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Generate impression based on findings. | Recurrent uveitis, arthritis evaluate for sarcoid LUNGS AND PLEURA: Right apical micronodule, most likely a granuloma.MEDIASTINUM AND HILA: No paratracheal or hilar lymphadenopathy. Normal heart size. Calcified right hilar lymph node, consistent with healed granulomatous infection.CHEST WALL: Nonspecific calcification ... | No specific evidence of sarcoidosis. Calcified right hilar lymph node, calcified micronodules in the spleen and a calcified right lung micro-nodule are most consistent with healed granulomatous infection. |
Generate impression based on findings. | Female 64 years old Reason: 64 year old woman with history of RLL NSCLC treated with SBRT 9 months ago. Please evaluate for interval change and compare to most recent CT scan as well as initial CT History: History of lung cancer for surveillance CHEST:LUNGS AND PLEURA: Multiple bilateral basilar predominant thin-walled... | 1. Minimal enlargement of the subpleural spiculated right lower lobe nodule.2. Enlarged right and left hilar lymph nodes, but otherwise stable lymphadenopathy.3. No new metastatic focus identified.4. Stage I lymphangioleiomyomatosis, unchanged. |
Generate impression based on findings. | Reason: Hx of Bladder Cancer s/p cystectomy with neobladder. Eval for recurrent/metastatic disease History: See above ABDOMEN:LUNG BASES: Basilar emphysema.LIVER, BILIARY TRACT: Right hepatic lobe hypodensity is too small to further characterize, unchanged and likely benign. Calcified granulomata.SPLEEN: Calcified gran... | No evidence of disease recurrence. Resolution of left lower quadrant fluid collection. |
Generate impression based on findings. | Reason: LAD on CT chest History: cough LUNGS AND PLEURA: Dependent groundglass opacities favoring subsegmental atelectasis. No suspicious pulmonary nodule or pleural effusion. A few scattered pulmonary micronodules are nonspecific.MEDIASTINUM AND HILA: Supraclavicular lymphadenopathy with a representative lymph node me... | Diffuse mediastinal and hilar lymphadenopathy without significant pulmonary abnormality. The distribution is slightly atypical for sarcoidosis. Lymphoma is a consideration. |
Generate impression based on findings. | Reason: hx of microscopic hematuria for several years, please evaluate with delayed imaging History: microscopic hematuria ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Gallstones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No signific... | No evident cause of patient's hematuria. |
Generate impression based on findings. | Sinonasal polyp. There is a left conchae bullosa. There is a 3 mm defect in the cartilaginous nasal septum, which is deviated mildly to the right. Otherwise, the nasal cavity is clear without evidence of sinonasal polyposis. There is a 7 mm wide right maxillary sinus retention cyst and mild mucosal thickening along the... | 1. Left conchae bullosa and a 3 mm defect in the cartilaginous nasal septum, which is deviated mildly to the right. Otherwise, the nasal cavity is clear without evidence of sinonasal polyposis. 2. diffuse brain parenchymal volume loss and patchy cerebral white matter hypoattenuation that likely represents microangiopat... |
Generate impression based on findings. | Two breast cancers now with elevated CEA 19-9 rule-out recurrence/metastasis. CHEST:LUNGS AND PLEURA: New 8-mm dependent groundglass nodular density superior segment right lower lobe (6/36). Unchanged nodular groundglass subpleural nodule left upper lobe (6/39).Subpleural fibrosis anterior right lung consistent with pr... | 1. Poorly defined 8 millimeter nodular density in the superior segment of the right lower lobe. Metastasis cannot be excluded though the appearance is atypical. Short-term follow-up in 2-3 months suggested. Though this occurs outside the expected radiation field, a post therapeutic area of fibrosis is a possibility.2. ... |
Generate impression based on findings. | Reason: 80F metastatic parathyroid ca with mediastinal metastasis and rising PTH. Please evaluate for growth, size, local extension, distant disease History: Rising PTH, dysphagia CHEST:LUNGS AND PLEURA: Near complete resolution of previous tree and bud opacities within the inferior right upper lobe of resolving infect... | While several reference pleural based nodules are no longer visualized, there are several new pulmonary nodules. In addition, the superior right paramediastinal soft tissue tumor has enlarged. Progressive enlargement of the left adrenal gland suggestive of metastases. Diffuse lucencies in the vertebral bodies; although... |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA. Nonenhanced head CT:Examination demonstrates no evidence of an acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex demonstrate normal density and unremarkable.The cortical sulci, ventricular sys... | Negative nonenhanced head CT. |
Generate impression based on findings. | Metastatic thyroid cancer. CHEST:LUNGS AND PLEURA: The previously seen right middle lobe micronodule is unchanged compared to 5/7/13. A new 4-mm nodule is seen in the right middle lobe (series 8, image 44). Basilar subsegmental atelectasis obscures the previously described 4-mm left basilar nodule.MEDIASTINUM AND HILA:... | 1. Increased size of the destructive left ninth rib lesion.2. New nonspecific right middle lobe nodule. Continued follow-up is recommended.3. Stable ill-defined right renal lesion. |
Generate impression based on findings. | Metastatic DTC on the cediranib + lenalidomide, held since 6.7.13. Head: There is no evidence of intracranial masses or abnormal enhancement. There is stable moderate cerebral white matter hypoattenuation that is likely related to microangiopathy. Mild prominence of the ventricular system is unchanged. The skull and re... | 1. Unchanged nonspecific soft tissue within the right thyroidectomy bed. Otherwise, no evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2. No evidence of intracranial metastases. |
Generate impression based on findings. | Reason: mets lung ca, bone mets, T790M, s/p 2 cycles of AP26113, pls c/w previous study to evaluate tx response. History: lung ca CHEST:LUNGS AND PLEURA: Right lower lobe mass measures 5.4 x 4.8 cm (series 5, image 50), previously 5.4 x 4.6 cm.There is extensive surrounding nodularity which may represent additional tum... | 1.Right lower lobe mass without significant interval change.2.Mesenteric soft tissue density anterior to the esophagus is unchanged.3.Reference lymph nodes without significant interval change in size.4.Sclerotic osseous lesions are unchanged. |
