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Generate impression based on findings. | Reason: apical pulmonary nodule on CXR History: apical pulmonary nodule on CXR LUNGS AND PLEURA: Multiple calcified and noncalcified micronodules, none suspicious for tumor.Apical and left basilar scarring including left basilar bronchiectasis is present. MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphaden... | 1. Prior granulomatous disease accounting for previously described pulmonary nodules.2. Large hiatal hernia possibly paraesophageal.3. Cholelithiasis without cholecystitis.4. Coronary artery calcifications. |
Generate impression based on findings. | 41 yo male with DM, HTN and acute onset right sided weakness/ numbness, pls evaluate for mass/ hemorrhage/ ischemia 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... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic CVA |
Generate impression based on findings. | Reason: metastatic head and neck ca, on therapy, eval for dz, compare to previous with measuremetns History: as above CHEST:LUNGS AND PLEURA: Stable moderate centrilobular emphysema.Scattered calcified micronodules. Noncalcified 5-mm nodule the right middle lobe unchanged and may reflect an intrapulmonary lymph node. N... | 1. Stable right middle lobe pulmonary nodule. No new suspicious pulmonary nodule or mass.2. The superior esophagus is more distended with the previously referenced posterior nodule measuring approximately 2 mm.3. Near complete resolution of the lower lobe groundglass opacities which may be related to aspiration.4. Skel... |
Generate impression based on findings. | 82-year-old female patient with history of bladder cancer. CT urogram for staging. ABDOMEN:LUNG BASES: Emphysematous changes bilaterally. Right lower lobe spiculated nodule measures 1.0 x 0.9 cm (series 5 image 18).LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS:... | 1.Bladder mass in the anterior wall involving the urachal remnant. Mass may be arising from the bladder versus urachal remnant adenocarcinoma.2.Uncommon abnormalities within the distal pancreas. Complex cystic mass may represent a cystadenoma versus cystadenocarcinoma. Pancreatic duct is dilated distal to this lesion. ... |
Generate impression based on findings. | Male, 32 years old, chronic sinusitis. The right frontal sinus is hypoplastic. The left frontal sinus and frontoethmoidal recesses are completely opacified with soft tissue. The ethmoid air cells are nearly completely opacified. The left sphenoid sinuses completely opacified and the right sphenoid sinus is partially op... | Pansinus mucosal inflammatory disease. |
Generate impression based on findings. | Male 77 years old; Reason: eval for hemothorax History: post op. LUNGS AND PLEURA: Interval resection of the lobulated left upper lobe nodule seen previously. There has been interval development of large mixed high and low fluid density accumulation with resultant collapse of the lung. A left chest tube is visualized w... | 1.Postsurgical changes from resection of the left upper lobe nodule with interval development of a large left-sided pneumohemothorax and collapse of the lung. 2.Interval placement of a left-sided chest tube.3.Focal air space opacity in the right upper lobe, which could represent a focus of infection. |
Generate impression based on findings. | Reason: h/o clear cell cancer of palate; eval for mets History: none LUNGS AND PLEURA: Scattered nonspecific micronodules unchanged. No suspicious pulmonary nodules or masses.Moderate upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal with... | No evidence of metastatic disease. No significant interval change. |
Generate impression based on findings. | 91-year-old male with history of prostate cancer on therapy CHEST:LUNGS AND PLEURA: Subpleural nodularity and calcification is unchanged.MEDIASTINUM AND HILA: Coronary arterial calcifications. No mediastinal lymphadenopathyCHEST WALL: Extensive sclerotic osseous metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: Unchange... | Extensive osseous metastatic disease, without significant interval change from the prior study. |
Generate impression based on findings. | Reason: H/o of cancer s/p RT. Please eval for recurrence History: None CHEST:LUNGS AND PLEURA: Right paramediastinal opacity with traction bronchiectasis, consistent with radiation fibrosis.Upper zone paraseptal emphysema.No suspicious nodules.MEDIASTINUM AND HILA: Reference right hilar lymph node measuring 8 mm in sho... | Stable disease. |
Generate impression based on findings. | Female 81 years old; Reason: Lung Ca, s/p radiation only. Followup of lung lesions. Also followup of aortic aneurysm. History: none. CHEST:LUNGS AND PLEURA: Severe centrilobular emphysema is visualized. Masslike consolidation posterior to the right bronchus intermedius within the right lower lobe is not significantly c... | 1.No significant change in the masslike consolidation posterior to the right bronchus intermedius within the right lower lobe.2.Stable size of the abdominal aortic aneurysms. |
Generate impression based on findings. | Status post resection of a clear cell carcinoma at the junction of the hard and soft palate. There are postoperative findings related to clear cell carcinoma resection and flap reconstruction at the junction of the hard and soft palate. There is relative deficiency of soft tissue along the left hard palate and a defect... | 1. Postoperative findings related to clear cell carcinoma resection and flap reconstruction at the junction of the hard and soft palate with soft tissue dehiscence and punctate defects in the hard palate, but no definite evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. 2. No evidence o... |
Generate impression based on findings. | 52 year-old female with metastatic melanoma CHEST:LUNGS AND PLEURA: No nodules or masses.MEDIASTINUM AND HILA: Bilateral hypodense thyroid lesions are nonspecific. No mediastinal or hilar adenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No si... | No evidence of metastatic disease. Nonspecific hypodense thyroid lesions. |
Generate impression based on findings. | Malignant neoplasm of ethmoidal sinus. Pt is a 52 y/o female with met melanoma, s/p 4 cycles of ipilimumab, CT neck:The patient is status post partial removal of a right nasal cavity mass. There are now postsurgical changes in the paranasal sinuses and nasal cavity related to tumor resection, with resection of the nasa... | 1.Since the prior examination there has been a no suggestion for recurrence of the patient's sinonasal neoplasm.2.No evidence for brain metastases. |
