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Generate impression based on findings. | Reason: 47 y/o with hx of Crohn's s/p multiple ab surgeries, SBO, presenting with partial SBO History: 47 y/o with hx of Crohn's s/p multiple ab surgeries, SBO, presenting with partial SBO ABDOMEN:LUNG BASES: Trace pleural effusion at bilateral bases with minimal overlying atelectasis.LIVER, BILIARY TRACT: There is mild intrahepatic and extrahepatic biliary ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Few mildly prominent periaortic lymph nodes.BOWEL, MESENTERY: Evidence of multiple abdominal surgeries. Evidence of colectomy with multiple primary anastomosis. Scattered subcentimeter mesenteric lymph nodes. Mild, diffuse dilation of small bowel compatible with chronic partial obstruction. No evidence of free intra-abdominal air or free fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Scattered, subcentimeter pelvic lymph nodes bilaterally.BOWEL, MESENTERY: Evidence of multiple abdominal surgeries. Evidence of colectomy with multiple primary anastomosis. Scattered subcentimeter mesenteric lymph nodes. Mild, diffuse dilation of small bowel compatible with chronic partial obstruction. No evidence of free intra-abdominal air or free fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Mild interval increase in small bowel dilation consistent with chronic partial obstruction likely from adhesions. No free intra-abdominal air.2.Redemonstration of intrahepatic and extrahepatic biliary ductal dilatation, not significantly changed compared to prior exam. |
Generate impression based on findings. | Reason: 38 y/o with hematuria History: 38 y/o with hematuria ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Mild intrahepatic biliary ductal dilatation. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis, nephrolithiasis, or renal mass. Duplicated left ureter.RETROPERITONEUM, LYMPH NODES: Mildly prominent retroperitoneal lymph nodes.BOWEL, MESENTERY: No evidence of obstruction. The appendix is normal. No pneumoperitoneum or mesenteric free fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Cystic right adnexal lesion measures 4.1 x 3.3 cm and is indeterminate by CT.BLADDER: Bladder wall edema and mucosal enhancement with perivesicular fat infiltration compatible with cystitis.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Cystitis.2.Indeterminate cystic right adnexal lesion. Pelvic ultrasound should be considered as clinically warranted. |
Generate impression based on findings. | Clinical question: Evaluate intracranial process. Signs and symptoms: New onset of delusions. Nonenhanced head CT:There is no detectable acute intracranial process CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Slight prominence of cortical sulci in the frontal convexity similar to prior exam and consistent with parenchymal volume loss at the site.There is also prominence of cerebellar and vermian folia for patient of stated age of 53 concerning for underlying proximal volume loss. This is also a similar observation is prior exam.Extensive chronic findings of calvarial of prior burr hole and bilateral frontal region and in the calcification under the soft tissues of the scalp in the bilateral parietal region suspected of calcified hemorrhage. This findings are identical to multiple prior exams. | No acute intracranial process. |
Generate impression based on findings. | 47-year-old female with history of breast cancer with known metastatic disease and presenting with new right upper quadrant pain ABDOMEN:LUNG BASES: Chest CT will be dictated separately. Posterior mediastinal lymph nodes and extensive palmar embolus involving the right lower lobe pulmonary arteries are noted. Interval enlargement in the size of the paracardiac lymph node.LIVER, BILIARY TRACT: Segments 5, 8 and part of 7 and 6 demonstrate heterogeneous enhancement. Previous described metastatic liver lesion cannot be differentiated from heterogeneously enhancing liver. This may be secondary to increase in size and number of metastatic lesions, hemorrhage into these lesions, fatty infiltration of the liver, perfusion difference or a combination of these factors. MRI of the liver may be helpful for further characterization of these changes in the liver. The liver is also increased and size compared to previous study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: Interval increase in the size of the retroperitoneal lymph nodes. Portacaval lymph node now measures 2.7 x 2.4 cm image number 58, series number 12. This lymph node was measuring 2.1 by 0.9-cm image number 87, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Left adnexal cystic mass measuring 5.7 x 5.3 cm is unchanged on image number 137, series number 12.BLADDER: No significant abnormality notedLYMPH NODES: Index external iliac lymph node measures 8 by 6 mm on image number 124, series number 12, decreased in size compared to previous study.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Lytic appearing lesions in the pelvic bones, sacrum and lumber spine are unchanged and likely represent metastatic disease. Again noted healing fractures.OTHER: No significant abnormality noted | Interval increase in the size of the upper abdominal adenopathy. Index pelvic lymph node is decreased in size.Interva increase in the size of the liver with large areas of heterogeneous enhancement which likely represents interval increase in the size and number of metastatic disease. MRI of the liver may be helpful for further evaluation.Right lower lobe pulmonary embolus and other chest findings. A separate chest report will be dictated for the same day CT of the chest. |
Generate impression based on findings. | Reason: Gallstone pancreatitis? History: Abd pain ABDOMEN:LUNG BASES: Basilar atelectasis.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: Left upper pole cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction. The appendix is normal. No pneumoperitoneum or mesenteric free fluid.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evident cause of the patient's abdominal pain. |
Generate impression based on findings. | 57 year old female with cardiac arrest. History of craniectomy Hardware components of occipital-axial fusion in near-anatomic alignment without radiographic evidence of complication. The scattered post-surgical foci of subcutaneous air are decreased compared to 10/11/13. The degree of basilar invagination appears unchanged from the prior examination. Evaluation of the brainstem and posterior fossa is limited by streak artifact and motion.No evidence of intracranial hemorrhage, mass, or edema. Normal size and configuration of the ventricles and basal cisterns. Mild mucosal thickening of the paranasal sinuses. Normally pneumatized mastoid air cells.Unremarkable visualized portions of the orbits. | Post-surgical changes of an occipital-axial fusion, without acute intracranial abnormality evident. |
Generate impression based on findings. | Female; 40 years old. Reason: 40F w/ SLE w/ multiple episode of syncope, eval for PE History: syncope Minimal contrast was infused into the patient and so findings are based on limited images obtained prior to study being aborted. PULMONARY ARTERIES: Non-diagnostic due to extravasation.LUNGS AND PLEURA: Mild dependent atelectasis/scarring, but no focal consolidation or pleural effusion. Benign appearing micronodules.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Scattered, mildly enlarged mediastinal and supraclavicular lymph nodes. CHEST WALL: Mild axillary lymphadenopathy. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Cholecystectomy clips. | Non diagnostic PE exam due to contrast extravasation as detailed above. |
Generate impression based on findings. | Clinical question: Status post craniotomy for tumor removal. Signs and symptoms: As above. Nonenhanced head CT:Examination demonstrate interval right anterior frontal and temporal large craniotomy for debulking of patient's known meningioma. There is expected postoperative changes of subarachnoid and epidural air collection under the craniotomy flap with resultant subtle mass effect on the right frontal lobe and midline shift of approximately 7 mm through the left at the level of septum pellucidum of the frontal horns.There is edema of the right inferior frontal lobe and with evidence of a small acute hematoma measuring 9 x 6-mm measured on coronal reformatted image image 24.There is widening of subarachnoid space at the level of the bulk meningioma from the basal cistern and along the planum sphenoidal. There is resultant significantly better visualization of pituitary gland and basal cistern. | 1.Interval right frontal -- temporal craniotomy for tumor debulking.2.Right inferior frontal edema and a small hematoma measuring approximately 7 mm.3.P in ost operative changes results in approximately 7 mm leftward midline shift at the level of septum pellucidum.4.Better visualization of basal cistern secondary to removal of tumor. |
Generate impression based on findings. | Reason: SBO History: distention, obstipation ABDOMEN:LUNG BASES: Basilar atelectasis and patchy consolidation.LIVER, BILIARY TRACT: Ascites.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple dilated and fluid filled small bowel loops measuring up to 4.5 cm with associated interloop fluid. There are decompressed small bowel loops in the right lower quadrant (coronal image 51) without a discrete transition point. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. Anterior abdominal wall mesh.OTHER: Multiple surgical staples throughout the abdomen and pelvis.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left iliac bone lytic lesion of indeterminate etiology. Left hip arthroplasty.OTHER: No significant abnormality noted. | 1.Small bowel obstruction with a transition point in the right lower quadrant. Small bowel wall thickening in the midabdomen. Ischemia cannot be excluded.2.Left iliac wing lytic lesion of indeterminate etiology. Metastatic disease cannot be excluded. Correlate for history of malignancy. |
Generate impression based on findings. | Stage 4 poorly differentiated squamous cell carcinoma of the glottic larynx with supraglottic and infraglottic extension status post chemotherapy and radiation. Head: There is a 3 mm diameter within the grey-white matter junction of the left middle frontal gyrus with surrounding vasogenic edema. There is a also 6 mm diameter enhancing nodule within the grey-white matter junction of the left inferior temporal gyrus with surrounding vasogenic edema. There is an ill-defined enhancing focus within the deep white matter of the anterior right frontal lobe without appreciable vasogenic edema, which may represent a portion of a developmental venous anomaly. There is no midline shift or herniation. The ventricles are within normal limits in size and configuration. There is mild scattered paranasal sinus mucosal thickening. The skull and orbits are unremarkable. Neck: There is thickening of the bilateral vocal folds with effacement of the vestibules, left greater than right. There is effacement of the paraglottic fat and irregularity of the anterior thyroid cartilages bilaterally. There is no significant infraglottic extension. There is mild mucosal thickening in the hypopharynx. There is a cluster of enlarged right supraclavicular lymph nodes, the largest of which measures 25 x 13 mm. There are also enlarged upper mediastinal lymph nodes, which are partially imaged. There is also a left apical lung nodule that measures up to 7 mm. Refer to the separate chest CT report for additional details. The nasopharynx, oral cavity and oropharynx are unremarkable. There is a right internal jugular venous catheter. The thyroid and major salivary glands are unremarkable. The major cervical vessels are otherwise patent. There is mild degenerative spondylosis, but no lytic or blastic lesions in the cervical spine. | 1. At least two enhancing intracranial lesions that measure up to 6 mm, which likely represent brain metastases. Brain MRI may be useful for further evaluation.2. Thickening of the bilateral vocal folds with effacement of the vestibules, left greater than right with effacement of the paraglottic fat and irregularity of the anterior thyroid cartilages bilaterally are compatible with known laryngeal carcinoma and superimposed treatment effects. 3. Cluster of enlarged right supraclavicular lymph nodes, the largest of which measures 25 x 13 mm are compatible with metastatic lymphadenopathy. 4. Enlarged upper mediastinal lymph nodes, which are partially imaged and a left apical lung nodule that measures up to 7 mm are also suspicious for metastatic disease. Refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 69-year-old male with known pancreatic head mass ABDOMEN:LUNG BASES: Emphysema.LIVER, BILIARY TRACT: 1.4-cm hypodense lesion near the dome of the liver in image number 18, series number 10, suspicious for metastatic disease.SPLEEN: No significant abnormality notedPANCREAS: Large pancreatic head mass measuring 4 by 3.1 cm image number 56 on series number 10 invading the splenic vein, SMA and SMV. Plastic stent in the distal common bile duct. There is nonocclusive thrombus in the distal branches of the SMV.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites is present.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Locally invasive large pancreatic adenocarcinoma with lesion suspicious for metastatic disease in the liver. |
Generate impression based on findings. | Reason: 54 yo M with hx of HCV/Etoh cirrhosis transferred from OSH for incarcerated inguinal hernia repair, now with abdominal pain, leukocytosis, eval for source of infection, also with cough, eval for improving pneumonia History: abdominal pain, leukocytosis, cough CHEST:LUNGS AND PLEURA: Right basilar scarring with a peripheral tree in bud abnormality in the right lower lobe. Few scattered pulmonary nodules. New right lower lobe nodule measures 6 mm (series 4, image 51). Centrilobular emphysema. No pleural effusions. MEDIASTINUM AND HILA: Prominent supraclavicular lymph nodes. Heart size is normal without pericardial effusion. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cirrhosis with ascites. Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Free intraperitoneal air. Dilated small bowel loops measuring up to 3.2 cm without a transition point. No loculated fluid collections.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Fluid filled bilateral inguinal hernias.OTHER: No significant abnormality noted. | 1. Free intraperitoneal air. Correlate with surgical date.2. Dilated small bowel loops without transition point suggests post-operative ileus.3. No drainable fluid collections.4. New right pulmonary nodule. |