Generate impression based on findings. | Reason: tube position abd pain History: abd pain ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: Air space disease of bilateral lung bases suggesting consolidation from... | 1.Gastric tube looped within the stomach and with tip in the first portion of the duodenum. The tube should be repositioned in Interventional Radiology.2.Mildly dilated loops of small bowel with air is abnormal but nonspecific. Contrast within the rectum represents proper bowel motility.3.Right lower lobe airspace cons... |
Generate impression based on findings. | Clinical question: Evaluate atrophy. Signs and symptoms: Dementia. Unenhanced head CT:There is no detectable acute intracranial process.Very subtle low-attenuation in subcortical white matter is nonspecific however could represent age indeterminate small vessel ischemic strokes considering patient's stated age of 86.Th... | 1.Very minimal age indeterminate small muscle ischemic stroke is suspected.2.Unremarkable exam otherwise for patient's stated age and in particular no evidence of atrophy as is questioned clinically. |
Generate impression based on findings. | Chest pain question PE. PULMONARY ARTERIES: Adequate infusion quality. No filling defects suggest the presence of an acute pulmonary embolus.LUNGS AND PLEURA: Small pleural fluid collections with dependent tree in bud opacities and atelectasis in a pattern most consistent with aspiration.MEDIASTINUM AND HILA: Interval ... | 1. No evidence of acute pulmonary embolus.2. Left renal mass suspicious for renal cell carcinoma.3. Interval development of mild mediastinal lymphadenopathy, possibly post inflammatory or post infectious however of unclear etiology given the presence of renal mass.4. Signs of moderate aspiration in the dependent lung f... |
Generate impression based on findings. | Male 72 years old Reason: evaluation of right upper lobe poorly differentiated adenocarcinoma; hx of resection LUL History: eval of RUL lung cancer LUNGS AND PLEURA: Right upper lobe perihilar lesion adjacent to the upper lobe anterior segmental bronchus measures 25 mm (image 55, series 4), previously 27 mm. Metallic f... | 1. Stable left perihilar lesion compatible with given diagnosis of lung cancer.2. No evidence of lymphadenopathy or metastatic disease. |
Generate impression based on findings. | Reason: 63 yo w/ abdominal distension RLQ pain, concern for possible partial BO. Please give IV and oral contrast. History: RLQ pain,abdominal distension, nausea ABDOMEN:LUNG BASES: Right Bochdalek hernia.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No signif... | No evidence of bowel obstruction or other acute intraabdominal abnormality. |
Generate impression based on findings. | Reason: lung cancer s/p 3 months on Tarceva. please evaluate for disease and compare with previous scans History: lung cancer CHEST:LUNGS AND PLEURA: Interval increase size of right suprahilar mass that now extends along the superior mediastinum to the apex. Reference measurement is 3.2 by 7.0 centimeters (series 3 ima... | Interval increase size of right suprahilar mass that now extends along the superior mediastinum to the apex, 3.2 by 7.0 cm. Right pleural effusion has increased, now moderate in size. Associated progressive pleural nodularity.Progressive fine nodularity involving the fissures, inter and intralobular septa within the ri... |
Generate impression based on findings. | Male, 84 years old, rhinorrhea, postnasal drip, history of dental abscess. Frontal sinuses and frontoethmoidal recesses are clear. Minimal patchy opacification through the ethmoid air cells. Sphenoid sinuses and sphenoethmoidal recesses are clear.Moderate peripheral mucosal thickening is seen in the left maxillary sinu... | Findings suggestive of chronic sinusitis in the left maxillary sinus. No significant disease is seen in the remaining paranasal sinuses. |
Generate impression based on findings. | Female, 38 years old, status post lumbar drain, evaluate for CSF leak. Laminectomy has been performed at the L4 level. A lumbar catheter enters the spinal canal at the L3-4 level coursing superiorly within the right lateral aspect of the thecal sac. Catheter tip terminates at the L1 level. No kink or discontinuity is i... | No evidence of paraspinal fluid collection is seen to suggest CSF leak. |
Generate impression based on findings. | Reason: persistent nausea. SBFT, gastric emptying study, and EGD negative. Please eval for portal vein thrombosis. History: persistent nausea, dry heaving ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No suspicious focal liver lesions. Status post cholecystectomy. No evidence of portal vein ... | Patchy areas of edematous colon representative of colitis, presumably related to patient's provided history of Crohn's disease. |
Generate impression based on findings. | Reason: metastatic breast cancer - baseline prior to starting new treatment regimen History: metastatic TNBC CHEST:LUNGS AND PLEURA: Multiple pulmonary metastases. Right lower lobe pulmonary nodule measures 2.2 x 2.1 cm (series 5, image 62). Left upper lobe pulmonary nodule measures 1.8 x 1.7 cm (series 5, image 32).ME... | 1. Pulmonary metastases.2. Hepatic metastasis.3. Hilar and mediastinal lymphadenopathy.4. Destructive T5 vertebral body lesion. |
Generate impression based on findings. | Head and neck cancer status post CRT CHEST:LUNGS AND PLEURA: Mild subpleural fibrosis in the lung periphery. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: 18-mm left inferior pulmonary ligament lymph node increased from previous size of 16mm (3/57). Mild high left paratracheal chain lymphadenopathy , ... | Progressive enlargement of a left inferior pulmonary ligament lymph node and a high left paratracheal lymph node are now consistent with indolent nodal metastases. |
Generate impression based on findings. | Female 64 years old Reason: adenocarcinoma of lung, ? surgically resectable History: wheezing CHEST:LUNGS AND PLEURA: There is a 25 x 15 mm (image 40, series 4) left lower lobe nodule adjacent to the left superior segment bronchus and abutting nearly 90 degrees of the aorta with preservation of the intervening fat plan... | 1. Left lower lobe perihilar mass abutting approximately 90 degrees of the aorta and compatible with patient's given history of adenocarcinoma of the lung.2. Numerous pleural based metastases in the left hemithorax.3. Enlarged para-aortic and left internal mammary chain lymph nodes suspicious for nodal metastases. Non-... |
Generate impression based on findings. | Metastatic breast cancer CHEST:LUNGS AND PLEURA: Postradiation changes in the right lung with apical and anterior ground glass, volume loss, and traction bronchiectasis. Stable size of the loculated right pleural effusion. Right lower lobe scar like opacities are unchanged. Bibasilar subsegmental atelectasis. No new su... | 1. Unchanged size and appearance of the reference right chest wall mass. 2. New enhancing pleural nodules in the right lung, consistent with metastases.3. Upper abdominal lymphadenopathy compatible with metastatic disease. |
