vessels (5/22): Nine o'clock position 5 mm, unchanged.Level of the main pulmonary artery (5/36): Two o'clock position 4 mm, unchanged. 10 o'clock position 4 mm, previously 5-mm.Level of the left ventricular apex (5/54): Five o'clock position 3 mm, unchanged. Seven o'clock position 2 mm, unchanged.Residual nodular tumor at the level of the left neodiaphragm not significantly changed. Pleural thickening and minimal loculated fluid in the left cardiophrenic angle anteriorly as well as in the deep right costophrenic angle, about the same. Nonindex area of pleural thickening posteriorly (5/44) new from previous. Residual pleural thickening at the left apex not significantly changed.MEDIASTINUM AND HILA: Tumor infiltration in the mediastinal fat anterior to the aortic arch minimally worse than on the previous exam but new from 6/14/13 (5/28). Tumor nodule in the contralateral anterior mediastinum adjacent to the ascending aorta (5/39) also new from 6/14/13 and increased compared to the previous examination. Pericardial thickening bilaterally is now suspicious for tumor, especially given areas of focal enhancement and nodularity. Mildly enlarged high right paratracheal lymph node (nonindex lesion) minimally larger and remains abnormally hyperattenuating, also suspicious for nodal metastases.Left hilar lymph node 13 mm, previously 8-mm (5/30)CHEST WALL: Left chest wall postoperative appearance.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Probable cyst in the right hepatic lobe tip. The dependent debris in the gallbladder and a phrygian cap appearance. Subcentimeter hypoattenuating lesions are too small to characterize.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Left diaphragmatic graft. Anterior left fat containing diaphragmatic hernia.OTHER: No significant abnormality noted. | Left hemithorax mesothelioma with reference measurements as above. Overall there has been slight worsening with increase in left hilar lymphadenopathy and number of visible residual pleural lesions. Nodular pericardial thickening highly suspicious for metastases. Bilateral tumor foci in the anterior mediastinal fat slightly larger. |
Generate impression based on findings. | Mesothelioma, follow-up CHEST:LUNGS AND PLEURA: Postsurgical changes throughout the left hemithorax with diaphragmatic mesh. Pleural thickening and irregular nodularity again consistent with history of mesothelioma with progression. Reference measurements are as follows:1. At the level of the second left rib (image 22 series 3), two o'clock measurement has increased to 19 mm or prior measurement of 13 mm.2. At the level of the aortic arch (image 35 series 3), the 8 o'clock measurement remains 3 mm with resolution of the soft tissue mass noted in the major fissure. Please note prior measurement at this location for all prior scans 2/26, 5/30, 6/20, 8/12 and current measures 3 mm3. At the level of the left hemidiaphragm and deep gutter (image 94 series 3), the 7 o'clock measurement remains 17 mm.Stable peripheral 6-mm left lower lobe nodule (image 59 series 5). Right lung remains unremarkable. No effusions.MEDIASTINUM AND HILA: Thyroid cysts on the right unchanged. The cardiac and pericardium are within limits other than moderate coronary calcifications.No lymphadenopathy.Small hiatal herniaCHEST WALL: Old healing rib fractures compatible with prior surgeryABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nonspecific small hypodensities unchanged and stable in appearance. Likely hepatic cysts. Gallbladder unremarkable.SPLEEN: Splenule without additional abnormalityADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered multiple renal cysts all unchanged. The left renal cyst with coarse calcifications specifically is stable in appearancePANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changesBOWEL, 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. | Interval progression with more focal pleural thickening in the left upper hemithorax with known underlying mesothelioma. See reference measurements provided. |
