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Generate impression based on findings. | Reason: s/p APR on 9/27, ongoing ileus, purulent drainage from pelvic drain, eval for obstruction, fluid collections. History: ileus/bowel obstruction ABDOMEN:LUNG BASES: Bilateral pleural effusions, right greater the left, with overlying compressive atelectasis. Mild patchy consolidation in the right middle and lower ... | 1.Status post proctectomy with fluid and gas in the presacral soft tissues suggestive of an infected fluid collection. 2.Persistent small bowel obstruction. 3.Ascites and pleural effusions. |
Generate impression based on findings. | Clinical question: 46 year-old female with AML, for a baseline sinus disease. Signs and symptoms: AML. Maxillofacial CT:Frontal sinuses demonstrate no evidence of disease.Ethmoid sinuses demonstrate mild (right greater than left) anterior ethmoid sinus disease.Sphenoid sinus demonstrate minimal mucosal thickening along... | 1.No evidence of acute sinusitis.2.Mild to moderate chronic sinusitis as detailed above.3.Occluded right ostiomeatal unit and bilateral sphenoethmoidal recess.4.Extensive soft tissue thickening in the right nasal passage with significant compromise of the air space detail. |
Generate impression based on findings. | Headache and posterior hematoma following syncope with fall. Rule out fracture or intracranial hemorrhage. There is a scalp hematoma overlying the left occipital region. There are no visualized fractures. There is no Intracranial hemorrhage, fluid collection, mass or hydrocephalus. Gray-white matter differentiation is ... | Scalp hematoma without underlying fracture or intracranial sequela of trauma. |
Generate impression based on findings. | 54-year-old female with malignant neoplasm of colon, Restaging CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post ablation changes in the right posterior liver with a large... | 1. Interval post ablation changes in the right lobe of liver with mild change in morphology. Previously described lesion along the inferior aspect of the ablation site has minimally decreased in size. Other reference hepatic lesion also appears minimally decreased in size.2. No new site of disease. |
Generate impression based on findings. | Clinical question: History of head and neck cancer, pulmonary micronodules, compared to prior exam, measurements please, baseline prior to starting chemo/RT. Signs and symptoms: None. Enhanced neck CT:Limited view of intracranial space demonstrate no abnormalities.Normal size and pattern of enhancement the bilateral ca... | 1.Interval removal of previously noted left neck necrotic node and with development of a rim enhancing seroma measuring 35mm in craniocephalad axis and 18 x 11 mm in transaxial dimensions.2.No evidence of recurrence of tumor or adenopathy by CT size criteria.3.Stable small nonpathologic by CT size criteria superior med... |
Generate impression based on findings. | Female 74 years old; Reason: R LE edema of unclear etiology; already ruled out for DVT (by doppler U/S) but unresponsive to furosemide/metolazone History: severe RLE edema. A large right knee joint effusion is seen with an associated large Baker's cyst exiting between the semimembranosus and medial gastrocnemius tendon... | Large knee joint effusion with rupture of a large Baker's cyst, which is likely the cause of the diffuse posterior soft tissue swelling and fat stranding in the lower extremity below the knee. |
Generate impression based on findings. | Reason: distention ileus History: pain and distension Lack of intravenous contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Basilar subsegmental atelectasis and small pleural effusions. Calcified hilar and mediastinal lymph nodes compatible with prior granulomatous disease.LIVER, BILIARY TRACT: Ri... | 1.ERCP related acute pancreatitis without evidence of local complications. |
Generate impression based on findings. | Reason: evaluate for stone or renal abscess History: flank pain, history of urostomy 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: Punctate calcifications in the left... | 1.New left hydronephrosis and hydroureter with thickening of the proximal ureteral wall. 2.Soft tissue density mass arising from the subcutaneous tissue of the left hip with prominent pelvic lymph nodes. Mild interval increase in size compared to 2008 CT study. Clinical correlation is advised. |
Generate impression based on findings. | Female; 57 years old. Reason: r/o PE History: desaturations PULMONARY ARTERIES: No evidence of pulmonary embolism. LUNGS AND PLEURA: Upper lobe predominant nodular ground glass opacities and bibasilar consolidation and small underlying pleural effusions, compatible with aspiration and/or infection. Calcified granuloma ... | 1.No evidence of pulmonary embolism. 2.Bibasilar consolidation and underlying pleural effusions, compatible with aspiration and/or infection. |
Generate impression based on findings. | Clinical question: Altered mental status, not moving her limbs, evaluate for cervical spinal abscess/hematoma. Signs and symptoms: Four limb there is cyst, AMS. Nonenhanced cervical spine CT:CT is to inappropriate exam due to its insensitivity for detection of hemorrhage or abscess in the spine. Consider an MRI exam fo... | 1.CT is not an appropriate exam for detection of intraspinal hemorrhage or abscess as is questioned clinically. If clinical concern persist consider MRI examination of cervical spine.2.Examination demonstrates no evidence of fracture or malalignment and no evidence of perispinal soft tissue abnormalities.3.Degenerative... |
Generate impression based on findings. | Female 85 years old Reason: r/o PE History: tachy, hypoxic PULMONARY ARTERIES: Technically adequate study without evidence of right heart strain or pulmonary emboli.LUNGS AND PLEURA: Apical predominant moderate centrilobular and paraseptal emphysema. Biapical and bibasilar scarring. Mild bronchial wall thickening sugge... | 1. Technically adequate study without evidence of pulmonary emboli.2. Moderate central and paraseptal emphysema.3. Mild bronchial wall thickening suggestive of bronchitis.4. Compression fracture the T6 vertebral body. |
Generate impression based on findings. | Malignant neoplasm of prostate, evaluation of disease after 53 days of investigational therapy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenule is noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKID... | 1. Interval decrease in left pelvic lymph node.2. Minimal interval increase in sclerotic focus in T11 and T3 vertebral body. |