Generate impression based on findings. | Female 28 years old; Reason: stones History: stones 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: Kidneys ... | 1.Nonobstructive 5-mm right lower pole renal calculus. |
Generate impression based on findings. | Head and neck cancer (hypopharynx, pyriform sinus), follow-up after chemotherapy and RT. LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Interval resolution of previously seen ground glass opacities.MEDIASTINUM AND HILA: Coronary artery calcifications. Normal heart size. No suspicious lymphadenopathy. Phys... | No evidence of metastatic disease to the chest. |
Generate impression based on findings. | Male, 72 years old, status post fall with tenderness along C-spine. Images are degraded by motion artifact. Within this limitation, the following observations are made.Periventricular hypoattenuation noted, right side more than left, compatible with age indeterminate ischemic change. A chronic appearing right basal gan... | 1. Age indeterminate right worse than left periventricular small vessel ischemic disease. Chronic appearing right basal ganglia lacunar infarct. No definite acute intracranial abnormalities.2. Hyperdense material tracking within the subcutaneous tissues of the suboccipital region may represent hematoma. Correlation for... |
Generate impression based on findings. | 63 year old man with chest pain. He has a history of CABG (LIMA to LAD; SVG to diagonal artery; and SVG to PDA to RPL to OM3).CPT Code: 75574 Coronary artery bypass grafts:LIMA to LAD. The LIMA to LAD is patent. The distal runoff vessel has non-obstructive atherosclerosis.SVG to diagonal artery is occluded.SVG to PDA t... | 1. LIMA to LAD patent. SVG to diagonal artery occluded. SVG to PDA to RPL to OM3 is patent. 2. The distal runoff vessels to each of the patent bypass grafts are free of obstructive disease. 3. There is severe native coronary artery disease as detailed above. Importantly, the major diagonal artery supplies a relatively ... |
Generate impression based on findings. | Male 65 years old Reason: shortness of breath and chest pain x 2 weeks History: none new PULMONARY ARTERIES: Technically adequate study. No evidence of pulmonary embolism or right heart strain.LUNGS AND PLEURA: Trace dependent atelectasis. No focal airspace opacity or pneumothorax.MEDIASTINUM AND HILA: Nonspecific prom... | 1. No evidence of pulmonary emboli. 2. No etiology found to explain the patient's symptomatology. |
Generate impression based on findings. | Female 19 years old Reason: r/o PE or R sided pulm pathology History: 19 yr old on OCPs with cough and SOB, previous temp, with HR 150s, O2 sat 96%, R sided wheeze.+d-dimer today. PULMONARY ARTERIES: Technically adequate study with no evidence of pulmonary embolism or right heart strain.LUNGS AND PLEURA: Area of conflu... | 1. No evidence of pulmonary emboli.2. Superior segment right lower lobe pneumonia without evidence of pleural effusion. |
Generate impression based on findings. | Female 82 years old Reason: acute R heart strain with apical ballooning History: acute R heart strain with apical ballooning PULMONARY ARTERIES: Technically adequate study with no evidence of pulmonary emboli. LUNGS AND PLEURA: 6-mm right lower lobe nodule (image 166, series 8) contains a small peripheral calcification... | 1. No evidence of pulmonary emboli.2. Cardiomegaly with associated biatrial enlargement.3. 6-mm right lower lobe nodule with peripheral calcification suggestive of granuloma; however, CT surveillance in 6 to 12 months recommended to confirm stability. 4. New compression fracture of the T6 vertebral body. |
Generate impression based on findings. | Male 74 years old Reason: eval for PE/ eval for aortic pathology History: cp PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. Upper normal pulmonary artery size may represent right heart mild strain. Pulmonary micronodule in the right middle lobe.LUNGS AND PLEURA: Assessment of the ... | 1. No evidence of pulmonary embolus.2. Cardiomegaly with morphology suggestive of chronic hypertension or less likely hypertrophic cardiomyopathy, consider cardiac echo to further evaluate as clinically warranted.3. Mild wedge deformity of the T11 vertebral body compatible with degenerative changes/mild compression fra... |
Generate impression based on findings. | Reason: r/o bleed, infection. hx PCKD known liver/pancreatic/renal cysts History: fever, white count ABDOMEN:LUNG BASES: Eventration of the left hemidiaphragm. Mild basilar atelectasis bilaterally.LIVER, BILIARY TRACT: Multiple hepatic cysts, grossly unchanged compared to prior exam. No evidence of intrahepatic or extr... | 1.No acute intra-abdominal processes.2.No evidence of infection in the abdomen or pelvis. |
Generate impression based on findings. | Reason: pancreatitis History: abdominal pain ABDOMEN:LUNG BASES: Mild left basilar atelectasis.LIVER, BILIARY TRACT: No suspicious focal liver lesions. No intrahepatic or hepatic duct dilatation. No evidence of cholelithiasis. Moderate to large amount of presumed blood surrounding the liver.SPLEEN: No significant abnor... | Hemorrhagic pancreatitis with hemoperitoneum and findings suggestive of active extravasation of blood. No evidence splenic artery pseudoaneurysm or splenic vein thrombosis. |
Generate impression based on findings. | Female 19 years old Reason: r/o PE History: LLE swelling, tachycardia PULMONARY ARTERIES: Injection was repeated as the first exam was technically inadequate. Repeat examination was also suboptimal. Given this technical limitation, no large central or lobar pulmonary emboli identified. LUNGS AND PLEURA: Low lung volume... | Technically limited study, but no large central or lobar pulmonary emboli identified. |
Generate impression based on findings. | Reason: abdominal pain History: abdominal pain ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: Cardiomegaly.LIVER, BILIARY TRACT: Enlarged, fatty liver with no suspicio... | 1.Moderate amount of free fluid in the dependent portion of the pelvis.2.Diverticulosis of the sigmoid and descending colon without evidence of diverticulitis. |
Generate impression based on findings. | Female 40 years old Reason: PE? History: atypical chest pain, syncope PULMONARY ARTERIES: Technically adequate study with no evidence of pulmonary embolism right heart strain.LUNGS AND PLEURA: Proximal bronchial wall thickening unchanged and compatible with chronic bronchitis. Scattered pulmonary micronodules unchanged... | 1. No evidence of pulmonary embolism.2. Proximal bronchial wall thickening compatible with chronic bronchitis.3. Nonspecific enlarged right hilar lymph node and bilateral subpectoral nodes are unchanged. |
