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Generate impression based on findings. | Reason: history of hematuria, please evaluate with CT urogram History: hematuria ABDOMEN:LUNG BASES: Redemonstration of extensive centrilobular and paraseptal emphysema. Severe atherosclerosis of the aortic valve and coronary arteries. Sclerotic calcifications of the descending thoracic aorta.LIVER, BILIARY TRACT: No s... | 1.Etiology of hematuria is not evident.2.Right large renal cysts.3.Bladder diverticulum arising from the right bladder wall.4.Ectatic descending aorta with interval enlargement of aneurysmal dilatation of bilateral iliac arteries with large mural thrombi.5.Thrombosis of the right superficial femoral artery.6.Redemonstr... |
Generate impression based on findings. | Reason: s/p Lap Appy with open abd wound that is now closing, c/o sudden severe abd pain x1 day with elevated blood sugars, assess for abscess/fluid collections History: s/p Lap Appy with open abd wound that is now closing, c/o sudden severe abd pain x1 day with elevated blood sugars, assess for abscess/fluid collectio... | 1.Small bowel obstruction with a transition point in the right pelvis.2.Wall enhancing loculated collections compatible with abscesses, decreased in size compared to the prior exam. |
Generate impression based on findings. | Chronic sinusitis. There is mild to moderate mucosal thickening within the bilateral maxillary sinuses. The bilateral infundibula are partially opacified. There is mild to moderate opacification of the ethmoid sinuses. There is mid mucosal thickening within the left sphenoid sinus. The right sphenoid sinus is clear. Th... | Mild to moderate scattered paranasal sinus opacification in a sporadic pattern. |
Generate impression based on findings. | Head and Neck cancer follow-up RT and chemo. CHEST:LUNGS AND PLEURA: Reference linear opacity in the right upper lobe measures 19 x 5 mm, previously 18 x 5 mm, not significantly changed (5/23). Right lower lobe nodule is 6 x 6 mm (5/76), previously 7 x 6 mm.Subpleural opacities superior segment right lower lobe unchang... | No significant change in index pulmonary lesions. Interval development of bronchial wall thickening and groundglass opacity in the right upper lobe which may be infectious or inflammatory. |
Generate impression based on findings. | 56-year-old male with follicular non-Hodgkin's lymphoma status post chemotherapy CHEST:LUNGS AND PLEURA: Basilar dependent atelectasis. No pleural effusions. No suspicious nodules or masses.Azygos pseudo-lobe.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusio... | Mixed response. Reference measurements are given above. |
Generate impression based on findings. | Reason: Hx NHL now s/p 4 cycles of RCHOP, eval response to treatment History: chemo, hx nhl CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Mild basilar atelectasis.Left lower lobe subpleural thickening.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without perica... | 1.Decreasing infiltrative retroperitoneal mass invading the right kidney with encasement of the IVC.2.Misty mesentery with multiple prominent mesenteric lymph nodes without significant interval change.3.T6 vertebral body metastasis, unchanged.4.No new sites of disease in the chest, abdomen, or pelvis. |
Generate impression based on findings. | Clinical question: Personality change, dysphonia. Signs and symptoms: As a ball. Unenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray --... | No acute intracranial process. Please see above comments. |
Generate impression based on findings. | Clinical question: Esophageal cancer with brain metastases, check response to WBRT. Enhanced head CT:There is a small focus of parenchymal enhancement in the left said about the measuring at approximately 6 mm in its transaxial dimensions (axial image 8 and sagittal reformatted image 35). This is a new finding since pr... | 1.Examination demonstrates multiple small new enhancing metastatic lesions in bilateral cerebral hemispheres as well as the left cerebellum since prior exam.2.Postoperative changes of left posterior temporal -- occipital craniotomy for removal of tumor and without evidence of recurrence of disease at this site.3.Stable... |
Generate impression based on findings. | Post inflammatory pulmonary fibrosis. Chronic cough, worsening interstitial opacities on CXR and severely reduced diffusion capacity on PFTs. LUNGS AND PLEURA: Moderate cylindrical and varicoid traction bronchiectasis in the mid and lower lung zones, seen to a lesser extent in the upper lobes. Diffuse mosaic attenuatio... | 1.Interval progression of moderate pulmonary fibrosis and bronchiectasis along with evidence of air trapping. This constellation of findings is most consistent with subacute hypersensitivity pneumonitis however the basilar distribution is atypical and superimposed fibrotic NSIP may be considered.2. Interval mild enlarg... |
Generate impression based on findings. | History of Ewing's sarcoma in second remission, respiratory insufficiency secondary to chemo radiation, evaluate for pulmonary metastatic nodules LUNGS AND PLEURA: Bilateral upper lobe predominant linear and subpleural opacities with scarring and traction bronchiectasis appears similar to the prior study. No pleural ef... | 1.Bilateral upper lobe predominant traction bronchiectasis and scarring is unchanged. No new pulmonary nodule.2.Manubrial and sternal lucent lesions are unchanged. Healing left fourth and fifth rib fractures. |
Generate impression based on findings. | Hodgkin's lymphoma stage III S. status post 4 cycles of chemotherapy. Restaging. CHEST:LUNGS AND PLEURA: Scattered calcified granulomas.Dependent atelectasis.MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes have regressed compared to prior chest CT. The reference low right paratracheal node now measures ... | Resolution of previously described splenic lesions. No substantial interval change in reference lymph nodes in the abdomen. Lymph nodes in the mediastinum have regressed compared to the most recent chest CT of 3/2013. |