Generate impression based on findings. | Reason: hx of pancreatic necrosis with pancreatic tail abscess, decreased drainage from drain, now with drain erythema and outer drainage History: above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No evidence of cholelithiasis. No evidence of intrahepatic biliary ductal dilatation. No foca... | 1.Complex septated pseudocyst in the tail of the pancreas with interval increase in size. The surgical drain is unchanged in location.2.Interval increase in size of pseudocyst in the body of the pancreas.3.Interval decrease in ascites and anasarca. |
Generate impression based on findings. | Reason: abd pain, leukocytosis, fever History: abd pain ABDOMEN:LUNG BASES: Nonspecific peripheral basilar reticular opacities, unchanged from CT chest dated 10/4/2013.LIVER, BILIARY TRACT: Mild ascites. Periportal and pericholecystic fluid/edema.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnorma... | Diffuse wall thickening and mucosal enhancement of the small bowel and colon most compatible with chemotherapy related enteritis/colitis. |
Generate impression based on findings. | Reason: ?duodenal mass obstruction History: Dizzyness, poor appetite, nausea, vomiting ABDOMEN:LUNG BASES: Multiple pulmonary nodules increasing in size and number. Index left lower lobe pulmonary nodule measures 1.2 cm (series 4, image 1), previously 0.9 cm.LIVER, BILIARY TRACT: Percutaneous biliary drain and stent wi... | 1.No evidence of bowel obstruction.2.Increasing pulmonary, hepatic, and peritoneal lesions. |
Generate impression based on findings. | Reason: PE? History: hypoxemia PULMONARY ARTERIES: There is opacification of the pulmonary arterial tree limits the examination. There is no evidence of pulmonary emboli within the central pulmonary arteries to the level of the bulbar branches.LUNGS AND PLEURA: Bilateral basilar subsegmental atelectasis and septal thic... | Limited exam demonstrates no evidence of large central pulmonary emboli. Bilateral basilar subsegmental atelectasis and septal thickening. |
Generate impression based on findings. | Reason: Appendicitis vs. Diverticulitis History: Lower abdominal pain. Additional history obtained from pathology report on 8/15/2013: History of myeloma status post stem cell transplant ABDOMEN:LUNG BASES: Mild dependent atelectasis in bilateral bases.LIVER, BILIARY TRACT: No suspicious focal liver lesions. No intrahe... | 1.Presumptive diverticulitis with intramural abscess and walled off perforation.2.Mild ectasia and aneurysmal dilatation of the infrarenal aorta prior to the iliac bifurcation.3.Nodular left adrenal gland with slight interval increase in size compared to 2012 CT study. |
Generate impression based on findings. | Male 58 years old Reason: Pt is a 58 y/o male with met melanoma, on vemurafenib, evaluate for progression History: met melanoma CHEST:LUNGS AND PLEURA: In the right upper lobe nodule is ill-defined flow is mild mural nodular component remaining. Overall dimensions including the solid and non-solid components is 8 x 6 m... | No new sites of disease. Small changes in measurements as above. |
Generate impression based on findings. | Reason: r/o dissection History: s/p high speed MVC CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality noted. No evidence of acute aortic injury.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No suspicious focal liver lesions. No evidence o... | 1.No evidence of acute aortic injury. 2.Nondisplaced fractures of the left transverse processes of L2 and L3. |
Generate impression based on findings. | Female 72 years old Reason: h/o HNC, compare to previous, measurements pls, h/o CRT History: none CHEST:LUNGS AND PLEURA: Moderate apical predominant centrilobular emphysema.Scattered pulmonary micronodules, unchanged. No new suspicious pulmonary nodules or masses identified.No focal air space opacities or pleural effu... | No significant interval change, and no evidence of metastatic disease in the chest or upper abdomen. |
Generate impression based on findings. | Male 70 years old Reason: More detailed view of LAD and possibly lobulated pleural effusions History: Diffuse LAD.Additional history: Reported Ex lap from McNeil. Possible sarcoid history. No malignancy found yet. CHEST:LUNGS AND PLEURA: Bilateral pleural effusions with some areas of loculation. Is this initial changes... | Adenopathy unchanged. Ascites, anasarca, bilateral pleural effusions, pulmonary edema. Cholelithiasis. Vascular flow phenomenon the liver with some areas of capsular retraction suggesting fibrosis. Discussed with covering physician Dr. Michael Drazier pager 1181 covering pager 2693. |
Generate impression based on findings. | Male; 37 years old. Reason: opacities on CXR, little change after thoracentesis - loculations? pneumonia? History: mild SOB, no other signs of pneumonia. LUNGS AND PLEURA: There is a moderate right pleural effusion with overlying compressive atelectasis/consolidation. There is a trace amount of a right pneumothorax. Mi... | 1.Right pleural effusion with trace right-sided pneumothorax. 2.Right basilar consolidation/atelectasis. This may represent a source of infection. |
Generate impression based on findings. | 49 year-old female with history of T1N1 right anterior tongue status post partial glossectomy and bilateral neck dissection. There is no clinically significant lymphadenopathy. The thyroid gland appears intact. The airway appears patent. There are no new soft tissue masses or findings suspicious for recurrence.The paro... | No evidence for local recurrence or clinically significant neck lymphadenopathy. |
Generate impression based on findings. | Female; 76 years old. Reason: Evaluate for progression of metastatic disease; compare to previous scan. CHEST:LUNGS AND PLEURA: Postsurgical changes compatible with left lower lobectomy and right upper lobe segmental resections. Innumerable small solid and ground glass pulmonary nodules are again noted. These are not s... | 1.Acute pulmonary emboli extending from the distal main pulmonary arteries into several bilateral lobar arteries as described above. 2.No significant interval change in diffuse pulmonary metastatic disease, with interval decrease in size of precarinal lymph node. |