Generate impression based on findings. | Female 45 years old; Reason: rule out PE History: hypoxia, atrial fibrillation. PULMONARY ARTERIES: No evidence of pulmonary emboli.LUNGS AND PLEURA: Redemonstrated is upper lobe predominant architectural distortion honeycombing and traction bronchiectasis as well as scattered foci of peripheral consolidation. These fi... | 1.No evidence of pulmonary emboli.2.Findings again compatible with known diagnosis of atypical UIP with slight increase in the size of several of the of the ground glass nodular opacities, which may represent progression and/or acute exacerbation. |
Generate impression based on findings. | Reason: f/u interval change in pulmonary nodules, lymphadenopathy; h/o probably sarcoidosis History: SOB, systemic malaise, obstructive lung disease LUNGS AND PLEURA: Multiple bilateral well defined pulmonary nodules ranging up to 11 mm in diameter, not significantly changed since 12/27/2009.Reticular interstitial opac... | 1. Multiple stable pulmonary nodules, consistent with a benign etiology such as sarcoidosis.2. Interval decrease in mediastinal and hilar lymphadenopathy but increase in interstitial lung disease, mainly at the lung bases, with evidence of fibrosis. Given the other findings this is most consistent with sarcoidosis, but... |
Generate impression based on findings. | Reason: pulmonary embolism History: shortness of breath PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism. Pulmonary artery is markedly dilated and measures 6.3 cm in diameter, previously measuring 6.7 cm. LUNGS AND PLEURA: New peripherally located nodule in the left lower lobe sup... | 1.No evidence of pulmonary embolism.2.New left lower lobe nodule. Follow-up CT scan in 3 months recommended.3.Marked dilation of the main pulmonary artery with slight interval decrease in caliber. Marked dilation of the right ventricle. |
Generate impression based on findings. | Refractory metastatic papillary thyroid cancer with lung metastases treated with cediranib. Head: There is no mass, cerebral edema, or abnormal intracranial enhancement. The ventricles, sulci, and cisterns are stable in size and configuration. The orbits are unremarkable. The mastoid air cells are clear. There is a lef... | 1. No definite evidence of locoregional tumor recurrence in the thyroidectomy bed.2. Unchanged lower cervical and partially imaged upper mediastinal lymphadenopathy. 3. No evidence of intracranial metastasis. |
Generate impression based on findings. | Reason: s/p bilateral lung transplant History: SOB PULMONARY ARTERIES: No evidence of PE to the subsegmental level.LUNGS AND PLEURA: Previously described soft tissue density in the right apex associated with surgical staples has reduced in size, approximately 8 x 16 mm (series 9 image 28), as compared to 16 x 16 mm.Wit... | 1. No pulmonary embolus to the subsegmental level.2. Within the medial segment of the right middle lobe and anterior aspects of the bilateral upper lobes, there is mild bronchial wall thickening, groundglass and several foci of mucoid impaction favoring inflammatory etiology. |
Generate impression based on findings. | Recurrent sinus infections, h/o nasal polyps. There are postoperative findings related to bilateral uncinectomy and internal ethmoidectomy. There is diffuse sclerosis and thickening of the paranasal sinus walls. There is moderate mucosal thickening within the left maxillary sinus. There is a small air-fluid level withi... | Postoperative findings related to bilateral uncinectomy and internal ethmoidectomy with pansinus opacification compatible with chronic sinusitis and a small air-fluid level in the right maxillary sinus that may represent superimposed acute sinusitis. Mild medial buckling of the lamina papyracea with apparent punctate d... |
Generate impression based on findings. | 12-year-old male with history of right rib lesions, status post biopsy concerning for LCH. LUNGS AND PLEURA: A left lower lobe lung mass is again noted which is increased in size since the prior examination, now measuring 2.2 x 1.8 cm (series 4, image 62), this lesion abuts the medial pleural surface and now exhibits i... | New lytic lesion in the anterolateral right seventh rib corresponding to the area of the patient's pain. Increasing size of left lower lobe mass which now demonstrates internal cavitation and is most compatible with a cavitary infection. Increased callus formation of previously identified expansile lytic lesion in the ... |
Generate impression based on findings. | 56-year-old male with history of abdominal pain and history of metastatic colon cancer CHEST:LUNGS AND PLEURA: Bilateral scattered micronodules. Largest measures 8 mm on image number 42 causes number 5 in the right middle lobe.This nodule is new from outside chest CT dated 5/24/2013MEDIASTINUM AND HILA: No significant ... | New subcentimeter lung nodule in the right middle lobe suspicious for metastatic disease.Interval development of left para-aortic adenopathy and left retroperitoneal mass causing left-sided hydronephrosis. |
Generate impression based on findings. | 73-year-old male with metastatic renal cell carcinoma, right arm weakness, known C7 metastasis Exam is limited in evaluation of solid organ pathology and vasculature due to the lack of IV contrast.CHEST:LUNGS AND PLEURA: Reference right upper lobe nodule measures 6 mm (image 34, series 4) and previously measured 10 mm ... | Limited study due to lack of IV contrast. Mild interval decrease in size of pulmonary nodules. Unchanged lytic metastasis to the left ilium. |
Generate impression based on findings. | Female 43 years old; Reason: 43yo female with stage IIC ovarian CA s/p ovarian CA. assess disease s/p surgery with colostomy and chemotherapy. assess disease status History: groin pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abn... | 1.No evidence of solid metastatic disease or recurrence detected. Loculated peritoneal abdominal collection in left abdomen. |