Generate impression based on findings. | 74-year-old adenocarcinoma of unknown primary with metastatic disease to lungs, bone and brain. Baseline CT prior to chemotherapy. CHEST:LUNGS AND PLEURA: Pleural based mass and associated atelectasis abutting the left heart border appears slightly larger measuring 5.0 x 3.8 cm (image 45; series 4). Note that it is impossible to differentiate mass from atelectasis. Centrilobular emphysema as noted previously. Moderate left pleural effusion with compressive atelectasis similar to slightly decreased since placement of pleural drainage catheter. Left pleural nodularity.MEDIASTINUM AND HILA: Large heterogeneous left thyroid mass is stable measuring 2.6 x 2.8 cm (image 16; series 4). Small amount of pericardial fluid. Cardiac size is normal. Subcentimeter mediastinal lymph nodes. Subcarinal adenopathy.CHEST WALL: Progressing lytic lesions compatible with osseous metastatic disease involving the ribs, and right humeral head. Osseous lesion in the thoracic spine with effacement of the spinal canal has increased slightly in size (image 47; series 4); consider correlation with spine MRI as clinically indicated. Enlarging presumed subcutaneous metastases posterior the right scapula measures 2.1 x 1.3 cm (image 37; series 4); the same lesion previously measured 1.8 x 1.2 cm (image 30; series 3; 8/22/2013 study).ABDOMEN:LIVER, BILIARY TRACT: Multiple well-circumscribed, subcentimeter hypoattenuating hepatic lesions, most likely represent cysts.SPLEEN: Nonspecific, subcentimeter hypoattenuating splenic lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS:New left adrenal metastasis measures 1.6 x 1.1 cm (image 81; series 4).KIDNEYS, URETERS: Bilateral renal hypoattenuating lesions, which are indeterminate, but most likely represent atypical cysts.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches. Subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple bony metastases again noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus is absent or atrophic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple lytic osseous lesions involving the lumbar spine and pelvis suspicious for metastatic disease. Right sacral lesion with cortical disruption.OTHER: No significant abnormality noted. | Interval progression of disease with reference measurements given above. Consider thoracic spine MRI for enlarging midthoracic vertebral body lytic lesion effacing the thecal sac as clinically indicated. |
Generate impression based on findings. | 60 year old female. Reason: Patient has LV dilation, coronary calcium, aortic calcification. extensive family history of CAD. please rule out obstructive CAD prior to possible liver transplant. History: Abnormal echocardiogram. Height: 63 in. Weight: 132 lbs. BSA: 1.62 m^2BMI: 23.4 kg/m^2Cardiac Morphology:Left Ventricle:EDV: 146 ml The left ventricle is normal in size, shape, wall thickness, and mildly increased in volume. Right Ventricle:EDV: 145 ml The right ventricle is normal in size, shape, wall thickness, and at the upper limit of normal in volume. Left Atrium: The left atrial volume minus the pulmonary veins is approximately 111 cc, within normal limits. There are four distinct pulmonary veins which drain normally into the left atrium.Right Atrium: The right atrial volume is within normal limits. The right atrium is structurally normal. Cardiac Veins: The coronary sinus is normal.Cardiac Valves: There are no aortic calcifications. There is no mitral annular calcification.Great Vessels: Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Aortic wall calcification are present at the sinus of valsalva, not involving the aortic valve or coronary arteries. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 27 mm Ascending: 30 mm Sinotubular Junction: 21 mm Descending: 20 mmPulmonary Artery: Main PA: 26 mmRight PA: 25 mmLeft PA: 23 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is focal dense calcification at the left main origin, without associated stenosis.LAD: The LAD gives rise to the diagonal and septal branches. There is dense calcification in the mid-distal LAD which precludes accurate assessment of stenosis severity.LCx: The left circumflex artery gives rise to the obtuse marginal branches. The LCx is relatively small. There is a punctate focus of calcification in the distal LCx, and otherwise no calcification in the LCx which precludes accurate assessment of stenosis severity.RCA: The RCA arises normally from the right sinus of valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and a posterolateral branch. There is a dense focal calcifications in the mid RCA precluding accurate assessment of stenosis severity at that location. There is diffuse calcification of the RCA throughout its course, without focal stenoses. EXTRACARDIAC CHEST | 1. Mildly increased left ventricular volume. Diffuse multifocal coronary calcification, including the left main origin, LAD and mid-RCA. 2. Aortic wall calcification at the sinus of valsalva, not involving the aortic valve or coronary arteries. 3. Cirrhotic liver. |