Generate impression based on findings. | Female 58 years old Reason: restaging History: hx of lymphoma Exam is not sensitive for detecting lesions in the vasculature or solid organs due to lack of intravenous contrast. Given that limitation, the following observations are made:CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Veno... | No pathologic size nodes. Stable small index nodes. Scarring right kidney. Gallbladder and spleen surgically absent. |
Generate impression based on findings. | Reason: h/o HNC, CRT, compare to previous, measurements pls, know pelvic mets History: none CHEST:LUNGS AND PLEURA: Index right apical pulmonary nodule measures 6 mm (series 6, image 13), unchanged. Index lingular nodule measures 8 mm (series 6, image 48), previously 8 mm. New scattered ground glass opacities in the ri... | 1.Increasing left pleural and fissural nodularity compatible with metastatic disease.2.New upper lobe ground glass opacities. Differential considerations include infection and drug reaction. |
Generate impression based on findings. | Male 48 years old Reason: 47Yrs male here for follow-up of T1N2B BOT scc completed TPF f/b TFHX 10/24/10. Please re-eval for recurrence CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary nodules, unchanged in size and distribution. Biapical scarring unchanged. No new suspicious pulmonary nodules or masses identified... | 1. Unchanged pulmonary nodules and apical scarring suggestive of sarcoidosis.2. No specific evidence of metastatic disease. |
Generate impression based on findings. | 64-year-old male with history of base of tongue cancer status post CRT, Oligomet on 4/13, reevaluate and compare to prior. There is new mild enhancement along the left posterior lateral aspect of the nasopharyngeal mucosa without mass effect or nodularity (best seen series 7, image 16).Redemonstrated are postsurgical a... | Stable postsurgical/post treatment changes of the neck as detailed above without evidence of enhancing mass, lymphadenopathy or fluid collection. |
Generate impression based on findings. | Male 61 years old Reason: h/o HNC, pulmonary micronodules, compare to previous, measurements pls, baseline prior to starting chemoRT LUNGS AND PLEURA: Stable scattered pulmonary micronodules.Reference right lower lobe micronodule measures 4 mm (image 266, series 4), previously 4 mm. Reference right middle lobe micronod... | 1. Stable pulmonary micronodules more likely postinflammatory than metastatic though continued follow up is recommended.2. Stable findings of chronic aspiration.3. Unchanged mediastinal and hilar lymphadenopathy. |
Generate impression based on findings. | Reason: fever History: fever LUNGS AND PLEURA: New small bilateral pleural effusions and interlobular septal thickening.Calcified granuloma in the right lower lobe and stable micronodule (image 50 series 5). Mild bronchial/bronchiolar wall thickening.No focal areas of consolidation.MEDIASTINUM AND HILA: Right central v... | 1.New small bilateral pleural effusions and interlobular septal thickening most prominent at the lung bases compatible with edema.2.New small amount of perihepatic ascites and splenomegaly.3.No specific evidence of acute infection. |
Generate impression based on findings. | Female; 46 years old. Reason: 46 female with AML, r/o baseline pulmonary infiltrate. LUNGS AND PLEURA: Scattered micronodules are present but there are no suspicious pulmonary nodules or masses. 4 mm micronodule along the left major fissure likely represents an intrapulmonary lymph node (series 4, image 38). No focal c... | No acute cardiopulmonary abnormalities noted. |
Generate impression based on findings. | Clinical question: History of head and neck cancer, compared to prior exam, measurements. Signs and symptoms: None. Enhanced neck CT:Limited view of the intracranial contents is unremarkable.Normal bilateral cavernous sinuses, skull base.Chronic sinusitis the visualized paranasal sinuses with slight interval improvemen... | 1.Stable enhanced CT of the soft tissues of the neck and without evidence of recurrence of tumor or cervical adenopathy since prior study.2.Negative enhanced head CT. |
Generate impression based on findings. | Reason: h/o HNC, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Stable scattered nonspecific micronodules. No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of pericardial effu... | No interval change. No evidence of metastatic disease. |
Generate impression based on findings. | 56 year old male with history of right tonsillar cancer, chemotherapy follow up examination. Posttreatment changes again include reticulation of the subcutaneous fat, thickening of the platysma, effacing of the deep fascial planes, and hyperemia of the submandibular glands. The previously demonstrated hyper enhancement... | 1.No CT evidence for residual or recurrent enhancing tumor.2.Continued interval decrease in size of reference lymph node. No new clinically significant lymphadenopathy.3.Enhancing tissue in the left ostiomeatal complex with complete opacification of the left maxillary sinus is again noted and unchanged. |
Generate impression based on findings. | Reason: Assess vasculature prior to kidney transplant History: Known PVD - assess vasculature prior to kidney transplant ABDOMEN:LUNG BASES: Small ground glass opacities in the left lung base.LIVER, BILIARY TRACT: No suspicious focal lesions. No intrahepatic or extrahepatic biliary ductal dilatation. No evidence of cho... | 1.No evidence of plaque of the external iliac artery.2.Mildly prominent pelvic lymph nodes bilaterally. |
Generate impression based on findings. | Reason: please evaluate for leakage from neobladder History: s/p cystectomy and orthotopic neobladder. XR cystogram is suggestive of entero-neobladder fistula. UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Status post cystectomy. Contrast opacifies the patient's neobladder with retrograde flow of contrast into the ... | Expected appearance of neobladder without evident leak. |
Generate impression based on findings. | Neurofibromatosis and VP shunt. Chronic abdominal pain. History of abdominal fluid loculations. ABDOMEN:LUNG BASES: Left pleural effusion has resolved. Minimal dependent atelectasis is identified. Left paraspinal soft tissue mass at the level of T10/11 measures 4.9 cm in its longest axis.LIVER, BILIARY TRACT: Enhanceme... | Right lower quadrant fluid collection has resolved. Left lower quadrant fluid collection is smaller. |
