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Generate impression based on findings. | 69 year old with malignant melanoma of the skin CHEST:LUNGS AND PLEURA: Emphysematous changes in the lung.Nor pleural effusion. Few micronodules bilaterally.MEDIASTINUM AND HILA: Small to mediastinum, referenced subcarinal lymph node measures 2.2 x 1.4 cm (image 39, 3).CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodule measures 1.6 x 0.9 cm (image 95, 3). This is indeterminate given the lack of noncontrast study.KIDNEYS, URETERS: Vascular calcifications noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the thoracic and abdominal aorta and its branches.Haziness noted in the root of the, mesentery measuring 2.3 x 2.5 cm with a punctate calcification within it suspicious for metastases (image 123., 3).BOWEL, MESENTERY: Multiple diverticula involving the descending and sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Mediastinal lymphadenopathy.2. Mesenteric haziness with a discrete mass with punctate calcification suspicious for metastases.3. Indeterminate left adrenal nodule. |
Generate impression based on findings. | Female 27 years old; Reason: assess for source of infection History: abd pain, severe sepsis 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:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of free fluid probably physiologic.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Note is made of numerous prior CT exams. No anatomic findings to explain the patient's symptoms. |
Generate impression based on findings. | Febrile neutropenia, recurrent fevers. R/O sinus infection. There is partial opacification of the bilateral anterior ethmoid sinuses and frontoethmoid recesses. There is mild mucosal thickening within the bilateral maxillary sinuses without evidence of air-fluid levels. The frontal and sphenoid sinuses are clear. There is unchanged deformity of the nasal bones, which may be related to remote fracture. There is near complete opacification of the right conchae bullosa, which has increased. The left conchae bullosa is clear, as is the remainder of the nasal cavity. There is mild nasal septal deviation to the left. There is partial opacification of the left mastoid air cells, which has increased slightly. The imaged intracranial structure and orbits are grossly unremarkable. The imaged facial soft tissues are also grossly unremarkable. | 1. Mild paranasal sinus opacification in a sporadic pattern with slight interval increased opacification of the right conchae bullosa.2. Partial opacification of the left mastoid air cells, which has increased slightly. |
Generate impression based on findings. | Fungal sinusitis and nasal polyps s/p ESS in Nov 2012. There are interval postoperative findings related to endoscopic sinus surgery for evacuation of fungal debris and removal of sinonasal polyposis, including right uncinectomy, partial right middle turbinectomy, right internal ethmoidectomy, and right sphenoidotomy. There is residual mild circumferential right maxillary sinus mucosal thickening. There is also mild mucosal thickening within the right frontoethmoid recess. Otherwise the neo-infundibula and remaining sinuses are clear. There is minimal opacification near the left olfactory recess. The nasal cavity is otherwise clear. The right ethmoid roof is approximately 5 mm lower than the left. The left ethmoid roof is thinned. The optic canals and carotid grooves are covered by bone. There is a punctate dehiscence in the right lamina papyracea. The imaged portions of the intracranial structures and orbits are unremarkable. | Interval endoscopic sinus surgery with mild residual mucosal thickening in the previously affected sites, but no discernable hyperattenuating material to suggest residual fungal debris. |
Generate impression based on findings. | 25-year-old female patient with history of Crohn's disease presents with severe abdominal pain x 4 days and pain with oral intake. Evaluate for abscess, phlegmon or obstruction. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Hyperenhancing mucosa and wall thickening of the colon. Thickening is more prominent in the right colon with the right colon wall measuring 1.3 cm (series 3 image 65). There is mild adjacent fat stranding and clusters of lymphadenopathy that is most prominent in the right lower quadrant. There appears to be an area of normal bowel in the mid transverse colon, consistent with a skip lesion. There is no perirectal disease.Intraluminal soft tissue densities within the sigmoid colon likely represent postinflammatory pseudopolyps.No evidence of abscesses, sinus tracts or fistulas.Small bowel is within normal limits.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: Hyperenhancing mucosa and wall thickening of the colon. Thickening is more prominent in the right colon with the right colon wall measuring 1.3 cm (series 3 image 65). There is mild adjacent fat stranding and clusters of lymphadenopathy that is most prominent in the right lower quadrant. There appears to be an area of normal bowel in the mid transverse colon, consistent with a skip lesion. There is no perirectal disease.Intraluminal soft tissue densities within the sigmoid colon likely represent postinflammatory pseudopolyps.No evidence of abscesses, sinus tracts or fistulas.Small bowel is within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Findings consistent with active Crohn's in the colon. No perirectal involvement or evidence of obstruction, abscesses, sinus tracts or fistulas.2.Intraluminal lesions in the sigmoid colon consistent with postinflammatory pseudopolyps. |
Generate impression based on findings. | Reason: Febrile neutripenia, evaluation for progression of PNA History: PNA progression LUNGS AND PLEURA: Faint residual groundglass opacity in the left upper lobe is stable to decreased. No new pulmonary nodules. Scattered punctate micronodules, some of which are calcified, are stable and presumably benign postinflammatory nodules.MEDIASTINUM AND HILA: Venous catheter tip in SVC. Scattered small subcentimeter lymph nodes are unchanged.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. | Stable to decreased postinfectious findings in the left upper lobe. No new pulmonary nodules or areas of opacity. |
Generate impression based on findings. | Reason: history of pulmonary nocardia and aspergillus, check for resolution. History: history of pulmonary nocardia and aspergillus, check for resolution. LUNGS AND PLEURA: Significant interval improvement, but not complete resolution, of lower lobe predominant centrilobular nodules and tree in bud opacity. Interval decrease in bronchial wall thickening. Minimal residual mild bronchiectasis.No new pulmonary nodules or areas of opacity.MEDIASTINUM AND HILA: No significant abnormality noted.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. | Significant interval improvement of findings of infectious bronchiolitis. No new opacities. |
Generate impression based on findings. | 37 year old female with recent gastrostomy tube placement and hemoglobin drop. ABDOMEN:LUNG BASES: Bilateral small effusions and atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Suprarenal IVC filter.BOWEL, MESENTERY: Interval placement of gastrostomy tube. A new heterogeneous attenuating collection about the stomach consistent with hematoma measuring up to 11.1 x 7.6 cm (image 51, series 4). Hematoma extends within the gastrohepatic ligament. Diffuse dilatation of the colon suggesting ileus.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Diffuse high density ascites consistent with hemoperitoneum.PELVIS:UTERUS, ADNEXA: IUD in the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild dilatation of the colon, suggestive of ileus.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Pelvic ascites/blood product with layering hematocrit. | 1. Status post gastrostomy tube placement with large hematoma surrounding the stomach and extending within the gastrohepatic ligament. Hemorrhagic product in the abdominal and pelvic peritoneum is also identified.2. Colonic ileus. |
Generate impression based on findings. | Male 37 years old; Reason: Prior to nephrectomy. For anatomy History: kidney allograft rejection 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: Atrophic consistent with known chronic medical renal disease. No suspicious lesion seen.RETROPERITONEUM, LYMPH NODES: Normal caliber aorta without atherosclerotic calcifications.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: Mild fat stranding right lower quadrant around the renal allograft. Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Normal caliber iliac vasculature without evidence of significant atherosclerotic calcifications.Renal allograft right iliac fossa and measures greater than 12-cm is seen on coronal image 62. Homogeneously nephrogram. No hydronephrosis. Single punctate calcification in the medial aspect of the lower pole near the renal hilus.Hypodense lesion with a heavy rim calcification seen in the right lower quadrant coronal image 55 measuring 3.1 x 2.4 cm with an average density of about 25 Hounsfield units. Etiology uncertain. This could be related to the renal allograft could represent a thrombosed aneurysm or old hematoma. It abuts and somewhat compresses the ureter to the renal allograft. | Rim calcified hypodense structure right lower quadrant probably related to prior surgery possibly representing old hematoma or thrombosed aneurysm. Weak nephrogram without excretion in the renal allograft in the right iliac fossa. Mild fat stranding and fluid near the renal allograft. Correlate clinically.Highly atrophic native kidneys consistent with the patient's known medical renal disease. |
Generate impression based on findings. | 29-year-old female patient with right lower quadrant pain x 3 days. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: Hypoattenuating liver parenchyma, consistent with fatty infiltration. Hepatomegaly, measuring 22 cm in craniocaudal dimension.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: Appendix is visualized and within normal limits.BONES, SOFT TISSUES: Left breast skin thickening with postsurgical clips in the breast tissue.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: Postoperative changes with fusion of the L5/S1 vertebral bodies.OTHER: No significant abnormality noted. | No acute intra-abdominal pathology to account for patient's symptomatology. |
Generate impression based on findings. | 33-year-old female patient with acute right lower quadrant pain and suprapubic pain radiating to the right flank with history of ovarian cysts and appendectomy. Evaluate for ovarian mass/tubo-ovarian abscess or other right lower quadrant pathology. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis. Pulmonary blebs adjacent to the heart on the right.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple subcentimeter hypoattenuating lesions in the bilateral kidneys are too small to characterize and likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Status-post appendectomy.BONES, SOFT TISSUES: Mild S-shaped scoliosis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: 2 cm cystic lesion in the right adnexa is consistent with a follicle (series 3 image 12). No adjacent fat stranding or abscess formation.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Status-post appendectomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Cystic lesion in the right adnexa is consistent with physiologic follicle. No CT evidence of tubo-ovarian abscess. If continued clinical concern, recommend transvaginal ultrasound to further evaluate. |
Generate impression based on findings. | 75 year old female with worsening LFTs ABDOMEN:LUNG BASES: Pleural effusions and basilar atelectasis and consolidation.LIVER, BILIARY TRACT: Nodular hepatic contour with hypertrophy of the left hepatic lobe, suggesting cirrhosis. Multiple hypodense lesions, many too small to characterize, likely represent cysts. Cholelithiasis as well as vicarious excretion of contrast. Patent hepatic vasculature.SPLEEN: Borderline splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small hypoattenuating lesions are too small to characterize. Small left upper pole calcifications.RETROPERITONEUM, LYMPH NODES: Scattered at the atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Enteric tube extends to the prepyloric gastric antrum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Abdominal and pelvic ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Fully catheter is noted within the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Abdominal and pelvic ascites. | 1. Cirrhotic hepatic morphology and abdominal and pelvic ascites. Borderline splenomegaly.2. Pleural effusions and basilar atelectasis and consolidation.3. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Female 50 years old; Reason: NHL, re-eval and compare to previous History: NHL ABDOMEN:LUNGS BASES: LIVER, BILIARY TRACT: About 17 cm in length coronal image 87. Possible fatty liver. No focal 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: Atherosclerotic changes aorta. No evidence of aneurysm. No pathologic size lymph nodes.BOWEL, MESENTERY: Small sliding type hernia.BONES, SOFT TISSUES: No significant abnormality noted..OTHER: No significant abnormality noted..PELVIS:UTERUS, ADNEXA: Surgical clips noted left adnexa. Right ovary and uterus normal.BLADDER: No significant abnormality noted..LYMPH NODES: Stable small obturator and femoral nodes. No pathologic size lymph nodes.BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: No significant abnormality noted..OTHER: No significant abnormality noted..1. | Stable small mediastinal nodes. No pathologic size nodes in the abdomen or pelvis. 2.Small areas of groundglass opacity in the right lung of questionable significance. Correlate clinically. 3.Possible fatty liver.4.Small hiatal hernia. |