Generate impression based on findings. | 49-year-old female with history of HIV and rectal cancer now with partial small bowel obstruction -- please evaluate for masses. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Prior noted segment 2 left lobe liver lesion has increased in size (series 3, image 32) now measuring 1.7 x 0.9 cm co... | 1. Marked fluid-filled distention of small bowel loops and marked increase ascites and probable mesenteric tumor deposits causing small bowel obstruction. 2. Large necrotic rectal mass with probable more proximal extension of tumor along sigmoid colon. 3. Increased size of liver metastasis. |
Generate impression based on findings. | 29 year-old male with bilateral nasal congestion and recurrent sinusitis, and nasal polyp on the left side. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is a retention cyst in the right maxillary sinus. The frontal sinuses, frontal-ethmoid recess... | Unremarkable CT paranasal sinus except for a right maxillary sinus retention cyst. |
Generate impression based on findings. | 63-year-old female patient with appendiceal cancer, off chemotherapy since March 2013. Evaluate for disease status. CHEST:LUNGS AND PLEURA: Pulmonary nodule in the left lower lobe adjacent to the left heart border is stable compared to prior examination.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, stable.CHEST ... | Stable, extensive pseudomyxoma peritonei and metastatic disease. |
Generate impression based on findings. | Pancreas cancer, restaging CHEST:LUNGS AND PLEURA: Again noted numerous bilateral pulmonary nodules consistent with metastatic disease. Index left upper lobe nodule measures 7 mm, slightly increased in size compared to previous study. Other pulmonary nodules are also slightly increased in size. Bilateral small pleural ... | Interval progression of disease with interval increase in the size of the lung nodules, pancreatic mass, retroperitoneal adenopathy. New sclerotic lesion involving the right iliac bone suspicious for metastatic disease. |
Generate impression based on findings. | Colon cancer restaging CHEST:LUNGS AND PLEURA: Scattered micronodules, unchanged.MEDIASTINUM AND HILA: Hiatal hernia, unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple hypodense lesions in the liver, grossly unchanged. The lesion near the dome in the right lobe measures 1.8 x... | No significant change from previous study. |
Generate impression based on findings. | Reason: Lung Cancer: restaging History: none CHEST:LUNGS AND PLEURA: Previously referenced pleural-based mass in the posterior basal segment left lower lobe favors the appearance of rounded atelectasis; however, increased the FDG activity on PET is compatible with tumor. It has slightly reduced in size, measuring 17 x ... | 1. Slightly decreased size of left lower lobe mass.2. Soft tissue nodularity at the left posterior costophrenic angle has slightly increased, which is contiguous with the main lower lobe mass with a small strand-like soft tissue component. Continued short interval follow-up is recommended. |
Generate impression based on findings. | Reason: metastatic thyroid ca, on therapy,eval for dz progression with measurements History: as above CHEST:LUNGS AND PLEURA: Smoothly marginated the right lower lobe nodule, now 22 x 18 mm, not significantly changed when using comparable measurement parameters.Multiple smaller nodules, also unchanged.Diffuse emphysema... | Stable disease. |
Generate impression based on findings. | 62 year old woman with cardiomyopathy treated with LVAD and percutaneous aortic valve closure. She is suspected of having thrombus in LVAD inflow canula.CPT: 75572 Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. Right atrium, vena cava... | The inflow canula to the left ventricular assist device is noted in the LV apex. Image interpretation is limited by a significant amount of beam hardening artifact; however, there appears to be a hypodensity near the orifice of the inflow canula which may represent a thrombus. The abnormality is better visualized on th... |
Generate impression based on findings. | Clinical question: Altered mental status. Signs and symptoms clearly AMS. Unenhanced head CT:No detectable acute intracranial process. CT is insensitive for detection of acute nonhemorrhagic ischemic strokes.Mild periventricular and subcortical low attenuation white matter likely representing age indeterminate small ve... | Mild age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question; rule out out CVA. Signs and symptoms: vertigo for 4 days. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for detection of acute nonhemorrhagic ischemic strokes.Encephalomalacia of the left anterior frontal consistent with a chronic left MCA territory ischemic ... | 1.No acute intracranial process.2.Chronic left frontal cortical stroke and unremarkable nonenhanced head CT otherwise. |
Generate impression based on findings. | Clinical question : Altered mental status, evaluate for bleed etc. signs and symptoms: As above. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for detection of acute non-hemorrhagic ischemic strokes.Prominence of cortical sulci, ventricular system and cerebellar -- vermian foli... | 1.No acute intracranial process.2.Prominence of cortical sulci, ventricular system and cerebellar -- vermian folia for patient stated age. Correlate with history and risk factors. |
Generate impression based on findings. | Clinical question: Evaluate intracranial mass. History of HIV. Signs and symptoms: Left-sided facial decreased sensation and occipital decreased sensation. Nonenhanced head CT:No evidence of acute intracranial process CT Homer is insensitive for detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral c... | No acute intracranial process. Chronic pansinusitis. |
Generate impression based on findings. | Clinical question: Leukopenia status post liver transplant. Signs and symptoms: As above. Nonenhanced head CT:No detectable acute intracranial process.Unremarkable cerebral cortex, cortical chest heart, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of th... | Unremarkable head CT. |
Generate impression based on findings. | Clinical question: Assess for intracranial hemorrhage, masses or signs of increased intracranial pressure. Signs and symptoms: Severe headache, dizziness worse with coughing. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic stro... | 1.No acute intracranial process. CT is insensitive for early dictation of acute nonhemorrhagic ischemic strokes.2.Nonspecific periventricular and subcortical low attenuation white matter as detailed. |
