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Generate impression based on findings. | AML, r/o baseline sinusitis. There is mild mucosal thickening within the bilateral maxillary sinuses. The ethmoid sinuses are clear. There is mild mucosal thickening within the bilateral sphenoid sinuses. The frontal sinuses are clear. There is nasal septal deviation and rightward spur that contract he medial wall of the right maxillary sinus. The nasal cavity is clear. The left ethmoid roof is slightly lower than the right ethmoid roof, but these are intact. The carotid grooves and optic canals are covered by bone. The imaged portions of the intracranial structures and orbits are grossly unremarkable. | Mild scattered paranasal sinus mucosal thickening without air-fluid levels. |
Generate impression based on findings. | 50 year old female with flatulence, eructation, and gas pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse hepatic steatosis again identified. Benign hepatic cyst seen in segment 8, unchanged. No solid parenchymal masses seen, however, presence of fat obscures lesions on CT and if concern over hepatic solid tumors exists, MR examination is recommended.Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate, nonobstructing left lower pole calyceal calcification seen without change. No other renal abnormality identified.RETROPERITONEUM, LYMPH NODES: No enlarged retroperitoneal lymph node is seen. Scattered mildly prominent mesenteric lymph nodes of uncertain significance are seen with the largest lymph node measuring 1.8 x 1.3 cm (series 3, image 52) not significantly changed..BOWEL, MESENTERY: Orally administered contrast rapidly progresses through normal stomach and small bowel to the colon without abnormality seen. No evidence of obstruction. No free mesenteric fluid seen.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: Orally administered contrast rapidly progresses through normal stomach and small bowel to the colon without abnormality seen. No evidence of obstruction. No free mesenteric fluid seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Diffuse hepatic steatosis. 2. Scattered mildly enlarged mesenteric lymph nodes of uncertain significance, but unchanged. 3. No abnormalities seen in the intestinal tract accounts for patient's symptomatology. |
Generate impression based on findings. | 65-year-old female with history of large cell lymphoma CHEST:LUNGS AND PLEURA: Few scattered pulmonary nodules, unchanged. Subcentimeter left lower lobe micronodular and is unchanged on image number 82, series number 5 measuring 6-mm.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: 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 significant change from previous study. |
Generate impression based on findings. | Syncope. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a small right maxillary sinus retention cyst. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | 74-year-old female with microhematuria and mild right-sided hydronephrosis This study is limited due to lack of IV contrast.ABDOMEN:LUNG BASES: Small amount of para cardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of nephrolithiasis.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: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study to look of IV contrast. No evidence of nephrolithiasis. |
Generate impression based on findings. | Prekidney transplant evaluation. Assess aorta and iliac vessels for kidney transplant The study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodense lesions in both kidneys likely representing cysts, however, cannot optimally characterized it to lack of IV contrast.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcifications involving the aorta, major branches and bilateral iliac vessels.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 | Limited study due to lack of IV contrast. Extensive atherosclerotic calcifications. |
Generate impression based on findings. | 75-year-old male with 7.8 cm, abdominal aortic aneurysm. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted in liver parenchyma, however, only arterial phase and noncontrast enhanced images were obtained and does not completely evaluate liver parenchyma. No abnormality seen in gallbladder or biliary tract. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple benign cortical renal cysts are seen. The right kidney -- no other significant abnormalities are seen in the kidneys.RETROPERITONEUM, LYMPH NODES: Large infrarenal, lumbar aortic aneurysm with maximal dimension of 8.5 x 7.7 cm with complete description with CT angiogram. No retroperitoneal abnormal masses..BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedCT ANGIOGRAM: Abdominal aorta shows normal caliber at the diaphragmatic cruise. Origins of the celiac axis and the superior mesenteric artery show normal appearing vessels. Right and left renal artery origins appear normal. No significant atherosclerotic narrowing or dilatations are seen in the proximal abdominal aorta, however, just distal to the renal arteries is a large lumbar aortic aneurysm with maximal dimension of 8.5 x 7.7 cm. the aneurysm ends at the aortic bifurcation, although minimal ectasia is seen of the proximal right and left common iliac arteries, which have a maximal diameter of 1.7-mm (right) and 1.5-cm (left) which become normal diameters at the bifurcation into internal and external iliac arteries bilaterally. Atherosclerotic peripheral calcification is seen in the common, external and internal iliac arteries, but without significant narrowing.PELVIS:PROSTATE, SEMINAL VESICLES: Marked prostatic enlargement seen without other abnormality.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Mildly ectatic common iliac arteries bilaterally bifurcate into normal sized internal and external iliac arteries, with peripheral atherosclerotic calcifications. For further details see CT angiogram reported above. | 1. Lumbar aortic aneurysm with maximal cross-sectional diameter of 8.5 x 7.7 cm. 2. Ectatic common iliac arteries bilaterally. 3. No significant narrowing seen in the abdominal/pelvic major arterial vasculature. 4. Marked prostatic hypertrophy. |
Generate impression based on findings. | Left MCA stroke on 10/23. There is patchy hypoattenuation within the left basal ganglia, which is more conspicuous than on the prior CT, compatible with evolving infarction. There is no evidence of hemorrhagic transformation. There is hyperdensity within the left MCA, which may represent thrombus. There is no evidence of midline shift or herniation. The ventricles are stable in size and configuration. The extracranial structures are unchanged. | Patchy hypoattenuation within the left basal ganglia, which is more conspicuous than on the prior CT, compatible with evolving infarction. No evidence of hemorrhagic transformation. |
Generate impression based on findings. | Abnormal bone marrow of the right mandibular condyle and ramus, indicating inflammation. There is patchy sclerosis and flattening of the right mandibular condyle as well as several 1 to 2 mm diameter subchondral cysts that are new findings from 2004 and correspond to the abnormality on the recent prior MRI. There is also irregularity of the margins of the right glenoid fossa. There is mild narrowing of the right temporomandibular joint space without evidence of osseous ankylosis. The left temporomandibular joint is essentially intact. The paranasal sinuses and mastoid air cells are clear. The imaged portions of the intracranial structures and orbits are grossly unremarkable. | Moderately advanced degenerative changes involving the right temporomandibular joint, which may be secondary to prior avascular necrosis. |
Generate impression based on findings. | 65-year-old male with metastatic thyroid cancer. CHEST:LUNGS AND PLEURA: No significant change in innumerable bilateral pulmonary metastases. Reference left upper lobe nodule measures 12 x 11 mm, previously measured 12 x 11 mm (series 5, image 28).Reference left upper lobe nodule measures 12 x 9 mm, previously measured 12 x 9 mm (series 5, image 30).No new nodules identified.MEDIASTINUM AND HILA: Soft tissue thickening along right brachiocephalic artery appear similar. No pathologically enlarged mediastinal lymph nodes. Right hilar adenopathy not significantly changed. Moderate to severe coronary artery calcifications. Heart size normal.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Mesenteric calcification with associated soft tissue extensions/scarring unchanged compared to 6/2013.BONES, SOFT TISSUES: Bone island in L1 vertebral body. Lucent lesions in L1, L3, and L4 vertebral bodies also unchanged and most compatible with hemangiomas. No new or suspicious bone lesions.OTHER: No significant abnormality noted. | Stable lung and hilar metastatic disease. |
Generate impression based on findings. | 71-year-old male patient with hematuria. Note that the lack of orally administered contrast limits evaluation of the bowel.ABDOMEN:LUNG BASES: Bilateral pleural effusions with associated atelectasis and volume loss, right greater left. There is redemonstration of a right anterior lung base nodule (series 5 image 5), stable from prior.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: Normal renal contour without masses. No hydronephrosis, hydroureter or renal calculi. On delayed images there is complete visualization of the left ureter without filling defects. There is normal filling of the right ureter proximally at the ureteropelvic junction and at the ureterovesical junction without visualization of mid ureter filling.Of note, there is an accessory renal artery to the lower pole of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative facet changes to the thoracic and lumbar spine. OTHER: Scattered atherosclerotic changes in the abdominal aorta and iliac arteries.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate, measuring 7.2 x 6.3 cm (series 6 image 153).BLADDER: Nondistended urinary bladder without bladder calculi.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative facet changes to the thoracic and lumbar spine. OTHER: Scattered atherosclerotic changes in the abdominal aorta and iliac arteries. | 1.No renal masses, hydronephrosis or renal calculi.2.Enlarged prostate.3.Bilateral pleural effusions.4.Stable right subpleural lung nodule. |
Generate impression based on findings. | 47-year-old male, evaluate for aortic dissection CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Aortic dissection arises at the origin of the left subclavian artery, similar to the prior study. The aortic root is uninvolved. The right innominate, left common carotid, and left subclavian arteries appear unremarkable. The coronary arteries appear unremarkable.CHEST WALL: Note is made of a right axillary bypass graft extending inferiorly beyond the field-of-view. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic bilateral kidneys with multiple cysts and hypoattenuating lesions too small to characterize and poorly enhancing renal cortex.RETROPERITONEUM, LYMPH NODES: The aortic dissection flap extends throughout the abdominal aorta and into the left external iliac artery, beyond the field-of-view. The large channel false lumen encircles the slitlike true lumen. The true lumen given rise to the right renal artery. The false lumen gives rise to the celiac artery. Both the true and false lumens extend into the left renal artery. A dissection flap extends distally within the SMA. The true lumen gives rise to the IMA, and right iliac artery. The dissection flap and a thin true lumen extend into the left external iliac artery.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: Aortic dissection flap extends throughout the abdominal aorta and into the left external iliac artery, beyond the field-of-view, as detailed above. | 1. Unchanged aortic dissection extending from the origin of the left subclavian artery throughout the thorax and abdomen into the left external iliac artery beyond the field-of-view, as detailed above. 2. Atrophic endstage native kidneys with multiple hypoattenuating lesions many too small to characterize. |
Generate impression based on findings. | Reason: 61yo F with papillary thyroid cancer invading esophagus and trachea, eval for extent of invasion History: same LUNGS AND PLEURA: Multiple pulmonary micronodules are nonspecific but may represent pulmonary metastases.No pleural effusions.Mild dependent atelectasis.MEDIASTINUM AND HILA: Status post thyroidectomy.Increased soft tissue in the thyroid bed may represent postsurgical changes, however tumor infiltration, cannot be evaluated without the use of intravenous contrast .No hilar or mediastinal lymphadenopathy identified.Cardiac size is normal without evidence a pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. At infiltration of the liver. | 1.Multiple pulmonary micronodules are nonspecific but may represent metastatic disease.2. Soft tissue fullness in the region of the thyroidectomy may be r postsurgical in origin. However, without the use of intravenous contrast tumor infiltration cannot be excluded. |
Generate impression based on findings. | Reason: hx of pseudomonus pneumonia and bronchiectasis s/p recent hospitalization for exacerbation in early june History: hx of pseudomonus pneumonia and bronchiectasis compare to previous chest CT 06/06/13 LUNGS AND PLEURA: Interval clearing of patchy air space opacities compatible with pneumonia.Persistent extensive bronchiectasis and bronchiolitis, most severe in the lower lobes.Moderately severe mainly upper zone centrilobular emphysema with subpleural reticulonodular chronic interstitial opacities.MEDIASTINUM AND HILA: New massively enlarged lymph nodes in the lower right paratracheal area, right hilum and subcarinal area. The lower right paratracheal lymph nodes measure more than 4 cm in diameter and contain an area of low density suggesting necrosis.Enlarged right hilar nodes surround the bronchus intermedius and produce some degree of bronchial narrowing.New small subpleural nodules are present posteriorly in both lower lobes.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Resolution of previous focal opacities compatible with pneumonia, with residual extensive bronchiectasis. 2. New massively enlarged right paratracheal and right hilar lymph nodes with internal necrosis and compression of right hilar bronchi, of uncertain etiology. Diagnostic considerations include necrotizing infection and neoplasm. |
