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Generate impression based on findings. | 66-year-old male with intracranial hemorrhage Redemonstrated is holohemispheric left subdural hematoma tracking along the falx and tentorium which is unchanged in size or extent, however demonstrates some decreased density in some locations secondary to evolution. As before this effaces the left hemispheric cortical sulci and left lateral ventricle and results in approximately 7 mm left to right midline shift, all of which is unchanged. There is no change in ventricular sizes.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | 1.Redemonstrated is holohemispheric left subdural hematoma tracking along the falx and tentorium which is unchanged in size or extent, however demonstrates some decreased density in some locations secondary to evolution. 2.Stable mass effect with 7 mm left to right midline shift. |
Generate impression based on findings. | 57-year-old male with intracranial hemorrhage and extra-axial hygroma, evaluate ventricular sizes. Right frontal soft tissue swelling is again noted. There is interval decrease in size of a low density right-sided subdural fluid collection extending further inferiorly compared to prior exam, now measuring 3 mm (previously 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 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. These findings are unchanged. The visualized portions of the orbits are intact. | 1.No significant interval change in the pattern and extent of parenchymal/ventricular hemorrhage with right to left midline shift. 2.Interval decrease in depth of low density right-sided subdural fluid collection. |
Generate impression based on findings. | Microscopy hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of nephrolithiasis. No evidence of hydronephrosis. No focal renal lesions.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT findings to explain patient's hematuria. |
Generate impression based on findings. | 59-year-old male with history of hepatocellular carcinoma benign deficiency anemia ABDOMEN:LUNG BASES: Small left-sided pleural effusionLIVER, BILIARY TRACT: Cirrhotic liver. Post TACE/RFA changes in the liver. Lack of IV contrast limits optimal evaluation of the liver for focal lesions. Cholelithiasis, unchanged.SPLEEN: Splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Significant no ascites, unchanged.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: Right inguinal hernia containing ascites. | Limited study due to lack of IV contrast. Cirrhosis, post TACE/RFA changes and evidence of portal hypertension including ascites are stable. |
Generate impression based on findings. | 50 year-old female with nausea and vomiting This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular left adrenal gland is unchanged.KIDNEYS, URETERS: Again noted bilateral hypodense lesions which cannot be optimally characterized due to lack of IV contrast, however, they are unchanged from previous study. Calcifications involving the bilateral kidneys are new but are likely vascular in origin. Punctate stones cannot be excluded.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 | No CT findings to explain patient's nausea and vomiting. Limited study due to lack of IV contrast.Bilateral renal hypodense lesions cannot be optimally characterized due to lack of intravenous contrast. |
Generate impression based on findings. | Metastatic prostate cancer and bilateral nephrostomy tubes This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Patient's known hepatic metastases lesions cannot be optimally evaluated with this noncontrast CT. However there are multiple small hypodense lesions in the liver compatible with patient's known metastatic disease.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval development of right sided hydronephrosis despite the right nephrostomy catheter. Left nephrostomy catheter is in place. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy, again noted.Interval enlargement of left psoas muscle, best seen on coronal image 34. There is also interval enlargement of the bilateral iliacus muscle, more prominent on the right, best seen again on image 34, coronal series. Lack of intravenous contrast limits the evaluation of these lesions and the exact etiology is unknown but likely diagnostic considerations include hematoma versus less likely a neoplasm or abscess.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive bone metastases, stable.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder is decompressed. Significant wall thickening. There is also stent stranding around the bladder wall.LYMPH NODES: Pelvic adenopathy, again noted.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Generalized anasarca involving the entire lower abdomen and pelvis. Extensive osseous metastases are stable.OTHER: No significant abnormality noted | Limited study due to lack of IV contrast. Extensive bone metastases, metastatic adenopathy, unchanged.Interval development of right-sided hydronephrosis despite the right nephrostomy tube.Interval enlargement of left psoas muscle and bilateral iliac is muscles, more prominent on the right . Etiology of these findings is unclear, however, most likely represents hematomas.Dr. Lurain was notified and acknowledged about the above findings at the time of dictation. |
Generate impression based on findings. | History of encephalitis, myelitis. Evaluate for cancer CHEST:LUNGS AND PLEURA: Emphysema. Scattered micronodules, nonspecific.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Infrarenal abdominal aneurysm measuring 3.8-cm in largest AP dimension.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Emphysema. Scattered micronodules in the lungs, nonspecific.Infrarenal abdominal aortic aneurysm.Fat infiltration of the liver. |
Generate impression based on findings. | 28 year old female with history of malignant melanoma CHEST:LUNGS AND PLEURA: Bilateral extensive pulmonary parenchymal metastatic disease. Index lesion in the right middle lobe now measures 1.5 x 1.2 cm on image number 35, series number 7. This lesion is smaller compared to previous study. Other pulmonary nodules are also slightly smaller to unchanged compared to previous study. A second referenced nodule in the right middle lobe measures 5 mm on image number 51, series number 7.New left-sided small pleural effusion.MEDIASTINUM AND HILA: Index right paratracheal mass demonstrates minimal enhancement and is significantly smaller measuring 2.5 x 2.4 cm in image number 23, series number 6. Previously measured second mediastinal adenopathy on the left side is also smaller now measuring 5.1 by 2.9-cm image number 26, series number 6. Other extensive mediastinal adenopathy is also smaller compared to CT dated 8/15/2013.CHEST WALL: Significant interval increase in the right axillary adenopathy. Index right axillary lymph node now measures 2.4 by 1.8-cm image number 20, series number 6. Previously, this lymph node was measuring 8-mm in diameter image number 16, series number 4.ABDOMEN:LIVER, BILIARY TRACT: Hepatic metastases, again noted. Index lesion near the caudate lobe is not significantly changed measuring 1.6 x 1.5 cm image number 72, series number 6.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Air is noted within the collecting system and ureter of the left kidney. Etiology is unknown. Pyelonephritis cannot be excluded. Correlation with clinical history is recommended. Mild left-sided hydronephrosis is unchanged.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy, again noted. Index left retroperitoneal lymph node measures 2.4 by 2.3-cm image number 113, series number 6, unchanged. Other retroperitoneal lymph nodes also grossly unchanged.BOWEL, MESENTERY: Extensive peritoneal carcinomatosis, again noted. No evidence of small bowel obstruction. Small amount of ascites, increased in size compared previous study.BONES, SOFT TISSUES: Index posterior subcutaneous soft tissue nodule measures 1.2 x 0.8 cm image number 129, series number 6, unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Suprapubic Foley catheter to terminate within the ileal pouch.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites, unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in the right axillary lymph nodes. Extensive metastatic adenopathy, which is decreased in size compared to previous study.Extensive bilateral pulmonary metastases are decreased as unchanged compared to previous study.Small left-sided pleural effusion.Extensive peritoneal carcinomatosis , retroperitoneal adenopathy and posterior left subcutaneous nodule unchanged from previous study.Interval elephant of air within the left renal collecting system and ureter of uncertain etiology. Pyelonephritis cannot be excluded.Hepatic metastases are unchanged. |
Generate impression based on findings. | 36-year-old male with periumbilical abdominal pain, history of colon cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver. No focal liver lesions.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: Multiple ventral hernias containing fat and nonobstructed bowel loops. No evidence of obstruction.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: Bilateral fat containing inguinal hernias. | Multiple ventral hernias and bilateral inguinal hernias containing fat and nonobstructed bowel loops.Fat infiltration of the liver. |
Generate impression based on findings. | 23 year-old female with right lower quadrant abdominal pain, fever and leukocytosis 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: Long segment wall thickening involving the predominantly distal small bowel loops. Appendix is unremarkable. There is mild fibrofatty proliferation and stranding of the fat involving the small bowel mesentery.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: Please see discussion above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Long segment bowel wall thickening associated with stranding of the mesentery and peritoneal fat. These findings can be secondary to inflammation (such as Crohn's disease) or infection. |
Generate impression based on findings. | 68-year-old female with bilateral flank pain Lack of IV contrast limits the evaluation of the abdomen and pelvis.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: Lack of intravenous contrast in the limits evaluation of the kidneys. Mild caliectasis involving the left kidney and right upper pole, unchanged. No evidence of renal stones.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 | No significant change from previous study. Limited study due to lack of intravenous contrast. |
Generate impression based on findings. | 39-year-old female with right upper quadrant pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Distended gallbladder with multiple gallstones, Serratia with gallbladder wall thickening, consistent with acute cholecystitis. No evidence of intra-or extrahepatic biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: 1.7 x 1 cm left adrenal nodule likely representing adenoma.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Nonspecific small retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Leiomyomatous uterusBLADDER: No significant abnormality notedLYMPH NODES: Nonspecific borderline enlarged lymph nodes. Index right obturator node measures 1.1 x 1.5 cm image number 128, series number 4.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Acute cholecystitis. Cholelithiasis.Leiomyomatous uterus.Left adrenal nodule likely representing an adenoma. |
Generate impression based on findings. | Right lower quadrant pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is not visualized. However, there is no inflammation in the right lower quadrant to suggest appendicitis.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 CT findings to explain patient's acute abdominal pain. |
Generate impression based on findings. | 61 year-old female with abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There are multiple subcentimeter hypodense lesions throughout the liver. These cannot be optimally characterized with this single phase CT.In addition there is an ill-defined 3.6 x 2.9 cm hyperdense mass near the dome of the liver on image number 10, series number 4. Further evaluation of this lesion with a dedicated liver MRI is recommended.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There are small simple cysts within the right kidney.There is an exophytic lesion measuring 7 by 7.1-cm image number 34, series number 4 arising from the left mid kidney. There are multiple heterogeneously hyperdense areas within this lesion suspicious for heterogeneous enhancement. However lack of noncontrast images limits optimal evaluation of this lesion. There is another hypodense lesion in the lower pole of the left kidney measuring 1.4-cm image number 42, series number 4, likely representing a cyst.RETROPERITONEUM, LYMPH NODES: Significant atherosclerotic changes involving the abdominal aorta and its major branches. There are significant atherosclerotic changes involving the origin of the celiac trunk.Aorto femoral bypass graft is occluded.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 | Possible enhancing left renal mass suspicious for renal cell carcinoma. Further evaluation with a dedicated renal mass CT or MR protocol is recommended.Hyperdense mass within the liver. This lesion cannot the optimally characterized with a single phase CT. Further evaluation with dedicated liver mass protocol CT is recommended.Extensive atherosclerotic changes involving the abdominal aorta and its major branches and iliac arteries. Aorto bifemoral graft is occluded. |