Generate impression based on findings. | 15-year-old female with a history of squamous cell carcinoma, tongue as primary location. Limited intracranial views are unremarkable. Limited views of the mastoid air cells and paranasal sinuses are clear. Limited views of the orbits are unremarkable.Somewhat ill-defined hyperenhancing right lateral tongue mass which spares the base of the tongue and may minimally across the midline, measuring approximately 2.3 x 4.6 cm (series 5 image 22). The floor of the mouth is not involved.Large conglomerate necrotic mass of lymphadenopathy in the both the infra- and suprahyoid right neck (level 2,3) which invades the sternocleidomastoid muscle and measures approximately 6.6 x 3.4 x 5.1 cm (series 5 image 27 and series 80536 image 38). In the left, primarily infrahyoid neck (level 2,3), there is a smaller conglomerate necrotic mass of lymphadenopathy which invades the sternocleidomastoid muscle and measures approximately 2.5 x 3.8 x 4.3 cm (series 5 image 40 and series 80356 image 40).There is no exophytic mass or focal effacement of the aerodigestive tract.Prominent submental space lymph nodes.The necrotic mass of lymphadenopathy abuts the posterior aspect of the right submandibular gland, otherwise the submandibular glands, parotid glands and thyroid gland are within normal limits.The internal jugular veins are nearly effaced bilaterally, with the right internal jugular vein circumferentially surrounded by tumor, but remain patent throughout their course. The common carotid arteries abut the medial aspect of the necrotic masses and are mildly medially displaced but patent.No suspicious osseous lesions are identified.The visualized lung apices are clear. Please see dedicated chest CT from today's date for further details. | 1. Enhancing right lateral tongue mass which spares the base of the tongue and floor of the mouth.2. Bilateral level 2 and 3 necrotic conglomerate masses of lymphadenopathy. |
Generate impression based on findings. | Lung caner diagnosed in 9/2013, but no therapy yet. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is a punctate ossific density fragment in the right temporomandibular joint, which may represent synovial osteochondromatosis with minimal associated degenerative changes. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial metastases. |
Generate impression based on findings. | 60 year-old male with history of non-Hodgkin's lymphoma, assess extent of disease. CHEST:LUNGS AND PLEURA: Scattered small cysts are unchanged. No pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Reference mediastinal lymph node measures 1.3 x 0.8 cm (image 39 series 3) and previously measured 1.0 x 0.7 cm.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Calcifications compatible with chronic pancreatitis are unchanged. Atrophy of the pancreatic head and uncinate process are also again noted. No ductal dilatation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cortical scarringRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches. Aneurysmal dilatation of the right common iliac artery is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No lymphadenopathyBOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Right external iliac bypass graft is again noted. Dilated right common iliac artery is unchanged. | Stable interval exam without evidence of metastatic disease. |
Generate impression based on findings. | 43-year-old female with non-Hodgkin's lymphoma and thyroid cancer, evaluate Limited intracranial views are unremarkable. The visualized mastoid air cells and paranasal sinuses are clear. Limited views of the orbits are unremarkable.No evidence of lymphadenopathy by CT size criteria. No soft tissue masses are identified in the neck. No exophytic mass or focal effacement of the aerodigestive tract. Postsurgical changes of a total thyroidectomy. No residual enhancing tissue is identified in the thyroidectomy bed. The submandibular glands and parotid glands are free of focal lesions. The cervical vasculature is patent bilaterally.The visualized lung apices are clear. Please see dedicated chest CT from today's date for further details. No suspicious osseous lesions are identified. | No evidence of local recurrent tumor or cervical lymphadenopathy. |
Generate impression based on findings. | 53-year-old female patient with history of ovarian cancer, currently receiving treatment. Compare to previous examination using measurements if applicable. CHEST:LUNGS AND PLEURA: Scattered micronodules, some of which are calcified. Stable right apical scarring.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Bilateral breast implants.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis.SPLEEN: Spleen is absent. Stable left upper quadrant soft tissue focus measures 1.5 x 0.9 cm (3 image 82) and most likely a represents an accessory spleen.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: Status post hysterectomy and bilateral oophorectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No new lesions to suggest recurrent or metastatic disease. |
Generate impression based on findings. | 42-year-old female patient with non-Hodgkin's lymphoma. Reevaluate compare to prior examination. CHEST:LUNGS AND PLEURA: Left upper lobe calcified granuloma is stable compared to prior examination.MEDIASTINUM AND HILA: No lymphadenopathy.CHEST WALL: Status-post thyroidectomy. Interval removal of right-sided chest port.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Small fluid density lesion in the pancreatic tail is stable compared to prior examination (series 3 image 101).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right extrarenal pelvis.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted. | 1.Examination is stable without evidence of lymphadenopathy.2.Pancreatic lesion is stable compared to prior examination and likely represents an IPMN. |
Generate impression based on findings. | 60 year-old male with solitary pulmonary nodule, schizoaffective disorder, confusion, aspiration, evaluate for CVA 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. Intracranial atherosclerotic vascular calcifications.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. Postcontrast imaging demonstrates no abnormal intracranial enhancement. | 1. No acute intracranial abnormalities. Please note, CT is insensitive for the detection of acute ischemia.2. No abnormal intracranial enhancement is present. |
Generate impression based on findings. | 46 your old female status post craniotomy for aneurysm, with small subdural, evaluate for changes. Redemonstrated are changes from previous left-sided craniotomy for drainage of a left-sided subdural hematoma. A left-sided subdural collection has decreased in size now measuring 4 mm (previously 8 mm). As before there is 5 mm midline shift towards the right, unchanged in extent.A ventriculostomy tube course through the right parietal into the body of the right lateral ventricle across the midline and has its tip along the frontal horn of the left lateral ventricle, unchanged in position.Hypodensity is again noted involving gray and white matter along the right inferior parietal lobule extending to the right temporal lobe and right occipital lobe. This is associated with asymmetric enlargement of the trigone of the right lateral ventricle as well as the temporal horn of the right lateral ventricle. There are no findings of interval hemorrhage.The patient is status post left-sided posterior communicating artery clip placement.Another smaller hypodense focus is present along the right superior frontal gyrus involving gray matter and some underlying white matter, also unchanged in extent.The patient is status post embolic coil occlusion of a right posterior communicating artery aneurysm.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.A residual left-sided subdural collection has decreased in size, now measuring 4 mm (previously 8 mm).2.Left-to-right midline shift of 5 mm is unchanged. |
Generate impression based on findings. | 37 year old female with unstable hemoglobin, assess for retroperitoneal bleed ABDOMEN:LUNG BASES: Bilateral pleural effusions and atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No retroperitoneal hemorrhage.BOWEL, MESENTERY: Large perigastric hematoma extending within the gastrohepatic ligament is unchanged in size, measuring 10.1 x 7.2 cm (image 46, series 5). Mild colonic distention again noted. A G-tube extends to the stomach. The retention balloon is mildly displaced from the anterior abdominal wall due to hematoma. Fluid tracks within the mesentery.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Abdominal ascites with layering hematocrit consistent with hemorrhagic product. | Large perigastric hematoma and intraperitoneal blood product, unchanged from the prior study. No evidence of active contrast extravasation. |
Generate impression based on findings. | Reason: assess for lung cancer History: history of smoking LUNGS AND PLEURA: Mild predominantly upper lobe centrilobular emphysema, unchanged.Very small nonspecific micronodules some subpleural scars, also unchanged.Small area with nodular and scarlike opacities in the right costophrenic angle laterally, generally unchanged, though some small opacities have cleared, compatible with resolving infection.Slightly increased opacity in the posterior left costophrenic angle is compatible with dependent atelectasis.No suspicious nodules.MEDIASTINUM AND HILA: Moderate calcification in the right and left coronary arteries and in the thoracic aorta.Mild nonspecific pericardial thickening anteriorly, unchanged.CHEST WALL: Mild degenerative disease in the spine.Very small benign-type calcification in the right breast, unchanged.Mild old fracture deformity of the right ninth rib posterolaterally.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Mild upper zone emphysema and focal right basilar scarring with probable mild bronchiolitis.2. No suspicious nodules. |
Generate impression based on findings. | History of shortness of breath and wheezing. Severe uncontrolled asthma. LUNGS AND PLEURA: Widespread bronchial wall thickening with multiple areas of mucus plugging. Multifocal but upper lobe predominant centrilobular nodules with some areas of tree in bud. 4 mm ground glass nodule in right upper lobe (image 16/90) is presumably related to the underlying process. MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes are seen, none of which are pathologic in size.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. | Widespread bronchial wall thickening with multiple areas of mucus plugging. Multifocal but upper lobe predominant centrilobular nodules with some areas of tree in bud. 4 mm ground glass nodule in right upper lobe is presumably related to the underlying process. Overall the findings could all be related to severe asthma. Alternative considerations include infectious bronchiolitis, hypersensitivity pneumonitis, or if the patient is a smoker, RB-ILD. |
Generate impression based on findings. | 43-year-old male patient with history of renal cell carcinoma status post partial nephrectomy. Evaluate for renal recurrence. 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: Status post partial right nephrectomy. No evidence of recurrent disease. No hydronephrosis.Exophytic hypoattenuating focus in the intrapolar region of the left kidney is too small to characterize, stable from prior examination and likely represents a cyst. Accessory left renal artery.Delayed images show excretion from the left kidney without filling defects. Proximal excretion from the right kidney is visualized.RETROPERITONEUM, LYMPH NODES: Non-pathologically enlarged lymph nodes, stable compared to prior examination.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. | Status post partial right nephrectomy without evidence of recurrent disease. |
Generate impression based on findings. | 65-year-old female s/p aneurysm clipping 10/24, post op surveillance Redemonstrated are changes from previous left parietal craniotomy for aneurysm clipping. Interval decrease of subdural hemorrhage and resolution of pneumocephalus, leaving CSF density fluid in it's place. Continued decrease in size of soft tissue swelling/fluid collection around the craniotomy site.Previously noted left frontal lobe area of hypoattenuation is significantly less conspicuous on the current exam. Mild left lateral ventricle effacement without midline shift has nearly resolved, although there remains some left hemispheric sulcal effacement. There is no evidence of herniation or interval new hemorrhage.Left aneurysm clip with extensive streak artifact obscures adjacent structures.The visualized portions of the paranasal sinuses are clear. New fluid is present within the dependent left mastoid air cells. The visualized portions of the orbits are intact. | 1.Interval decrease of subdural hemorrhage and resolution of pneumocephalus, leaving CSF density fluid in it's place. 2.Previously noted left frontal lobe area of hypoattenuation is significantly less conspicuous on the current exam.3.Mild left lateral ventricle effacement without midline shift has nearly resolved, although there remains some left hemispheric sulcal effacement. |