Generate impression based on findings. | 66-year-old male with history of metastatic gastric cancer CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are unchanged. No new suspicious nodules or masses.MEDIASTINUM AND HILA: Reference right paratracheal lymph node measures 1.2 x 0.9 cm (image 36, series 3) and previously measured 1.3 x 0.9 cm. Scattered atherosclerotic calcifications of the aortic arch and its branches. Marked atherosclerotic changes of the coronary arteries. Right central venous catheter extends to the SVC. Thickening of the esophageal wall at the gastroesophageal junction appears similar to the prior study.CHEST WALL: Interval decrease in axillary lymphadenopathy with no residual adenopathy. Right chest wall port.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: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Small residual lymph node at the gastroesophageal junction measures 0.9 x 0.6 cm (image 85, series 3) and previously measured 0.9 x 0.6 cm.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted | Interval decreased axillary lymphadenopathy with otherwise unchanged reference measurements and no new sites of disease. |
Generate impression based on findings. | 85 year-old female with left hand weakness and facial droop. There is evolution of prior areas of infarction seen in the right frontal and parietal regions and right posterior temporal occipital lobes with continued loss of distinction of the grey-white matter margin. There is no hemorrhagic conversion or increased size of these lesions.There is a small area of hypodensity in the mid right lateral frontal subcortical and deep white matter which now appears more confluent, previously seen as scattered areas of diffusion and FLAIR abnormalities on MR from 9/6, which may represent interval age-indeterminate ischemia superimposed on more chronic ischemia.The ventricles and basal cisterns are normal in size and configuration.There is evidence of hyperostosis frontalis, otherwise the calvaria and skull base are normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | 1. Small area of hypodensity in the right lateral frontal lobe white matter which appears more confluent than on prior MR which may represent interval age-indeterminate small vessel ischemic changes superimposed on more chronic evolving areas of ischemia. Nonenhanced CT is suboptimal for evaluation of acute ischemic stroke and MR imaging may be considered for further characterization.2. Evolution of prior infarctions seen in the right frontal and parietal and right posterior temporal and occipital lobes. |
Generate impression based on findings. | 43 female with sepsis, tachycardia, and abdominal pain. ABDOMEN:LUNG BASES: Pleural effusions and adjacent atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy.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: G-tube extends to the stomach with the balloon well seated against the anterior abdominal wall. Lack of IV contrast limits evaluation of the bowel wall, but the previously noted colonic wall thickening appears to have resolved with normal haustral folds now visualized. No evidence of bowel obstruction, free or loculated fluid collectionBONES, 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: Lack of IV contrast limits evaluation of the bowel wall, but the previously noted colonic wall thickening appears to have resolved with normal haustral folds now visualized. No evidence of bowel obstruction, free or loculated fluid collectionBONES, SOFT TISSUES: Degenerative changes of the pubic symphysis. OTHER: No significant abnormality noted | 1. No specific abdominal or pelvic findings to account for the patient's pain and tachycardia. The previously noted distal colonic wall thickening has resolved.2. New small pleural effusions and adjacent atelectasis. |
Generate impression based on findings. | Muscle weakness. There is a large confluent area of edema in the right MCA territory and smaller areas of edema in the left MCA territory superimposed upon chronic areas of white matter hypoattenuation. The degree of swelling has generally increased as evidenced by increased effacement of the right lateral ventricle. There is no evidence of hemorrhagic transformation. There is approximately 2 mm of midline shift to the left and mild right uncal medialization. The imaged paranasal sinuses and mastoid air cells are clear. There is left intraocular silicone oil and a right lens implant. | Interval evolution of bilateral MCA territory infarcts, right greater than left, with increased swelling, but no evidence of hemorrhagic transformation. |
Generate impression based on findings. | 32-year-old female patient with history of lung mass. Follow-up for lung mass vascularities. Status post bilateral lower lobe nodule resection 2010. CHEST:LUNGS AND PLEURA: Postsurgical changes in the right lower lobe and left lower lobe. No new nodules.MEDIASTINUM AND HILA: No lymphadenopathy.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:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral lower lobe postsurgical changes without new nodules. |
Generate impression based on findings. | 63 year-old female with breast cancer, baseline prior to starting new chemo regimen, evaluate left neck mass. There are postsurgical findings related to recent left anterior neck mass excision with an open skin defect that is surrounded by a predominantly hypoattenuating ill-defined exophytic mass, which appears to have increased in size somewhat, now measuring up to approximately 9 cm, previously 8 cm. The mass is centered in the infrahyoid left neck and extends from the level of the left sternoclavicular joint to the level of the hyoid bone. There remains infiltration of the left paraspinal muscles including the scalene muscles and extensive surrounding skin thickening and stranding of the subcutaneous fat. In addition, the mass extends through the superior lateral left chest wall into the left lung apex and into the left neural foramina at C5 and C6. Within the limits of CT, no definite intraspinal canal extension. The left subclavian artery extends through the soft tissue induration and appears patent throughout its visualized distribution. The left vertebral artery is encased within the tissue density, but remains patent throughout its visualized course. The left common carotid artery is also encased by the mass, but remains patent. The left jugular vein is obliterated at the level of the left neck mass, unchanged. No additional cervical lymphadenopathy is identified aside from the aforementioned conglomerate left neck mass. The aerodigestive tract is unremarkable with no exophytic mass or focal effacement. Smaller size of the left piriform sinus is chronic and at least partially partially attributed to the retropharyngeal course of the left common carotid artery. The salivary glands and thyroid gland are unremarkable. There is a partially imaged left axillary/left retropectoral necrotic appearing mass which extends posteriorly along the left lateral thoracic cage. There is also incompletely imaged superior mediastinal lymphadenopathy. There is erosion of the left sternomanubrial articulation and left first rib-sternal articulation may be secondary to tumoral invasion or osteomyelitis. There are bilateral apical lung nodules, left greater than right. Refer to the separate chest CT report for additional details. | 1. Interval increase in size of the previously operated large left neck mass that involves multiple critical structures, as detailed in the findings section.2. Partially imaged mediastinal lymphadenopathy and left axillary/retropectoral necrotic mass and lung nodules. Please refer to the dedicated chest CT for further details.3. Erosive changes at the left sternomanubrial articulation and left first rib-sternal articulation may be secondary to tumoral invasion and/or osteomyelitis. |
Generate impression based on findings. | 73 year old male with superficial bladder cancer, undergoing staging. CHEST:LUNGS AND PLEURA: 4-mm nonspecific right lower lobe nodule (series 6, image 48). Prior imaging did not go this high in the body to image this portion of the chest for comparison. Left basilar atelectasis unchanged.MEDIASTINUM AND HILA: Minimally. Normal size, mediastinal and hilar lymph nodes with the largest node (series 4, image 37) in the precarinal space measuring 0.6-cm in short axis dimension.. coronary calcification and mitral annular calcification seen. No other abnormalities are seen.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hemangioma seen at dome of liver. Liver parenchyma otherwise shows no mass lesions. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The left upper pole kidney shows medial parenchymal atrophy, most likely vascular in nature. Renal parenchyma otherwise shows no solid mass lesions with small cortical benign cysts seen in left kidney. No hydronephrosis.The ureters are slightly dilated in their distal course as they approach the bladder with slight prominent wall appearance -- this most likely relates to prior chronic inflammation or bladder outlet obstruction as they are seen bilaterally..RETROPERITONEUM, LYMPH NODES: No adenopathy 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 enlarged lymph nodes are identified -- the largest lymph node in the anterior left obturator, internal region has a short axis diameter of 7 mm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Nonspecific 4-mm right lower lobe lung nodule. No old studies are available to determine the chronicity of this lesion. 2. No adenopathy or other evidence of metastatic disease. |
Generate impression based on findings. | 62 year old female with metastatic breast cancer. CHEST:LUNGS AND PLEURA: Lungs are underinflated with scattered ground glass opacities likely representing subsegmental atelectasis. Trace left pleural effusion. Left apical consolidation in not significantly changed, which may reflect post radiation reaction. Left basilar atelectasis/consolidation also appears similar.Multiple pulmonary lung nodules have mildly but definitely increased in size; reference right lower lobe nodule measures 10 mm, previously measured 8 mm (series 4, image 40). No new nodules identified.MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes are increased in size since prior exam; for reference, left paratracheal node measures 1.4 x 1.9 cm, previously measured 1.1 x 1.4 cm (series 3, image 23). Heart size normal. No pericardial effusion. Prominent main pulmonary artery measuring 3.6 cm in diameter suggestive of pulmonary arterial hypertension (series 3, image 27).Right venous catheter terminates in right atrium.CHEST WALL: Infiltrative left supraclavicular mass extending into the left axilla and left lateral chest wall; reference left axillary centrally necrotic lesion mildly increased in size, measuring 3.9 x 3.5 cm, previously measured 3.5 x 3.1 cm (series 3, image 23). Please see dedicated neck CT report for findings regarding destructive, ulcerated left lower neck lesion.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right kidney is absent. Left kidney contains subcentimeter hypodensities, too small to characterize, but likely benign 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: Metallic device is present in the subcutaneous soft tissues of the left lower abdomen.OTHER: No significant abnormality noted. | 1.Mild increase in size of multiple lung nodules, consistent with metastases2.Mild increase in mediastinal lymphadenopathy.3.Mild increase in necrotic left axillary lesion.4.No evidence of intra-abdominal metastatic disease.5.Please see separate neck CT report for findings regarding left lower neck lesion. |
Generate impression based on findings. | Clinical question: Ventriculogram. Omnipaque 180 needed. Signs and symptoms: Hydrocephalus status post EVD placement low CSF output. Nonenhanced head CT:Examination performed after referring clinical service is injected to cc of Omnipaque 180 into the ventricular catheter.Examination demonstrate no contrast in the detectable left-sided ventricular system. The injected contrast appears fairly well demarcated and with contiguous linear fashion and not within the ventricular system. The contrast likely within the subarachnoid space or right-sided subdural space since it is located immediately under the widened epidural space under the right frontoparietal craniotomy flap. The widened epidural space under the craniotomy flap measures approximately 9 mm similar to prior exam.Compared to prior exam from 10 -- 18 -- 13 there is interval increased size of the lateral and the third ventricle.There is no evidence contrast in the well identified left lateral ventricles, third ventricle or the subarachnoid space on the left side. No change in the position of tube previously placed catheters. | 1.Injected Omnipaque 180 contrast through the catheter is not within the ventricular system. There is also no detectable contrast in the subarachnoid space of the left hemisphere.2.There is interval increased size of left lateral ventricle and third ventricle since prior exam.3.There is no change in the size of tube previously placed catheters.4.There is widening of the epidural space under the right sided craniotomy changes measuring approximately 9 mm in size.5.Injected contrast accumulates in a well demarcated contiguous fashion immediately medial to the dura under the craniotomy flap.6. |
Generate impression based on findings. | 50 year-old male with left lower quadrant pain and urinalysis with positive blood. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No nephrolithiasis. Mild prominence of the left collecting system and perinephric stranding as well as mild left hydroureter.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: A 3-mm stone is noted at the left ureterovesicular junction.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 3-mm calculus within the ureterovesicular junction and mild left hydroureter with prominence of the left collecting system and mild perinephric stranding. No nephrolithiasis. |