Generate impression based on findings. | 68-year-old male with history of bilateral palatine tonsil squamous cell carcinoma and prior metastatic disease to right neck node. Evaluate for recurrence. The partially visualized orbits are normal. Scattered mild paranasal mucosal thickening. The mastoid air cells are clear. Limited view of the intracranial structur... | 1.No new neck mass or cervical lymphadenopathy to suggest recurrence.2.Bilateral linear lung opacities are unchanged, likely areas of scarring. Please see dedicated CT of the chest from today.3.Moderate to severe degenerative disc disease affects the cervical spine. |
Generate impression based on findings. | Reason: pt with met esophageal ca s/p 4 cycles of chemo History: now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Left basilar consolidation/atelectasis slightly more dense than the prior exam.Subpleural nodule in the left lower lobe as well as scattered left upper and lower lo... | 1.Resolution or decrease in size of previously identified pulmonary micronodules . No new suspicious pulmonary nodules or masses.2.Stable gastrohepatic lymph node.3.No sites of disease identified. |
Generate impression based on findings. | Evaluate for possible disease progression, specifically in the liver. CHEST:LUNGS AND PLEURA: Minimal scarring at the lung bases.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Unchanged left anterior chest wall Port-A-Cath with tip of catheter in the superior vena cava. Right breast skin thickening ... | No substantial interval change compared to prior. Multiple bony metastases. Stable reference measurements. |
Generate impression based on findings. | Female 36 years old Reason: history of parathyroid carcinoma, eval for recurrence. LUNGS AND PLEURA: Resolution of subsegmental atelectasis and focal consolidation in the left costophrenic angle. No new air space abnormality identified. Subpleural nodular density in the right middle lobe unchanged since 2011 and could ... | No CT evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | Reason: has lung adenocarcinoma mets to liver, hips, on chemo check response History: pain CHEST:LUNGS AND PLEURA: Status post right lower lobectomy. Apical scarring and bronchiectasis, unchanged. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar adenopathy. Heart size is normal. N... | 1.Right hepatic lobe metastasis, unchanged.2.Sclerotic lesion in the T12 vertebral body, unchanged.3.No new sites of disease in the chest, abdomen, or pelvis. |
Generate impression based on findings. | Reason: History of HCC. Staging workup prior to enrollment in a clinical trial. History: na CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Atherosclerotic calcifications of the coronary arteriesCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Liver contour: Cirrho... | 1.Segment 1 lesion demonstrates early enhancement with washout compatible with known disease.2.Increase in size of segment 2 lesion with chemoembolization material demonstrating residual peripheral enhancement with washout suspicious for residual disease and inferior extension of disease and questionable portal vein in... |
Generate impression based on findings. | Newly diagnosed SLL with night sweats. Staging. CHEST:LUNGS AND PLEURA: Scarring at both lung apices. There is a 9 x 10 mm nodule at the right lung base medially (image 85; series 4).MEDIASTINUM AND HILA: Multiple small mediastinal lymph nodes. A high left paratracheal node (image 14; series 3) measures 2.0 x 1.7 cm. C... | 1. Multiple enlarged lymph nodes with reference measurements given above. The largest nodes are located in the right lower quadrant in the pericecal region.2. 1 cm right basilar pulmonary nodule. |
Generate impression based on findings. | Female 63 years old Reason: new stage IV endometrial cancer needs chemo, evaluate metastatic disease History: see above CHEST:LUNGS AND PLEURA: Calcific granulomata right lung and right hilum. No suspicious lung nodules or effusions.MEDIASTINUM AND HILA: Cluster of two or possibly septated hypodense nodules in the left... | Postsurgical changes. Small amount of fluid in the cul-de-sac. Lungs granulomatous disease. |
Generate impression based on findings. | Male 29 years old Reason: Crohn abd pain History: Abd pain distention.Additional history from pathology report of 7/22/13 indicates that the patient has a history of ileocolonic Crohn's disease has had two resections in the current anastomotic stricture at that time. ABDOMEN:LUNG BASES: No significant abnormality noted... | Findings consistent with Crohn's disease involving the rectum, rectosigmoid and sigmoid colon as described.Patent ileocolic anastomosis without evidence of disease activity.Splenic cysts. Cholelithiasis. |
Generate impression based on findings. | Reason: assess for right inguinal mass History: right inguinal mass 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, UR... | Nonspecific near fluid attenuation lesion lateral to the right spermatic cord may represent a lymphocele or a small amount of peritoneal fluid within a hernia. |
Generate impression based on findings. | Aplastic anemia and neutropenic fever. Rule out sinusitis. The maxillary, ethmoid, frontal, and sphenoid sinuses are clear. The ethmoid roofs are nearly symmetric and appear intact. The carotid grooves and optic canals are intact. The nasal cavity and mastoid air cells are clear. The imaged intracranial structures and ... | No evidence of sinusitis. |
Generate impression based on findings. | Clinical question: Rule out intracranial hemorrhage. Signs and symptoms: Difficult to arouse. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for detection of acute non-hemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF cis... | Negative nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Brain hemorrhage? Acute stroke. Signs and symptoms: Acute alteration of mental status. Unable to move. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic stroke.Unremarkable cerebral cortex, cortical sulci, ventricula... | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Rule out acute hemorrhage or infarct. Signs and symptoms: History of multiple sclerosis, right-sided weakness and fall. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for the touch of acute nonhemorrhagic ischemic strokes.There is prominence of the ce... | No accurate intracranial process. Please see above comments. |