Generate impression based on findings. | 55-year-old male presenting with hematuria ABDOMEN:LUNG BASES: Nonspecific micronodules predominantly in the left lower lobe. Chest CT may be helpful for further evaluation.LIVER, BILIARY TRACT: There are multiple, scattered hypodense lesions in the liver. Some of the lesions are too small to accurately characterize. However there are at least a few lesions suspicious for metastatic disease. An index lesion measures 1 cm on image number 26, series number 6 in the right lobe of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of renal stones. No evidence of focal renal lesions other than a few bilateral subcentimeter hypodense lesions which most likely represent cysts. No evidence of hydronephrosis. There is also a subcentimeter angiomyolipoma on image number 75, series number 3 in the lower pole of the right kidney.RETROPERITONEUM, LYMPH NODES: There is retroperitoneal adenopathy. An index left para-aortic node measures 1.5 by 1.1-cm on image number 80, series number 6.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate gland is heterogeneous and enlarged.BLADDER: No obvious wall thickening or a mural lesion arising from the bladder.LYMPH NODES: Bilateral pelvic adenopathy. An index necrotic left sided pelvic node measures 2.2 x 2.3 cm on image number 119, series number 6.BOWEL, MESENTERY: Perirectal adenopathy is also present. A rectum cannot be optimally evaluated. Rectal carcinoma can also not be excluded.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Retroperitoneal and pelvic adenopathy suspicious for metastatic disease. Primary cancer is unknown but prostate or rectal cancer is suspected.Bilateral small renal cysts. No evidence of stones or solid renal lesions.Hepatic subcentimeter lesions suspicious for metastatic disease. Other small lesions are too small to accurately characterize.Scattered micronodules in the lung bases, predominantly in the left lower lobe, nonspecific. Chest CT may be helpful for further evaluation. |
Generate impression based on findings. | Malignant melanoma CHEST:LUNGS AND PLEURA: Index right lower lobe pulmonary nodule measures 5 mm on image number 73, series number 4, unchanged. Second peripheral right lower lobe nodule measures 6 mm on image number 82, series number 4, not significantly changed from previous study.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Index right axial lymph node measures 1.1 x 0.9 cm image number 19, series number 3, slightly smaller compared to previous study. Adjacent lymph nodes are stable. Soft tissue mass in the right posterior chest wall it appears more hypodense compared to previous study and cannot be differentiated from the surrounding muscles. Within the limitations, this lesion measures 3 x 2.2 cm image number 37, series number 3, not significantly changed from previous study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mesenteric lymph nodes are unchanged. Index left lower quadrant mesenteric lymph node measures 1.1-cm on image number 135, series number 3.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval increase in the size of the index right axillary lymph node. No other significant change from previous study. |
Generate impression based on findings. | 28 year old female with superficial mass and induration in the left upper medial thigh. No acute fracture or dislocation in the visualized osseous structures. There is a peripherally enhancing fluid collection which measures 2.4 x 1.8 cm in the superficial soft tissues of the upper medial thigh (series 80936, image 79). Adjacent fat stranding and a small amount of free pelvic fluid are also noted. Findings are suspicious for abscess formation vs necrotic metastatic lesion. Remaining visualized soft tissues within normal limits. Please refer to separate CT chest, abdomen , pelvis report. | Peripherally enhancing fluid collection in upper medial thigh with surrounding fat stranding, suspicious for abscess versus metastatic lesion. |
Generate impression based on findings. | 79-year-old male with desaturation and hypotension. PULMONARY ARTERIES: Diagnostic quality exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Surgical changes in the right hemithorax, with right lung wedge resection and resection of posterior chest wall. Interval increase in right apical consolidation and cavitation. Loculated bilateral pleural effusions, right more than left, mildly increase on the right; interval increase in multiple foci of gas in the right upper pleural space. Findings are most compatible with progression of infection, including suspected development of cavitary pneumonia in the superior segment of the right lower lobe and development of empyema given increase in gas and loculation (series 8, image 64). Superimposed bronchopleural fistula is also suspected given increase of air in the pleural space.Persistent diffuse bronchial wall thickening, increased in the left base, as well as persistent centrilobular nodules and tree in bud opacities, predominantly in the lung bases; findings compatible with bronchiolitis.Percutaneous pleural drain terminates in the right apex.MEDIASTINUM AND HILA: Heart size normal. There are calcifications in coronary arteries and aorta. Enlarged lower mediastinal lymph nodes nonspecific and may be reactive in nature.Tracheostomy tube terminates at the thoracic inlet. Lack of visualization of the superior vena cava in the superior mediastinum (series 7, image 65).CHEST WALL: Postsurgical changes in the posterior right upper chest wall. Interval increase in gas in the soft tissues of the right upper posterior chest wall. Multiple chest wall collaterals.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Partially visualized images of the abdomen reveal moderate amount of free intraperitoneal air. Early enhancement of hepatic segment 4 and is compatible with inflow from chest wall collaterals, compatible with occlusion of the SVC. Thickening of adrenal glands bilaterally, not significantly changed. | 1.No pulmonary embolus.2.Interval increase in cavitation of right upper lobe consolidation with associated increase in air and loculated right pleural effusion, suspicious for progression of infection and development of empyema. Suspected development of bronchopleural fistula given increase in pleural space gas and adjacent cavity in the lung.3.Bronchial wall thickening and diffuse tree in but opacities most compatible bronchiolitis, which may be due to aspiration.4.Moderate amount of free intraperitoneal air.5.SVC occlusion with multiple chest wall collaterals.6.Postsurgical changes in the right upper lung and right chest wall. |
Generate impression based on findings. | 66-year-old male with intracranial hemorrhage experiencing altered mental status Redemonstrated is holohemispheric left subdural hematoma tracking along the falx and tentorium which is unchanged in size, extent, or or density. As before this effaces the left hemispheric cortical sulci and left lateral ventricle and results in approximately 7 mm left to right midline shift, all of which is unchanged. There is no change in ventricular sizes.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | Redemonstrated is holohemispheric left subdural hematoma tracking along the falx and tentorium which is unchanged. |
Generate impression based on findings. | 45 year-old female with shortness of breath. PULMONARY ARTERIES: Diagnostic exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Upper lobe predominant architectural distortion, honeycombing, and traction bronchiectasis as well as scattered foci of peripheral consolidation are not significantly changed and compatible with known UIP. Bilateral pleural thickening again noted. Trace left pleural effusion.Apparent diffuse ground glass opacity may be related to PE technique and lung underinflation. Postsurgical changes in the left upper lobe.MEDIASTINUM AND HILA: Large main pulmonary artery measuring 3.8 cm is not significantly changed. Stable cardiomegaly. No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Diagnostic exam without evidence of pulmonary embolus.2.Findings compatible with known diagnosis of UIP although the distribution is atypical, without significant interval change. |
Generate impression based on findings. | 66-year-old male with intracranial hemorrhage experiencing continued altered mental status Redemonstrated is holohemispheric left subdural hematoma tracking along the falx and tentorium which is unchanged in size, extent, or or density. As before this effaces the left hemispheric cortical sulci and left lateral ventricle and results in approximately 7 mm left to right midline shift, all of which is unchanged. There is no change in ventricular sizes.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | Redemonstrated is holohemispheric left subdural hematoma tracking along the falx and tentorium which is unchanged. |
Generate impression based on findings. | 57-year-old male with intracranial hemorrhage and extra-axial hygroma, now obtunded. Right frontal soft tissue swelling has decreased. There is near resolution of the previously demonstrated low density right-sided subdural fluid collection extending further inferiorly compared to prior exam.Right-sided parenchymal hemorrhage with surrounding edema involving the frontal, parietal and temporal lobes is not significantly changed from prior exam. When measured at the same locations used previously, there is decreased midline shift now measuring 6 mm (previously 10 mm).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.Left sphenoid and mastoid fluid is unchanged. The visualized portions of the orbits are intact. | 1.No significant interval change in the pattern and extent of parenchymal/ventricular hemorrhage although there is decreased right to left midline shift. 2.Interval near resolution of previously described low density right-sided subdural fluid collection. |
Generate impression based on findings. | Reason: Pt with history of lung transplant now with SOB. Please evaluate for PE History: SOB, tachypnea Technically adequate exam.PULMONARY ARTERIES: Filling defects are seen in bilateral segmental arteries compatible with bilateral pulmonary emboli. LUNGS AND PLEURA: There has been an interval lung transplant since prior CT. Scattered, nonspecific calcified and noncalcified micronodules. No suspicious pulmonary nodules or masses. Mild scarring/atelectasis at the right lung base.Moderate left pleural effusion with overlying left lower lobe atelectasis, unchanged from prior radiographs. Minimal right pleural effusion.Few scattered, peripheral ground glass opacities bilaterally compatible with edema or hemorrhage. Mild bronchial wall and septal thickening at the bases likely represent a component of pulmonary edema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No pericardial effusion. Left ventricular enlargement. Mild coronary artery calcification.Per cardiology/ICU request, the diameters of the LV and RV measure 6.5 cm and 1.5 cm, respectively. RV: LV ratio = 0 .84. CHEST WALL: Chest wall anasarca.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified foci in the left upper abdomen may represent diverticuli. | 1. Bilateral pulmonary emboli in the segmental arteries.2. Left moderate pleural effusion with overlying atelectasis as seen on prior chest radiographs.Findings discussed with Dr. Kallepalli in the ED at 9:10p.m. on 10/27/2013 over phone by Dr. Vasnani. |
Generate impression based on findings. | 61-year-old female with diarrhea, concern for graft-versus-host disease. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. No focal hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: Small cystic lesions in the pancreatic head and the distal pancreas, which measures 1.8 x 1.2 cm (image 48, series 3).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Distal and terminal ileal wall thickening is nonspecific. Mild proximal bowel wall dilatation, likely representing an ileus.BONES, SOFT TISSUES: Multifocal lucent lesions involving the vertebral bodies some of which appear to represent hemangiomas. Moderate degenerative changes of the lower thoracic spineOTHER: 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: Multifocal lucent lesions involving the proximal femurs, pelvis and vertebral bodies. Moderate degenerative changes of the lumbar spine. Fracture deformities involving the superior pubic rami near the pubic symphysis. Anterior abdominal wall injection granulomas.OTHER: Trace pelvic fluid. | 1. Nonspecific mild distal small bowel wall thickening which may be infectious/inflammatory or represent graft-versus-host disease.2. Nondisplaced fractures of the pubic rami adjacent to the pubic symphysis as well as multifocal lucent osseous lesions, which may represent disease involvement.3. Nonspecific small cystic pancreatic body and tail lesions, which may be further evaluated with MRCP if clinically warranted.These findings were discussed with Dr. Sweis (pager 2460) at the time of dictation. |
Generate impression based on findings. | 52-year-old female patient with history of left flank pain. Evaluate for nephrolithiasis. ABDOMEN:LUNG BASES: Trace bilateral atelectasis. Multiple bilateral pulmonary micronodules (series 4; images 1, 12, 20).LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Multiple punctate calcifications in the splenic parenchyma, likely representing granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney with nonobstructing punctate renal calculus in the superior pole. No hydronephrosis, perinephric fat stranding or obstructing renal calculi.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes in the abdominal aorta and iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic lesion in posterior ninth rib.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: Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1.No obstructing renal calculi or specific findings to account for patient's symptomatology.2.Posterior ninth rib sclerotic lesion, most likely benign.3.Multiple bilateral pulmonary micronodules. Suggest dedicated CT chest. |
Generate impression based on findings. | 39-year-old female with end-stage renal disease and MSSA bacteremia from recurrent post-permacath removal, altered mental status, concern for endocarditis, septic emboli. Nonspecific region of subtle hypoattenuation in the posterior left parietal white matter.The CSF spaces are appropriate for the patient's stated age with no midline shift. No intracranial hemorrhage is identified. No intra/extra-axial fluid collections.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | No acute intracranial hemorrhage. Nonspecific region of subtle hypoattenuation in the posterior left parietal region. If clinically desired, this finding may be further characterized with contrast enhanced MRI of the brain.These findings were discussed with Dr. Reid at 8:30 a.m. on 10/28/2013 |
