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Generate impression based on findings. | Female 79 years old; Reason: 79 y.o. female with hx of appendiceal cancer and resection; please evaluate for changes and or abnormalities History: appendiceal cancer LUNG BASES and lower chest: Nodule in the visualized right lower lobe (series 4 image 10) appears stable to minimally larger from October 2012; continued attention on follow-up is suggested. Subcentimeter focus left breast (series 3 image 5) incompletely assessed but unchanged from prior CT.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Subcentimeter hypodensity within the body of the pancreas (series 3 image 49) is unchanged from October 2012. No pancreatic ductal dilatation. Small pancreatic calcification noted in the tail, nonspecific.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Stable scarring adjacent to the cecum. No evident local recurrence in the surgical bed. No ascites or discrete peritoneal nodularity. 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: Normal caliber pelvic bowel loops. No ascites or discrete peritoneal nodularity.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Stable scarring adjacent to the cecum. No ascites or discrete peritoneal nodularity. 2. Subcentimeter hypodensity in the pancreatic body is unchanged.3. Right lower lobe pulmonary nodule, stable to minimally larger from October 2012; attention on follow up suggested |
Generate impression based on findings. | Female 44 years old; Reason: hematuria, pelvic pain History: pelvic pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 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: Lumboperitoneal shunt for pseudotumor should be noted in the posterior paraspinal soft tissues extending into the abdomen.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: Lumboperitoneal shunt for pseudotumor should be noted in the posterior paraspinal soft tissues extending into the abdomen. | 1.No CT evidence of patient's hematuria. |
Generate impression based on findings. | Male, 40 years old, history of medullary thyroid cancer, assess for adenopathy and recurrence. Patient is status post thyroidectomy. No enhancing lesions or concerning masses are evident within the thyroidectomy bed. There are small soft tissue densities within the operative bed bilaterally and probable scattered small nodes. It is possible that one of these corresponds to the abnormality noted in the right thyroidectomy bed on prior sonogram. For reference, one of these lesions on the right measures 5 x 3 mm (image 60 series 5). Also for reference, a probable lymph node along the medial margin of the left sternocleidomastoid muscle measures 11 x 6 mm (image 50 series 5).Evidence of bilateral neck dissection is seen. There is linear scarring/soft tissue thickening bilaterally within the dissection beds compatible with postoperative change. No pathologically enlarged or morphologically aggressive lymph nodes are demonstrated.The right vocal cord is medialized and the right piriform sinus is enlarged, findings which suggest vocal cord dysfunction/paralysis.The salivary glands are free of focal lesions. The cervical vessels are patent and unremarkable. Lung apices are clear. No concerning bony lesions are demonstrated. | Status post thyroidectomy without evidence of recurrent disease. There are small non-specific soft tissue foci within the resection bed, one of which may correlate with the abnormality suspected on prior sonography. No pathologically enlarged or aggressive appearing lymph nodes are demonstrated. |
Generate impression based on findings. | Reason: h/o pharynx cancer History: r/o lung mets LUNGS AND PLEURA: Apical radiation fibrosis unchanged.There is no evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Moderate coronary artery calcifications are present.CHEST WALL: Status post tracheostomy and neck dissection.Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic calcifications and prior cholecystectomy, unchanged. IVC filter. | No change, and no sign of metastases. |
Generate impression based on findings. | Reason: s/p right hepatectomy now with fevers History: as above ABDOMEN:LUNG BASES: Enlarging right-sided pleural effusion with overlying atelectasis which now occupies approximately one half of the right hemithorax. New small left pleural effusion.LIVER, BILIARY TRACT: Status post resection of the right lobe of the liver. There is an enlarging fluid collection in the right hepatic fossa at the site of resection which also contains air and currently measures 8.3 x 5.1 cm (image 29; series 3). The surgical drain which was previously in the collection has been removed.Hypodense, subcentimeter lesion in the dome of the left lobe of the liver is unchanged (image 18; series 3). Unchanged, hypodense cyst in the left lobe of the liver adjacent to the confluence of hepatic veins. Unchanged metallic common bile duct stent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Unchanged hypodense lesion in the right kidney is too small to further characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small right lower quadrant tubular structure containing air and contrast presumably represents the appendix. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Increasing ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Air in the bladder is presumably secondary recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subcentimeter bone cysts in the right femoral head.OTHER: Increasing ascites. | 1.Status post resection of the right lobe of the liver. 2.Enlarging perihepatic fluid collection containing air. Plan is for percutaneous drainage.3.Increasing bilateral pleural effusions (right greater than left)4.increasing abdominal and pelvic ascites. |
Generate impression based on findings. | Sarcoma. Three months of therapy. Evaluate response to treatment. CHEST:LUNGS AND PLEURA: Scattered pulmonary nodules redemonstrated. Enlarging left pleural effusion.*Index pleural based nodular opacity (series 4; image 53) measures 2.8 x 2.4 cm, smaller compared to previous.*Index right middle lobe nodule (series 4; its image 55) measures 1 x 0.6 cm, unchanged. MEDIASTINUM AND HILA: Calcified intrathoracic nodes redemonstrated. Multinodular enlarged thyroid gland and coronary calcifications redemonstrated. Coronary artery calcifications.CHEST WALL: Left pacemaker. Sclerotic foci T7-T8 and lateral ninth rib unchanged.ABDOMEN:LIVER, BILIARY TRACT: Confluent ill-defined hypoattenuating focus posterior segment right lobe (series 3; image 89) measuring 1.6 x 1.1 cm remains relatively inconspicuous but probably unchanged. Gallstones. No biliary dilatation.SPLEEN: Status post splenectomy.PANCREAS: Surgical clips abutting pancreatic head.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Renal cysts are redemonstrated. At the upper pole the left kidney, there are several indeterminate subcentimeter nodules (due to small size and patient motion) which should be followed on subsequent scans to determine stability.RETROPERITONEUM, LYMPH NODES: Surgical clips in retroperitoneum level of and abutting the left renal vein. Reference aortocaval lymph node measures 2.8 x 2.1 cm, not changed substantially compared to prior (image 113; series 3).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: Surgical clips right lower quadrant obturator/inguinal area unchanged. Atherosclerotic calcifications. No evidence of aneurysm. | No substantial interval change except increasing small left pleural effusion. Measurements are given above. |
Generate impression based on findings. | Female, 64 years old, status post fall with subarachnoid hemorrhage. Evaluate for aneurysm. Non-angiographic findings:Precontrast images of the brain demonstrates infiltration of the scalp and a small subgaleal hematoma at the high vertex. No skull fractures are seen.No evidence of extra axial blood is seen on this examination. Brain parenchyma is within normal limits. No focal parenchymal edema or loss of the gray-white distinction is seen.No abnormal extra-axial fluid collections are detected. The ventricular system is patent and normal in size.Angiographic findings:No aneurysms are detected. No areas of high-grade focal stenosis or vascular occlusion are seen. Minimal atherosclerotic calcification affects the supraclinoid ICAs.The ACOM artery is within normal limits. The left PCOM artery is small but visualized. The right PCOM artery is not discretely visualized. Normal variant duplication of the left SCA is noted. | 1. No intracranial aneurysms or other specific vascular abnormalities are detected. 2. No evidence of significant intracranial blood product is seen in this examination. Evidence of scalp injury at the vertex is seen. |
Generate impression based on findings. | Rule out diverticulitis. Left lower quadrant pain. ABDOMEN: Exam is limited in evaluation of solid organ pathology due to lack of IV contrast.LUNG BASES: A trace left pleural effusion similar in size to prior. Minimal subsegmental atelectasis bilaterally again noted also.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcified splenic granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys with mildly increased attenuation likely from prior contrast administration.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches. No evidence of hematoma.BOWEL, MESENTERY: Unchanged ventral hernia repair.BONES, SOFT TISSUES: Unchanged osteoarthritis of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Mild, thickwalled bladder as described previously..LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No bowel obstruction.BONES, SOFT TISSUES: Marked degenerative change of the thoracolumbar spine.OTHER: No evidence of hematoma. | No substantial interval change and no definite evidence of diverticulitis. Note that early or mild diverticulitis may be occult on imaging. |
Generate impression based on findings. | T1N2b left BOT/vallecula SCC, s/p chemoradiation completed on 2/1/13. There is persistent edema in the oropharynx and partial effacement of the left glossotonsillar sulcus without evidence of discrete mass lesion. There is no residual or recurrent significant cervical lymphadenopathy. For example, a left level 1B lymph node measure s 4 x 3 mm, previously 4 x 3 mm. The major salivary glands are unchanged. The thyroid gland appears unremarkable. There is right internal jugular venous catheter. The cervical vascular is otherwise intact. No focal osseous lesions are identified. The paranasal sinuses and mastoid air cells are clear. The imaged intracranial structures and orbits are unremarkable. The imaged lung apices are clear. | No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | 46-year-old female with hypoxia and dyspnea. LUNGS AND PLEURA: Lungs underinflated with bilateral scattered, patchy areas of air trapping. Superimposed subsegmental consolidation in right upper lobe (series 4, image 25). No pleural effusions. Right upper lobe nodule measures 4 mm (series 4, image 28).MEDIASTINUM AND HILA: Mildly patulous, fluid-filled esophagus. Moderate cardiomegaly. No pericardial effusion. No pathologically enlarged mediastinal lymph nodes. Small right lateral tracheal diverticulum at the thoracic inlet (series 3, image 4). Significant collapse of the airway is present.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Patchy subsegmental consolidation in right upper lobe suspicious for pneumonia. Follow-up PA and lateral chest radiographs are recommended in 6 weeks to confirm resolution.2. Lungs underinflated with bilateral patchy areas of ground glass opacity, which are likely related to combination of underinflation and subsegmental atelectasis with associated air-trapping. Collapse of the airways is suspicious for bronchomalacia.2.Cardiomegaly.3.4-mm nodule in right upper lobe; in a low risk patient no follow-up is required. In a high risk patient, 12 months follow-up CT is recommended. |
Generate impression based on findings. | Ipilimumab for metastatic melanoma - please assess response to therapy and compare to previous imaging CHEST:LUNGS AND PLEURA: Increasing (both in size and number) bilateral ground-glass nodules. *Enlarging left lower lobe pulmonary nodule which appears more solid measures 3.5 x 3.5 cm (image 48; series 9).*Enlarging right upper lobe pulmonary nodule measures 1.7 x 1.9 cm (image 32; series 9)*enlarging right lower lobe ground-glass nodule measures 1.9 x 1.9 cm (image 59; series 9)MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. The ascending aorta remains aneurysmal measuring 4.3-cm in AP dimension. Coronary artery calcifications.CHEST WALL: Right axial lymph node measures 1.7-cm in short axis dimension, unchanged (image 24; series 7). Right chest wall port terminates at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions.SPLEEN: Scattered splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland nodule, unchanged.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval progression of pulmonary metastases with measurements given above |