Generate impression based on findings. | Concern for polyarteritis nodosum Following observations are made given limitations of an arterial weighted study.ABDOMEN:LUNG BASES: Small bilateral pleural effusions with overlying compressive atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No signif... | Diffuse small vessel visceral vasculitis compatible with the suspected clinical history of polyarteritis nodosa. |
Generate impression based on findings. | Clinical question: Breast cancer with brain metastases. Signs and symptoms: Breast cancer with brain metastases. Nonenhanced head CT:Examination demonstrates a focus of decreased attenuation of white matter in right frontal lobe consistent with vasogenic edema. A subtle associated mass effect with the findings. Within ... | 1.Large focus of vasogenic edema and internal focus of cystic change in high convexity right frontal lobe with subtle associated mass effect highly concerning for a metastatic lesion.2.Two additional small focus of vasogenic edema as detailed and suspected for additional possible foci of metastatic lesions. This is als... |
Generate impression based on findings. | Concern for polyarteritis nodosum Following observations are made given limitations of an arterial weighted study.ABDOMEN:LUNG BASES: Small bilateral pleural effusions with overlying compressive atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No signif... | Diffuse small vessel visceral vasculitis compatible with the suspected clinical history of polyarteritis nodosa. |
Generate impression based on findings. | Female 39 years old Reason: r/o PE History: SOB PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolism.LUNGS AND PLEURA: Small/moderate bilateral pleural effusions with associated compressive atelectasis left greater than right. Perihilar consolidation in the superior segment of the left lowe... | 1. No evidence of pulmonary embolism.2. Pleural effusions, consolidation/atelectasis and groundglass opacities compatible with aspiration or aspiration pneumonia in the appropriate clinical setting.3. Innumerable nonspecific small cervical lymph nodes of uncertain significance. |
Generate impression based on findings. | Male 73 years old; Reason: Pt is 73 yo M with hx of Multiple myeloma and Bil leg weakness and paresthesias History: bil leg weakness and paresthesias. Within the lower lumbar spine, sacrum and pelvis bilaterally there are numerous osteolytic lesions with a permeative cortical destructive pattern noted in the left iliac... | Diffuse myelomatous disease, especially involving the left iliac wing, without acute fracture, dislocation or discrete soft tissue lesions. There are no specific findings in the pelvis to account for the bilateral nature of the patient's weakness and paresthesias. |
Generate impression based on findings. | Reason: Pancreatic protocol CT: evidence of exocrine pancreas loss History: low fecal elastase, chronic diarrhea, high fecal fat ABDOMEN:LUNG BASES: Small right pleural effusion.LIVER, BILIARY TRACT: Small punctate calcification at the dome of the right lobe of the liver likely representing granulomata. No evidence of ... | 1.Findings consistent with chronic pancreatitis.2.Fluid-filled loops of small and large bowel with diffuse thickening of the large bowel wall compatible with colitis of nonspecific etiology. |
Generate impression based on findings. | Reason: assess for bowel inflammation, sbo History: n/v/bloody diarrhea abd pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse hepatic steatosis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNE... | 1.Mild left colon and rectal wall thickening and fat standing suggests colitis of indeterminate etiology.2.Hepatic steatosis. |
Generate impression based on findings. | Reason: r/o obstruction History: intermittent nausea/vomiting x 1.5 wks ABDOMEN:LUNG BASES: Dependent basilar atelectasis bilaterally.LIVER, BILIARY TRACT: No suspicious focal liver lesions. No evidence of cholelithiasis. No intrahepatic or extrahepatic ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS... | No evidence of small bowel or large bowel obstruction. |
Generate impression based on findings. | Chest pain. Shortness of breath. PULMONARY ARTERIES: Technically inadequate examination for evaluation of the pulmonary arteries to the segmental level. No pulmonary embolus is seen. No evidence of right heart strain.LUNGS AND PLEURA: Mild bibasilar subsegmental atelectasis and scarring, likely secondary to patient's h... | No evidence of pulmonary embolism. No specific findings to otherwise account for the patient's symptoms. |
Generate impression based on findings. | History of hematuria This study is limited due to lack of IV contrast.ABDOMEN:LUNG BASES: Dependent atelectasis lung bases.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URET... | Limited study due to lack of IV contrast. Bilateral hypodense and hyperdense lesions are unchanged but they cannot be optimally characterized due to lack of IV contrast. Follow-up imaging with MRI may be helpful for these lesions. Right nephrolithiasis.Left ovarian cyst. |
Generate impression based on findings. | Reason: r/o low hernia or pelvic mass- R sided History: severe pain to pelvic area and wt loss- h/o hernia repair, and R testicular removal for torsion in 2002 ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Small right hepatic lobe hypodensity is too small to further characterize.SPLEEN: No ... | Findings compatible with uncomplicated diverticulitis. |
