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Generate impression based on findings. | 15 year-old male with congenital scoliosis. There is a left sided L2/L3 hemivertebra and lumbar levoscoliosis. There is mild deformity with sclerosis of the L3 endplates. The vertebral bodies, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The intervertebral disk spaces are preserved. The paraspinal soft tissues are unremarkable.There are mild disc bulge of the mid and lower lumbar spine. | Left sided L2/L3 hemivertebra and lumbar levoscoliosis. Mild disc bulge of the mild and lower lumbar spine. |
Generate impression based on findings. | 24 year-old male with head injury. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. Bilateral basal ganglial calcifications. 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. |
Generate impression based on findings. | 28 year-old female status post MVC. There is a left frontal scalp hematoma. 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 or calvarial fracture. Left frontal scalp hematoma. |
Generate impression based on findings. | 20 year-old female with expressive aphasia. 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. The orbits are unremarkable. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, submandibular, and thyroid glands are unremarkable. No lymphadenopathy or mass is noted. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. Limited view of the chest is unremarkable. | 1. No acute intracranial abnormality. 2. Unremarkable CT neck soft tissue. |
Generate impression based on findings. | 61 year-old male with altered mental status. The CSF spaces are prominent representing volume loss with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hypodensities of a marked degree are present. This was also present on the previous exam and is unchangedThe visualized portions of the paranasal sinuses are partially opacified. The visualized portions of the mastoid air cells are partially opacified. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries.There is redemonstration of a small midline scalp lesion, stable. | No intracranial hemorrhage. Stable periventricular and subcortical white matter changes of a marked degree are nonspecific. Differential considerations include vascular related lesions as well as neurodegenerative or related to prior treatment. CT is insensitive for the early detection of nonhemorrhagic CVA. |
Generate impression based on findings. | 22 year-old male with blunt head trauma. 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 except for opacification of the left frontal and anterior ethmoid sinuses. There is left preseptal soft tissue thickening. The orbits are unremarkable. | 1. No acute intracranial abnormality. 2. Left preseptal soft tissue thickening. Opacification of the left frontal and anterior ethmoid sinuses. The orbital contents are unremarkable. |
Generate impression based on findings. | 76 year-old male with altered mental status. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and appropriate for the patient's age. 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. Lens prosthesis. | No acute intracranial abnormality. Mild small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. |
Generate impression based on findings. | 57 year-old male with altered mental status. The ventricles, sulci, and cisterns are symmetric and appropriate for the patient's age. 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. Chronic blowout fracture of the left lamina papyracea. | No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. |
Generate impression based on findings. | 26 year-old female with seizure. 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. |
Generate impression based on findings. | 80 year-old male with altered mental status. There is confluent hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and prominent, representing brain volume loss. 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. Lens prostheses. | No acute intracranial abnormality. Moderate to severe small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. |
Generate impression based on findings. | 100 year-old female with altered mental status. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and prominent, representing brain volume loss. 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 except for opacification of the right mastoid. Intracranial arterial calcifications and ectasia. Left lens prosthesis. | No acute intracranial abnormality. Moderate small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. |
Generate impression based on findings. | 78 year-old male with acute change in mental status. There is a focus of hypoattenuation in the right occipital lobe, new since prior. There are foci of hypoattenuation in the cerebellum, unchanged. There is patchy hypoattenuation in the periventricular white matter, unchanged. The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for partial opacification of the left frontal sinus and mastoids. Right lens prosthesis. | 1. No acute intracranial hemorrhage. 2. New focus of in the right occipital lobe, which may represent an acute or subacute infarct. Given the patient's history of cancer, metastasis cannot be ruled out. MRI is recommended for further evaluation. 3. Mild chronic small vessel ischemic disease. |