Generate impression based on findings. | Reason: PE History: sob PULMONARY ARTERIES: One suboptimal opacification of the pulmonary arterial tree. No large central pulmonary emboli can be identified.LUNGS AND PLEURA: Decreased lung volumes with elevation right hemidiaphragm.Areas of the scarring and atelectasis noted medially in the right upper and lower lobes.Focal subpleural groundglass opacity in left upper lobe may represent an area of hemorrhage or infarction.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of the pericardial effusion.Mild coronary artery calcification.CHEST WALL: Multiple old rib fractures bilaterally. Right shoulder arthroplasty. Partial collapse of several thoracic vertebrae unchanged from the prior exam.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple right renal cysts unchanged from the prior exam. | 1.Limited exam demonstrates no evidence of large central pulmonary emboli.2.Decreased lung volumes with elevation right hemidiaphragm.3.Focal subpleural groundglass opacity in the left upper lobe may represent an area of hemorrhage or infarction. |
Generate impression based on findings. | Reason: Head and neck cancer. Baseline evaluation. History: as above Reason: Head and neck cancer. Baseline evaluation. History: as above CHEST:LUNGS AND PLEURA: A partially necrotic, nodular mass extends from the right infrahilum into the right lower lobe. This encircles the central right lower and middle lobe bronchi, mildly narrowing the majority of them and obstructing the bronchus to the anterior basal segment. Associated postobstructive atelectasis. Because of its configuration, it is difficult to measure. However, on axial images a reference measurement is 4.1 x 4.6 cm (series 4 image 58). It extends from the hilum into the lower lobe over a length of approximately 6 cm (series 80232 image 41).There are several pulmonary nodules within the left lung that are suspicious for metastases. A reference nodule in the left upper lobe (series 5 image 27 measures 7 x 8 mm). A several additional upper lobe nodules occupy the apex of the posterior pleural surface and anterolateral subpleural location.A second referenced pulmonary nodule is pleural-based at the posterior basal segment left lower lobe (series 5 image 59). This measures 10 x 10 mm). An additional nodule is noted within the left lower lobe, adjacent to the diaphragm (series 5 image 67).No pleural effusion.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. Enlarged high right paratracheal lymph node measuring 2.8 cm (series 4 image 21). Right hilar lymphadenopathy is contiguous with the previously described mass. No left hilar lymphadenopathy. Mild subcarinal lymphadenopathy. Mildly enlarged right paraesophageal lymph node at the hiatus.CHEST WALL: Right port catheter terminates the central superior vena cava.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Low-density lesion within the left hepatic lobe a incompletely characterized.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | A partially necrotic, nodular mass extends from the right infrahilum into the right lower lobe with associated postobstructive atelectasis of the right lower lobe.Right high paratracheal adenopathy.Multiple pulmonary nodules on the left compatible with metastases. |
Generate impression based on findings. | Female; 40 years old. Reason: r/o PE History: syncope No contrast was infused into the patient and so findings are based on limited images obtained prior to study being aborted. PULMONARY ARTERIES: Nondiagnostic study of the pulmonary arteries due to contrast extravasation as detailed above. | Nondiagnostic exam of the pulmonary arteries due to contrast extravasation and resultant early termination of the study. |
Generate impression based on findings. | Reason: anasarca/ascites - eval liver triple phase History: anasarca/ascites CHEST:LUNGS AND PLEURA: Partially calcified nodule in the right lung and calcified hilar lymph nodes.Follow-up on repeat scans is indicated.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Liver with cirrhotic appearance. Cholelithiasis. There is no gross evidence of acute cholecystitis although CT is insensitive in in characterizing gallbladder disease in the setting of ascites. Portal vein appears patent. Hepatic vasculature appears patent. There is an ill-defined area of possible arterial enhancement right lobe of the liver, segment 5 (series 80792, image 59) which has questionable washout in the delayed phase. Increased amount of ascites limits evaluation of this lesion.SPLEEN: Mild splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonenhancing subcentimeter hypodense lesion in the superior pole of the right kidney likely represents a benign renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Portosystemic collaterals seen in the abdominal wall, caput medusae.OTHER: Large amount of abdominal ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Lytic lesion in the right iliac bone.OTHER: No significant abnormality noted | 1.Questionable lesion in the right lobe of the liver. Follow up imaging with MR after paracentesis would be useful. 2.Cirrhotic liver with large amount of ascites and portosystemic collaterals.3.Partially calcified nodule in the right lung with calcified hilar lymph nodes. |
Generate impression based on findings. | Reason: Evaluate for fluid collection/abscess, Pneumonia History: uptrending WBC, confusion CHEST:LUNGS AND PLEURA: Low lung volumes with basilar atelectasis/consolidation and small pleural effusions.MEDIASTINUM AND HILA: Endotracheal tube terminates above the level of the carina. Right central catheter tip terminates in the right atrium. Thrombus in the right internal jugular vein. Heart size is normal without pericardial effusion. Nonspecific mediastinal lymphadenopathy, unchanged.CHEST WALL: Right chest wall fluid collection with surrounding surgical clips, unchanged.ABDOMEN:LIVER, BILIARY TRACT: Scattered hypodensities are too small to further characterize, but likely benign.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. There is fluid in the surgical bed, unchanged. Hyperdense left upper pole lesion is indeterminate, but unchanged. Atrophic left kidney.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdomen aorta and its branches.BOWEL, MESENTERY: Interval placement of two percutaneous abdominal drains. Loculated fluid collection in the left hemi-abdomen measures 2.6 x 2.3 cm (series 4, image 115) decreased in size from the prior exam. Interval resolution of left lower quadrant fluid collection. Mild mesenteric fat stranding. Right lower quadrant ileostomy. No evidence of bowel obstruction. BONES, SOFT TISSUES: Body wall edema.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Interval placement of percutaneous abdominal drains with interval decrease / resolution of two abdominal fluid collections.2.Bilateral pleural effusions.3.Right IJ thrombus. |
Generate impression based on findings. | Reason: evaluate for PE History: chest pain, SOB PULMONARY ARTERIES: Technically adequate exam demonstrates no evidence of pulmonary emboli. The pulmonary artery is of normal caliber.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Cardiac size is normal without evidence of pericardial effusion.No hilar or mediastinal lymphadenopathy.CHEST WALL: Degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable left adrenal nodule. | No evidence of pulmonary emboli. No significant cardiopulmonary abnormalities. |
Generate impression based on findings. | Reason: stroke History: stroke status post revascularization and reperfusion There is redemonstration of a patchy hypodensity in the inferior aspect of the right cerebellar hemisphere and a new patchy hypodensity in the superior aspect of the right cerebellar hemisphere. In addition there is a new hypodensity in the medial posterior aspect of the left occipital lobe.There is redemonstration of a marked atherosclerotic calcifications along the distal vertebral arteries left more than rightThe hyperdense basilar artery sign identified on the early 10/14 exam has resolved.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage.2.Patchy hypodensities in the right cerebellar hemisphere and left occipital lobe are compatible with acute infarctions |
Generate impression based on findings. | Reason: eval for PE, rib metastases History: new DVT, pleuritic pain PULMONARY ARTERIES: Large pulmonary emboli occupying the right and left pulmonary arteries, nearly obstructive within the distal right pulmonary artery. This large clot burden extends into the right superior and inferior lobar arteries. The proximal right inferior lobar artery is markedly expanded and appears focally obstructed (series 9 image 111). Right inferior segmental and subsegmental, right middle lobe segmental and subsegmental pulmonary emboli are present. On the left, clot burden is decreased when compared to the right. However, emboli do extend into the right superior segmental and subsegmental branches. The right descending bulbar pulmonary artery is filled free of filling defect. Several nodules abut the left lower lobe segmental and subsegmental arteries without evidence of significant filling defect.LUNGS AND PLEURA: Multiple pulmonary nodules that have decreased in size and number when compared to the outside study. Reference pulmonary nodule in the right upper lobe measures 7 x 11 mm (series 10 image 34).Posterior pleural based ground glass may represent pulmonary hemorrhage with associated infarct (series 10 image 72).MEDIASTINUM AND HILA: The heart size is normal. Particular attention is made to the right ventricle which is not enlarged (not larger than that of the left). Despite the large clot burden, there is no significant flattening nor leftward bowing noted the intraventricular septum. No contrast reflux is noted into the suprahepatic IVC. Enlarging right cardiophrenic lymphadenopathy.Mediastinal lymphadenopathy in the prevascular, paratracheal, AP window and subcarinal locations. Reference subcarinal lymph node measures 3.2 x 4.0 cm (series 9 image 101). Bilateral hilar lymphadenopathy.CHEST WALL: Hilar lymphadenopathy. There is irregularity of left lateral inferior rib (series 10 image 140) which may represent metastasis.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Minimal perihepatic ascites in the limited visualization of the upper abdomen. Evidence of prior cholecystectomy. There is subtle low density does diffuse within the right and left hepatic lobes (series 9 image 238) that is better characterized on the CT upper abdomen and pelvis performed on the same day, compatible with metastases. Porta hepatis lymphadenopathy.Multilevel degenerative changes of the thoracic spine. | Large pulmonary emboli occupying the right and left pulmonary arteries, nearly obstructive within the distal right pulmonary artery. This large clot burden extends into the right superior and inferior lobar arteries. The proximal right inferior lobar artery is markedly expanded and appears focally obstructed. Posterior pleural based ground glass may represent pulmonary hemorrhage with associated infarct. Multiple pulmonary nodules compatible with metastases that have decreased in size and number when compared to the outside study.Relatively stable mediastinal and hilar lymphadenopathy. |
Generate impression based on findings. | Male; 59 years old. Reason: rule out pe History: sinus tachycardia PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary trunk demonstrates normal caliber.LUNGS AND PLEURA: Basilar atelectasis/scarring without focal consolidation or significant pleural effusion. Upper lobe predominant centrilobular emphysema. Mild bronchial wall thickening. Multiple scattered calcified granulomas but no suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Multiple calcified mediastinal and hilar nodes are compatible with prior granulomatous infection. Esophageal wall thickening may represent esophagitis. Note is made of anomalous left upper lobe pulmonary venous return via drainage through a left-sided SVC to the systemic circulation. CHEST WALL: Mild multilevel degenerative changes of the visualized spine. No axillary or subpectoral lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism. 2.Mild bronchial wall thickening and basilar atelectasis/scarring without focal lung opacity. Findings may represent bronchitis or asthma. 3.Anomalous left upper lobe pulmonary venous return as described above, a normal variant. |
Generate impression based on findings. | Clinical question: Check prior to heparin drip. Signs and symptoms: Check prior to heparin drip. Nonenhanced head CT:Examination demonstrates no evidence of acute intracranial hemorrhage no evidence of hemorrhagic conversion of a large right hemispheric subacute ischemic stroke.Extent, overall morphology and size of the right hemispheric subacute stroke remains identical to prior exam.Normal size of ventricular system and without interval change.Resultant mass-effect and 6-mm midline shift to the left also remains identical to prior study.Stable postoperative changes of a large right sided craniectomy for decompression of ischemic stroke.Stable small extra-axial hemorrhage in the right temporal -- frontal region similar to prior exam. | 1.No convincing evidence of any acute new finding since prior exam.2.Stable nonhemorrhagic very large right hemispheric subacute ischemic stroke and its associated mass effect and 6-mm leftward midline shift.3.Stable normal size of ventricular system since prior exam.4.Stable small amount of subdural blood product at the level of the craniectomy since prior exam. |
Generate impression based on findings. | Reason: eval postop changes History: s/p mechanical thrombectomy The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a patchy hypodensity in the inferior aspect of the right cerebellar hemisphere. There is contrast present within the intracranial vasculature now. There is no evidence for hemorrhagic conversionThere is redemonstration of marked atherosclerotic calcifications in the distal vertebral arteries left more than rightThe visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage.2.Findings are compatible with acute stroke involving the right cerebellar hemisphere |
Generate impression based on findings. | Male 71 years old Reason: history of calcified lung nodules LUNGS AND PLEURA: Calcified left lower lobe nodule compatible with a granuloma unchanged. No suspicious pulmonary nodules or mass identified. No pleural effusions.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease unchanged.Multiple hypodense lesions in the thyroid compatible multinodular goiter. Moderate coronary artery calcifications, predominately the left anterior descending artery.Normal heart size and no pericardial effusion.Small hiatal hernia.CHEST WALL: Multilevel degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Fatty infiltration of the liver. Punctate calcifications in the splenic parenchyma compatible with prior granulomas disease. | Evidence of prior granulomatous disease. No suspicious pulmonary nodules. No follow-up recommended. |