Generate impression based on findings. | Cellulitis and abscess. There is a peripherally enhancing fluid collection in the right preauricular region that appears to be located within the superificial lobe of the parotid gland, measuring 13 AP x 12 RL x 17 SI mm. There is stranding of the overlying subcutaneous fat and skin thickening, as well as mild hyperemi... | 1. A peripherally enhancing fluid collection in the right preauricular region that appears to be located within the superificial lobe of the parotid gland and measuring up to 17 mm with associated cellulitis and mild reactive adenopathy likely represent a parotid abscess. A superimposed infected first branchial cleft c... |
Generate impression based on findings. | 36-year-old male status-post ileocecal and sigmoid resections, presenting with tachycardia and poor oral intake ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No s... | Intra-abdominal large fluid collection and distal small bowel obstruction.Dr. Rodriguez was notified and acknowledged about these findings at the time of dictation. |
Generate impression based on findings. | Fever. History of HIV. Right upper lobe opacity on chest radiograph. LUNGS AND PLEURA: Consolidations in the posterior segment of the right upper lobe, superior segment of the right lower lobe, and superior segment of the left lower lobe, likely representing multifocal pneumonia. No cavitation is evident. There are no ... | Multiple areas of consolidation, likely representing multifocal pneumonia. The dependent locations of these opacities raises the question of aspiration. |
Generate impression based on findings. | Reason: assess for sbo, post op complication, hydro History: abd pain s/p nephrectomy Lack of intravenous contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Left basilar subsegmental atelectasis/scarring.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted... | Status post left partial nephrectomy. Indeterminate collection in the surgical bed with perinephric stranding and fluid tracking along the left psoas muscle. |
Generate impression based on findings. | 58-year-old male status post Whipple surgery, restaging CHEST:LUNGS AND PLEURA: Emphysema, unchanged. There is a subcentimeter left lower lobe nodule on image number 80, series number 4 measuring 4 mm, new from previous study. Other scattered micronodules are stable.MEDIASTINUM AND HILA: No significant abnormality note... | Interval progression of disease with interval development of hepatic metastases and new left lower lobe lung nodule. Ill-defined retroperitoneal soft tissue encasing and invading the extrahepatic main portal vein and SMV. |
Generate impression based on findings. | Reason: appy History: RLQ pain ABDOMEN:LUNG BASES: Mild basilar pleural thickening bilaterally.LIVER, BILIARY TRACT: Status post cholecystectomy. No suspicious focal liver lesions. No intrahepatic ductal dilatation. Mild dilatation of the common duct which may be within normal limits given post cholecystectomy status.S... | Normal-appearing appendix without evidence for appendicitis. |
Generate impression based on findings. | Painful respiration. History of prior PE/DVT, not on anticoagulation. PULMONARY ARTERIES: Technically inadequate examination for evaluation of the pulmonary arteries to the subsegmental level. No pulmonary embolus is identified. No evidence of right heart strain.LUNGS AND PLEURA: No focal air space opacities or pleural... | No evidence of pulmonary embolism. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: G tube wound infection History: Abdominal pain ABDOMEN:LUNG BASES: Well-defined basilar pulmonary cysts suggest lymphangioleiomyomatosis (LAM). No pleural effusions. Small hiatal hernia.LIVER, BILIARY TRACT: Right hepatic lobe hypodensity is too small to further characterize but likely benign.SPLEEN: Accessory ... | Feeding tube tip inflated in the jejunum. Subcutaneous tract thickening likely represents chronic inflammation. . |
Generate impression based on findings. | Reason: 67 female with aplastic anemia, neutropenic fever, lung infiltrate per CXR. Please assess pulmonary infiltrate History: Hypoxia LUNGS AND PLEURA: Patchy interstitial predominant opacities with areas of confluent consolidation throughout both lungs, without pleural effusions.Azygos pseudo-lobe, a normal variant.... | Diffuse pneumonia, the pattern most consistent with pneumocystis although other etiologies including viral infection are in the differential diagnosis, as well as pulmonary hemorrhage or ARDS. |
Generate impression based on findings. | Reason: 71 yr old male with history of t-MDS; post allo SCT History: Evaluate LUNGS AND PLEURA: Residual basilar reticular opacities persist, but there is no evidence of current infection. Minimal bronchiectasis affects the lung bases.Benign-appearing micronodules, some calcified, are unchanged. MEDIASTINUM AND HILA: C... | No evidence of new infection with residual interstitial opacities. |
Generate impression based on findings. | Reason: 50 female with chronic myelomonocytic leukemia, recent pneumonia at outside hospital. now with recurrent fevers, assess for infiltrate History: Fever LUNGS AND PLEURA: Consolidation of the medial segment of the right middle lobe consistent with pneumonia possibly simple bacterial.Nonspecific basilar dependent o... | 1. Right middle lobe pneumonia, possibly bacterial.2. Multiple lymph nodes and splenomegaly consistent with known chronic myelomonocytic leukemia. |
Generate impression based on findings. | Reason: R/o Pulm Aspergillosis History: Cystic fibrosis flare - Hx of pulm aspergillosis in the apst LUNGS AND PLEURA: Multiple thin-walled cysts are present in both upper lobes compatible with cystic bronchiectasis, some of which contain a small amount of fluid. Extensive bronchiectasis and tree in bud opacity are pre... | Extensive cystic bronchiectasis consistent with cystic fibrosis. The no evidence of aspergilloma or other specific evidence of Aspergillus infection. |