Generate impression based on findings. | 65 year-old male with status epilepticus. There are confluent hypoattenuation in the cerebral white matter. There are foci of hypoattenuation in the basal ganglia. The ventricles, sulci, and cisterns are symmetric and prominent, representing volume loss. The gray-white matter differentiation is normal. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. The patient is intubated. There are fluids in the paranasal sinuses and nasal cavity. | 1. No acute intracranial hemorrhage. 2. Confluent hypoattenuation in the cerebral white matter may be due to advanced small vessel ischemic disease of indeterminate age, neurodegeneration or treatment. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 3. Foci of hypoattenuation in the basal ganglia likely represent age indeterminate lacunar infarcts. |
Generate impression based on findings. | 57 year-old female with altered mental status. There is a focus of hypoattenuation in the right insular and posterior basal ganglia. 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. | 1. No acute intracranial hemorrhage. 2. A focus of hypoattenuation in the right insular and posterior basal ganglia may represent an acute/subacute infarct. MRI is recommended for further evaluation. |
Generate impression based on findings. | 54-year-old female with history of sickle cell disease with shortness of breath and history of venous thromboembolic disease in the right upper extremity. PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Mild bibasilar scarring. Mild centrilobular emphysema. No consolidation or pleural effusions. No suspicious pulmonary nodules. MEDIASTINUM AND HILA: Bilateral thyroid nodules are incompletely visualized but appear grossly similar to the prior exam. Left chest port with catheter tip at the cavoatrial junction. Stent in the right brachiocephalic vein is unchanged in position. The right internal jugular and right brachiocephalic veins are incompletely visualized due to lack of contrast administration in this region. The right subclavian vein is slightly less distended, however this may be due to a lack of right-sided infusion on this study. Aneurysmal dilatation of the ascending aorta measuring 4.3 cm in diameter, unchanged. Enlarged main pulmonary artery measuring 3.8 cm in diameter is unchanged and suggestive of pulmonary hypertension. Severe cardiomegaly with atherosclerotic arterial calcifications. Small pericardial effusion. Mildly enlarged subcarinal node is nonspecific. No hilar lymphadenopathy.CHEST WALL: Multiple venous collaterals are noted in the right chest wall. Bilateral axillary lymphadenopathy is increased. Reference node in the right axilla measures 2.1 cm in short axis (7/56), previously 1.5 cm. The breasts are outside the field of view and incompletely visualized. Diffusely sclerotic spine, compatible with history of sickle cell disease.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Reflux of contrast into the hepatic veins. There is lack of opacification of the right hepatic vein. Calcification in the hepatic dome is stable. The visualized kidneys are atrophic. Spleen is not visualized. | 1.No evidence of a pulmonary embolus.2.Right brachiocephalic stent is incompletely evaluated due to lack of contrast.3.Nonspecific bilateral lymphadenopathy is increased from the prior exam.4.Cardiomegaly with enlargement of the main pulmonary artery, suggestive of pulmonary hypertension.5.Stable aneurysmal dilatation of the ascending aorta. |
Generate impression based on findings. | Right lower quadrant pain for 3 days ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nonspecific subcentimeter hypodensities in the liver. These are too small to characterize without most likely benign.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small amount of air in the right gluteal soft tissues tissues likely secondary to previous injections.OTHER: Small amount of fluid in the pelvis. | No CT findings to explain patient's right lower quadrant pain. Appendix is unremarkable. |
Generate impression based on findings. | 53 year old female with history of DVT, now with chest pain PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Left lower lobe pleural-based micronodule is unchanged. No consolidation or pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic hypodensity is too small to characterize but unchanged in size. Cholecystectomy clips. Small hiatal hernia. | No evidence of a pulmonary embolus. |
Generate impression based on findings. | 31-year-old male with history of CF now with cough and shortness of breath and wedge shape opacity seen on chest x-ray. PULMONARY ARTERIES: Technically adequate study. Filling defect in a right lower lobe subsegmental branch is compatible with a pulmonary embolus.LUNGS AND PLEURA: Interval decrease in large left lower lobe cavitary lesions seen on the prior exam with small residual consolidation and scarlike opacities in this region. There is a new 3.7 x 5.4 cm cavitary lesion in the right lower lobe.Redemonstration of mild bronchiectasis and bronchial wall thickening. Mucus plugging is increased from the prior exam. These findings are compatible with patient's history of cystic fibrosis. Stable right middle lobe atelectasis and mucus plugging. Small right lower lobe pleural effusion.MEDIASTINUM AND HILA: Right-sided chest port with tip terminating in the right atrium. Heart size is normal without pericardial effusion. Right hilar lymphadenopathy is unchanged. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small splenule. | 1.Filling defect in a right lower lobe subsegmental branch is compatible with a pulmonary embolus.2.Resolution of left lower lobe cavitary lesion with interval development of right lower lobe cavitary lesion. These findings are suggestive of infection, particularly atypical infection such as a fungal pneumonia.3.Diffuse bronchiectasis and mucous plugging compatible with history of cystic fibrosis.4.Stable hilar lymphadenopathy. |