Generate impression based on findings. | 41-year-old female with pain, rule out stone. ABDOMEN:LUNG BASES: Trace pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis, hydroureter or kidney or ureteral stones.RETROPERITONEUM, LYMPH NODES: Gonadal vein phleboliths.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foci of gas extends along the right bladder wall, which may represent emphysematous cystitis.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Foci of gas extending along the bladder wall, suspicious for emphysematous cystitis. This finding was discussed with Dr. Bassi (covering pager 4367) at the time of dictation. 2. No nephrolithiasis, ureteral stones or hydronephrosis. |
Generate impression based on findings. | Male 53 years old; Reason: evaluate for infection/obstruction History: tachycardia, vomiting CHEST:LUNGS AND PLEURA: Interval increase in bilateral pulmonary nodules. Reference right lower lobe nodule best seen on image 46 of series 5 measures 1.1 x 0.9 cm previously 1 x 0.7 cm. Reference pleural-based right anterior middle lobe focus as seen on image 70 series 3 measures1.3 x 2.6, previously 1.4 x 1.2 cm.Stable small bilateral pleural effusions, right greater than left.New groundglass opacities in both lower lobes bilaterally a which may indicate infection versus less likely neoplasm or drug reaction.MEDIASTINUM AND HILA: No significant abnormality noted. Interval placement of an NG tube.CHEST WALL: Right Port-A-Cath is not significantly changed with its tip in the cavoatrial duction.ABDOMEN:LIVER, BILIARY TRACT: Significant interval increase in size and number of extensive confluent bilobar hepatic metastatic lesions. Reference segment 8 hepatic dome lesion as seen on image 73 series 3 now measures 6 x 5.5cm previoulsy 5 x 4.5 cm.Pneumobilia again noted. Biliary wall stent unchanged in position. Probable thrombosis of the right portal vein and narrowing of the main portal vein unchanged unchanged.SPLEEN: No significant abnormality notedPANCREAS: Prominence of pancreatic duct unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval increase in ascites which is now moderately large in quantity. Reference mesenteric lesion at the level of the SMA origin best seen on image 124 of series 3 measures 3.1 x 2.2cm previously 3.5 x 2.3 cm. Centrally located reference mesenteric mass best seen on image 114 of series 3 measures 2.8 x 4.4cm previously 2.7 x 3.9 cm. However, other mesenteric mass lesions have increased in the interval. Omental nodularity slightly increased.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Interval increase in ascitesBONES, SOFT TISSUES: No significant abnormality notedOTHER: Central filling defect noted in the left common femoral vein, with expansion of the vein. This finding is nonspecific although DVT cannot entirely be ruled out. | 1. Interval increase in size and confluence of extensive bilobar hepatic metastatic disease associated with interval increase in degree of ascites and increase in size of mesenteric metastatic lesions and omental nodularity.2. Central filling defect and expansion of the left common femoral vein concerning for DVT, although non specific on CT examinationInterval increase in the size of the lung nodules and interval development of bilateral groundglass opacities in the lower lobes as described above.Dr. Moore was notified of the finding at 8:30 am on 10/28/13 |
Generate impression based on findings. | 53 year old female with chest pain, left facial droop, left arm weakness, differential blood pressures. CHEST:LUNGS AND PLEURA: 6-mm right middle lobe nodule. Basilar atelectasis.MEDIASTINUM AND HILA: Normal caliber aorta without evidence of dissection. Scattered atherosclerotic calcifications of the coronary arteries and aortic arch.CHEST WALL: Prominent subcentimeter axillary lymph nodes. Moderate degenerative changes of the thoracic spine. Scattered high-density pellets in the anterior abdominal wall.UPPER ABDOMEN: No significant abnormality noted. | 1. No evidence of aortic dissection or aneurysm.2. 6-mm right middle lobe nodule, for which 6 month follow-up is suggested. |
Generate impression based on findings. | 45-year-old male with history of cholangiocarcinoma CHEST:LUNGS AND PLEURA: 6-mm subpleural nodule in the right lower lobe on image number 44, series number 11. Follow-up CT is recommended.There is a new 1.2 by 0.9-cm nodule in the right lower lobe image number 67, series number 11. This lesion is suspicious for metastatic disease.MEDIASTINUM AND HILA: Multiple mediastinal adenopathy. An index aorticopulmonary node measures 1.6 by 1 cm image number 41, series number 10.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: There is a large mass in the left lobe of the liver measuring 8.8 x 6.7 cm image number 84, series number 10. This mass is unchanged and was previously measuring 9 x 6.5 cm number 23, series number 3. There are multiple satellite lesions within the liver is also grossly unchanged compared to previous study. Multiple metallic foci within the liver which represent radiation pellets. Artifacts from these metallic foci limits although evaluation of the liver.SPLEEN: Significant splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy, not significantly changed from previous study. An index periceliac node measures 1.5 by 1.2-cm image number 111, series number 10.BOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of ascites..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change in the dominant left lobe liver lesion and satellite liver lesions consistent with patient's known history of cholangiocarcinoma. Evaluation of the liver is limited due to multiple metallic foci within the liver and there associated artifacts.Interval development of a right lower lobe pulmonary nodule, suspicious for metastatic disease.Metastatic mediastinal and retroperitoneal adenopathy.Splenomegaly. |
Generate impression based on findings. | 49 year-old female with headache, hemoglobin 5.4, evaluate for bleeding, anemia, shortness of breath Mild hypoattenuation in the periventricular white matter is nonspecific and may represent small vessel ischemic disease of indeterminate age.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Partial empty sella. | 1. No acute intracranial abnormalities.2. Mild hypoattenuation in the periventricular white matter is nonspecific and may represent the sequela of small vessel ischemic disease of indeterminate age. |
Generate impression based on findings. | 45-year-old male with peritoneal signs, lactic acidosis. ABDOMEN:LUNG BASES: Moderate pleural effusions, larger on the right with associated consolidation and atelectasis. Cardiomegaly. Nodular opacity at the right lung base.LIVER, BILIARY TRACT: Calcified granuloma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodense renal lesions some too small to characterize as well as two hyperdense lesions which likely represent complex cysts, but for which follow up imaging is recommended to exclude neoplasm.RETROPERITONEUM, LYMPH NODES: The abdominal aorta and its branches are normal in caliber without evidence of aneurysm or occlusion..BOWEL, MESENTERY: Enteric tube extends to the stomach. Free fluid extends within the mesentery.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Fluid extends within the mesentery. The bowel is normal in caliber without visualized wall thickening.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate ascites. | 1. No specific evidence of bowel ischemia or abdominal aortic abnormality.2. Moderate pleural effusions, abdominal and pelvic ascites and cardiomegaly, suggesting heart failure.3. Multiple renal lesions some likely representing complex cysts for which follow up dedicated imaging (MRI or CT) in one year is recommended. |
Generate impression based on findings. | 37-year-old male patient with history of HIV and abdominal pain. Evaluate for acute intra-abdominal process. ABDOMEN:LUNG BASES: Bilateral dependent atelectasis. Pulmonary micronodule in the left lower lobe (series 4 image 9).LIVER, BILIARY TRACT: No significant abnormality noted. No visualized cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Oral contrast progressed through normal appearing stomach and small bowel. Bowel is normal in caliber. Appendix is visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No findings to account for patient's symptomatology.2.Pulmonary micronodule in left lower lobe. |
Generate impression based on findings. | 54-year-old female with nausea and vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nonspecific, punctate hypodensities in the liver are too small to accurately characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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 | Unremarkable study. |
Generate impression based on findings. | Female, 66 years old, altered mental status. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. At most, there may be minimal periventricular hypoattenuation which is nonspecific but could represent underlying age indeterminate small vessel ischemic disease.No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. Opacification of the right sphenoid sinus is again seen, similar to prior. Mucosal thickening has improved and the left sphenoid sinus.The bilateral parietal bones are thin, a stable finding which may be congenital or which may reflect prior surgery. | No acute intracranial abnormality. |
Generate impression based on findings. | Reason: what is the exte t of intrinsic lung disease? History: SOB LUNGS AND PLEURA: Emphysema. Extensive scarring, volume loss, and bronchiectasis involving the right upper lobe. Nonspecific 7-mm nodule in medial right lower lobe. Diffuse bronchial wall thickening. Bibasal atelectasis. Very small right pleural effusion. Scattered punctate pulmonary nodules. Calcified granuloma right lower lobe.MEDIASTINUM AND HILA: Cardiomegaly. Coronary calcification. Small pericardial effusion. Atherosclerotic calcification of the aorta and its branches.CHEST WALL: Degenerative change involving the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Emphysema. 2. Extensive scarring, volume loss, and bronchiectasis involving the right upper lobe. The findings appear chronic though superimposed infection cannot be excluded.3. Nonspecific 7-mm nodule in medial right lower lobe. Follow up CT in 3 - 6 months is recommended to excluded growth/malignancy.4. Diffuse bronchial wall thickening which is nonspecific but most commonly seen in asthma or bronchitis. |
Generate impression based on findings. | Male, 76 years old, pinpoint pupils, new right-sided weakness, delirium, tremors, altered mental status. Periventricular hypoattenuation is a non-specific finding which most commonly represents age-indeterminate small vessel ischemic disease. This finding is unchanged.No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.The bones of the calvarium and skull base are intact. | No acute intracranial abnormality. |
Generate impression based on findings. | Female, 49 years old, status post GI bleed with elevated INR and altered mental status. Mild periventricular hypoattenuation is a non-specific finding which most commonly represents age-indeterminate small vessel ischemic disease.No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The right sphenoid sinus is opacified with sclerosis of the sinus walls suggesting chronic inflammation. The remaining para nasal sinuses are clear. The nasal septum is very irregular and likely perforated.The bones of the calvarium and skull base are otherwise intact. | No acute intracranial abnormalities. |
Generate impression based on findings. | 87 year old male with worsening white blood cell count and pneumonia. CHEST:LUNGS AND PLEURA: Bilateral moderate pleural effusions with associated basilar subsegmental consolidation/atelectasis. Scattered ground glass opacities are most compatible with mild edema. Mild centrilobular emphysema predominantly affecting upper lobes.MEDIASTINUM AND HILA: Mild to moderate chronic calcification of the coronary arteries and aorta. Moderate cardiomegaly. Small pericardial effusion. Hypoattenuation of the blood pool suggestive of anemia. Several calcified mediastinal lymph nodes compatible with prior granulomatous infection.CHEST WALL: Prominent axillary lymph nodes are nonspecific and may be reactive in nature.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Diffuse haziness of the mesentery is most compatible with edema due to generalized fluid overload. No evidence of loculated fluid collection to suggest abscess. No obstruction. Colonic distention and moderate amount of fecal material.BONES, SOFT TISSUES: Severe degenerative changes at L5-S1. There is a central compression fracture of L1 with moderate loss of height; this is age indeterminate, however, given the well-defined fracture margins, subacute nature is suspected (sagittal series image 42). No evidence of retropulsion of fracture fragments.Heterogeneous bone marrow within the right iliac bone is nonspecific, possibly related to focal Paget's disease given patient's age (series 4, image 141).OTHER: No significant abnormality noted. | 1.No specific findings to suggest source of infection.2.Moderate bilateral pleural effusions with associated basilar consolidation/atelectasis, pericardial effusion, and diffuse haziness of abdominal mesentery; findings are suggestive of generalized hypervolemia/CHF.3.Compression fracture of L1. |
Generate impression based on findings. | Reason: intubated with history of bilateral pneumothoracies with bilateral chest tubes in place History: intubated with history of bilateral pneumothoracies with bilateral chest tubes in place LUNGS AND PLEURA: Right chest tube directed towards posterior-superior apex. Left chest tube directed anteromedially. No evidence of significant pneumothorax. Small bilateral pleural effusions. Bibasal atelectasis. Upper lobe predominant ground glass, interstitial and air space abnormality. Similar but less severe findings are noted in the left lower lobe. Bibasilar atelectasis. Endotracheal tube above the carina with aspirated debris in central airways. Mild bronchiectasis, especially in the upper lobes.MEDIASTINUM AND HILA: Heterogeneous multi-nodular thyroid. Coronary calcification. Trace pericardial fluid.CHEST WALL: Degenerative change involving the thoracic spine. Subcutaneous emphysema on the right.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple hypodense hepatic lesions are presumably cysts but inadequately evaluated. NG tube tip in stomach. | No evidence of significant pneumothorax. Upper lobe predominant ground glass, interstitial and air space abnormality which is nonspecific but suggestive of pneumonia though there are some findings such as bronchiectasis which imply a degree of chronicity. |