Generate impression based on findings. | Right nasopharyngeal carcinoma with recurrence, status re-resection and postoperative chemo re-irradiation completed on 3/14/2012. HEAD: There is no intracranial mass or abnormal enhancement to suggest metastatic disease. There is unchanged hypoattenuation in the right anterior temporal lobe, which is likely related to radiation therapy. The ventricles and sulci are stable in size and configuration. There is persistent opacification of the right mastoid air cells. There are no lytic or blastic lesions.NECK: There is mild generalized pharyngeal mucosal edema related to treatment. However, no discrete mass is discernable. Likewise, there is no significant cervical lymphadenopathy by size criteria. For example, a left level 4 lymph node measures 6 x 9 mm, previously 6 x 9 mm. The submandibular glands are atrophic. The parotid glands are unremarkable. The thyroid gland is also unremarkable. There is mild scattered paranasal sinus mucosal thickening. The major cervical vascular structures are grossly intact. There are unchanged fine linear opacities within the lower trachea. There is mild degenerative change including disk osteophyte complex at C5-C6. The imaged lung apices are clear. | 1. No evidence of locoregional tumor recurrence in the right nasopharynx. No significant cervical lymphadenopathy.2. No evidence of intracranial metastatic disease. |
Generate impression based on findings. | 46-year-old female with history of head and neck cancer. CHEST:LUNGS AND PLEURA: No new or suspicious nodules. Calcified granuloma in left lower lobe. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall port catheter terminates in right atrium.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: Nodularity of the right atrial gland is noted (series 3, image 96); too small to characterize. Left adrenal gland unremarkable.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. Gastrostomy tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No specific signs of metastatic disease. Nodularity of the right adrenal gland unlikely to be metastatic in etiology, but can be followed on subsequent exams. |
Generate impression based on findings. | 80 year old female with ovarian cancer status post resection of growing metastasis. Left lower quadrant pain. Assess for disease progression. CHEST:LUNGS AND PLEURA: Scattered punctate micronodules at the left lung apex and right base are unchanged.MEDIASTINUM AND HILA: No significant abnormality CHEST WALL: Right-sided venous access device is in expected position.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality SPLEEN: Calcified splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: New retroperitoneal adenopathy. For reference purposes, a left para-aortic lymph node measures 1.5 x 1.5 cm (image 104; series 3). This lymph node was not present on the prior exam.BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: Small ventral hernia containing fat is stable..OTHER: No significant abnormality noteddPELVIS:UTERUS, ADNEXA: Status post hysterectomy. No abnormal enhancing soft tissue is seen in the surgical bed.BLADDER: No significant abnormality noteddLYMPH NODES: Previously described masses are seen along the course of the left external iliac vessels are not longer present, presumably resected. New pelvic adenopathy. For reference purposes, there is a new enlarged obturator lymph node which measures 2.8 x 1.9 cm (image 155; series 3) along the left pelvic sidewall.BOWEL, MESENTERY: Extensive sigmoid diverticulosis again noted with inflammation in the left lower quadrant, probably representing diverticulitis. No evidence of diverticular abscess at the current time. This finding was indicated to the clinical service (Dr. Lee's PA at 26123) at the time of dictation.BONES, SOFT TISSUES: A left inguinal mass as been resected. Postsurgical changes are noted. This area should be followed serially with imaging to assess for residual recurrent tumor.OTHER: No significant abnormality notedd | New adenopathy in the abdomen and pelvis. Left lower quadrant diverticulitis; clinical service was notified of this finding at the time of dictation. Status post left inguinal mass resection. |
Generate impression based on findings. | 70 year-old male status post chest tube placement for pneumothorax. LUNGS AND PLEURA: Large left pneumothorax. Left chest tube terminates in the upper left hemithorax. Severe emphysema affects both lungs, with including large subpleural bullae and left lower lobe subpleural pneumatocele. No pleural effusions. Subsegmental atelectasis in partially collapsed left lung. Postsurgical changes in the right lower lung ,consistent with right middle and right lower lobectomy. Focal fibrosis and architectural distortion in right base with associated traction bronchiectasis.MEDIASTINUM AND HILA: There is rightward shift of the mediastinum. Extensive pneumomediastinum. Severe atherosclerotic calcifications affect the aorta and coronary arteries.CHEST WALL: Extensive subcutaneous emphysema bilaterally affecting the lower neck and chest, left more than right. Healed right rib fractures. Moderate to severe degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis. Extensive atherosclerotic calcifications affect the abdominal aorta and its branches. Right renal artery stent is present. | 1.Large left pneumothorax with chest tube in place and rightward mediastinal shift. Severe emphysema with subpleural bulla formation and a large left subpleural pneumatocele in addition to evidence of pulmonary fibrosis.2.Extensive subcutaneous emphysema and pneumomediastinum.3.Postsurgical volume loss right lower lung without evidence of bronchopleural fistula from this site.4.Exact site of air leak is not conclusively identified on this study; consider xenon nuclear medicine exam for further evaluation. |
Generate impression based on findings. | Parotid neoplasm of the the for progression of metastatic disease. CHEST:LUNGS AND PLEURA: Scattered bilateral poorly defined pulmonary nodules measuring up to 16 x 12 -mm (5/54, right upper lobe). No pleural fluid.MEDIASTINUM AND HILA: The ascending segment of the aortic arch appears ectatic, measuring 4-cm in oblique transverse dimension (3/30). The aortic root measures 4.3-cm in AP dimension (3/59). Atherosclerotic calcifications of the aorta and great vessels noted.Physiologic volume of pericardial fluid. Heavily calcified aortic valve, correlate for history of aortic valve stenosis. Right jugular chest port tip at the SVC/RA junction. Severe coronary artery calcifications. Normal heart size.CHEST WALL: Surgical clips left chest wall. Right jugular chest port.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Numerous hypoattenuating hepatic lesions consistent with metastases, the majority are within segments IVa and IVb of the liver. Largest conglomerate of lesions measures 5.6 x 5.9 cm on coronal series image 77. A in addition, there are a few fluid attenuating cysts.SPLEEN: Splenic artery is heavily calcified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Possible left hydronephrosis and proximal hydroureter. There is subtle wall enhancement and possible nodularity in the medial wall of the proximal left ureter (3/131). Probable bilateral extrarenal pelves. Renal vascular calcifications. Subcentimeter hypoattenuating lesions in the kidneys are too small to accurately characterize. An inferior pole right kidney cortical lesion measures slightly higher than simple fluid, indeterminate.PANCREAS: Calcifications in the pancreatic head.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Fat stranding anterior to the liver just beneath the right diaphragm just cranial to the bulk of the hepatic metastases may be reactive however there is a slightly nodular quality and localized metastatic invasion cannot be excluded. The undersurface of the right hemidiaphragm is thickened and has a poorly defined inferior border at this level.OTHER: No significant abnormality noted. | Bilateral pulmonary nodules and numerous hepatic lesions are most consistent with metastases. Hazy infiltration of the right hemidiaphragm undersurface and adjacent fat, unable to exclude localized soft tissue invasion. Although the patient has extrarenal pelves, areas of possible enhancement and nodularity in the proximal left ureter are suspicious for metastases causing obstruction which cannot be excluded without delayed excretory phase imaging. Aortic valve appears heavily calcified, correlate for aortic valve stenosis. |
Generate impression based on findings. | Male 42 years old; Reason: evaluate abd wall for ventral hernia History: ventral hernia on exam, prev abd surgery ABDOMEN: The absence of intravenous contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:LUNGS BASES: Small right pleural effusion. The heart is markedly enlarged with pacemaker leads noted. No nodule or mass detected.LIVER, BILIARY TRACT: Cirrhotic changes of the liver are noted without focal lesion although limited given lack of IV contrast.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted. Extrarenal pelvis or parapelvic cysts noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small midline umbilical hernia noted with a neck measuring 1.7 cm containing fluid. no bowel loops are in this hernia. There is no obstruction or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Marked abdominal ascites.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. | 1.Cirrhotic liver with marked ascites.2.Changes compatible with heart failure and AICD placement3.small umbilical hernia without obstruction in the neck of 1.7 cm. |
Generate impression based on findings. | Male, 44 years old, tongue base cancer, status post CRT. Since the prior examination, extensive mucosal hyperemia and edema has developed involving the pharynx, soft palate, base of tongue and supraglottic larynx. There is a thin retropharyngeal effusion. The subcutaneous fat and fascial planes are infiltrated and the platysma is thickened, findings more so on the left than on the right.Within this background, no definite focal left tongue base mass is seen. Presumed lymphoid prominence is redemonstrated at the right tongue base. Accurate measurement is difficult due to the extensive changes noted above, but at approximately 1.7 x 1.2 cm (image 34 series 5), this tissue has probably not changed much in size.Scattered lymph nodes are redemonstrated in both sides of the neck, more so on the left, none of which meets criteria for pathologic enlargement. Overall, most of these nodes appear similar in size and distribution to the prior exam. Two left level Ia lymph nodes may be slightly more plump when compared to the prior examination measuring 9 x 8 mm and 13 x 9 mm (image 40 and 39 of series 5), previously 9 x 6 mm and 8 x 8 mm. A left level IIa reference node measures 5 x 4 mm (image 36 series 5), previously 7 by 6 mm, showing developing calcification. A reference left level 3 lymph node measures 6 x 4 mm (image 42 series 5), previously 7 x 5 mm.The salivary glands and thyroid are free of focal lesions. The cervical vessels are patent and unremarkable. The lung apices are clear. No concerning osseous lesions are seen. | 1. Fairly extensive mucosal edema and hyperemia most likely reflects treatment related mucositis. No definite evidence of recurrent primary tumor.2. Most of the lymph nodes in the neck are stable to slightly smaller. Two level Ia nodes are slightly more prominent, but given the extensive surrounding inflammatory changes, these are felt most likely to be reactive. |
Generate impression based on findings. | Ovarian cancer. Evaluate for disease response/progression. CHEST:LUNGS AND PLEURA: The referenced right lower lobe nodule measures 6 mm (image 53, series 4), unchanged. MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes are present with no interval change in size. The reference subcarinal lymph node measures 3.2 X 1.7 cm (image 45, series 3), unchanged.CHEST WALL: There is a right chest port in place with the tip at the level of the cavoatrial junction. Multiple small sclerotic foci are seen within T6, 9 and 11 vertebral bodies, which appear unchanged since the prior examination. The previously described mixed density lesions in the lower thoracic vertebral bodies also appear unchanged since the prior examination.ABDOMEN:LIVER, BILIARY TRACT: Again noted are numerous hepatic metastases with interval decrease in size. The referenced segment 8 lesion measures 2.7 cm. The hepatic vasculature appears patent and there is no evidence of intrahepatic biliary ductal dilatation. Cholelithiasis is again noted. Previously described subhepatic fluid collection is no longer seen.SPLEEN: Multiple, small hypodensities seen within the spleen appears stable since prior examination.PANCREAS: The pancreas remains atrophic.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small high density, calcific foci within the renal pelvises bilaterally likely representing nonobstructive nephrolithiasis are unchanged. Subcentimeter hypoattenuating lesions are seen in both kidneys and are too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The patient is status post gastrojejunostomy with a suture line seen in the upper abdomen. Stable peritoneal carcinomatosis is evident, with the referenced lesion (image 100, series 3) again measuring 1.1 x 0.8 cm.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The patient is status post total abdominal hysterectomy and bilateral salpingo-oophorectomy.BLADDER: The bladder is nondistended.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple hyperdense lesions are seen in both the right hemipelvis as well as the lower lumbar vertebral bodies. These appear stable in size and morphology when compared to the prior CT examination.OTHER: No significant abnormality noted. | Overall no substantial interval change with measurements given above. |