Generate impression based on findings. | Female 28 years old Reason: PE? History: tachycardic and desalts PULMONARY ARTERIES: Technically limited study due to patient respiratory motion artifact. No definitive pulmonary embolism identified. LUNGS AND PLEURA: Diffuse ground glass opacities and pleural effusions with associated body wall edema suggestive of pul... | 1. Suboptimal study, but no evidence of pulmonary embolism.2. Diffuse ground glass opacities, septal thickening and small pleural effusions compatible with pulmonary edema.3. Dependent basilar atelectasis with possible superimposed infection, correlate clinically4. Minimal subhepatic and perisplenic ascites, likely rel... |
Generate impression based on findings. | Male 68 years old Reason: eval for e/o worse pna History: fever, chills, hx heart transplant with aspergillus LUNGS AND PLEURA: New patchy consolidation with air bronchograms and surrounding ground glass opacities in the posterior segment of the right upper lobe compatible with pneumonia.New basilar atelectasis with as... | 1. New right upper lobe posterior segment pneumonia.2. Findings suggestive of mild aspiration.3. unchanged likely post infectious pulmonary nodules. 4. Unchanged postoperative mediastinal changes. |
Generate impression based on findings. | Female 59 years old Reason: further characterize pleural effusion on CXR History: sob, cough LUNGS AND PLEURA: Large left-sided pleural effusion which tracks into the major fissure and measures simple fluid density. There is prominent associated compressive atelectasis. There is nodularity and non-dependent fluid at th... | 1. Large left pleural effusion with nodular component concerning for underlying pulmonary nodule. Given the associated findings, this is suspicious for a malignant effusion and would consider reevaluation with CT examination after thoracentesis to evaluate for underlying malignancy.2. Spiculated right lower lobe pulmon... |
Generate impression based on findings. | Reason: Does patient have evidence of urologic disease to explain hematuria? Please schedule for CT pyelogram History: hematuria out of proportion to UTI ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy. No suspicious focal liver lesions. No evidence of intrahepatic ... | 1.Thickened, edematous bladder wall with mural enhancement compatible with cystitis. No evidence of involvement of the upper urinary tract. 2.Stable subcentimeter cystic focus in the pancreas. |
Generate impression based on findings. | Primary CNS lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Stable reference right hilar lymph node best seen on image 46 of series 3 measuring 1.2 x 0.9 cm.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No sign... | Stable examination; no new adenopathy. |
Generate impression based on findings. | Reason: Evaluate for renal stone versus appendicitis. Has right lower quadrant pain. Worsening and radiating to right flank now. History: Has right lower quadrant pain. Worsening and radiating to right flank now. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No suspicious focal liver lesions... | 1.No evidence of acute appendicitis.2.Probable functional cyst of the right adnexa without associated inflammatory changes.3.Within the limitation of an IV contrast study, there is no evidence of ureteral stones. No evidence of hydroureter or hydronephrosis. |
Generate impression based on findings. | Rectal carcinoid ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Left lobe segment two benign hemangioma best seen on image 20 of series 11 measuring 1.1 x 1.2 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedK... | Mildly enlarged pelvic mesenteric lymph nodes. Special attention to these nodes on future surveillance scans suggested. Otherwise unremarkable examination. |
Generate impression based on findings. | Chronic renal disease; evaluate for nephrolithiasis and angiomyolipoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable cholelithiasisSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable... | Stable left renal benign angiomyolipoma. No evidence for acute GU related abnormality. Specifically, no evidence for renal obstruction or nephrolithiasis. |
Generate impression based on findings. | Anal carcinoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable peripheral segment two left lobe low attenuation focus best seen on image 12 series 3 measuring 0.4 x 0.7 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant ab... | Status post hysterectomy and resection of vaginal cuff/cul-de-sac mass lesion. Mild soft tissue prominence adjacent and lateral to the inferior left vaginal fornix; while this may represent postoperative change, special attention to this area on future surveillance scans suggested. |
Generate impression based on findings. | Reason: 74 yo F with septic shock and abdominal pain, please eval for diverticulitis, cholecystitis, or intrabdominal abscess History: as above ABDOMEN:LUNG BASES: Mild pleural effusions bilaterally with overlying atelectasis.LIVER, BILIARY TRACT: Cholelithiasis without gallbladder wall thickening. In the context of as... | 1.Cholelithiasis without gross evidence of acute cholecystitis. Interpretation of gallbladder pathology is difficult in the context of ascites. Ultrasound could be useful for further evaluation of gallbladder.2.No evidence of diverticulitis. |
Generate impression based on findings. | Reason: evaluate fluid collections History: evaluate fluid collections ABDOMEN:LUNG BASES: Moderate left-sided pleural effusion with overlying atelectasis/consolidation. LIVER, BILIARY TRACT: Mosaic attenuation of the liver diffusely is suggestive of parenchymal dysfunction/fatty infiltration. Hepatic vasculature is pa... | 1.Fluid collection around the spleen with interval decrease in size.2.Left mid hemiabdomen fluid collection with near complete resolution.3.Unchanged loculated fluid collection in the pelvis.4.Left anterior hemiabdomen drain does not appear to be communicating with the level of collection.5.Fatty liver with perfusion a... |
Generate impression based on findings. | Reason: evaluate for possible worsening pulmonary nodules vs. septic emboli; also evaluate for etiology of tender abdomen with guarding History: progressive SOB, increased opacities seen on CXR, abdominal distention Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ ... | 1.Interval decrease in size of right upper lobe spiculated mass. Interval improvement is suggestive of infection.2.Cholelithiasis. In the context of ascites and a noncontrast study, interpretation of gallbladder pathology is difficult. Ultrasound is could be useful for further evaluation.3.Moderate amount of ascites. |
Generate impression based on findings. | Cellulitis to anterior suprapubic area, sepsis. Assess for cellulitis versus deeper infection. There is reticulation of the subcutaneous fat of the mons pubis extending to the perineal/labial region inferiorly, along the suprapubic subcutaneous fat superiorly, and into the right flank region. The reticulation extends t... | Findings compatible with cellulitis as described above. |