Generate impression based on findings. | 46 year old female patient with no past medical history presents with mid abdominal pain, nausea and vomiting x 2 weeks. ABDOMEN:LUNG BASES: Trace left-sided pleural effusion with associated atelectasis. 5-mm well-circumscribed left lower lobe nodule (series 4 image 11).LIVER, BILIARY TRACT: No significant abnormality ... | 1.Submucosal edema and mucosal enhancement of the stomach, consistent with gastritis.2.Uterus with two lesions, which likely represent uterine fibroids. Pelvic sonography is suggested.3.5-mm left lower lung nodule. |
Generate impression based on findings. | Female, 26 days old, with apparent life threatening event, abnormal movements and breathing, possible seizure. The cerebral and cerebellar hemispheres and brainstem are normal for age in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass... | No acute intracranial abnormality or other specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Female 60 years old; Reason: Re-evaluate disease status prior to new systemic therapy for newly diagnosed metastatic disease; compare to previous scan and provide bi-dimensional measurements History: Stage IV metastatic melanoma CHEST:LUNGS AND PLEURA: Numerous lung nodules are again seen throughout both lungs ranging ... | 1. Stable numerous bilateral pulmonary, parenchymal masses, most consistent with metastatic disease. No new lesions. 2. Increase in size of the large right adrenal mass, compatible with metastatic disease. |
Generate impression based on findings. | 82 year old male with history of chest pain evaluate for aneurysm or dissection CHEST:LUNGS AND PLEURA: Micronodules some of which are calcified indicating chronic granulomatous disease.MEDIASTINUM AND HILA: The ascending aorta is ectatic and measures 4.1 cm. Moderate coronary arterial calcification. Minimal thinning o... | 1. Ascending thoracic aortic ectasia without evidence of aneurysm or dissection.2. Moderate atherosclerotic calcification and plaque of the aorta and coronary arteries with associated mild narrowing of the ostia of the renal arteries.3. Colonic diverticulosis without evidence of diverticulitis. |
Generate impression based on findings. | Clinical question: Rule out stroke. Signs and symptoms: Acute onset of slurred and confusion and left face droop at 8:30. Nonenhanced head CT:There is evidence of interval extensive hemorrhage in the right posterior temporal -- occipital subacute ischemic stroke since prior study. Hematoma at the site measures approxim... | 1.Internal large acute hemorrhage in the right posterior temporal -- occipital ischemic stroke measuring at least 65 x 39-mm in size. There is resultant subtle mass effect on the right lateral ventricle all over without midline shift.2.There is evidence of subarachnoid hemorrhage surrounding the parenchymal hematoma in... |
Generate impression based on findings. | Male, 11 years old, status post motor vehicle accident. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are... | Unremarkable examination of the head. |
Generate impression based on findings. | 59-year-old male with leukopenia status post liver transplant Evaluation of solid organ pathology and vasculature is limited due to lack of IV contrast.CHEST:LUNGS AND PLEURA: Increased right pleural effusion involving 50% of the hemithorax with associated atelectasis of the right lower lobe.MEDIASTINUM AND HILA: No me... | 1. Large right pleural effusion with associated atelectasis of the entire right lower lobe.2. No intra-abdominal fluid collection/ascites.3. Resolution of previously identified bowel obstruction. |
Generate impression based on findings. | 71-year-old male patient presents with abdominal pain, nausea and decreased oral intake. Concern for complete/partial bowel obstruction. ABDOMEN:LUNG BASES: Scattered micronodules, some of which are calcified.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No si... | 1.Small bowel perforation of unclear etiology with extravasation of oral contrast into adjacent collection. Ischemia cannot be excluded. No evidence of bowel obstruction.2.Clonic diverticulosis without CT evidence of diverticulitis. |
Generate impression based on findings. | Clinical question: Intracranial hemorrhage. Signs and symptoms: Intracranial hemorrhage. Unenhanced head CT:New since prior exam is evidence of dissection of right posterior temporal -- occipital hematoma into the right lateral ventricle and with acute blood now layering in the dependent portion of body and trigone as ... | 1.No convincing evidence of any significant new or increased hemorrhage since prior exam.2.Interval dissection of right hemispheric hematoma and with resultant acute blood in the right lateral ventricle.3.No significant appreciable interval change in the extent of bilateral subarachnoid hemorrhage.4.No change in the si... |
Generate impression based on findings. | 11-year-old male status post high-speed motor vehicle collision presents with lumbar spine tenderness. ABDOMEN:LUNG BASES: No focal air space opacities or pleural effusions.LIVER, BILIARY TRACT: The liver is normal in size and attenuation. No focal hepatic lesions are identified. There is no intrahepatic or extrahepati... | Normal examination. |
Generate impression based on findings. | Female 41 years old; Reason: r/o pancreatic abscess History: abdominal pain, nausea, vomiting ABDOMEN:LUNGS BASES: Heart size is enlarged. Minimal basilar atelectatic changes. No basilar pleural effusions.LIVER, BILIARY TRACT: Liver is enlarged and hypoattenuating suggestive of fatty infiltration. No suspicious hepatic... | 1.No bowel obstruction.2.Hepatomegaly.3.Atrophic native kidneys. |
Generate impression based on findings. | 38 year-old female with fever, leukocytosis, evaluate for abscess. ABDOMEN:LUNG BASES: Bilateral extensive groundglass air space opacities, suggesting edema/ARDS or infection. Paraseptal emphysema.LIVER, BILIARY TRACT: Vicarious excretion of contrast into the gallbladder.SPLEEN: No significant abnormality notedPANCREAS... | 1. Right lower pole renal hematoma. 2. Increased abdominal and pelvic ascites and anasarca.3. Extensive pulmonary opacities better evaluated on prior chest CT indicating edema/ARDS or infection.4. Diffuse ileus. |