Generate impression based on findings. | Reason: 54 male with AML, neutropenic fever. r/o sinusitis History: Neutropenic fever The ostiomeatal complex units are patent bilaterally. There is some mild mucosal thickening present along the ostiomeatal complex units but they are patent. Within the nasal cavity no obstructive lesions are appreciated.The frontal sinuses are clear.Maxillary sinuses demonstrate some mild mucosal thickening along the left maxillary sinus and to a lesser degree right maxillary sinus. Ethmoid air cells are clear . Sphenoid sinuses are clear. There is opacification along the posterior nasopharynx probably related to retained secretions and apposition of the soft palate against the nasopharynx.Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. | 1.No evidence for paranasal sinus outlet obstruction.2.No convincing evidence for acute sinusitis.3.There is some mild opacification of maxillary sinuses due to mucosal thickening which is likely inflammatory |
Generate impression based on findings. | Female; 60 years old. Reason: h/o HNC, CRT, compare to previous, measurements pls LUNGS AND PLEURA: Postoperative changes consistent with left upper lobectomy. Scattered punctate micronodules are again noted and unchanged. No suspicious pulmonary nodules or masses. Upper lobe predominant centrilobular emphysema. No focal consolidation or pleural effusion. Mild right basilar scarring.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Aortic arch and coronary calcifications are again noted.CHEST WALL: Right chest port tip at confluence of brachiocephalic veins. No axillary lymphadenopathy. Left axillary epidermoid inclusion cyst.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Cholecystectomy clips. Left upper pole renal cyst is unchanged. | Stable interval exam without evidence of metastatic disease. |
Generate impression based on findings. | Recurrent squamous cell carcinoma of the nasopharynx status post surgery, chemotherapy and radiation. Research scan for Merck MK3475-012 Study (IRB13-0311). Head: There are post-treatment findings in the nasopharynx, central skull base, and sinonasal region. There is ill-defined enhancing tissue intermixed with trapped secretions and air within the posterior nasopharynx extending into the clivus and left petrous apex, which has decreased in size since the MRI from August 2013, now measuring approximately 18 mm AP x 22 mm SI, previously 23 mm AP x 35 SI, accounting for differences in technique. However, the residual tumor is difficult to discern from adjacent areas of presumed mucositis. There is also persistent epidural extension and cavernous sinus involvement. There is no significant stenosis of the carotid arteries. There is no mass effect upon the brain. There is no abnormal enhancement within the brain parenchyma. The ventricles are stable in size and configuration. There is complete left tympanomastoid opacification and partial right mastoid opacification. There is scattered paranasal sinus mucosal and an air fluid level within the right maxillary sinus. The orbits are unremarkable. There are retrosomatic and posterior arch C1 defects, which are normal variants.Neck: Aside from the nasopharyngeal mass with skull base invasion, no other mass lesions or significant cervical adenopathy is identified in the neck. The aerodigestive track is patent. The thyroid gland is unremarkable. There is a right internal jugular venous catheter. The major cervical vessels are patent. The imaged portions of the lungs are clear. There are no lytic or blastic lesions in the cervical spine. | 1. Post-treatment findings in the nasopharynx, central skull base, and sinonasal region with interval decease in size of the ill-defined nasopharyngeal carcinoma extending from the the posterior nasopharynx extending into the clivus and left petrous apex, now measuring approximately 18 mm AP x 22 mm SI, although the tumor is difficult to discern from presumed adjacent inflammation. MRI with contrast may be useful for further delineation.2. No evidence of brain metastases or significant cervical lymphadenopathy. |
Generate impression based on findings. | Reason: rule out thymic hyperplasia or thymoma History: ptosis, fatiguable weakness There is a mediastinal lipomatosis present at 10 the thymus does not appear to be particularly enlarged. There is generalized atrophy of head and neck musculatureWithin the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact. The vertebral arteries are relatively small as is the basilar artery. This is often related to bilateral fetal origins of posterior cerebral arteries, however the circle of Willis is not included on exam to further evaluate.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. The template number two osteophytes present at C5-6 and C6-7. There is no significant compromise of spinal canal or exiting nerve roots appreciated on this exam. | 1.No evidence for thymoma or an enlarged thymus.2.There is generalized atrophy of the visualized head and neck musculature. |
Generate impression based on findings. | Left knee swelling, abnormal Doppler. Evaluate for cause of swelling. There is a large joint effusion with enhancing synovium extending approximately 9 cm craniocaudally from the patella with a transverse dimension of approximately 7 cm. There is posterior extension of the effusion into the popliteal fossa. There is subchondral sclerosis in the lateral tibial plateau and small medial and lateral compartment osteophytes. There is sclerosis of the lateral femoral condyle which is degenerative in etiology. No fracture is evident. | 1. Large joint effusion of the knee.2. Degenerative changes of the knee as described above without fracture evident. |
Generate impression based on findings. | Reason: 54 male with AML, neutropenic fever. r/o infiltrate History: Neutropenic fever LUNGS AND PLEURA: Multiple poorly marginated opacities with a nodular configuration are consistent with atypical pneumonia, especially of a fungal etiology.No significant sized pleural effusions are present.MEDIASTINUM AND HILA: There is no significant mediastinal or hilar lymphadenopathy.Heart size is normal although there are severe coronary calcifications and low attenuation of the circulating blood pool consistent with anemia.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips are present, otherwise grossly unremarkable limited upper abdomen views. | Multi-focal pneumonia likely fungal in etiology. |
Generate impression based on findings. | Reason: ich History: ich There is redemonstration of a right hemispheric hematoma associated with an drainage catheter. The hematoma appears very similar compared to prior exams measuring 45 mm in width and 22 mm AP dimension which is very similar prior exams. Please note that this hematoma is irregular. A right thalamic hematoma measuring 8 mm in diameter and is still present. Intraventricular blood is still present. Midline shift is still present. There is a shift of the septum pellucidum approximately 14 mm to the left of midline which previously was the same.There is redemonstration of the ventriculostomy tube coursing through the left frontal lobe into the left lateral ventricle with the tip in the frontal horn.The visualized portions of the paranasal sinuses demonstrate mucosal thickening and partial opacification with air fluid levels in the sphenoid sinuses status-post intubation. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.The examination is stable compared to yesterday's exam. There is redemonstration of a large right hemispheric hematoma associated with a midline shift and intraventricular hemorrhage and a left-sided ventriculostomy tube. |
Generate impression based on findings. | Reason: ich History: ich There is redemonstration of the ventriculostomy tube which course of the right frontal lobe into the right lateral ventricle with the tip in the region of foramen of Monroe. Horns of the lateral ventricles remain mildly dilated. Biventricular diameter and appears stable when compared to the prior exam with a 32 mm at the level of the entry point of the ventriculostomy tube on coronal imaging.Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact, however there appears to be some bulging in the optic nerve heads. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Stable position of ventriculostomy tube .3.Stable size The appearance of optic nerve heads is unchanged and suggestive of a possible papilledema. Please correlate with clinical history and the intracranial pressure and with funduscopic findings4.Stable size of lateral ventricles which are mildly dilated5.Periventricular and subcortical white matter changes of a mild degree are nonspecific. They are unusual at age 39 but most likely treatment related. |
Generate impression based on findings. | Reason: 71 y/o male with RLE numbness, MRI findings questioning for iliacis hematoma. Please evaluate. History: Hematoma ABDOMEN:LUNG BASES: Scattered pulmonary micronodules. Near resolution of previously described pleural effusions and basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Accessory splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Fused supernumerary kidneys. Nephrolithiasis and simple cysts noted in the most superior kidney.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: Percutaneous drain within a decreasing right anterior abdominal wall fluid collection measuring 5.1 x 0.8 cm (series 3, image 105), previously 7.2 x 1.5 cm. Decreasing left anterior abdominal wall fluid collections. No evidence of bowel obstruction. Left lower quadrant ostomy.BONES, SOFT TISSUES: Bilateral iliac is collections compatible with hematomas, unchanged from the prior exam. Superimposed infection cannot be excluded.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Thickened bladder wall. Foley catheter is presentLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right hip arthroplasty.OTHER: No significant abnormality noted | 1. Bilateral iliacus collections are unchanged and suggest hematomas. Superimposed infection can not be excluded.2. Decreasing anterior abdominal wall fluid collections. |
Generate impression based on findings. | 86 year old female with altered mental status. Evaluate subdural hematoma. Left pterional craniotomy changes are again noted, with postsurgical air in the left subdural space. The left convexity heterogeneous subdural hematoma is unchanged at 7 mm thick when measured similarly (coronal series 80356, image 43). It demonstrates areas of lower density when compared to the prior exam, consistent with expected evolution of blood products. The right holohemispheric heterogeneous subdural hematoma measures 7 mm thick, previously 8 mm when measured similarly (coronal series 80356, image 43). A small component of the hematoma is seen along the midline at the falx, stable in appearance. There are no findings to suggest interval new hemorrhage. The midline shift measures 2 mm, minimally decreased.Normal size and configuration of the ventricles and basal cisterns. There are diffuse deep and periventricular white matter hypodensities likely related to small vessel ischemic changes. Minimal mucosal thickening of the left maxillary sinus, otherwise normally pneumatization of the paranasal sinuses and mastoid air cells. | 1. Bilateral evolving subdural hematomas, without significant interval change in size.2. No evidence of new acute hemorrhage. |
Generate impression based on findings. | Reason: 24F w/ h/o perforated gastic antrum s/p ex lap represents from LTAC w/ uptrending WBC and worsening anemia, eval for intraabd infection, abscess; no focal abd pain History: elevated WBC, no focal abd pain CHEST:LUNGS AND PLEURA: Increasing right pleural effusion and decreasing left pleural effusion. Improving upper and middle lobe consolidation compatible with infection.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Unchanged subcapsular fluid.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal medullary calcifications, unchanged. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Intra-abdominal ascites has decreased from the prior exam. Loculated fluid collection in the left lower quadrant measures 11.9 x 3.5 cm (coronal image 50). Nonspecific colonic wall thickening has improved from the prior exam. No pneumoperitoneum. BONES, SOFT TISSUES: There is an extensive soft tissue loculated fluid collection with internal foci of gas extending superiorly to the level of the midthoracic spine (sagittal image 64).OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter with intravesicular air, likely iatrogenic.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Soft tissue defect in the region of the sacrum compatible with a decubitus ulcer. Multiple rim enhancing collections with internal gas in the ischiorectal fossa, some of which appear inseparable from the rectum and anus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Increasing enhancing fluid collections with internal gas extending up the posterior soft tissues of the back and extending into the ischiorectal fossa. Some collections appear inseparable from the rectum and anus. The possibility of fistulous communication with the bowel can not be excluded. Necrotizing fasciitis is a differential consideration.2.Medullary calcifications suggest papillary necrosis. |
Generate impression based on findings. | Reason: r/o colitis, teflitis - aware this will be sub-optimal without IV contrast History: neutropenia, LLQ ab pain, diarrhea ABDOMEN:LUNG BASES: Mild dependent atelectasis bilaterally.LIVER, BILIARY TRACT: Gallbladder sludge without evidence of cholelithiasis or cholecystitis. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Status post right adrenalectomy.KIDNEYS, URETERS: Status post right nephrectomy. Small stone in the left kidney with a hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered mesenteric lymph nodes. Evaluation of bowel wall thickness is limited without IV contrast. No pericolonic or mesenteric fat stranding to indicate acute inflammation of the bowel.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No pericolonic or mesenteric fat stranding to indicate acute inflammation of the bowel.BONES, SOFT TISSUES: Two sclerotic foci in the left femoral head. Punctate sclerotic focus in the left femoral neck.OTHER: No significant abnormality noted. | 1.Lack of IV contrast limits the evaluation of bowel wall thickness. No pericolonic or mesenteric fat stranding to suggest acute inflammatory process involving the bowel.2.Mildly prominent mesenteric lymph nodes may be of infectious, inflammatory, or neoplastic in etiology.3.Nonobstructing renal stone in the left kidney. |
Generate impression based on findings. | Colon carcinoma CHEST:LUNGS AND PLEURA: Stable emphysema. Stable calcified granulomas and micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant change in numerous bilobar low attenuation lesions. Reference segment 2 lesion best seen on image 91 of series 3 measures 1.1 x 0.9 cm. Reference segment 8 lesion best seen on image 91 of series 3 measures 1.3 x 0.9 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral renal cystsRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Stable enlarged prostateBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination |
Generate impression based on findings. | Reason: evalaute for intrabdominal pathology History: RLQ pain after unknown blunt trauma ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Calcified hepatic granulomata. SPLEEN: Calcified splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No pneumoperitoneum or mesenteric free fluid.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No acute intra-abdominal abnormality. |
Generate impression based on findings. | Reason: evaluate upper urinary tracts for stones, malignancy History: microscopic hematuria, irritative voiding symptoms ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Punctate calcifications in the liver likely represent granulomata. No suspicious hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of obstructing ureteral stone. No evidence of nephrolithiasis. No filling defects in the left ureter. The right distal ureter is not opacified and is likely due to peristalsis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Few scattered sigmoid diverticulosis. The appendix is normal in appearance.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No nephrolithiasis, hydronephrosis or evident focal mass. |
Generate impression based on findings. | Male 78 years old; Reason: Eval after 10 cycles of Sutent per IRB 11-0049 History: hx/o RCC CHEST:LUNGS AND PLEURA: Moderate emphysema affects the upper lobes of the lungs. There are a few scattered pulmonary micronodules some of which are calcified. No dominant lung lesion. There are trace effusions.MEDIASTINUM AND HILA: Heart size is normal. Small pericardial effusion.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Hypodense segment 7 lesion measures 1.3 x 1.3 cm (image 88/series 3) previously, 1.3 x 1.1 cm. The inferior segment 7 lesion measures 1.5 x 1.1 cm (image 94/series 3) previously, 1.8 x 0.9 cm.No definite new hepatic lesions. No ductal dilatation.SPLEEN: Probable residual splenic tissue located posterior medially.PANCREAS: No significant abnormality notedADRENAL GLANDS: Adrenalectomy.KIDNEYS, URETERS: Status post left nephrectomy. No hydronephrosis the right kidney. Multiple right renal cysts some of which are hyperdense and possibly are hemorrhagic cysts.RETROPERITONEUM, LYMPH NODES: Reference portacaval lymph node measures 2.9 x 1.4 cm (image 116/series 3) previously, 2.5 x 1.3 cm.BOWEL, MESENTERY: Colonic wall thickening and edema involving the cecum and ascending colon with adjacent fluid. No bowel obstruction is evident.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic foci in the right ilium are unchanged.OTHER: No significant abnormality noted | 1.Minimal change in the size of the reference lesions.2.Colonic wall thickening and edema involving the ascending colon. |
Generate impression based on findings. | Female 57 years old Reason: Metastatic breast cancer on treatment, evaluate for response and extent of disease. History: Metastatic breast cancer on treatment, evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Persistent occlusion of the bronchus intermedius secondary to a right infrahilar soft tissue mass with associated near complete right middle and lower lobe atelectasis. Persistent traction bronchiectasis of the perihilar region, likely related to radiation changes.Interval decrease in one of the reference nodules and remainder are stable:Right middle lobe reference nodule measures 20 x 14 mm (image 44, series 4), previously 25 x 15 mm.Reference perifissural left lower lobe nodule measures 17 x 11 mm (image 36, series 4), previously 17 x 11 mm.Reference paramediastinal nodularity in the left upper lobe measures 9 mm (image 28, series 4), previously 9 mm.Additional pulmonary nodule abutting the left mediastinum lateral to the left transverse arch measures 13 mm (image 22, series 4), previously 13 mm. New satellite nodules seen surrounding this nodule.Multiple, mostly subpleural non-referenced nodules largely unchanged.MEDIASTINUM AND HILA: Right chest wall Port-A-Cath with the tip in the right atrium.Reference lower right paratracheal node measures 7 mm (image 35, series 3), previously 12 mm.Right inferior mediastinal mass encasing the right inferior pulmonary vein and right descending pulmonary artery not significantly changed. Minimal coronary artery calcifications.CHEST WALL: Bilateral mastectomy with bilateral saline implants intact. Right chest Port-A-Cath. No significant axillary, subpectoral or supraclavicular lymphadenopathy. Sclerotic focus in the posterior T1 vertebral body suspicious for osseous metastasis.Right rib fracture again noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic metastases unchanged: largest measures 2.6 x 1.7 cm (image 20, series 3), previously 2.6 x 1.7 cm.SPLEEN: Nonspecific stable hypodensity in the posterior spleen unchanged.ADRENAL GLANDS: Unchanged nonspecific nodularity of the left adrenal gland.KIDNEYS, URETERS: Bilateral renal cysts unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference gastrohepatic lymph node measures 19 x 12 mm (image 87, series 3), previously 19 x 12 mm.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic focus in a posterior T1 vertebral body suspicious for osseous metastasis.OTHER: No significant abnormality noted. | 1. Sclerotic focus in the T1 vertebral body concerning for osseous metastasis.3. Interval decrease of one reference pulmonary nodule and stable remaining pulmonary nodules, and new satellite nodules associated with non-referenced nodule.3. Interval decrease in size of the reference right paratracheal node.4. Stable hepatic metastases and gastrohepatic node. |
Generate impression based on findings. | Reason: rule out thymic hyperplasia or thymoma. Eval for lung nodules or infiltrates History: positive AChR ab, ptosis, fatiguable weakness, sob LUNGS AND PLEURA: Mild basilar scarring/discoid atelectasis.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Hilar or mediastinal lymphadenopathy.No evidence of an anterior mediastinal mass or thymic hyperplasia.Cardiac size is normal without evidence of the pericardial effusion.CHEST WALL: Evident changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | The no significant cardiopulmonary abnormalities. Specifically no evidence of an anterior mediastinal mass or thymic hyperplasia. |
Generate impression based on findings. | Reason: Pt with Tonsil ca sp 10-069 (CRT) in 4/201. Please re-eval and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: Benign appearing punctate micronodules, but no evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Mild upper esophageal thickening.No evidence of mediastinal or hilar lymphadenopathy.Aortic calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.Moderate bilateral gynecomastia is present.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted, although there is a small accessory splenule.ADRENAL GLANDS: Enlarged, nodular, stable left adrenal gland. Small nodule right adrenal.KIDNEYS, URETERS: Hypodense cystlike lesions are stable.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aortic calcifications and thrombus extending into the proximal left iliac, unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No change, and no evidence of metastases. |
Generate impression based on findings. | Reason: T4BN0 SNUC HNC s/p resection f/b TFHX 10/1/08. please re-eval for recurrence History: as above CHEST:LUNGS AND PLEURA: 4-mm groundglass nodule left upper lobe (image 65 series 4) compatible with atypical adenomatous hyperplasia.No suspicious pulmonary nodules or masses.Azygos pseudo-lobe redemonstrated.MEDIASTINUM AND HILA: Calcified hypoattenuating nodule in the left lobe of the thyroid gland unchanged.Calcified left hilar lymph nodes and mediastinal nodes compatible with prior granulomatous disease.Residual thymic tissue redemonstrated.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable right lobe hypodensity most likely representing a cyst.SPLEEN: Numerous calcifications compatible with a prior granulomatous disease.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Duplicated IVC considered to be a normal variant. | No interval change. No evidence of metastatic disease. |
Generate impression based on findings. | Female; 63 years old. Reason: pt with lung ca s/p lobectomy and h/o breast ca History: now needs disease evaluation compare to previous scans and comment. CHEST:LUNGS AND PLEURA: Postsurgical changes compatible with right upper lobectomy and mediastinal lymphadenectomy are again noted. The soft tissue lesion along the craniocaudal suture line in the right lung has increased in size and now measures 1.7 x 1.4 cm, previously 1.1 x 0.6 cm (series 5, image 77). No new suspicious pulmonary nodules or masses. Mild diffuse centrilobular emphysema. Mild basilar scarring as well as left upper lobe peripheral areas of scarring/atelectasis. No focal consolidation or pleural effusion. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Postsurgical changes and lymphedema s/p left mastectomy are stable. Right fifth and sixth rib deformities are compatible with prior trauma. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Punctate hypoattenuating foci are again noted but too small to characterize. No suspicious hepatic lesions or biliary ductal dilatation. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Unchanged hypoattenuating right adrenal focus, most likely a benign cyst. KIDNEYS, URETERS: Exophytic right renal cyst. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic focus in L5 vertebral body is most likely a bone island. OTHER: No significant abnormality noted. | 1.Postsurgical changes compatible with right upper lobectomy and mediastinal lymphadenectomy, with interval increase in size of soft tissue lesion along the craniocaudal suture line in the right lung. This finding is suspicious for tumor recurrence.2.No additional sites of disease identified. |
Generate impression based on findings. | Reason: evaluate for disease progression/metastasis. History: angiosarcoma of T spine. 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:CHEST:LUNGS AND PLEURA: Motion limits the elevation of the lung base. Right lower lobe nodular opacity is not seen on this study.MEDIASTINUM AND HILA: Mild cardiomegaly. Stable appearance of mediastinal lymphadenopathy. Reference pretracheal lymph node measures 1.2 x 2.7 cm (series 3, image 31) remains grossly unchanged compared to prior exam. Atherosclerotic calcification of the aortic arch and coronary arteries.CHEST WALL: Postsurgical changes of the thoracic spine is again seen. Stable posterior paraspinal soft tissue density, likely postsurgical.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Punctate calcification in the caudate lobe may represent granulomata.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate calcifications in bilateral kidneys, left greater than right may represent vascular calcifications or nonobstructing nephrolithiasis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Osteopenic changes to pelvis.OTHER: No significant abnormality noted | Lack of intravenous contrast and motion limits the assessment. Stable examination. |
Generate impression based on findings. | Reason: lung cancer History: s/p lung resection LUNGS AND PLEURA: Right lower lobectomy with right hemithorax postsurgical volume loss and pleural thickening. Nonspecific ground glass opacity throughout the right lung has not changed. There is no evidence of tumor recurrence.Right intrapulmonary lymph node unchanged, image 64 series 4.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Severe coronary artery calcification is present. CHEST WALL: Gynecomastia is unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Stable left adrenal enlargement and vascular calcifications are present. | Prior right lower lobectomy, without evidence of tumor recurrence. |
Generate impression based on findings. | Reason: s/p LVAD with respiratory failure f/u lung mass History: f/u lung mass LUNGS AND PLEURA: Increasing size of the previously identified cavitary nodule within the peripheral right upper lobe. This currently measures 3.1 x 3.1 cm (High resolution series 5 image 133), as compared to 2.5 x 2.7 cm. Increasing internal consolidation. No extension into the chest wall. This remains suspicious for infection, with etiologies such as aspergillus or less likely nocardia. Although lower in the differential, vasculitis may be considered.Basilar patchy consolidation in within the lower lobes is not significantly changed, suspicious for a component of infection. Diffuse coarse ground glass opacity has not significantly decreased. Although a component represents edema, pulmonary hemorrhage is a consideration.MEDIASTINUM AND HILA: The heart remains significantly enlarged with severe left ventricular chamber dilatation. Left ventricular assist device at the apex. Left biventricular AICD is in place.Patient remains intubated. Stable size low right paratracheal lymph node.Enteric tube projects to the stomach.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Increasing size of the previously identified cavitary nodule within the peripheral right upper lobe. This currently measures 3.1 x 3.1 cm (High resolution series 5 image 133), as compared to 2.5 x 2.7 cm. Increasing internal consolidation. No extension into the chest wall. This remains suspicious for infection with details above. |
Generate impression based on findings. | Patient with previous left shoulder infection, and antibiotic spacer in place. Evaluate glenoid bone stock for TSA/RTSA. CT images of the left shoulder demonstrate contrast that stays within the shoulder joint and does not communicate with the subacromial bursa indicating an intact rotator cuff. There are osteophytes and subchondral cysts in glenoid compatible with severe degeneration of the articular surface of the glenoid. These changes were not seen on the prior study from 4/25/2013.There is a humeral intramedullary rod with an antibiotic spacer. There is no significant muscle atrophy. | Severe degenerative changes of the articular surface of the glenoid as described above. |
Generate impression based on findings. | Reason: Ptis a 56 y/o male with urothelial cancer, s/p radical cysetctomy with neobladder, CT urogram, 3D views, delayed images History: urothelial cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Reference paraesophageal lymph node measures are 0.9 cm (series 8, image 67), previously 1.3 cm. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: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: The kidneys demonstrate symmetric parenchymal enhancement and contrast excretion. No evidence of mass.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Status post cystectomy with creation of neobladder. LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral fat containing inguinal hernias.OTHER: No significant abnormality noted. | 1.Reference paraesophageal lymph node without significant interval change.2.No new sites of disease. |