Generate impression based on findings. | 70 year-old female with history of renal cell carcinoma CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules are again identified. Reference left upper lobe nodule measures 6 x 6 mm (image 26 series 11) and previously measured 7 x 6 mm.Reference left lower lobe nodule measures 1.1 x 0.8 cm (image 45 series 11) and previously measured 5 x 8 mm. Mild basilar atelectasis.MEDIASTINUM AND HILA: Right hilar lymph node measures 3.0 x 2.3 cm and previously measured 2.8 x 1.8 cm (image 45, series 10), increased in size. Additional hilar lymph nodes are noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple bilateral hepatic metastases are again identified, several which have increased in size. Small reference lesion along the hepatic dome in segment 8 measures 6x5 mm and previously measured 8 x 8 mm (image 68, series 10). Reference segment 7 lesion measures 1.4 x 1.1 cm and previously measured 1.0 x 1.0 cm (image 67, series 10).SPLEEN: Small splenules are again noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Small left adrenal gland nodule is unchanged.KIDNEYS, URETERS: Status post right nephrectomy. Small left hypoattenuating lesions, likely representing cysts, are unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent or atrophic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval progression of disease with reference measurements given above. |
Generate impression based on findings. | 39-year-old female patient with history of bilateral orbital swelling times years and recently diagnosed with Castleman's disease from submental node biopsy. CHEST:LUNGS AND PLEURA: Scattered micronodules in the right lung (series 7 image 38, 46, 57).MEDIASTINUM AND HILA: Small scattered lymph nodes.CHEST WALL: Extensive axillary lymphadenopathy. Index lymph node measures 1.6 x 1.3 cm in the right axilla (series 401 image 28).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: Hypoattenuating focus in the inferior pole of the left kidney measures 0.8 x 1.0 cm (series 401 image 110), and is too small to characterize.RETROPERITONEUM, LYMPH NODES: Scattered small lymph nodes.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: Extensive pelvic and inguinal lymphadenopathy. Index lymph node in the left obturator region measures 1.7 x 2.5 cm (series 401 image 162).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Extensive lymphadenopathy in the chest, abdomen and pelvis.2.Scattered pulmonary micronodules in the right lung. 3.Left kidney inferior pole hypoattenuating focus is too small to characterize and likely represents a cyst. |
Generate impression based on findings. | Vomiting. Hemoglobin drop. Rule out hematoma. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Multiple pancreatic and peripancreatic low density collections probably represent pseudocysts. The largest is located in the pancreatic tail and measures 5.1 x 5.0 cm (image 31; series 3). This compresses the splenic vein but the splenic vein remains patent. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastric wall edema. This is a nonspecific finding on CT and would suggest correlation with upper endoscopy if clinically indicated. Gastric varices.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: Rectal wall edema. Consider proctitis. Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Pelvic ascites. | Multiple presumed pancreatic pseudocysts. Gastric and rectal wall edema consider correlation with endoscopy and/or colonoscopy as clinically indicated. Pelvic ascites. No evidence of retroperitoneal hematoma. |
Generate impression based on findings. | 46 showed female with history of pancreatitis, assess the pancreas. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic lesions. Status post cholecystectomy. No intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS:Interval resolution of previous noted pseudocysts and extensive soft tissue infiltration surrounding the distal pancreas. There is atrophy of the distal pancreas, likely relating to prior necrotizing pancreatitis. The adjacent vasculature appears patent without evidence of aneurysm.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small exophytic left renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status-post appendectomy. The bowel is normal in caliber.BONES, SOFT TISSUES: Ventral hernia containing small bowel without evidence of obstruction.OTHER: 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: Ventral hernia containing small bowel without evidence of obstructionOTHER: No significant abnormality noted | Interval resolution of pancreatitis and pseudocysts with residual atrophy of the distal gland but no additional complication. |
Generate impression based on findings. | 60 year-old female with head and neck cancer. CHEST:LUNGS AND PLEURA: Emphysema. Stable scarlike opacity in superior segment of right lower lobe (series 8, image 43). Scattered punctate calcified and noncalcified micronodules, most compatible with granulomas. No new or suspicious nodules.No consolidation or pleural effusions.MEDIASTINUM AND HILA: Reference precarinal node measures 10 mm, previously measured 10 mm (series 6, image 31). Heart size normal. No pericardial effusion. Calcified right hilar nodes, compatible with prior granulomatous infection. Hiatal hernia.Anomalous origin of left vertebral artery directly from the aortic arch.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable mild intra- and extrahepatic biliary ductal dilation. No suspicious liver lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Partially visualized left ureteral stent and mild left hydronephrosis. Right kidney unremarkable.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 exam without evidence of metastatic disease. |
Generate impression based on findings. | 68-year-old male with history of prostate cancer. Status post prostatectomy in 2010 now with hematuria. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Prominence of the pancreatic duct is of unclear significance.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No nephrolithiasis, hydronephrosis or ureteral stones. Symmetric renal cortical enhancement and excretion filling the ureters to the level of the bladder without visualized abnormality.RETROPERITONEUM, LYMPH NODES: Marked atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine, worst at L5/S1.OTHER: No significant abnormality noted | No nephrolithiasis, ureteral stones or findings to explain the patient's hematuria. |
Generate impression based on findings. | 60 year-old female with lung cancer and lymphoma. CHEST:LUNGS AND PLEURA: Status post left upper lobectomy with resultant volume loss. Mild centrilobular emphysema.No significant change in the left lower lobe ground glass nodule measuring 10 mm, previously measured 12 mm (series 5, image 128).Previously seen groundglass nodule in the right base no longer identified.New punctate nodule in the lateral aspect of the right lower lobe measures 4 mm (series 5, image 143).No consolidation or pleural effusions. Elevation of left hemidiaphragm, increased since prior exam and may be due to phrenic nerve paralysis.MEDIASTINUM AND HILA: Again seen are densely calcified nodes, compatible with prior granulomatous disease.Coronary artery and atherosclerotic calcifications. Heart size is normal. No pericardial effusion.Enlarged left cardiophrenic lymph node is increased in size, currently measuring 12 mm, previously measured 8 mm (series 3, image 63).CHEST WALL: Status post median sternotomy.Destructive left chest wall soft tissue mass invading anterior mediastinum is increased in size, measuring 4.2 x 8.2 cm, previously measured 2.5 x 6.6 cm (series 3, image 46).ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No suspicious liver lesions. Cholelithiasis.SPLEEN: Not visualized.ADRENAL GLANDS: Hypoattenuating right adrenal nodule cannot be completely characterized on this exam, however, has been stable since 2011 and most likely represents benign adenoma (series 3, image 100).KIDNEYS, URETERS: Stable bilateral hypoattenuating renal lesions, most compatible with benign cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcifications throughout aorta and its branches. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Postsurgical changes in anterior abdominal wall.Lytic lesion in left iliac bone is new since 2011, highly suspicious for metastatic lesion (coronal series image 41).OTHER: No significant abnormality noted. | 1.Interval increase in size of destructive left chest wall mass, which invades the anterior mediastinum. There is associated increase in left hemidiaphragm elevation, which maybe related to phrenic nerve injury caused by this mass.2.Interval increase in size of left cardiophrenic lymph node.3.New 4-mm punctate micronodule in right lower lobe.4.Stable 10-mm ground glass nodule in left lower lobe.5.Lytic lesion in left iliac bone is new since 2011, highly suspicious for metastatic lesion. |
Generate impression based on findings. | Posterior mediastinal mass. CHEST:LUNGS AND PLEURA: Subsegmental right lower lobe atelectasis surrounding the posterior mediastinal mass. Small right pleural effusion. No suspicious lung parenchymal nodules or masses are seen. This mass abuts the right upper lobe bronchus and bronchus intermedius, displacing the right upper lobe bronchus anteriorly. The central bronchi appear patent.MEDIASTINUM AND HILA: 6.0 x 4.4 x 6.0 cm soft tissue mass in the right aspect of the posterior mediastinum (series 3, image 27), which appears to extend just past the midline. This lesion is homogenous in attenuation with faint enhancement. No mediastinal or hilar lymphadenopathy. Normal sized heart without pericardial effusion. CHEST WALL: Subcentimeter axillary lymph nodes bilaterally. High attenuation foci in the left axillae are suspicious for calcified lymph nodes.The aforementioned posterior mediastinal mass extends to the osseous spine, without extension into the spinal canal. No osseous changes are seen in the adjacent ribs or vertebrae. ABDOMEN:LIVER, BILIARY TRACT: Normal morphology. No focal lesions. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: Normal in appearance.PANCREAS: Normal in appearanceADRENAL GLANDS: Normal in appearanceKIDNEYS, URETERS: Normal symmetric enhancement without pelvicaliceal dilatation. No focal renal lesions. RETROPERITONEUM, LYMPH NODES: No abdominal lymphadenopathy.BOWEL, MESENTERY: Normal appearing bowel loops.BONES, SOFT TISSUES: No osseous lesions are seen.PELVIS:PROSTATE, SEMINAL VESICLES: Normal in appearance.BLADDER: Normal in appearance.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Normal appearing bowel loops.BONES, SOFT TISSUES: No osseous lesions are seen.OTHER: No ascites. | 6.0 cm posterior mediastinal mass, suspicious for neuroblastoma. No specific evidence of metastatic disease. |
Generate impression based on findings. | History of metastatic breast cancer, restaging. CHEST:LUNGS AND PLEURA: Minimal bibasilar atelectasis. No suspicious pulmonary nodules or masses. MEDIASTINUM AND HILA: Cardiac size is normal. No pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest port with tip at the cavoatrial junction. Bilateral mastectomy with breast implants. Status post left axillary lymph node dissection.ABDOMEN:LIVER, BILIARY TRACT: Multiple, bilobar hypoattenuating hepatic lesions, consistent with metastases continue to regress. Reference lesion in the right hepatic lobe measures 2.2 x 1.0 cm (image 103; series 3). Hepatic and portal veins are patent.SPLEEN: Previously described hypoattenuating lesion the spleen is not well demonstrated on today's exam.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: Multiple sclerotic and lytic osseous lesion suspicious for metastases throughout the visualized axial skeleton, similar to prior exam. Note that bone scan is a more sensitive evaluation for the detection of osseous metastases.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: Multiple sclerotic and lytic osseous lesion suspicious for metastases throughout the visualized axial skeleton, similar to prior exam. Note that bone scan is a more sensitive evaluation for the detection of osseous metastases.OTHER: No significant abnormality noted. | 1.Interval decrease in size of liver metastases.2.Stable appearance of osseous and splenic metastases. |
Generate impression based on findings. | 76-year-old male with history of bladder cancer. Status post resection. CHEST:LUNGS AND PLEURA: Severe upper lobe predominant centrilobular and paraseptal emphysema. Scattered pulmonary micronodules and small nodules along the pleura and fissures some of which are calcified.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes with the largest anterior mediastinal lymph node measuring 1.2 x 1.0 cm (image 30, series 4). Atherosclerotic calcifications of the aorta and coronary vessels.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating right hepatic lesion. Cholelithiasis without evidence for cholecystitis.SPLEEN: Splenic granuloma.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: Marked atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystectomy with ileal conduit diversion.LYMPH NODES: Status post pelvic lymph node dissection. Prominent inguinal lymph nodes are identified. No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Status post cystectomy with ileal conduit diversion without specific evidence of metastatic disease. Prominent mediastinal and inguinal lymph nodes for which follow up imaging is suggested.2. Severe emphysema with scattered micronodules. |