Generate impression based on findings. | 68-year-old female with discharge and pain per rectum CHEST:LUNGS AND PLEURA: Scattered micronodules some of which are calcified consistent with prior granulomatous disease. Scattered ground glass opacities may represent edema and atelectasis.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the aortic arch and coronary arteries. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Unchanged right hepatic cysts. No biliary ductal dilatation. SPLEEN: Splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Moderate left hydronephrosis and hydroureter extending to the distal left ureter with transition adjacent to a bowel anastomosis suggesting stricture.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Ventral hernia containing stomach without evidence of obstruction. Large ventral abdominal wall defect.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: Left lower quadrant colostomy with stomal hernia containing bowel and mesentery noted. No fluid within the hernia sac. No evidence of fistula or fluid collection. Collapsed Hartmann's pouch is poorly visualized.BONES, SOFT TISSUES: Large ventral abdominal wall defect.OTHER: No significant abnormality noted. | 1. New moderate left hydronephrosis and hydroureter extending to the distal left ureter adjacent to a bowel anastomosis, raising the possibility of stricture. This finding was discussed with Dr. Adamsky (pager 2701) at the time of dictation.2. Extensive postsurgical change with persistent ventral abdominal wall defect and left stomal hernia without evidence of obstruction, fistula or fluid collection. |
Generate impression based on findings. | 68-year-old male with possibly enlarging lipoma in the right supraclavicular area, evaluate. Limited intracranial views are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.In the right paraglottic space inferior to the hyoid bone and along the thyrohyoid membrane there is an ovoid well-circumscribed lesion with a thin enhancing rim measuring approximately 1.7 x 1.0 cm (series 80372 image 31). The internal contents of this lesion measure above simple fluid density (approximately 20 to 30 Hounsfield units). There are no exophytic masses or focal effacement of the aerodigestive tract.No lymphadenopathy by CT size criteria. The right supraclavicular space is within normal limits without identification of a mass. The thyroid gland, parotid glands and submandibular glands are free of focal lesions. The cervical vasculature is patent. No soft tissue masses are identified in the neck.The visualized lung apices are clear. Multilevel degenerative changes of the cervical spine including flowing anterior osteophyte formation compatible with DISH which results in mild mass effect/deformity of the anterior hypopharynx. No suspicious osseous lesions are present. There are central disc protrusion and neuroforaminal narrowing at C3-C4, C4-C5 and C6-C7. | 1. No mass is present in the right subclavicular space.2. Small right paraglottic space low density mass as described above is nonspecific but may represent a laryngocele with proteinaceous debris. Additional less likely diagnostic considerations include an atypical thyroglossal duct cyst, submucosal cyst, desmoid and cystic neoplasm. |
Generate impression based on findings. | Reason: please compare to outside CT chest 8/2/13 - RLL lung nodule; LAD was biopsied and is non necrotizing granuloma History: cough, dyspnea LUNGS AND PLEURA: 16 x 13 mm irregular pulmonary nodule in right lower lobe (image 75/95) is not significantly changed. There are multiple small satellite nodules surrounding the index lesion, also unchanged. No new pulmonary nodules. Punctate calcified granuloma in left lower lobe.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy is unchanged, the subcarinal node is the largest at 16 mm in short axis (image 42/95).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. | No change in right lower lobe pulmonary nodule. While it is nonspecific and malignancy cannot be definitively excluded, the appearance and small satellite nodules surrounding the lesion may be seen in infectious/inflammatory causes, such as histoplasmosis. No change in intrathoracic lymphadenopathy. |
Generate impression based on findings. | 34-year-old female status post duodenal switch with abdominal pain and nausea, evaluate for SBO. 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: Postoperative changes consistent with duodenal switch without evidence of complication. The bowel is normal in caliber.BONES, SOFT TISSUES: Interval weight loss.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postoperative changes above duodenal switch, without evidence of obstruction or complication. BONES, SOFT TISSUES: Interval weight loss.OTHER: No significant abnormality noted | 1. Postoperative changes consistent with duodenal switch, without evidence of complication or obstruction. |
Generate impression based on findings. | Aneurysm. CT: There are postoperative findings related to left pterional craniotomy for left MCA aneurysm clipping. The aneurysm clip produces considerable streak artifact that obscures surrounding structures. Otherwise, there is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is partial resorption of the craniotomy bone flap.CTA: There are postoperative findings related to left MCA aneurysm clipping. The aneurysm clip produces considerable streak artifact that obscures surrounding structures. Within these limitations, there is no definite evidence of recurrent aneurysm at this site. There is a 1 mm wide outpouching along the left aspect of the ACOM. There is no definite evidence of steno-occlusive disease. | 1. A 1 mm wide outpouching along the left aspect of the ACOM likely represents an infundibulum rather than a saccular aneurysm. 2. Postoperative findings related to left MCA aneurysm clipping.2. No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Reason: Lung cancer s/p crt. Please re-eval. Thanks. History: Lung cancer CHEST:LUNGS AND PLEURA: Extensive volume loss involving the right upper lobe likely due to a combination of the mass and radiation therapy. Continued decrease in size of index right upper lobe lesion now measuring 29 x 17 mm on image 29/104 (33 x 23 mm on prior).Reference left upper lobe nodule has continued to increase, now measuring 14 mm on image 29/104 (10 mm on prior).Small subcentimeter nodule in left lower lobe (image 59/104) unchanged. Left lower lobe calcified granuloma unchanged. No new pulmonary nodules.MEDIASTINUM AND HILA: Scattered small lymph nodes are unchanged.Severe coronary artery calcification and stents.Aortic valve calcification. Small hiatal hernia. CHEST WALL: Degenerative change involving the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Small bilateral adrenal nodules are unchanged.KIDNEYS, URETERS: Stable small presumed renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes of the aorta and its branches, unchanged. Small lymph nodes are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving the spine with presumed schmorl's node in L2 unchanged.OTHER: No significant abnormality noted. | 1. Interval decrease in right upper lobe mass.2. Continued increase in left upper lobe pulmonary nodule suggestive of metastatic disease. |
Generate impression based on findings. | 43-year-old male patient with history of renal cell carcinoma status post partial nephrectomy. Evaluate for renal recurrence. 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: Status post partial right nephrectomy. No evidence of recurrent disease. No hydronephrosis.Exophytic hypoattenuating focus in the intrapolar region of the left kidney is too small to characterize, stable from prior examination and likely represents a cyst. Accessory left renal artery.Delayed images show excretion from the left kidney without filling defects. Proximal excretion from the right kidney is visualized.RETROPERITONEUM, LYMPH NODES: Non-pathologically enlarged lymph nodes, stable compared to prior examination.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. | Status post partial right nephrectomy without evidence of recurrent disease. |
Generate impression based on findings. | 53 year old male experiencing headache. Redemonstrated are several periventricular and subcortical foci of low attenuation within the white matter without mass effect. The ventricles and sulci remain normal in appearance. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Redemonstrated is mucosal thickening within bilateral maxillary sinuses as well as in a few scattered ethmoid air cells, as well as frothy material within the left sphenoid sinus. Well pneumatized bilateral mastoid air cells and middle ear cavities. | 1.Nonspecific periventricular and subcortical foci of low attenuation within the white matter without mass effect. Although this most likely represents chronic small vessel ischemic disease, if there is clinical concern for ischemia and/or other pathologies, MRI with gadolinium would be recommended.2.No acute intracranial hemorrhage.3.Redemonstrated is mucosal thickening within bilateral maxillary sinuses as well as in a few scattered ethmoid air cells, as well as frothy material within the left sphenoid sinus. |
Generate impression based on findings. | Chronic fungal and bacterial sinusitis, immunocompromised. There are postoperative findings related to endoscopic sinus surgery, including bilateral uncinectomy, nasoantral window, and partial ethmoidectomy. There is a 3mm wide right maxillary sinus retention cyst. The remaining paranasal sinuses and nasal cavity are otherwise clear. The right ethmoid roof is lower than the left, but these appear to be intact. The optic canals and carotid grooves are covered by bone. There are postoperative findings related to right canal wall up mastoidectomy. The mastoid bowl is clear. Likewise, the imaged left mastoid air cells are clear. The imaged intracranial structures and orbits are grossly unremarkable. | Unremarkable postoperative findings related to endoscopic sinus surgery with small right maxillary sinus retention cyst, but otherwise clear paranasal sinuses and nasal cavity. |
Generate impression based on findings. | 62-year-old history of gastric neuroendocrine tumor status post resection of metastatic lymph node with appearance of new lesions in the liver. Postoperatively. Stable since February 2011. Restaging CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No arterially enhancing lesion noted on today's imaging.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: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No measurable metastatic disease |
Generate impression based on findings. | View ventricular size and communication of ventricles. There is a right transfrontal ventricular catheter that terminates once again in just superior to the right foramen of Monro. There is a small focus of pneumocephalus adjacent to the catheter in the right lateral ventricle. There is also a partially imaged fourth ventricle catheter that extends from the third ventricle to the posterior craniocervical junction. Contrast material fills the bilateral lateral ventricles and third ventricles. There is no appreciable contrast within the cerebral aqueduct. Rather, there is contrast within the lumen of the fourth ventricular catheter that extends to the subarachnoid space at the craniocervical junction. The presence of contrast within the bilateral foramina of Luschka and inferior fourth ventricle are likely retrograde. Contrast is also present within the suprasellar cistern and basal cisterns. The lateral and third ventricles appear to the stable to minimally increased in size since the prior exam. There are postoperative findings related to Chiari decompression. The left cerebellar tonsil remains low lying and abuts the spinal cord, which appears to be compressed. | 1. Contrast ventriculography indicates patency of the right transfrontal and fourth ventricle shunt catheters.2. The lateral and third ventricles appear to the stable to minimally increased in size since the prior exam, which may be attributable to technique.3. Stable postoperative findings related to Chiari decompression in which the left cerebellar tonsil remains low lying and abuts the spinal cord, which appears to be compressed. |
Generate impression based on findings. | Reason: evaluate ILD History: cough sob fibrosis and DAD on biopsy LUNGS AND PLEURA: Bilateral subpleural and linear interstitial abnormality with areas of traction bronchiectasis. Mild basilar predominance. No significant groundglass opacity or air trapping. Equivocal honeycombing in the periphery of the left upper lobe (image 106/291) and at the posterior lung bases.MEDIASTINUM AND HILA: Scattered small mediastinal nodes. Coronary calcification. Some thinning of the LV apex likely due to old infarct. Small lateral hernia.CHEST WALL: Degenerative change involving the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Two subcentimeter hypodensities in the liver are too small to characterize but most likely benign. | Bilateral subpleural and linear interstitial abnormality with areas of traction bronchiectasis. Mild basilar predominance. Equivocal honeycombing in a few locations. The findings most likely represent, though are not diagnostic of, UIP. (More typical findings of diffuse alveolar damage such as consolidation or ground glass opacity are not present on this scan though may be present histologically if the biopsy was performed during an accelerated phase of illness). |
Generate impression based on findings. | 71 year-old female status post ACOM aneurysm clipping and recent subdural hematoma, 6 month follow-up. No CT findings to suggest interval reaccumulation of left frontoparietal subdural hemorrhage. There is no new intracranial hemorrhage. Again seen is a focus of hypoattenuation in the region of the anterior limb of the left internal capsule, extending into the left lentiform nucleus and left globus pallidus with associated ex vacuo dilatation of the anterior horn of left lateral ventricle, unchanged. There is no evidence of intracranial mass or edema. There is no mass effect or midline shift. There is preservation of the gray-white matter interface. There is no evidence of acute territorial ischemia. The remainder of the ventricles and basal cisterns are normal in size and configuration. There is no effacement of the basal cisterns. Postoperative changes consistent with a left frontal craniotomy and ACOM aneurysm clipping. The remainder of the calvaria and skull base are radiographically normal. The visualized mastoid air cells and paranasal sinuses are within normal limits. | No CT findings to suggest interval reaccumulation of left frontoparietal subdural hemorrhage. No acute intracranial hemorrhage. |