Generate impression based on findings. | Left pulsatile Tinnitus, Hx of tympanic rupture. The images are partially degraded by patient motion.On the right, the external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The facial nerve describes a normal course. There is no aberrant or lateralized internal carotid artery. There is no jugular bulb dehiscence or high riding jugular bulb. The inner ear structures are unremarkable. On the left, the external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The facial nerve describes a normal course. There is no aberrant or lateralized internal carotid artery. There is no jugular bulb dehiscence or high riding jugular bulb. The inner ear structures are unremarkable | Unremarkable temporal bones without evidence of aberrant or lateralized internal carotid artery, jugular bulb dehiscence or high riding jugular bulb, or glomus tympanicum. |
Generate impression based on findings. | Reason: Pt with metastatic pancreatic cancer, evaluate for progression. History: Metastatic pancreatic cancer. CHEST:LUNGS AND PLEURA: New left upper lobe pulmonary nodule measures 6 x 4 cm (series 5, image 32). New nodularity along the left major fissure.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes, some of which are calcified. Index right paratracheal lymph node measures 9 mm (series 3, image 25), previously 4 mm. Heart size is normal without pericardial effusion.CHEST WALL: Right chest Port-A-Cath tip terminates at the superior cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Hepatic metastases are unchanged. Left hepatic lobe lesion measures 7 x 5 mm (series 3, image 85), unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic tail mass is decreased in size measuring 2.5 x 1.6 cm (series 3, image 102), previously 3.5 x 2.2 cm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. New pulmonary nodules.2. Increasing paratracheal lymph node.3. Decreasing pancreatic mass.4. Hepatic metastases are unchanged. |
Generate impression based on findings. | Sinonasal undifferentiated carcinoma status post treatment. Head: There is no abnormal intracranial enhancement. No acute intracranial hemorrhage, edema or abnormal fluid collection is identified within the brain parenchyma. The ventricles are stable in size and configuration. There are stable post-surgical findings related to right parietal and bifrontal craniotomies with osteoplastic flap and associated bifrontal encephalomalacia.Neck: There are postsurgical findings related to right partial maxillectomy and anterior skull base resection with medial and inferior orbital wall reconstruction. There is unchanged smooth diffuse mucosal thickening within the lateral aspect of the remaining right maxillary sinus, ethmoid roof, and right sphenoid sinus. There is no significant cervical lymphadenopathy by size criteria. The aerodigestive tract is patent. There is an unchanged partially calcified left thyroid nodule that measures up to 10 mm. The major salivary glands are unremarkable. The major cervical vessels are patent. There is mild to moderate multilevel degenerative spondylosis without lytic or blastic lesions. The imaged portions of the lungs are clear with an azygous lobe. Please refer to the separately dictated CT chest report for further details. | 1. No evidence of intracranial metastatic disease.2. Stable postsurgical findings without evidence of locoregional tumor recurrence or significant lymphadenopathy. |
Generate impression based on findings. | Reason: h/o palate cancer History: r/o lung mets LUNGS AND PLEURA: Scattered benign-appearing micronodules and scarring are unchanged.There is no evidence of pulmonary or pleural metastases. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.Moderate aortic root and coronary calcifications are present.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Unchanged hepatic cyst like hypodensities. Stable small upper abdominal lymph nodes. | No change, and no evidence of metastases. Stable benign-appearing micronodules and scarring. |
Generate impression based on findings. | 71-year-old male with history of bladder cancer ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left-sided hydronephrosis, moderate to severe with left renal atrophy, unchanged. Right renal cysts and air in the right kidney collecting system, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Moderate to severe left-sided hydronephrosis, unchanged. |
Generate impression based on findings. | History of gastrointestinal stromal tumor CHEST:LUNGS AND PLEURA: Index right upper lobe nodule measures 3 x 4 mm on image number 27, series number 9. No other nodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Peritoneal carcinomatosis, again noted Index omental lesion in the right upper abdomen measures 2.6 x 1.2 cm image number 104, series number 7, smaller compared to previous study. However, more superior peritoneal masses around the stomach is increased in size compared to previous study. A large lesion abutting the greater curvature of the stomach now measures 9.4 x 6.2 cm image number 88, series number 7. Previously, it was measuring 7.1 by 3.5-cm image number 92, series number 7.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Decrease in the size of the index omental mass. However the majority of omental masses more superior compared to the index lesion have increased in size within the interval. |
Generate impression based on findings. | 77-year-old male with history of pancreas cancer CHEST:LUNGS AND PLEURA: Wedge-shaped ground glass opacity in the right upper lobe, unchanged from previous study. Right middle lobe and left lower lobe atelectasis, unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hepatic hypodense lesions are unchanged compared to previous study.SPLEEN: No significant abnormality notedPANCREAS: Pancreas is very heterogeneous in the body and tail. Patient's known pancreatic cancer cannot be reproducibly measured. Invasion of SMA is unchanged. Splenic vein is occluded. Soft tissue infiltration around the celiac axis, unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | 62-year-old male with history of lung cancer CHEST:LUNGS AND PLEURA: Index left upper lobe mass now measures 1.6 x 1.1 cm image number 21, series number 6, not significantly changed from previous study. Groundglass opacities in lingula with some suggested nodularity is again noted. Nodularity is increased with in the interval suggestive of lymphangitic spread of the tumor.MEDIASTINUM AND HILA: Index right hilar lymph node measures 2 x 1.9 cm image number 41, series number 4, not significant changed. Index pretracheal lymph node measures 1.4 by 1 cm image number 34, series number 4, not significantly changed from previous study.CHEST WALL: Sclerotic bone metastases involving the vertebral bodies and the ribs are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Scattered small nonspecific hypodensities are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse wall thickening of the stomach, unchanged.BONES, SOFT TISSUES: Sclerotic lesions involving L1 and L2 vertebral bodies, unchanged. There is compression fracture of L1 vertebral body, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: New peritoneal soft tissue densities most prominent in the pelvis consistent with peritoneal carcinomatosis.BONES, SOFT TISSUES: Sclerotic metastases involving the left ischium, unchanged.OTHER: No significant abnormality noted | No significant change in sclerotic bone metastases.Lung lesions are also stable except for increase in the nodularity in the left upper lobe. New peritoneal carcinomatosis. Wall thickening surrounding the stomach may also be manifestation of peritoneal carcinomatosis. |
Generate impression based on findings. | 47-year-old male with left lower quadrant 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: Left renal cyst is unchanged and measures 7 by 7.8 cm.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Simple left renal cyst. |
Generate impression based on findings. | Zone to 7-year-old male with history of cancer at the rectosigmoid junction CHEST:LUNGS AND PLEURA: Emphysema multiple nodules in the left lower lobe. Largest measures 3.2 x 2.5 cm image number 72, series number 5. These nodules are suspicious for metastatic disease.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, not enlarged by CT criteria.CHEST WALL: No significant abnormality notedABDOMEN:This study is limited due to lack of IV contrast.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right upper pole stone. The right lower pole cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Thickwalled bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of IV contrast. Left lower lobe metastatic lung nodules. |
Generate impression based on findings. | Hard palate mucoepidermoidcancer, status post wide local excision with buccal fat pad flap. Streak artifact related to dental amalgam obscured surrounding structures. There are stable postoperative findings related to partial left hard palate resection with an associated defect in the posterior maxillary alveolus and tuberosity and fat graft reconstruction. There is an unchanged periodontal lucency affecting the lingual root of ADA 13. There is unchanged mild mucosal thickening within the left maxillary sinus. There is no discrete mass lesion in the surgical bed. There are no significantly enlarged cervical lymph nodes by CT size criteria. The aerodigestive track is patent. There is an unchanged air-filled left laryngocele that measures up to 13 mm. The major salivary glands and thyroid gland are unremarkable. The major cervical vessels are patent. There is mild degenerative spondylosis. The imaged intracranial structures and orbits are unremarkable. There is mild pulmonary emphysema in the imaged lung apices. | Stable postoperative findings without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | 63-year-old male with history of gastrointestinal stromal tumor CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Stable small hypodense lesion in the spleen is unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable exam without an acute or metastatic process. |
Generate impression based on findings. | 57-year-old female with stage IV pancreatic cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Multiple thyroid nodules are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Index right hepatic lobe lesion measures 1.5 x 1.3 cm in on image number 99, series number 3, not significantly changed from previous study. Another index lesion adjacent to the gallbladder fossa is also unchanged measuring 9-mm in diameter image number 117, series number 3.SPLEEN: No significant abnormality noted.PANCREAS: Patient's known mass in the pancreatic head is difficult to measure and differentiate from surrounding organs but it measures 2.5 x 2.3 cm on image number 118, series number 3, smaller compared to previous study. Significant dilatation of the pancreatic duct is unchanged. Splenic vein collaterals are unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval decrease in the size of patient's known pancreatic head mass. hepatic lesions are unchanged. |
Generate impression based on findings. | Clinical question: Rule out intracranial hemorrhage. Signs and symptoms: Status post fall. Has right thigh hematoma. Nonenhanced head CT:Examination demonstrates no detectable intracranial or calvarial posttraumatic findings. There is however a right central and lateral orbital soft tissue hematoma measuring up to 15 x 25 mm size. Visualized right retro-orbital space and globe as well as lacrimal gland remain unremarkable.Images through intracranial space demonstrate fairly extensive bilateral hemispheric white matter low-attenuation which resultant expansion of supratentorial ventricular system consistent with age indeterminate advanced small vessel ischemic strokes. There is suggestion of interval worsening of findings since prior exam from 2011 study.All paranasal sinuses and bilateral mastoid air cells, middle ear cavities remain pneumatized.There are bilateral mixed density material within external auditory canals. Findings there not associated with any bony changes and are believed to represent secretions/wax. | 1.Nonenhanced head CT demonstrate soft tissue hematoma measuring at 25 x 15-mm in the right supra and right lateral orbit. No associated bony changes of calvarial or right orbital osseous structures.2.Advanced age indeterminate small muscle ischemic strokes with interval worsening since prior study from 2011. |
Generate impression based on findings. | Head and neck CA s/p resection and reconstruction with resultant foreign body. There are recent postoperative findings related to right transzygomatic partial maxillectomy and mandibulectomy with temporomandibular joint disarticulation for resection of a masticator space mass. There is extensive ill-defined fluid soft tissue swelling and emphysema with surgical drain in position. There are surgical screws embedded within the right inferior and lateral orbital rim. There is also a screw within the remaining posterior partially opacified right maxillary sinus, just inferior to the orbital floor. There is a 4 mm long linear metallic structure that likely represents a vascular clip located in the right malar fat pad approximately 9 mm inferior to the orbital rim. There is persistent right lateral periorbital soft tissue swelling, but the orbital contents are unremarkable. There is moderate opacification of the left maxillary sinus and bilateral ethmoid sinuses. The bilateral mastoid air cells are underpneumatized and there is tympanomastoid opacification. The imaged intracranial structures are grossly unremarkable. | Postoperative findings related to right partial maxillectomy and mandibulectomy for resection of a masticator space mass with a detached screw that has migrated into the posterosuperior portion of the partially opacified remaining maxillary sinus. No radio-opaque foreign body is identified within the right orbit.Discussed with Dr. Stenson at 2:30 PM on 10/15/13. |
Generate impression based on findings. | History of bladder cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastatic or recurrent disease. |
Generate impression based on findings. | 76-year-old female with history of bladder cancer CHEST:LUNGS AND PLEURA: Severe emphysema, unchanged. Right lower lobe linear atelectasis, unchanged.MEDIASTINUM AND HILA: Subcentimeter outpouching at the level of the distal arch representing a small pseudoaneurysm is unchanged compared to previous study.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific, hypodense benign lesions in the liver are unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Subcentimeter cystic lesion in the body of the pancreas is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Infrarenal abdominoaortic aneurysm measures 4.8-cm in largest AP dimension, increased in size compared to previous study. The right common iliac arteries aneurysm measures 2.9 cm in largest AP dimension, unchanged from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in the size of the infrarenal abdominal aortic aneurysm. Subcentimeter pseudoaneurysm arising from the proximal descending thoracic aorta is unchanged. |