Generate impression based on findings. | Reason: Any progression RA lung diseas? Extent bronchiectasis vs ILD. History: Rare cough. LUNGS AND PLEURA: Stable appearance of the lungs with areas of paraseptal emphysema, bronchiectasis, and mild basilar predominant fibrosis. No suspicious pulmonary nodules or masses. No pleural effusions.Lobe groundglass opacities.No air trapping identified in the expiratory images.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes without interval change.Mild cardiac enlargement without evidence of a pericardial effusion.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | Paraseptal emphysema , bronchiectasis, and minimal subpleural fibrosis without significant interval change.. |
Generate impression based on findings. | Female; 54 years old. Reason: h/o HNC, pre-chemo CT, compare to previous, measurements. LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No 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. Gastrostomy tube is in place. | No evidence of metastatic disease. |
Generate impression based on findings. | Dizziness and giddiness. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is moderate patchy white matter hypoattenuation. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1. no evidence of intracranial hemorrhage, mass, or cerebral edema. However, MRI may be useful for further interrogation2. Moderate patchy white matter hypoattenuation, which may be related to small vessel ischemic disease. |
Generate impression based on findings. | Right lower lung nodule CHEST:LUNGS AND PLEURA: A mildly spiculated subcentimeter nodular density observed immediately posterior to the right major fissure in the right lower lobe (image 61 series 5) appears unchanged from the two prior outside exams dated 3/18/13 and 3/19/12. This focus remains 9 x 7 mm and not associated with surrounding additional abnormality. Calcified pleural plaque noted in the right hemithorax and diaphragm.The remaining lungs are otherwise significant for mild central lobular emphysema and scattered micronodules nonsuspicious. No effusions..MEDIASTINUM AND HILA: No lymphadenopathy.Moderate coronary calcifications with a cardiac and pericardial appearance otherwise unremarkable.Small hiatal herniaCHEST WALL: Mild rib deformity involving the lower lateral left ribs, presumably postsurgical and following surgical wedge resection.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: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Nonspecific stable appearing nodular density in the right lower lobe, unchanged for 18 months. Post surgical changes involving the left lower chest wall. No findings to suggest current or recurrent metastatic disease. |
Generate impression based on findings. | Reason: Pre-Kidney Evaluation Dedicated CT renal protocol History: Pre-Kidney Evaluation Dedicated CT renal protocol ABDOMEN:LUNG BASES: Basilar atelectasis/scarring.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 1.7-cm left lower pole mass demonstrates 20 HU enhancement. Additional indeterminate bilateral renal lesions, some of which are hyperdense. Mild to moderate atherosclerosis of the abdominal aorta. Mild atherosclerosis of the common iliac arteries.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis. Previously administered enteric contrast in the colon.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted. | 1.Enhancing 1.7cm left lower pole renal mass suspicious for a cystic renal neoplasm (possibly small RCC). 2.Mild to moderate atherosclerosis of the abdominal aorta. Mild atherosclerosis of the common iliac arteries. |
Generate impression based on findings. | 14-year-old male. Chest pain, worsening deformity. Evaluate pectus recurrence. LUNGS AND PLEURA: Scattered micronodules, such as a 3 mm right upper lobe (series 4, image 35). No focal airspace consolidation or pleural effusion.MEDIASTINUM AND HILA: Normal size of the heart without compression by sternum. No significant mediastinal shift.CHEST WALL: Post-surgical changes of pectus excavatum repair. Mild tilt of the sternum that causes the right anterior ribs to be posterior to the left. There is a focal bulge of the costochondral cartilage eccentric to the left (series 3, image 62) from the T8 to T10 level. No residual pectus deformity. UPPER ABDOMEN: No significant abnormality seen in the visualized upper aspect of the liver, spleen, or kidneys. | 1. No specific findings to account for the patient's symptoms.2. Pectus excavatum repair. |