Generate impression based on findings. | Female 30 years old; Reason: Gastric cancer needs restaging with new physical findings of neck and axillary lymphadenopathy History: Gastric cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Soft tissue density anterior mediastinum likely represents residual thymic tissue. Mediastinal adenopathy is roughly stable. Reference precarinal lymph node measures 1.2 x 0.7 cm (image 31; series 3), unchanged compared to prior.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No definite metastases identified. Gallbladder is partially collapsed.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: Increase in size and number. The reference left periaortic lymph node measures 0.6 x 0.6 cm (image 107; series 3), relatively unchanged.BOWEL, MESENTERY: Extensive fatty infiltration of the mesentery, increased since the prior exam. Increasing mesenteric adenopathy with index lesion measuring 1.2 x 1 .7 cm (series 3 image 116), previously 0.9 x 10 cm.. No change in gastrohepatic lymphadenopathy.There is omental and peritoneal nodularity, worrisome for carcinomatosis. This is also progressive previous exam.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status-post oophorectomy. Nodular thickening in the cul de sac appears stable since previous exam.BLADDER: No significant abnormality noted.LYMPH NODES: Small scattered lymph nodes are larger, with the reference left iliac node measuring 1.2 x 1 .2 cm (series 3 image 157), previously 0.7 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Increased free fluid in the cul-de-sac. | 1. Progression of retroperitoneal, mesenteric and, peritoneal adenopathy and carcinomatosis as above. |
Generate impression based on findings. | Reason: rule out thyroid cancer metastases History: none LUNGS AND PLEURA: Multiple bilateral micronodules, some of which are calcified, unchanged since the previous scan, compatible with previous infection and intrapulmonary lymph nodes.No suspicious nodules.Right apical scar, unchanged.MEDIASTINUM AND HILA: Status post thyroidectomy with multiple surgical clips in the thyroid bed.Mildly enlarged superior right paratracheal lymph node, unchanged or slightly decreased from previous.Extensive ascending aortic calcification and moderate coronary calcification.CHEST WALL: Status post right mastectomy and axillary node dissection.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Several very small hypodense areas in the liver, unchanged, compatible with cysts.Moderate fatty infiltration of the liver. Moderately enlarged lesser curve gastric lymph node, unchanged. | Stable micronodules compatible with a benign etiology.No sign of metastases. |
Generate impression based on findings. | Reason: sarcoid History: sarcoid . LUNGS AND PLEURA: Bilateral scattered benign appearing micronodules, largest measuring 4 mm in the right lower lobe (series 4, image 78).MEDIASTINUM AND HILA: No significant lymphadenopathy. Punctate calcification in the para-aortic region (series 3, image 32).CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No significant abnormality and no evidence of sarcoidosis. |
Generate impression based on findings. | Invasive papillary thyroid carcinoma status post thyroidectomy. There are interval postoperative findings related to total thyroidectomy. There is no mass lesion in the surgical bed to suggest residual or recurrent tumor. There is no significant cervical lymphadenopathy. The trachea and esophagus are unremarkable. The major salivary glands are unremarkable. The major cervical vessels are patent. The paranasal sinuses and mastoid air cells are clear. The imaged intracranial structures and orbits are grossly unremarkable. There are no lytic or blastic lesions. The imaged portions of the lungs are clear. | Interval postoperative findings related to total thyroidectomy without evidence of residual or recurrent locoregional tumor and no significant cervical lymphadenopathy. |
Generate impression based on findings. | Left preauricular lesion. There is an soft tissue mass within the superficial left parotid lobe, which measures approximately 20 AP x 15 RL x 25 SI mm. The mass appears to be slightly bosselated. There is no widening of the stylomastoid foramen or effacement of the trigeminal fat pad. The other major salivary glands are unremarkable. There is no significant cervical lymphadenopathy. The thyroid gland is unremarkable. The major cervical vessels are patent. There are multiple right maxillary dental caries with associated periodontal lucencies. The osseous structures are otherwise intact. Thre is mild scattered paranasal sinus mucosal thickening. The imaged intracranial structures and orbits are unremarkable. | 1. A mass within the superficial left parotid lobe measures approximately up to 25 mm. Differential considerations include most likely a pleomorphic adenoma and less likely other salivary gland neoplasms or nerve sheath tumor. Parotid MRI may be useful for further characterization if clinically warranted.2. Right maxillary dental caries with associated periodontal lucencies. |
Generate impression based on findings. | Reason: 23 male with newly diagnosed ALL, r/o baseline pulmonary infiltrate History: ALL LUNGS AND PLEURA: Left moderate pleural effusion with overlying atelectasis and consolidation. Right mild pleural effusion with overlying atelectasis. Linear opacity in the superior portion of the lower lobe extending to the hilum suggestive of atelectasis/consolidation.MEDIASTINUM AND HILA: Multiple scattered subcentimeter paratracheal, supraclavicular. Prominent lymphoid tissue in the mediastinum. Bilateral hilar coalescing lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Although the spleen is not fully visualized, it appears enlarged. | 1.Bilateral pleural effusions, left greater than right, with overlying consolidation which may be compressive atelectasis but infection cannot be excluded.2.Prominent lymphoid tissue in the mediastinum.3.Splenomegaly, although spleen is fully visualized. |
Generate impression based on findings. | Gastric cancer needs restaging with new physical findings of neck and axillary lymphadenopathy. There are numerous enlarged and hyperattenuating cervical lymph nodes. Reference lymph nodes include the following:* A left level 5 lymph node measures 14 x 9 mm (image 25, series 6).* A right level 5 lymph node measures 11 x 7 mm (image 38, series 6).* A right level 3 lymph node measures 11 x 8 mm (image 36, series 6).* A left supraclavicular lymph node measures 13 x 9 mm (image 49, series 6).There are also enlarged bilateral axillary lymph nodes. Refer to the separate chest CT report for additional details. The thyroid gland is unremarkable. The nasopharynx, oropharynx, oral cavity, hypopharynx, larynx, and trachea are unremarkable. There are no lytic or blastic lesions. There is a left internal jugular venous catheter. The imaged intracranial structures and orbits are unremarkable. The imaged portions of the lungs are clear. | 1. Numerous enlarged and hyperattenuating cervical lymph nodes consistent with metastases. 2. Enlarged bilateral axillary lymph nodes. Refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 60 year-old male with abdominal pain, rule out stone or cholecystitis ABDOMEN:LUNG BASES: Bilateral pleural effusions. Marked cardiomegaly with dilatation of the right atrium. Cardiac leads are partially visualized.LIVER, BILIARY TRACT: Dilated hepatic veins, indicating right heart dysfunction. The gallbladder appears unremarkable. No focal hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys with several hypoattenuating lesions like representing cysts. No nephrolithiasis or hydronephrosis.RETROPERITONEUM, LYMPH NODES: The echogenic components of the aortic balloon pump extend from the level of the SMA and celiac artery to the left renal vein.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate 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: Surgical change, consistent with hernia repair.OTHER: Moderate pelvic ascites. | 1. No evidence of acute intra-abdominal abnormality to account for the patient's pain.2. Cardiomegaly and dilated hepatic veins as well as bilateral pleural effusions and mild abdominal and pelvic ascites indicating heart failure. |
Generate impression based on findings. | 69 year-old female with squamous cell lung carcinoma and active leukemia, worsening pleural effusion and shortness of breath. LUNGS AND PLEURA: Interval increase in large right pleural effusion, with associated basilar consolidation. No significant left pleural effusion. Previously seen right apical scar like opacity is not well delineated on current exam due to increase of underlying effusion and new right apical consolidation (series 5, image 27). Given right apical consolidation, evaluation for nodules/lesions in this location is difficult.Right middle lobe pleural based nodularity is increased, with reference nodule measuring approximately 11 mm, previously measured 7 mm (series 5, image 43).Stable left lower lobe nodule measuring 5 mm, previously measured 5 mm (series 5, image 78).Stable subpleural nodule in the anterior aspect of left upper lobe measures 7 mm, previously measured 7 mm (series 5, image 46).Severe upper lobe predominant emphysema.MEDIASTINUM AND HILA: New right paratracheal and right hilar lymphadenopathy causing narrowing of right upper lobe and bronchus intermedius (series 3, image 45); accurate measurement of these lymph nodes is difficult to lack of IV contrast, however, right paratracheal node measures approximately 1 0.1 x 2.0 cm (series 3, image 37). Severe calcifications in coronary arteries and aorta.Previously seen soft tissue infiltration of superior mediastinum, which may be radiation related, is less well appreciated on current exam due to lack of IV contrast, although likely not significantly changed.Central venous catheter tip terminates in upper RA.CHEST WALL: Patchy sclerosis and lucency in T5 vertebral body unchanged. No axillary lymphadenopathy. Nodularity in left breast unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | 1.Interval increase in large right pleural effusion, with associated compressive atelectasis in the right base and new consolidation in the right apex. 2.Progressive increase in pleural based nodularity in right lower lobe since 2012, suspicious for recurrent neoplasm.3.New right paratracheal and right hilar lymphadenopathy causing narrowing of right upper lobe and bronchus intermedius. |
Generate impression based on findings. | Female 30 years old Reason: 30 yo female with right ureteral stent, pls evaluate for abscess, fluid collection if CT w/o renal stone protocol is negative History: right flank pain, RLQ pain. ABDOMEN: Evaluation of bowel is limited by lack of oral contrast.LUNG BASES: Moderate large bilateral pleural effusions of uncertain etiology. Associated compressive atelectasis or consolidation in the lung bases, right greater than left. Correlate clinically.Visualized mediastinal structures are unremarkable.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Pre-IV contrast shows nephroureterostomy stent in place and no evidence of nephrolithiasis. There is perinephric fat stranding, fairly extensive extending around and caudal to the kidney.Right kidney is somewhat large relative to the left with diminished nephrogram relative to the left kidney. Areas of striation of the nephrogram and particularly more marked broad area of wedge-shaped hypoattenuation involving the lower pole with some peripheral areas of and hypoenhancement and fluid density. This is likely related to, infection but a component of infarction.A second area of hypoattenuation with a somewhat rounded configuration. A central hypoattenuation is seen in the upper pole concerning for an intrarenal abscess. This is seen on coronal series 8, 0348 image 32/87.The left kidney is normal.RETROPERITONEUM, LYMPH NODES: Scattered small retroperitoneal nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate to marked generalized anasarca.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: Distal end of the right nephroureterostomy stent is seen in the urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Moderate to marked generalized anasarca.OTHER: No significant abnormality noted | Multifocal areas of hypoattenuation and focal fluid collections developing in the right upper and right lower poles consistent with renal infection and early abscess formation. Overall diminished nephrogram on the right.Ascites.Moderate bilateral pleural effusions. Atelectasis or consolidation. Right greater than left.Anasarca. |
Generate impression based on findings. | 30 year-old female patient with history of ulcerative colitis status post proctocolectomy with recent second step of IPAA and diverting ileostomy presents with severe pelvic pain, fever and blood-tinged discharge from pouch. Evaluate for pelvic fluid/abscess. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Oral contrast rapidly progressed through normal appearing stomach and small bowel. Diverting ileostomy in the right lower quadrant with passage of contrast into the pouch without abnormalities. No fat stranding, suspicious lymphadenopathy or fluid collection involving the small bowel or mesentery.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: Diverting ileostomy in the right lower quadrant. No fat stranding, suspicious lymphadenopathy or fluid collection involving the small bowel or mesentery.Ileoanal pouch with sutures.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Posterior to the ileoanal pouch there is a fluid collection that measures 4.3 x 3.8 cm (series 3 image 117). Wall enhancement and trace air within this region is suggestive of infection in this 10 days postoperative patient. | Fluid collection posterior to the ileoanal pouch. Although CT is not sensitive for characterization of fluid within this collection, an enhancing wall and air within the collection suggests infection. |