Generate impression based on findings. | 73-year-old male with shortness of breath and tachycardia. PULMONARY ARTERIES: Diagnostic exam. The there is a filling defect in a segmental branch of the right middle lobe, compatible with pulmonary embolus (series 6, image 142; coronal series image 46). No other pulmonary emboli are identified.LUNGS AND PLEURA: Small bilateral pleural effusions with bilateral basilar atelectasis. Groundglass opacity in the right upper lobe, not specific but may represent mild edema.Several calcified and noncalcified micronodules, which are most likely benign in nature.MEDIASTINUM AND HILA: No significantly enlarged mediastinal lymph nodes. Moderate or calcifications affect coronary arteries and aorta. Status post CABG. Moderate cardiomegaly. No right ventricular enlargement or interventricular septal bowing to suggest right heart strain. Enlarged main pulmonary artery consistent with pulmonary arterial hypertension. Central venous catheter terminates in distal SVC.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of ascites in upper abdomen. | 1.Small, solitary pulmonary embolus in subsegmental branch of right middle lobe. No evidence of right heart strain.2.Bilateral small pleural effusions with underlying atelectasis/consolidation in the bases.3.Mild ground glass opacity in the right upper lobe, nonspecific but suspected to represent mild focal edema in setting of pleural effusions.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: h/o lip cancer History: r/o lung mets LUNGS AND PLEURA: There is a calcified granuloma in the right lower lobe (series 5, image 84). MEDIASTINUM AND HILA: Right lower paratracheal lymph node measuring 1.1 cm (series 3, image 28). Minimal atherosclerotic calcification of the coronary arteries and aortic arch. Heart size is normal.CHEST WALL: Posterior osteophyte protruding into the spinal canal at T3 T4.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple subcentimeter hypodense lesions in the left hepatic lobe and one hypodense lesion in the right are too small to further characterize. Left kidney was not visualized. Splenic artery calcifications. | No evidence of metastatic disease. |
Generate impression based on findings. | 74-year-old male with left tongue mass consistent with cancer. LUNGS AND PLEURA: Moderate centrilobular emphysema. No consolidation or pleural effusions. No suspicious nodules or masses. Several punctate calcified granulomas are identified.MEDIASTINUM AND HILA: Enlarged, heterogeneous thyroid gland, with hyperdense nodule in left lobe. No mediastinal lymphadenopathy. Heart size normal. Mild atherosclerotic calcifications affect the aorta and coronary arteries, as well as the aortic valve.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. While the entire pancreas is not visualized, there is significant dilation of the pancreatic duct in the tail of the pancreas, measuring up to 7 mm in diameter (series 3, image 108). No evidence of intrahepatic biliary dilation, Diffuse thickening of stomach wall is nonspecific but may be related to gastritis or due to under distention. Multiple calcification are present in the upper retroperitoneum, of unclear etiology.Hypodense lesion in left kidney likely represent benign cysts.Bilateral adrenal gland thickening. | 1.No evidence of intrathoracic metastatic disease. 2.Significant dilation of partially visualized pancreatic duct; advise dedicated abdominal and pelvic CT to exclude a more proximally obstructing pancreatic ductal mass.. 3.Nonspecific gastric wall thickening, which may be due to gastritis, varices or under distention. |
Generate impression based on findings. | Reason: r/o PE History: sob PULMONARY ARTERIES: No significant abnormality noted. Study is technically adequate. No filling defects.LUNGS AND PLEURA: Bibasilar atelectasis. Bilateral reticular and patchy ground glass opacities, left greater than right, with basilar predominance. There is associated architectural distortion and mild traction bronchiectasis. There is no honeycombing. No pleural effusions.MEDIASTINUM AND HILA: Small subcentimeter para-aortic lymph nodes. Large left lower paratracheal lymph nodes. Sternotomy wires.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material and acquisition of images in an early phase markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolus.2.Bilateral paraseptal emphysematous changes with patchy groundglass opacities suggestive of prior infection, NSIP or COP. |
Generate impression based on findings. | Lymphosarcoma. Progressive fatigue. Restage. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant adenopathy identified.CHEST WALL: Focal sclerotic area in the lateral right rib (image 43; series 3) is unchanged.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly and fatty infiltration of the liver, not significantly changed.SPLEEN: Benign appearing cystic splenic lesion, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 9-mm high density lesion in the upper pole of the left kidney image (image 100; series 3) not significantly changed compared to previous study. Right kidney is unremarkable. Circumaortic left renal vein as a normal variant.RETROPERITONEUM, LYMPH NODES: The perigastric reference lymph node measures 1.3 x 1 cm (image 89; series 3), unchanged. 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 adenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Near complete resolution of the abdominopelvic lymph nodes as described above. Subcentimeter exophytic lesion involving the upper pole of the left kidney is unchanged. |
Generate impression based on findings. | 59-year-old female with pancreatic cancer. LUNGS AND PLEURA: Punctate calcified and noncalcified micronodules in both lower lobes, most consistent with prior granulomatous disease. No suspicious nodules or masses identified. Minimal dependent atelectasis. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall port catheter with tip in distal SVC. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Soft tissue seen around the celiac origin, better evaluated with recent abdominal CT. | 1.No specific evidence of intrathoracic metastatic disease.2.Evidence of prior granulomatous disease. |
Generate impression based on findings. | 59-year-old female assess for disease involvement UTERUS, ADNEXA: Status post hysterectomy. Small cystic structure in the left pelvis likely represents the left ovary.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of metastatic disease in the pelvis. |
Generate impression based on findings. | Right temple skin squamous cell carcinoma. There is skin thickening overlying the right zygomatic arch with associated loss of subcutaneous fat, compatible with scar from prior skin tumor resection. There is no definite nodular component to suggest locoregional tumor recurrence. However, there are ill-defined heterogeneous right parotid lymph nodes, the largest of which measures 21 x 21 mm, previously 17 x 20 mm. There is no other significant cervical lymphadenopathy by size criteria. There are no lytic or blastic lesions. The thyroid gland is heterogenous. The airway is patent. Thre is mild to moderate atherosclerotic plaque at the bilateral carotid bifurcations. The imaged intracranial structures are grossly unremarkable. There is partially imaged bilateral pleural based nodularity with course calcifications. | Interval increase in size of the necrotic metastatic right parotid lymphadenopathy. No definite evidence of locoregional tumor recurrence of the right temporal skin squamous cell carcinoma. |
Generate impression based on findings. | 47 year old female. Reason: History of bladder mass, please evaluate with CT urogram & delayed imaging. McCune-Albright syndrome. Bladder lesions on cystoscopy are suspicious for CIS. ABDOMEN:LUNG BASES: Two Harrington spinal fixation support rods in the thoracic and lumbar spine. Levoscoliosis of the lumbar spine. No pleural effusions. No focal pulmonary opacities. Cardiomediastinal silhouette is unremarkable.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: Diffuse skeletal changes compatible with polyostotic fibrous dysplasia and McCune-Albright syndrome. Cortical thinning, predominantly in the pelvis. Severe lumbar levoscoliosis. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Bilateral simple adnexal cysts, 2.2 cm diameter on the right and 4.8 x 5.8 cm on the left at image 86 of series 3. Multiple smaller cysts are present. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Changes of polyostotic fibrous dysplasia. Bilateral femoral long stem metallic implants with associated metal streak artifact. Pelvic asymmetry and longstanding lumbar levoscoliosis. OTHER: No significant abnormality noted | Bilateral adnexal cysts. Bony changes due to McCune-Albright syndrome with multiple intact metallic appliances. No measurable metastatic disease. No lymphadenopathy. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male, 64 years old, lip cancer, evaluate for recurrence. Mild prominence of the tongue base mucosa is seen, a stable finding which likely reflects lymphoid prominence. No suspicious mucosal lesions are demonstrated. No pathologic adenopathy is detected in the neck by size criteria. A pretracheal lymph node in the mediastinum is borderline enlarged at 1.5 x 1.1 cm (image 72 series 6), similar to prior.The region of the lips is obscured by dental streak artifact. Elsewhere in the face, no mass lesions are detected.The salivary glands and thyroid are free of focal lesions. The cervical vessels are patent and unremarkable. Lung apices show no significant abnormality. No concerning osseous lesions are seen. | 1. No definite evidence of mass lesions or pathologic adenopathy in the neck.2. A borderline enlarged mediastinal lymph node is better assessed on the accompanying chest CT. |
Generate impression based on findings. | Male, 74 years old, left tongue mass consistent with cancer. Lack of IV contrast reduces sensitivity for small lesions and for adenopathy in the neck. Given this limitation, the following observations are made.Head CT:Hypoattenuation is present within the right frontal lobe extending to the level of the cortex, most likely representing chronic ischemic change. A chronic stroke is also evident in the right cerebral hemisphere. Periventricular hypoattenuation is nonspecific but compatible with age indeterminate small vessel ischemic disease. Lucency within the pons is likely of similar etiology.No definite evidence of focal parenchymal edema or mass effect is seen to suggest the presence of metastatic disease.Neck CT:A mass is present centered on the left glossotonsillar sulcus involving the oral tongue and to some degree the floor of mouth, the palatine tonsil and likely a portion of the left soft palate. The lesion measures 4.2 x 3.1 cm transaxial (image 23 series 6) and 4.5 cm in the coronal plane (image 50 series 80420).Without the benefit of IV contrast, no definite adenopathy is detected in the neck, at least by size. The salivary glands are within normal limits. The thyroid is enlarged and heterogeneous bilaterally. There is a 1 cm hyperdense focus within the left thyroid lobe.Bilateral apical lung scarring is demonstrated. No evidence of concerning or focally destructive osseous lesions is seen. Cervical degenerative disk disease is present at all levels. This results in minimal encroachment upon the spinal canal at C5-6 and C6-7, and scattered moderate to severe foraminal narrowing. | 1. Large left tongue mass as described above compatible with stated history.2. No definite evidence of adenopathy in the neck, though lack of IV contrast reduces sensitivity in this regard.3. Thyroid abnormalities would be better assessed on sonography.4. No evidence of intracranial metastatic disease. Areas of ischemic change are demonstrated. |
Generate impression based on findings. | Left parotid adenoid cystic carcinoma which progressed on 2 lines of cytotoxic chemotherapy (carbo/5FU/cetuximab, paclitaxel). There are postoperative findings related to left total parotidectomy and lateral temporal bone resection with flap reconstruction. There is a heterogeneous mass within the left parapharyngeal space, lateral to the styloid process and medial to the surgical bed, that measures 13 AP x 17 RL x 22 mm, previously 14 AP x 19 RL x 24 SI mm in May 2013. The remaining major salivary glands and thyroid gland are unremarkable. There is no significant cervical lymphadenopathy by size criterial. The osseous structures are unremarkable, aside from mild degenerative cervical spondylosises. The major cervical vessels are patent. The imaged intracranial structures are grossly unremarkable. There are bilateral maxillary sinus retention cysts. There is a right apical lung nodule that measures up to 8 mm, which is not significantly changed. | 1. Slight decrease in size of the recurrent adenoid cystic carcinoma within the left parapharyngeal space adjacent to the medial surgical margin, which now measures up to 22 mm. No significant cervical lymphadenopathy.2. A right apical lung nodule that measures up to 8 mm is consistent with metastatic disease, but is not significantly changed. Refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 27 year old male. Reason: evaluate for appendicitis or hernia History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality. Small splenule. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated appendix in the right lower quadrant measures 1.2 cm diameter with hyperenhancing mucosa and appendicolith. Small amount of free fluid in the pelvis. 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: Appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Acute appendicitis. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 85 years old Reason: assess for patellar fx History: questionable fx on XR, point tenderness, inability to bear weight There is a vertically oriented nondisplaced comminuted patellar fracture through the lateral facet. There is an associated moderate-sized lipohemarthrosis within the joint space. There is severe medial tibiofemoral compartment narrowing, subchondral sclerosis and tricompartmental osteophytosis compatible with severe osteoarthritis. | Patellar fracture and severe osteoarthritis as above. |