Generate impression based on findings. | 53-year-old male with fungal sinusitis and URI symptosis. Opacification of the right maxillary sinus has improved, yet there remains a thin band of soft tissue density demonstrated within the retromaxillary fat immediately posterior to the right maxillary sinus wall which extends to the pterygopalatine fossa. Previousl... | Improvement in pan sinus findings as described in detail above. There remains a thin band of soft tissue density demonstrated within the retromaxillary fat immediately posterior to the right maxillary sinus wall which extends to the pterygopalatine fossa. Previously demonstrated mottled appearance of the involved adjac... |
Generate impression based on findings. | History of Ewing's sarcoma. Pre-transplant evaluation. CHEST:LUNGS AND PLEURA: No evidence of lung parenchymal nodules or opacities. No pneumothorax or pleural effusions.MEDIASTINUM AND HILA: Right-sided Port-A-Cath has been removed. A new left-sided IJ venous access has as been placed and its tip is at the right atriu... | Sclerotic and lytic lesions over both iliac wings, consistent with a known history of Ewing's sarcoma also visualized on pelvic MR from outside institution on 08/05/13. |
Generate impression based on findings. | 61 year old patient. Headache and nausea -- rule out intracranial hemorrhage. There is no intracranial mass, fluid collection, hemorrhage, hydrocephalus or CT evidence of acute ischemia. Gray-white differentiation is normal and the midline is intact. Orbits and paranasal sinuses are unremarkable. | Unremarkable CT examination of the head. |
Generate impression based on findings. | NSIP from HP looking for change. SOB. LUNGS AND PLEURA: Bilateral heterogeneous subpleural interstitial abnormality with areas of groundglass opacity and traction bronchiectasis are not significantly changed. New nonspecific 4 mm irregular subpleural micronodule in right upper lobe (image 25/89) is presumably postinfla... | Interstitial lung disease in NSIP pattern not significantly changed. New nonspecific 4 mm subpleural nodule in right upper lobe is presumably postinflammatory though continued follow up is recommended. |
Generate impression based on findings. | Altered mental status. There is patchy hypoattenuation within the PICA territory of the right cerebellar hemisphere. There is no significant mass effect including tonsillar herniation. There is marked calcification of the vertebral arteries bilaterally and the basilar artery. There is less prominent calcification withi... | 1.Patchy low-attenuation within the right cerebral hemisphere. This could represent sequelae of ischema versus edema related to an underlying lesion. MRI is recommended for better characterization.2.Significant vascular calcification within the posterior circulation. 3.No supratentorial abnormality, though CT is subopt... |
Generate impression based on findings. | History of head and neck cancer. CHEST:LUNGS AND PLEURA: Scattered punctate micronodular unchanged and presumably postinflammatory. No new pulmonary nodules.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Coronary calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Abs... | Stable CT with no definitive evidence of metastatic disease. |
Generate impression based on findings. | History of metastatic breast cancer on treatment. CHEST:LUNGS AND PLEURA: Stable basilar scarring. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Right thyroid nodule unchanged. Coronary calcification.CHEST WALL: Moderate degenerative disease of the thoracolumbar spine. Small stable nodule in the right breast (i... | Stable metastatic disease. |
Generate impression based on findings. | Base of tongue cancer. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Bibasilar and right middle lobe linear scarring, unchanged. Punctate right upper lobe granuloma.MEDIASTINUM AND HILA: Scattered small mediastinal nodes, all < 1cm. Aspirated debris in trachea (image 20/110).CHEST WALL: No signific... | 10 mm exophytic lesion involving the right kidney which is presumably a very small renal cell carcinoma. Alternatively, but less likely, this could represent complex cyst or metastatic disease. |
Generate impression based on findings. | 56-year-old male with neuroendocrine carcinoma, need triphasic CT for Therasphere mapping/injection CHEST:LUNGS AND PLEURA: Few small micronodules in the right lung. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Tip of porta-cath at the junction of right atrium and SVC. ABDOMEN:LIVER, BILIARY TRACT:... | 1. Status post right hepatectomy with multiple arterially enhancing lesions throughout the left lobe of liver and caudate lobe likely representing metastatic neuroendocrine disease.2. Lytic lesion in T11 vertebral body with a sclerotic rim most likely degenerative than bone metastasis. |
Generate impression based on findings. | History of thoracic aneurysm. Evaluate for routine surveillance. LUNGS AND PLEURA: Calcified granuloma in right lower lobe. Scattered areas of peripheral scarring. Scattered small punctate micronodules are presumably post inflammatory.MEDIASTINUM AND HILA: Thoracic aortic aneurysm. The ascending aorta measures 44 mm. T... | Thoracic aortic aneurysm measuring up to 44 mm in diameter. |
Generate impression based on findings. | 71-year-old female with microscopic hematuria 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: Symmetric nephrogram... | No CT findings to explain patient's symptoms. |
Generate impression based on findings. | Female 38 years old; Reason: pt history of metastatic breast cancer, receiving treatment - please eval for response/progression and compare with previous. History: see above CHEST:LUNGS AND PLEURA: Extensive subpleural emphysematous changes. There are multiple bilobar pulmonary nodules. A new left lower lobe pulmonary ... | 1.Progression in the pulmonary and hepatic lesions. |
Generate impression based on findings. | History of head and neck cancer. CHEST:LUNGS AND PLEURA: Reference pulmonary nodules are stable to decreased.Left upper lobe nodule (image 56/104) measures 2 mm previously measuring 3 mm.Left lower lobe reference nodule (image 78/104) measures 3 mm unchanged.No new pulmonary nodules identified. Other scattered punctate... | Pulmonary micronodules are stable to decreased. Stable left axillary lymph nodes. |