Generate impression based on findings. | Male; 52 years old. Reason: change in lung nodules History: sob LUNGS AND PLEURA: Scattered pulmonary micronodules are present, one of which is cavitary. This referenced left upper lobe nodule has moderately increased in size and measures 10 x 7 mm, previously 7 x 6 mm (series 4, image 70) and associated with wall thickening when compared to prior CT. Adjacent pleural thickening is noted and the focal area of scarring in the left upper lung medial to this cavitary finding is otherwise unchanged (series 5, image 22) and likely not associated. Moderate upper lobe predominant centrilobular emphysema. Linear opacities in the right lung base are compatible with scarring. No pleural effusions. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Severe coronary and aortic calcifications. No significant mediastinal or hilar lymphadenopathy. CHEST WALL: Mild degenerative disease of the visualized spine. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Abdominal aortic and celiac trunk calcifications. | Interval increase in size of left upper lobe pulmonary cavitary nodule, while not definitely a primary malignant process or infection, if either are of concern clinically, short-term 2 month follow-up is recommended. |
Generate impression based on findings. | Asthma patient, check for infection LUNGS AND PLEURA: A discrete focal consolidation with small cavitation is observed in the right upper lung with extension towards the pleural surface with minimal adjacent pleural thickening. This finding measures 1.9 x 1.4 cm (image 17 series 6) and is not associated with any additional adjacent significant findings. No effusions. The left lung demonstrates a smaller and less well-defined ground glass opacity peripherally in the left lower lobe superior segment (image 50 series 6). The remaining lungs are otherwise clear.MEDIASTINUM AND HILA: No lymphadenopathy.Mild coronary calcifications without additional cardiac or pericardial abnormalitySmall hiatal hernia.CHEST WALL: Nonspecific focal chunky and benign appearing calcification left breast.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Bilateral right upper and left lower lobe pulmonary changes suggesting infection, possibly atypical pneumonia and or fungal in the appropriate clinical setting. However in light of the patient's age, a primary malignancy cannot entirely be excluded but a superimposed secondary process on the left side. Comparison with any prior imaging would possibly assist in narrowing this differential, if available. |
Generate impression based on findings. | 26-year-old female with history of MVA. Evaluate for fracture. There is loss of the normal cervical lordosis which may be due to positioning or muscle spasm. The cervical vertebral bodies are appropriate in overall alignment and height. No fractures or subluxations are identified in the cervical spine. There is no significant compromise to the spinal canal or neural foramina.The prevertebral soft tissues are within normal limits. | No evidence for cervical spine fracture or subluxation. |
Generate impression based on findings. | Lung cancer and MAI, on chemo and antibiotics. Evaluate for response. Dyspnea and cough. CHEST:LUNGS AND PLEURA: Interval increase in size of right upper lobe mass. Some of the previously adjacent to opacities are now inseparable. Reference of level measurement is 5.7 x 3.8 cm, previously 5.4 x 3.3 cm (6/29).Previously described subpleural nodule in the right upper lobe is not currently measurable, now a flat linear density coursing across the border of the right middle and upper lobes. Position was verified by referring to remote earlier films.Numerous additional nodules and areas of nodular peribronchial consolidation in the right lung appear stable to slightly increased in size and/or density. Left lower lobe consolidation. Previously seen cyst but now contains an internal fluid level. Bullous emphysema. Bronchiectasis in the left lower lobe consistent with history of MAI. Consolidation and atelectasis of the medial aspect of the remaining left lung. The patient appears to status post left upper lobectomy. Loculated fluid collection left hemithorax with enhancement of both the visceral and parietal pleura, the latter appears new from the prior examination and could be the result of tumor or empyema.MEDIASTINUM AND HILA: Interval enlargement of lymph nodes in the high right paratracheal chain (4/15-17),paraaortic (4/22) low left paratracheal (4/33), and left hilar region lymphadenopathy. Necrotic enlarged left lower lobar level lymph node (4/47) and mildly enlarged subcarinal lymph nodes unchanged.CHEST WALL: Interval enlargement of a subcentimeter low cervical lymph node on the right (4/4). Cortical thickening and deformity of left posterior ribs 5-7, chronic.