Generate impression based on findings. | Reason: 75Yrs male here for follow-up of T1N2bM0 left SCCA BOT, treated with CRT and completed 12/17/10 ; re-eval for recurrence History: as above CHEST:LUNGS AND PLEURA: Scattered punctate micronodules are stable and presumably benign. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Scattered small subcentimeter lymph nodes are unchanged.CHEST WALL: Degenerative the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Presumed hepatic cysts are unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: NegativeKIDNEYS, URETERS: Stable right renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic location in the aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving the spine. Focal area of sclerosis in the L4 vertebral body unchanged since 10/12/2010 and presumably benign.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: mets lung cancer, s/p right adrenalectomy for mets, s/p 9 wks of Nivolumab, pls c/w previous study and evaluate tx response. History: mets lung cancer. CHEST:LUNGS AND PLEURA: Reference right apical spiculated nodule has decreased (image 18, series 5) now measuring 14 x 10 mm (previously 20 mm x 17 mm).Scattered punctate micronodules are stable. No new pulmonary nodules.Emphysema.MEDIASTINUM AND HILA: Borderline borderline left paratracheal lymph node is stable (image 39 such 154). Borderline right hilar lymph node is stable to marginally increased (image 46/154).CHEST WALL: The lucency within T5 (image 34/154) is grossly stable). Subcentimeter subcutaneous nodule on left (55/24) is stable. Small axillary lymph nodes are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic hypodensities are too small to characterize but stable and presumably benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Status post right adrenalectomy. Stable small subcentimeter left adrenal nodule.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Soft tissue metastasis to right flank has significantly decreased now measuring 6 mm in image 135/154 (14 mm on prior).OTHER: No significant abnormality noted. | Interval decrease in right upper lobe nodule and right flank soft tissue metastasis. |
Generate impression based on findings. | Female 68 years old; Reason: newly diagnosed right breast IDC; CT for metastatic work-up History: none CHEST:LUNGS AND PLEURA: Mild right apical subpleural thickening. No suspicious lesions. No pleural effusions.MEDIASTINUM AND HILA: Aberrant right subclavian artery passing posterior to the esophagus.The aorta is tortuous. No mediastinal lymphadenopathy.CHEST WALL: Soft tissue mass in the right chest wall a measures 2.9 x 2.6 cm (image 32/series 3). ABDOMEN:LIVER, BILIARY TRACT: Liver contour is smooth. No suspicious hepatic lesions. Hepatic and portal veins are patent.SPLEEN: Small hypervascular splenic lesion possibly hemangioma.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: Degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted. | 1.Right breast mass without evident metastatic disease. |
Generate impression based on findings. | 85 year-old female with chronic cough and postnasal drip. The orbits are unremarkable except for lens prostheses and a punctate hyperdensity in the left preseptal soft tissue or eyelid. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There appears s small inspissated cyst or osteoma in the left posterior ethmoid. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal apart from mild nasal septal deviation. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable. | No evidence of sinusitis. |
Generate impression based on findings. | T1N2bM0 left SCCA BOT, treated with CRT completed 12/17/10. There are stable post-treatment findings in the region of the oropharynx. There is no evidence of mass lesions to suggest locoregional tumor recurrence. There is no significant cervical lymphadenopathy. Apparent narrowing of the supraglottic airway and cricopharyngeal prominence is likely physiologic. The airways are otherwise patent. The major salivary gland and thyroid are unchanged. The right internal jugular vein remains inapparent. The other major cervical vessels are otherwise intact. The imaged paranasal sinuses and mastoid air cells are clear. The osseous structures and dentition appears unchanged with a residual defect in the lingual cortex of the left mandible body related to osteonecrosis and debridement. The imaged intracranial structures and orbits are grossly unremarkable. There is a possible 2 mm right apical lung nodule (image 74, image 6). Refer to the separate chest CT report for additional details. | Stable post-treatment findings without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | Male 84 years old; Reason: Hx of Bladder Cancer s/p cystectomy with ileal conduit. Eval for recurrent/metastatic disease History: See above ABDOMEN:LUNGS BASES: Minimal atelectasis in the right middle lobe.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. Clustered calcifications in the gallbladder neck region likely representing stones there were previous to distributed in the gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. No hydronephrosis and the left kidney. Probable cyst at the upper pole.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Post operative changes in the small bowel or ileal conduit creation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Status-post cystoprostatectomyBLADDER: Status post cystectomyLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Colonic diverticula without active inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Status post right nephrectomy, cystoprostatectomy and ileal conduit creation without evident metastatic disease.2.Calcifications about the gallbladder neck most likely representing stones |
Generate impression based on findings. | Reason: Thymoma or other evdince of malignancy. History: Positive acetyl choline receptor ab, thrombocytopenia, neuropathy LUNGS AND PLEURA: Punctate subpleural micronodule in periphery of right upper lobe (image 34/109) likely postinflammatory.MEDIASTINUM AND HILA: Scattered small nonspecific mediastinal nodes. Coronary calcification. No evidence of thymoma.CHEST WALL: Healed rib fractures on right. Dense focus of sclerosis in the anterior left fourth rib is presumably a bone island, especially in the absence of known malignancy. Degenerative disease involving thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Well-circumscribed hypodensity in right lobe of liver is near water attenuation and presumably a cyst. A low-density left adrenal nodule is subcentimeter and nonspecific though likely benign. Small subcentimeter splenule. Calcified granuloma in right upper quadrant. The | No evidence of thymoma or pulmonary malignancy. |
Generate impression based on findings. | 58-year-old male with perirectal area of fluctuance at 9 o'clock. PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Moderately distended and unremarkable.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The bowel is normal in caliber. No wall thickening or fluid collections.BONES, SOFT TISSUES: No evidence of perirectal inflammation, loculated fluid collection, or other findings to account for patient's symptoms.OTHER: No significant abnormality noted | No specific findings to account for the patient's pain. Specifically, no evidence of perirectal abscess or inflammation. |
Generate impression based on findings. | 52-year-old female malignant neoplasm of the esophagus, unspecified site, loss of weight, status post transhiatal esophagectomy in June 2012 for locally advanced squamous cell carcinoma. Patient received pre-operative chemotherapy and radiation therapy. CHEST:LUNGS AND PLEURA: Small, punctate nodule in the left lower lobe measures 4 x 4 mm (image 66, 5), unchanged from prior study. No new nodules noted.Left lingular septal thickening with some tree in bud appearance could represent atypical infection over metastases.MEDIASTINUM AND HILA: Postsurgical changes consistent with esophagectomy and gastric pull up. Referenced right paratracheal lymph node measures 1 x 0 .5 cm, reduced in comparison with prior study, when it measured 1.3 x 0.7 cm (image 40, 3). The other mediastinal and axillary lymph nodes appear unremarkable.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Normal fatty involution in the region of the head of the pancreas. Atrophic body and tail of pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Referenced aortocaval lymph node measures 0.6 x 0.8 centimeters (image 103, 3), unchanged from prior study, when it measured 0.6 x 0.9 cm. Referenced portacaval lymph node measures 2.1 x 0 .9 cm, previously measured 2.5 x 0.8 cm (image 88 on 3) mostly unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval decrease in mediastinal lymph nodesStable normal size retroperitoneal lymph nodes.Stable left lower lobe micronodule. |
Generate impression based on findings. | 63-year-old male with history of hoarseness and cough and nodule seen on radiograph. Evaluate for mass LUNGS AND PLEURA: Innumerable bilateral pulmonary nodules are seen, none of which appear calcified. There is a dominant left upper lobe spiculated mass (series 4 image 28) which measures approximately 2.7 x 1.8 cm. The spiculated mass abuts the mediastinal pleura and may be invading the pleura. There are several small foci of emphysema. One right lower lobe nodule (series 4 image 39) measures approximately 7 mm.MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes are seen, some demonstrate coarse calcifications internally. One right paratracheal lymph node measures approximately 1.5 cm in the short axis (series 3 image 38). Mild anterior pericardial thickening.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Arterial calcifications are noted, without other significant normality. | 1.Innumerable bilateral pulmonary nodules, none of which are calcified. There is a dominant left upper lobe spiculated mass which abuts the mediastinal pleura. This is nonspecific but consistent with lung carcinoma, although it is conceivable that this finding could represent an infectious etiology such as histoplasmosis.2.Mediastinal lymphadenopathy as described above.These findings were discussed with the ordering physician Dr. Demeter by phone during interpretation. |
Generate impression based on findings. | Female 46 years old; Reason: eval adrenal lesion History: incidentally found adrenal lesions ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Patient status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Bilateral fat containing lesions are likely adrenal myelolipomas.Additionally, along the lateral limb of the left adrenal gland, there is a lesion which measures 20 HU on precontrast, 107 HU on portal venous phase imaging and 47 HU on delayed phase imaging for an absolute washout of 68%, likely indicating an adenoma.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: Atrophic or surgically absent. Cyst noted on the left adnexa.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.Two myelolipomas, and one lesion which is compatible with an adenoma on the left lateral limb of the adrenal gland. |
Generate impression based on findings. | Reason: s/p R lower lobe resection, hx blastomycosis History: s/p R lower lobe resection, hx blastomycosis CHEST:LUNGS AND PLEURA:Post op change right lower lobe with pleural thickening and a small amount of loculated pleural fluid. Right middle lobe pleural retraction and interstitial opacities suggestive of scarring.New scattered ground glass nodules measuring up to 6 x 7 mm (series 5, image 46) which are nonspecific but suggestive of infection.MEDIASTINUM AND HILA: No significant mediastinal lymphadenopathy. Heart size is normal. No pericardial effusion. Mild atherosclerotic calcification of the aortic arch. Aberrant right subclavian artery, normal variant.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic hemangiomas. Cholelithiasis unchanged. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple small hypodense lesions in bilateral kidneys are too small to further characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Post op change right lower lobe with pleural thickening and small loculated effusion.2.New scattered ground glass nodules measuring up to 7 mm which are nonspecific but suggestive of infection. Continued follow up is recommended. |