Generate impression based on findings. | Reason: appy v ovarian cyst v other History: infraumbilical pain for 1 day 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, ... | 1.No findings to explain patient's stated symptoms.2.Bilateral adnexal cysts with no evidence of surrounding inflammation are likely functional given patient's age. 3.No evidence of acute appendicitis. |
Generate impression based on findings. | 57-year-old female status post cervical fusion revision now with hand clumsiness. Hardware components of occipital-axial fusion in near-anatomic alignment without radiographic evidence of complication. The surgical screw extending into the right C2 lamina has been replaced with a shorter thicker screw which no longer p... | 1.Postsurgical changes as described above without evidence of acute complication. |
Generate impression based on findings. | Reason: hx of prostate ca, fever of unknown origin. r/o occult infection/abscess or malignancy History: fever of unknown origin CHEST:LUNGS AND PLEURA: Small focus of air space consolidation in the left lung lingula (series 4, image 43). Small bilateral pleural effusions.MEDIASTINUM AND HILA: No significant abnormality... | Small focus of air space consolidation in the left lung lingula is suggestive of focal infection. This may include fungal etiologies particularly at the patient is immunocompromised. |
Generate impression based on findings. | Reason: stone History: pain ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty, enlarged liver without focal li... | Enlargement of the pancreatic head and blunting of the uncinate process with mild surrounding fat stranding suggestive of pancreatitis. No surrounding fluid collection.Findings were communicated to the ER over the phone by Dr. Chang at 9:22 a.m. on 10/12/2013. |
Generate impression based on findings. | Reason: ? fluid collection around abdominal drain History: fluid leaking from around drain site ABDOMEN:LUNG BASES: A moderate to large right-sided pleural effusion with overlying atelectasis.LIVER, BILIARY TRACT: Status post resection of the right lobe of the liver. Mixed density perihepatic fluid with mixed foci of g... | 1.Status post resection of the right lobe of the liver. 2.Mixed density perihepatic fluid with foci of air likely represents postoperative fluid collection. Foci of air may be secondary to surgical drain but clinical correlation for infection is recommended as air can represent abscess formation. |
Generate impression based on findings. | Reason: intrabdominal abnormal, check colonic stent placement History: hematochezia ABDOMEN:LUNG BASES: Bilateral pleural effusion, right greater than left with overlying atelectasis/consolidation.LIVER, BILIARY TRACT: Stable hypodense lesion in the right lower liver (series 3, image 42). SPLEEN: No significant abnorma... | 1.Diffuse calcified peritoneal disease consistent with known metastatic ovarian cancer remains unchanged.2.Interval placement of colonic stent with minimal resolution of proximal colon and small bowel dilatation.3.No significant change in bony metastatic lesions.4.Stable hypodense lesion in the right lobe of the liver ... |
Generate impression based on findings. | Reason: aneurysm vs other cause for abd pain History: pain and distension ABDOMEN:LUNG BASES: Paraseptal and central lobular emphysematous changes. Mild bronchiectasis.LIVER, BILIARY TRACT: Hepatic cyst in the left lobe of the liver and hepatic cysts in the right lobe of the liver remain stable compared to prior exam. ... | 1.Infrarenal aortic stent graft is unchanged with a small amount of mural thrombus in the graft lumen.2.Stable unopacified infrarenal aortic aneurysm sac.3.Unchanged occlusion of the celiac trunk with retrograde filling of its branches.4.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Reason: abd pathology History: Status post D&C one week ago with pain and fevers ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No evidence of cholelithiasis. No suspicious focal liver lesions. No intrahepatic or extrahepatic ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS:... | Complex, large heterogeneous fluid collection with cystic components in the pelvis with a thin enhancing rim is compatible with evolving hematoma. Secondary infection cannot be ruled out. |
Generate impression based on findings. | Reason: eval for peri-rectal abscess History: peri-rectal tender to palpation, fluctuance, iduration PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: Colonic diverticula without evidence of diverticulitis.... | Perirectal induration of the soft tissue of the right buttock compatible with cellulitis. There is no drainable fluid collection. The fistula is clinically suspected, MR would be useful. |
Generate impression based on findings. | Female 53 years old Reason: eval for stone History: R flank pain. Exam is not sensitive for detecting lesions in the bowel solid organs due to the lack of oral intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cho... | Punctate calcifications left kidney unchanged. Scarring left kidney unchanged. No evidence of hydronephrosis.Small amount of air in the uterine fundus. Correlate clinically.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 35 years old; Reason: diffuse abdominal pain History: abdominal pain, nausea, vomiting 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 ab... | 1.Leiomyomatous uterus. Otherwise, no CT evidence for patient's abdominal pain. |
Generate impression based on findings. | Female 67 years old; Reason: stone? History: L flank pain ABDOMEN: The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made: LUNG BASES: Bibasilar scarring/atelectasis.LIVER, BILIARY TRACT: Multiple hypoattenuatin... | 1. No renal stone or ureteral stone is clinically questioned. Stable bilateral renal cysts.2. Leiomyomatous uterus unchanged3. Right adrenal adenoma |
Generate impression based on findings. | Female 44 years old Reason: eval appendicitis History: RLQ 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: N... | No evidence of appendicitis. Multiple uterine masses noncalcified nonspecific but likely fibroids. Prominent endometrial cavity maybe related to compression and partial obstruction by the fibroids. Correlate clinically. |
Generate impression based on findings. | Female 89 years old; Reason: obstruction? constipation? History: no bm, pain ABDOMEN:LUNGS BASES: Bilateral dependent atelectasis with scarring in the left lung base. No nodule or mass detected.LIVER, BILIARY TRACT: The liver is normal in size and morphology. Small hypoattenuating lesions too small to characterize are ... | 1.Large fecal burden suggesting constipation without evidence of obstruction or free air.2.Small hypoattenuating lesion in the body of the pancreas, incompletely characterized on this examination and may suggest IPMN. MRI/ M.R.C.P. could help characterize lesion3.Age indeterminant compression deformity of T12. |