Generate impression based on findings. | Male 74 years old; Reason: NHL, re-eval and compare to previous History: NHL CHEST:LUNGS AND PLEURA: Subpleural nodule adjacent to the minor fissure (image 59/series 130) is nonspecific and unchanged. No dominant lung lesion. The pleural spaces are clear. The central airways are patent.MEDIASTINUM AND HILA: Heart size ... | 1.Stable exam |
Generate impression based on findings. | 87-year-old male status post fall, hitting head Redemonstrated is encephalomalacia present along the right orbital gyrus and gyrus rectus. Periventricular and subcortical confluence white matter hypodensities of a moderate to severe degree are again noted, unchanged. The ventricles are unchanged in size or shape withou... | No acute intracranial abnormality. |
Generate impression based on findings. | Question pneumonia, granuloma. Left lower lobe nodule on CXR. LUNGS AND PLEURA: 8-mm cavitary nodule in left upper lobe (image 13/100) Nonspecifc area of scarring or atelectasis in right posterior upper lobe. Scattered punctate micronodules.MEDIASTINUM AND HILA: Lower paraesophageal lymphadenopathy with nodes measuring... | 1. Small 8-mm cavitary nodule in left upper lobe suggestive of malignancy. Alternatively this could be the result of infection such as TB, though this would be atypical. Its location and size would make a high yield transthoracic needle biopsy limited though PET/CT may be of utility. Short term imaging and clinical fol... |
Generate impression based on findings. | Male 49 years old; Reason: evaluate for parastomal hernia History: ventral hernia at stoma site ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver has a smooth contour. No suspicious hepatic lesions. Hepatic portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No sig... | 1.Right lower ostomy with redundant loops of bowel within the ostomy superficial to the fascial plane in the subcutaneous tissues. No evident peristomal hernia or obstruction. |
Generate impression based on findings. | Reason: 83 male with CML on niltonib now with chemical pancreatitis. Please assess for radiographic evidence, aware that study suboptimal without IV contrast, but patient has renal insufficiency History: Pancreatitis ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of so... | No CT evidence of pancreatitis or associated complications. |
Generate impression based on findings. | Reason: RP bleed History: drop in hgb, abdomen pain Lack of intravenous contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Motion artifact limits evaluation of the lung bases. Small pleural effusions with basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No signific... | No evident retroperitoneal hematoma. |
Generate impression based on findings. | Reason: 67 yo female with rectal cancer who completed XRT on 9/9/13. Need to evaluate extent of disease and for any evidence of metastatic disease. History: none CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Hear... | Sclerotic expansile lesion of the left iliac wing is suspicious for metastasis. Correlate for additional malignancy (breast), as an isolated metastasis to the left iliac wing would be unusual for a rectal cancer. |
Generate impression based on findings. | Male 58 years old Reason: right flank pain History: pain radiating to grown Exam is not sensitive for detecting lesions in the bowel, solid organs of vasculature due to the lack of oral or intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality n... | Scarring right kidney. Single punctate calcification right kidney possibly representing nephrolithiasis. No hydronephrosis or hydroureter.Cholelithiasis with no evidence of cholecystitis. |
Generate impression based on findings. | Locally advanced esophageal cancer s/p chemo XRT/ Finished XRT 9/13/2013. Evaluate extent of disease and for metastases. CHEST:LUNGS AND PLEURA: Scattered punctate micronodules, the largest of which are calcified, are likely postinflammatory. Very mild emphysema.MEDIASTINUM AND HILA: Circumferential distal esophageal w... | Distal esophageal mass extending into proximal stomach consistent with known carcinoma. No evidence of pulmonary or hepatic metastases. |
Generate impression based on findings. | Female 67 years old Reason: 67 y/o F w/ new d/o breast ca needs staging imaging. Please evaluate for metastatic disease History: none CHEST:LUNGS AND PLEURA: Moderate left pleural effusion and small right pleural effusion. Several lung nodules bilaterally consistent with metastatic disease.For baseline purposes right u... | Right breast mass. Lung metastases and lymphadenopathy. Osseous metastases. Other findings as above. |
Generate impression based on findings. | 49-year-old male with ataxia. Redemonstrated is patchy hypoattenuation within the PICA territory of the right cerebellar hemisphere. There is no significant mass effect nor tonsillar herniation. There is marked calcification of the vertebral arteries bilaterally and the basilar artery making the diagnosis of arterial o... | 1.Persistent patchy low-attenuation within the right cerebral hemisphere which could represent sequelae of ischema versus edema.2.Marked calcification of the vertebral arteries bilaterally and the basilar artery making the diagnosis of arterial occlusion difficult.3.MRI and/or MRA could further characterize the cerebel... |
Generate impression based on findings. | Reason: NHL, re-eval and compare to previous. Please measure pulmonary nodule. History: NHL, pulmonary nodule CHEST:LUNGS AND PLEURA: Increasing left upper lobe pulmonary nodule measures 3.1 x 2.3 cm (series 4, image 30), previously 2.3 x 1.7 cm. Scattered micronodules without significant interval change. There are mul... | Increasing left upper lobe pulmonary mass. Otherwise, stable exam. |
Generate impression based on findings. | Clinical question: Evaluate lumbar fusion. Signs and symptoms: Radicular pain in left leg. Nonenhanced lumbar MRI:The alignment of vertebral column is abnormal and with evidence of minute retrolisthesis of L1 on L2, mild grade 1 retrolisthesis of L2 on L3 and minute retrolisthesis of L4 on L5.There is evidence of exces... | 1.Evidence of bilateral transpedicular screw placement and posterior fixating rods extending from L2 to L5. The right transpedicular screw at L5 projects into the superior aspect of the right neural foramina.2.Minimal bony lucency surrounding the transpedicular screws at L2 as detailed.3.Articulating facets and facet s... |