Generate impression based on findings. | Reason: intrahepatic cholangiocarcinoma please compare index lesions to previous Nadir measurements in May for RECIST History: As above CHEST:LUNGS AND PLEURA: Scattered pulmonary nodules, some of which are calcified, unchanged. No pleural effusions.MEDIASTINUM AND HILA: Reference prevascular lymph node measures 2.0 x ... | 1.Reference hepatic mass is ill-defined and difficult to measure but appears unchanged or slightly increased in size.2.Increasing reference prevascular lymph node.3.Unchanged retroperitoneal lymphadenopathy. |
Generate impression based on findings. | Chronic myelomonocytic leukemia, recurrent fevers. r/o sinusitis. The bilateral maxillary, ethmoid, and sphenoid sinuses are clear. The frontal sinuses are not pneumatized. The right ethmoid roof is 2 mm higher than the left, but these structures are otherwise intact. The optic canals and carotid grooves are covered by... | No evidence of sinusitis. |
Generate impression based on findings. | Female; 66 years old. Reason: acute aphasia, left MCA stroke, vessel stenosis? History: aphasia CT head:Since the prior CT on 10/3/2013, there has interval appearance of patchy irregular hypoattenuation in the left MCA territory involving the frontal and parietal lobes in a similar distribution as the patchy restricted... | 1.Interval evolution of known stroke seen on the MRI brain examination from 10/5/2013 without evidence of hemorrhagic transformation. A component of underlying acute ischemia within this area cannot be entirely excluded, and an MRI can be obtained as clinically indicated.2.Approximately 80% stenosis of the left M1/M2 j... |
Generate impression based on findings. | Reason: Pancreas Cancer: Restaging History: none CHEST:LUNGS AND PLEURA: Reference right apical pulmonary nodule measures 1.7 x 1 .2 cm (series 12 on image 14), previously 1.3 x 1.0 cm.Several other pulmonary nodules appear increased in size.MEDIASTINUM AND HILA: No mediastinal or hilar adenopathy. Heart size is normal... | 1.Multiple new osseous metastases.2.Pulmonary nodules, increasing in size.3.Increasing hepatic metastases. |
Generate impression based on findings. | 63-year-old female with esophageal carcinoma CHEST:LUNGS AND PLEURA: Right upper lobe subpleural nodule is unchanged measuring 8 x 6 mm on image number 35 on series number 4.Left upper lobe nodule adjacent to the pulmonary vessels measures 7 mm on image number 31, series number 4. Bilateral small pleural effusions, mor... | No significant change from previous study. |
Generate impression based on findings. | Intracerebral hemorrhage. There is continued evolution in the attenuation characteristics, but no significant overall interval change in size of the large intraparenchymal hematoma with associated vasogenic edema centered within the right basal ganglia and thalamus that extends into the ventricular system. However, the... | 1. Continued evolution in the attenuation characteristics, but no significant overall interval change in size of the large intraparenchymal hematoma with associated vasogenic edema centered within the right basal ganglia and thalamus with extension into the ventricular system, but slightly increased hemorrhage along th... |
Generate impression based on findings. | 79-year-old male with history of metastatic prostate cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Index supraclavicular lymph node now measures 1.2 by 1.1-cm on image number 9, series number 3, minimally enlarged compared to previous study. Other supraclavicular lymph nodes are a... | Interval progression of disease with interval development of a bilateral hydronephrosis, more on the left compared to the right side. Interval increase in the size of the retroperitoneal, pelvic and mesenteric adenopathy. Bone metastases are stable. |
Generate impression based on findings. | Reason: 71 yof with h/o breast cancer and R flank pain x3 wks History: R flank pain x3 wks 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: Mild paraseptal emphysematous... | 1.No findings to account for the patient's symptoms.2.No evidence of nephrolithiasis or hydronephrosis. |
Generate impression based on findings. | 62 year old female with history of pancreatic cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Thromboses of the right internal jugular vein, again noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver.SPLEEN: No sig... | No significant change from previous study. |
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 ... | Stable postoperative findings related to left cerebral hemisphere grid electrode insertion without change in the position of the hardware, 5 mm of midline shift, and no definite evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | Female 77 years old Reason: 77 y.o with hx of Left breast cancer T2 (2.3 cm) N0 s/p mastectomy SLbX now with 2 cm Left axilla node FNA positive History: Left recurrent breast cancer, need to assess for distant mets CHEST:LUNGS AND PLEURA: 7-mm right lower lobe nodule with an ill-defined margin, differential includes pr... | 1. Indeterminate right lower lobe pulmonary nodule somewhat suspicious for primary lung carcinoma, less likely metastasis. Recommend 6 month CT follow-up to confirm stability.2. Markedly enlarged left axillary lymph node compatible with metastasis. |
Generate impression based on findings. | Seminoma status post orchiectomy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable subcentimeter peripheral segment 4b low-attenuation focus.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: ... | Stable negative examination; no evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | Glomus tympanicum tumor in left middle ear. On the right, 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, but may be dehiscent along th tympanic segment. The inner ear structu... | A soft tissue mass within the posterior middle ear cavity adjacent to the cochlear promontory and extending into the hypotympanum, which measures approximately up to 12 mm is compatible with a glomus tympanicum. |