Generate impression based on findings. | 84 year old female. Reason: r/o diverticulitis, left pyelo History: weakness and LLQ pain ABDOMEN:LUNG BASES: Minimal left lower lobe opacities. No acute infiltrate or effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Enlarged cystic left adrenal measures 3 cm in diameter. KIDNEYS, URETERS: Septated right upper pole renal cyst. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without diverticulitis. Dilated rectum with inspissated stool, compatible with severe constipation. Probable rectal inflammatory changes. BONES, SOFT TISSUES: Degenerative changes of the lumbosacral spine and pelvis. OTHER: No significant abnormality noted | Left adrenal cystic mass. Complex right upper pole renal cyst. No diverticulitis. Dilated rectum, constipation. |
Generate impression based on findings. | 33 year old female. Reason: R/O stone History: flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. No hydronephrosis or fat stranding. 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: There is a 3mm calcification in or near the distal right ureter without associated hydroureter (image 811 of series 2). This may be a nonobstructing calculus. If indicated, obtain a contrast-enhanced CT scan for further evaluation. | No hydronephrosis. Questionable non-obstructing 3 mm calcification at the distal right ureter. Otherwise negative exam. No other abnormality was found to explain flank pain. |
Generate impression based on findings. | 61 year old female. Reason: ascites vs mass. History: abd pain. ABDOMEN:LUNG BASES: Moderate right pleural effusion. Associated compressive atelectasis of the adjacent right middle and lower lobes. Solid 9 mm nodule adjacent to the right lower lung most likely arises from the diaphragmatic pleura but may also be subpleural. The likely extrapulmonary nature of this nodule is best demonstrated on coronal and sagittal reconstructions. Normal heart size without pericardial effusion. No significant lymphadenopathy. Small hiatal hernia. LIVER, BILIARY TRACT: Low attenuation in most of the right hepatic lobe has been present since the CT PE exam on 10/17/2013 suggests fatty infiltration. Cirrhotic morphology of the liver with slow main portal venous flow on 10/18/2013 US exam. Perihepatic and perisplenic free fluid. Portal vein appears patent.SPLEEN: Splenomegaly. The spleen is more than 13 cm in length. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate ascites. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate ascites. | Fatty infiltration of cirrhotic liver. Ascites. Patent portal vein. Splenomegaly. Right pleural effusion. |
Generate impression based on findings. | 63 year old female. Reason: assess for hematoma, obstruction. History: abd pain, s/p intravaginal laceration, on coumadin ABDOMEN:LUNG BASES: No infiltrates or effusions. Mild pericardial thickening. Normal heart size. LIVER, BILIARY TRACT: Hepatic hypodensities are compatible with simple cysts. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral simple renal cysts. 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: Atrophic uterus and adenxa. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No hematoma. No obstruction. No specific abnormality to explain abdominal pain. |
Generate impression based on findings. | 60 year old female. Reason: evaluate for cholecystitis/ cholelithiasis. History: RUQ pain, n/v ABDOMEN:LUNG BASES: Severe bullous emphysematous changes in a hyperexpanded right lung. Mediastinal shift to the left. LIVER, BILIARY TRACT: No significant abnormality noted. Gallbladder is unremarkable. 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: Mildly thickened fluid filled jejunal loops in the left upper quadrant suggests enteritis. 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 | Normal gallbladder. Possible enteritis in the left upper quadrant. |
Generate impression based on findings. | 53 year old male. Reason: Pt with flank pain with hx of L. nephrostomy tube and pyelo in 9/2013. Please eval for renal abscess. History: flank pain, fever ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatic hypodensities are too small to characterize. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Small left adrenal nodule. KIDNEYS, URETERS: Right nephrolithiasis. No right-sided hydronephrosis.7-mm stone in the left mid ureter with interval resolution of left-sided hydronephrosis and dilated proximal left ureter.Interval placement of a left nephroureterostomy tube in the expected position. Mild left perirenal fat stranding, but no definite evidence of pyelonephritis. No evidence of renal abscess. 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: Foley catheter in bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Left ureteral stone is unchanged in position at proximal ureter. Right nephrolithiasis. Status post left nephroureterostomy. No hydronephrosis or pyelonephritis. No renal abscess. |
Generate impression based on findings. | 18 year old female. Reason: r/o acute appendicitis History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Normal appendix. 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 | No specific abnormality to explain the RLQ pain. |
Generate impression based on findings. | 31 year old female. Reason: eval for kidney stone History: right flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Normal appendix in the right lower quadrant.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 | No specific abnormality to explain right flank pain. No hydronephrosis. No renal stones. Normal appendix. |
Generate impression based on findings. | 74-year-old male with history of bladder cancer, liver mass seen on prior CT. Reason: Assess for worsening of seroma. ABDOMEN:LUNG BASES: Right lower lobe subpleural reticulations and minimal bibasilar atelectasis, similar to prior exam.LIVER, BILIARY TRACT: The liver is normal in morphology. The segment IVb hepatic lesion is heterogeneously hypodense and unchanged since the prior CT exams. Status post cholecystectomy. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Unchanged small right adrenal nodule. Normal left adrenal gland.KIDNEYS, URETERS: Bilateral hydronephrosis, right greater than left, similar to prior exam. High density material within the collecting systems likely representing debris. Unchanged subcentimeter nodule adjacent to the right kidney medially.Both ureters are dilated and terminate in surgical clips at the pelvic inlet. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy. BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Large amount of residual stool in the rectum, compatible with constipation. BONES, SOFT TISSUES: The pelvic post-op seroma seen on the 2/17/2013 exam has resolved. OTHER: Small narrow mouthed hernia at the incision site containing fat. Small amount of free fluid in the pelvis. | Segment IVb hepatic hemangioma is stable. Atrophic kidneys with dilated ureters that terminate at the pelvic inlet. Pelvic seroma has resolved. Large amount of residual stool in the rectum, compatible with constipation. |
Generate impression based on findings. | 19 year old male. Reason: 19 yo male with abd pain and weight loss, rule out SB inflammation, Crohn's disease. History: abd pain and weight loss 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: No significant abnormality noted.BOWEL, MESENTERY: Contiguous dilation and wall thickening with abnormal mural contrast enhancement at the terminal ileum (located in the mid-pelvis) to the mid-transverse colon compatible with active Crohn's 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: Terminal ileum and ascending colon inflammatory changes compatible with Crohn's disease. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Terminal ileum and ascending colon inflammatory changes compatible with active Crohn's disease. |
Generate impression based on findings. | 25 year old female. Reason: evaluate for peri-rectal abscess or fluid collection. History: prev pilonidal cyst i \T\D w/ purulent drainage, lower back pain UTERUS, ADNEXA: Radiodense IUD is in the expected position. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Inspissated stool in rectum and sigmoid suggests constipation. BONES, SOFT TISSUES: 1.3 x 3 cm lesion dorsal to sacrum in the soft tissues at image 39 of series 4. This lesion extends craniocaudally 3.4 cm on coronal image 63. The lesion contains probable gas bubbles and has an enhancing rim, probably due to abscess. Does not extend to the bony sacrum or into the pelvis. The lesion is located just cranial to the buttock crease. OTHER: No significant abnormality noted | Abscess in midline soft tissues dorsal to the sacrum containing debris. Constipation in rectum and sigmoid. |
Generate impression based on findings. | 63 year old female. Endometrial cancer. SOB, on oxygen. PULMONARY ARTERIES: Technically adequate examination for pulmonary embolism to the segmental level. No pulmonary embolism is seen. LUNGS AND PLEURA: Trace right pleural effusion. Mild bibasilar dependent atelectasis. Scattered calcified and noncalcified micronodules. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Calcified left hilar nodes from prior granulomatous disease. No mediastinal or hilar lymphadenopathy. Mild atherosclerotic calcification of the aortic arch. Normal heart size. Right chest wall Port-A-Cath tip terminates low in the right atrium. Small paracardiac lymph nodes, similar to prior exam.CHEST WALL: Right chest wall port. Mild degenerative disk disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Omental nodularity in the visualized upper abdomen consistent with peritoneal carcinomatosis. | 1. No evidence of pulmonary embolism.2. Trace right pleural effusion and mild bibasilar atelectasis.3. Peritoneal carcinomatosis. |
Generate impression based on findings. | Reason: r/o bleed History: AMS Although the study is without contrast, there is residual contrast within the vessels and the venous sinuses from prior abdominal contrast enhanced study.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. Small vessel ischemic disease of indeterminate age not significantly changed compared to prior exam.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 evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | 80-year-old male. Chest pain, right-sided, posterior. LUNGS AND PLEURA: Multifocal ill-defined, nodular airspace opacities scattered throughout both lungs, some with surrounding ground-glass opacities. The appearance of these nodular opacities is most consistent with an infectious process. Mild centrilobular emphysema.MEDIASTINUM AND HILA: Severe atherosclerotic calcification of the coronary arteries and moderate atherosclerotic calcification of the thoracic aorta. Multiple small subcentimeter mediastinal lymph nodes. Post-operative changes of CABG.CHEST WALL: Median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Multiple nodular opacities scattered throughout the lung, most likely represent an opportunistic infection given patient's immunocompromised state, consider fungal etiologies. 2. Mild centrilobular emphysema. |
Generate impression based on findings. | 19 year-old male with history of neuroblastoma presents with right flank abdominal pain, evaluate for kidney stone. ABDOMEN:LUNG BASES: No focal air space opacities or pleural effusions.LIVER, BILIARY TRACT: No focal hepatic lesions. No biliary ductal dilatation.SPLEEN: Normal in size and attenuation.PANCREAS: Normal in size and attenuation.ADRENAL GLANDS: Symmetric in size without focal lesions present.KIDNEYS, URETERS: There is mild right hydronephrosis and hydroureter with multiple right collecting system stones present. The largest stone measures 7 mm and is present at the right renal hilum (series 3, image 40). A 4 mm stone is present in the right proximal ureter (image 48). Smaller stones are also present in the mid ureter (image 91) and distal ureter (image 115) near the ureterovesical junction.A punctate nonobstructing left collecting system renal stone is noted (image 51). There is no left sided hydronephrosis.There is a slightly delayed right nephrogram.RETROPERITONEUM, LYMPH NODES: Enhancing right paraspinal masses are again noted compatible with the patient's history of neuroblastoma. Mass at the T11-T12 level measures 3.6 x 1.0 cm in the axial plane (series 6, image 29), previously 3.5 x 1.0 centimeters. The mass at the L1 level measures 3.2 x 2.0 cm (image 34), previously 3.2 x 1.9 cm. These masses are not significant changed in size since the prior examination. Additional enhancing nodules along the right psoas muscle are also not significantly changed compared to the previous exam.No new mass lesions are identified.BOWEL, MESENTERY: No bowel obstruction present.BONES, SOFT TISSUES: No suspicious osseous lesions are present.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Suture material again noted in the right lower quadrant may reflect postsurgical changes of prior appendectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Multiple obstructing calculi in the right collecting system measuring up to 7 mm with associated right-sided hydronephrosis.2.Right-sided paraspinal masses compatible with neuroblastoma appear similar to the prior study. |