Generate impression based on findings. | Male, 72 years old, pinpoint pupils, new right-sided weakness, altered mental status. Areas of encephalomalacia consistent with chronic infarct are seen within the right posterior frontal and left posterior parietal/occipital regions, unchanged. No CT evidence of acute territorial ischemia is seen.No intracranial hemorrhage or abnormal extra-axial fluid collection is detected. No generalized mass effect is seen. The ventricles and sulci remain mildly prominent consistent with parenchymal volume loss, unchanged. Intracranial vascular calcifications are noted.The visualized paranasal sinuses are clear. The bones of the calvarium are intact. | 1. Stable areas of chronic ischemia.2. No definite CT evidence of acute territorial ischemia or other acute findings. |
Generate impression based on findings. | 28-year-old male patient with left flank pain. Evaluate for stone or other intra-abdominal pathology. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephroureteral stent in place with mild caliectasis. Minimal fat stranding along the course of the left ureter. No right-sided hydronephrosis. No perinephric fat stranding. No renal calculi.RETROPERITONEUM, LYMPH NODES: Retrocardiac lymphadenopathy with dominant node measuring 2.1 x 1.3 cm (series 3 image 1). There is also retroperitoneal lymphadenopathy in the left periaortic area with index lymph node measuring 1.6 x 1.2 cm (series 3 image 79).BOWEL, MESENTERY: No significant abnormality noted. Appendix is visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Focus of hypointensity near the left crus of the diaphragm (series 3 image 44) may represent small diaphragmatic lipoma versus small congenital diaphragmatic defect.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Bilateral fat filled inguinal hernias.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Left nephroureteral stent in place with mild caliectasis. No renal calculi.2.Retrocardiac and retroperitoneal lymphadenopathy. Chest CT is recommended for further evaluation. |
Generate impression based on findings. | Male 57 years old; Reason: evidence of renal pathology in post renal transplant patient History: nausea, anorexia, renal failure by labs ABDOMEN: The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:LUNGS BASES: No nodule or mass detected. The heart is mildly enlarged. Bibasilar atelectasis 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: The native kidneys are atrophic. Exophytic 1.4 x 1.9 cm soft tissue attenuating lesion off the superior pole of the right kidney is noted (series 5 image 44). This lesion is incompletely characterized given lack of IV contrast. The transplanted right iliac fossa kidney demonstrates no focal lesion although limited by lack of IV contrast. Mild caliectasis without overt hydronephrosis or perinephric fluid collection noted.RETROPERITONEUM, LYMPH NODES: Moderate atheromatous calcifications noted in the abdominal aorta and iliac vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Focal exophytic soft tissue attenuating lesion off the superior pole right kidney, incompletely characterized given lack of IV contrast. Further evaluation with ultrasound advised to rule out RCC.2. No evidence of focal lesion, hydronephrosis, or perinephric fluid collections around the transplanted right iliac fossa kidney. |
Generate impression based on findings. | 56-year-old female status post endoscopic sinus surgery for removal of left-sided inverted papilloma. There has been interval removal of the previously demonstrated soft tissue mass that was present within the left nasal passage incorporating the left inferior turbinate. The left ostiomeatal complex and medial maxillary sinus wall have been resected. Although there is some mild mucosal thickening within the left maxillary sinus, there are no residual soft tissue masses. Elevation of the inferior left orbital floor is no longer conspicuous.There is new, minimal mucosal thickening within the inferior right maxillary sinus. The right ostiomeatal unit remains patent. Redemonstrated are right Haller cells.Anterior ethmoid air cell opacification has nearly resolved.The remaining paranasal sinuses are aerated. Frontal ethmoidal and sphenoethmoidal recesses remain patent.Mastoid air cells and middle ear cavities are well pneumatized bilaterally.Orbits and visualized cranial contents are unremarkable. | 1.Interval resection of left-sided inverted papilloma. Although there is some mild mucosal thickening within the left maxillary sinus, there are no residual soft tissue masses. Elevation of the inferior left orbital floor is no longer conspicuous.2.There is new, minimal mucosal thickening within the inferior right maxillary sinus. 3.Anterior ethmoid air cell opacification has nearly resolved. |
Generate impression based on findings. | Female, 84 years old, status post trauma. Maxillofacial:Bilateral peri-zygomatic/periorbital soft tissue hematomas are demonstrated, similar to what was seen on prior head CT. The right-sided hematoma is more infra-orbital while the left-sided hematomas are more peri-zygomatic. Mild soft tissue swelling seems to extend into the eyelids bilaterally.The globes are round and symmetric. The right lens is normally positioned. The left lens has been replaced. There is an ophthalmologic device in place along the superolateral margin of the left globe, likely for treatment of glaucoma. The optic nerves are unremarkable. The extraocular muscles are unremarkable. The intraconal fat is clean.No maxillofacial fractures are detected.Partially visualized is a large left temporal parenchymal hematoma as well as bilateral subarachnoid hemorrhage, better seen on prior CT.C-spine:Alignment is within acceptable limits. Vertebral body heights are preserved. No fracture or traumatic dislocation is demonstrated.Significant loss of disk height is seen at C4-5 and C5-6 and C6-7. Large posterior disk-osteophyte complexes are present from C3-4 through C6-7 which cause effacement of the ventral thecal sac. The facet joints are also hypertrophied at these levels, more so on the left. Ligamentum flavum calcification is seen at C5-6. The degree of spinal canal encroachment would be better assessed on MRI. Moderate foraminal narrowing is also seen through these levels.The thyroid is enlarged and heterogeneous, findings which are nonspecific. Ultrasound would provide a better assessment if clinically warranted. | 1. Bilateral peri-zygomatic and periorbital soft tissue hematomas without underlying maxillofacial fracture or injury to the orbital structures. 2. No cervical spine fracture or acute dislocation. Advanced degenerative disk disease is seen at multiple levels resulting in at least some degree of spinal canal encroachment. These findings would be better assessed on MRI if clinical concern warrants.3. Partially visualized intracranial hemorrhage was better assessed on prior head CT.4. Enlarged, heterogeneous thyroid. Thyroid sonography may be considered as clinically warranted. |
Generate impression based on findings. | 58 year-old male with new leukemia. LUNGS AND PLEURA: Linear opacity in the right apex most compatible with scar. Mild upper lobe predominant centrilobular emphysema. No consolidation or pleural effusions.Scattered punctate calcified and non-calcified micronodules bilaterally all measuring approximately 1 to 2 mm; while these are nonspecific, they are most likely are result of prior granulomatous infection.MEDIASTINUM AND HILA: Prominent but benign appearing lymph nodes with preserved fatty hila are seen in the upper mediastinum (series 3, image 39, 37). Heart size normal. No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Nonspecific punctate calcified and noncalcified micronodules bilaterally, which are most likely the result of prior granulomatous infection.2.No specific findings to suggest active infection.3.Emphysema. |
Generate impression based on findings. | Reason: palate cancer History: r/o chest mets LUNGS AND PLEURA: Minimal amount of aspirated debris on the left. Two small subpleural less than 4-mm nodules in the left lower lobe (series 4, image 114 and 181).MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Two punctate micronodules on the left which are much more suggestive of postinflammatory nodules than metastases. However, continued follow-up is recommended to exclude any growth. |
Generate impression based on findings. | 37-year-old male patient with history of ulcerative colitis presents with flare. Evaluate for inflammatory process. ABDOMEN:LUNG BASES: Bilateral dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small hypoattenuating focus in the intrapolar region of the left kidney measures 0.5 x 0.8 cm (series 3 image 38), is too small to characterize and is stable from prior examination.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Bowel is normal in caliber without wall thickening. No mesenteric fat stranding or fluid collections.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Bowel is normal in caliber without wall thickening. No mesenteric fat stranding or fluid collections.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of acute inflammatory bowel disease.2.Stable hypoattenuating focus in the left kidney is stable and mostly represents a simple cyst. |
Generate impression based on findings. | 74-year-old male with esophageal cancer. CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules are stable to slightly decreased in size. Reference right upper lobe and nodule is difficult to measure however measures approximately 8 mm, previously measured 7 mm (series 5, image 30). Reference left basilar nodule measures 11 x 11 mm, previously measured 12 x 12 mm (series 5, image 70). No new nodules identified. No significant change in right lower lobe consolidation, with septal nodular thickening also appearing unchanged and compatible with lymphangitic spread of disease. Stable small right pleural effusion. No significant left pleural effusion.Severe emphysema.MEDIASTINUM AND HILA: Mild decrease in mediastinal and supraclavicular lymphadenopathy (series 3, image 9, 12). Reference prevascular node measures 3 mm, previously measured 4 mm (series 3, image 35).Status post esophagectomy and gastric pull-up; mid esophageal stent is present and filled with fluid in its distal portion (series 3, image 53).Severe atherosclerotic calcifications affect the coronary arteries and aorta.CHEST WALL: Degenerative changes affect the thoracic spine. Partial resection of right sixth rib again noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Apparent increase in reference to left lobe lesion, which may be partially due to variability in timing of contrast bolus; this lesion currently measures 3.4 x 2.6 cm, previously measured 3.0 x 2.6 cm (series 3, image 88). Other metastatic liver lesions do not appear significantly changed in number or extent.There are venous collaterals around the pancreatic head due to SMV thrombosis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts. Hypoattenuating, ill-defined focus in superior pole of right kidney not significantly changed (series 3, image 104).PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: IVC filter in place. No retroperitoneal lymphadenopathy. Severe atherosclerotic changes of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Jejunostomy tube in left abdomen unchanged in location.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mild improvement in supraclavicular and mediastinal lymphadenopathy.2.Stable to slightly decreased size of innumerable bilateral lung nodules. 3.Stable right basilar consolidation, compatible with lymphangitic spread of disease.4.Apparent mild increase in size of reference metastatic liver lesion, which may be partially due to difference in timing of contrast bolus. Other liver lesions are stable. Continued follow-up is recommended. |
Generate impression based on findings. | Seizure. Rule out vasculitis. Unenhanced CT Head: There are small areas of subtle hypoattenuation demonstrated within the right paramedian parietal lobe (axial series 3 image 39) and within the right precentral gyrus (image 41). There is no associated hemorrhage, mass or fluid collection. The midline is intact. Bones and orbits are unremarkable. There is a very small amount of soft tissue thickening within left maxillary sinus.CTA neck: There is a normal 3 vessel arch. Proximal carotid arteries have a normal appearance and no aneurysm demonstrated. There is no stenosis by NASCET criteria. Proximal vertebral arteries have a normal appearance and course and there is no aneurysm or steno-occlusive lesion demonstrated. CTA brain: There is a small lobar (1 mm) medially directed outpouching within the cavernous segment of the left internal carotid most likely representing an infundibular arterial origin. There is no aneurysm or steno-occlusive lesion demonstrated. There are patent anterior and posterior communicating arteries. Posterior circulation including the vertebral, basilar,PICA, AICA and superior cerebellar arteries are normal. There is no aneurysm or steno-occlusive lesion demonstrated. There are no findings which suggest vasculitis though CT can be insensitive in this regard, particularly within the distal vessels. | 1.Subtle areas of parenchymal hypoattenuation as above. This most likely represents edema. An MRI was subsequently performed, refer to that report for further detail.2.No specific vascular abnormalities in the head or neck.3.No CTA evidence of vasculitis. |