Generate impression based on findings. | 24-year-old female patient with Crohn's disease, now postoperative day 15 from TAC and end ileostomy with persistent fevers and malaise. ABDOMEN:LUNG BASES: Interval increase in moderate left-sided pleural effusion with associated atelectasis and volume loss. Right lung base scarring versus atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Stable perisplenic fluid collection.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left pelvic kidney without hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ileostomy is stable compared to prior examination. Status post subtotal colectomy with rectosigmoid Hartmann's pouch.Redemonstration of a pigtail drain in the right pericolic gutter. There is interval placement of a pigtail catheter drain in the right hemipelvis with interval decrease in right pelvic fluid collection. Interval placement of pigtail catheter in the left hemipelvis with interval decrease in fluid collection in size and trace free air.Residual small fluid collection in the right hemipelvis and trace fluid in the left hemipelvis demonstrate peripheral enhancement and mass effect, consistent with an abscess.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.Breakdown of the skin along the suture line at the level of the umbilicus and pelvis. No fistulous communication present.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: Right lower quadrant ileostomy is stable compared to prior examination. Status post subtotal colectomy with rectosigmoid Hartmann's pouch.Redemonstration of a pigtail drain in the right pericolic gutter. There is interval placement of a pigtail catheter drain in the right hemipelvis with interval decrease in right pelvic fluid collection. Interval placement of pigtail catheter in the left hemipelvis with interval decrease in fluid collection in size and trace free air.Residual small fluid collection in the right hemipelvis and trace fluid in the left hemipelvis demonstrate peripheral enhancement and mass effect, consistent with an abscess.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.Breakdown of the skin along the suture line at the level of the umbilicus and pelvis. No fistulous communication present.OTHER: No significant abnormality noted. | 1.Interval placement of two pigtail drains in the pelvis with decrease in size of pelvic fluid collections.2.Skin breakdown along the suture margin. |
Generate impression based on findings. | T3N2bM0 left tonsil cancer, who completed induction carbo taxol and TFHX on 12/14/12. Head: There is no abnormal intracranial enhancement. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses are clear. The right mastoid air cells are underpneumatized. The skull and extracranial soft tissues are unremarkable. Neck: There are stable post-treatment findings in the oropharyngeal region. There is no discrete mass lesion to suggest locoregional tumor recurrence. There is no significant cervical lymphadenopathy. For example, a left level 2 lymph node measures 7 x 4 mm. The airways are unremarkable. The thyroid and major salivary glands are unchanged. There is moderate calcified plaque at the bilateral carotid bifurcations. There is diffuse osteopenia, but no lytic or blastic lesions. The imaged portions of the lungs are clear. | 1. Stable post-treatment findings without evidence of locoregional tumor recurrence or cervical lymphadenopathy. 2. No evidence of intracranial metastases. |
Generate impression based on findings. | 55-year-old female with refractory diffuse large B cell lymphoma status post stem cell transplant in need of reimaging CHEST:LUNGS AND PLEURA: Mild basilar scarring/atelectasis.MEDIASTINUM AND HILA: Reference mediastinal lymph node measures 1.8 x 1.6 cm and previously measured 1.6 x 1.4 cm (image 38, series 401). No new adenopathy.CHEST WALL: Prominent axillary adenopathy is unchanged. Left axillary surgical clips.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland nodule is unchanged measuring 1.5 x 0.9 cm (image 98, series 401).KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Reference confluent mesenteric adenopathy measures 2.8 x 1.0 cm in size (image 131, series 401) and previously measured 3.0 x 1.2 cm. Multiple additional mesenteric lymph nodes appear unchanged.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: Reference confluent mesenteric adenopathy measures 2.8 x 1.0 cm in size (image 131, series 401) and previously measured 3.0 x 1.2 cm. Multiple additional mesenteric lymph nodes appear unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Unchanged reference lymphadenopathy. |
Generate impression based on findings. | Reason: Pt with HNC s/p CRT . please re-eval for recurrent dz and compare to prior exams History: as above CHEST:LUNGS AND PLEURA: Aspiration bronchiolitis in the right middle and right lower lobes, with a new area of subsegmental atelectasis and focal consolidation in the right middle lobe.Focal ground glass opacity in the left lower lobe is slightly decreased, also compatible with aspiration.No suspicious nodules.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy. Moderate aortic and coronary arterial calcifications.Calcification in the mitral annulus.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple small hypodensities compatible with cysts, unchanged.Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple small cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Splenic artery and aortic calcification.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.Aspiration bronchiolitis in the right middle and right lower lobe with focal right middle lobe subsegmental atelectasis.2. No sign of metastatic disease. |
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: No significant abnormality noted.MEDIASTINUM AND HILA: Left supraclavicular reference lymph node is stable at 6 mm (image 3/133).Previously referenced AP window lymph node is marginally increased at 9 mm in its short axis (image 26/133), 9 mm on prior.Previously referenced subcarinal lymph node is stable at 8 mm in short axis (image 33/133), 8 mm on prior.Right hilar lymph node is stable at 12 mm in its short axis (image 35/133).Wall thickening of the distal esophagus is stable.CHEST WALL: Right axillary lymph node measures 21 mm on image 14/133 (21 mm previously).Right breast lesion with eccentric microcalcifications measures 15 x 11 mm on image 55/133 (unchanged). Small left sided axillary nodes are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small gastrohepatic lymph node measures 8 mm on image 76/133 (8 mm on prior).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. | Metastatic breast cancer with stable reference measurements as above. |
Generate impression based on findings. | Squamous cell carcinoma. LUNGS AND PLEURA: No nodules or masses. No focal air space opacities or pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal sized heart without pericardial effusion.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Normal appearance of the upper abdomen. | Normal examination. No evidence of metastatic disease. |
Generate impression based on findings. | Female 51 years old; Reason: Right Locally advanced Breast cancer with probable lymph node involvement. C/o Right rib abd back pain, evaluate for metastatic disease. History: Right Locally advanced Breast cancer with probable lymph node involvement. C/o Right rib abd back pain, evaluate for metastatic disease. CHEST:LUNGS AND PLEURA: 5-mm right lower pulmonary nodule (image 37 / series 5) has ground glass features. No pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. Small to moderate pericardial effusion.CHEST WALL: Diffuse right breast thickening. The mid appearing enlarged right axillary lymph node measures 3.1 x 2.0 cm (image 30/series 4). ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule measures 2.2 x 2.0 cm (image 87/series 4), unchanged.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic lesion in the T12 vertebral body, new from priorOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Mild endometrial thickening.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic L1 vertebral body, unchanged from priorOTHER: No significant abnormality noted. | 1.Right breast mass with extension to the skin and malignant appearing right axillary adenopathy.2.Nonspecific right lower lobe 5-mm ground glass nodule, follow up is suggested3.Diffuse sclerosis of the L1 vertebral body, unchanged for two years.4.New lytic lesion in the T12 vertebral body.5.Consider dedicated spine imaging for further evaluation of these two lesions.6.No change in the left adrenal lesion. |
Generate impression based on findings. | 63-year-old male with history of metastatic thyroid cancer, compare with previous. CHEST:LUNGS AND PLEURA: Calcified right lower lobe granuloma. No new pulmonary nodules or masses.MEDIASTINUM AND HILA: Unchanged reference left supraclavicular (level 4) lymph node measures 1.0 x 0.7 cm (image 9 series 16) and previously measured 1.2 x 0.8 cm. Additional prominent cervical lymph nodes are identified.CHEST WALL: Lytic lesion in the left humeral head appear similar to the prior study. Prominent left axillary lymph nodes are reidentified with faint calcification suggesting treatment effect. Unchanged sclerotic lesions of the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Distended and unremarkable.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis without evidence of inflammation.BONES, SOFT TISSUES: Left hip arthroplasty.OTHER: No significant abnormality noted | Unchanged reference lesions and osseous metastases. |
Generate impression based on findings. | 31-year-old male patient with testicular cancer. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Two enlarged retroperitoneal lymph nodes adjacent to the left gonadal vein. Dominant lymph node measures 1.7 x 1.3 cm (series 3 image 135). Superiorly located lymph node measures 1.3 x 0.9 cm (series 3 image 127).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: Status post radical left orchiectomy. | Two enlarged retroperitoneal lymph nodes with measurements provided. |
Generate impression based on findings. | DLBCL status post R-CHOP x 6 was completed on 4/2009. There is no significant cervical lymphadenopathy by CT size criteria. The Waldeyer structures are unremarkable. The airways are patent. The salivary glands and thyroid are unchanged. The major cervical vessels are patent. The imaged lung apices are clear. The osseous structures are unchanged. The imaged intracranial structures and orbits are grossly unremarkable. | No significant cervical lymphadenopathy to suggest recurrent lymphoma. |
Generate impression based on findings. | 41 year-old female with worst headache of life. There is a 7 x 7-mm pineal cyst. 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 paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. Small pineal cyst. |
Generate impression based on findings. | unspecified sinusitis, nasopharyngeal globus sensation, nasopharyngeal globus sensation The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. The nasal septum is mildly deviated towards the right.The frontal sinuses are clear.Maxillary sinuses are clear. Ethmoid air cells are clear . Sphenoid sinuses are clear. Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. | No evidence for paranasal sinus outlet obstruction. |
Generate impression based on findings. | 56-year-old female with Crohn's disease status post completion proctectomy in October 2013 now with resolving SBO with persistent abdominal pain. Assess for mesenteric or portal vein thrombosis. 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: Dilated small bowel loops, especially the jejunal loops, and proximal ileum loops with transition point in the mid abdomen best seen on image 78 consistent with partial small bowel obstruction. The distal small bowel loops appear collapsed. Haziness within the mesentery noted, which could be postoperative in nature. Fluid noted within the pelvis, with soft tissue in the presacral space, which could be postoperative in nature. This is most likely etiology could be due to adhesions.Portal vein and SMV, SMA are patent.Right lower quadrant ileostomy noted. Persistent narrowing of the 3rd part of the duodenum at image 62, suspicious for stricturing due to Crohns and less likely peristalsis or SMA syndrome. 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: Fluid noted within the pelvis, with soft tissue in the presacral space, which could be postoperative in nature.OTHER: No significant abnormality noted | 1. Findings consistent with partial small bowel obstruction involving the jejunal and distal ileal loops with transition point in mid abdomen; most likely etiology being postoperative adhesions. SMV, portal vein and SMA are patent.Fluid noted within the pelvis, with soft tissue in the presacral space, which could be postoperative in nature.2. Persistent narrowing of the 3rd part of the duodenum at image 62, suspicious for stricturing due to Crohns and less likely peristalsis or SMA syndrome. Findings conveyed to Dr. Katdare, Mukta at the time of dictation via the phone at 3:29 pm. |
Generate impression based on findings. | 61-year-old female with headache and blurred vision Redemonstrated are patchy foci of low attenuation with the periventricular white matter without associated mass effect. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is maintained. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | Small vessel ischemic disease of indeterminate age. |
Generate impression based on findings. | 84-year-old male with mantle cell non-Hodgkin's lymphoma and status post 13 cycles of chemotherapy. There has been stable in size of the reference lymphadenopathy. No new lymphadenopathy noted. Reference measurements are as follows: 1. Right level 2 lymph node measures 7 x 5 mm (image 103, series 5), previously 7 x 5 mm.2. Left level 2 lymph node measures 7 x 5 mm (image 105, series 5), previously measuring 8 x 6 mm.3. Right level 3 lymph node measures up 4 x 3 mm (image 137, series 5), previously measuring 4 x 3 mm.Bilateral lens prostheses. The orbits are otherwise unremarkable. Parenchymal volume loss and intracranial vascular calcifications. The visualized brain is otherwise unremarkable.The previously seen cyst in the right vallecula is unchanged. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. Dilatation of the right piriform sinus and medialization of the right vocal cord is again seen. Hypoattenuating nodule in the left thyroid gland appears less conspicuous. The parotid and submandibular are unremarkable. Postsurgical findings from prior sinus surgery again noted. The paranasal sinuses and mastoid air cells are clear. Atherosclerotic calcifications in the left subclavian artery, carotid bifurcations and proximal left internal carotid artery are unchanged.Moderate degenerative changes in the cervical spine are unchanged. There is multilevel neural foramina narrowing secondary to uncovertebral joint hypertrophy. Diffuse idiopathic skeletal hyperostosis of the cervical and upper thoracic spine is unremarkable. Please see dedicated chest CT report, which is dictated separately. | No cervical lymphadenopathy. Stable reference lymph nodes. |