Generate impression based on findings. | 58-year-old male with shortness of breath, history of GBM PULMONARY ARTERIES: Limited exam due to poor opacification. No pulmonary embolus is evident to the segmental level.LUNGS AND PLEURA: Increase in right basilar atelectasis/consolidation with complete collapse of the right lower lobe and subsegmental atelectasis of the right middle lobe. Moderate right-sided pleural effusion is increased from the prior exam. Subsegmental atelectasis/consolidation of the left lower lobe, similar to the prior exam. Left upper lobe ground glass opacity.MEDIASTINUM AND HILA: Mildly enlarged right hilar lymph node is nonspecific. No hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic hypodensities appear stable. Left renal cyst is unchanged. | 1.Limited exam, however no pulmonary embolus is evident to the segmental level.2.Increased and right basilar atelectasis/consolidation with complete collapse of the right lower lobe, subsegmental atelectasis of the right middle lobe and increase in a moderate right pleural effusion.3.Left upper lobe ground glass opacity is nonspecific. |
Generate impression based on findings. | Right flank pain and hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis without biliary dilatationSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral nephrolithiasis without evidence of hydronephrosis. No stones in the ureters.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Postsurgical changes in the pelvis. | Bilateral nephrolithiasis and cholelithiasis. |
Generate impression based on findings. | History of left adrenal nodule ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is a 1.3-cm nodule in the left adrenal gland. The nodule measures 27 Hounsfield units on the noncontrast images, 144 Hounsfield unit on the portal venous phase images and 67 Hounsfield unit on the delayed images. These numbers indicate absolute washout percentage of 66% and relative washout of 54%. These findings are more suggestive of an lipid poor adenoma. Follow-up imaging is recommended.Right adrenal gland is unremarkable.KIDNEYS, URETERS: Punctate stones in the upper and lower pole of the left kidney without evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 3-cm right ovarian cyst.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Left adrenal nodule with enhancement characteristics suggestive of a lipid poor adenoma. Follow-up imaging with MRI in 6 month to one year may helpful.Left nephrolithiasis without evidence of hydronephrosis. |
Generate impression based on findings. | History of recurrent stage III endometrial cancer 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: Bilateral nephrostomy tubes with mild residual hydronephrosis on the left side.RETROPERITONEUM, LYMPH NODES: Index left para-aortic node measures 1.4 by 1 cm on image number 54, series number 3, not significantly changed from previous study. The more inferior para-aortic node, however, has increased in size and now measures 1.9 by 2 cm on image number 67, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Large pelvic mass containing small amount of air now measures 6.5 by 7.3 cm on image number 96, series number 3, smaller compared to previous study. The extension of the mass into the left adnexa is again noted, slightly increased compared to previous study. Invasion of the sigmoid colon and air in the mass is again noted. The mass extends to the pelvic sidewall and likely invades the left external iliac vein.BLADDER: Bladder wall is invaded by the pelvic mass.LYMPH NODES: Index right inguinal lymph node measures 1.4 x 1.4 cm number 107, series number 3, smaller compared to previous study. Other bilateral inguinal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Slight interval increase in the size of the distal left para-aortic adenopathy and extension of the pelvic mass into the left adnexa. Right inguinal lymph node is decreased in size compared to previous study.Mild left hydronephrosis persists despite the left nephrostomy catheter. Left ureter is invaded by the pelvic mass. |
Generate impression based on findings. | 74-year-old male with possible pancreatic ductal dilatation The study is limited due to lack of IV contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: This study is not optimal for evaluation of the pancreas. There is pancreatic ductal dilatation the tail of the pancreas with an abrupt transition to a normal sized pancreatic duct in the region of the mid body. A focal neoplasm in that location cannot be excluded on this noncontrast study.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrolithiasis. Vascular calcifications.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Very limited study due to lack of intravenous contrast. Pancreas cannot be evaluated optimally with this noncontrast study. Pancreatic ductal dilatation in the tail with transition point in the mid body. Focal pancreatic neoplasm in that location cannot be excluded. Further evaluation with contrast enhanced MRI is recommended. |