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: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Colonic diverticuli.BONES, SOFT TISSUES: Partially calcified soft tissue extraperitoneal nodule unchanged compared to recent exams, minimally larger when comparing back to exams of 2011 and earlier and could reflect a complex urachal cyst. Although considered unlikely urothelial adenocarcinoma or other primary tumor cannot be entirely excluded.OTHER: No significant abnormality noted. | 1. Interval worsening of necrotic mediastinal and left hilar lymphadenopathy, which may be due to tumor or active infection.2. Interval development of pleural enhancement and a fluid level within the emphysematous cyst in the left lung; findings are suspicious for infection in the pleural space.3. Findings consistent with chronic MAI infection in the left lung. The areas of consolidation in the left lung are hypoattenuating relative to expected density of lung parenchyma and similar to the contralateral tumor infiltration therefore tumor is favored over an infection though it is likely that combination exists within the left lung. 4. Index measurement of right upper lobe mass is larger. |
Generate impression based on findings. | Male 53 years old Reason: Does this patient have a lung nodule? History: per patient, had a lung nodule, not imaged in >1 year LUNGS AND PLEURA: Right lower lobe subpleural granuloma unchanged since 2011 exam. Other small micronodules identified likely represent intrapulmonary lymph nodes.Moderate centrilobular emphysema.MEDIASTINUM AND HILA: No evidence of mediastinal or hilar lymphadenopathy. Normal heart size and no pericardial effusion.CHEST WALL: Multiple nonspecific small subpectoral lymph nodes. Small well-defined focal lucency with sclerotic margin seen in the superoposterior T12 vertebral body, unchanged and likely benign in etiology. Adjacent small punctate high-density focus just lateral to the aforementioned lucency of unclear etiology, unchanged. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple globular calcifications scattered throughout the pancreatic parenchyma with associated pancreatic parenchymal atrophy and ductal dilatation compatible with chronic pancreatitis. Multiple left-sided simple renal cysts. | 1. Peripheral right lower lobe granuloma unchanged since 12/5/2011.2. Moderate emphysema. 3. Findings compatible with chronic pancreatitis. |
Generate impression based on findings. | Reason: evaluate recently treated HCC History: cirrhosis with HCC ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Liver contour: The liver contour is nodular. Features of portal hypertension: Enlarged portal vein with multiple portosystemic collaterals consistent with portal hypertension. Mild ascites surrounding the liverPortal vein: Attenuated right portal vein, likely thrombosed with bland thrombus. Hepatic veins: Patent. A mild focal biliary dilation.Hepatic artery: Patent. Lesions: Tumor cavity measures 3.4 x 2.6 cm (image 22 , series 17 ) in segment 7 , arterial enhancement - none; washout - none ; peripheral rim enhancement - none .There is a wedge-shaped lesion in the superior to the treated lesion in is likely resulting from portal venous occlusion. Redemonstration of numerous low attenuating, nonenhancing lesions are seen throughout the liver likely representing hepatic cysts. Status post cholecystectomy. Common bile duct is dilated and may be normal given post-cholecystectomy state.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the descending abdominal aorta and bilateral iliac arteries. BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Segment 7 hepatic lesion status post chemoembolization without residual nodular enhancement, washout or rim enhancement.2.Redemonstration of numerous, likely hepatic cysts.3.Redemonstration of thrombosis of the right portal vein. |
Generate impression based on findings. | Dyspnea and other respiratory abnormalities. Solitary nodule follow-up LUNGS AND PLEURA: Evaluation of lungs is limited due to mild motion and extreme motion on the prior 2010 exam. Within this limitation, gross stability of multiple subcentimeter nodules in the right lower lobe, the largest measuring 8 mm (image 30 series 4) posteriorly. These lesions are essentially unchanged from 2010 but moderately larger and more numerous when compared to 2005. Although not dedicated expiration imaging, mild mosaic air trapping is suggested and similar grossly to prior studies. No effusions or other discrete focal airspace pulmonary abnormalities other than basilar atelectasis greater on the left and adjacent to the enlarged heart.MEDIASTINUM AND HILA: Interval enlargement of multiple scattered lymph nodes. For reference a right paratracheal node at the old aortic arch (image 19 series 3) measures 1.3 cm in short axis compared to 1.0 cm. a large