Generate impression based on findings. | Reason: 52M w R neck mass, c/f head and neck cancer, please evaluate for possible mets History: R neck mass LUNGS AND PLEURA: Benign-appearing pulmonary micronodules, intrapulmonary lymph nodes and scarring is present.No specific evidence of pulmonary or pleural metastases, although continued monitoring is recommended.MEDIASTINUM AND HILA: Bilateral thyroid cysts.No evidence of mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary or pleural metastases. Benign appearing micronodules should be monitored on continued follow-up as part of the patient's cancer surveillance. |
Generate impression based on findings. | Male, 33 years old, throat and neck pain which worsens through the day. Assess for mass. The oral tongue and floor of mouth are unremarkable. Mild mucosal irregularity at the level of the base of tongue likely reflects the presence of lymphoid tissue. The nasopharyngeal and palatine tonsils are mildly prominent but without concerning features, therefore likely reactive.The epiglottis is thin unremarkable. The aryepiglottic folds and vocal cords are unremarkable. The infraglottic airway is within normal limits.No evidence of pathologically enlarged or aggressive appearing lymph nodes is seen in the neck. The salivary glands are free of focal lesions. There is a small focus of hypodensity within the right thyroid lobe which is nonspecific.The cervical vascular structures are within normal limits. Lung apices are unremarkable. No concerning or destructive osseous lesions are seen. There is an anterior osteophyte arising from the C6-7 disk space. These are usually incidental and asymptomatic, though rarely, osteophytes at this location may contribute to dysphagia.A mucus retention cyst is present in the left maxillary sinus. | 1. No concerning mass lesions or pathologic adenopathy.2. Mild lymphoid prominence is likely reactive. |
Generate impression based on findings. | 73-year-old male with tachycardia and shortness of breath PULMONARY ARTERIES: Diagnostic quality exam. Again seen is small filling defect within a segmental branch of the right middle lobe, compatible with pulmonary embolus and not significantly changed (series 8, image 146). No other filling defects to suggest additional pulmonary emboli are identified.LUNGS AND PLEURA: Small bilateral pleural effusions, left more than right, are not significantly changed; associated subsegmental basilar atelectasis/consolidation also unchanged. Ground glass opacities in the right upper lobe are slightly increased in the right apex (series 9, images 38, 20).Again seen are several calcified and noncalcified micronodules, likely benign in nature.MEDIASTINUM AND HILA: No significant enlarged mediastinal lymph nodes. Moderate atherosclerotic calcifications affect coronary arteries and aorta.Status post CABG. Moderate cardiomegaly is stable. No right ventricular enlargement or intraventricular septal bowing to suggest right heart strain.Enlarged main pulmonary artery measuring 3.3 cm in diameter consistent with pulmonary arterial hypertension. Central venous catheter terminating in distal SVC unchanged.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable small amount of ascites in the upper abdomen. Postsurgical changes in partially visualized thoracolumbar junction. | 1.Stable appearance of small, solitary pulmonary embolus in segmental branch of right middle lobe. No evidence of right heart strain.2.Stable bilateral pleural effusions and small amount of ascites fluid.3.Mild increase in ground glass opacity in right upper lobe, suspected to represent mild focal edema, less likely this could represent hemorrhage or pneumonia. |
Generate impression based on findings. | 52-year-old male with a heavy smoking history, right neck mass, swelling, evaluate. Multiple enlarged lymph nodes forming a conglomerate right neck mass which measures 3.4 x 4.0 x 5.3 cm (series 6 image 39 and series 80481 image 53). The lesion extends from the right infrahyoid neck inferiorly to the level of the right submandibular space superiorly. The lesion abuts a portion of the right common carotid artery which remains patent. The right internal jugular vein is patent. No soft tissue mass or focus of enhancement to suggest the location of a primary neoplasm is identified throughout the aerodigestive tract.Multiple additional enlarged right sided cervical nodes are identified including level IIa, IIb, III, and IV. No enlarged left-sided cervical nodes are identified.Reference level IIb lymph node measures 1.8 x 1.6 cm (series 6 image 42).Multiple nonspecific hypoattenuating thyroid nodules. The airway remains patent.Multilevel degenerative changes of the cervical spine without suspicious osseous lesions. Degenerative changes are most pronounced at C5 through C7 and include uncovertebral spurring with some neuroforaminal compromise Straightening of the cervical spine may be secondary to positioning.Limited intracranial views are grossly unremarkable. The orbits are unremarkable. Mild mucosal thickening of the left maxillary sinus, otherwise the paranasal sinuses and mastoid air cells are clear. | Extensive right neck lymphadenopathy without identification of a soft tissue mass or discrete focus of enhancement to suggest the location of a primary neoplasm. |
Generate impression based on findings. | Reason: pt with h/o lung ca s/p resection History: now needs follow up evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Stable post surgical changes in the right lung involving the right upper lobe resection with partial atelectasis/consolidation of the right lower lobe and paramediastinal fibrosis most likely secondary to radiation therapy. No suspicious pulmonary nodules or masses.Upper lobe predominant centrilobular emphysema.No pleural effusions. MEDIASTINUM AND HILA: Cardiac size is normal without evidence of a pericardial effusion.No hilar or mediastinal lymphadenopathy.Multiple small retrocrural lymph nodes similar in appearance to prior exams.Right thyroid lobe hypodense lesion unchanged.CHEST WALL: Asymmetric prominent right breast tissue without significant interval change.Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Exophytic left renal cyst unchanged.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: Sclerotic focus in the left sacrum unchanged over numerous exams.Severe degenerative disk disease at the L5-S1 level.OTHER: No significant abnormality noted. | No interval change. No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 50 year-old male with metastatic gastroesophageal junction adenocarcinoma. CHEST:LUNGS AND PLEURA: Paraseptal emphysema. No nodules or masses. Tiny micronodule in the superior right upper lobe is unchanged. Right middle lobe ground glass nodule measures 7 mm (image 25, series 4) and and previously measured 7 mm.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy with a large subcarinal lymph node measuring 1.8 x 1.0 cm (image 47, series 3). Marked distal esophageal wall thickening near the gastroesophageal junction, consistent with the patient's known primary. Right port catheter tip extends to the SVC.CHEST WALL: Prominent subcentimeter axillary lymph nodes. Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Interval decrease in size of multiple hepatic metastases with increased hypoattenuation and faint calcification likely representing treatment effect. Reference right hepatic lesion measures 6.7 x 1.2 cm (image 98, series 3 and previously measured 9.2 x 13.9 cm. Reference left hepatic lesion measures 9 x 10 mm (image 107, series 3) and previously measured 16 x 19 mm. 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: Soft tissue mass arising from the gastroesophageal junction measures 5.9 x 3.7 cm and previously measured 6.3 x 4.9 cm, decreased in size and demonstrating treatment effect.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate hypertrophy.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 | Interval decrease in size of multiple reference lesions which demonstrate treatment effect as detailed above. No new lesions. |
Generate impression based on findings. | Reason: right jaw cancer History: r/o lung mets LUNGS AND PLEURA: Stable scattered micronodules.No new suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Stable mild cardiac enlargement without evidence of a pericardial effusion.Left central venous catheter with its tip in the SVC.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No interval change. No evidence of metastatic disease. |
Generate impression based on findings. | 69-year-old female patient with history of frank hematuria. Evaluate for upper urinary tract lesions. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis, perinephric fat stranding or renal calculi. Multiple subcentimeter nonenhancing hypoattenuating foci in the bilateral kidneys that are too small to characterize and likely represent cysts. Exophytic, well circumscribed hypoattenuating lesion that does not demonstrate enhancement and measures 4.0 x 4.0 cm (series 8049 image 54), consistent with simple cyst.Delayed images demonstrate patent bilateral collecting systems without filling defects. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis in the transverse colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild atherosclerotic changes in the abdominal aorta and iliac arteries. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis in the transverse colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild atherosclerotic changes in the abdominal aorta and iliac arteries. | 1.No suspicious renal masses, renal calculi or filling defects in the collecting system.2.Left intrapolar region exophytic simple cyst.3.Multiple bilateral subcentimeter hypoattenuating foci are too small to characterize and likely represent cysts. |
Generate impression based on findings. | Reason: re0eval met ACC History: see above CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules consistent with metastases. The right upper lobe nodule now measures 14 x 12 mm (image 48, series 6) compared to 14 x 12 mm previously. The right lower lobe nodule contiguous with the right pulmonary artery measures 18 x 15 mm (image 44, series 6) compared to 15 x 14 mm. The subpleural right lower lobe nodule is not significantly changed, measuring 5 x 6 mm (image 53, series 6)The left lower lobe nodule measures 14 x 12 mm (image 48, series 6) stable. Linear atelectasis and peripheral consolidation in the lingula is compatible with radiation reaction.No new pulmonary nodules.MEDIASTINUM AND HILA: Grossly stable azygoesophageal lymphadenopathy (image 37, series 4). Severe coronary artery calcifications. Atherosclerosis affects the thoracic aorta.CHEST WALL: Degenerative change involving spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. Wedge-shaped hyperdensity in right posterior segment of liver (image 81/148) likely a hemangioma and is better seen on current study due to phase of contrast enhancement.SPLEEN: Splenic granulomas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense right renal lesion, most likely represents a benign cyst.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: Wide neck ventral hernia containing non-obstructed loops of bowel. OTHER: No significant abnormality noted. | Grossly stable to marginally increased reference measurements with no new sites of disease. |
Generate impression based on findings. | Male 61 years old; Reason: staging workup History: prostate cancer recently diagnosed 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: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Focal bulge with heterogenous enhancement of the prostate is noted. Prostatic calcifications are seen.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative disease noted in the spineOTHER: No significant abnormality noted. | 1.No evident metastatic disease detected. |
Generate impression based on findings. | Reason: History of metastatic breast cancer on treatment, evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment, evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Bilateral nonspecific pulmonary micronodules are stable in size and number. MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. Normal heart size. No significant coronary artery calcifications.CHEST WALL: Cortical thickening and sclerosis of the anterior right eighth rib unchanged. Focal sclerotic lesion in the anterior fourth rib, unchanged. Focal sclerotic lesions in left ribs 4, 7, and 8 unchanged. Focal sclerotic lesions in T3, T5, T6, and T11 unchanged.Enhancing right axillary lymph node measures 19 x 13 mm, previously measuring 15 x 10 mm (series 4, image 25). There are additional smaller enhancing lymph nodes in the right axilla and deep to the pectoral muscles also with slight interval increase in size. Reference left axillary lymph node measures 15 x 8 mm, previously measuring 15 x 6 mm (series 4, image 29). Additional smaller left axillary lymph nodes are unchanged in size.Bilateral breast skin induration, right greater than left. There are numerous enhancing masses and nodules within the right breast with interval increase in size. There is nodular enhancement along the medial aspect of the left breast, not significantly changed from prior exam.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypodense liver lesions, grossly unchanged compared to prior exam. Linear hypoattenuation in the right hepatic lobe is unchanged. Reference cystic metastases in the right hepatic lobe measures 24 x 19 mm, previously measuring 23 x 19 mm (series 4, image 85).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Nonspecific soft tissue thickening around the celiac axis is unchanged compared to prior examinations.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Scattered small , subcentimeter mesenteric lymph nodes are unchanged. BONES, SOFT TISSUES: Sclerotic lesions in L1, L2, and L4.OTHER: No significant abnormality noted. | 1.Nonspecific pulmonary micronodules are stable in size and number.2.Sclerotic skeletal metastasis are grossly unchanged compared to prior exam.3.Increase in enhancing masses and nodules in the right breast. Left breast enhancing nodularity is relatively stable compared to prior exam.4.Bilateral axillary and subpectoral lymphadenopathy with slight interval increase in size.5.Stable reference cystic right hepatic lobe metastasis. |