Generate impression based on findings. | 76-year-old male with history of carcinoid tumor CHEST:LUNGS AND PLEURA: Scattered subcentimeter micronodules are unchanged.MEDIASTINUM AND HILA: Dilated main pulmonary arteries unchanged.CHEST WALL: Index left axillary prominent lymph node measures 1.2 x 0.9 cm image number 49, series number 7, unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | Melanoma CHEST:LUNGS AND PLEURA: Stable biapical scarring. Scarring is more prominent on the left side with calcified pleural plaques and associated volume loss.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable hepatic cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal mass now measures 10 by 6.2 cm on image number 99, series number 11, increased in size compared to previous study. Left adrenal mass measures 6.2 by 4.9-cm image number 99, series number 11, increased in size compared to previous study.KIDNEYS, URETERS: Stable left renal cysts.RETROPERITONEUM, LYMPH NODES: Index aortocaval lymph node measures 1.8 x 1 .4-cm on image number 112, series number 11, slightly smaller compared to previous study. This lymph node cannot the well-differentiated from the pancreas.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in the size of the right gluteal soft tissue nodule which now measures 1 cm in diameter on image number 155, series number 11. Previously was measuring 6 mm.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder wall is thickened.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size of the bilateral metastatic lesions and right gluteal subcutaneous nodule.Minimal interval decrease in the size of the aortocaval index retroperitoneal lymph node. |
Generate impression based on findings. | Reason: worsening SOB with known nodules and interstitial disease History: shortness of breath, hypoxia LUNGS AND PLEURA: Subpleural diffuse reticular interstitial opacities with septal thickening and centrilobular nodules.. There has been significant interval improvement in the multiple nodular opacities.Right subpulmonic high density fluid collection with calcific rim is unchanged over 7 years.Postoperative changes in the right lower lobe.No significant air trapping.MEDIASTINUM AND HILA: Large mediastinal lymph nodes stable mildly increased in size.Enlarged pulmonary artery compatible with pulmonary to hypertension.Cardiac enlargement without evidence of a pericardial effusion.Extensive calcification of the mitral annulus with moderate coronary artery calcifications.CHEST WALL: Post right-sided thoracotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. The partially visualized right renal cyst. Extensive atherosclerotic disease. | 1.Interval improvement in the multiple nodular opacities .2.Persistent reticular interstitial opacities and septal lines compatible with underlying chronic interstitial lung disease and possible superimposed edema.3.Mediastinal lymphadenopathy unchanged. |
Generate impression based on findings. | GE junction cancer CHEST:LUNGS AND PLEURA: Index left upper lobe nodule measures 8 x 10 mm on image number 60, series number 5, increased in size compared to previous study. Index right upper lobe nodule measures 10 mm in diameter image number 27, series number 5, minimally increased in size compared to previous study. Other subcentimeter nodules have also minimally increased in size compared to previous study.MEDIASTINUM AND HILA: Index mediastinal lymph node adjacent to the trachea and now measures 1.1 x 0.8 cm image number 15, series number 3, not significantly changed. Other mediastinal lymph nodes are also unchanged. Wall thickening of the distal esophagus is unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple liver metastases are again noted. Index right hepatic lobe lesion measures 1.7 by 1 cm image number 83, series number 3, slightly smaller. However it's very difficult to differentiate this lesion from the surrounding normal liver.Index left lobe lesion measures 8.7 x 5.4 cm image number 100 two, series number 3, significantly increased in size compared to previous study.SPLEEN: Previously mentioned hypodense lesion in the spleen is unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index gastrohepatic lymph node measures two by 1.7 cm on image number 92, series number 3, not significantly changed from previous study. Index aortic lymph node measures 1.3 by 1 cm image number 117, series number 3, not significantly changed. Other retroperitoneal lymph nodes are also stable.BOWEL, MESENTERY: Wall thickening of the proximal stomach and is slightly increased.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Unremarkable.BOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: Expansile sclerotic lesion in the left iliac wing and left pubic bone unchanged.OTHER: No significant abnormality noted | Slight interval increase in the size of the lung lesions and some of the hepatic lesions. Retroperitoneal lymph nodes are stable.Slight interval increase in the amount of wall thickening of the stomach.Pelvic expansile/sclerotic bone lesions are stable. |
Generate impression based on findings. | 71-year-old male with history of bladder cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate stone in the left lower pole collecting system without evidence of hydronephrosis. Previously noted right renal stone is no longer visualized.RETROPERITONEUM, LYMPH NODES: Index retroaortic lymph node measures 1.4 by 1.1 cm on image number 130, series number 7, minimally increased in size compared to previous study. Other retroperitoneal lymph nodes also increased in size compared to previous study. There are also new retroperitoneal lymph nodes as well as a new infiltrative soft tissue density lesion between the inferior vena cava and aortic bifurcation on image number 141, series number 7.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomyBLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size and number of the retroperitoneal adenopathy suspicious for metastatic disease. |
Generate impression based on findings. | Female 69 years old Reason: esophogeal cancer History: dysphagia CHEST:LUNGS AND PLEURA: Two nodular fissural densities compatible with intrapulmonary lymph nodes in the left major and right minor fissures.Mild centrilobular emphysema. Bilateral posterior subpleural/pleural nodularity likely scarring or atelectasis.MEDIASTINUM AND HILA: Circumferential asymmetric thickening of the distal esophagus extending to the level of the GE junction compatible with patient's known adenocarcinoma. Indeterminate hypodense poorly circumscribed soft tissue mass appears to arise off the intra-diaphragmatic portion of the distal esophagus concerning for exophytic extension of the primary adenocarcinoma, but may also be lymphatic in origin.Calcified hilar and mediastinal lymph nodes compatible with prior granulomatous disease. No evidence of mediastinal or hilar lymphadenopathy.Minimal coronary artery calcifications.CHEST WALL: Patient status post right mastectomy and a right axillary lymph node dissection. Nonspecific enlarged right subpectoral lymph node measures 13 mm in short axis (image 16, series 401).ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Hypodense focus in the left lobe of the liver is too small to characterize. Calcified focus in the porta hepatis likely representing a granuloma. Prominent extrahepatic duct without evidence of obstruction.SPLEEN: Multiple punctate calcifications in the splenic parenchyma compatible with prior granulomatous disease.ADRENAL GLANDS: Fat density nodule in the left adrenal gland compatible with an adrenal myelolipoma.KIDNEYS, URETERS: Bilateral hypodense renal lesions compatible with simple renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Enlarged retroperitoneal lymph nodes: reference peripancreatic node measures 17 mm in short axis (image 81, series 401). There is also an enlarged gastrohepatic node.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sutures in the anterior body wall compatible with prior fascial repair attempt with associated diastases of the rectus abdominis. Well-circumscribed lucent lesion in the posterolateral L1 vertebral body, likely a hemangioma as it was not FDG avid on the PET scan of the same day.OTHER: No significant abnormality noted. | 1. Asymmetric circumferential thickening of the distal esophagus compatible with patient's known adenocarcinoma, with an indeterminate associated soft tissue density, which may be exophytic tumor or lymphatic in nature.2. Enlarged right subpectoral lymph node of uncertain significance.3. Retroperitoneal and gastrohepatic lymphadenopathy. |
Generate impression based on findings. | 66 year old female with history of mesothelioma ABDOMEN:For chest findings please refer to dedicated chest CT report performed same dayLIVER, BILIARY TRACT: Hepatic hypodensities are stable.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in the size of the infiltrative soft tissue mass invading the anterior abdominal wall. The mass now measures 9.7 by 4 .1 cm on image number 73, series number 9. The mass invades the abdominal cavity. The thickness of the soft tissue in the perihepatic region measures 2 cm on image number 54, series number 9, not significantly changed compared to previous study.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Leiomyomatous uterus, unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: Index right femoral lymph node measures 1.8 x 1.2 cm in image number 108, series number 9, not significantly changed compared to previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval significant increase in the size of the infiltrative mass invading the anterior abdominal wall extending into the abdominal cavity.Slight interval increase in the size of the right femoral lymph node. Retroperitoneal lymph nodes are stable. |
Generate impression based on findings. | Reason: h/o HNC, compare to previous, measurements pls, h/o CRT History: none LUNGS AND PLEURA: No sign of pulmonary or pleural metastases.Prior groundglass opacities have resolved.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative abnormalities and osteophyte formation affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Very small accessory splenule noted. | No evidence of metastases or significant change. |
Generate impression based on findings. | Slight vision change. There is a stereotactic frame in position, which produces streak artifact that obscures the underlying anatomy. The known right frontoparietal masses with surrounding vasogenic edema are better depicted on the recent prior MRI. There are post biopsy images are well, which show air along the right transfrontal approach and a punctate bone fragment deposited at the target. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. There is a left occipital subcutaneous nodule that measures up to 13 mm, which likely represents an inclusion cyst. | Intraoperative stereotactic images show interval biopsy of a right frontal mass without evidence of acute intracranial hemorrhage or midline shift. |
Generate impression based on findings. | Reason: Colon Cancer: restaging History: none CHEST:LUNGS AND PLEURA: Stable bilateral pulmonary nodules.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes, normal in appearance. Moderate atherosclerotic calcifications of the coronary arteries.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No suspicious focal liver lesions. Gallbladder with high density material in the lumen. This may represent cholelithiasis but given the fact that patient has no history of cholelithiasis on prior examination, a communication between the gallbladder and colon cannot be excluded. Clinical correlation is advised. There is associated gallbladder wall thickening which may be accentuated by gallbladder collapse. No intrahepatic or extrahepatic biliary ductal location. SPLEEN: No significant abnormality noted. Soft tissue density mass adjacent to spleen as seen on prior exam likely represents an accessory spleen.PANCREAS: Small punctate calcification in the tail of the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small subcentimeter hypodense lesions in the right kidney are unchanged in size and appearance.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Evidence of abdominal surgery.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is evidence of right hemicolectomy. There is diffuse thickening of the small bowel around and distal to the anastomosis site. There is associated surrounding fat stranding and engorgement of the blood vessels. There is no evidence of mass. Scattered diverticula of the descending colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild amount of pelvic ascites. | 1.Diffuse edema of the large portion of the small bowel starting at the anastomosis site and extending distally with surrounding fat stranding and engorgement of the vessels. These findings are nonspecific, and inflammatory, infectious, or ischemic etiology cannot be excluded. These findings may also be due to chemotherapy treatment. Mild amount of pelvic ascites.2.High density material within the gallbladder may represent cholelithiasis although without a history of cholelithiasis and or relatively recent surgery, and he should between the gallbladder and the colon cannot be excluded. Clinical correlation is advised. |
Generate impression based on findings. | 58-year-old female with history of malignant solitary fibrous tumor CHEST:LUNGS AND PLEURA: Previously noted ground glass opacities within the left lung have resolved. Again noted multiple large pulmonary/pleural masses within the right hemithorax. Index right para-crural lesion measures 3.5 x 1.5 cm image number 82, series number 3, not significantly changed from previous study.However, other pleural-based masses has significantly increased in size. A large mass in the right lower lobe now measures 10 by 10.7-cm on image number 38, series number 3. Previously, this lesion was measuring 9 by 9 .4-cm image number 31, series number 3.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: There are no focal liver lesions. However, there is infiltration of the perihepatic space and right hemidiaphragm by patient's known pleural masses. In addition there is also a more inferior and posterior separate perihepatic mass, which has increased in size compared to previous study. The mass now measures 3.8 x 2.4 cm on image number 98, series number 3. Previously, it was measuring 2.1 x 1.8 cm on image number 87, series number 3.SPLEEN: Nonspecific 1.2-cm hypodense splenic lesion is unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in the size of the right-sided pulmonary/pleural masses and perihepatic masses. |