loop in the node or conglomerate nodal mass in the precarinal space (image 25 series 3) currently measures 1.8 cm in short axis compared to 1.4 cm.Marked pulmonary artery hypertension with enlargement measuring 4.6 cm in diameter at level of carina (image 27 series 3).The cardiac and paracardial otherwise appears unchanged with marked coronary and annular calcifications. Moderate cardiomegalyCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. A dense focal amount in the gastric lumen is consistent with retained medication. Associated discrete nodular densities are observed in the left adrenal, partially visualized due to incomplete evaluation of the upper abdomen. One discrete lesion currently measures 1.9 x 1.6 cm, previously 1.5 x 1.0 cm (image 91 series 3). | . 1. Multiple right lower lung pulmonary nodules not grossly changed from 2010 but increased in size and number from 2005. 2. Moderately enlarged lymph nodes. 3. Diffuse mosaic lung pattern compatible with air space disease versus perfusion abnormalities unchanged from previous. |
Generate impression based on findings. | Male 40 years old; Reason: eval for kidney stone on the left History: uti, hx of stones, new L flank pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right kidney is normal in morphology. No hydronephrosis or perinephric inflammation . Probable cyst in the interpolar region of the right kidney.There is moderate left perinephric inflammation. A punctate nonobstructive calculus is located at the lower pole of the left kidney. Probable cysts at the lower pole of the left kidney. No drainable fluid collections. No hydronephrosis. The left distal ureter is mildly dilated however, no stone is evident in its course.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Nonobstructive left renal calculus ; Left renal inflammation and perinephric inflammation. Differential considerations for a noncontrast CT include pyelonephritis, non radiopaque stone or recently passed stone.2.Recommend a follow imaging following the acute phase to ensure resolution. |
Generate impression based on findings. | Reason: h/o met hnc, getting chemo, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Stable scattered nonspecific micronodules.No suspicious pulmonary nodules or masses.Minimal basilar scarring/discoid atelectasis.MEDIASTINUM AND HILA: Stable mediastinal lymphadenopathy with reference right paratracheal lymph node (image 19 series 3) measuring 12 mm x 25 mm previously measuring 12 mm x 26 mm.Heavily calcified hilar mediastinal lymph nodes are compatible with prior granulomatous disease.Stable mild cardiac enlargement without evidence of pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Degenerative changes in the thoracic spine with stable sclerosis of the T8-8 for Cuba body.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable scattered small hypodensities too small to characterizeSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes in the thoracic spine.OTHER: No significant abnormality noted. | 1.No evidence of pulmonary metastases.2.Stable T8 is sclerotic lesion.3.No new sites of disease identified. |
Generate impression based on findings. | Reason: Met small cell bladder cancer, delayed views, CT urogram, evaluate for response to therapy History: met small cell bladder cancer CHEST:LUNGS AND PLEURA: Centrilobular emphysema. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Interval decrease of left supraclavicular lymph node, now measuring 1.5 x 0.7 cm, previously 3.2 x 3.5 cm (series 6, image 1). This lymph node is incompletely evaluated. No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion. Small hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating lesion in segment 5 measures 2.2 x 1.5 cm (series 6, image 75), previously 2.2 x 1.4 cm. This may represent a benign cyst. Additional hypoattenuating lesions are too small to further characterize, but unchanged in appearance and likely benign.SPLEEN: Calcified splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Severe persistent right hydronephrosis, unchanged. Contrast does not opacify the right ureter. Interval resolution of left hydronephrosis. Bilateral renal hypodensities are too small to further characterize.RETROPERITONEUM, LYMPH NODES: Interval near resolution of retroperitoneal lymphadenopathy. Reference paraaortic lymph node measures 2.0 x 0.9 cm (series 6 and image 107), previously 4.6 x 3.7 cm. Reference portocaval lymph node is no longer discretely measurable. Third reference retroperitoneal lymph node mass is no longer measurable.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: There is minimal opacification of the bladder on delayed images with irregular wall thickening of the posterolateral left bladder wall measuring 6.7 x 0.7 cm (series 6, image 159), previously 6.9 x 5.4 cm. Laminated bladder stone.LYMPH NODES: Reference left pelvic lymph node measures 1.2 x 1.0 cm (series 6, image 168), previously 3.6 x 2.5 cm.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Marked interval decrease in bladder mass.2.Near resolution of lymphadenopathy in the supraclavicular, retroperitoneal, and pelvic regions.3.Persistent severe right hydronephrosis compatible with a high grade UPJ obstruction.4.Interval resolution of left hydronephrosis. |