Generate impression based on findings. | 47 year old female with follicular non-Hodgkin's lymphoma, evaluate extent of disease. CHEST:LUNGS AND PLEURA: Few scattered pulmonary micronodules are unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Left inguinal lymphadenopathy with reference lymph node measuring 5.0 x 2.3 cm (image 20, series 3) and previously measuring 3.9 x 2.4 cm. The second left reference lymph node measures 1.6 x 1.2 cm and previously measured 1.6 x 1.6 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mild increased size of left inguinal lymph nodes without new lesion identified. |
Generate impression based on findings. | 74-year-old male patient with history of renal cell carcinoma status post left radical nephrectomy. Evaluate for tumor recurrence or metastases. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: Hypoattenuating lesion in the left lobe of the liver demonstrates peripheral nodular enhancement and most likely represents a hemangioma (series 5 image 24). Multiple hypoattenuating, nonenhancing lesions in liver parenchyma (series 5 image 23, 28, 35), stable compared to prior examination.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right kidney without contour abnormalities, hydronephrosis or lesions. Delayed imaging demonstrates patent collection system. Left kidney surgically removed. There is a hypoattenuating, nonenhancing focus in surgical bed and measures 4.0 x 2.5 cm (series 5 image 40).RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes in the abdominal aorta and iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of the thoracic and lumber spine. Sclerotic lesion in the L2 vertebral body is stable compared to prior examination.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: Mild bladder wall thickening, consistent with chronic bladder outlet obstruction.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Asymmetric, ill-defined hyperattenuation in the left iliac wing without cortical changes.OTHER: No significant abnormality noted. | 1.Hypoattenuating, nonenhancing focus in the surgical bed is nonenhancing and likely represents postsurgical fluid collection. Recommend continued surveillance.2.Ill-defined hyperattenuation of the left iliac wing is stable compared to prior examination, this of uncertain etiology and is most likely benign.3.Multiple liver lesions are stable and too small to characterize. 4.Hypoattenuating lesion in the left lobe of the liver with peripheral enhancement likely represents a hemangioma. |
Generate impression based on findings. | 43 year-old female with metastatic breast cancer CHEST:LUNGS AND PLEURA: Unchanged mild left paramediastinal scarring/radiation change.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Left lumpectomy changes with associated surgical clips. Status post left axillary lymph node dissection. Stable sclerotic vertebral body lesions at T7, T9, and T12 and moderate degenerative disk disease. A clip is noted in the right breast.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. No focal hepatic lesions.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: Stable sclerotic vertebral body lesions.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable interval exam without new metastatic lesions. Unchanged sclerotic thoracic vertebral body foci. |
Generate impression based on findings. | 62-year-old male with AML. Evaluate for infection. LUNGS AND PLEURA: No consolidation or pleural effusions. Scattered linear opacities, including in the right apex, right middle lobe, right base, and lingula, are most compatible with scarring.No specific evidence of infection.Scattered bilateral micronodules; largest of these is located in the left lower lobe and measures 4 mm (series 4, image 71).MEDIASTINUM AND HILA: Mild calcifications affect the coronary arteries. Size normal. No pericardial effusion. No lymphadenopathy.Central venous catheter tip in distal SVC.CHEST WALL: No significant abnormalityUPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. No significant abnormality and partially visualized upper abdomen. | 1.No evidence of active infection.2.Scattered lung micronodules, likely benign in etiology. |
Generate impression based on findings. | 65 year old male with right apical and right middle lobe nodules. Please evaluate. LUNGS AND PLEURA: Linear opacities with associated calcification and bronchiectasis in right apex, most compatible with scarring, appear unchanged. Previously measured right apical pleural based nodule is mildly decreased and measures 14 x 15 mm, previously measured 17 x 17 mm (series 4, image 17).Stable right middle lobe nodule measures 7 mm, previously measured 7 mm (series 4, image 6). Several other punctate micronodules bilaterally are unchanged. No new nodules.Interval improvement in previously seen upper lobe predominant ground glass opacities. Minimal ground glass opacities in both bases compatible with minimal atelectasis. There is mild persistent interstitial reticulation in both bases, right more than left, suspicious for mild fibrosis.MEDIASTINUM AND HILA: Status post CABG. Stable mild cardiomegaly. ICD leads unchanged. Moderate coronary artery calcifications. No lymphadenopathy or pericardial effusion.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. | 1.Continued improvement in previously seen ground glass opacities, consistent with clinical diagnosis of subacute hypersensitivity pneumonitis. Mild persistent reticulation in lung bases, right more than left, suspected to represent mild fibrosis. 2.Stable right middle lobe nodule measuring 7 mm; continued follow-up in 6-12 months is recommended.3.Mild decrease in right apical nodule, currently measuring 15 mm; continued follow-up recommended. |
Generate impression based on findings. | Reason: evaluate mediastinal lymphadenopathy History: patient has history of breast cancer and recent enlarged paratrach node noted on outside CT LUNGS AND PLEURA: Postop change right upper lobe.MEDIASTINUM AND HILA: Interval increase in right lower paratracheal lymph node now measuring 16 mm in short axis. No significant left-sided mediastinal or hilar lymphadenopathy. Small subcentimeter cardiophrenic lymph node (image 70/108), unchanged. Port tip at RA/SVC junction.CHEST WALL: Status post left mastectomy. Right chest wall port. Small right axillary lymph nodes unchanged.New small coarse calcification in the right breast, correlate with results of dedicated breast imaging studies.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Postop change involving the stomach. Interval increase in size of left upper abdominal water density structure which is presumably an adrenal cyst. Stable punctate hepatic hypodensity, presumably a cyst. | 1. Interval increase in nonspecific right lower paratracheal lymphadenopathy. No significant left-sided mediastinal or hilar lymphadenopathy.2. Small right axillary lymph nodes unchanged. |
Generate impression based on findings. | 65-year-old female evaluate kidneys for returned renal mass ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hemangioma in the right lobe of the liver and subcentimeter lesion in the dome of the liver are stable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Previously seen enhancing mass at the lower pole of the left kidney is resected. No evidence of recurrence. Benign simple cysts in the upper pole left kidney are unchanged.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes are unchanged.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 | Interval resection of the left renal mass. No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Male, 57 years old, larynx cancer. The previously seen small exophytic mass arising from the left vocal cord with subglottic extension is no longer discretely identified. The vocal cords demonstrate a mildly undulating contour but are free of focal masses. No evidence of paraglottic disease. No invasion of the thyroid cartilage is seen. Mild supraglottic edema/hyperemia is likely related to therapy.The remainder of the aerodigestive tract is within normal limits. No pathologic adenopathy is detected by size criteria. The salivary glands are free of focal lesions. There is a very small hypodense focus within the left thyroid lobe, not clearly demonstrated on the prior exam. Cervical vessels are patent. Lung apices significant for paraseptal emphysema. No concerning osseous lesions are detected. | 1. A small mass previously seen arising from the left vocal cord is no longer clearly identified. 2. No evidence of pathologic adenopathy is seen. |
Generate impression based on findings. | 63 year old male. Reason: cad History: chest pain Height: 73 in Weight: 210 lbs BSA: 2.2 m^2BMI: 27.7 kg/m^2Calcium Score:LM: 0LAD: 28LCx: 0RCA: 0Total: 28, This represents the 41% for this patient's age and gender.Cardiac Morphology:Left Ventricle:EDV: 134 ml The left ventricle is normal in size, shape, wall thickness, and volume. Right Ventricle:EDV: 168 ml The right ventricle is normal in size, shape, wall thickness, and volume. Left Atrium: The left atrial volume minus the pulmonary veins is within normal limits. There are four distinct pulmonary veins which drain normally into the left atrium.Right Atrium: The right atrial volume is within normal limits. The right atrium is structurally normal. Cardiac Veins: The coronary sinus is normal.Cardiac Valves: There are no aortic calcifications. There is no mitral annular calcification.Great Vessels: Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 40 mm Ascending: 38.5 mm Sinotubular Junction: 31 mm Descending: 27 mmPulmonary Artery: Main PA: 29 mmRight PA: 21 mmLeft PA: 21 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:LM: The left main coronary artery is very short as it arises normally from the left sinus of valsalva and bifurcates immediately into the left anterior descending and left circumflex coronary arteries. There is no significant plaque in the left main.LAD: The LAD gives rise to the diagonal and septal branches. There is minimal multifocal calcification in the proximal LAD without associated stenosis. There are two punctate calcifications in the LAD wall proximal to the origin of the 1st diagonal branch. LCx: The left circumflex artery gives rise to the obtuse marginal branches. No significant stenoses or calcifications are present. RCA: The RCA arises normally from the right sinus of valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and a posterolateral branch. No stenoses or calcifications. EXTRACARDIAC CHEST | 1. Normal ventricular volume and morphology.2. Coronary artery calcification with Agatston Score 28, 41st percentile for a 63 year old male. Calcifications are in the proximal LAD. Very short left main coronary artery. |
Generate impression based on findings. | Reason: re evaluation for post treatment for larynx cancer History: hoarse LUNGS AND PLEURA: Apical scarring and paraseptal emphysema is present.Scattered punctate benign-appearing micronodules are seen but there is no evidence of pulmonary or pleural metastases.Mild bronchial wall thickening seen in both lower lung zones.MEDIASTINUM AND HILA: Small thyroid cyst.There is no mediastinal or hilar lymphadenopathy. Mild/moderate coronary artery calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Retained contrast is seen in a descending colon diverticulum.Small accessory splenule. | Paraseptal emphysema. No sign of metastases. |
Generate impression based on findings. | Female 75 years old; right lower quadrant pain ABDOMEN:LUNGS BASES: No nodule or mass detected. Numerous nodules with dystrophic calcifications noted in the bilateral breasts.LIVER, BILIARY TRACT: No focal mass detected. The gallbladder is contracted. Mild intra-and extrahepatic biliary ductal dilatation noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Surgical sutures noted in the right lower quadrant along the cecum, likely from prior appendectomy. There is apparent thickening of the terminal ileum, however this is suboptimally evaluated given lack of distention. No inflammatory reaction, lymphadenopathy or appendix visualized in the right lower quadrant.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is atrophic or surgically absent. Bilateral cystic structures in the adnexa are presumed ovaries. 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.Apparent thickening of the terminal ileum although suboptimally evaluated given lack of distention. No intra-abdominal inflammatory reaction noted. |
Generate impression based on findings. | Male 64 years old; Reason: pancreatic cancer restaging History: pancreatic cancer restaging CHEST:LUNGS AND PLEURA: Nonspecific micronodule in the right upper lobe on image 31/series 5.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal adenopathy.Right chest wall port terminates at the cavoatrial junction. CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Extensive hepatic metastases. Some of the lesions have decreased in size. The reference right hepatic lobe lesion measures 1.7 x 1.2 cm (image 111/series 3) previously, 3.6 x 2.1 cm.The hepatic and portal veins are patent. Mild periportal edema.SPLEEN: No significant abnormality notedPANCREAS: Status post Whipple procedure. The remainder of the pancreas is mildly atrophic. Pancreatic stent terminates within the bowel.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy has decreased. Left para-aortic lymph node measures 1.6 x 1.2 cm (image 129/series 3) previously, 1.7 x 1.6 cm.BOWEL, MESENTERY: Post operative changes in the bowel. No bowel obstruction. Small mesenteric lymph nodes. Mild stranding in the omentum which may represent edema.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: Post operative changes in the small bowel.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Slight decrease in the size of the liver lesions.2.Decrease in the size of the para-aortic lymphadenopathy. |
Generate impression based on findings. | Reason: PE History: CP PULMONARY ARTERIES: No evidence of PE.LUNGS AND PLEURA: Large right-sided pleural effusion with compressive atelectasis. Moderate left pleural effusion with compressive atelectasis. Mild pulmonary edema. Nonspecific 9-mm pulmonary nodule in the right middle lobe (image 104/149).MEDIASTINUM AND HILA: Cardiomegaly. Moderate pericardial effusion. Venous catheter tip in SVC.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. NG tube tip in stomach. Please see recent abdomen pelvis CT report for further details. | 1. No evidence of PE.2. Moderate pericardial effusion.2. Bilateral pleural effusions, right greater than left; pulmonary edema. 3. Nonspecific 9-mm pulmonary nodule right middle lobe. Follow up CT in 3 - 6 months is recommended to exclude growth/malignancy. |