Generate impression based on findings. | Closed fracture of nasal bones. This exam confirms the presence of a fracture of the nasal bones which is minimally depressed (3 mm). The septum is normal and there is no blow out fracture. There is very lucency around the third (unerupted) these molars bilaterally as well as the left first mandibular molar. This could... | Displaced/mildly comminuted nasal bone fractureperiapical lucencies associated with the left first mandibular molar and unerupted bilateral third molars which could represent periodontal disease, periapical cysts or abscesses. |
Generate impression based on findings. | 32-year-old male with suspected urosepsis, evaluate for pyelonephritis or abscess. 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 notedK... | 1. No evidence of pyelonephritis or abscess. Bladder wall thickening, which may be chronic/related to cystitis. 2. Right hip effusion3. Decubitus ulcer.4. Foley balloon inflated in the mid urethra. |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage. Signs and symptoms: Headache. Nonenhanced head CT:Examination demonstrates expected post operative changes of a wide left suboccipital craniotomy/neck to me and good placement of prostheses. The anterior leading edge of the craniotomy extends into the left mastoid air cells a... | Expected postoperative changes of a left suboccipital craniotomy/craniectomy as detailed. No prior exams for comparison. |
Generate impression based on findings. | Female 41 years old; Reason: assess for fluid collection explaining persistent bacteremia History: fevers, left hip pain ABDOMEN:LUNGS BASES: Left basilar atelectasis and subsegmental consolidation.LIVER, BILIARY TRACT: Liver is mildly enlarged. Gallbladder is contracted. Hepatic vasculature are patent. No suspicious h... | 1.Mild heterogeneous enhancement of the kidneys. Correlate for urinary tract infection or pyelonephritis.2.No drainable fluid collections in the abdomen or pelvis.3.No bowel obstruction. |
Generate impression based on findings. | 53-year-old female patient presents with abdominal pain, constipation bloating. Evaluate for mass or obstruction. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: Homogenously hypoattenuating liver parenchyma, consistent with fatty infiltration.SPLEEN: No significant abnormality noted.PAN... | 1.Mild, uncomplicated distal sigmoid diverticulitis. Consider colonoscopy after acute phase of illness.2.Fatty liver. |
Generate impression based on findings. | Clinical question: Chronic sinusitis, history of ESS and nasal polyp. Signs and symptoms: Nasal obstruction, rhinorrhea, recurrent sinusitis. Medtronic fusion sinus CT:Frontal sinuses.Complete opacification of bilateral frontal sinuses unchanged since prior exam.Ethmoid sinuses.Complete opacification of bilateral ethmo... | Extensive pansinusitis as detailed above. |
Generate impression based on findings. | 58 year old female with phantom pain, which does not improve with medication. Complains of swelling of the left thigh. Dopplers are negative for DVT. Rule out thigh pathology. The patient has undergone amputation through the knee. Note is made of an intra-medullary rod and screw device affixing a healed fracture of the... | Postoperative changes, as described above, with fluid collections adjacent to the femur and associated underlying erosion, compatible with abscess formation and osteomyelitis. These findings were relayed to Dr. Hong at the time of dictation. |
Generate impression based on findings. | Female 70 years old; Reason: source of atypical chest pain, repeated fever, persistent upper abdominal pain and nausea; history of hiatal hernia repair, GERD, labile hypertension. CHEST:LUNGS AND PLEURA: Right lung basecalcified granuloma.The pleural spaces are clear. Mild bronchial wall thickening and volume the right... | 1.Status post cholecystectomy.2.No bowel obstruction.3.Suboptimal evaluated soft tissue mass at the level of the fundus may represent changes from hiatal hernia surgery ; Follow up is suggested.4.Nodular changes of the gastric folds. |
Generate impression based on findings. | 23 year-old male with ALL receiving chemo, neutropenia, low platelets and headaches. CT HEADThe ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The oss... | 1. No acute intracranial abnormality. 2. No evidence of acute sinusitis. 3. Rightward nasal septal deviation with a bony spur. |
Generate impression based on findings. | Altered mental status. There is hyperattenuation symmetrically distributed within the basal ganglia bilaterally most likely representing mineralization. There is no intracranial mass, hemorrhage, hydrocephalus or CT evidence of ischemia. The midline is intact. Paranasal sinuses and mastoid air cells are unremarkable. T... | Mild nonspecific left-sided proptosis without other visualized abnormality. CT is a suboptimally sensitive modality for assessing ischemia and if there is persistent concern, MR is recommended. |
Generate impression based on findings. | Male, 65 years old, intracerebral hemorrhage. Evaluate for source of bleeding. Non-angiographic findings:Right thalamic acute parenchymal hemorrhage is demonstrated measuring 1.8 x 1.4 cm with very mild surrounding edema. Hemorrhage has dissected into the ventricular system where it casts a large portion of the right f... | 1. Right thalamic parenchymal hemorrhage with intraventricular extension. Mild local mass effect is seen. No significant generalized mass effect or brain herniation is demonstrated. No evidence of significant ventricular dilatation is detected at this point.2. CTA of the neck and head demonstrates no significant vascul... |
Generate impression based on findings. | 50 year-old male with mitral valve regurgitation. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The para... | No acute intracranial abnormality. |
Generate impression based on findings. | 47-year-old female patient with abdominal pain. Evaluate for acute abdominal process. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Heterogeneously enhancing right hepatic lobe is consistent with a partially recanalized right portal vein thrombosis.SPLEEN: No significant abnormality noted.P... | 1.No acute intra-abdominal process.2.New cavernous transformation of the right portal vein.3.Right ovarian cyst is unchanged. Consider pelvic sonography.4.Stable left adrenal nodule. |