Generate impression based on findings. | Clinical question: Evaluate for ventricular communication. Signs and symptoms: Headache. Unenhanced head CT:Axial contiguous non-enhanced CT of head was performed. 2 cc of Omnipaque injected through the right EVD catheter on the floor prior patient's arrival to the CT scanner.Examination demonstrates extensive contrast within the subarachnoid space in the basal cistern, bilateral sylvian fissures and perimesencephalic cistern. There is also evidence of contrast within the subarachnoid space in the posterior fossa and including the fourth ventricle.There is no detectable contrast in the supratentorial ventricular system in this initial head CT post EVD contrast injection. Since prior exam there is further resorption of previously noted pneumocephalus in the dome a trace amount of residual air intracranially present.No evidence of any interval change in the position of two previously placed catheters. | 1.Examination demonstrates extensive contrast within the subarachnoid space in the supratentorial space and posterior fossa and including the fourth ventricle. There is however no detectable contrast within the supratentorial ventricular system on this initial study.2.Interval decreased postoperative pneumocephalus with trace amount of air remaining.3.Stable exam otherwise since prior study from 10 -- 5 -- 13. |
Generate impression based on findings. | SCC of the right tonsil region, at least T4bN2c status post chemotherapy. Head: There no significant interval change in size of the mass along the floor of the right middle cranial fossa, right cavernous sinus, and a portion of Meckel cave through a widened foramen ovale. There has also been progressive lytic destruction of the right central skull base. There is unchanged mild cerebral white matter hypoattenuation, stable and likely representing age indeterminate small vessel ischemic disease. The ventricles are stable in size and configuration. Neck: There is an ill-defined heterogeneously enhancing mass centered in the right tonsillar fossa with extension to the medial right masticator space, soft palate, hard palate, superior carotid space, and posterior right maxillary sinus. The degree of soft palate involvement appears to have decrease in size along with decreased narrowing of the oropharyngeal airway, while there is greater encroachment into the right maxillary sinus. In addition to the erosion of the right central skull base, there has been slight progressive erosion of the right pterygoid plates, mandibular tuberosity, greater wing of the sphenoid, and lateral wall of the petrous carotid canal. There is no significant narrowing of the carotid arteries and the jugular veins also appear to be patent. There is also erosion of the right posterior hard palate with minimal extension of enhancing tissue into the right inferior meatus. There is also obliteration of the fat pad of the pterygopalatine fossa by the mass. There is no significant cervical lymphadenopathy. There are unchanged enlarged superior mediastinum lymph nodes. Refer to the concurrent separate chest CT report for additional details. The salivary glands and thyroid are unchanged. There is extensive degenerative spondylosis and temporomandibular joint degenerative change, left greater than right. | Ill-defined squamous cell carcinoma centered in the right tonsillar fossa with extension to the medial right masticator space, soft palate, hard palate, superior carotid space, posterior right maxillary sinus, pterygopalatine fossa, floor of the right middle cranial fossa, right cavernous sinus, and a portion of Meckel cave. The component of the tumor in the right maxillary sinus appears to have increased in size, while the portion that involves the soft palate appears to have decrease in size. Other portions of the tumor are not significant changed. Some areas of associated bone erosion have progressed, which may be due to the effects or tumor and/or treatment. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.