Generate impression based on findings. | 59-year-old female with persistent abdominal pain that worsens with peritoneal dialysis and mildly elevated liver function tests The study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of free air in the peritoneum is likely secondary to peritoneal dialysis catheter . Small amount of fluid is present in the pelvis. The tip of the peritoneal dialysis catheter is in the left lower quadrant in the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of fluid in the pelvis. Small fat containing umbilical hernia. | Limited study due to lack of IV contrast. Small amount of free fluid and free air in the abdomen likely secondary to peritoneal dialysis catheter. |
Generate impression based on findings. | 37-year-old male with history of sepsis, evaluate for source This study is limited due to lack of IV contrast.CHEST:Bilateral small pleural effusions and dependent atelectasis. There is an area of also a lesion in the right lower lobe. Although this may represent atelectasis, superimposed infection cannot be excluded. Small amount of air pericardial effusion.ABDOMEN:LIVER, BILIARY TRACT: Changes secondary to liver transplant. No focal liver lesions.SPLEEN: Mild splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is mild right-sided hydronephrosis likely secondary to involve both the right ureter by the pelvic peritransplant hematoma. Bilateral punctate nephrolithiasis.RETROPERITONEUM, LYMPH NODES: IVC filter is in place.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Right iliac fossa transplant kidney. High density collection containing air surrounding the transplant kidney inferior medial, medial and anterolateral to the transplant kidney is unchanged compared to the previous study. No evidence of hydronephrosis. Small amount of hematoma is also present in the right lower quadrant anterior abdominal wall.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The wall of the rectum and sigmoid is slightly thickened. Mild colitis cannot be excluded.BONES, SOFT TISSUES: Right hip prosthesis.OTHER: No significant abnormality noted | Limited study due to the provided contrast. Right lower lobe consolidation. Superimposed infection cannot be excluded. Hematoma around the right iliac transplant kidney causing mild right-sided hydronephrosis and hydroureter.This hematoma contains air and is unchanged from previous study. Secondary infection of the hematoma cannot be excluded.Mild wall thickening of the rectosigmoid. Focal colitis cannot be excluded.Postsurgical changes secondary to liver transplant and splenomegaly. |
Generate impression based on findings. | 78-year-old male with history of colon cancer This study is limited due to lack of IV contrast.CHEST:LUNGS AND PLEURA: Bilateral small pleural effusions and dependent atelectasis.MEDIASTINUM AND HILA: Enlarged main pulmonary artery suggestive of probably hypertension. Mild cardiomegaly.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Indeterminate right adrenal nodule measuring 2.1 x 2.6 cm image number 98 on series number 302.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a large right inguinal hernia containing nonobstructed distal small bowel, colon loops and small amount of ascites.Patient`s known sigmoid cancer is noted best seen on image number 166, series number 302.BONES, SOFT TISSUES: Generalized anasarca.OTHER: No significant abnormality noted | Limited study to lack of IV contrast.Patient's known cancer is noted in the sigmoid colon.Large inguinal hernia containing nonobstructive bowel loops.Indeterminate right adrenal nodule. MRI of the adrenal glands may be helpful for further evaluation. Cardiomegaly, pulmonary arterial hypertension, small amount of pleural effusions and dependent atelectasis. |
Generate impression based on findings. | Evaluate evolution of subdural hemorrhage in a patient with headache. Evaluation is severely limited secondary to patient motion.Stable appearing 7-mm subdural hemorrhage overlying the right posterior cerebral convexity with sulcal effacement without evidence of midline shift. Stable appearing left subdural hemorrhage. Small amount of bilateral subarachnoid hemorrhage, stable from prior exam. Findings suggesting moderate chronic small vessel disease. Right periorbital soft tissue laceration. | No change from prior exam. |
Generate impression based on findings. | Motor vehicle traffic accident ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small cysts in the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No changes secondary to motor vehicle accident. |
Generate impression based on findings. | 42 year-old female with history of left flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral punctate renal stones. There is also a 6 mm stone in the proximal left ureter causing mild left caliectasis. No stones in the right ureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 6-mm left proximal left ureteral stone causing mild left hydronephrosis. Bilateral nephrolithiasis. |
Generate impression based on findings. | 36-year-old female with history of left flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is a 4-mm stone in the left UVJ causing mild left-sided hydroureter and hydronephrosis. Punctate stone in the right kidney without evidence of hydronephrosis, best seen on image number 54, series number 3.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Small left UVJ stone causing mild left hydronephrosis and hydroureter. |