Generate impression based on findings. | 33-year-old male with history of squamous cell carcinoma of the right tongue treated with chemoradiation and partial glossectomy. Postsurgical changes status post removal of a right submandibular gland and partial glossectomy are similar to prior study. No abnormal enhancement, new discrete mass, or clinically signific... | 1.Stable treatment related changes of the right tongue and right neck without evidence of residual or recurrent tumor.2.No clinically significant lymphadenopathy.3.Sclerosis involving the right mandible is unchanged given differences in technique when compared to the prior CT and MRI modalities and is presumably treatm... |
Generate impression based on findings. | Female 45 years old Reason: Dx Metastatic Breast Ca History: Evaluate disease/Check progression CHEST:LUNGS AND PLEURA: Redemonstration of postradiation fibrotic changes in the anterior portion of the lung along the right upper lobe. Nodular scarring in the right apex and several small subpleural nodules on the right a... | Progression of disease particularly in the liver and lymphadenopathy in the retroperitoneum. |
Generate impression based on findings. | Reason: metastatic breast cancer on therapy please assess response and compare to previous imaging History: MBC CHEST:LUNGS AND PLEURA: Stable bilateral micronodules.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the aortic arch, coronary arteries. Calcified hilar lymph nodes.CHEST WALL: No significant abnorma... | Stable examination. |
Generate impression based on findings. | Esophageal cancer status post 3 additional cycles of chemo. Needs disease evaluation. CHEST:LUNGS AND PLEURA: Bilateral nodular airspace opacities with variable cavitation.Reference left upper lobe lesion is slightly larger at 17 x 11 mm on image 37/103 (16 x 8 mm on prior). Reference left lower lobe lesion again measu... | Left upper lobe reference nodule slightly larger. Left lower lobe reference nodule stable in size though is now more solid. No new sites of disease. |
Generate impression based on findings. | History multiple myeloma. Low-grade fevers. Assess for possible pneumonia. LUNGS AND PLEURA: New basilar predominant interstitial abnormality with very mild bronchiectasis and patchy areas of groundglass opacity. New small area of consolidation at left base and to a lesser degree involving the lingula.MEDIASTINUM AND H... | Basilar predominant interstitial abnormality with mild bronchiectasis and patchy groundglass opacity. A few small areas of consolidation are also noted. The findings are suggestive of aspiration/aspiration pneumonia, though a drug reaction may appear similarly. The findings are relatively nonspecific and can also be se... |
Generate impression based on findings. | Female 73 years old Reason: evaluate for recurrence of hernia, or seroma. post ventral hernia repair in 12/2012 History: persistent abdominal bulge post hernia repair ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREA... | Broad-based nonobstructive ventral hernia. Large left renal cyst. Atherosclerotic disease. |
Generate impression based on findings. | Reason: 19F w/ h/o sickle cell s/p cholecystectomy w/ RUQ pain, white count and fever, eval for appendicitis vs intraabd infection History: RUQ pain ABDOMEN:LUNG BASES: Basilar subsegmental atelectasis.LIVER, BILIARY TRACT: Periportal edema is nonspecific. Status post cholecystectomy.SPLEEN: Atrophic spleen.PANCREAS: N... | 1.Wall thickening of the terminal ileum of indeterminate etiology. Differential considerations include infectious/inflammatory etiologies. 2.No evidence of appendicitis. 3.No drainable fluid collections. |
Generate impression based on findings. | Female 67 years old Reason: pt with met lung ca s/p 2 cycles of chemo last one 9/27 Diabetic on insulin too History: now needs disease evaluation prior to more chemo any changes since last Ct compare and comment CHEST:LUNGS AND PLEURA: Large right pleural effusion markedly increased in size compared to the prior exam. ... | Near complete collapse of right lung with large increasing pleural effusion and persistent consolidation and small aerated right upper lobe. Increasing size right adrenal nodule. Persistent mediastinal adenopathy. Redemonstration of osseous findings as described. |
Generate impression based on findings. | Reason: 70 y/o M w/ stage IIIb NSCLC s/p chemo needs restaging in 10/2013 History: cough CHEST:LUNGS AND PLEURA: Interval increase in the paramediastinal and paravertebral fibrosis with increasing left lower lobe consolidation and interstitial opacities compatible with post radiation changes. Left basilar consolidation... | 1.Left basilar mass/consolidation without significant interval change.2.Increasing paramediastinal and paravertebral fibrosis, increasing left basilar interstitial opacities , and increasing left pleural thickening/effusion most likely representing post radiation changes.3.Moderate to large sized pericardial effusion i... |
Generate impression based on findings. | Reason: history of ovarian cancer. baseline scan prior to starting new treatment - please use measurements if applicable. thanks! History: see above if you CHEST:LUNGS AND PLEURA: Few scattered pulmonary micronodules. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is norm... | 1.Omental nodularity compatible with peritoneal carcinomatosis.2.Sclerotic T3 foci compatible with metastatic disease.3.Nonspecific hypodense splenic lesions may represent metastases.4.Retroperitoneal and mesenteric lymphadenopathy. |
Generate impression based on findings. | 84-year-old male with history of bitemporal headaches which come and go, often present in the afternoon. There is no detectable acute intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus. The cortical sulci and ventricular system remain within normal size and morphology for patient's stated age o... | 1.Persistent chronic pansinusitis.2.No acute intracranial abnormality. |
Generate impression based on findings. | Reason: hyperaciditiy (pH =1 in stomach), multiple gastric ulcers, refractory reflux, evaluate for neuroendocrine tumor History: vomiting, reflux, ulcers. ABDOMEN:LUNG BASES: No significant abnormality noted. Bilateral breast implants.LIVER, BILIARY TRACT: Hypoattenuating, nonenhancing lesion in the right lobe of the l... | No evidence to explain patient's stated symptoms. |