Generate impression based on findings. | Female 60 years old Reason: eval aortic pathology History: abd pain, back pain, cp.Additional history CT technologist left flank pain. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Normal caliber aorta with no evidence of aneurysm or dissection.CHEST WALL: No significant abnormality not... | No evidence of aneurysm or dissection. Bullet fragment and postsurgical changes are right pelvis soft tissues. |
Generate impression based on findings. | Male 74 years old Reason: s/p ex-lap for SBO requiring take back, washout transferred from OSH intubated, sedated, on pressors History: same Exam is insensitive detecting lesions in the bowel solid organs due to the lack of oral or intravenous contrast. Also streak artifacts as the patient cannot raise her arms. Given ... | Massive generalized ascites with loculation. Small amount of intraperitoneal air probably related to the recent surgery. Infected fluid collections cannot be excluded. Anasarca. Pleural effusions. Postsurgical changes. Other findings as above. |
Generate impression based on findings. | Female 71 years old Reason: 71 yo F with hx of ESRD on HD, recurrent GI bleed 2/2 small bowel source, s/p DBE 10/10 demonstrating duodenal lesion, evaluate for submucosal lesion vs mass lesion History: bleeding 2/2 small bowel source, duodenal lesion on double balloon enteroscopy needing CT enterography for further eva... | No bleeding site seen. Probable duodenal mass. Massive ascites and concern for focus of carcinomatosis. Patent fem-fem graft. Anasarca. Chronic medical renal kidneys. Probable hepatic cysts. Other findings as above. |
Generate impression based on findings. | Female 66 years old; Reason: Assess disease progress History: abdominal distension; CHEST:LUNGS AND PLEURA: No focal consolidation. Biapical scarring. Stable 4-mm right lower lobe nodule (series 5 image 54). Additional scattered irregular micronodules bilaterally are nonspecific and stable. Emphysematous changes noted.... | 1.Stable omental and peritoneal carcinomatosis.2.Stable lymphadenopathy in the retroperitoneum and pelvis.3.Stable nonspecific scattered irregular pulmonary nodules and micronodules, continued follow-up is recommended.4.Stable left sided mild hydronephrosis with ureteral dilatation to the mid ureter is ofunknown etiolo... |
Generate impression based on findings. | Female 51 years old; Reason: 51yo female with stage III ovarian CA, s/p surgery and chemotherapy. assess for disease progression History: as above CHEST:LUNGS AND PLEURA: Few scattered pulmonary micronodules are unchanged. The pleural spacesare clear. Central airways are patent.MEDIASTINUM AND HILA: Heart size is norma... | 1.Stable exam without evident recurrent disease. |
Generate impression based on findings. | Reason: concern for abscess of the leg History: discharge s/p Left hip core decompression with autologous bone grafting CT of the left hip demonstrates a partially loculated fluid collection under left hip scar measuring approximately 4.2 x 1.3 x 1.3 cm (series 80393, image 40). There is surrounding hyperenhancement an... | Subcutaneous fluid collection involving lateral hip suspicious for early abscess as described above. |
Generate impression based on findings. | Female 68 years old Reason: Patient with treatment related aml with neutropenic sepsis, now with worsening mental status and lactic acidosis. Please evaluate for abdominal sources of infection; had perinephric stranding on previous CT History: Tachypnea, AMS The exam is not sensitive for detecting lesions in the bowel ... | Bilateral pleural effusions and airspace opacities. Correlate clinically. Small amount of ascites. No loculation to suggest abscess. Anasarca. Postsurgical changes. |
Generate impression based on findings. | Female 84 years old; Reason: 84 yr old patient with ovarian cancer eval disease process. please compare to prior scan History: none The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made: ABDOMEN:LUNG BASES: Sca... | 1. Stable to slight decrease in size of the previously referenced lesions.2. New soft tissue small bowel mesenteric mass in the right lower quadrant as described above. |
Generate impression based on findings. | Male 63 years old Reason: r/o bleed History: s/p LVAD, low Hgb Exam is not sensitive for detecting lesions in the bowel, solid organs of vasculature due to lack of oral or intravenous contrast. Given those that limitation, the following observations are made:CHEST:LUNGS AND PLEURA: Bibasilar atelectasis and scarring, i... | Perihepatic fluid of uncertain significance. No evidence of retroperitoneal hemorrhage. Increasing bibasilar atelectasis or consolidation. Other findings as above. |
Generate impression based on findings. | Reason: Please evaluate for PE History: tachycardia, chest pain, dilated PA on CXR PULMONARY ARTERIES: Technically adequate examination. No acute pulmonary emboli identified. The main pulmonary artery is top normal in size without evidence of right heart strain.LUNGS AND PLEURA: Moderate centrilobular emphysema with ba... | 1. No pulmonary embolus. 2. Emphysema similar to prior.3. New left anterolateral sixth and seventh rib fractures. |
Generate impression based on findings. | Reason: PE? History: hypoxemia and tachycardia PULMONARY ARTERIES: Technically adequate examination. No pulmonary emboli are identified.The main pulmonary artery is normal in size without evidence of right heart strain.LUNGS AND PLEURA: Mild-moderate centrilobular emphysema is present. There are linear streaky opacitie... | 1.No pulmonary embolism.2.Mild bilateral axillary lymphadenopathy and right peri-areolar fluid density lesion which can be evaluated with mammography if clinically indicated. 3.Mild-moderate centrilobular emphysema. |
Generate impression based on findings. | Female 47 years old Reason: w h/o crohn's disease, now with enterocutaneous fistulas History: enterocutaneous fistulas ABDOMEN:LUNG BASES: Bibasilar atelectasis or consolidation.LIVER, BILIARY TRACT: Cirrhotic morphology. No definite focal lesions. Small amount of perihepatic fluid.SPLEEN: Splenomegaly 14.7 cm cephaloc... | Cirrhotic morphology liver. Expected postsurgical changes bowel no evidence of obstruction. Possible enterocutaneous fistula at the surgical wound as detailed above. Left adnexal cyst or cystic lesion unchanged. Other findings as above. |
Generate impression based on findings. | Reason: r/o pe History: tachycardia, hypoxia PULMONARY ARTERIES: Study is slightly limited by patient motion but is technically adequate. No pulmonary emboli are identified.The main pulmonary is normal in size without evidence of right heart strain. LUNGS AND PLEURA: Bilateral moderate pleural effusions with associated... | 1.No evidence of pulmonary embolism.2.Bilateral moderate pleural effusions and associated compressive atelectasis, similar to previous.3.Increased bilateral groundglass opacities, right greater than left, nonspecific and may represent pulmonary edema, infection, or pulmonary hemorrhage.4.Destructive process involving T... |