Generate impression based on findings. | Rectal carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Status post right hepatectomy. Vague low attenuation focus within segment two of the left lobe of the liver best seen o... | Stable examination without acute, inflammatory, or metastatic process. |
Generate impression based on findings. | Lung nodule follow up LUNGS AND PLEURA : The groundglass nodule in the right middle lobe adjacent to the major fissure (series 4, image 178) is unchanged in size or appearance, measuring 7 x 8 mm. Multiple additiona calcified and noncalcified micronodules measuring less than 4 mm are unchanged in size and appearance.ME... | Stable size and appearance of the nonspecific right middle lobe nodule over 4 months. Given the size of this nodule, follow up CT is recommended in 6 months for monitoring of a possible minimally invasive adenocarcinoma. |
Generate impression based on findings. | Clinical question: Left-sided subdural. Evaluate for change. Signs and symptoms: None, follow-up for resolution. Nonenhanced head CT:Previously noted right sided subdural hematoma demonstrates significant interval decrease since prior exam. Minimal residual subdural anterior to the tip of right frontal lobe measuring a... | 1.Near complete resolution of reduced amount of the right subdural hematoma. Very small localized residual subdural anterior to the right frontal pole as detailed above.2.Significant interval decrease in size of left hemispheric subdural. A small low-density subdural measuring approximately 6 mm in thickness only in th... |
Generate impression based on findings. | History of bladder cancer CHEST:LUNGS AND PLEURA: Severe emphysema.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLA... | Asymmetric wall thickening involving the base of the bladder. |
Generate impression based on findings. | Reason: history of tonsil cancer with paratracheal recurrence History: history of tonsil cancer with paratracheal recurrence LUNGS AND PLEURA: Bilateral apical post radiation changes. Stable scattered nonspecific micronodules.No suspicious pulmonary nodules or masses.No pleural effusion.MEDIASTINUM AND HILA: Increasing... | 1.New increased soft tissue in the high right paratracheal region at the level of the thoracic inlet is suspicious of neoplastic involvement and metastatic disease.2.Stable right hilar lymphadenopathy. Interval increase in an enlarged precarinal lymph node. |
Generate impression based on findings. | Reason: 52 F with metastatic anal cancer s/p chemoRT, please eval for interval change. History: none CHEST: LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified. No dominant lesion. Basilar scarring/atelectasis. No pleural effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is norm... | 1.Hepatic metastases increasing in size and number.2.Near interval resolution of perirectal soft tissue mass. |
Generate impression based on findings. | 78-year-old male with history of prostate cancer CHEST:LUNGS AND PLEURA: New, nonspecific, wedge-shaped, vertebral groundglass opacities in the right upper lobe, best seen on image number 34, series number 4. These are nonspecific. Follow-up imaging is recommended for further evaluation.Small left-sided pleural effusio... | Interval increase in the size of the left adrenal nodule. Diffuse bone metastases and index pelvic lymph node are unchanged. New small ground glass opacities in the right upper lobe. Follow-up imaging is recommended. |
Generate impression based on findings. | Reason: Back pain, pelvis mass History: back, groin pain ABDOMEN:LUNG BASES: No significant abnormality noted. Small subcentimeter, soft tissue density lesions in bilateral breasts.LIVER, BILIARY TRACT: Hypodense lesion in the right lobe of the liver, segment 6/7 and another hypodense lesion in the right lobe of the li... | 1.Two hypodense lesions in the right lobe of the liver. Recommend MR liver to further characterize the lesions.2.Large peripherally calcified and necrotic appearing fibroid within an enlarged liver. |
Generate impression based on findings. | Female 69 years old Reason: h/o aortic aneurysm, f/u eval History: none LUNGS AND PLEURA: New upper lobe subpleural nodule, likely post infectious or post inflammatory in etiology. Remainder of scattered micronodules unchanged since 10/7/2010.Basilar scarring unchanged.Apical predominant centrilobular emphysemaMild dif... | Fusiform and partially saccular aneurysmal dilatation of the distal aortic arch, unchanged since 10/7/2010 |
Generate impression based on findings. | Reason: copd, pulm htn, lung transplant eval History: as above, shortness of breath. LUNGS AND PLEURA: Increased lung volumes with diffuse marked changes of emphysema.Right upper lobe peripheral pulmonary cyst.New right apical 8mm by 12-mm nodule (image 9 series 4) and adjacent 6 mm x 13 mm thickwalled cyst or cavitary... | 1.New right apical nodule and adjacent cavitary/cystic lesion concerning for neoplasia.2.Mediastinal adenopathy.3.Markedly increased lung volumes and severe diffuse emphysema. |
Generate impression based on findings. | Reason: Pancreas Cancer: Restaging History: none CHEST: LUNGS AND PLEURA: Scattered pulmonary micronodules. No dominant lesion. No pleural effusions. Bibasilar atelectasis.MEDIASTINUM AND HILA: Left paratracheal lymph node measures 1.9 x 1.1 cm (series 11, image 12), previously 1.8 x 1.1 cm. No additional lymphadenopat... | 1. Increasing hepatic metastases.2. New right anterior abdominal wall soft tissue nodules are nonspecific, but may represent metastatic foci.3. Stable left paratracheal lymph node.4. Pancreatic mass, slightly small in size. 5. Persistent SVC thrombus. |
Generate impression based on findings. | Microscopic hematuria and abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormalit... | Within the limitations of a noncontrast study, negative for acute, inflammatory, or neoplastic process. No GU related abnormality noted. |