Generate impression based on findings. | Clinical question: Follow-up lead placement. Signs and symptoms: Lead placement. Nonenhanced head CT:Examination demonstrate interval placement of bilateral DBS leads. No detectable there is soft parenchymal edema or hemorrhage.The leads bilaterally entered the calvarium via bilateral hypodensity paramedian posterior f... | 1.Expected minimal postoperative pneumocephalus in the right frontal region.2.Bilateral DBS needle placement with the tips appear to project in bilateral cerebral peduncles. The appropriate placement of the leads should be determined by referring clinical physician.3.Stable exam otherwise since prior study. |
Generate impression based on findings. | 57 year-old male with hemorrhage and hemiparesis. Right basal ganglia/thalamic hematoma has decreased in density. The degree of surrounding parenchyma edema has not substantially changed.A small amount of blood at the level of the foramina of Monro and within the third and lateral ventricles has been less. Blood produc... | 1.Resolving right basal ganglia/thalamic, intraventricular, posterior interhemispheric fissure and right tentorium hemorrhage. .2.Mild interval increase of ventriculomegaly.3.No definite evidence of new hemorrhage. |
Generate impression based on findings. | Severe headache following MVA without loss of consciousness. No intracranial hemorrhage, mass, hydrocephalus or CT evidence of ischemia. The midline is intact. Ventricles and cisterns have normal size and morphology. The mandibular condyles are anteriorly subluxed bilaterally overlying the articular eminence which may ... | No abnormality demonstrated. |
Generate impression based on findings. | MVA. No loss of consciousness. Beam hardening artifact limits sensitivity within the inferior portion of the field of view. Within this limitation there is normal alignment. Vertebral body and intervertebral disk is maintained and there is no visualized fracture. The odontoid is intact. There is no prevertebral soft ti... | No sequela of trauma demonstrated. |
Generate impression based on findings. | Altered mental status. There is minimal ill-defined periventricular hypodensity and some mild prominence of the ventricular system which has been stable since the prior exam. No intracranial mass, hemorrhage or mass effect. There is no CT evidence of acute CVA, however MR is a more sensitive modality for assessment. Th... | Subtle patchy periventricular hypoattenuation and stable mild prominence of the ventricular system. CT is suboptimal in its ability to assess acute ischemia. If there is concern for CVA, MRI would be more sensitive. |
Generate impression based on findings. | Reason: r/o Pulmonary embolism History: shortness of breath PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Bibasilar scarring and dependent atelectasis not significantly changed from prior exam. MEDIASTINUM... | 1.No evidence of pulmonary embolism.2.No other acute cardiopulmonary abnormalities. |
Generate impression based on findings. | Male 60 years old; Reason: metastatic prostate cancer evaluation of disease as baseline for initiation of investigational therapy. History: metastatic prostate cancer CHEST:LUNGS AND PLEURA: 5-mm nodule in the superior segment left lower lobe along the fissure. Few other micronodules scattered frontal lungs.MEDIASTINUM... | 1.Exophytic enhancing mass in the mid pole left kidney concerning for RCC2.Extensive osseous metastasis. 3.Elia Martinez was notified of the findings at 9:32 am on 11/5/13 |
Generate impression based on findings. | 79 years old male with retromolar trigone squamous cell carcinoma status post surgery. Area of encephalomalacia involving the right cerebellar hemisphere is consistent with old ischemia. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Postoperative change is demonstrated within the l... | 1.Stable postoperative changes. No definite evidence of residual or recurrent disease is seen in the operative bed. No pathologic adenopathy by size criteria.2. Interval development of the right internal jugular vein thrombosis. |
Generate impression based on findings. | 74 year-old female with known abdominal aortic aneurysm presenting with left-sided abdominal pain. ANGIOGRAPHY:Revisualization of the patient's known type B aortic dissection with the dissection flap originating cranial to the superior most aspect of the exam. The flap extends to the level of the right renal artery; un... | 1. Partially visualized type B aortic dissection extending to the level of the right renal artery is not significantly changed compared to prior. Aneurysmal dilatation of the suprarenal abdominal aorta and the bilateral common iliac arteries is also similar to prior.2. Uncomplicated diverticulosis of the sigmoid colon.... |
Generate impression based on findings. | ICH. There has been interval mild progression in the amount of intraparenchymal blood products and edema in centered in the right temporo-occipital region with evolution of blood products including development of a fluid fluid level posteriorly (axial image 21 - 6.0 x 4.6 cm). There has been redistribution of intravent... | 1.Mild interval progression in the amount of intraparenchymal hemorrhage and edema with evolution of blood products including development of a fluid fluid level.2.Redistribution of intraventricular and subarachnoid hemorrhage.3.Stable mild ventriculomegaly. No herniation or midline shift. |
Generate impression based on findings. | 69-year-old male with metastatic RCC. CHEST:LUNGS AND PLEURA: Right perihilar mass with associated distal basilar atelectasis and consolidation has progressed from the prior study.MEDIASTINUM AND HILA: Necrotic subcarinal mass measures 8.5 x 3.8 cm and previously measured 8.1 x 4.2 cm (image 45 series 11).CHEST WALL: N... | 1. Interval progression of multifocal metastatic disease as detailed above.2. Right paramediastinal mass with associated basilar atelectasis/consolidation, correlate for postobstructive pneumonia. |
Generate impression based on findings. | 64 year-old male with left ear swelling and facial droop. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. ... | 1. No acute intracranial abnormality. 2. Soft tissue swelling of the left ear drum and membranous external auditory canal. |
Generate impression based on findings. | Male 52 years old; Reason: newly diagnosed parotid cancer, right upper quadrant pain with mass palpated on exam History: r/o lung mets CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Hypoattenuating 2.5 x 2.5 cm thyroid lesion in the right lobe, incompletely characterized .CHEST WALL: No s... | 1.No evident metastatic disease2.Thyroid nodule incompletely characterized by CT. |