Generate impression based on findings. | right MCA aneurysm on MRA; further delineate with CTA Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right posterior communicating artery is similar in size to the right P1 segment. The left posterior communicating artery is very very small. The anterior communicating artery is medium size. The A1 segments are similar in size.There is a 3.3x3.3mm right carotid terminus aneurysm present.There is a 5 mm x 3 mm axial dimension aneurysm present at the proximal left ophthalmic segment directed just along the planum sphenoidaleThere is a 1mm wide neck left MCA aneurysmThere is a 1.2-mm left cavernous carotid aneurysm present at the posterior band of the cavernous internal carotid artery areCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is a 3.5 mm right carotid terminus aneurysm present with a small neck. 2.There is a 5mm left ICA opthalmic segment aneurysm present.3.There is a 1mm wide neck left MCA aneurysm4.There is a 1.2-mm left cavernous carotid aneurysm present |
Generate impression based on findings. | 78-year-old female with right lower extremity weakness, pathology positive history of lung adenocarcinoma There is a large new region of hypodensity containing an ill-defined cystic portion involving primarily posterior left frontal brain with partial effacement of the adjacent sulcus. On the comparison exam, there were no enhancing foci at this location.There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Paranasal sinus opacification is again noted and unchanged. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | There is a large new region of hypodensity containing an ill-defined cystic portion involving primarily posterior left frontal brain with partial effacement of the adjacent sulcus. Given the patient's known lung adenocarcinoma, this is presumed metastasis until proven otherwise. Recommendation is made for brain MRI with gadolinium enhancement to further characterize this lesion as well as to better assess for smaller lesions that would not be detectable by noncontrast CT technique. |
Generate impression based on findings. | 35-year-old female, pre-kidney transplant evaluation Limited exam due to the lack of IV and oral contrast in the evaluation of solid organ pathology and vasculature.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: Atrophic native kidneys, and calcified infarcted right iliac fossa transplant.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post laparoscopic gastric banding without evidence of complication or malfunction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Status post L1 and L2 laminectomy.OTHER: Few scattered atherosclerotic calcifications of the common and right external iliac vessels. Faint circumferential calcifications of the femoral vessels are noted as well. | 1. Few scattered iliac atherosclerotic calcifications.2. Atrophic native kidneys and old infarcted right iliac fossa allograft.3. Status post laparoscopic gastric banding without evidence of complication or malfunction. |
Generate impression based on findings. | Male 84 years old; Reason: History of Mantle Cell NHL History: s/p 13 cycles of chemotherapy CHEST:LUNGS AND PLEURA: Right apical and left basilar atelectasis. Calcified granuloma in the right lower lobe.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Post operative changes of median sternotomy and coronary artery bypass grafting.Left chest wall pacer and leads terminating in the heart. No new mediastinal lymphadenopathy. Subcarinal lymph node measures 1.3 x 0.9 CM (image 44 , series 3) , unchanged.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructive right renal calculi. Perinephric calcified consistent extending from the lower pole of the left kidney, unchanged without evident internal enhancement.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Small bowel is normal in caliber. Scattered colonic diverticula. There is a bland mucosa involving the descending colon and sigmoid colon suggestive of chronic colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomyBLADDER: Urinary bladder herniates into the left inguinal canal.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes affect the lumbar spine and hips.OTHER: No significant abnormality noted | 1.Stable exam without recurrent lymphadenopathy in the chest, abdomen or pelvis.2.Findings suggestive of chronic colitis. |
Generate impression based on findings. | Red eye with pain with extraocular movements & lid swelling. There is mild diffuse left preseptal subcutaneous fat stranding and swelling. However, there is no evidence of post-septal cellulitis. The left optic nerve and extraocular muscles are unremarkable. There are no abnormal fluid collections. The right orbit is unremarkable. There is partially imaged moderate retention cyst formation within the bilateral maxillary sinuses and mild opacification of the ethmoid sinuses. There is minimal opacification of the right mastoid air cells. The imaged intracranial structures are unremarkable. | Left preseptal cellulitis, but no evidence of postseptal cellulitis or abscess. |
Generate impression based on findings. | Male 60 years old; Reason: 60 year old man with DLBCL in CR. Compare to prior scan. History: none CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small nonobstructive left renal calculi. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostatic calcifications.BLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine with grade 1 anterolisthesis of L4 on L5 due to bilateral pars defects.OTHER: No significant abnormality noted | 1.Stable exam; no evident lymphadenopathy in the chest, abdomen or pelvis. |
Generate impression based on findings. | Reason: r/o pe History: hypoxia PULMONARY ARTERIES: No significant abnormality noted.LUNGS AND PLEURA: Linear scarring and atelectasis at the lung bases, marginally increased. Small presumed intrapulmonary lymph node along the fissure (image 143/274) unchanged.MEDIASTINUM AND HILA: Cardiomegaly. Scattered small subcentimeter nodes are unchanged.CHEST WALL: Osseous changes of sickle cell disease. Right chest wall port. Port tip at RA/SVC junction. Small axillary lymph nodes unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Atrophic spleen. Status post cholecystectomy. | No evidence of PE. Linear scarring and atelectasis at the lung bases, marginally increased. |
Generate impression based on findings. | Reason: cad History: chest discomfort, reported history of positive stress test Calcium Score:LM: 0LAD: 136 LCx: 0RCA: 298Total: 434, This represents the 91th percentile for this patients age and gender.Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of Valsalva and trifurcates into the left anterior descending, ramus intermedius and left circumflex coronary arteries. There are no significant stenoses present in the left main.Ramus Intermedius: This is a large caliber vessel that courses from the anterolateral to inferolateral left ventricular wall. It is mildly tortuous in the midsegment. No significant stenosis is visualized.LAD: The left anterior descending coronary artery is tortuous, suggestive of hypertension. It courses normally in the anterior interventricular groove, supplying three diagonal and several septal branches. The first diagonal branch arises immediately distal to the ostium of the LAD and is diminutive in caliber.Multifocal disease is observed in the LAD. A mixed plaque initiates at the ostium of the LAD with a small, eccentric focus of calcification. Beyond the focus of calcification, a continuous and noncalcified plaque extends into the mid segment, over a distance of 2.6 cm. This contributes to approximately 30% stenosis.At this point, more extensive mixed plaque with dense calcification is observed, extending beyond the ostium of D2. The second diagonal branch is tortuous and appears free of significant stenosis. The noncalcified plaque within the LAD contributes to approximately 50% (moderate) and, at some points, approximately 80% (severe) stenosis. Blooming artifact from calcification precludes quantification of potential stenosis at these calcified locations. Step off artifact is noted at the mid LAD from respiratory motion. A third diagonal branch arises at the apex.LCx: The left circumflex coronary artery is small. It courses normally in the left atrioventricular groove. No significant obtuse marginal branch is identified, in the presence of a large ramus intermedius branch. There are no significant stenoses in the left circumflex coronary artery.RCA: The right coronary artery arises normally from the right sinus of Valsalva. Multifocal mixed plaques occupy the RCA. The proximal 2.3 cm of the RCA are unremarkable. At this point, there is a mixed plaque. The noncalcified component contributes to approximately 50% stenosis. Approximately 1.5 cm distal to this location, multifocal mixed plaques are present. The noncalcified components contribute to varying degrees of stenosis, up to 80% at one segment. The RCA is the dominant coronary artery, as the proximal posterior descending artery appears to arise from the RCA at the inferior atrioventricular groove. However, beyond the proximal first centimeter of the PDA, the remainder of this vessel not visualized. Left Ventricle: The left ventricular late diastolic volume is visually upper limits normal. There is a small column of contrast extending to the right atrium raising a question of a patent foramen ovale.Right Ventricle: Visually the right ventricular late diastolic volume is within normal limits.Left Atrium: Visually, the left atrial volume appears to be normal in size. There are 5 distinct pulmonary veins which drain normally into the left atrium. There is a separate right middle lobe pulmonary vein. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrial volume is normal in size. The superior and inferior vena cavae are unremarkable. The coronary sinus is normal in size. Valves: There is no calcification on the aortic or mitral valves.Great vessels: The visualized portions of the thoracic aorta demonstrate no evidence of dissection or aneurysm. The aortic arch is not visualized. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion. | 1. Multifocal, significant coronary artery disease, most pronounced in the LAD and right coronary artery, as above. 2. Total Calcium score was 434; 91th percentile for age and gender. |
Generate impression based on findings. | Reason: IPF with acute desaturation and drop in DLCO eval for PE History: increased SOB PULMONARY ARTERIES: Technically adequate examination with no sign of pulmonary embolism.LUNGS AND PLEURA: One diffuse chronic interstitial disease with evidence of fibrosis but no specific evidence of honeycombing, compatible with UIP or fibrosing NSIP, unchanged from the previous scan.No sign of pneumonia or or other acute changeMEDIASTINUM AND HILA: Severe coronary artery calcification.No significant lymphadenopathy.CHEST WALL: Degenerative disease in the spine.Elevation of the right hemidiaphragm, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hepatic cyst in the left lobe | 1. No sign of pulmonary embolism or other acute change.2. Chronic interstitial lung disease with extensive fibrosis, compatible with UIP or fibrosing NSIP, unchanged from the previous scan. |
Generate impression based on findings. | Left level 3 LAD and large, pearly white smooth mass in the midline of the vallecula. There is a uniformly hyperattenuating (>1000 HU), lobulated spheroid lesion arising from the inferior aspect of the uvula that measures 11 AP x 11 RL x 11 SI mm. There is moderate obstruction of the oropharyngeal airway. The oral cavity and remainder of the pharyngeal structures, including the tonsils and adenoids, are otherwise unremarkable. The larynx and trachea are also unremarkable. There is no evidence of significant cervical lymphadenopathy. The thyroid gland and major salivary glands are unremarkable. The major cervical vessels are intact. The imaged paranasal sinuses and mastoid air cells are clear. The imaged intracranial structures are orbits are unremarkable. The osseous structures are unremarkable. The imaged portions of the lungs are clear. | A densely calcified 11 mm diameter mass arising from the inferior aspect of the uvula may represent a pedunculated calcifying fibrous tumor, squamous papilloma, or perhaps choristoma with associated moderate obstruction of the oropharyngeal airway. No significant cervical lymphadenopathy. |
Generate impression based on findings. | History of pulmonary embolus on anti-coagulation and subclavian clot. Swelling of arm and face. PULMONARY ARTERIES: The pulmonary arteries are normal in appearance. Opacification to the level of the segmental arteries is present and no filling defects are seen. LUNGS AND PLEURA: No pleural effusion is seen. Residual base opacities are present but are decreased. No pneumothorax is present. A right middle lobe micro-nodule is again seen.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. The heart is normal in size and there is no pericardial effusion.CHEST WALL: No axillary lymphadenopathy is identified.UPPER ABDOMEN: No significant abnormality noted. | No segmental pulmonary emboli identified. Decrease in lung base opacities. Resolved pleural effusion. |