Generate impression based on findings. | Lung cancer status post two cycles of chemotherapy please evaluate for disease and compare with baseline on 7/24/13 CHEST:LUNGS AND PLEURA: Multiple bilateral subpleural and peripheral pulmonary nodules not significantly changed from prior study. Stable postsurgical changes in the right middle lobe.MEDIASTINUM AND HILA... | 1. Minimally decreased right hepatic lesion.2. Stable bilateral pulmonary nodules.3Stable sclerotic sacral lesion. Unchanged compression deformity T6 vertebral body.. |
Generate impression based on findings. | Male 56 years old Reason: Esophageal/GEJ AC: Restaging History: none CHEST:LUNGS AND PLEURA: First reference right apical ground glass nodule now measures 5 mm (image 20, series 5), previously 3 mm.Second reference right apical ground glass nodule now measures 6 mm (image 19, series 5), previously 4 mm.No new focal air... | 1. Slight interval enlargement of the right upper lobe nodule.2. Slight interval enlargement of reference lymph nodes.3. Stable adrenal metastases.4. Esophageal thickening extending into proximal stomach.5. No new sites of disease. |
Generate impression based on findings. | History of squamous cell carcinoma of the tongue status post CRT. LUNGS AND PLEURA: Scattered punctate micronodules are stable and presumably postinflammatory.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly ... | No evidence of metastatic disease. |
Generate impression based on findings. | Smoker, recurrent pneumonia, history of aspiration. Rule out nodule, assess for COPD. LUNGS AND PLEURA: Clustered groundglass opacities are noted at the left lung base and lingula. Areas of scarring or atelectasis are noted at the right medial lung base. Multifocal small centrilobular nodules are present, right greater... | 1. Findings consistent with chronic aspiration, right greater than left, less severe than on 2009 CT. 2. No new suspicious pulmonary nodules. 3. Centrilobular emphysema.4. Hiatal hernia. |
Generate impression based on findings. | Reason: Please evaluate for upper tract recurrence of bladder cancer History: hx of bladder carcinoma in situ s/p TURBT and intravesical BCG therapy ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Fatty infiltration.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality... | 1.Asymmetric enhancement and enlargement of the prostate is highly suggestive of prostate malignancy.2.New left pelvic lymphadenopathy. |
Generate impression based on findings. | Male 66 years old Reason: pt with nexly dx small cell lung ca no therapy so far only surgical bx History: doing well now needs disease evaluation CHEST:LUNGS AND PLEURA: Interval right upper lobectomy removing a round solid mass previously seen in the posterior segment of the right upper lobe. There is residual soft ti... | 1. Nodular thickening of the right pleura which should be followed to exclude pleural metastatic disease.2. Soft tissue density seen along the staple line from a prior right upper lobectomy likely postoperative in nature; however, residual tumor cannot be excluded.3. Large left thyroid mass, more likely a primary thyro... |
Generate impression based on findings. | Male 79 years old Reason: evaluate aortic aneurysm repair History: h/o aneurysm. CHEST:LUNGS AND PLEURA: Redemonstration of index left lower lobe nodule series 8 image 86 measuring 0.9 x 0.8 cm. Previously 0.9-cm. Is probably unchanged.Left apical nodule too small to accurately measure estimated that 0.8 x 0.3 cm serie... | No interval change in appearance of the aorta. Stable left lower lobe nodule. Other findings as above. |
Generate impression based on findings. | Lung cancer restaging. Cough. CHEST:LUNGS AND PLEURA: Multifocal consolidative lung masses are stable in appearance. Reference right lower lobe mass measures 5.0 X 4.2 cm (series 4, image 61), unchanged. Small bilateral loculated pleural effusions are stable.MEDIASTINUM AND HILA: Atherosclerotic calcification of the ao... | Stable multifocal consolidative masses consistent with history of mucinous adenocarcinoma. No new sites of disease. |
Generate impression based on findings. | Reason: rule out bowel perforation History: s/p ileal conduit c/b wound dehiscence and debridement, now with brown output from wound (?tube feedings) ABDOMEN:LUNG BASES: Motion artifact limits evaluation of the lung bases. Bilateral pleural effusions with overlying compressive atelectasis. Right base consolidation.LIVE... | 1. Enterocutaneous fistula involving the midline abdominal wound and adjacent small bowel.2. Bowel containing parastomal hernia about the colostomy. |
Generate impression based on findings. | Headache and dizziness. Rule out intracranial hemorrhage. No intracranial mass, fluid collection, hemorrhage, hydrocephalus or CT evidence of acute ischemia. Gray-white matter differentiation is maintained bilaterally and the midline is intact. Bones are unremarkable. Visualized portions of the orbits are unremarkable.... | No intracranial abnormality demonstrated. |
Generate impression based on findings. | History of head and neck cancer status post cycle 5 of 5 CRT on 9/13/13 CHEST:LUNGS AND PLEURA: Emphysema. Scattered punctate micronodules are stable and presumably postinflammatory.MEDIASTINUM AND HILA: Atherosclerotic calcifcation of the aorta and its branches. Coronary calcification. Port tip at RA/SVC junction.CHES... | No evidence of metastatic disease. |
Generate impression based on findings. | Male; 56 years old. Reason: altered mental status, hypoxia, rule out PE History: altered mental status, hypoxia Motion artifact limits diagnostic sensitivity.PULMONARY ARTERIES: No evidence of pulmonary embolism. Mildly enlarged pulmonary trunk diameter is suggestive of pulmonary arterial hypertension.LUNGS AND PLEURA:... | 1.No evidence of pulmonary embolism. 2.Small right pleural effusion. |
Generate impression based on findings. | Clinical question: Evaluate for abscess. Signs and symptoms: Right facial swelling/pain. Enhanced CT of maxillofacial region:Examination demonstrate soft tissue edema and subcutaneous fat stranding on the right and extending from the level of the body of mandible superiorly to the soft tissues of the cheek. This findin... | 1.Examination demonstrate dental decay and periapical lucency of the right maxillary premolar tooth.2.There is edema and soft tissue thickening of the right side of the face and cheek and at the level of mandible/maxilla which is more pronounced at the level of the above described dental decay. There is however no conv... |