Generate impression based on findings. | Male, 69 years old, history of renal cell carcinoma, screening scans per IRB 13-0696. An 8 x 8 mm round intrinsically hyperdense and enhancing nodule is present within the right frontal lobe compatible with a hemorrhagic metastasis. Moderate surrounding edema is observed.A second 10 x 9 mm enhancing focus is present wi... | Two metastatic lesions are demonstrated, one in the right frontal lobe and one in the left frontal lobe. |
Generate impression based on findings. | Male 46 years old; Reason: eval for PE History: dyspnea, increased O2 requirement PULMONARY ARTERIES: There has been interval recurrence of the small filling defect in the right upper lobe segment branch (series 8, image 91). This filling defect likely represents recurrence of pulmonary embolism, which was not seen on ... | 1.Recurrence of the right upper lobe segment pulmonary embolus. 2.No significant change in the chronic lung changes from pulmonary sarcoid.3.Redemonstration of enlargement of the main pulmonary trunk diameter consistent with pulmonary artery hypertension.Findings discussed with the reason ED resident Dr. Saint-Hilaire ... |
Generate impression based on findings. | 65-year-old male patient with hematuria status post cystectomy and neobladder and 2007 and status post artificial urethral sphincter placement. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Hypoattenuating subcentimeter lesion in the right lobe of the liver (series 7 image 14) is too small ... | 1.No specific findings to explain etiology of patient's hematuria.2.Mild thickening and enhancement of the neobladder wall is nonspecific.3.No evidence of recurrent disease. |
Generate impression based on findings. | Male 71 years old; Reason: 71 year old man with DLBCL. S/p chemo. Compare to prior scan. History: none CHEST:LUNGS AND PLEURA: The pleural are clear. No dominant lung lesion has developed. The central airways are patent.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.... | 1.Stable examination with no significant size change in the reference lesions.2.Cholelithiasis |
Generate impression based on findings. | Reason: lung ca History: RA/CA/SOB/SMOKER LUNGS AND PLEURA: Mild interval increase in left lung aeration and residual postsurgical scar and suture material in the left upper lobe. The adjacent focal thickening measures 14 x 7 mm (series 4, image 24), previously measuring 13 x 7 mm.Focal poorly defined groundglass opaci... | Stable small solid nodules, micronodules, and groundglass opacities. No specific evidence of recurrent disease. |
Generate impression based on findings. | Male, 50 years old, new diagnosis of head and neck cancer, evaluate disease. The maxillary sinuses are only partially visualized but there is evidence of bilateral endoscopic sinus surgery. The right maxillary sinus is opacified by soft tissue material which extends to involve the nasal cavity back to the level of the ... | 1. Large left submandibular sialolith with evidence of mild glandular inflammation and ductal dilatation.2. No mucosal based mass, pathologic adenopathy or other specific findings of active malignancy are seen in the neck.3. Evidence of prior sinus surgery with extensive soft tissue opacification of the right maxillary... |
Generate impression based on findings. | 45-year-old male with peritoneal mesothelioma, evaluate for progression ABDOMEN:LUNG BASES: Left subpleural nodularity and atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy. No focal hepatic lesions.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality notedADRENAL GLANDS: Nodule abutting the... | Stable to slightly increased size of index lesions as detailed above. |
Generate impression based on findings. | 64-year-old male patient with melanoma of the skin. Reevaluate disease status for recurrence; compare to previous scan. CHEST:LUNGS AND PLEURA: Stable calcified right lower lobe nodule.MEDIASTINUM AND HILA: No enlarged mediastinal or hilar lymph nodes. Stable calcified mediastinal and right hilar lymph nodes consistent... | Stable examination without suspicious appearing lymphadenopathy. |
Generate impression based on findings. | Mesothelioma status post two further doses of treatment. CHEST:LUNGS AND PLEURA: Left hemithorax pleural thickening and volume loss consistent with provided history of mesothelioma. Reference measurements as follows:Level of the aortic arch (3/34): 4 o'clock position 5 mm, previously 6-mm. 9 o'clock position 2 mm, prev... | Although the reference level measurements are not significantly changed, this does not accurately reflect the overall tumor burden which has slightly increased since the previous examination. New pericardial fluid collection with thickening and nodularity suspicious for pericardial involvement by tumor. Invasion of the... |
Generate impression based on findings. | Non-small cell lung cancer, follow-up CHEST:LUNGS AND PLEURA: Postsurgical changes with a left upper wedge resection unchanged. Residual scarring stable. No evidence of for localized recurrence in this region. The focal nodular thickening along the left inferior margin (image 66 series 4) remains 14 x 7 mm. No suspicio... | No evidence of focal recurrence. Reference measurements provided |
Generate impression based on findings. | 53-year-old female with DLBCL lymphoma on therapy, evaluate prior. CHEST:LUNGS AND PLEURA: Multiple scattered micronodules many of which are calcified consistent with prior granulomatous disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TR... | 1. No significant interval change or new adenopathy.2. Sub-centimeter polypoid gastric lesion. |
Generate impression based on findings. | Male 44 years old; Reason: pulm abnorm? History: dyspnea. LUNGS AND PLEURA: Dependent subsegmental atelectasis bilaterally but no focal opacities to indicate pneumonia. Scattered calcified and noncalcified pulmonary micronodules which is nonspecific and likely post inflammatory. No suspicious nodules or masses in the l... | No acute cardiopulmonary abnormalities to explain the patient's shortness of breath. |
Generate impression based on findings. | Screening for malignancy and other cause of dyspnea on exertion. COPD and CHF history. Aortic valve replacement. LUNGS AND PLEURA: Diffuse moderate centrilobular emphysema again greater in the upper lungs. No superimposed acute abnormality, however multiple small granulomas are again observed scattered. No effusions.ME... | Essentially stable diameter of the descending aorta and moderate COPD changes. No superimposed acute new findings |