Generate impression based on findings. | Reason: eval for hydrocephalus History: headache and vp shunt The CSF spaces are nondilated and unchanged. Stable right frontal approach VP shunt with tip in the third ventricle. Hypoattenuation of the parenchyma surrounding the course of the VP shunt without mass effect suggestive of focal encephalomalacia.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. | Stable right frontal approach VP shunt with no evidence of hydrocephalus. |
Generate impression based on findings. | 37-year-old female. Hypercoagulable patient. Tachycardia. Evaluate for PE. PULMONARY ARTERIES: Technically adequate examination. No pulmonary embolism is evident.LUNGS AND PLEURA: Mild bibasilar dependent atelectasis. Mild lower lobe bronchial wall thickening, suggests bronchitis/asthma. No pleural effusion. Calcified left lower lobe granuloma.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without significant pericardial effusion. Small AP diameter of the chest wall with compression of the left atrium.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. IVC filter is suprarenal with its apex in the intrahepatic IVC, higher in location than expected. | 1. No evidence of pulmonary embolism. 2. Mild bronchial wall thickening and bibasilar subsegmental atelectasis, of uncertain etiology.3. Higher than expected location of IVC filter, which is suprarenal in position. |
Generate impression based on findings. | 69 year-old female. Lung transplant evaluation. IPF. LUNGS AND PLEURA: Diffuse reticular and groundglass opacities with traction bronchiectasis. Subpleural mild microcystic honeycombing is seen in the in the lung bases and upper lobes. Small lung volumes. Marked interval progression of disease when compared to 2011 CT.No suspicious pulmonary nodules or masses are evident.MEDIASTINUM AND HILA: Nonspecific multiple hypoattenuating foci in the right thyroid lobe and isthmus. Multiple small mediastinal lymph nodes. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Interstitial changes compatible with UIP pattern, markedly progressed from 2011 exam. 2. No suspicious pulmonary nodules or masses. |
Generate impression based on findings. | Reason: 84M, acutely altered mental status for one day, please eval for bleed or other abnormality History: AMS Hypodense area in in the right occipital lobe without significant mass effect or sulcal effacement represents a chronic infarct. An additional larger hypodense area in the left parietal lobe with preservation of the gray-white matter differentiation and without mass effect or sulcal effacement also represents focal encephalomalacia from a chronic infarct. Mild periventricular white matter hypoattenuation suggestive of age indeterminant small vessel ischemic disease.No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. Empty sella.The CSF spaces are appropriate for the patient's stated age with no midline shift. The visualized portions of the paranasal sinuses are clear. Near total opacification of the right mastoid air cells. The visualized portions of the orbits are intact. | 1.Right occipital and left parietal hypodensities represent chronic infarcts.2.Mild periventricular white matter hypoattenuation suggestive of age indeterminant small vessel ischemic disease.3.Near total opacification the right mastoid air cells. |
Generate impression based on findings. | 13-year-old male with right lower quadrant pain. Evaluate for appendicitis or other acute abdominal process. ABDOMEN:LUNG BASES: No focal air space opacities or pleural effusions.LIVER, BILIARY TRACT: The liver is normal in size and attenuation. No extrahepatic or intrahepatic delayed ductal dilatation is present. The gallbladder appears normal.SPLEEN: The spleen is normal in size and attenuation.PANCREAS: The pancreas is normal in size and attenuation.ADRENAL GLANDS: The adrenal glands are symmetric in size and attenuation.KIDNEYS, URETERS: The kidneys are symmetric in size and attenuation with preserved corticomedullary differentiation. No hydronephrosis is present.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy is present.BOWEL, MESENTERY: There is no bowel obstruction. The appendix is visualized in the right lower quadrant and appears normal.Scattered mildly enlarged mesenteric lymph nodes are present measuring up to 8 mm in short axis (series 3, image 70).BONES, SOFT TISSUES: The bones appear normal.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The sigmoid colon wall appears mildly prominent which may reflect underdistention, though subtle pathology in this location is not entirely excluded on this examination. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Normal appendix. Mildly enlarged nonspecific mesenteric lymph nodes without acute abnormality present to explain the patient's right lower quadrant pain. |
Generate impression based on findings. | 76-year-old male. Right buccal cancer. Worsening pain. LUNGS AND PLEURA: Biapical scarring from prior radiation. Mild linear scarring in the right lower lobe. Calcified granulomas and scattered micronodules, similar to prior exam. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Tracheostomy is noted with small amount of dependent debris in the trachea. Severe atherosclerotic calcification of the coronary arteries and thoracic aorta. Mitral annulus calcification. Mild interval increase in size of multiple mediastinal lymph nodes, for example, a precarinal node measures 13 mm in short axis (previously 10 mm). Normal heart size. CHEST WALL: Healed bilateral rib fractures. Severe degenerative disk disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Unchanged rim calcified hepatic cyst. G-tube is noted. | 1. Mild interval increased size of mediastinal lymph nodes, which is nonspecific. No specific findings to account for the patient's symptoms.2. No suspicious pulmonary nodules. |
Generate impression based on findings. | Reason: Assess for mass, sign of infarct History: Persistent headache, poor balance, unsteady gait 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 evidence for acute intracranial hemorrhage, mass effect, or edema. |
Generate impression based on findings. | 74 year-old female. Possible history of COPD/CHF presenting with dyspnea, ? fibrosis on CXR. Evaluate for pulmonary disease. LUNGS AND PLEURA: Moderate right and small left pleural effusions with compressive atelectasis in the lung bases. Moderately severe upper lobe predominant centrilobular emphysema. Right middle lobe mass measuring 7.8 x 8.7 cm extends to the pleural surface (series 3, image 63). Multiple bilateral pulmonary nodules are present, the largest of which is in the left lower lobe at 2.4 x 2.6 cm (series 4, image 50).MEDIASTINUM AND HILA: Cardiomegaly without significant pericardial effusion. Moderate atherosclerotic calcification of the thoracic aorta and coronary arteries. Prominent 9 mm lymph node anterior to the great vessels (series 3, image 22). Main pulmonary artery diameter measures 3.5 cm, suggestive of pulmonary artery hypertension.CHEST WALL: Anasarca.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Visualized aspect of the liver demonstrates a nodular contour, raising the possibility of cirrhosis. Perihepatic ascites. | 1. Right middle lobe mass is highly suspicious for a primary lung malignancy. Multiple bilateral pulmonary nodules, the largest in the left lower lobe, likely represent intrapulmonary metastasis.2. Mildly enlarged superior mediastinal lymph node.3. Bilateral pleural effusions, moderate on the right and small on the left. 4. Ascites and anasarca. Findings suggestive of cirrhosis. |
Generate impression based on findings. | Reason: assess for mass, bleed History: seizure, hx radiation necrosis, brain tumor Right frontal craniotomy defect with underlying right frontal encephalomalacia from prior tumor resection as previously noted. Previously noted focus in the right frontal lobe measures 1.2 x 0.8 cm and is not significantly changed in size compared to MR findings. There is a suggestion of interval increase in surrounding edema involving the right frontal lobe with mass effect on the right frontal horn without significant midline shift. The remainder of the CSF spaces are mildly dilated but unchanged from prior exam.Right lacunar infarct is unchanged. Enlarged sella with punctate calcifications of the occupying parenchyma with postsurgical changes appear similar to prior exam.The visualized portions of the paranasal sinuses are clear. Partial opacification of the mastoid air cells bilaterally. The visualized portions of the orbits are intact. | 1.Hyperdense lesion of uncertain etiology in the right frontal lobe again noted which is increased in density but unchanged in size or shape.2.Suggestion of interval increase in surrounding edema along the posterior aspect of the right frontal lobe hypodense abnormality. MRI with contrast is recommended for better characterization. |
Generate impression based on findings. | 57 year-old female. Cough, fever, SOB. Evaluate for septic emboli. LUNGS AND PLEURA: Moderate bilateral upper lobe fibrosis, right greater than left, with architectural distortion and traction bronchiectasis consistent with sarcoidosis. Chronic appearing reticulonodular ground glass opacities in the lower lobes are likely also related to sarcoidosis. Scattered calcified lung granulomas.MEDIASTINUM AND HILA: Right IJ central line tip is in the upper right atrium. Main pulmonary artery has a diameter of 3.5 cm, suggestive of pulmonary artery hypertension. Moderately enlarged mediastinal lymph nodes and probably hilar lymphadenopathy. Mild atherosclerotic calcification of coronary arteries.CHEST WALL: Mildly enlarged axillary lymph nodes bilaterally.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Left renal cyst. | 1. Upper lobe predominant chronic interstitial lung disease consistent with sarcoidosis.2. No acute signs of infection. |
Generate impression based on findings. | Reason: mass, bleed? History: atypical HA 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 evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: evaluate for bleed History: headache after head injury HEAD: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.CERVICAL SPINE: The cervical vertebral bodies are appropriate in overall alignment and height. No fractures or subluxations are identified in the cervical spine. The visualized paraspinal contents are unremarkable. There is no significant compromise to the spinal canal or neural foramina of the cervical spine.If there is significant concern for cord injury or ligamentous injury, MRI should be considered. | No evidence for acute intracranial hemorrhage, mass effect, or edema. No evidence of fracture or subluxation of the cervical spine. |
Generate impression based on findings. | Male 81 years old Reason: severe arthritis UPPER EXTREMITY: There is a high riding humeral head compatible with a chronic rotator cuff tear.There are numerous subchondral cysts of the glenoid and femoral head as well as diffuse moderate osteophytosis of the femoral head, scapula, acromion and clavicle. This findings are compatible with moderate osteoarthritis. There is an ossific density superior to the joint space and adjacent to the acromion compatible with heterotopic bone. No evidence of underlying fracture.Other: There is a solid appearing 8mm pulmonary nodule in the right middle lobe of indeterminate etiology. | 1. Degenerative changes as described above.2. Findings compatible with a chronic rotator cuff tear.3. 8mm pulmonary nodule in the right middle lobe, if the patient is at high risk for lung cancer, follow up CT in 3 to 6 months is recommended. |
Generate impression based on findings. | Reason: r/o bleed History: fall, AMS HEAD: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.Mild mucosal thickening of the right maxillary sinus, improved compared to prior exam. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.CERVICAL SPINE:The cervical vertebral bodies are appropriate in overall alignment and height. No fractures or subluxations are identified in the cervical spine. The visualized paraspinal contents are unremarkable. Submandibular lymphadenopathy likely reactive. Ossification of the posterior longitudinal ligament with narrowing of the spinal canal at C2-C3.If there is significant concern for cord injury or ligamentous injury, MRI should be considered. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.No cervical spine fracture.3.Ossification of the posterior longitudinal ligament with narrowing of the spinal canal at C2-C3. |
Generate impression based on findings. | 51 year old female. Reason: non-Hodgkins lymphoma. please assess for progression of disease or other abnormality. History: history of NHL, recent hip fracture CHEST: LUNGS AND PLEURA: Dependent atelectasis. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly. The liver spans more than 22 cm craniocaudally. 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: Elongated right groin lesion extends more than 7.5 cm (coronal image 78) from the inguinal canal to the labia in the superficial soft tissues. Contains fat density internally, unusual for lymphadenopathy. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive bony destruction of the right hemipelvis with lytic changes to the ilium and ischium, especially medially. Large associated right pelvic soft tissue mass measures 4 x 6 cm (image 176, series 4). There is a large intramedullary lytic lesion in the right proximal femur that extends beyond the range of this exam. The right femur lesion extends to the intertrochanteric region. OTHER: No significant abnormality noted. | Hepatomegaly. Large right pelvic lytic lesion with associated soft tissue mass. Intramedullary right proximal femur mass is not completely evaluated. Right groin mass extends from inguinal canal to labia. |