Generate impression based on findings. | Reason: tongue cancer History: r/o chest mets LUNGS AND PLEURA: Linear atelectasis and scarring at lung bases, right greater than left. No evidence of pulmonary metastases. Small 6-mm nonspecific groundglass nodules in the left upper lobe (image 19/97) are unchanged. Scattered punctate calcified and noncalcified micronodules, suggestive of postinflammatory granulomas, unchanged.MEDIASTINUM AND HILA: Postop change involving the lower neck. Please see dedicated neck CT report for further details.Atherosclerotic calcification of the aorta and its branches. Coronary calcification.CHEST WALL: Degenerative changes involving the spine with partial collapse of T12, unchanged. Left breast calcification unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Stable CT with no evidence of metastatic disease. Stable ground glass nodules in left upper lobe which may be due to atypical adenomatous hyperplasia or adenocarcinoma in situ. Continued follow up is recommended. |
Generate impression based on findings. | Male, 54 years old, tonsil cancer status post CRT. Multiple postsurgical/treatment related findings are again seen including asymmetry and a probable defect at the level of the left soft palate, infiltration of the fascial planes in the left neck, and atrophy of the left sternocleidomastoid muscle. Within this background, and allowing for streak artifact arising from dental amalgam and orthopedic hardware, no definite recurrence of tumor is seen. No pathologic adenopathy is detected by size criteria.The parotid glands are unremarkable. The submandibular glands are small. The thyroid is free of focal lesions. The cervical vessels are unremarkable. Lung apices are clear. No concerning osseous lesions are demonstrated.Occipital to C2 fusion hardware is redemonstrated in stable position. Bony fusion is evident across the left occipital condyle, left lateral mass of C1 and left lateral mass of C2. The joints of the right craniocervical junction remain patent. | No evidence of recurrent tumor or pathologic adenopathy. |
Generate impression based on findings. | Reason: Pt with hx of BOT Ca. Please re-eval and compare to previous scans History: as above CHEST:LUNGS AND PLEURA: Punctate micronodules, some which are calcified, are unchanged. No evidence of metastases.MEDIASTINUM AND HILA: Reference AP window lymph node measures 7 mm (image 38/155), unchanged. CHEST WALL: Degenerative change involving thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypodense hepatic lesions are nonspecific but stable and presumably benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postop change versus scarring involving the left inferior kidney.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: Degenerative change involving spine.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: pulmonary embolism History: shortness of breath PULMONARY ARTERIES: There is no evidence of pulmonary emboli. The pulmonary artery is markedly enlarged (4.7 cm) compatible with pulmonary arterial hypertension. LUNGS AND PLEURA: Mild basilar scarring/discoid atelectasis.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Cardiomegaly with right ventricular enlargement.No pericardial effusion.CHEST WALL: Degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary emboli.2.Marked enlargement of pulmonary artery compatible with pulmonary to hypertension.3.Cardiomegaly with right ventricular enlargement. |
Generate impression based on findings. | Peripheral T-cell lymphoma CHEST:LUNGS AND PLEURA: Changes secondary to left pneumonectomy.MEDIASTINUM AND HILA: Index mediastinal lymph node is smaller measuring 1.5 by 0.9-cm image number 27, series number 401.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Choleithiasis, unchangedSPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Geographic lucency in the left superior ramus without cortical breakthrough, unchanged, suggestive of benign etiology. OTHER: No significant abnormality noted. | Slight interval decrease in the size of the mediastinal lymph node |
Generate impression based on findings. | Reason: NSCLC s/p maintainence chemo, restaging scans History: cough CHEST:LUNGS AND PLEURA: Reference left upper lobe mass measures 34 x 10 mm on image 42/110, unchanged.Reference subpleural nodule at left base measures 4 mm on image 77/110, 5 mm previously.New nonspecific 5-mm and smaller pulmonary nodules are noted in the right middle and upper lobes in a predominantly perifissural location. The largest is in the right middle lobe (image 56/110). The location and relatively clustered nature of the nodules makes infectious or aspiration related etiologies leading considerations though a follow-up CT is recommended to exclude growth as these may also represent metastases.MEDIASTINUM AND HILA: Reference right peritracheal lymph node measures 6 mm on image 28/155, unchanged. Trace pericardial fluid especially around the aortic root. Borderline heart size. Left thyroid nodule, unchanged.CHEST WALL: Stable sclerotic foci in the T5 vertebrae and spinous process of T11. Degenerative change elsewhere.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable hepatic calcification and small hypodensities. Stable adrenal nodules. Stable renal cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small upper abdominal subcentimeter lymph nodes are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. New nonspecific 5-mm and smaller pulmonary nodules in the right middle and upper lobes in a predominantly perifissural location. The location and relatively clustered nature of the nodules makes infectious or aspiration related etiologies leading considerations though a follow-up CT is recommended in 3 - 6 mo to exclude growth as these may also (though less likely) represent metastases.2. Stable left upper lobe mass. |
Generate impression based on findings. | Female 78 years old; Reason: Hx of Bladder and Kidney cancer s/p right partial nephrectomy and cystectomy with ileal conduit. Eval for recurrent/metastatic disease History: See above CHEST:LUNGS AND PLEURA: Basilar fibrotic changes. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Enlarged left thyroid lobe.ABDOMEN:LIVER, BILIARY TRACT: Well marginated hypodense lesion in the left hepatic lobe with cystic characteristics is unchanged.Subcentimeter scattered hypodense lesions are too small to characterize.Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post partial right nephrectomy. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Post operative changes in the small bowel with a right lower quadrant ileal conduit.There is a large contrast containing structure in the right hemiabdomen with suture lines. This may represent an distended small bowel.BONES, SOFT TISSUES: Two small tracts extend from the rectus fascia to the skin surface.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomyLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Colonic diverticulosis. Other findings as above.BONES, SOFT TISSUES: Severe degenerative changes affects the right hip. Soft tissue thickening in the lower rectus muscle. Degenerative disk affects the lower lumbar spine.OTHER: No significant abnormality noted. | 1.Stable exam.2.Oral contrast containing structure in the right midabdomen may represent a dilated loop of small bowel.3.Low lobe predominant pulmonary fibrosis.4.Partial right nephrectomy.5.Small tracts extend from the skin surface to the fascial plane further evaluation with a fistulogram can be performed if needed.6.Cholelithiasis. |
Generate impression based on findings. | Reason: evaluate ILD History: cough sob LUNGS AND PLEURA: Bilateral, right greater than left, diffuse interstitial without significant ground glass opacities, with traction bronchiectasis and architectural distortion. There is a diffuse honeycombing and small patchy areas of consolidation. There is mild bronchial wall thickening and reticulonodular septal thickening. There is no apical or basilar predominance but is predominantly subpleural. No specific evidence for micronodules or lung mass. There is no pleural effusion. There are a few hyperlucent lobes. No significant air-trapping is seen.MEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes are present. The heart size is normal. Mild coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Bilateral, right greater than left, diffuse interstitial without ground glass opacities, with patchy areas of consolidation and associated honeycombing, traction bronchiectasis, and architectural distortion. These findings suggest possible UIP, fibrosing NSIP or chronic hypersensitivity pneumonitis. |
Generate impression based on findings. | 42-year-old female with previous history of abdominal pain and kidney stone This study is limited to the lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis. Pneumobilia.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal stone without evidence of hydronephrosis. No evidence of right-sided stones. No evidence of bilateral ureteral stones.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Questionable wall thickening involving the proximal and descending colon and cecum, incompletely imaged on this noncontrast CT. There are borderline enlarged retroperitoneal lymph nodes adjacent to the ascending colon.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 | Left renal stoneWall thickening of the proximal ascending colon. Further evaluation with colonoscopy very helpful. |
Generate impression based on findings. | 48-year-old female patient with possible MEN syndrome. Evaluate for possible adrenal mass. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Bilateral adrenal glands within normal limits.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No adrenal abnormalities.2.No acute intra-abdominal abnormalities. |
Generate impression based on findings. | Reason: evaluate ILD History: cough sob LUNGS AND PLEURA: Mild subpleural reticulation is identified in the upper and lower lung zones bilaterally.There is no evidence of architectural distortion, groundglass opacities, or honeycombing.No evidence of air trapping on the expiratory images.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary and aortic calcification.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Very mild nonspecific subpleural fibrosis which may be post inflammatory in origin. No evidence of architectural distortion, honeycombing, or groundglass opacities. |
Generate impression based on findings. | 54-year-old male with head and neck cancer. CHEST:LUNGS AND PLEURA: Stable scattered pulmonary micronodules. No new or suspicious nodules.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size normal. Borderline right hilar node is unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter renal hypodensities most compatible with cysts, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small dilated paravertebral veins on left of doubtful clinical significance unchanged.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 evidence of metastatic disease. |
Generate impression based on findings. | 50 year-old man with history of sarcoma, status post resection CHEST:LUNGS AND PLEURA: Again noted bilateral multiple metastatic lesions which are increased in size compared to previous study. Right lower lobe index nodule now measures two .8 by 2.1-cm in image number 61, series number 4. Small amount of bilateral effusions, unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is an ill-defined hypodense lesion in the mid right kidney measuring 1.7-cm in diameter image number 114, series number 701. The etiology of this is indeterminate. Follow-up with renal MRI may be helpful for further evaluation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Ill-defined presacral soft tissue density mass eroding the anterior cortex of the sacrum measuring 4.6 x 3.1 cm on image number 177, series number 701.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size of the metastatic lung lesions.Destructive lesion involving the sacrum.Indeterminate right renal lesion. Further evaluation with mass protocol renal MRI is recommended. |
Generate impression based on findings. | Reason: thymoma, please evaluate for disease and compare with previous scans History: thymoma CHEST:LUNGS AND PLEURA: Reference posterior right upper lobe nodule is largely obscured by surrounding consolidation. It measures 20 x 11 mm on image 34/98. The surrounding ground glass and interstitial abnormalities associated with some traction bronchiectasis, especially in the medial right middle and lower lobes is presumably related to radiation pneumonitis though continued follow-up is recommended. No new pulmonary nodules.MEDIASTINUM AND HILA: Continued decrease in anterior mediastinal mass now measuring 32 x 11 mm on image 31/126 (34 x 18 mm on prior). Extensive perilesional fat stranding. Port tip in SVC. Coronary calcification. Atherosclerotic calcification of the aorta and branches. Small partially calcified subcarinal lymph node is unchanged. Hiatal hernia.CHEST WALL: Multiple right-sided rib fractures in various stages of callus formation. Right chest wall port. Status post median sternotomy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered punctate hepatic hypodensities are too small to characterize but stable.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Hiatal hernia.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality noted. | 1. Continued decrease in anterior mediastinal mass.2. Right upper lobe pulmonary nodule is grossly stable though difficult to evaluate due to new surrounding opacity which is presumably related to XRT. |