Generate impression based on findings. | 44-year-old female with history Avandamet short cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Ill-defined soft tissue density in the anterior mediastinum, more prominent compared to previous chest CT dated 3/6/2013. This likely represents thymus, however, mediastinal adenopathy c... | Interval increase in the anterior mediastinal soft tissue density compared to previous chest CT. This may represents thymus, however, adenopathy cannot be excluded. Follow-up imaging is recommended.Thickwalled bladder. |
Generate impression based on findings. | Reason: Evaluate for progression of metastatic disease; compare to previous scan History: dyspnea CHEST:LUNGS AND PLEURA: Status post left lower lobectomy with paramediastinal radiation reaction.Multiple right lung nodules compatible with metastases.The reference right lower lobe nodule is now obscured by adjacent radi... | Interval growth of pulmonary metastases. |
Generate impression based on findings. | Hodgkin's lymphoma CHEST:LUNGS AND PLEURA: Stable right middle lobe referenced nodule best seen on image 76 of series 5 measuring 1 x 1 cm.MEDIASTINUM AND HILA: Stable mediastinal confluent adenopathy. Reference prevascular focus seen on image 38 of series 3 measures 3.8 x 1.3 cm.CHEST WALL: Stable reference left supra... | Stable examination. No new adenopathy. |
Generate impression based on findings. | 74-year-old male with history of gastric cancer CHEST:LUNGS AND PLEURA: Focal area of ground glass opacity in the right upper lobe appears less dense on today's study. Scattered micronodules are unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BI... | No significant change in the peritoneal carcinomatosis and lymph nodes..Focal area of groundglass opacity in the right upper lobe appears less dense. |
Generate impression based on findings. | 35-year-old female with abdominal swelling ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormal... | Unremarkable study. |
Generate impression based on findings. | 73-year-old male with history of chronic lymphoid leukemia This study is limited due to lackCHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Index right superior posterior mediastinal lesion measures 1.3 by 0.7-cm in image number 12, series number 4, not significantly changed from previous ... | Slight interval decrease in the size of the abdominal lymph nodes. Chest and pelvis lesions are stable. |
Generate impression based on findings. | Clinical impression: Evaluate for hemorrhage. Signs and symptoms: Head trauma two days ago, on Coumadin, positive loss of consciousness. Nonenhanced head CT:Examination demonstrate no evidence of an acute intracranial process in particular hemorrhage is detected. CT however is insensitive for detection of acute nonhemo... | 1.No detectable acute intracranial process.2.4-mm ectopia of cerebellar tonsils through the foramen magnum and unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | History of stomach cancer and atypical cells in the peritoneal washings CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. Index node measures 1.3 by 1 cm image number 31, series number 3 the pretracheal space.CHEST WALL: No significant abnormalit... | Large gastric wall mass likely extending into the perigastric fat and associated with focal pericardial nodularity locally. |
Generate impression based on findings. | 36-year-old male for pre-kidney transplant evaluation ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral ki... | Possible perirectal abscess. Clinical correlation and if necessary confirmation with a pelvic MRI may be helpful.These findings are communicated with Dr. Thistlethwaite`s office at the time of dictation. |
Generate impression based on findings. | 32-year-old male with history of lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significa... | No significant change from previous study. |
Generate impression based on findings. | 91 year-old female with abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: 9 x 9 mm hypodense lesion in the of the pancreas, incompletely characterized with this single phase CT. M.R.C.P. maybe helpfu... | No CT findings to explain patient's acute abdominal pain.Nonspecific small cystic lesion in the head of the pancreas. M.R.C.P. may helpful for further evaluation of this lesion. |
Generate impression based on findings. | Reason: History of metastatic breast cancer on treatment, evaluate for response and extent of disease History: History of metastatic breast cancer on treatment, evaluate for response and extent of disease CHEST:LUNGS AND PLEURA: Left basilar scarring/discoid atelectasis. Stable scattered nonspecific micronodules.No new... | 1.Continued interval decrease in mediastinal and right axillary lymphadenopathy.2.Stable hepatic lesion.3.Noted sites of disease identified. |
Generate impression based on findings. | 76-year-old male with history of bladder cancer CHEST:LUNGS AND PLEURA: Stable right micronodules. Stable calcified plaques.MEDIASTINUM AND HILA: Ectatic ascending aorta measuring 4.6-cm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abno... | Mixed response to the referenced lesions as detailed above. |
Generate impression based on findings. | Clinical question: Please evaluate pituitary for central hypogonadism, cannot do MRI due to pacemaker. Signs and symptoms: Central hypogonadism. Pre-and post-enhanced head CT:Limited evaluate scan for precise assessment of the pituitary gland.Examination demonstrates normal size and overall morphology of sella, normal ... | 1.Negative pre-and post enhanced head CT.2.Based on this exam there is no detectable abnormality of the pituitary gland/pituitary stalk/sella, cavernous sinuses, skull base or suprasellar cistern. |
Generate impression based on findings. | Colon carcinoma off therapy CHEST:LUNGS AND PLEURA: Interval increase in size and number of numerous bilateral subcentimeter nodules, worrisome for metastatic foci. The reference right lower lobe nodule best seen on image 63, series 5, now measures 4 mm in diameter; this is in comparison to 2 mm on 8/14/2013. A represe... | Interval appearance of multiple bilateral subcentimeter pulmonary nodules, worrisome for new metastatic foci. Associated with interval increase in size of bilobar hepatic metastases and right abdominal wall metastatic mass. |