Generate impression based on findings. | 61 year-old female with history of lymphoma, abdominal pain, nausea, in need of restaging. CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged.MEDIASTINUM AND HILA: Confluent soft tissue in the mediastinum extending to the left lower neck appears similar to the prior study. Multiple small prominent paratracheal lymph nodes are noted. Right central venous catheter tip extends to the SVC.CHEST WALL: Right chest wall port. No axillary adenopathy.ABDOMEN:LIVER, BILIARY TRACT: Right hepatic hemangioma is unchanged. New confluent soft tissue surrounding the portal vein at the porta hepatis is suspicious for disease involvement. For reference, a lymph node anterior to the portal vein measures 1.5 x 5.5 cm (image 303, series 6) and previously measured 2.5 x 0.8 cm (image 108, series 3).SPLEEN: Marked splenomegaly extending inferiorly to the pelvis, measuring greater than 26 cm, increased from the prior study. Reference hypoattenuating splenic lesion measures 1.6 x 2.1 cm and previous measured 2.0 x 1.3 cm (image 71, series 604). Additional hypodense lesions are also noted. Adenopathy is noted adjacent to the splenic hilum.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: New periaortic and mesenteric lymphadenopathy in the upper abdomen.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. | Marked splenomegaly and abdominal lymphadenopathy, increased from the prior study, consistent with disease progression. |
Generate impression based on findings. | Female 30 years old Reason: 30 yo female with right ureteral stent, pls evaluate for abscess, fluid collection if CT w/o renal stone protocol is negative History: right flank pain and RLQ pain. ABDOMEN: Evaluation of bowel is limited by lack of oral contrast.LUNG BASES: Moderate large bilateral pleural effusions of uncertain etiology. Associated compressive atelectasis or consolidation in the lung bases, right greater than left. Correlate clinically.Visualized mediastinal structures are unremarkable.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Pre-IV contrast shows nephroureterostomy stent in place and no evidence of nephrolithiasis. There is perinephric fat stranding, fairly extensive extending around and caudal to the kidney.Right kidney is somewhat large relative to the left with diminished nephrogram relative to the left kidney. Areas of striation of the nephrogram and particularly more marked broad area of wedge-shaped hypoattenuation involving the lower pole with some peripheral areas of and hypoenhancement and fluid density. This is likely related to, infection but a component of infarction.A second area of hypoattenuation with a somewhat rounded configuration. A central hypoattenuation is seen in the upper pole concerning for an intrarenal abscess. This is seen on coronal series 8, 0348 image 32/87.The left kidney is normal.RETROPERITONEUM, LYMPH NODES: Scattered small retroperitoneal nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate to marked generalized anasarca.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: Distal end of the right nephroureterostomy stent is seen in the urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Moderate to marked generalized anasarca.OTHER: No significant abnormality noted | Multifocal areas of hypoattenuation and focal fluid collections developing in the right upper and right lower poles consistent with renal infection and early abscess formation. Overall diminished nephrogram on the right.Ascites.Moderate bilateral pleural effusions. Atelectasis or consolidation. Right greater than left.Anasarca. |
Generate impression based on findings. | 64-year-old male with leg weakness, rule out intracerebral hemorrhage or CVA. Mild hypoattenuation in the periventricular white matter is nonspecific and likely represents small vessel ischemic disease of indeterminant age.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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. | No acute intracranial abnormalities.Please note that CT is insensitive for the detection of acute ischemia. |
Generate impression based on findings. | 17 year-old male with history of headache. There is no evidence of acute intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration. The calvaria and skull base are normal. The imaged paranasal sinuses and mastoid air cells are normally pneumatized. The skull and extracranial soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage, mass, or edema. |
Generate impression based on findings. | 67 year-old female with metastatic urothelial cancer with increased pain -- evaluate for progression. CHEST:LUNGS AND PLEURA: Innumerable pulmonary, parenchymal metastases again seen. Referenced right lower lobe lesion (series 6, image 74) measures 3.2 x 4 .2 cm, increased from previous measurement of 3.5 x 3.0. Left lower lobe reference lesion (series 5, image 24) now measures 2.3 x 2 .0 cm, increased from previous measurement of 2.0 x 1.6. Other non-reference lesions have similarly increased in size. No pleural effusions.MEDIASTINUM AND HILA: Increasing mediastinal lymphadenopathy seen diffusely. The referenced right paratracheal lymph node (series 4, image 42) now measures 2.3 x 2 .0 cm, previously 1.8 x 1.5 cm.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Increasing size of prior existing metastatic lesions in the liver and new lesions are now seen. The referenced right lower lobe nodule (series 4, image 122) now measures 1.3 x 1 .4 cm, previously 1.0 x 1.0-cm. gallbladder is again moderately distended without focal abnormality or gallstones. Extrahepatic bile duct is mildly dilated with a maximal diameter of 1.1 cm, unchanged. No intrahepatic biliary duct dilatation is seen and is unlikely. This represents biliary obstruction. 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 lymphadenopathy is again seen encasing the aorta and inferior vena cava. The distribution and size does not appear significantly changed. The referenced conglomerate periaortic lymph node (series 4, image 128) measures 2.4 x 3.3 cm, previously 2.5 x 2.9 cm. the referenced. There are no caval lymph node (series 4, image 112) now measures 1.7 x 2 .3 cm, not significantly changed from prior 2.3 x 1.6 cm. No new areas of lymph node involvement are seen.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: Bladder is deviated to the left pelvis and extends cephalad in a manner with an appearance suggestive of continent neobladder although postoperative changes are not seen in the bowel or mesentery and this may be native bladder.LYMPH NODES: Slightly prominent. Lymph nodes are again seen in the right external iliac lymph node chain, unchanged in size with maximal cross-sectional dimension of 1.0-cm (series 4, image 165). No new areas of lymph node enlargement seen in most of the lymph nodes are subcentimeter.The referenced right inguinal lymph node (series 4, image 189) is unchanged, measuring 2.4 x 1.5 cm compared with previous 2.3 x 1.4 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Increasing pulmonary, parenchymal metastatic disease. 2. Increasing mediastinal lymphadenopathy. 3. Increasing size and number of liver metastases. 4. Stable retroperitoneal lymphadenopathy. 5. Stable right inguinal enlarged lymph node. |
Generate impression based on findings. | Female 68 years old; Reason: 68 female with thrombocytopenia, prolonged immobilization. now with hip pain, left > right s/p bed transfer. r/o hip fracture vs. hematoma History: bilateral hip pain, left greater than right Bone mineralization is decreased. Status post total right hip arthroplasty with hardware components in anatomic alignment. No right hip fracture is evident.Mild to moderate osteoarthritis affects the left hip. No fracture is evident.Post operative changes in the pelvis.The right bladder is decompressed by a Foley catheter.Nonspecific soft tissue edema in the presacral space without fluid loculation. No hematoma is evident.Degenerative disk changes of the lower lumbar spine. | 1.First post total right hip arthroplasty.2.No evident pelvic fracture.3.No evident hematoma. |
Generate impression based on findings. | 52-year-old female patient with abdominal pain, nausea and vomiting. Evaluate for obstruction. ABDOMEN:LUNG BASES: Bibasilar scarring and 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: Postoperative changes from suspected prior bowel resection with end to end anastomosis in the lower abdomen (series 3 image 103). Proximally, there is thickening of distal loops of small bowel in the mid lower abdomen, consistent with edema. Minimal adjacent fat stranding. No abscess formation.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: Postoperative changes from suspected prior bowel resection with end to end anastomosis in the lower abdomen (series 3 image 103). Proximally, there is thickening of distal loops of small bowel in the mid lower abdomen, consistent with edema. Minimal adjacent fat stranding. No abscess formation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid in the pelvis. | 1.Edematous, thickened loops of small bowel consistent with enteritis versus ischemic changes. Correlate clinically with severity of patient's symptoms.2.Small amount of free fluid in the pelvis. |
Generate impression based on findings. | Male 77 years old; Reason: eval for bowel perforation, hematoma History: s/p lumbar spine bone biopsy ABDOMEN:LUNGS BASES: Emphysematous changes in lung bases. No nodule or mass detected.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: Atherosclerotic calcifications of the tortuous abdominal aorta and its branches. Ectasia of the abdominal aorta measures 2.7 cm, as well as the common iliac arteries.BOWEL, MESENTERY: Debris filled stomach. The bowel is otherwise normal in caliber. No evidence of free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Prominent prostate.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Gas in the posterior paraspinal soft tissues at L4/L5 reflects recent biopsy. Compared with the prior CT there has been increased osseous destruction involving the right aspect of the L5 vertebral body, transverse process and pedicle with soft tissue extending around the vertebra into the adjacent musculature which likely represents a combination of neoplasm and hematoma. Moderate degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted. | 1.Post biopsy changes at L5 without evidence of bowel perforation. Osseous destruction and soft tissue infiltration extending into the musculature as detailed above likely reflects a combination of the underlying neoplasm and post biopsy hematoma.2.Abdominal aortic and iliac arterial ectasia. |
Generate impression based on findings. | Male 68 years old; Reason: cause of n/v abdominal pain in pt with colon cancer History: n/v abdominal pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Hypoattenuating right hepatic lesion measures 2.4 x 2.1 cm (image 36, series 3).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: Dilated cecum measuring up to 8 cm with transition point along the ascending colon with associated wall thickening, presumably representing the patient's colon cancer. Mild interloop fluid. The distal small bowel is dilated with air-fluid levels and measures up to 3 cm. No evidence of bowel perforation. There are also peritoneal/omental implants anterior to the liver and along the paracolic gutter, with one perihepatic implant measuring 7 x 9 mm (image 34, series 3).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated cecum measuring up to 8 cm with transition point along the ascending colon with associated wall thickening. Interloop fluid is noted. The distal small bowel is dilated with air-fluid levels and measures up to 3 cm. No evidence of bowel perforation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Bowel obstruction with transition point along the ascending colon, presumably at the site of the patient's colon cancer as detailed above. Interloop fluid may relate to the patient's metastatic disease rather than early ischemia.2.Hepatic and peritoneal/omental metastatic disease. |
Generate impression based on findings. | Liver failure with change in mental status. There is unchanged nonspecific mild cerebral white matter hypoattenuation. There is unchanged focal calcification within the left insula or middle cerebral artery, which is of uncertain clinical significance. There is no evidence of intracranial mass, fluid collection, hemorrhage, hydrocephalus. The bones and extracranial soft tissues are unchanged, except for a partially imaged right enteric tube. | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | 42-year-old female with history of syncope and headache. There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | No evidence of acute intracranial hemorrhage, mass, or edema. |
Generate impression based on findings. | 29-year-old female with dysuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Para-aortic lymphadenopathy with one lymph node measuring 1.6 x 0.7 cm (image 50 series 3) for reference.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Fibroid uterus and ovarian varices.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 | 1. No specific findings to account for the patient's pain/dysuria.2. Fibroid uterus.3. Para-aortic lymphadenopathy presumably relating to the patient's underlying immunodeficiency virus. |
Generate impression based on findings. | HIV, off HAART x 4 years, L frontal HA and L side weakness. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Syncope. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is minimal nonspecific cerebral white matter hypoattenuation that is likely related to microangiopathy. There is unchanged moderate diffuse prominence of the ventricles and sulci, compatible with cerebral volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable, including a left lens implant. | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | 48-year-old female patient with abdominal pain and elevated lipase. Evaluate for pancreatitis. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Homogenous parenchyma with normal enhancement without calcifications. There is peripancreatic fat stranding and fluid. No hemorrhage, necrosis or abscess. No splenic vein thrombosis.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: Mild multilevel degenerative changes of the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Exophytic, noncalcified mass contiguous with the uterus possibly represents noncalcified fibroid (coronal series 80260 image 56). There is a 2.2 x 2.0 left adnexal cystic structure (series 3 image 24).BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes of the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1.Peripancreatic fat stranding and fluid consistent with acute pancreatitis without complication.2.Noncalcified uterine mass, most likely a noncalcified fibroid. |