Generate impression based on findings. | Reason: eval lung nodule History: f/u LUNGS AND PLEURA: Left lower lobe nodular opacity with surrounding groundglass (image 62 series 6) is more solid in appearance compared to the exam dated 3/5/12. However, is not significantly changed compared to the most recent exam dated 4/30/13Minimal scarring/discoid atelectasis in the lingula unchanged.No new suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion. Moderate coronary artery calcification.CHEST WALL: Diffuse degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Left basilar nodular opacity with surrounding groundglass is unchanged compared to the most recent exam dated 4/30/13. However, when comparison is made to the exam dated 3/5/12 the solid component has increased. This does raise the concern for an indolent neoplasm. Continued follow-up examination in 6 months is recommended.2.There is no evidence of metastatic disease. |
Generate impression based on findings. | 75-year-old male patient with increased left upper abdominal quadrant. CHEST:LUNGS AND PLEURA: Stable emphysematous changes in the apices bilaterally. Bilateral dependent atelectasis. Stable calcified granulomas. Stable bilateral micronodules.MEDIASTINUM AND HILA: Stable small mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right intrapolar region nonobstructive renal calculus.RETROPERITONEUM, LYMPH NODES: Stable mildly enlarged retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent or atrophic uterus.BLADDER: No significant abnormality noted.LYMPH NODES: Stable moderately large pelvic lymph nodes bilaterally.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable CT scan of the chest, abdomen and pelvis without acute pathology. |
Generate impression based on findings. | Female, 50 years old, lumbago. Alignment is anatomic. There is degenerative endplate irregularity at the L4-5 disk space which results in mild loss of vertebral body height. Otherwise, the vertebral bodies are morphologically normal. No fractures are seen.Loss of disk height with extensive endplate irregularity and sclerosis is seen at L4-5. This was present on the prior MRI but may be mildly progressed. A diffusely bulging disk is seen at this level which, along with ligamentum flavum thickening, results in at least a moderate spinal canal stenosis, not significantly changed from prior. There is evidence of both bony and soft tissue encroachment upon the neural foramina, also similar to prior.Within the limitations of CT, no significant disk pathology is seen at other levels. At most, there is mild disk bulging at L3-4. Facet hypertrophy is present at all levels becoming more conspicuous at lower levels.Spinal canal contents are not adequately assessed on CT. | Advanced degenerative disk disease at L4-5 with disk bulging and ligamentum flavum hypertrophy, both of which contribute to a moderate spinal canal stenosis. Accounting for differences in technique, the degree of canal stenosis appears similar to that seen on the prior MRI. |
Generate impression based on findings. | 34-year-old male patient with abdominal pain. Evaluate for small bowel abnormality. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal-appearing stomach and small bowel. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Mild anterior L2 vertebral body height loss, stable compared to prior examination.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis. There is mild thickening and enhancement of short segment of the distal sigmoid colon. No significant pericolonic fat stranding.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mild thickening of distal sigmoid colon, consistent with residual inflammation.2.Colonic diverticulosis without evidence of diverticulitis. |
Generate impression based on findings. | 61 year old male. Reason: Evaluate for thrombus in or around LVAD / kink in graft. History: S/P L MCA embolic stroke Cardiac Morphology:Left Ventricle:Left ventricular enlargement and wall thickening with LVAD cannula at the apex. The left ventricle has an LVAD input cannula at the apex that is in close apposition to the ventricular free wall, partially obstructing the input channel. For reference, see coronal image 57. The LVAD output cannula has eccentric thrombus along its length. For reference, see coronal image 72. The LVAD output cannula has internal diameter of approximately 2.4 cm and the thrombus measures between 3 and 5.5 mm in thickness along most of its length, especially in the segment surrounded by a wire mesh. Right Ventricle:The right ventricle is at the upper limit of normal in volume, but otherwise normal in shape and wall thickness. Transvenous pacemaker leads in the RV apex. Left Atrium: The left atrial volume minus the pulmonary veins is within normal limits. There are four distinct pulmonary veins which drain normally into the left atrium. No thrombus in the LA or appendage.Right Atrium: The right atrial volume is within normal limits. The right atrium is structurally normal. Cardiac Veins: The coronary sinus is normal.Cardiac Valves: There are no aortic calcifications. There is no mitral annular calcification.Great Vessels: Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 28 mm Ascending: 27 mm Sinotubular Junction: 24 mm Descending: 23 mmThe junction of the LVAD output cannula and ascending aorta is 9 mm in diameter at image 128 of series 8. Pulmonary Artery: Main PA: 31 mmRight PA: 19 mmLeft PA: 21 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary Artery Anatomy:This examination was primarily protocoled for evaluation of the LVAD and not detailed examination of the coronary arteries. LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. LAD: The LAD gives rise to the diagonal and septal branches. There is multifocal calcification in the proximal LAD.LCx: The left circumflex artery gives rise to the obtuse marginal branches. RCA: The RCA arises normally from the right sinus of valsalva. It is the dominant coronary artery giving rise to the posterior descending artery and a posterolateral branch. EXTRACARDIAC CHEST | 1. LVAD input cannula is closely apposed and partially obstructed by ventricular free wall.2. LVAD output cannula has diffuse eccentric thrombus along its length.3. LAD multifocal coronary calcification. The results were discussed with the clinical service at the time of the examination. |
Generate impression based on findings. | 67 year old patient with history of cancer at base of tongue. Please re-evaluate and compare to previous scans. CT head: The 2.9 x 1.6 cm partially calcified ovoid lesion at the anterior aspect of the right middle cranial fossa is unchanged and most likely represents a meningioma. There is no intracranial mass, fluid collection, hemorrhage, hydrocephalus or focus of pathologic enhancement. The midline is intact. Bones, paranasal sinuses and mastoid air cells are unremarkable. Orbits are unremarkable.CT neck: At the left base of the tongue, there is asymmetry in the pattern of volume loss and enhancement. This is unchanged in configuration since the prior exam and there is no CT evidence of residual or recurrent tumor.There is intravertebral disk height loss at C5-6. There are no aggressive appearing bony lesions demonstrated. Previously described cervical adenopathy is not demonstrated on today's exam. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. There are calcifications in the left internal carotid artery. There is intervertebral disk height loss at C5-6. There are no aggressive appearing bony lesion is demonstrated. | Stable post-treatment changes including asymmetry the base the tongue without mass or enhancement pattern suggesting residual/recurrent tumor. |
Generate impression based on findings. | Female, 77 years old, unstable gait. No CT evidence of acute territorial ischemia is demonstrated. No intracranial hemorrhage is seen.The lateral and third ventricles are prominent in relation to the sulci. No periventricular hypodensity is seen. Otherwise, no abnormal extra-axial fluid collections are detected. There is no evidence of mass effect.The bones of the calvarium are intact. The paranasal sinuses and mastoid air cells are clear. | 1. No CT evidence of acute territorial ischemia or acute intracranial hemorrhage.2. Prominence of the supratentorial ventricles, out of proportion to the sulci, could be normal variation or reflective of an unusual pattern of central atrophy. However, given the clinical history, the possibility of normal pressure hydrocephalus should also be considered. |
Generate impression based on findings. | Flank pain, blood in urine Limited study due to lack of IV contrast.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: Punctate stone in the lower pole of the right kidney 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: 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 | Right punctate nephrolithiasis without evidence of hydronephrosis. |
Generate impression based on findings. | 55-year-old female patient with metastatic large cell neuroendocrine lung cancer, status post chemotherapy. Please compare with prior examination to evaluate disease status. CHEST:LUNGS AND PLEURA: Bilateral prominently upper lobe moderate centrilobular emphysematous changes, stable. Scattered mild atelectasis. Pleural based micronodule in the posterior left upper lobe measures 3 mm (series 13 image 107) and is new since prior examination. Micronodule and right lower lung is stable compared to prior examination (series 13 image 193).MEDIASTINUM AND HILA: Reference precarinal lymph node measures 2.0 x 1.3 cm (series 12 image 39), previously 2.0 x 1.4 cm. Reference right hilar lymph node measures 2.1 x 1.4 cm (series 12 image 45), previously 1.9 x 1.5 cm.CHEST WALL: Stable supraclavicular lymph nodes. Numerous hypoattenuating lesions in the thyroid bilaterally.ABDOMEN:LIVER, BILIARY TRACT: Numerous hepatic metastases, unchanged in appearance. Reference lesion in the right hepatic lobe measures 4.8 x 3.3 cm (series 12 image 118), previously 4.1 x 3.3 cm.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic duct prominence, stable. Stable thickening of the pancreatic tail. No focal pancreatic lesions.ADRENAL GLANDS: Right adrenal gland nodule measures 2.2 x 1.8 cm (series 11 image 29), previously 2.1 x 1.8 cm on 6/19/2013.KIDNEYS, URETERS: Left renal sinus cyst, stable. Otherwise, no significant abnormalities.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant change in diffuse sclerotic changes in the axial and appendicular skeleton.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant change in diffuse sclerotic changes in the axial and appendicular skeleton.OTHER: No significant abnormality noted. | 1.Unchanged chest, abdominal, pelvic and bone metastatic disease.2.New posterior left lower lung micronodule is nonspecific. |
Generate impression based on findings. | 66-year-old female with recent history of splenic artery embolism. Presenting with diffuse abdominal pain ABDOMEN:LUNG BASES: Dependent atelectasis and trace pleural effusion on the right side.LIVER, BILIARY TRACT: Postsurgical changes secondary to liver transplant.SPLEEN: Interval embolization of patient's known splenic artery aneurysm. Metallic artifacts future embolization coils in the splenic hilum limits optimal evaluation of the spleen.There is heterogeneous enhancement/non-enhancement of more dense 50% of the spleen suggestive of infarct.PANCREAS: Multiple cystic pancreatic lesions in the head and body of the pancreas are stable.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Borderline enlarged retroperitoneal lymph nodes, stable.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: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval embolization of patient's known splenic artery aneurysm with interval development of infarct or more than 50% of the spleen. |
Generate impression based on findings. | Evaluate for neoplastic process on a patient with paraneoplastic syndrome CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: There are some supraclavicular and superior mediastinal enlarged lymph nodes. Index superior mediastinal node measures 1.5 by 1.1 centimeter in image number 10, series number 3.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Cholelithiasis.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: Borderline enlarged retroperitoneal 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: Pelvic adenopathy. Index left inguinal node measures 1.8 x 1.2 cm image number 173, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Supraclavicular, retroperitoneal and pelvic borderline enlarged enlarged lymph nodes. Their etiology and significance is unknown.Fatty infiltration of the liver.Cholelithiasis. |
Generate impression based on findings. | 64-year-old female with change in neurological examination, generalized muscle weakness, evaluate for edema Redemonstration of right MCA distribution ischemia with a significant interval increase in associated cytotoxic edema and increasing leftward midline shift now measuring approximately 12 mm, previously measured 4 mm. Additionally, there has been an interval increase in patchy hypoattenuation along the posterior aspect of aforementioned right MCA distribution territorial ischemia. Note is made of a right mildly hyperdense MCA compatible with hyperattenuating clot.Significant interval increase in previously identified left frontal lobe subcortical/cortical hypoattenuation and mass effect compatible with interval development/progression of a left frontal cortical stroke.The right lateral ventricle is now completely effaced and the right temporal horn is also effaced. The basal cisterns are now effaced. The fourth ventricle remains patent. No dilatation of the left lateral ventricle on the current study.No intracranial hemorrhage is identified. 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. Left intraocular silicone oil, unchanged. | 1. Interval increase in right-sided cytotoxic edema with significant interval increase in mass effect and leftward midline shift which now measures approximately 12 mm. Slight interval posterior progression of large territory infarct.2. Interval development/progression of a primarily left frontal lobe cortical stroke.3. Interval development of effacement of the basal cisterns without transtentorial herniation.These findings were discussed with Dr. Wheeler at the time of interpretation 4:30 p.m. on 10/28/2013 |
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