Generate impression based on findings. | Male 80 years old male with small cell lung cancer: eval for metastatic burden and biliary pathology History: obstructive labs CHEST:LUNGS AND PLEURA: Right apical dense consolidation and volume loss compatible with priorradiation therapy, unchanged. New moderate left pleural effusion, and trace right pleural effusion.... | 1.Slight decrease in size of the large epigastric mass.2.Interval increase in size of right lower quadrant soft tissue masses.3. New large fluid collection with focus of gas in the right lower quadrant concerning for abscess. 4. New moderate left pleural effusion with scattered ground glass nodules in the lungs, also n... |
Generate impression based on findings. | Female 85 years old Reason: 85 year woman after CABG develops profound metabolic acidosis and distended abdomen; perforated or ischemic bowel suspected. History: respiratory distress (prompting intubation), abdominal discomfort Exam is not sensitive for detecting lesions in the solid organs, bowel vasculature the to th... | Small amount of ascites. Fat stranding in the retroperitoneum slightly right greater than left with extension to the region of the gallbladder. I cannot exclude an inflammatory process involving gallbladder or less likely the right kidney. Possible cholelithiasis.Extensive bibasilar atelectasis or consolidation and ass... |
Generate impression based on findings. | Female 74 years old; Reason: r/o abd/pelvic mass History: weight loss, and severe R LE edema ABDOMEN:LUNGS BASES: Patient status post cardiac surgery with pacemaker leads noted. Extensive calcification noted. Right lung base scarring noted.LIVER, BILIARY TRACT: The liver is normal in morphology and size. Numerous subce... | 1.Numerous cystic lesions throughout the pancreas. MRI M.R.C.P. with warranted for full characterization2.status post transplant kidney in the right iliac fossa without evidence of mass lesion or perinephric fluid collection3.diverticulosis without diverticulitis4.focal aneurysmal dilation of the abdominal aorta with e... |
Generate impression based on findings. | Female 47 years old; Reason: Evaluate liver lesions - 3 were deemed to be hemangiomas on MRI but other lesions were seen on chest CT but not on MRI, also had lytic lesion on T4 on chest CT History: weight loss ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: A total of 3 lesions are noted in ... | 1.Total 3 hemangiomas in the liver with numerous too small to characterize lesions. |
Generate impression based on findings. | Reason: Infiltrate/consolidation, compare to previous imaging History: Worsening leukocytosis and continued fevers LUNGS AND PLEURA: Numerous bilateral, diffusely distributed pulmonary nodules are new from the 9/25/2013 study. Some of the nodules are cavitary (series 4, image 42). Given the time course, these are most ... | 1.Numerous bilateral pulmonary nodules some of which are cavitary new from 9/25/2013 exam are most likely infectious in etiology and may represent septic emboli of bacterial or fungal etiology.2.Interval increase in right-sided pleural effusion and development of new left-sided pleural effusion with associated compress... |
Generate impression based on findings. | Reason: progression of disease? esophagus patency with mass, lung pathology History: chest pain, dysphagia, history of lung cancer undergoing RT CHEST:LUNGS AND PLEURA: The reference right lower lobe mass measures 3.5 X 4.8 cm (series 5, image 66) and has increased in size from 2.1 x 2.8 cm, compatible with malignancy.... | 1.Right lower lobe lung mass measuring 3.5 X 4.8 cm, increased from previous and compatible with malignancy. Additional right middle lobe nodule and lingular micronodule unchanged.2.Bulky right hilar and subcarinal lymphadenopathy compatible with metastatic disease, with decrease in size of reference lesions.3.New diff... |
Generate impression based on findings. | Clinical question: Rule out bleed. Headache. Signs and symptoms: Headache in patient with history of aneurysm. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Streak artifact from patient's previously placed aneurysm clips in... | No acute intracranial findings. Expected postoperative changes of left frontal craniotomy for clipping of aneurysm. |
Generate impression based on findings. | Clinical question: Rule-out mass. Signs and symptoms: Rule out mass. New onset of seizure. Unenhanced head CT:There is no detectable acute intracranial process. There is no evidence of a mass, edema, midline shift, hydrocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF cisterns and gray -- ... | Negative nonenhanced head CT. |
Generate impression based on findings. | Clinical question: 67-year-old female with history of anaplastic anemia and thrombocytopenia presents with bacteremia and type I respiratory failure, new seizing. Signs and symptoms: Seizures. Nonenhanced head CT:Extensive streak artifact reduces the sensitivity of the exam for detection of subtle intracranial findings... | Suboptimal exam due to streak artifact however no convincing evidence of any acute intracranial process. |
Generate impression based on findings. | Clinical question: Any change in ventricular size. Signs and symptoms: 17 year old male with NFl, VP shunt and headache. Nonenhanced head CT:Examination demonstrate interval increased size of supratentorial ventricular system. There is an isointense mass in the basal cistern which is very poorly defined and difficult t... | 1.Interval increased size of supratentorial ventricular system with further effacement of cortical sulci.2.Stable bilateral frontal approach ventricular catheter and their position since prior exam.3.No convincing evidence of an isodense mass in the basal cistern and likely representing chiasmatic tumor.4.Stable large ... |
Generate impression based on findings. | Clinical question: Stroke. Signs and symptoms: Seizure and nonverbal. Nonenhanced head CT:Examination demonstrates very subtle focus of low attenuation with apparent involvement of the cortex and subcortical white matter of left anterior temporal and frontal lobe. There is lobar widening of adjacent cortical sulci. The... | 1.No convincing evidence of an acute ischemic stroke. CT however is insensitive for detection of acute non-hemorrhagic ischemic stroke.2.A subtle focus of low-attenuation in the left anterior temporal and inferior frontal lobe is believed to represent volume averaging less likely possibility of stroke cannot be entirel... |