Generate impression based on findings. | 46-year-old male patient with nausea, vomiting and abdominal pain. Patient had CT scan of the abdomen and pelvis yesterday, presumably with intravenous contrast. Note that the lack of intravenous contrast limits evaluation of vasculature, lymph nodes, solid and hollow viscera.ABDOMEN:LUNG BASES: Elevated right hemidiaphragm, stable compared to chest x-ray 12/24/2010. Small right pleural effusion and atelectasis. Trace left lung base atelectasis/scarring.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate, nonobstructing renal calculus in the lower pole of the left kidney. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Mild retroperitoneal fat stranding.BOWEL, MESENTERY: Oral contrast rapidly progressed through normal appearing stomach, small bowel and colon. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Coarse subcutaneous calcifications along the anterior abdominal wall consistent with prior injections.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Urinary bladder distended with intravenous contrast from recent outside study, per patient.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Oral contrast rapidly progressed through normal appearing stomach, small bowel and colon. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Coarse subcutaneous calcifications along the anterior abdominal wall consistent with prior injections. | 1.Mild retroperitoneal fat stranding is nonspecific. Recommend clinical correlation for possible urinary tract infection or pyelonephritis.2.Distended urinary bladder with retained intravenous contrast consistent with neurogenic bladder.3.No evidence of bowel obstruction. |
Generate impression based on findings. | 71-year-old female patient with history of bladder cancer status post radical cystectomy has left iliopsoas abscess and pelvic osteomyelitis presents with fevers, left hip and back pain, increasing leukocytosis. Evaluate for improvement in fluid collection. ABDOMEN:LUNG BASES: Bibasilar atelectasis or scar. Coronary artery calcifications. LIVER, BILIARY TRACT: No intra- or extra-hepatic biliary duct dilatation. There is nofocal hepatic abnormality. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst. Presumed small right renal cyst. Renovascularcalcifications and punctate nonobstructing calculus in the lower pole of the right kidney.Mild left-sided hydronephrosis, new since 9/29/2013. No right-sided hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ostomy in the right lower quadrant. There is no bowel dilatation.BONES, SOFT TISSUES: Degenerative changes.OTHER: Small amount of ascites. Diffuse atherosclerotic vascular calcification. IVCfilter is in the expected position. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Status post cystectomy.LYMPH NODES: Pelvic lymphadenopathy concerning for nodal metastases.BOWEL, MESENTERY: Ostomy in the right lower quadrant. There is no bowel dilatation.BONES, SOFT TISSUES: Degenerative changes.OTHER: Diffuse atherosclerotic vascular calcification. IVCfilter is in the expected position. Surgical drain noted within left pelvic heterogeneous fluid collection, no significant change in size.Numerous scattered foci with thick, enhancing walls within the pelvis and along the peritoneum are suggestive of nodal metastases versus abscesses (series 3 image 26, 70, 75, 87). There are numerous irregularly shaped fluid collections with thin walls within the pelvis that likely represent lymphoceles (series 3 image 77). | 1.Multiple fluid collections consistent with metastases and lymphoceles. Given the rising leukocytosis, cannot rule-out abscesses.2.Minimal left hydronephrosis, likely from compression of ureter.Findings discussed with Dr. Abbo via telephone at 9:30 AM on 10/25/13 by Dr. Dachman. |
Generate impression based on findings. | Right perihilar opacity on chest radiograph. Difficulty breathing. Please note that the examination is limited by poor contrast bolus and low mAs.LUNGS AND PLEURA: 6.3 x 4.8 x 6.0 cm (series 3, image 26) soft tissue mass in the superior segment of the right lower lobe, which abuts pleura. This lesion abuts the right upper lobe bronchus and bronchus intermedius, displacing the right upper lobe bronchus anteriorly. The central bronchi appear patent. This is mild adjacent right lower lobe subsegmental atelectasis. No definite additional nodules or masses are seen.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal sized heart without pericardial effusion. The aforementioned mass abuts the right aspect of the posterior mediastinum.CHEST WALL: Prominent subcentimeter axillary lymph nodes bilaterally. High attenuation foci in the left axillae are suspicious for calcified lymph nodes.No spinal cord compromise or osseous changes adjacent to the aforementioned right sided mass.UPPER ABDOMEN: Normal appearance of the upper abdomen. | 6.3 cm mass in the right hemithorax, which is suspicious for a round pneumonia or soft tissue mass. Given the limited examination and non-specific appearance, differential considerations include bacterial and fungal infection, including Mycobacterium and Histoplasma, neuroblastoma, and lymphoproliferative disease. |
Generate impression based on findings. | 18 year-old female with history of headache. There is a subtle curvilinear hyperdensity along the right transverse sinus. This finding is possibly artifactual, however MR imaging could be considered to better evaluate the possibility of extra-axial blood product or some other dural/extra-axial process. No other evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. There is mild nonspecific mucosal thickening in the sphenoid sinus. The mastoid air cells are normally pneumatized. | Subtle curvilinear hyperdensity along the right transverse sinus which may be artifactual, however MR imaging could better evaluate the possibility of extra-axial blood product or some other process, in the appropriate clinical setting. These findings were discussed with Dr Roman by phone at 11:20 on 10/25/13. |
Generate impression based on findings. | Cervicalgia. Motor vehicle traffic accident. Head: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There are multiple dental caries with associated periodontal lucencies. There is a punctate hyperattenuating focus within the superficial left frontal scalp, which may represents a dystrophic calcification. Cervical Spine: There is loss of cervical lordosis without spondylolisthesis. The vertebral body heights are preserved. No acute fracture is identified. A well corticated osseous fragment posterior to the truncated C6 spinous process, which likely represents sequela of a chronic avulsion injury. There is mild degenerative spondylosis with a small partially calcified posterior disc-osteophyte complex at C7-T1. The paraspinal soft tissues are unremarkable. The imaged portions of the lungs are clear. | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. No evidence of acute cervical spine fracture or spondylolisthesis.3. Multiple dental caries with associated periodontal lucencies. |
Generate impression based on findings. | 18 year old female with altered mental status. There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are normal. The imaged paranasal sinuses and mastoid air cells are normally pneumatized. | No evidence of intracranial hemorrhage, mass, or edema. |
Generate impression based on findings. | Reason: what is the mass near the heart History: mass seen on previous imaging LUNGS AND PLEURA: Multifocal scattered foci of ground glass with tree in bud opacities are concentrated in the lower lobes. Associated lower lobe bronchial wall thickening and areas of mucoid impaction suggestive of a bronchiolitis with a degree of chronicity. No associated pleural effusion.MEDIASTINUM AND HILA: Nasogastric tube projects to the stomach.The heart is normal size. There is a small pericardial effusion located anteriorly. No discrete intracavitary mass is identified; however, this is a non-ECG gated study and cardiac motion precludes evaluation for a potential small mass.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Low density flanking the falciform ligament favors fatty infiltration. | Multifocal scattered groundglass with tree in bud opacities, most concentrated in the lower globes. Associated lower lobe bronchial wall thickening. The findings are consistent with bronchiolitis, likely related to aspiration with a degree of chronicity.No intracardiac mass is identified on this non-ECG gated examination. If a high clinical suspicion for a cardiac mass does exist, consider repeat imaging with ECG gated cardiac CTA. |
Generate impression based on findings. | Vision changes. The pituitary gland appears somewhat hyperattenuating. The pituitary gland measures up to approximately 9 mm in craniocaudal dimension, which is within normal limits for the patient's demographics and there is no evidence of abutment of the optic apparatus. The remainder of the intracranial structures are unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues, including the orbital contents, are unremarkable. | The pituitary gland appears somewhat hyperattenuating, but measures up to approximately 9 mm in craniocaudal dimension, which is within normal limits for the patient's demographics. Nevertheless, this may represent a Rathke cleft cyst or pituitary hemorrhage. A dedicated pituitary MRI may be useful for further evaluation. |
Generate impression based on findings. | 57-year-old male with history of seizure with fall and confusion. There is a large area of low attenuation in the left frontal lobe, surrounding vasogenic edema, and thickening of the left cingulate gyrus and corpus callosum which corresponds to the patient's known tumor. There is unchanged asymmetry with a larger CSF space surrounding the right hemisphere which is likely due to mass effect in the left cerebral hemisphere, however there is no evidence of midline shift. It should be noted that unenhanced CT is suboptimal for evaluation of tumor status.There are unchanged scattered bilateral peri-ventricular hyperdensities which are chronic and correlate to strong susceptibility artifact on prior MR, likely calcifications or chronic blood product.There is scalp swelling over the left occiput. There is evidence of prior frontal craniotomy, otherwise the calvaria and skull base are normal. The paranasal sinuses and mastoid air cells are normally pneumatized. | 1.No evidence of acute intracranial hemorrhage.2.Findings consistent with patient's known left frontal lobe tumor.3.Periventricular hyperdensities which likely represent calcifications. |
Generate impression based on findings. | Reason: h/o HNC, CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or pleural effusion. MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. Moderate coronary artery calcification.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small right lobe hyperdense lesion unchanged, compatible with anhemangioma.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. | No evidence of metastatic disease. |
Generate impression based on findings. | Hemiplegia. There is a hyperattenuating intraparenchymal hematoma centered in the right basal ganglia that measures 35 AP x 30 RL x 25 SI mm. There is associated extension of the hemorrhage into the ventricular system and approximately 5 mm of midline shift. There is effacement of the third ventricle with mild dilatation of the lateral ventricles. There is a focus of hypoattenuation in the right frontal corona radiata. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | Acute intraparenchymal hemorrhage centered in the right basal ganglia that measures up to 35 mm with associated intraventricular extension, 5 mm of midline shift to the left, and obstructed lateral ventricle. Hypoattenuation in the right corona may represent an associated infarct. |
Generate impression based on findings. | Female, 85 years old, right MCA stroke, assess mass effect. Patchy hypoattenuation within the right MCA distribution is again seen involving the frontal and parietal lobes, the insula, and the temporo-occipital region. The appearance and geographic extent of these abnormalities have not significantly changed from the prior exam.Mild local mass effect is demonstrated in association with the above findings as indicated by mild sulcal effacement. No significant generalized mass effect or brain herniation is seen. No evidence of hemorrhagic conversion is seen.Patchy hypoattenuation is seen elsewhere in the brain within the periventricular regions and within the left basal ganglia which is compatible with small vessel ischemic disease.No new lesions are demonstrated. No intracranial hemorrhage or abnormal extra-axial fluid collections are seen. The ventricular system remains patent and is within normal limits for size. | 1. Evolving right MCA territory infarct appears similar to the prior exam. Mild local sulcal effacement is seen, but there is no significant generalized mass effect.2. No areas of significant hemorrhagic conversion are seen. No new lesions are detected. |