Generate impression based on findings. | 72-year-old female patient with stage IV chronic kidney disease, hypertension present with abdominal/back pain. Evaluate for renal stone versus aortic dissection. Note that the lack of intravenous contrast limits evaluation of vasculature, and lymph nodes and solid viscera.ABDOMEN:LUNG BASES: Bilateral dependent atelectasis versus scarring.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal lesion measures 4.1 x 2.0 cm (series 3 image 25), stable.KIDNEYS, URETERS: Status post left nephrectomy.Hyperattenuating right renal cysts are unchanged compared to prior examination. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Aorta and iliac arteries normal in caliber with atherosclerotic changes.BOWEL, MESENTERY: Colonic diverticulosis without CT evidence of diverticulitis.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine. Partial fusion of the bilateral SI joints.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: Colonic diverticulosis without CT evidence of diverticulitis.Bilateral fat containing inguinal hernias.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine. Partial fusion of the bilateral SI joints.OTHER: No significant abnormality noted. | 1.No renal calculi, hydronephrosis or aortic dissection.2.Bilateral fat containing inguinal hernias.3.Left adrenal mass, stable. |
Generate impression based on findings. | 66 year old female with Crohn's disease and prior ileal stricture ABDOMEN:LUNG BASES: Small right pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Coarse splenic calcification.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffusely distended small bowel with air-fluid levels with transition point in the distal ileum. There marked narrowing of the distal and terminal ileum extending 13 to 14 cm proximal to the ileocecal valve. Multiple loops of dilated small bowel with wall thickening and hyper enhancing mucosa indicating acute inflammation. A small amount of free interloop fluid is identified in the right lower quadrant. No evidence of fistula or loculated fluid collection. No bowel wall pneumatosis or free air. The colon is collapsed. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diffusely distended small bowel with air-fluid levels with transition point in the distal ileum. There marked narrowing of the distal and terminal ileum extending 13 to 14 cm proximal to the ileocecal valve. Multiple loops of dilated small bowel with wall thickening and hyper enhancing mucosa indicating acute inflammation. A small amount of free interloop fluid is identified in the right lower quadrant. No evidence of fistula or loculated fluid collection. No bowel wall pneumatosis or free air. The colon is collapsed.BONES, SOFT TISSUES: Severe joint space narrowing and degenerative changes of the left hip. Degenerative changes of the thoracolumbar spine. OTHER: No significant abnormality noted | Small bowel obstruction secondary to high grade distal ileal stricture with small bowel wall thickening and hyperenhancement consistent with acute inflammation. Small amount of interloop free fluid without evidence of abscess or perforation. |
Generate impression based on findings. | Clinical question: Altered mental status. Signs and symptoms: Disoriented and somnolence. Nonenhanced head CT:Examination demonstrates a focus of low attenuation involving the cortex and the subcortical white matter left posterior temporal -- parietal junction consistent with acute to early subacute ischemic nonhemorrhagic stroke. There is very subtle associated regional mass-effect and effacement of cortical sulci. Minimal periventricular low-attenuation white matter concerning for age indeterminant small vessel ischemic stroke is also noted. Mild prominence of the supratentorial ventricular system and cortical sulci are noted.Calvarium demonstrate extensive uniform lytic and sclerotic changes which has the appearance of Paget disease.Unremarkable orbits and paranasal sinuses as well as mastoid air cells. | 1.Acute to early subacute left posterior temporal -- parietal nonhemorrhagic cortical stroke.2.Mild age indeterminate small vessel ischemic strokes and slight prominence of cortical sulci/ventricular system.3.Extensive lytic/sclerotic changes of calvarium suspicious for Paget's disease. |
Generate impression based on findings. | Clinical question: No intracranial abnormalities. Signs and symptoms: Worse headache of her life, MVA with questionable loss of consciousness two days ago. Nonenhanced head CT:there is no detectable posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA Nonenhanced head CT:Examination demonstrates a large focus of low attenuation in the distribution of right middle cerebral without any appreciable mass effect or hemorrhage. There is expansion of right lateral ventricle likely representing ex vacuo. The finding represent a chronic right MCA territory nonhemorrhagic ischemic stroke.CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes. Correlate with history and the pattern of onset of symptoms and follow up with MRI exam.Minimal periventricular low attenuation of white matter is concerning for age indeterminant small vessel ischemic strokes. Unremarkable ventricular system otherwise and with maintained midline.Calvarium and soft tissues of the scalp are unremarkable.Orbits, paranasal sinuses and mastoid air cells are unremarkable. | 1.CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes. 2.Chronic right MCA territory large nonhemorrhagic ischemic stroke with ex vacuo dilatation of right lateral ventricle.3.Mild age Indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question: Increased size of pituitary adenoma? Acute bleed/mass. Signs and symptoms: Headache. Nonenhanced head CT: No detectable acute intracranial process CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes. No detectable pituitary either normal and normal size of the sella turcica.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. Note however is made of a small left maxillary sinus retention cyst. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | 51-year-old male patient with hydradenitis. Assess for extent of hydradenitis. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Scattered nonenlarged 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: Multiple hypoattenuating, nonenhancing lesions in the right kidney are too small to characterize and likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic and lumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Inguinal lymphadenopathy bilaterally. Conglomerate of lymph nodes in the right inguinal region measures 3.1 x 1.5 cm (series 3 image 24).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is a network of superficial subcutaneous phlegmons in the right lower back and buttocks bilaterally. Some of these areas have low attenuation centrally and may contain fluid versus necrotic tissue. The largest collection in the right buttock measures 1.5 x 5.1 cm (series 3 image 157). There is extension into the gluteal folds to the perineum and perianal tissue bilaterally.There is fatty infiltration of the gluteus maximus muscle on the right.OTHER: No significant abnormality noted. | Network of superficial subcutaneous phlegmons in the right lower back and buttock with extension into the perineum and perianal tissue bilaterally. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage, large intracranial mass. Signs and symptoms:seizure. Nonenhanced head CT:No detectable acute intracranial process, CT however he is insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation remains within normal for patient stated age of 24.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Negative nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Hemorrhage? Signs and symptoms: Pelvic,sbp addendum to 10. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci and the ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. | No acute intracranial findings. Unremarkable head CT. |
Generate impression based on findings. | 41 year old female with persistent MRSA bacteremia of unknown source and new opacity on chest x-ray. LUNGS AND PLEURA: Multifocal areas of consolidation in both lungs, highly suspicious for multifocal pneumonia. No significant pleural effusions.MEDIASTINUM AND HILA: Multiple mildly enlarged mediastinal lymph nodes, which may be reactive in nature. Heart size within normal limits. No pericardial effusion.Fat containing lesion in midline of lower neck, unchanged and likely represents lipoma (series 3, image 4).CHEST WALL: Multiple enlarged left axillary lymph nodes are mildly increased in size; reference leftnode measures 3.9 x 3.0 cm, previously measured 3.7 x 3.0 cm (series 3, image 34). Left breast mass not significantly changed, measuring 3.3 x 4.1 cm and previously measured 3.3 x 4.1 cm (series 3, image 27).UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered areas of peripheral hypodensity in both partially visualized kidneys are not significantly changed, possibly representing infarctions. | 1.Bilateral multifocal consolidation is suspicious for pneumonia. Septic emboli would be considered less likely.2.No significant change in left breast mass.3.Mild increased left axillary lymphadenopathy. |
Generate impression based on findings. | Reason: Evidence of pulmonary embolus History: SOB, tachycardia, cirrhosis from autoimmune hepatitis PULMONARY ARTERIES: Motion degrades the quality of the exam. No evidence of pulmonary embolism.LUNGS AND PLEURA: Ground glass opacity in the left apex. Bilateral diffuse groundglass opacities with increased interstitial markings, right greater than left. Bilateral areas of dependent and linear atelectasis. Focal area of bronchiectasis in the right upper lobe. No pleural effusions. No pneumothorax.MEDIASTINUM AND HILA: Heart size is normal. Aneurysm the interatrial septum may be associated with patent foramen ovale (PFO). Further interrogation may be considered echocardiography if this has not been evaluated. No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Large amount of ascites. Cirrhotic morphology of an incompletely visualized liver. Ill-defined poorly visualized mass in left lobe of the liver better characterized on CT abdomen study completed on the same day. Exophytic hypodense lesion in the upper pole of the right kidney. Mesenteric fat stranding. | 1.No evidence of pulmonary embolism.2.Bilateral, diffuse groundglass opacities with increased interstitial markings. Differential includes hypersensitivity pneumonitis, post infectious etiology, or drug reaction. 3.Bilateral dependent and linear atelectasis.4.Poorly visualized lesion in the left lobe of the liver better characterized on CT abdomen study completed on the same day. |
Generate impression based on findings. | Clinical question: Lung cancer. Evaluate for metastases. Signs and symptoms: No increased nausea and dizziness. Enhanced head CT:Examination demonstrate no detectable abnormal enhancement of brain parenchyma or leptomeninges to suggest metastatic disease.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Calvarium is unremarkable.Soft tissues of the scalp are unremarkable.Images through the orbits are unremarkable.All visualized paranasal sinuses and bilateral mastoid air cells, middle ear cavities remain well pneumatized. | Negative enhanced head CT. |
Generate impression based on findings. | Clinical question: 82-year-old male with history of CVA, MRI, with CABG, presents with falls. Signs and symptoms: Falls. Nonenhanced head CT:There is no detectable acute intracranial process, CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Small focus of cortical/subcortical low attenuation in the left occipital lobe likely representing chronic cortical stroke as was noted on prior exam from 2010.Mild to moderate periventricular and subcortical low attenuation of white matter with mild ex vacuo dilatation of lateral ventricles remains grossly similar to prior exam from 2010. No convincing evidence of any abnormality in the posterior fossa.Minute bilateral cavernous carotid and left vertebral artery vascular calcification is present. Thecalvarium and soft tissues of the scalp are unremarkable.Unremarkable orbits.Unremarkable paranasal sinuses, mastoid air cells and middle ear cavities. | 1.No convincing evidence of an acute intracranial process CT however it is insensitive for early detection of acute nonhemorrhagic strokes.2.Left occipital small chronic cortical stroke stable since prior study.3.Mild age indeterminate small vessel ischemic strokes and ex vacuo dilatation of lateral ventricles remains nearly identical to prior exam.4.No convincing evidence of any abnormality in the posterior fossa. The |
Generate impression based on findings. | 42-year-old female patient with abdominal pain, nausea, vomiting and previous total colectomy. Evaluate for small bowel obstruction or pancreatitis. ABDOMEN:LUNG BASES: Partially imaged moderately large pericardial effusion is stable compared to prior examination.LIVER, BILIARY TRACT: Hepatomegaly, measuring 23 cm in craniocaudal dimension.SPLEEN: No significant abnormality noted.PANCREAS: No CT evidence of pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post subtotal colectomy with postsurgical changes in the right lower abdomen. There is interval improvement in the small bowel obstruction with decrease in small bowel dilatation. In the right hemipelvis there are numerous matted loops of small bowel. An anterior loop of small bowel is dilated to 4.9 cm with desiccation of stool, consistent with chronic stasis. Near one of several sites of anastomosis, there is a loop of edematous small bowel (series 3 image 113) that has increased inflammation compared to prior examination.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.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: Status post subtotal colectomy with postsurgical changes in the right lower abdomen. There is interval improvement in the small bowel obstruction with decrease in small bowel dilatation. In the right hemipelvis there are numerous matted loops of small bowel. An anterior loop of small bowel is dilated to 4.9 cm with desiccation of stool, consistent with chronic stasis. Near one of several sites of anastomosis, there is a loop of edematous small bowel (series 3 image 113) that has increased inflammation compared to prior examination.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine.OTHER: Small amount of free fluid in the pelvis. | 1.Interval improvement in small bowel obstruction and dilatation of the small bowel with continued desiccation of stool within the right hemipelvis, consistent with chronic stasis. 2.Loop of small bowel in the pelvis with interval increase in inflammatory changes, consistent with enteritis.3.Moderately large pericardial effusion, stable. |