Generate impression based on findings. | Dropping hemoglobin ABDOMEN:LUNG BASES: Dependent atelectasis at the lung bases.LIVER, BILIARY TRACT: Hypodense lesions in the liver are unchanged. Small amount of air in the liver may be secondary to pneumobilia. Significantly distended gallbladder is unchanged from previous study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is some high density of the both kidneys likely represents a prior contrast injection. Correlation with previous recent history of contrast injections recommended.RETROPERITONEUM, LYMPH NODES: Bilateral lower extremity venous catheters. No evidence of retroperitoneal hematoma.BOWEL, MESENTERY: No evidence of intraperitoneal hematoma.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: Extending in the right inguinal region likely secondary to insertion of the right arterial and venous femoral catheters.OTHER: No significant abnormality noted | No evidence of intraperitoneal or retroperitoneal hematoma. |
Generate impression based on findings. | Left flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mildly dilated left ureter secondary to a 5 mm stone in the left distal ureter close to the UVJ best seen in image number 105, series number 3. No stones or hydronephrosis of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Small distal left ureteral stone causing mild dilatation of the left ureter. |
Generate impression based on findings. | Ventral hernia This study is limited due to lack of IV contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes secondary to poor and right gastric bypass surgery . small fat containing periumbilical hernia is unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Small fat containing paramedical hernia is unchanged. |
Generate impression based on findings. | 73-year-old male with tachycardia and tachypnea, evaluate for pulmonary embolus PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: Moderate right and small left pleural effusion, increased from the prior exam, with associated compressive atelectasis of the right lower lobe.MEDIASTINUM AND HILA: Mild coronary artery calcifications.CHEST WALL: Lytic lesion in the posterior aspect of the T5 vertebral body is stable in size.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic mass seen on the prior exam is better seen on prior CT due to differences in phase of contrast. Abdominal ascites is increased from the prior exam. | 1.No evidence of a pulmonary embolus.2.Interval development of moderate right and small left pleural effusions with associated compressive atelectasis of the right lower lobe.3.Lytic lesion in the T5 vertebral body appears similar to recent CT and may represent either benign or malignant processes.4.Increased abdominal ascites.5.Hepatic lesions are better seen on prior study due to differences in phase of contrast evaluation. |
Generate impression based on findings. | 27-year-old female with CMV viremia and abdominal pain, rising transaminitis. History of graft-versus-host disease. ABDOMEN:LUNG BASES: Trace right pleural effusion and minimal basilar atelectasis.LIVER, BILIARY TRACT: Periportal edema, small amount of fluid around gallbladder, and heterogeneous enhancement of the liver, suspicious for hepatitis. Prominence of common bile duct not significantly changed.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Previously seen striated enhancement pattern of kidneys is not appreciated on current exam. No hydronephrosis or other significant abnormality is identified.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple small and large bowel loops are filled with fluid, however, no significant dilation or bowel thickening is identified; this may be due to diffuse mild ileus or gastroenteritis. Small amount of free fluid is present in the right lower quadrant.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of free fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Periportal edema and heterogeneous enhancement pattern of liver parenchyma, suggestive of hepatitis given history of rising transaminitis. 2.Distention of gallbladder and small amount of pericholecystic fluid most likely also due to hepatitis.3.Multiple fluid-filled, nondilated loops of small and large bowel, which may be due to mild diffuse ileus or gastroenteritis given patients viremia. |
Generate impression based on findings. | 44-year-old male with metastatic bladder cancer, abdominal pain, possible ileus. 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: Moderate left hydronephrosis due to obstruction of the distal ureter by a heterogeneous retroperitoneal metastatic lesion. There is delayed excretion of contrast into the left clipping system, supportive of functionally significant obstruction.Foci of gas within the both collecting systems, likely represent reflux from neobladder.No right hydronephrosis.RETROPERITONEUM, LYMPH NODES: Left retroperitoneal lesion/lymphadenopathy just below bifurcation of aorta measures 4.2 x 2.5 cm, and is likely cause of previously mentioned left hydronephrosis (series 7, image 106). IVC filter in place.BOWEL, MESENTERY: There is a fluid collection with internal foci of gas in the right lower quadrant measuring 2.4 x 4.6 cm, which may be postsurgical seroma/lymphocele, although internal foci of gas in are suspicious for superimposed infection (series 4, image 122).