Generate impression based on findings. | 53 year old female with gastric cancer. Compare to prior. CHEST:LUNGS AND PLEURA: Stable nonspecific left upper lobe micronodule. Focal pleural nodularity in the right upper lobe is unchanged. No suspicious pulmonary masses or nodules. MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes are stable in size and number. CHEST WALL: Unchanged left upper chest wall port with the catheter tip within the inferior SVC. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion or biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Stable hypodensity within the tail of the pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild right hydroureter. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Unchanged mild diffuse thickening of the gastric body and antral wall.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Punctate subcentimeter mesenteric nodules are grossly unchanged a regressed. The reference mid abdominal nodule has resolved.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. | Stable to interval regression of disease. |
Generate impression based on findings. | 30 year-old male with perinatal HIV, headaches, EBV, pneumonia. CHEST:LUNGS AND PLEURA: New patchy left lower lobe groundglass opacities and consolidation consistent with pneumonia. No pleural effusions.MEDIASTINUM AND HILA: Multiple moderately prominent superior and subcarinal mediastinal lymph nodes mildly increase in size compared with the prior study. One subcarinal lymph node measures 1.4 x 1.6 cm and previously measured 1.1 x 1.3 cm (image 35, series 3).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:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Prominent inguinal lymph nodes with normal-appearing fatty hila.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Left lower lobe pneumonia and mediastinal lymphadenopathy, which is likely reactive in etiology. |
Generate impression based on findings. | 57-year-old male patient with history of gastric ulcer. Evaluate for bleeding or perforation. Note that the lack of intravenous and oral contrast limits evaluation of the vasculature, lymph nodes, solid organs and bowel.ABDOMEN:LUNG BASES: Bilateral atelectasis versus scarring in the lung bases. Pulmonary micronodule on the major fissure in the left lung most likely represents a lymph node (series 4 image 8).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: Surgical staples noted at the gastroesophageal junction. No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is trace fluid along the perihepatic margin. Slight fat stranding adjacent to the gallbladder and porta hepatis is nonspecific and there are no associated focal abnormalities. No intraperitoneal free air. Mild atherosclerotic changes in the abdominal aorta and iliac arteries.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: Comminuted fracture of the right iliac wing. Multilevel degenerative changes in the thoracic and lumbar spine. Marked volume loss of L2 vertebral body without significant retropulsion. Fracture fragments appear sclerotic margins, suggesting a chronic fracture.OTHER: No intraperitoneal free air. Mild atherosclerotic changes in the abdominal aorta and iliac arteries. | 1.No intraperitoneal free air to suggest perforation. Limited evaluation of gastric mucosa given lack of contrast. 2.Trace perihepatic fluid and minimal fat stranding adjacent to the porta hepatis is nonspecific and is not associated with obvious focal abnormality.3.Chronic comminuted right iliac wing fracture and L2 vertebral body volume loss.4.Pulmonary micronodule in left lung is likely a lymph node. |
Generate impression based on findings. | 26-year-old female with pain in the surgical site from recent C-section. ABDOMEN:LUNG BASES: Bilateral pleural effusions with associated basilar atelectasis.LIVER, BILIARY TRACT: Poor opacification of the hepatic veins may be due to contrast bolus timing, but if there is clinical concern for Budd-Chiari syndrome doppler ultrasound evaluation is recommended.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild ascites.PELVIS:UTERUS, ADNEXA: Large boggy post partum/C-section appearing uterus. Small 1.9 cm fluid collection at the uterine tip is also likely postoperative in etiology.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes of the subcutaneous tissues relating to the C-section without loculated fluid collection.OTHER: Mild ascites. | 1. Findings consistent with recent C-section without evidence of loculated fluid collection/abscess.2. Poor opacification of the hepatic veins may be due to contrast bolus timing, but if there is clinical concern for Budd-Chiari syndrome doppler ultrasound evaluation is recommended.3. Small pleural effusions with associated atelectasis. |
Generate impression based on findings. | Feeding difficulties and Miss management. Bariatric surgery with nausea and vomiting. Following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: Small left pleural effusion with incompletely visualized basilar consolidation. Consider aspiration.LIVER, BILIARY TRACT: Status post cholecystectomy. No evidence of intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple right renal calculi. Large right renal calculus at ureteropelvic junction with apparent chronic obstruction resulting in cortical thinning of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post gastric bypass. No evidence of obstruction. Contrast is identified in the colon and distal small bowel.BONES, SOFT TISSUES: Abdominal wall spinal stimulator with lead traversing the soft tissues into the flank. Lead is difficult to follow but appears to be intact.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is atrophic or absent. Ovaries are not visualized.BLADDER: No significant abnormality notedLYMPH NODES: Small pelvic lymph nodes noted.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: L the 5 S1 spondylolisthesisOTHER: No significant abnormality noted | 1. Status post gastric bypass with no evidence of obstruction. 2. Status post cholecystectomy. 3. Presumably chronic obstructing right UPJ calculus with cortical thinning of the right kidney. 4. Left pleural effusion and basilar consolidation; consider aspiration. |
Generate impression based on findings. | 25-year-old male status post lung transplant for cystic fibrosis. Evaluate for empyema. LUNGS AND PLEURA: Small bilateral pleural effusions, left slightly more than right. Near complete consolidation of left basilar segments as well as subsegmental consolidation, increased since prior exam, and ground glass opacities in both upper lobes and right lower lobe. Bilateral bronchial wall thickening is also present. Although evaluation for empyema suboptimal due to lack of IV contrast, no specific findings to suggest empyema are present.Left mainstem bronchus stent is in place. MEDIASTINUM AND HILA: Surgical clips are present in the mediastinum, consistent with bilateral lung transplant. Left central venous catheter terminates in the right atrium. Multiple enlarged mediastinal lymph nodes, which are nonspecific and may be reactive in nature.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Small bilateral pleural effusions, increased left lower lobe consolidation and scattered areas of ground glass opacity and subsegmental consolidation bilaterally; findings suspicious for aspiration or multifocal pneumonia, with superimposed mild edema. Evaluation for empyema is suboptimal due to lack of IV contrast, however, no specific findings to suggest empyema are identified.2.Status post bilateral lung transplant. |
Generate impression based on findings. | 78 year old female status post right lower lobe resection for lung cancer. One year follow-up. LUNGS AND PLEURA: Status post right lobe resection with resultant volume loss in right hemithorax and stable postsurgical scarring in the right base.Severe centrilobular emphysema. New ill-defined opacity in the left upper lobe which is nonspecific and may represent scarring (series 4, image 30).No pleural effusions or consolidation.MEDIASTINUM AND HILA: No significant lymphadenopathy. Severe coronary artery calcifications. Heart size normal.CHEST WALL: Stable nodule in right breast. Healed fracture in lateral aspect of right fourth rib. Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple prominent retrocrural lymph nodes are unchanged. Subcentimeter hyperdense focus in the right kidney is unchanged since 8/2012 and most compatible with hemorrhagic or proteinaceous cyst (series 3, image 111). Hypodensity in superior pole of left kidney unchanged, most compatible with a cyst. | Postsurgical changes in right lung. New ill-defined opacity in left upper lobe is nonspecific and may represent scarring, however, continued follow-up is recommended. |
Generate impression based on findings. | Female, 53 years old, altered mental status, thrombocytopenia. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.The bones of the calvarium and skull base are intact. | Unremarkable examination. No evidence of intracranial hemorrhage. |
Generate impression based on findings. | Prostate cancer. Follow-up. ABDOMEN:LUNG BASES: Multiple subcentimeter nodules in the lung parenchyma described previously have enlarged slightly compared to the prior examination and some of the nodules are cavitated. The time course of growth and cavitation would be highly unusual for metastases. I would advise correlation with dedicated chest CT. For reference purposes, a nodule at the left lung base which currently measures 8 x 11 mm (image 9; series 4), previously measured 7 x 5 mm (image 16; series 4; 10/19/2012). None of the visualized nodules of the lung bases are currently large enough for biopsy. Gynecomastia.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Several small hypoattenuating foci, appearing stable compared to previous CT, nonspecific but likely ureters and renal cysts. Nonobstructive left renal calculus.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis, without diverticulitis. Foci of gas in the small bowel suggests small bowel feces sign, correlate with obstructive symptoms.BONES, SOFT TISSUES: Gynecomastia.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Postsurgical changes of prior prostatectomy and lymphadenectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis, predominantly in the sigmoid, without diverticulitis.BONES, SOFT TISSUES: Degenerative disease of the spine.OTHER: No significant abnormality noted | Enlargement of subcentimeter bibasilar pulmonary nodules, some of which are cavitated. The constellation of findings associated with these is highly atypical for metastases; I would advise correlation with dedicated chest CT. |
Generate impression based on findings. | Reason: h/o nasopharyngeal ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Postsurgical findings reflective of left upper lobectomy.Stable scarring and subsegmental atelectasis involving the left lower lobe. Persistent calcified granulomata. No new suspicious pulmonary nodules or pleural effusion.MEDIASTINUM AND HILA: The mediastinum is shifted to the left from postsurgical volume loss. The heart size remains normal. No interval pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Several dependent high density foci are noted within the gallbladder most consistent with cholelithiasis. No pericholecystic inflammation.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: Multilevel degenerative changes without interval vertebral body compression fracture.OTHER: No significant abnormality noted. | No evidence of metastases. |
Generate impression based on findings. | Reason: h/o HNC, compare to previous, measurements pls, s/p CRT History: none CHEST:LUNGS AND PLEURA: Scattered benign appearing micronodules are present. However, there is no evidence of pulmonary or pleural metastases.Scattered regions of ground glass opacity and bronchial wall thickening are suggestive of chronic aspiration.MEDIASTINUM AND HILA: Small thyroid cysts are present.There is no evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: Very mild degenerative abnormalities affect the mid thoracic spine.A right jugular catheter terminates in the SVC.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 51-year-old male with mesothelioma status post two cycles of neoadjuvant chemotherapy. Please compare with outside PET CT and MRI. CHEST:LUNGS AND PLEURA: Diffuse pleural thickening with associated volume loss in right hemithorax, consistent with known history of mesothelioma. Small right pleural effusion loculated along the right base. Reference measurements are made as follows:At the level of the origin of great vessels, 3 o'clock position measures 17 mm, previously measured 19 mm (series 3, image 26).At the level of the origin of great vessels, 6 o'clock position measures 14 mm, previously measured 18 mm (series 3, image 26).At the level of the hepatic dome, 5 o'clock position measures 17 mm, previously measured 19 mm (series 3, image 70).MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes. For reference pretracheal lymph node measures 1.1 cm, previously measured 1.5 cm (series 3, image 26). Heart size normal. No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: 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. | Right hemithorax mesothelioma, with mild interval decrease in diffuse pleural thickening. |
Generate impression based on findings. | Cholangiocarcinoma restaging. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: There are small, non-pathologic mediastinal lymph nodes.CHEST WALL: Subcentimeter axillary lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: There is a new low density hepatic nodule in segment 7 measuring 11 x 9 mm (image 94; series 8) presumably representing metastasis. Two other vague hypodense subcentimeter areas are identified in the left lobe (image 93 and 94; series 8) which should be followed The gallbladder has been removed. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Postsurgical changes around the pancreas. Pancreatic atrophy again noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes consistent with Whipple procedure. There are small, scattered mesenteric lymph nodes.BONES, SOFT TISSUES: No observed osseous metastatic disease.OTHER: There is irregular beating in aneurysmal dilatation of the celiac axis. The distal celiac measures 1.4 x 1.4 cm (image 36; series 7). In retrospect this was present previously but more conspicuous on today's examination due to the arterial weighting of one of the series. This is not changed substantially since the oldest study available for comparison (4/19/2013); comparison to earlier studies (if these exist) would be beneficial. The appearance is most compatible with segmental arterial mediolysis.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No observed osseous metastatic disease. OTHER: Mild ectasia of the right common iliac artery which measures 1.8 cm in diameter. | 1. New presumed metastasis in the right lobe the liver.2. Probable segmental arterial mediolysis affecting celiac axis. Continued 6 month CT imaging follow up is advised for this to determine stability.PWR |