Generate impression based on findings. | Acute respiratory failure, question ARDS. Hypoxia. LUNGS AND PLEURA: Extensive air space opacities bilaterally as follows: Dense consolidation in the posterior lower lobes bilaterally. A elsewhere there is a lobular pattern of air space opacities ranging from groundglass to solid in appearance and the majority is not a... | Extensive bilateral segmental and lobar distribution groundglass and air space opacities with lower lobe consolidation and bronchial wall thickening. Radiographic pattern may be consistent with early acute stage ARDS however if the patient is not clinically in the acute stage, the lack of septal thickening would be aty... |
Generate impression based on findings. | Asthma. Now with cough and dyspnea LUNGS AND PLEURA: Right apical scarring and diffuse central lobular emphysema unchanged. Persistent bronchial wall thickening consistent with patient's underlying known asthma unchanged. No new findings to suggest subpleural changes or air trapping. The two previously identified micro... | Persistent chronic bronchitis and/or asthma. No new superimposed acute abnormalities. No findings to suggest interstitial lung disease |
Generate impression based on findings. | Head and neck cancer, follow-up CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No effusions. No new focal air space opacities. MEDIASTINUM AND HILA: No acute lymphadenopathy stable calcified AP window and hilar lymph nodes representing old granulomatous disease exposure. Mild increased pericardial t... | No findings to suggest metastatic disease |
Generate impression based on findings. | 71 year-old female with head and neck cancer. The orbits are unremarkable. The paranasal sinuses are clear. There is partial opacification of the mastoid air cells. Limited view of the intracranial structure is unremarkable. There is redemonstration of treatment related changes consisting of pharyngeal and laryngeal mu... | Stable treatment related changes of the neck without recurrent neck mass or cervical lymphadenopathy. |
Generate impression based on findings. | 60 year old male with history of large cell neuroendocrine carcinoma, follow up examination. Postsurgical change is redemonstrated in the upper mediastinum status post resection of a large tumor which was visualized on the exam of 06/08/11. Today's exam remains stable with only mild residual soft tissue thickening in t... | Stable postsurgical change in the upper mediastinum and lower neck with no evidence of recurrent tumor or pathologic adenopathy. |
Generate impression based on findings. | Reason: h/o doe with VATs c/f NSIP v chronic microaspiration, still with sx after tx for gerd/aspiration eval for progression of dz History: cough w mucus, pain w deep inspiration LUNGS AND PLEURA: Post surgical changes seen in the periphery of the right mid and lower lung zones. Basilar predominant ground glass opacit... | Interval new groundglass component and shift in appearance, again non specific but concerning for possible NSIP. No new superimposed pulmonary abnormality |
Generate impression based on findings. | Tongue cancer CHEST:LUNGS AND PLEURA: Interval enlarging of a small subpleural nodule in the left lower lobe (image 67 series 6). Current measurement is 4 mm, previously 2 mm and not identified in 2012. Old scarring in the right middle lobe unchanged. Mild centrilobular and paraseptal emphysema greater in the upper lun... | Suspicious new solitary nodule in the left lung base concerning for metastatic disease or possibly a new primary given its solidarity |
Generate impression based on findings. | 52-year-old male with neck swelling and pain, newly diagnosed parotid cancer Limited intracranial views are unremarkable. Limited views of the mastoid air cells clear. Limited views of the paranasal sinuses demonstrate mild mucosal thickening of the maxillary sinuses.Necrotic appearing rim enhancing lesion along/abutti... | Solitary rim enhancing necrotic appearing lesion along/abutting the inferior most aspect of the right parotid gland measures 1.8 x 1.4 cm (series 6 image 26). No lymphadenopathy by CT size criteria. |
Generate impression based on findings. | Mesothelioma status post neoadjuvant chemo/RT and surgical resection CHEST:LUNGS AND PLEURA: Fluid-filled left pneumonectomy cavity without significant change in appearance. Left diaphragmatic graft. Trace right pleural fluid collection. Subcentimeter nodular density in the subpleural fat anteriorly on the right which ... | 1. Persistent soft tissue mass in the left lateral chest wall, unable to exclude infected hematoma or atypical appearance of tumor.2. Small soft tissue mass isoattenuating to costochondral cartilage between the right third and fourth ribs may represent supernumerary anterior costochondral cartilage versus an occult mas... |
Generate impression based on findings. | Kidney cancer, follow-up for metastatic disease LUNGS AND PLEURA: Minimal and upper lobe predominant ground glass opacities are again observed and possibly persistent mild aspiration. No suspicious new acute focal air space abnormalities. No effusions. Scattered micronodules and basilar scarring are unchanged, many mic... | No findings to suggest metastatic pulmonary or osseous disease |
Generate impression based on findings. | Male 42 years old; Reason: ct pe History: SOB. PULMONARY ARTERIES: No evidence of pulmonary emboli. Main pulmonary artery diameter is 2.9 cm which is within normal limits.LUNGS AND PLEURA: No focal opacities, pleural effusions or pneumothorax. Scattered nonspecific micronodules and no suspicious pulmonary nodules.MEDIA... | No pulmonary emboli and no findings to explain the patient's shortness of breath. |
Generate impression based on findings. | Hydatidiform mole, check for metastatic disease. LUNGS AND PLEURA: Scattered micronodules and cysts, all unchanged. No suspicious new nodules or masses. No effusions. Stable mild scarring in the left lung and faint ground glass nonspecific focal changes in the left upper lobe and left lower lobes again also unchanged. ... | Improvement with stable appearing lymph nodes and pulmonary changes suggesting bronchiolitis and scarring. Previously referenced lesions discussed |
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