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy and creation of neobladder.BLADDER: Status post cystoprostatectomy and creation of neobladder. Percutaneous right-sided catheter enters the neobladder.LYMPH NODES: Heterogeneous, enhancing mass in the left hemipelvis measures 2.5 x 6.2 cm (series 7, image 128); consistent with metastatic lymphadenopathy. More inferiorly located small fluid collection adjacent to surgical clips most likely represent postsurgical seroma/lymphocele (series 7, image 139).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Left retroperitoneal and pelvic metastatic lesions/lymphadenopathy causing obstruction of left ureter and resultant moderate left hydronephrosis.2.Postsurgical changes status post cystoprostatectomy and neobladder creation. Small fluid collections in left hemipelvis and right lower quadrant likely represent seromas/lymphoceles. However, the fluid collection in right lower quadrant contains foci of gas, which is suspicious for superimposed infection and abscess formation. |
Generate impression based on findings. | 62-year-old female with generalized abdominal pain radiating to bilateral flanks. History of ESRD, recent pyelonephritis. Rule out mesenteric inflammation. ABDOMEN:Within the limits of a non-IV contrast enhanced examination limiting evaluation of abdominal parenchymal organs and vascular structures, the following observations can be made:LUNG BASES: Trace bilateral pleural effusions.LIVER, BILIARY TRACT: No significant abnormality noted. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild bilateral perinephric fat stranding, slightly more prominent from the prior exam. No nephrolithiasis, hydronephrosis, or frank fluid collection is seen bilaterally. Pyelonephritis cannot be excluded given the lack of contrast. Vascular calcifications in the left kidney are noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The bowel is normal in caliber without evidence of obstruction. See comment below.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small fat-containing ventral hernia.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Extensive diverticulosis of the sigmoid colon. Appearance of generalized mesenteric stranding superior to the segment of diverticulosis is unchanged from prior exam. No frank fluid collection. This haziness may represent inflammatory changes, however is a nonspecific finding, with questionable significance especially in a chronic setting.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Slight increase in the bilateral perinephric stranding with no fluid collection. Lack of contrast limits further evaluation, and pyelonephritis cannot be excluded.2.Nonspecific mesenteric haziness superior to the sigmoid colon, stable, and of questionable clinical significance.3.Extensive diverticulosis of the sigmoid colon. |
Generate impression based on findings. | Headache. 43 years old feamle. 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 A1 segments are similar in diameter.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a subarachnoid hyperdensity present anterior to the brainstem and along the posterior aspect of this are sellar cistern and along the paramesencephalic cisterns and the proximal portions of the sylvian fissures.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. The anterior communicating artery is very small. There is a fetal origin of the left posterior communicating artery associated with an infundibulum at its origin and a medium-sized left P1 segment. The right posterior communicating artery is tiny and also has a small infundibulum | 1.No evidence for aneurysm.2.No evidence for cerebral vascular occlusive disease subarachnoid hemorrhage in a pattern suggestive of benign parimesencephalic bleed which is eccentric towards the right side. |
Generate impression based on findings. | Male 31 years old; Reason: r/o stone History: L flank pain The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: No significant abnormality noted. Stable left lower lobe atelectasis versus scarring.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 4-mm stone noted in the proximal left ureter (series 5 image 65). Mild hydroureter and ureteritis, however no frank hydronephrosis, perinephric fluid collections, or extensive perinephric edema. Bilateral, subcentimeter nonobstructing renal stones are unchanged. Probable subcentimeter left renal cyst, too small to characterize, also unchanged..RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Collapsed without evidence of stones.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. 4mm left proximal ureteric stone with associated mild hydroureter and ureteritis. No hydronephrosis or perinephric fluid collections. Multiple non-obstructing subcentimeter renal stones bilaterally are unchanged. |
Generate impression based on findings. | 72-year-old male with history of laryngeal cancer presenting with hemoptysis LUNGS AND PLEURA: Moderate left pleural effusion with adjacent atelectasis. Scattered groundglass opacities in the left upper lobe. Left lower lobe consolidation. Minimal right lower lobe atelectasis/consolidation.MEDIASTINUM AND HILA: Debris is noted in the central airways. No mediastinal lymphadenopathy. Scattered atherosclerotic calcifications of the aorta and coronary arteries.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. A G-tube is partially visualized.No significant abnormality noted. | Moderate left pleural effusion with associated atelectasis and consolidation as well as scattered ground glass opacities suspicious for infection and/or aspiration. Given the patient's age this should be followed to resolution to exclude underlying malignancy.Findings were communicated to the ED by the radiology resident on call at the time of exam via StatConsult tool. |