Generate impression based on findings. | 48-year-old male with fever, abdominal pain, diarrhea evaluate for source of diarrhea. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Interval improvement in hepatic steatosis. No focal hepatic lesions or biliary ductal dilatation. Cholecystectomy clips.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes are again noted, nonspecific but perhaps relating to the patient's underlying immunodeficiency virus.BOWEL, MESENTERY: Postsurgical changes of gastric bypass are again noted. Submucosal fat deposition in the terminal ileum suggests prior infectious/inflammatory disease.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: Wall thickening and edema in the rectosigmoid colon suggesting proctitis. The descending colon is poorly distended, but demonstrates submucosal fat deposition suggesting chronic inflammation.BONES, SOFT TISSUES: Small ventral hernia containing fat.OTHER: No significant abnormality noted | Rectosigmoid wall thickening and edema most likely infectious/inflammatory in etiology. Chronic inflammatory changes in the descending colon and terminal ileum perhaps related to history of colitis/enteritis. |
Generate impression based on findings. | 34-year-old male with history of testicular cancer CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged. No new nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL 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: Left testicular prosthesis is partially visualized. | Stable exam without new evidence of metastatic disease. |
Generate impression based on findings. | 68-year-old male with left flank pain, evaluate for stones. ABDOMEN:LUNG BASES: Multiple pulmonary nodules are identified at the lung bases measuring up to 9 mm (image 3 series 4).LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is a 5 mm stone just proximal to the left ureterovesicular junction. No significant hydroureter or hydronephrosis. Right renal cyst and small left hyperdense lesion likely representing a complex cyst are incompletely evaluated on this noncontrast study.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Marked degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Marked degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted | 1. 5 mm stone just proximal to the left ureterovesicular junction without significant hydronephrosis or hydroureter.2. Multiple pulmonary nodules at the lung bases, recommend CT chest for further evaluation and correlation with patient history. These finding were discussed with Dr. Gerber (pager 6662) at the time of dictation. |
Generate impression based on findings. | 58-year-old male patient with metastatic prostate cancer status post chemotherapy presents with pain, weight loss and rising PSA. Evaluate for progression. CHEST:LUNGS AND PLEURA: Stable right lower lobe micronodule (series 5 image 58). Stable biapical emphysematous changes.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Extensive sclerotic osseous lesions, stable.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic left kidney with subcentimeter hypodensity in the upper pole, stable. Intrapolar thin-walled cyst in the right kidney, consistent with simple cyst.RETROPERITONEUM, LYMPH NODES: Stable index retroperitoneal lymph node measures 0.7 x 0.8 cm (series 3 image 115), previously 0.9 x 0.8 cm on 1/11/2013.BOWEL, MESENTERY: Sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic osseous lesions involving the pelvis and proximal femurs bilaterally, stable. No acute fractures.OTHER: No significant abnormality noted | 1.Stable extensive diffuse sclerotic osseous lesions.2.Stable reference subcentimeter retroperitoneal lymph node. |
Generate impression based on findings. | 65-year-old male with base of tongue cancer. LUNGS AND PLEURA: New groundglass opacities in lung apices. Minimal dependent atelectasis in both bases. Several new clusters of subpleural nodules are seen in the lung bases (series 6, image 57, 60, 76). No consolidation or pleural effusions. No suspicious nodules identified. MEDIASTINUM AND HILA: No pathologically enlarged lymph nodes. Heart size normal.CHEST WALL: Right chest wall port catheter, with tip in SVC. Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left renal cysts. | 1.New ground glass opacities in lung apices, suspected to represent radiation reaction. 2.Several new small clusters of subpleural punctate nodules in lung bases; findings may be related mild atypical infection/bronchiolitis or aspiration.3.No evidence of metastatic disease. |
Generate impression based on findings. | Testicular germ cell tumor. CHEST:LUNGS AND PLEURA: Left lower lobe pulmonary nodule all and is smaller and measures 1.1 x 1.1 cm (formerly 1.9 x 1.6). No other nodules are seen.MEDIASTINUM AND HILA: Cardiac silhouette size is normal. No mediastinal or hilar lymphadenopathy is identified.CHEST WALL: Left vascular access device has its tip in right atrium.ABDOMEN:LIVER, BILIARY TRACT: Enhancement is normal. No mass is identified. Gallbladder is distended.SPLEEN: Normal in size.PANCREAS: Normal in appearance.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Normal cortical enhancement. No pelvicaliceal dilatation.RETROPERITONEUM, LYMPH NODES: Lymph node superior to left renal artery measures 1.2 x 1.4 cm (formerly 1.2 x 1.7). No other retroperitoneal lymphadenopathy is identified.BOWEL, MESENTERY: Duodenojejunal junction is normally positioned. No dilated bowel loops are seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Incompletely distended and normal in appearance.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A calcification is noted in a right lower quadrant bowel loop (series 3, image 173/224). This may be a pill. An appendicolith is also a possibility.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No abnormality identified. | The left lower lobe nodule has decreased in size. Retroperitoneal lymphadenopathy is resolving. |
Generate impression based on findings. | Pancreatic neoplasm. Stage IV pancreas cancer. Compare previous. CHEST:LUNGS AND PLEURA: Multiple pulmonary micronodules are again seen, and appears stable in size since the prior examination. The reference left upper lobe nodule currently measures 4 x 5 mm unchanged (image 127; series 4).MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy. The right-sided port catheter tip terminates in the distal IVC. There is a dense calcific changes consistent with atherosclerotic disease seen within the arch of the aorta and coronary arteries. There is an artificial mitral valve in place.CHEST WALL: Right chest wall port catheter is again noted.ABDOMEN:LIVER, BILIARY TRACT: Unchanged minimal intrahepatic biliary ductal dilatation without evidence of extra hepatic biliary ductal dilatation. The hepatic and portal veins appear patent.SPLEEN: No significant abnormality noted.PANCREAS: The ill defined hypo-enhancing lesion within the uncinate process of the pancreas appears stable in size compared to the prior examination and currently measures 3.3 x 3.2 cm (image 118; series 3). Note that there was a typographical error on the prior report. The mass measured 3.2 x 3.3 cm (image 117; series 4; 8/27/2013 study) on that examination. Vascular encasement again noted, 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. | No substantial change compared to prior with reference measurements given above. |
Generate impression based on findings. | Male, 46 years old, seizure with trauma. Scalp swelling is evident in the left occipital region which may be related to trauma. No skull fractures are seen.The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | Mild left occipital scalp injury is suspected. No acute intracranial abnormality. |
Generate impression based on findings. | 69-year-old female, restaging after gastrectomy 2012 CHEST:LUNGS AND PLEURA: Calcified right upper lobe granuloma and tiny micronodules are unchanged. No new suspicious nodules.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease. Central venous catheter tip in the right atrium.CHEST WALL: Right chest wall port. No axillary adenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. No biliary ductal dilatation. Status post cholecystectomy.SPLEEN: Nonspecific hypodense splenic lesions are unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral hypodense lesions consistent with cysts are unchanged. Left lower pole staghorn calculus with associated obstruction appear similar to the prior study.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post distal gastrectomy. No evidence of recurrent disease.BONES, SOFT TISSUES: Degenerative changes of the thoracic lumbar spine. Ventral hernias containing bowel without evidence of obstruction.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval resolution of previously noted colonic inflammation.BONES, SOFT TISSUES: Ventral hernias containing bowel without evidence of obstruction.OTHER: No significant abnormality noted. | 1. Status post distal gastrectomy without evidence of recurrent or metastatic disease.2. Unchanged hypodense nonspecific splenic lesions.3. Chronic left lower pole renal obstruction and staghorn calculus. |
Generate impression based on findings. | Reason: eval for recurrence, hx of stage 1 lung ca for surveillance, also hx prostate cancer History: none CHEST:LUNGS AND PLEURA: Stable right middle lobe nodule measuring 6 mm (series 5, image 55), an intrapulmonary lymph node stable since at least 2006, requiring no further follow-up. There is unchanged subpleural fibrosis with traction bronchiectasis and bronchiolectasis. There is interval increase in paraseptal emphysema and honeycombing, primarily on the left. Small stable micronodules.MEDIASTINUM AND HILA: Stable mildly prominent para-aortic lymph nodes. Stable calcified mediastinal lymph nodes. Mild atherosclerotic coronary calcifications. Heart size is normal.CHEST WALL: New sclerotic focus in the T4 vertebral body suspicious for new metastatic prostate cancer focus. Stable sclerotic focus in the left iliac, also suspicious for metastatic prostate cancer.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral hypodense lesions of varying size in the kidneys, stable and likely represent benign renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable, scattered borderline para-aortic nodes.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of recurrent pulmonary disease.2.Mild interval increase in paraseptal emphysematous changes.3.New sclerotic focus in the T4 vertebral body worrisome for prostate metastases. |
Generate impression based on findings. | 65 year old female with status post multiple lung resections for lung neoplasm. LUNGS AND PLEURA: Status post bilateral wedge resections with resultant volume loss and scarring. The previously measured soft tissue adjacent to suture in left lung has resolved and is no longer measurable (series 5, image 146). Right apical scarring appears similar.Left upper lobe ground glass nodule with tiny solid components is stable in size, measuring 5 mm (series 5, image 91), but increased in density since 20012. No new nodules identified.Additional left apical nodule measures 4 mm, unchanged (series 5, image 77).Motion artifact at the lung bases limits evaluation of these areas.MEDIASTINUM AND HILA: Several mildly enlarged mediastinal lymph nodes unchanged. Moderate coronary artery calcifications. Heart size normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Previously seen small splenic artery aneurysm not well identified on this study due to motion artifact. | 1.Postsurgical changes in the lungs without evidence of recurrence or metastatic disease. The previously measured soft tissue adjacent to suture line and left upper lobe has resolved.2.Stable size of left upper lobe semi-solid nodule, likely a small indolent malignancy such as minimally invasive adenocarcinoma given increase in density over time. Additional left apical micronodule is stable and could be a small AAH or MIA. |
Generate impression based on findings. | 74-year-old female patient with history pancreatic cancer status post vaccine therapy. CHEST:LUNGS AND PLEURA: Stable calcified granulomas and pleural based pulmonary micronodules. Trace bilateral dependent atelectasis.MEDIASTINUM AND HILA: Stable small mediastinal lymph nodes. Stable index precarinal lymph node (series 3 image 36).CHEST WALL: Right chest port with tip in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Hypodense lesion in the uncinate process of the pancreas measures 1.1 x 0.9 cm (series 3 image 14), previously 1.3 x 0.9 cm in 10/2012 and 0.6 x 0.7 cm in 2010. Postoperativechanges of distal pancreatectomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right renal cyst.RETROPERITONEUM, LYMPH NODES: Abdominal aorta and iliac arteries normal in caliber with atherosclerotic changes.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: Sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Hypodense lesion with enhancing stable compared to most recent exam and enlarged compared to 2010. Lesion appearance is consistent with an intraductal papillary mucinous neoplasm.2.Stable lymph nodes. |
Generate impression based on findings. | Male, 71 years old, status post shunt placement. Since the prior examination, a right frontal approach ventricular shunt catheter has been placed. The tip is at midline in the vicinity of the foramen of Monro.As of yet, there has been no significant change in the caliber or morphology of the ventricular system. The lateral ventricles, and to a lesser degree the third ventricle, remain dilated, similar to prior. The fourth ventricle is normal in size. Many cisterna magna is reidentified.Mild pneumocephalus is an expected finding in the recent postoperative period. No significant parenchymal or extra-axial hemorrhage is seen. A generalized mass effect is noted. No evidence of focal parenchymal edema seen.There is a small fluid level within the left maxillary sinus. Paranasal sinuses are otherwise well pneumatized. | Expected findings status post ventricular shunt placement. |