Generate impression based on findings. | Reason: h/o HNC, s/p induction, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Right greater than left subpleural bronchiectasis and bronchiolectasis with scattered areas of honeycombing. No significant associated ground glass opacity. There is mild thickening of the interlobular septa within regions of peripheral fibrosis. Mild nodular thickening of the major fissures are also present.Dependent pulmonary opacities favor that of subsegmental atelectasis. Small pulmonary micronodules along with lower lobe bronchial wall thickening suggestive of mild bronchiolitis. No suspicious pulmonary nodules or pleural effusion.MEDIASTINUM AND HILA: Interval tracheostomy tube placement.Small high right paratracheal lymph node is stable. No mediastinal or hilar lymphadenopathy.The heart size is normal. No pericardial effusion.CHEST WALL: A ventriculoperitoneal shunt occupies the anterior thoracic wall right of midline and enters the peritoneum at the superior abdomen.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Percutaneous gastrostomy tube positioned at the gastric fundus.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Stable nodularity left adrenal gland.KIDNEYS, URETERS: Hypodensities in the kidneys most compatible with cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Multilevel degenerative changes of the lumbar spine.OTHER: No significant abnormality noted. | Right greater than left subpleural bronchiectasis and bronchiolectasis with scattered areas of honeycombing. No significant associated ground glass opacity. There is mild thickening of the interlobular septa within regions of peripheral fibrosis. Mild nodular thickening of the major fissures are also present.Small pulmonary micronodules along with lower lobe bronchial wall thickening suggestive of mild bronchiolitis. No suspicious pulmonary nodules or pleural effusion. |
Generate impression based on findings. | 76-year-old female with history of bladder cancer CHEST:LUNGS AND PLEURA: Severe emphysema, unchanged. Right lower lobe linear atelectasis, unchanged.MEDIASTINUM AND HILA: Subcentimeter outpouching at the level of the distal arch representing a small pseudoaneurysm is unchanged compared to previous study.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific, hypodense benign lesions in the liver are unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Subcentimeter cystic lesion in the body of the pancreas is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Infrarenal abdominoaortic aneurysm measures 4.8-cm in largest AP dimension, increased in size compared to previous study. The right common iliac arteries aneurysm measures 2.9 cm in largest AP dimension, unchanged from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in the size of the infrarenal abdominal aortic aneurysm. Subcentimeter pseudoaneurysm arising from the proximal descending thoracic aorta is unchanged. |
Generate impression based on findings. | Male; 37 years old. Reason: evaluate for disease progression. History: Malignant fibrous histiocytoma of the bone. LUNGS AND PLEURA: Postoperative changes compatible with prior partial left upper lobe resection. The heterogeneous, enhancing left hilar mass is again noted and continues to narrow the left mainstem and lobar bronchi. The mass has increased in size since the prior study and measures 4.5 x 3.8 cm, previously 2.3 x 1.8 cm (series 3, image 28). No new suspicious nodules or masses. Left pleural thickening , small effusion, and scarring in the left lower lobe is mildly improved.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Small subcentimeter mediastinal and supraclavicular lymph nodes are not significantly changed.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Punctate hypodense focus in the spleen is too small to fully characterize. No significant lymphadenopathy. | Interval increase in size of left hilar mass as described above. |
Generate impression based on findings. | History CML with splenomegaly. Status post colectomy with left upper quadrant pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality noted. Normal sized spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Physiologic left corpus luteum.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Trace ascites likely physiologicBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Negative for acute, inflammatory, or neoplastic process. Specifically, no evidence for splenomegaly |
Generate impression based on findings. | History of bladder cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastatic or recurrent disease. |
Generate impression based on findings. | 71-year-old male with history of bladder cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate stone in the left lower pole collecting system without evidence of hydronephrosis. Previously noted right renal stone is no longer visualized.RETROPERITONEUM, LYMPH NODES: Index retroaortic lymph node measures 1.4 by 1.1 cm on image number 130, series number 7, minimally increased in size compared to previous study. Other retroperitoneal lymph nodes also increased in size compared to previous study. There are also new retroperitoneal lymph nodes as well as a new infiltrative soft tissue density lesion between the inferior vena cava and aortic bifurcation on image number 141, series number 7.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomyBLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size and number of the retroperitoneal adenopathy suspicious for metastatic disease. |
Generate impression based on findings. | CT CHEST ABDOMEN PELVIS W, 10/15/2013 1:52 PM CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, unchanged.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is normal without pericardial effusion. Moderate atherosclerosis at the origin of the right subclavian artery.CHEST WALL: Right chest wall Port-A-Cath tip terminates in the right atrium. Hiatal hernia.ABDOMEN:LIVER, BILIARY TRACT: Index segment VII hypoattenuating lesion measures 8 x 6 mm (series 3, image 94), previously 9 x 6 mm. Status post cholecystectomy with unchanged mild biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted. RETROPERITONEUM, LYMPH NODES: Moderate atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Index left external iliac lymph node measures 7 x 5 mm (series 3, image 172), previously 7 x 6 mm. Index right inguinal lymph node measures 1.9 x 1.7 cm (series 3, image 198), previously 1.2 x 1.1 cm.BOWEL, MESENTERY: Sigmoid diverticulosis without diverticulitis. Right perirectal mass measures 1.6 x 1.4 cm (series 3, image 183), previously 1.6 x 1.4 cm.BONES, SOFT TISSUES: Nonspecific sclerotic focus in the left inferior pubic ramus is unchanged.OTHER: No significant abnormality noted. | 1. Increasing right inguinal lymph node.2. Other reference measurements without significant interval change. |
Generate impression based on findings. | T4N0M0 SCC R alveolar ridge status post right neck dissection and CRT complete in 4/2006, with pathologic fracture of mandible treated external fixator, which has since been removed. Last seen in clinic 10/16/12 exposed root, devascularized bone, and purulence around tooth #30 with >1000000 CFU/gram Candida and >100000 CFU/gram Veillonella. There is a displaced pathologic fracture of the right mandibular body, which otherwise demonstrates areas of mixed sclerosis and lucency. There is ill-defined adjacent soft tissue swelling but no discrete fluid collection to suggest abscess. The temporomandibular joints are intact. The paranasal sinuses and mastoid air cells are clear. There are bilateral lens implants. The imaged intracranial structures are grossly intact. | Displaced fracture of the right mandibular body, which otherwise demonstrates areas of mixed sclerosis and lucency that are likely related to osteonecrosis and/or osteomyelitis. Ill-defined adjacent soft tissue swelling may be due to inflammation, although tumor recurrence cannot be entirely excluded. No evidence of abscess. |
Generate impression based on findings. | Clinical question: Assess cervical laminoplasty. Signs and symptoms: Six months follow-up post cervical laminoplasty. Nonenhanced cervical spine CT:The alignment of vertebral column is anatomical and stable since prior exam.There is mild kyphosis of the cervical spine which likely is a result of positioning.Foramen magnum is unremarkable.C2 -- C3 demonstrate degenerative disk disease, left uncovertebral hypertrophy change and left-sided asymmetric facet hypertrophy changes with resultant left neural foraminal compromise. This is similar to prior exam.There is evidence of posterior wide bilateral laminectomies at C3, C4, C5 and C6 levels similar to prior exam. There is posterior fixating screws (placed within the facets) and rods at these levels similar to prior exam.There is no detectable hardware failure or complication.There is no evidence of bony graft at the level of laminectomies.There is no evidence of laminoplasty as is indicated in the provided clinical data.As was noted on multiple prior exams there is fairly advanced degenerative disk disease at C3 to C4 through C7 -- T1 levels with the worst level of involvement at C3 -- C4 and C4 -- C5 levels. | 1.Stable and normal anatomical alignment the vertebral column.2.Stable postoperative changes of multilevel wide bilateral laminectomies from C3 through C6.3.Posterior fusion with placement of fixating screws and rods from C3 through C5 without evidence of hardware failure or complications.4.No detectable bony graft for posterior cervical fusion. |
Generate impression based on findings. | Reason: metastatic prostate cancer, evaluation of disease after 3 cycles of investigational therapy. History: metastatic prostate cancer, CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Reference precarinal lymph node measures 2.0 by 1.0 cm (series 3, image 34), unchanged. Heart size is normal without pericardial effusion. Coronary artery calcifications.CHEST WALL: Diffuse skeletal metastases.ABDOMEN:LIVER, BILIARY TRACT: Innumerable new metastatic lesions. Index right hepatic lobe lesion measures 4.4 x 4.2 cm (series 3, image 101).SPLEEN: Calcified splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes in the distal small bowel. No evidence of bowel obstruction.BONES, SOFT TISSUES: Diffuse skeletal metastases.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Status post cystectomy with ileal conduit.LYMPH NODES: Status post bilateral pelvic lymph node node dissection. Stable right pelvic lymphocele measures 4.3 x 3.6 cm (series 3, image 173).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse skeletal metastases.OTHER: No significant abnormality noted. | 1.New innumerable hepatic metastases.2.Diffuse skeletal metastases. |
Generate impression based on findings. | Clinical question: Nasal septum fracture? Signs and symptoms: Difficulty breathing through the nose, bruising around eyes, laxity of bride of nose. Unenhanced maxillofacial CT:Examination demonstrate a linear right nasal bone fracture with minimal medial and posterior displacement. There is compromise of right internal nasal valve on the right adjacent to the fracture. There is no convincing evidence of an overlapping soft tissue abnormalities of the overlapping soft tissues. The age of fracture cannot be properly assessed. Please correlate with history and physical exam/palpation. This finding is best appreciated on axial bone density series 80516 images 14 and 15 and coronal bone density series 80240 images 1 & 2.There is no convincing evidence of nasal bone fracture as is questioned clinically. There is however mild nasal septum deviation to the left and with mucosal contact with the left inferior turbinate.There is increased soft tissue density in the superior right nasal passage without associated any bony changes and likely representing because of thickening or secretion. This finding extends superiorly and is contiguous with minimal mucosal thickening in the anterior aspect of right sphenoid chamber and occluded right sphenoethmoidal recess.Frontal sinuses are well pneumatized and unremarkable.Ethmoid sinuses demonstrate minimal diffuse bilateral mucosal thickening.Sphenoid sinus demonstrates minimal mucosal thickening along their anterior wall (right greater than left) and with occluded bilateral sphenoethmoidal recess.Right maxillary sinus demonstrates minimal mucosal thickening along its medial wall however the right ostomy noted in the remains patent.Left maxillary sinus and the straight compromise the left ostiomeatal unit secondary to localized mucosal thickening at its origin and unremarkable otherwise.Bilateral loss air cells and middle ear cavities are well pneumatized and unremarkable.Images through the orbits are unremarkable. | 1.There is evidence of right nasal bone fracture of indeterminate age with minimal displacement and resultant compromise of right internal nasal valve.2.There is no convincing evidence of nasal septum fracture as is questioned clinically. There is however nasal septum deviation to the left and with mucosal contact the left inferior turbinate. 3.Minimal increased soft tissue density in the superior right nasal passage which is continuous with minimal mucosal thickening in the right chamber of the sphenoid sinus and with occluded right sphenoethmoidal recess.4.Minimal mucosal thickening of the other sinuses and with occluded left ostiomeatal unit as detailed. |
Generate impression based on findings. | Reason: followup nodule History: dyspnea LUNGS AND PLEURA: Severe centrilobular emphysema.Pulmonary nodule within the right lower lobe, adjacent to the major fissure (high-resolution series 5 image 202), unchanged from prior study. This documents stability over 7 months. If the patient is at low risk, confirmation over a one year time period is recommended (with additional chest CT March 2014). If the patient is at high risk, such as having smoking or malignancy history, follow up imaging over a total of 18 to 24 months is recommended.Nodular fissural density (series 5 image 174) is compatible with an intrapulmonary lymph node. No new pulmonary nodules or new pleural effusion is present.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion No mediastinal or hilar lymphadenopathy..CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Pulmonary nodule within the right lower lobe, adjacent to the major fissure, unchanged from prior study. This documents stability over 7 months. If the patient is at low risk, confirmation over a one year time period is recommended (with additional chest CT March 2014). If the patient is at high risk, such as having smoking or malignancy history, follow up imaging over a total of 18 to 24 months is recommended. |