Generate impression based on findings. | 74 year old female. Colon carcinoma. Reason: intermediate attenuation focus IN LOWER RIGHT POLE OF KIDNEY ON 10/17/13 CT. DR. CHANG RECOMMENDED DEDICATED RENAL PROTOCOL CT History: RENAL LESION CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable segment 8 subcentimeter low attenuation focus; favor benign etiology such as cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Minimally complex renal cyst at the right lower pole does not enhance with IV contrast. Findings are compatible with a septated dense (30 HU) cyst, Bosniak 2.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval appearance of moderately large parastomal hernia with loops of colon within the hernia sac. Not associated with bowel wall thickening, or bowel obstruction.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absentBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval decrease in size of presacral postoperative fluid collection.BONES, SOFT TISSUES: Stable extensive bony sclerosis and deformities.OTHER: No significant abnormality noted. | Atypical cyst in right lower pole is Bosniak 2, benign. No abnormal enhancement. No renal mass. Other findings are stable since 10/17/2013. |
Generate impression based on findings. | 24 year old female. Reason: evaluate for intraabdominal process History: severe abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Moderately large fecal load in the ascending and transverse colon, without obstructing lesion. Findings compatible with constipation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Moderately large fecal load in the ascending and transverse colon, without obstructing lesion. Findings compatible with constipation. |
Generate impression based on findings. | 68 year-old female. Nodules on last CT. Reevaluate. LUNGS AND PLEURA: Scattered calcified and noncalcified micronodules, most likely post-infectious in etiology. 5 mm subpleural nodule with a pleural tail (series 5, image 142) is unchanged, most likely representing an intrapulmonary lymph node. Large calcified granuloma in left lung base.MEDIASTINUM AND HILA: Moderate calcification of thoracic aorta and coronary arteries. Calcified mediastinal and hilar nodes, consistent with prior granulomatous disease.CHEST WALL: Mild degenerative disk disease of the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Colonic diverticula. | Stable 5 mm nodule in the left lung base, most likely a benign intrapulmonary lymph node. Post-infectious micronodules, unchanged. No further imaging follow-up for these findings is recommended. |
Generate impression based on findings. | Reason: CVA History: CVA Large hyperdense lesion with a halo of hypodensity in the right cerebellum compatible with a hemorrhagic infarct with surrounding edema. There is blood in the fourth ventricle tracking up through the cerebral aqueduct and into the third and lateral ventricles. The CSF spaces are nondilated. There is slight midline shift to the left.There is effacement of the quadrigeminal cistern, prepontine cistern, and supracerebellar cisterns raising concern for upward herniation. There is no appreciable midline shift.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. ET tube noted. | Acute intraparenchymal hemorrhage involving the right cerebellum with effacement of the surrounding cisterns raising concern for upwards transtentorial herniation. There is also blood within the CSF spaces. There is no midline shift.Findings were discussed with Dr. Demeter at 0200 on 10/26/2013 over the phone by Dr. Baad. |
Generate impression based on findings. | Reason: AMS, febrile neutropenia, r/o mass/bleed 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. Minimal periventricular white matter hypoattenuation around the frontal horns of the lateral ventricles suggestive of age indeterminant small vessel ischemic disease.Partially opacified anterior and posterior ethmoidal sinuses. Mucous retention cyst in the right maxillary sinus and mucosal thickening of the left maxillary sinus. Mucosal thickening of the right sphenoid sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | No evidence for acute intracranial hemorrhage, mass effect, or edema. |
Generate impression based on findings. | Reason: Change in ventricles/extraventricular CSF History: External ventricular drain Right frontal soft tissue swelling is unchanged. There is mild interval increase in size of a low density right-sided subdural fluid collection extending further inferiorly compared to prior exam. The maximal thickness measures 7 mm.Extensive right-sided parenchymal hemorrhage with surrounding edema involving the frontal, parietal and temporal lobes is not significantly changed from prior exam. There is an unchanged midline shift towards the left measuring 1 cm.Left frontal approach ventriculostomy drain with tip in the left lateral ventricle remains unchanged in position. The right lateral ventricle remains near completely effaced. There is minimal, unchanged layering hemorrhage in the left posterior horn of the lateral ventricle. There is no effacement of the cisterns.There is near total opacification of the left sphenoid sinus. There is mucosal thickening of the left maxillary sinus. Bilateral near total opacification of the mastoid air cells. The visualized portions of the orbits are intact. | 1.No significant change in the size of the CSF spaces.2.No significant interval change in the pattern and extent of parenchymal/ventricular hemorrhage. 3.Minimal interval increase in low density right-sided subdural fluid collection. |
Generate impression based on findings. | Reason: ich History: ich Right basal ganglia hemorrhage causing effacement of the right lateral ventricle remains relatively stable in size. There is a redistribution of intraventricular blood in the right ventricle to the posterior horn. There is effacement of the third ventricle. Persistence of blood in the cerebral aqueduct and fourth ventricle. There is minimal to no midline shift to the left. Right frontal approach ventriculostomy catheter tip is unchanged in position. Mucus retention cyst in the left maxillary sinus. The remainder of 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. ET tube is noted. | No significant change in the size and appearance of the right basal ganglia hemorrhage. |
Generate impression based on findings. | Reason: stroke follow-up History: hemiplegia Extensive right MCA distribution ischemia with effacement of the sulci and right lateral ventricle is again demonstrated without increasing size. The remainder of the CSF space are nondilated. There is a slight interval increase in midline shift now measuring 4 mm, previously measuring 2-3 mm. The infarct region remains uniformly hypodense with well defined margins. There is no evidence of hemorrhagic transformation. There is no effacement of the cisterns.The previously noted left-sided cortical/subcortical area of hypoattenuation in the left frontal lobe appears to be increased in size compared to prior exam.Periventricular white matter hypoattenuation is again seen likely indicating age indeterminate small vessel ischemic disease.Mild mucosal thickening of the right axillary and left sphenoid sinuses. The remainder of the visualized paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Nasogastric tube noted in the left nare. | 1.Stable large right-sided ischemic infarct along the MCA distribution with mild interval increase in midline shift to the left.2.Interval extension of geographical territory of left frontal lobe ischemic infarct. |
Generate impression based on findings. | Reason: edema? History: large right middle cerebral artery stroke and Patchy hypoattenuation in the right MCA distribution is again seen primarily involving the frontoparietal junction and temporo-occipital junction. The appearance in geographic extent of these abnormalities have not significantly changed compared to the prior exam. There is mild local mass effect as demonstrated by mild effacement of the sulci. No intracranial hemorrhage is identified. Patchy periventricular white matter hypoattenuation suggestive of age indeterminate small vessel ischemic disease.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is no effacement of the cisterns.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. | Right MCA territory ischemic infarct with mild local mass effect is unchanged compared to prior exam. |
Generate impression based on findings. | Reason: s/p A1 aneurysm clipping History: cerebral aneurysm clipping Status post left parietal craniotomy. Interval decrease of subdural pneumocephalus and subcutaneous air associated with the craniotomy. Interval decrease in size of soft tissue swelling/fluid collection around the craniotomy site. Interval decrease in size of the hyperdense extra-axial component underlying craniotomy site previously measuring 7 x 20 mm, currently measures 4 x 14 mm.Previously noted left frontal lobe area of hypoattenuation is stable in size although more well demarcated compared to prior exam. There is stable mild left lateral ventricle effacement without midline shift. There is no evidence of herniation.Left aneurysm clip with extensive streak artifact obscures surrounding structures.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Expected evolution of postsurgical findings related to recent craniotomy and aneurysm clipping. Interval decrease in size of extra-axial hyperdense collection deep to the craniotomy site.2.Frontal hypodense area is stable in size.3.Interval decrease in soft tissue swelling/fluid collection around the craniotomy site. |
Generate impression based on findings. | 84-year-old female with subarachnoid hemorrhage. There is a hyperdense intraparenchymal focus suggestive of a hemorrhagic contusion in the left temporal lobe measuring 2.8 x 2.9 x 2.4 cm (AP x transverse x CC) with blood tracking along the sulci giving it a subarachnoid component. There is associated local mass effect as demonstrated by sulcal and left lateral ventricle effacement. There is a second smaller hyperdensity in the sylvian fissure suggestive of a subarachnoid hemorrhage.Mixed density well marginated lesion in the soft tissue overlying the left zygoma measures 2.4 x 2.0 cm suggestive of a hematoma. There is no evidence of fracture. There is a hyperdense well-marginated a lesion in the soft tissue overlying the right zygoma measuring 4.2 x 2.4 cm also suggestive of a hematoma. There is no evidence of fracture. There is extensive bilateral periorbital soft tissue swelling and and fat stranding.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is no effacement of the cisterns.Mild mucosal thickening of the left sphenoid and bilateral maxillary sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | Constellation of findings suggest head trauma resulting in left temporal hemorrhagic contusion and subarachnoid hemorrhage.1.New hyperdense intraparenchymal hemorrhage, likely hemorrhagic contusion, in the left temporal lobe with a subarachnoid component. There is local mass effect without midline shift.2.New smaller hyperdensity in the sylvian fissure suggestive of a subarachnoid hemorrhage, likely secondary to head trauma.3.Bilateral hematomas overlying the zygomas with extensive facial soft tissue swelling. |
Generate impression based on findings. | 37 year-old female with history of middle cerebral artery infarction, experiencing seizure and altered mental status. There has been expected evolution of the patient's large right MCA distribution infarct which now approaches encephalomalacia with gliosis. There has been interval resolution of mass effect, now demonstrating left to right midline shift (previously right to left midline shift) due to the loss of ipsilateral brain, and associated ex vacuo dilatation of the right lateral ventricle. Additionally, the right cerebral peduncle is now smaller, consistent with formation of Wallerian degeneration.No interval acute hemorrhage. No extra-axial fluid collections. The basal cisterns are patent. No new areas of infarction identified. No focal calvarial lesion is identified. The mastoids are clear. The orbits are intact. | 1.Expected evolution of patient's previously demonstrated large right MCA distribution infarct.2.No acute intracranial hemorrhage.3.No CT evidence of new acute territorial, cortical infarct.4.The findings consistent with Wallerian degeneration involving the right cerebral peduncle. |
Generate impression based on findings. | 51-year-old female with history of right jaw cancer, evaluate for recurrence. Redemonstrated is surgical change consistent with right hemi-mandibulectomy. Bone graft material affixed to the native mandible by a plate and screw device demonstrates new osseous bridging across the edges of the graft material and the native mandible suggesting interval healing. No hardware complications are demonstrated. The right mandibular condyle is anteriorly positioned relative to the mandibular fossa, unchanged in appearance.Adjacent soft tissue flap is stable in appearance with persistent infiltration of the fascial planes consistent with prior therapy. There are no new masses or foci of discrete enhancement. Within this surgically altered a background, no definite evidence of disease recurrence is seen.There is no clinically significant lymphadenopathy. The right submandibular gland has been resected. The thyroid gland is not clearly visualized and may be atrophic or resected. No significant vascular abnormalities are detected. No focal destructive bony lesions are seen. Left maxillary as well as ethmoid sinus disease has resolved. Right maxillary sinus disease has improved. | 1. Redemonstrated is surgical change consistent with right hemi-mandibulectomy. Bone graft material affixed to the native mandible by a plate and screw device demonstrates new osseous bridging across the edges of the graft material and the native mandible suggesting interval healing.2. No evidence of recurrent disease or pathologic adenopathy. |