Generate impression based on findings. | Fever, congestion, r/o sinusitis. There is right maxillary sinus retention cyst that measures up to 15 mm and mild mucosal thickening medially. There is also mild mucosal thickening within the bilateral frontoethmoid recesses. The other paranasal sinuses are clear. The nasal cavity is clear and there is no significant ... | No evidence of acute sinusitis. |
Generate impression based on findings. | Clinical question: Evaluate for acute intracranial process. Signs and symptoms: Possible seizure, + LOC Nonenhanced head CT:There is no evidence of acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.There are moderate periventricular and subcortical patchy foci ... | 1.No detectable acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.2.Mild age indeterminate small vessel ischemic strokes.3.Mild chronic pansinusitis. |
Generate impression based on findings. | Chronic lymphocytic leukemia diagnosed in 2006. There is no significant interval change in the size of previously cervical lymph nodes.For reference, the following measurements are provided:* Left level 1B lymph node measures 12 x 9 mm (series 4, image 30), previously 12 x 9 mm.* Left level 2A lymph node measures 11 x ... | No significant interval change in the lymphadenopathy related to treated leukemia. However, assessment is limited due to lack of IV contrast. |
Generate impression based on findings. | Clinical question: History of nasal congestion and postnasal drip, evaluate sinus. Signs and symptoms: As above. Medtronic fusion sinus CT:Frontal sinuses are poorly developed and remains small however without evidence of disease.Ethmoid sinuses are well pneumatized and without evidence of disease.Sphenoid sinus is wel... | No evidence of acute or chronic sinusitis. |
Generate impression based on findings. | Reason: Cholangiocarcinoma please compare to previous scan to determine response to chemo please provide index leison measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: Multiple nonspecific pulmonary nodules are unchanged.MEDIASTINUM AND HILA: Small supraclavicular lymph nodes. No mediastinal or hilar ly... | Cholangiocarcinoma and portal vein thrombosis without significant interval change in reference measurements. |
Generate impression based on findings. | Female 68 years old Reason: on therapy for lung abscess; monitoring response to therapy History: cough LUNGS AND PLEURA: Large right upper lobe cavitary lesion measuring 6.1 x 8.0 cm (image 35, series 4) with predominately dependent and adhered nodular partially calcified material within the cavity suggestive of an asp... | 1. Large right upper lobe cavitary lesion with dependent calcified material compatible with aspergilloma/fungus ball.2. Multifocal areas of subpleural consolidation and nodules likely infectious or post infectious in etiology.3. The above two could be all the result of mycobacterial infection, although not necessarily ... |
Generate impression based on findings. | Reason: evaluate for appendicitis History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No suspicious focal liver lesions. No intrahepatic or dilatation. Evidence of cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No ... | 1.Focal wall thickening of the proximal appendix with mild surrounding fat stranding. Early appendicitis cannot be excluded. No abscess, perforation, or bowel obstruction.2.Heterogeneously enhancing, bulbous uterus. This may be due to postoperative changes or uterine fibroids. Please correlate clinically. |
Generate impression based on findings. | History of bladder cancer CHEST:LUNGS AND PLEURA: Severe emphysema.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLA... | Asymmetric wall thickening involving the base of the bladder. |
Generate impression based on findings. | 76-year-old male with history of bladder cancer CHEST:LUNGS AND PLEURA: Stable right micronodules. Stable calcified plaques.MEDIASTINUM AND HILA: Ectatic ascending aorta measuring 4.6-cm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abno... | Mixed response to the referenced lesions as detailed above. |
Generate impression based on findings. | Gross hematuria and left flank pain ABDOMEN:LUNG BASES: Bilateral small pleural effusions and dependent atelectasis.LIVER, BILIARY TRACT: Well-defined hypodense lesion the right lobe of the liver measuring 2-cm in image number 35, series number 8, likely representing a simple cyst.SPLEEN: No significant abnormality not... | CT findings suggestive of distal left ureteral injury. Persistent nephrogram with lack of contrast excretion of the left kidney. Postsurgical changes in the pelvis.Gynecology resident on call (pager #8142) while not defined in a pouch about the above findings at the time of dictation. |
Generate impression based on findings. | Non-Hodgkin's lymphoma CHEST:LUNGS AND PLEURA: Stable micronodulesMEDIASTINUM AND HILA: Stable bilateral thyroid nodulesCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL ... | Interval decrease in size of right renal infiltrative mass and perinephric soft tissue. Slight interval decrease in size of bulky right inguinal adenopathy. Retroperitoneal and mesenteric adenopathy relatively stable. No new adenopathy. |
Generate impression based on findings. | Male 65 years old Reason: baseline eval prior to starting new systemic targeted therapy History: hx of metastatic thyroid cancer CHEST:LUNGS AND PLEURA: Biapical scarring/fibrosis compatible with prior radiation unchanged.Right lower lobe reference nodule measures 7 mm (image 27, series 4), previously 6 mm. Remainder o... | 1. Unchanged non-specific pulmonary nodules. 2. Increasing mediastinal lymphadenopathy and hepatic metastases.3. Osseous metastasis unchanged except for progression in the left scapula, refer to nuclear medicine bone scan from the same day for further evaluation. |
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