Generate impression based on findings. | Clinical question: Fever. Signs and symptoms: Fever. Enhanced maxillofacial CT:Frontal sinuses.Very minimal mucosal thickening in the dependent portion of bilateral maxillary sinuses are noted. This is a new finding since prior exam from July of 2013.Ethmoid sinuses.Minimal bilateral chronic sinus disease which is new ... | 1.No evidence of acute sinusitis.2.No detectable abnormal enhancement on post infused images in the region of exam.3.Chronic pansinusitis with interval worsening of sinus disease since prior exam. There are occluded bilateral ostiomeatal units and sphenoethmoidal recesses. |
Generate impression based on findings. | Clinical question: 60-year-old male with AML, neutropenic fever, rule out sinusitis. Signs and symptoms: Neutropenic fever. Non-enhanced maxillofacial CT:Examination demonstrates no evidence of acute sinusitis.Very minimal because of thickening in bilateral frontal sinuses is noted.Minimal mucosal thickening in bilater... | 1.Very minimal chronic sinus disease as detailed.2.Patent bilateral ostiomeatal units and bilateral sphenoid joint recess. 3.No evidence of acute sinusitis. |
Generate impression based on findings. | Clinical question: Anisocoria right 5 left 1. Signs and symptoms: As above. Nonenhanced head CT:Large acute this setting hematoma in the right frontal lobe and its surrounding vasogenic edema is again noted. There is however increased mass effect on the right frontal horn and midline shift to the left. There is increas... | 1.New since prior exam is further effacement of gray -- white matter differentiation in the right frontal and temporal lobe with resultant further near complete effacement of adjacent cortical sulci.2.Slight interval increased mass effect and leftward midline shift since prior study.3.No convincing evidence of interval... |
Generate impression based on findings. | Reason: r/o R sided stone vs pyelo History: R flank pain radiating to suprapubic- urinary urg Lack of IV contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No s... | Tiny bilateral lower pole calculi without hydronephrosis. Infiltration of the perinephric fat on the right may reflect a recently passed stone or, in the appropriate clinical setting, pyelonephritis. |
Generate impression based on findings. | Reason: 75 y/o man with hx of metastatic intrahepatic cholangiocarcinoma s/p stent placement p/w RUQ pain and fever, r/o obstruction History: 75 y/o man with hx of metastatic intrahepatic cholangiocarcinoma s/p stent placement p/w RUQ pain and fever, r/o obstruction ABDOMEN:LUNG BASES: Mild pleural effusions bilaterall... | 1.Large heterogeneous centrally located hepatic mass is again seen and relatively unchanged in size.2.Interval placement of intrahepatic biliary stent extending to the duodenum.3.Stable mild focal intrahepatic biliary ductal dilatation in the left lobe of the liver.4.No evidence of bowel obstruction.5.Right adrenal met... |
Generate impression based on findings. | Reason: Please eval for source of fever, tachycardia, abdominal pain History: s/p cystectomy, ileal conduit on 9/26/13. admitted for fever with workup otherwise negative ABDOMEN:LUNG BASES: Multiple new basilar pulmonary nodules. A left lower lobe pulmonary nodule measures 1.0 x 0.8 cm (series 5, image 19). Small bilat... | 1.Large loculated fluid collection with internal gas in a right lower quadrant compatible with an infected fluid collection.2.Amorphous collection in the cystectomy bed with foci of gas suggests infected fluid collection or bowel wall injury, although there is no contrast extravasation to suggest the latter.3.Multiple ... |
Generate impression based on findings. | History: 71 yo M with metastatic NSCLC p/w SOB and new afib concern for PE. PULMONARY ARTERIES: No evidence of pulmonary embolism. LUNGS AND PLEURA: Subpleural right upper lobe mass which invades the chest wall is unchanged in size and measures 4.9 x 3.6 cm (series 7, image 82). Mixed ground glass and solid opacity in ... | 1.No evidence of pulmonary embolism. 2.No significant interval change in subpleural right upper lobe mass and hepatic metastasis. Left upper lobe mixed solid and ground glass opacity is also unchanged and may represent an additional site of primary malignancy. |
Generate impression based on findings. | 52-year-old female with chronic sinusitis Within the nasal cavity no obstructive lesions are appreciated.The frontal sinuses and bilateral the lateral recesses are clear.Maxillary sinuses demonstrate minor mucosal thickening along the floors of the maxillary sinuses with obstruction of bilateral ostiomeatal units, unch... | 1.Persistent mucosal thickening which obstructs the osteomeatal complex units. Only the right sphenoid sinus demonstrates interval improvement.2.There is approximately 1 cm calcified focus abutting the dura at the convexity in a right paramedian location, which is stable in appearance and consistent with a small benign... |
Generate impression based on findings. | Female 25 years old Reason: 25F w/ ESRD w/ hemptoysis, unilateral effusion and tachycardia concerning for PE History: sob, tachycardia, effusion PULMONARY ARTERIES: Technically limited study due to patient motion and poor opacification. No central pulmonary emboli, and no evidence for right heart strain.There is high-g... | 1. No evidence of pulmonary emboli in the central pulmonary arteries. Technically limited study.2. High grade stenosis of the right subclavian artery with prominent collateralization and possible stenosis of the SVC at the level of the azygos.3. Mediastinal, hilar, supraclavicular, axillary and subpectoral lymphadenopa... |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage. Signs and symptoms: Left facial droop and history of old CVA. Fell down. Nonenhanced head CT:There are no prior exams for comparison.There is no convincing evidence of an acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic stro... | 1.No acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic stroke.2.Age indeterminate mild to moderate small vessel ischemic strokes.3.Large chronic right PCA cortical stroke with resultant ex brought to the location of right trigone and right temporal horn. |
Generate impression based on findings. | Neck pain following syncope with fall. There are no visualized fractures. Vertebral body and intervertebral disk heights are maintained. The odontoid is intact. There is no prevertebral soft tissue swelling.There are significant degenerative changes of the spine considering the patient's age.C2-3: There is a mild disk ... | There is no visualized sequela of trauma, though note is made of significant changes related to degenerative disk disease including multilevel protrusions/extrusions from the C3-4 through C6-7 levels. If there are attributable symptoms, this could be better assessed by C-spine MRI. |
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