Generate impression based on findings. | 58-year-old male with history of type A dissection status post emergent repair CHEST:LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema is unchanged.MEDIASTINUM AND HILA: Type A dissection status post repair appears similar to the prior study. The dissection flap arises in the supravalvular aorta and extends into both subclavian arteries, the left common carotid artery, and distally through the thoracic aorta. Scattered atherosclerotic calcifications of the coronary arteries. Small bilateral pleural effusions with adjacent atelectasis.CHEST WALL: Status post median sternotomy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Scattered bilateral hypodensities, too small to characterize, but likely representing cysts. Decreased left renal cortical enhancement.RETROPERITONEUM, LYMPH NODES: The dissection flap extends inferiorly through the abdominal aorta into the left femoral artery. The flap extends into the celiac artery, which arises predominantly from the false lumen. The flap extends towards the left renal artery which arises from the false lumen. The right renal artery arise from the true lumen. The dissection flap extends into the proximal SMA with interval thrombosis of the false lumen, but patency of the true lumen. There has been interval progression of the flap into the right external iliac artery with no enhancement in the false lumen representing either near complete thrombosis of the right external iliac with thin channel of enhancement in true lumen, or slow flow in false lumen. Moderate atherosclerotic calcifications of the common iliac arteries and their branches.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: Severe degenerative changes of the lumbar spine and right hip with multiple small osseous fragments about the joint.OTHER: No significant abnormality noted | 1. Type A dissection status post repair with no opacification of the false channel lumen in the right external iliac artery representing either thrombosis of false lumen new extension or slow flow in extension of false lumen. Markedly narrowed true lumen in right external iliac artery with full reconstitution in the right femoral artery at end of dissection. Unchanged decreased left renal enhancement. Interval thrombosis of the false lumen extending into the SMA with continued patency of the larger true lumen contributing component. The repaired dissection within the thorax is unchanged.2. Severe centrilobular and paraseptal emphysema.3. Unchanged severe degenerative changes of the right hip. |
Generate impression based on findings. | 93 year-old female with history of colon cancer and lung mass -- evaluate for metastatic disease. ABDOMEN:LUNG BASES: Right hilar lymph node mass (series 3, image one) incompletely evaluated on first image measures 3.0 x 1.7 cm. Parenchymal air space consolidation more distally represents combination of postobstructive atelectasis and probable underlying lung mass.Bilateral pleural effusions. Large pericardial effusion.LIVER, BILIARY TRACT: In balloon space-occupying lesions throughout the liver replacing much of the liver parenchyma representing widespread metastases. Reference lesion further. Further evaluation in left lateral segment (series 3, image 50, 1) measures 1.8 x 1.5 cm.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: New lytic lesion in the T11 vertebral body (sagittal series image 54, and axial series 3, image 30).OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: New1 lytic lesion with soft tissue mass in the posterior left acetabulum (series 3, image 126). Additional lytic lesions seen in the left and right iliac bones.OTHER: No significant abnormality noted | 1. Right hilar lymphadenopathy with postobstructive airspace consolidation and probable parenchymal lung mass. 2. Extensive new liver metastases diffusely through liver. 3. Scattered new lytic lesions, most consistent with bony metastases. Bony metastases raise the question of whether this represents a new lung cancer with metastatic disease rather than colon cancer metastases. |
Generate impression based on findings. | 57 year-old male with hypoxemia and shortness of breath. History of pseudomonas pneumonia and bronchiectasis. History of CLL status post CT on 2/2012. PULMONARY ARTERIES: Diagnostic exam without evidence of pulmonary embolus.LUNGS AND PLEURA: No significant change in moderate centrilobular emphysema and bilateral basilar bronchiectasis with bronchial wall thickening.Increased subpleural consolidation in the right base. New right upper lobe scattered nodular opacities and interlobular septal thickening.Persistent basilar predominant subpleural tree in bud opacities bilaterally, compatible with residual bronchiolitis.MEDIASTINUM AND HILA: Mild increase in mediastinal bulky lymphadenopathy which encases right central bronchi, causing increased narrowing of the right upper lobe bronchus and bronchus intermedius (series 8, image 161, 146). Reference right the paratracheal node is not significantly changed, measuring 4.1 cm (series 8, image 109). Right main pulmonary artery and its branches are also encased by lymphadenopathy, however, remain patent. Heart size normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No pulmonary embolus.2.Increased subsegmental consolidation in the right base, which may represent recurrent infection or aspiration. 3.New right upper lobe scattered nodular opacities and interlobular septal thickening, also most compatible with infection. Septal thickening consistent with focal mild edema, which is likely due to central venous and lymphatic compression by bulky mediastinal lymphadenopathy. 4.Mediastinal lymphadenopathy causing encasement of right pulmonary arteries and narrowing of right central bronchi; this is mildy increased since 10/24/2013 but significantly increased since 6/6/2013. 5.Bronchial wall thickening and bronchiectasis predominantly affecting the lung bases; while this may be post infectious in nature, graft versus host disease and bronchiolitis obliterans are also suspected given patient's history of stem cell transplant. |
Generate impression based on findings. | Female 36 years old; Reason: repeat UTIs, abd pain History: repeat UTIs, abd pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Too small to characterize lesion in the kidneys bilaterally. No renal or ureteral stone, hydronephrosis, or perinephric fluid collections detected.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. Physiologic changes 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 evident intra-abdominal pathology detected. In particular, no evidence of renal or ureteral pathology seen. |
Generate impression based on findings. | 81 year old female with history of syncopal episode and outpouching seen in the ascending aorta on echocardiogram. Additional history from the patient's medical record: Patient has history of colon cancer. ANGIOGRAPHY: The ascending aorta is mildly ectatic measuring 3.8 cm in the coronal plane, however the luminal contour is smooth and regular without focal outpouching or aneurysm. Variant arch anatomy with the left common carotid arising from the right brachiocephalic artery. Partially visualized atherosclerotic calcification creates an approximately 30% narrowing of the left common carotid.Mild atherosclerotic calcification affects the ostia of the celiac axis and the superior mesenteric artery without significant luminal narrowing. More moderate atherosclerotic calcification affects the origin of the renal arteries creating an approximately 50% luminal narrowing on the right.LUNGS AND PLEURA: Moderate apical predominant centrilobular and paraseptal emphysema.Well marginated lobular right lower lobe pulmonary nodule is not significantly changed measuring 12 x 9 mm (series 8 image 66), previously 13 x 9 mm.Scattered calcified right lung granulomas and right hilar lymph nodes compatible with prior granulomatous infection.MEDIASTINUM AND HILA: The heart is normal in size. Moderate to severe 3-vessel coronary atherosclerotic calcification. Mild calcification affects the aortic valve. No pericardial effusion.CHEST WALL: Moderate degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Indeterminate left adrenal nodule is not significantly changed in size measuring 27 x 22 mm (series 9 image 126), previously 28 x 23 mm.Unchanged left renal cysts and multiple additional bilateral renal hypodensities that are statistically most likely also benign renal cyst. | 1. Mildly ectatic ascending thoracic aorta measures 3.8 cm in the coronal plane. There are no focal contour irregularities or aneurysmal outpouchings and the size is not significantly changed over multiple prior exams.2. Right lower lobe pulmonary nodule and left adrenal nodule as described are not significantly changed.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male, 54 years old, status post tumor resection. Evaluate tumor site. Expected findings are noted status post left frontoparietal craniotomy including pneumocephalus and a small amount of blood product along the resection bed. Previously seen left parietal extra-axial tumor has been resected. No definite evidence of residual tumor is seen, though MRI would provide a more sensitive evaluation.There is at most mild parenchymal edema underlying the prior site of tumor. Mild regional mass effect exists in the form of sulcal effacement. No significant generalized mass effect is detected. No abnormalities are seen remote from the resection bed. The ventricular system remains patent and within normal limits for size. | Expected postoperative findings status post resection of a left frontoparietal region tumor. |
Generate impression based on findings. | 83 year old female with neutropenia, rigors, back pain and dark stool -- evaluate for typhlitis ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Benign cyst lateral segment -- no significant abnormality seen in liver parenchyma. Vascularity to liver appears normal. Gallbladder and biliary tract shows no abnormalities.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable parapelvic, renal cysts bilaterally -- no hydronephrosis or dilated ureters. No parenchymal renal masses. No perinephric fluid collections identified.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification throughout. The aorta and iliac arteries without other vascular abnormality. No adenopathy or masses seen.BOWEL, MESENTERY: No significant abnormality noted in stomach, small bowel or colon with no wall thickening, mass lesions, or evidence of obstruction. No free mesenteric fluid..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Prior hysterectomy -- no other abnormalities.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted in small bowel or colon with no wall thickening, mass lesions, or evidence of obstruction. No free mesenteric fluid..BONES, SOFT TISSUES: Severe, diffuse degenerative changes in the lower lumbar spine and sacrum with approximately 50% anterior listhesis of L4 on L5. Postsurgical changes in the right iliac bone.OTHER: No significant abnormality noted | 1. No diagnostic abnormality seen in the gastrointestinal tract. 2. Severe degenerative changes in lower lumbar spine and sacrum with spondylo-listhesis as described above. 3. No other abnormalities seen. |
Generate impression based on findings. | 25-year-old female patient with abdominal pain. Evaluate for appendicitis or intra-abdominal infection. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly distended appendix, measuring 1 cm in diameter (series 3 image 83), with moderately thickened and enhancing wall. No periappendiceal fluid or perforation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Physiologic changes in the uterus. Left corpus luteum cyst.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly distended appendix, measuring 1 cm in diameter (series 3 image 83), with moderately thickened and enhancing wall. No periappendiceal fluid or perforation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Physiologic free pelvic fluid. | 1.Mildly distended appendix with moderate wall thickening without peripelvic fluid collection or perforation. Findings consistent with early appendicitis.2.Left corpus luteum cyst. |
Generate impression based on findings. | Male 50 years old; Reason: 50 year old man with Hodgkin lymphoma s/p allogeneic stem cell transplant. Compare to prior scans. History: Recent onset of abdominal pain. CHEST:LUNGS AND PLEURA: Mild paramediastinal fibrotic changes. No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Interval removal of right chest port.ABDOMEN:LIVER, BILIARY TRACT: Normal morphology of the liver. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Unchanged small retroperitoneal lymph nodes not enlarged by CT standards.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy. BOWEL, MESENTERY: Colon diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination without enlarged nodes in the chest, abdomen, pelvis. |
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