Generate impression based on findings. | COPD and smoking history with outside hospital abdominal CT imaging which revealed 3-mm right middle lobe nodule. LUNGS AND PLEURA: Scattered punctate micronodules measuring up to 4 mm in the left apex (image 13/113). Some demonstrate calcification, consistent with healed granulomatous disease. Basilar scarring and ate... | 1. Scattered punctate pulmonary micronodules measuring up to 4 mm which are presumably benign postinflammatory nodules. However, in high risk patients, these are typically followed with CT at 12 months to evaluate for growth and exclude malignancy.2 Emphysema.3. Bronchial wall thickening which is nonspecific but most l... |
Generate impression based on findings. | Lung cancer status post neoadjuvant chemo and RT. CHEST:LUNGS AND PLEURA: The solid portion of the left apical lung mass with irregular margins measures 20 x 15 mm on image 18/89 (18 x 20 mm previously). The nodule is contiguous with the pleura and may be invading it. As on prior scan, a measurement of the total diamet... | 1. Interval decrease in left upper lobe nodule.2. Stable small intrathoracic nodes.3. Interval increase in extensive bronchiectasis and bronchiolitis. This is likely due to aspiration or possibly infection. Though not typical of metastatic disease, continued follow-up is recommended. |
Generate impression based on findings. | Female 84 years old Reason: eval acute infection History: altered mental status, R-sided opacity on CXR LUNGS AND PLEURA: Series acquired during expiration limiting evaluation.Right perihilar focal consolidation with air bronchograms, associated ground glass opacities and bronchial wall thickening compatible with aspir... | 1. Right perihilar consolidation compatible with aspiration or pneumonia. Given the patient's age this should be followed to resolution to exclude underlying malignancy.2. Right apical status groundglass nodule suggestive of a infectious or inflammatory etiology; however, recommend CT surveillance in 6 to 12 months to ... |
Generate impression based on findings. | Head and neck cancer. Baseline evaluation. CHEST:LUNGS AND PLEURA: Apical scarring and fibrosis presumably related to radiation changes. No evidence of pulmonary metastases.MEDIASTINUM AND HILA: Port tip at RA/SVC junction.CHEST WALL: Right chest wall port.Expansile lesion of right posterior ninth rib is highly suggest... | Expansile lesion of right posterior ninth rib highly suggestive of metastatic disease. No evidence of pulmonary metastases. |
Generate impression based on findings. | Clinical question: Dental trauma, swelling and redness to upper lip with missing and loose upper and lower front teeth. Maxillofacial CT:Examination demonstrates absence of the right lateral mandibular incisor likely secondary to recent trauma. There is also absence of bony density anterior to the missing tooth and pre... | 1.Absence of right mandibular second incisor and the left first maxillary incisor likely secondary to recent trauma. Small bony fracture at the level of right first maxillary incisor and absence of bone anteriorly at the level of missing right mandibular incisor presumed fracture. 2.No evidence of mandibular fracture o... |
Generate impression based on findings. | Clinical question: Rule-out intracranial process. Signs and symptoms: Decreased responsiveness. Nonenhanced head CT: No detectable acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF cisterns a... | No acute intracranial process. |
Generate impression based on findings. | Clinical question: Infarct the worsening/edema. Signs and symptoms: Comatose. Nonenhanced head CT: No acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Unremarkable images through posterior fossa and with normal size and midline fourth ventricle.Subacute right M... | 1.No acute intracranial process.2.Stable extensive right hemispheric MCA territory subacute nonhemorrhagic ischemic stroke.3.Grossly similar multiple right basal ganglia lacunar infarcts.4.Stable mildly prominent supratentorial ventricular system and maintained midline. |
Generate impression based on findings. | Clinical question: Evaluate for intracranial abnormalities. Signs and symptoms: Blunt head trauma and loss of consciousness. Nonenhanced head CT:No evidence of acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Crowding of cerebellar tonsils at the level of foramen magnum as was noted on ... | 1.No acute intracranial process.2.Revisualization of crowding of cerebellar tonsils at the level of foramen magnum as was noted on prior MRI exam. |
Generate impression based on findings. | Clinical question: Evaluate for obstructing, VA shunt. Signs and symptoms: Headache, blurred vision and recent shunt revision. Nonenhanced head CT:Examination demonstrates collapsed supratentorial ventricular system and a left-sided approach ventricular catheter which projects in the expected location of collapsed righ... | 1.No acute intracranial process.2.Stable shunted collapsed supratentorial ventricular system and with maintained midline.3.Cerebella parenchymal volume loss and ex vacuo dilatation of the fourth ventricle similar to prior exam. |
Generate impression based on findings. | Female 65 years old Reason: 65 F with metastatic mullerian tumor, hypoxic History: hypoxia PULMONARY ARTERIES: Technically adequate study. The pulmonary trunk is enlarged measuring 3.5 cm in diameter. There is a filling defect in the right main and inferior lobar pulmonary arteries (image 110 and image 107, series 8) c... | 1. Pulmonary emboli in the right main and inferior lobar pulmonary arteries.2. New multifocal nodular opacities and areas of consolidation suggestive of infection possibly septic emboli. If the patient is immunocompromised atypical infection such as fungal or aspergillosis should be included in the differential..3. Sep... |
Generate impression based on findings. | Clinical question: Rule-out intracranial mass, infarct. Signs and symptoms: Headache, transient left-sided weakness. Unenhanced head CT:No detectable acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular syst... | No acute intracranial process or |
Generate impression based on findings. | Abdominal pain there the umbilicus ABDOMEN:LIVER, BILIARY TRACT: Ill-defined, wedge-shaped hypodensity in the liver likely represents perfusion difference.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant... | No CT findings to explain patient's acute abdominal pain. Possible cellulitis involving the umbilicus.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
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