Generate impression based on findings. | Right sided headache x6d. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Adenoid cystic parotid gland cancer. Liver metastases. Evaluate right lower lobe for possible metastatic focus. CHEST: LUNGS AND PLEURA: Left basilar scarring. No pleural effusions or consolidation. Unchanged 9-mm left upper lobe nodule (series 9; image 40). An additional micronodule (series 5, image 42) in the right lower lobe is also unchanged. Calcified micronodules are compatible with prior granulomatous disease.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Scattered calcified mediastinal and hilar lymph nodes are compatible with prior granulomatous disease. Heart size is normal without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Large heterogeneous mass involving nearly the entire left hepatic lobe as well as the caudate lobe measures approximately 23.0 x 15.5 cm (image 104; series 7) stable to slightly enlarged compared to prior. Extrahepatic main portal vein remains narrowed by the lesion which abuts the splenic vein at the level of the confluence with SMV. Nonvisualized left portal vein, likely with cavernous transformation, described previously. The lesion abuts the intrahepatic IVC and the right hepatic vein, stable. Mild intrahepatic biliary ductal dilatation is unchanged.SPLEEN: Spleen size upper limits of normalPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Stable small upper abdominal lymph nodes, including gastrohepatic ligament lymph nodes and periportal/portacaval nodes. Small retroperitoneal lymph nodes, including left para-aortic lymph nodes and aortocaval lymph nodes, unchanged. Reference aortocaval lymph node (series 7; image 142) measures 0.8 cm x 0.6 cm, unchanged. Reference left common iliac lymph node (series 7; image 153) measures 0.8 cm x 0.5 cm, also unchanged. BOWEL, MESENTERY: Normal caliber bowel loops. Stomach is displaced by the hepatic mass.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Subcentimeter iliac chain lymph nodesBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No substantial interval change compared to prior exam; equivocal enlargement of hepatic mass. Reference measurements are given above. |
Generate impression based on findings. | 61-year-old female with history of lung cancer. CHEST:LUNGS AND PLEURA: Right paramediastinal scarring/radiation change appears similar to prior study. The previously noted right lower lobe nodular opacity with associated tree in bud abnormality is decreased, most suggestive of resolving infectious or inflammatory process (series 7, image 49). No new nodules. Stable trace right pleural effusion.MEDIASTINUM AND HILA: No discrete lymphadenopathy. Soft tissue surround in the right hilum unchanged in configuration. Heart size normal. No pericardial effusion. Moderate coronary artery and aortic valve calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable post treatment changes without specific evidence of metastatic disease.2.Decreased right lower lobe nodular opacity with associated tree in bud nodularity, most consistent with resolving infectious or inflammatory process. Additional 3 month CT follow up recommended given lack of complete resolution. |
Generate impression based on findings. | Male, 57 years old, intracerebral hemorrhage. There has been no significant interval change in the degree and extent of parenchymal and ventricular hemorrhage. As before, there is very extensive right-sided parenchymal hemorrhage with evidence of subarachnoid extension far anteriorly, similar to prior. Minimal layering hemorrhage is also present in the left occipital horn.New from the prior examination is the development of a low density subdural fluid collection along the right hemisphere. At its point of maximal thickness, this collection measures 6 mm.Pattern of encephalomalacia/edema involving the right frontal, parietal and to a lesser degree the temporal lobes as well as the right basal ganglia is unchanged. Midline shift to the left of approximately 9 to 10 millimeters has not substantially changed. Hypoattenuation within the left corona radiata is also stable. Left frontal approach ventricular shunt catheter is in stable position. The right lateral ventricle remains nearly completely effaced. The left lateral ventricle remains mildly prominent, similar to the prior exam. The fourth ventricle is unremarkable. | 1. No significant interval change in the pattern and extent of parenchymal/ventricular hemorrhage. No definite new acute hemorrhage is seen.2. Interval development of a thin low density right-sided subdural fluid collection. This could represent a subdural effusion or the effects of reduced mass effect. New bleeding is considered unlikely. |
Generate impression based on findings. | Female, 64 years old, hemiparesis. Follow-up infarct. Extensive right MCA distribution ischemia is redemonstrated involving nearly the entire right frontal lobe, part of the right parietal lobe, right temporal lobe and insula, and patchy involvement of the right basal ganglia. The geometric extent of this abnormality has not substantially changed. The infarct region has become more uniformly hypodense with better defined margins which is consistent with typical evolution.Less extensive patchy areas of cortical/subcortical hypoattenuation are also seen in the left frontal lobe compatible with evolving ischemia. These also demonstrate typical evolution and are not substantially worsened. Elsewhere in the brain, periventricular hypoattenuation is again seen, nonspecific but likely indicating age indeterminate small vessel ischemic disease. There is a focal lucency within the left caudate head.Regional mass-effect involving the right sided stroke exists including complete effacement of the sulci and partial effacement of the right lateral ventricle which has mildly progressed. There remains a very mild midline shift to the left, at most 2 to 3 mm.No evidence of hemorrhagic transformation seen. No new areas of infarct are detected within the limits of CT. | Expected interval evolution of a large right MCA distribution infarct as well as scattered smaller areas of ischemia in the left MCA distribution. Regional mass-effect has progressed slightly as demonstrated by a greater degree of right lateral ventricular effacement. No frank brain herniation is detected as of yet. |
Generate impression based on findings. | Male 60 years old; Reason: Pt is a 59 y/o male with urothelial cancer, evaluate for recurrence, CT urogram, 3D reconstruction, delayed views History: urothelial cancer NECK BASE: Small hypoattenuating nodule in the inferior portion of the left thyroid lobe is unchanged.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: No significant abnormality noted. In particular, prompt symmetric excretion of the bilateral ureters is noted without focal filling defect, stenosis, or mass lesion detected.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: 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 | No evidence of metastatic disease. |
Generate impression based on findings. | Pain in joint, assess for possible metastatic disease. Symptoms most pronounced involving the fourth TMT joint. Diffuse demineralization limits sensitivity, however within this appearance, only two small discrete sclerotic suspected cysts are observed in the base of the third and fourth metatarsals. Both appear benign and although the 3rd metatarsal finding does not demonstrate a uniform cortex and a small irregularity is identified with moderate degenerative changes (image 162 series 2), there is no associated findings to support an acute or sub acute abnormality No associated superimposed acute or subacute abnormality, specifically no definite fracture or findings to suggest a distinct lytic or sclerotic lesions. Osseous alignment is observed throughout.The surrounding soft tissues are intact. No abnormal fluid collections or muscular abnormality. Only minimal soft tissue stranding is observed, please correlate with physical exam and opposite foot.This study was read in combination with Dr Stacy. | Mild to moderate osteoarthritic disease involving the bases of the 3rd and 4th metatarsals. |
Generate impression based on findings. | Female, 57 years old, history of Parkinson's disease who is status post deep brain stimulator, with right-sided weakness. Bilateral frontal approach D.D.S. leads are redemonstrated in stable position. Tips are located in the vicinity of the inferior thalami.Since the prior examination, postoperative pneumocephalus has resolved. Parenchymal morphology is within normal limits. No mass effect detected. No focal parenchymal edema or loss of gray-white distinction is seen. No abnormal extra-axial fluid collections or evidence of acute intracranial hemorrhage is demonstrated. The ventricular system remains patent and normal in size. | Bilateral DBS leads remain in place. No definite parenchymal abnormalities are seen to account for the patient's symptoms. |
Generate impression based on findings. | Reason: h/o anaplastic thyroid ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Multiple pulmonary micronodules are unchanged dating back to 3/22/2011, likely postinflammatory. No suspicious pulmonary nodules or interval pleural effusion.Stable right Bochdalek hernia.MEDIASTINUM AND HILA: Moderate hiatal unchanged. The heart size is normal. No mediastinal or hilar lymphadenopathy.There has been a thyroidectomy.In the anterior mediastinum, there is a triangular soft tissue density measuring 7 x 13 mm (series 4 image 43). On the lung windows, there is surrounding groundglass opacity. This may represent a focus of resolving inflammation. Confirmation with a short interval CT is recommended.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple exophytic cysts are stable.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. | Stable benign appearing pulmonary nodules. No suspicious pulmonary nodule. New soft tissue density in the anterior mediastinum measuring 7 x 13 mm without associated lymphadenopathy. On the lung windows, there is surrounding groundglass opacity. This may represent a focus of resolving inflammation. Confirmation with a short interval CT is recommended. |
Generate impression based on findings. | Cough and shortness of breath with history of bronchiectasis and mycobacterial infection. LUNGS AND PLEURA: Scarring at the lung apices. New symmetric groundglass opacity in the dependent upper lobes bilaterally (5/65). On the right this is somewhat spherical in appearance (9-mm, 5/66).Mild cylindrical bronchiectasis with numerous areas of endobronchial debris and impaction. Volume loss due to chronic endobronchial impaction in the right middle lobe and lingula not significantly changed.Some of the more discrete solid nodules on the prior study are smaller and have become calcified, indicative of healing, while other lesions have cleared in the interim. Acute appearing peripheral groundglass opacity left lower lobe (5/164), new from previous.Solid irregular peripheral nodule in the right upper lobe seen previously with associated ground glass opacities has resolved in the interim.No pleural fluid or pneumothorax.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Normal heart size. Coronary artery calcifications. Mild pericardial thickening is unchanged.CHEST WALL: Surgical clips in the left chest wall. Left mastectomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. | 1. New foci of groundglass opacity consistent with focal pneumonitis due to either aspiration or infection. The distribution is more typical of aspiration-related pathology though mycobacterial infection could produce this appearance as well. Follow up CT is suggested after medical management to assess for clearance and exclude noninfectious lesions.2. No significant change in mild bronchiectasis. Diffuse areas of chronic endobronchial impaction related to presumed MAI have improved but not completely cleared and some changes will likely remain chronic. |
Generate impression based on findings. | Female, 78 years old, difficulty extubating, TC movements, evaluate for stroke. No CT evidence of acute territorial ischemia is demonstrated. There may be very mild periventricular hypodensity which likely represents aging determinate small vessel ischemic disease.No mass effect is detected. No intracranial hemorrhage or abnormal extra-axial fluid collections are seen. The ventricular system is patent and within normal limits for size.The bones of the calvarium are intact. The visualized paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Subdural hemorrhage. There are postoperative findings related to right microcraniotomy for decompression of a right subdural hematoma. There is interval appearance of moderately hyperattenuating subdural hematoma overlying the left frontal convexity that measures up to 5 mm in thickness. Otherwise, there has been interval resolution of the right temporal convexity and right parafalcine subdural fluid collections. There has been interval evolution of the right temporal lobe and bilateral occipital lobe infracts, which are now encephalomalacic. The ventricles are stable in size and configuration with persistent effacement of the right frontal horn. There is no midline shift. The imaged paranasal sinuses and mastoid air cells are clear. The extracranial structures are unchanged. | 1. Interval appearance of moderately hyperattenuating subdural hematoma overlying the left frontal convexity that measures up to 5 mm in thickness, which likely represents subacute upon chronic hemorrhage. Otherwise, interval resolution of the right temporal convexity and right parafalcine subdural fluid collections. 2. Interval evolution of the right temporal lobe and bilateral occipital lobe infracts, which are now encephalomalacic. |
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