Generate impression based on findings. | Reason: evaluate for intracranial bleed History: altered mental status Additional history from prior reports: metastatic breast cancer with brain metastases. Patchy hypodense area in the right hypothalamus correlates with known metastatic lesion seen on prior MR. The known right cerebellar and vermian metastatic lesions are difficult to appreciate on this noncontrast scan. Mild patchy periventricular white matter hypoattenuation suggestive of age indeterminate small vessel ischemic disease. Punctate calcifications in the left basal ganglia, unchanged. No intracranial hemorrhage is identified. Mild to moderate age-related volume loss with associated prominent ventricles and sulci. No midline shift.Mucus retention cyst in the right maxillary sinus. The remainder of the visualized paranasal sinuses are clear. Bilateral opacification of the mastoid air cells, new compared to prior exam. The visualized portions of the orbits are intact. Probable osteoma arising from the left frontal bone is again noted. | No evidence for acute intracranial hemorrhage, mass effect, or edema. |
Generate impression based on findings. | 35-year-old female with history of metastatic melanoma, evaluate for disease progression. Redemonstrated enlarged bilateral cervical and supraclavicular lymph nodes as seen on the prior study. Reference measurements are given below.Left level 2 lymph node which measures 10.7 mm (series 7 image 15) previously 12 x 9 mm.Left level 5 lymph node which measures 8 x 3 mm (series 7 image 29) previously 10 x 6 mm.Right jugulodigastric lymph node measures 12 x 7 mm (series 7 image 19), previously 12 x 8 mm. Right level 5 lymph node measures 8 x 7 mm (series 7 image 45), previously 13 x 11 mm.Right supraclavicular lymph node measures 11 x 10 mm and 16 x 7 mm (series 7 image 52, 53) previously 16 x 12 mm and 19 x 12 mm respectively.The visualized aerodigestive tract is unremarkable. The salivary and thyroid glands are normal in appearance. Cervical vascular structures are intact. Mild mucosal thickening in the right maxillary sinus has nearly resolved. Otherwise, the paranasal sinuses are unremarkable. Orbits and mastoids are unremarkable. No destructive osseous lesions identified.Limited images through the inferior cerebellum are unremarkable. | Interval decrease in size of all reference lymph nodes as described in detail above. |
Generate impression based on findings. | Reason: 80M h/o head and neck CA s/p surgical resection and reconstruction, presents with acute altered mental status, please evaluate for acute intracranial processes/bleed History: altered mental status Two small hypodense lesions in the left basal ganglia likely represents an old lacunar infarct. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The CSF spaces are appropriate for the patient's stated age with no midline shift. Mild mucosal thickening of the right maxillary sinus and ethmoidal cells. The remainder of the visualized paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. NG tube in the right nare. | No evidence for acute intracranial hemorrhage, mass effect, or edema. |
Generate impression based on findings. | Reason: encephalopathy, hemorrhage History: tremors, waxing and waning of mental status Bilateral subdural collections are decreased in size although there is increase in density of the collections, right greater than left. This represents an interval small bleed, however without overt clot formation. Given this, the subdural collections are decreased in size bilaterally and as a result there is decrease in effacement of the ventricles. There is no midline shift.Patchy periventricular white matter hypoattenuation suggestive of an age indeterminate small vessel ischemic disease.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. | Bilateral subdural hematomas showing slight increase in density indicative of small interval bleed since prior exam. However, both collections are smaller in size resulting decreased effacement of the lateral ventricles. |
Generate impression based on findings. | 54 year old female with history of multiple sclerosis presenting with ataxia and left-sided weakness No evidence of acute intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. Extensive than ventricle and subcortical low attenuation white matter is highly suspected of advanced small vessel ischemic disease versus multiple sclerosis. CT is insensitive for the detection of ischemic strokes. Calvarium, visualized paranasal sinuses and mastoid air cells are unremarkable. | 1.Advanced small vessel ischemic strokes of indeterminate age versus multiple sclerosis.2.No detectable acute intracranial findings. |
Generate impression based on findings. | Female; 26 years old. Reason: evaluate for PE History: history of clot in PICC line. PULMONARY ARTERIES: Incomplete study due to contrast extravasation event as described above. | Incomplete study due to contrast extravasation event with details above. |
Generate impression based on findings. | Female; 26 years old. Reason: assess for pe, please extend to abdomen History: chest and back pain, concern for clot of PICC. PULMONARY ARTERIES: Technically inadequate study secondary to suboptimal contrast opacification of the pulmonary arteries. Given this limitation no large saddle embolus is identified.LUNGS AND PLEURA: Minimal basilar scarring/atelectasis. No focal airspace opacity, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Left central venous catheter tip in SVC.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Postsurgical changes compatible with prior gastric bypass, incompletely visualized. | Markedly limited exam but no evidence of large saddle embolus. |
Generate impression based on findings. | Female; 28 years old. Reason: Concern for PE History: chest pain. PULMONARY ARTERIES: No evidence of pulmonary embolism to the first segmental level. Upper normal pulmonary trunk diameter.LUNGS AND PLEURA: Mild basilar scarring/atelectasis. No focal consolidation, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion or evidence of right heart strain. No mediastinal or hilar lymphadenopathy.CHEST WALL: Mildly prominent axillary lymph nodes with fatty hila.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism to the first segmental level. 2.No additional acute cardiopulmonary abnormality identified. |
Generate impression based on findings. | 64-year-old female status post seizure in setting of known infarction, evaluate for changes in ischemic territory Extensive right MCA distribution ischemia with effacement of the sulci and right lateral ventricle is again demonstrated without significant interval change. There is stable midline shift now measuring 4 mm. The infarct region remains uniformly hypodense with well defined margins. There is no evidence of hemorrhagic transformation. There is no effacement of the cisterns.The previously noted left-sided cortical/subcortical area of hypoattenuation in the left frontal lobe appears to have again slightly increased in size compared to prior exam. There is no evidence of hemorrhagic transformation.Periventricular white matter hypoattenuation is again seen likely indicating age indeterminate small vessel ischemic disease.Mild mucosal thickening of the right axillary and left sphenoid sinuses. The remainder of the visualized paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Nasogastric tube noted in the left nare. | 1.Stable large right-sided ischemic infarct along the MCA distribution.2.Slight interval increase in size of left frontal lobe ischemic infarct.3.No hemorrhagic transformation.4.Stable midline shift, right to left. |
Generate impression based on findings. | Vomiting and abdominal pain This study is limited fetal echo of IV contrastABDOMEN:LUNG BASES: Large lateral hernia. There is soft tissue density lesion at the junction of the esophagus and stomach. Lack of intravenous and oral contrast limits optimal location of this lesion. A neoplasm in this location cannot be excluded. Endoscopy is recommended for further evaluation.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral punctate renal stones without evidence of hydronephrosis.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: The uterus is not visualized. The ovaries are unremarkable.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 | Limited study due to lack of IV contrast. Large lateral hernia with a soft tissue density lesion at the junction of the stomach and esophagus. A distal esophageal neoplasm cannot be excluded. Further evaluation with endoscopy is recommended.Bilateral nephrolithiasis without evidence of hydronephrosis. |
Generate impression based on findings. | 64-year-old female with bilateral infarctions, evaluate for progression. Extensive right MCA distribution ischemia with effacement of the sulci and right lateral ventricle is redemonstrated without significant interval change. There is stable midline shift measuring 4 mm. The infarct region remains uniformly hypodense with well defined margins. There is no evidence of hemorrhagic transformation. There is no effacement of the cisterns.The previously noted left-sided cortical/subcortical area of hypoattenuation in the left frontal lobe is unchanged. There is no evidence of hemorrhagic transformation.Periventricular white matter hypoattenuation is again seen likely indicating age indeterminate small vessel ischemic disease.Mild mucosal thickening of the right axillary and left sphenoid sinuses with superimposed air fluid levels in the consistent with intubation. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Nasogastric tube noted in the right nare. | 1.Stable large right-sided ischemic infarct along the MCA distribution.2.Stable left frontal lobe ischemic infarct.3.No hemorrhagic transformation.4.Stable midline shift, right to left. |
Generate impression based on findings. | 22-year-old female with history of flank pain This study is limited due to lack of IV contrast.ABDOMEN:LUNG BASES: Cardiomegaly.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The right kidney measures 11.3 cm. Left kidney measures 10.1 cm. There is mild caliectasis involving the right kidney. No evidence of stones bilaterally. These findings are nonspecific and evaluation of the kidneys is limited due to lack of intravenous contrast. Pyelonephritis cannot be excluded based on CT findings.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 due to lack of IV contrast.Cardiomegaly. Slightly enlarged right kidney with mild caliectasis. Pyelonephritis cannot excluded. No evidence of nephrolithiasis. |
Generate impression based on findings. | Small bowel obstruction, nausea vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatic cysts and right lobe hemangioma, unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral mild hydronephrosis, more prominent on the right compared to the left.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy, not significantly changed from previous study. An index left paraortic node measures 1.2 by 0.9-cm image number 54, series number 3.BOWEL, MESENTERY: Interval development of significant small bowel obstruction. Proximal small bowel loop measures up to 6 cm. The level of obstruction is in the pelvis, in the midline, best seen in image number 84, series number 3. Lack of opacification of small bowel loops and rectosigmoid severely limits optimal evaluation of the pelvis.There is likely a small collection between the small bowel loops measuring 2.1 by 1 cm image number 83, series number 3. The fluid and air on image number 80 series number 3 in the midline is likely to be in the sigmoid colon, however, lack of wall enhancement around this fluid also raises the possibility of extraluminal fluid collection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There are calcifications in the distal ureters. Significant amount of fat stranding around the uterus obscures the boundaries of the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval development of significant distal small bowel obstruction likely secondary to radiation changes. Due to lack of ossification of the distal small bowel loops and rectosigmoid, extraluminal fluid collection(s) in pelvis cannot be excluded.Bilateral hydronephrosis, more prominent on the right compared to left.Retroperitoneal adenopathy.These findings are discussed with the clinical team at the time of dictation. |
Generate impression based on findings. | 88 year old male with subdural hygromas, evaluate progression, patient experiencing altered mental status. Bilateral subdural collections are stable in size and unchanged in density characteristics without interval new hemorrhage. There is no midline shift.Patchy periventricular white matter hypoattenuation suggestive of an age indeterminate small vessel ischemic disease.No mass lesions or mass effect are appreciated intracranially. 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. | Bilateral subdural collections are stable in size and unchanged in density characteristics without interval new hemorrhage. |
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