Generate impression based on findings. | Reason: evaluate ILD History: sob LUNGS AND PLEURA: Basilar predominant subpleural reticulation, septal thickening, architectural distortion, and traction bronchiectasis. There is minimal basilar honeycombing. No groundglass opacities. No air trapping.Bilateral pleural thickening similar in appearance to the prior exam.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Prominent right paratracheal and subcarinal lymph nodes.Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Radiolucency in the T10 vertebral body compatible with an hemangioma.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Mild basilar predominant fibrosis in a UIP pattern. Etiologies include idiopathic, mixed connective tissue disease, and less likely drug reaction (amiodarone). |
Generate impression based on findings. | Reason: mitral regurgitation- previous groin cannulation History: SOB VESSELS:The length of the ascending thoracic aorta from the sinotubular junction to the ostium of the innominate artery is approximately 8.6 cm (series 80916 image 60). Common origin of the innominate and left common carotid arteries. Minimal calcified atherosclerotic plaque occupies the distal transverse arch. No calcification is present within the descending thoracic aorta. No significant tortuosity of the thoracic aorta is identified.SINUS OF VALSALVA: 3.6 X 3.8 x 4.0 cmSINOTUBULAR JUNCTION: 3.3 X 3.5 cmASCENDING THORACIC AORTA AT LEVEL OF MAIN PULMONARY ARTERY: 3.3X 3.4 cmASCENDING THORACIC AORTA IMMEDIATELY PROXIMAL TO THE INNOMINATE ARTERY: 3.1 X 3.0 cmPROXIMAL DESCENDING THORACIC AORTA IMMEDIATELY DISTAL TO THE LEFT SUBCLAVIAN ARTERY: 2.6 X 3.0 cmDESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 2.8 X 2.7 cmINFRARENAL ABDOMINAL AORTA: 1.9 X 2.0 cmRIGHT COMMON ILIAC ARTERY: 11 X 11 mmRIGHT EXTERNAL ILIAC ARTERY: 7.6 X 8.7 mmRIGHT COMMON FEMORAL ARTERY: 8.8 X 8.9 mmLEFT COMMON ILIAC ARTERY: 11 X 11 mmLEFT EXTERNAL ILIAC ARTERY: 8 X 8 mmLEFT COMMON FEMORAL ARTERY: 9 X 11 mmCHEST:LUNGS AND PLEURA: Small right pleural effusion. Scattered calcified granulomas. A subpleural reticulation lateral basal segment right lower lobe. 5-mm nodule within the left upper lobe, abutting the major fissure (series 11 image 63).MEDIASTINUM AND HILA: The right atrial electrode abuts the right lateral atrial wall without perforation. The ventricular electrode is positioned at the RV apex.Heart size is mildly enlarged secondary to left atrial chamber dilatation. No pericardial effusion. Mild triple vessel coronary arterial calcification.No mediastinal or hilar lymphadenopathy. Multiple calcified lymph nodes compatible with prior granulomatous infection.CHEST WALL: Left chest wall univentricular AICD pulse generator. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small pericaval lymph node posterior to the common hepatic artery.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No abdominal aortic aneurysm or significant tortuosity is identified.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Surgical clips are noted within a loop of bowel in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Bilateral fat filled inguinal hernia. | 1.The length of the ascending thoracic aorta from the sinotubular junction to the ostium of the innominate artery is approximately 8.6 cm. No ascending thoracic aneurysm nor dissection. Access vasculature measurements as above.2.Small right pleural effusion. |
Generate impression based on findings. | Reason: eval liver vs other acute process History: abd distention ABDOMEN: Within the limitations of a non-IV contrast enhanced examination which limits evaluation of solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: Small micronodules in the right lung base (series 4, image 2 and 8). Moderate left pleural effusion with some fluid tracking along the minor fissure. Mild hiatal hernia.LIVER, BILIARY TRACT: Questionable hypodense lesion in the right lobe of the liver (series 3, image 18). Another questionable hypodense lesion in the left lobe of the liver (series 3, image 27).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mildly prominent para-aortic lymph node measuring 1.7 x 0.7 cm (series 3, image 53). Moderate to severe atherosclerotic calcification of the aorta and bilateral iliac arteries.BOWEL, MESENTERY: Loops of small bowel and large bowel displaced towards the center by large amount of intraperitoneal fluid. No evidence of small bowel obstruction. Soft tissue nodularity of the omentum is consistent with peritoneal carcinomatosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Large amount of peritoneal fluid.PELVIS:UTERUS, ADNEXA: Enlarged, bulbous uterus with calcified fibroids. Heterogeneous, cystic appearing lesions in bilateral adnexa suspicious for malignancy.BLADDER: Partially collapsed bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Loops of small bowel and large bowel displaced towards the center by large amount of intraperitoneal fluid. No evidence of small bowel obstruction. Soft tissue nodularity of the omentum is consistent with peritoneal carcinomatosis.BONES, SOFT TISSUES: Small lytic lesions with sclerotic rims in the right acetabulum. OTHER: Large amount of pelvic ascites. | Lack of IV contrast limits assessment.1.Heterogeneous, cystic-appearing mass is in bilateral adnexa suspicious for malignancy. There is a large amount of intraperitoneal ascites with peritoneal carcinomatosis compatible with pseudomyxoma peritonei. 2.Mildly prominent para-aortic lymph node.3.Few subcentimeter micronodules in the right lung base.4.Moderate left-sided pleural effusion. |
Generate impression based on findings. | Female; 66 years old. History of mesothelioma. LUNGS AND PLEURA: Postsurgical changes compatible with right pneumonectomy and diaphragmatic graft placement with large amount of fluid in the right hemithorax are not significantly changed. Previously noted thickening along the inferior right pleura anterior to the liver is not included in the study range. Please see separate CT abdomen report for further details. Scattered left-sided micronodules are not significantly changed. There is no pleural thickening, pleural effusion, or other suspicious lesion in the left lung.MEDIASTINUM AND HILA: Leftward mediastinal deviation with compression of the right atrium is unchanged. Normal heart size without pericardial effusion. Reference left hilar node is unchanged in size and measures 12 mm (series 6, image 48). No additional mediastinal or hilar lymphadenopathy. Atrial septal occluder device.CHEST WALL: Anterior chest wall tumor is incompletely visualized on this study. Please see dedicated abdominal CT report for further characterization. Anterior wedging deformities of several midthoracic vertebrae. No significant axillary lymphadenopathy. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic hypodensities are unchanged and likely represent cysts. Please see dedicated abdominal CT report for additional findings. | 1.Postsurgical changes status post right pneumonectomy as described above, without evidence of local recurrence or metastatic disease in the chest.2.Please see separately dictated abdominal CT report for further details on incompletely imaged anterior chest wall tumor. |
Generate impression based on findings. | Reason: palpable mass 1 inch epigastric region , needs also po contrast to rule out hernia History: none ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate circumferential wall thickening of the gastric antrum.BONES, SOFT TISSUES: Small fat-containing umbilical hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Intrauterine device.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Nonspecific circumferential thickening of the gastric antrum, unchanged from the prior exam. Endoscopy is recommended. |
Generate impression based on findings. | Laryngeal neurofibroma. Dysphagia. The hypoattenuating left laryngeal circumscribed oval mass centered along the left vocal cord measures 4.0 x 2.5 cm on sagittal images (sagittal series 80265, image 45), previously 3.9 x 2.0 cm, with supraglottic extension. This mass causes effacement of the left pyriform sinus, outward bowing of the left thyroid cartilage, focal rightward deviation of the airway, and marked airway narrowing. The left vallecula is not well visualized as the left epiglottic leaflet is displaced anteriorly by the mass.There is a 0.7 x 0.7 x 1.7 cm hyperdense versus enhancing tubular lesion along the posterior base of tongue (series 3, image 29). This lesion extends inferiorly, with its caudal portion curving anteriorly towards the hyoid bone. This lesion appears isointense on prior T2 imaging with a T2 hypointense rim. It is excluded from the field of view on multiple prior MR sequences.The nasopharynx, oropharynx, oral cavity are otherwise unremarkable. No cervical lymphadenopathy is seen.The cervical vasculature appears patent. The thyroid gland is prominent with small bilateral hypodense nodules. The parotid and submandibular glands appear normal.Post surgical changes of a posterior fusion of C5-C7 and right C6 hemilaminectomy. Grade 1 anterolisthesis of C6 on C7. No radiographic evidence of hardware complication. | 1. 4.0 cm nonenhancing hypodense mass centered at the left vocal cord as described above, which is slightly enlarged compared to 11/10/12 with supraglottic extension. Mass effect on adjacent structures, including the airway which is deviated to the right and narrowed. 2. 0.7 x 0.7 x 1.7 cm tubular enhancing versus hyperdense lesion along the posterior base of tongue. This is likely along the foramen cecum, and given relative signal similarity on prior T2-weighted images to thyroid tissue, this most likely represents lingual thyroid tissue, although the differential also includes a thyroglossal duct cyst.3. Prominent heterogeneous thyroid gland. Correlation with thyroid function tests and ultrasound, if clinically warranted, may be helpful. |
Generate impression based on findings. | Reason: advanced ovarian cancer, s/p chemo and suboptimal surgery, evaluate residual disease History: see above CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Reference right paratracheal lymph node measures 9 x 7 mm (series 3, image 31), previously 9 x 9 mm. Reference precarinal lymph node measures 1.7 x 1.1 cm (series 3, image 36), previously 1.9 x 1.4 cm. Cardiophrenic and retrocrural lymphadenopathy is unchanged.Heart size is normal without pericardial effusion. Coronary artery calcifications.CHEST WALL: Degenerative changes of the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: Mild nodular thickening along the anterior hepatic surface compatible with peritoneal metastases is unchanged. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral nonobstructive calculi.RETROPERITONEUM, LYMPH NODES: Gastrohepatic lymph node mass with vascular encasement measures 3.4 x 2.6 cm (series 3, image 86), previously 3.3 x 2.1 cm. Increasing retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Status post omental resection with a small amount of free intraperitoneal air anterior to the liver.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Index right external iliac lymph node measures 1.5 x 0.9 cm (series 3, image 156), previously 1.2 x 0.7 cm.BOWEL, MESENTERY: Increasing soft tissue nodularity in the pelvis (series 3, image 161).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Decreasing free fluid in the pelvis. | 1. Increasing gastrohepatic and retroperitoneal lymphadenopathy.2. Increasing soft tissue nodularity and lymphadenopathy in the pelvis.3. Slight decrease in mediastinal lymphadenopathy.3. Status post omentectomy. |
Generate impression based on findings. | Urothelial carcinoma CHEST:LUNGS AND PLEURA: Slight interval decrease in size of reference left lower lobe nodule best seen on image 64, series 4 measuring 0.7 x 0.7 cm; this is in comparison to 0.9 x 0.9 cm on 8/6/2013. Other subcentimeter nodules stable, including reference left upper lobe nodule best seen on image 32, series 4, measuring 0.5 cm in diameter.MEDIASTINUM AND HILA: Stable small pericardial effusionCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter low-attenuation foci.SPLEEN: Status post splenectomyPANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephrectomy site clear.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absentBLADDER: No significant abnormality noted.LYMPH NODES: Stable reference right external iliac lymph node best seen on image 165 of series 3 measuring 1.8 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval decrease in size of reference left lower lobe lung nodule; otherwise, stable examination. |
Generate impression based on findings. | Reason: ascending thoracic aneurysm last exam 1 year ago measured 3.2cm Looking for interval change History: thoracic aneurysm CHEST:LUNGS AND PLEURA: There is respiratory motion artifact.Biapical pleural parenchymal thickening. Bibasilar subsegmental atelectasis with ground glass opacities that may represent blurring from respiratory motion.MEDIASTINUM AND HILA: Heart size is normal. No other cardial effusion.No mediastinal or hilar lymphadenopathy.The following orthogonal dimensions of the thoracic aorta are as follows:Sinus of Valsalva: 37 x 39 x 39mmSinotubular junction: 36 x 35mmMID ascending thoracic aorta at the level of the main pulmonary artery: 45 x 45 mmAscending thoracic aorta, immediately proximal to the innominate artery: 26 x 23 mmDistal transverse arch: 22 x 21mmCHEST WALL: Respiratory motion creates artifact at the mid chest wall.ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic hypodensities of various sizes which are incompletely evaluated. They may represent cysts or possibly hemangiomas.SPLEEN: No significant abnormality notedADRENAL GLANDS: Small low-density nodule right adrenal gland favoring that of an adenoma. Confirmation with an in and opposed phase MRI may be obtained, if clinically appropriate.KIDNEYS, URETERS: No significant abnormality notedPANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of the visualized lumbar spineOTHER: No significant abnormality noted | Ascending thoracic aneurysm with a maximal dimension at the level of the mid ascending thoracic aorta 45 x 45 mm. Recommend follow up imaging with ECG gated CTA thorax. |
Generate impression based on findings. | Nocturnal cough, nasal stuffings. The maxillary sinuses are clear. There is minimal scattered bilateral ethmoid sinus mucosal thickening. The sphenoid sinuses are clear. The frontal sinuses are clear. There is mild nasal septal deviation. There is a small right conchae bullosa. The nasal cavity is clear. The turbinates do not appear particularly enlarged. The ethmoid roofs are nearly symmetric and intact. The optic canals and carotid grooves are covered by bone. There are advanced degenerative changes affecting the left temporomandibular joint. The imaged intracranial structures and orbits are grossly unremarkable. | No evidence of acute sinusitis or obstructive nasal lesions. |
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