Generate impression based on findings. | Female; 6 years old. Reason: eval appendicitis, R pelvic mass History: eval appendicitis, R pelvic mass ABDOMEN:LUNG BASES: There is minimal dependent subsegmental atelectasis at the right lung base. The left lung base is clear. The visualized heart is normal in size.LIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary dilation.SPLEEN: No focal splenic lesions.PANCREAS: No focal pancreatic lesions. No pancreatic ductal dilation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The bilateral kidneys are symmetric in size and shape. No focal renal lesions. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No abdominal lymphadenopathy. There are a few, scattered prominent lymph nodes seen in the right hemiabdomen adjacent to the cystic mass described below, which may be reactive.BOWEL, MESENTERY: Normal caliber of the small and large bowel without evidence of obstruction. A normal appendix is visualized in the right lower quadrant.BONES, SOFT TISSUES: No suspicious osseous lesions.OTHER: There is a small amount of free fluid in the right hemiabdomen in both the retroperitoneum and right paracolic gutter extending into the pelvis.PELVIS:UTERUS, ADNEXA: There is a multiloculated, cystic mass measuring approximately 8.2 x 5.6 x 12.5 cm (transverse by AP by craniocaudal, image 72/series 3 and image 52/series 80240) centered in the right pelvis. There is no fat-containing component, calcification, or mural nodularity. The ovaries are not well visualized. Normal CT appearance of the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No suspicious osseous lesions.OTHER: No significant abnormality noted | 1. Multiloculated, cystic mass which may be due to ovarian neoplasm such as a cystic teratoma, dermoid, or lesion within the cystadenoma spectrum. Evaluation of the adnexa is limited by CT and correlation with pelvic ultrasonography is recommended.2. Small amount of abdominal, retroperitoneal, and pelvic ascites, which may be reactive. |
Generate impression based on findings. | 47-year-old female with somnulence and altered mental status. There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | Normal brain CT. CT is insensitive for the early detection of non-hemorrhagic CVA and MRI may be considered. |
Generate impression based on findings. | Facial pain, periorbital edema, and pain extraocular movement. Recent oral surgery. Extensive streak artifact associated with metallic implants in both maxillary and mandibular dentition obscures the surrounding anatomy. Within this limitation, there is mild diffuse preseptal subcutaneous stranding in the region of the inferior eyelid. No fluid collection is evident. There is no evidence of postseptal cellulitis and the right orbit is unremarkable. The paranasal sinuses are clear. The osseous structures and imaged portions of the intracranial structures are unremarkable. | Left preseptal cellulitis without evidence of a postseptal component of abscess.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 52-year-old male with LVAD and abdominal distention. ABDOMEN:LUNG BASES: Small right pleural effusion. Bilateral pleural catheters in place. Bilateral basilar consolidation/atelectasisLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications affect the aorta and its branches.BOWEL, MESENTERY: There is mild dilation of the appendix, measuring 7 mm in diameter, without evidence of inflammation to suggest appendicitis.No bowel obstruction is present. There is gaseous distention of the colon, predominantly affecting the ascending and transverse.BONES, SOFT TISSUES: No significant abnormality notedOTHER: LVAD is in place. There is fluid with internal foci of gas immediately superior to the LVAD generator along the posterior aspect of the anterior abdominal wall; this may in part represent postsurgical inflammation although foci of gas are concerning for superimposed infection (series 3, image 35).PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in place. The gas in bladder likely due to instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Gaseous distention of ascending and transverse colon, without evidence of bowel obstruction.2.Fluid and foci of gas along the anterior abdominal wall adjacent to LVAD; while this may in part be postsurgical in nature, superimposed infection is possible given associated gas.3.Small right pleural effusion with bilateral lung base consolidation/atelectasis. |
Generate impression based on findings. | Male 63 years old; Reason: met CRC restaging History: increased pain and bloating CHEST:LUNGS AND PLEURA: No dominant lung lesion. The pleural spaces are clear. Subcentimeter right lower lobe nodules appear stable.MEDIASTINUM AND HILA: Left prevascular node measures 1.6 cm, previously 1.4-cm (image 41 / series 3). Right hilar lymph node measures 1.2 x 0.7 cm (image 52/series 3) previously, 1.2 x 0.7 cm.CHEST WALL: A right chest wall port terminates at the cavoatrial junction.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic lesions are reference right hepatic lobe lesion measures 4.0 x 2.7 cm (series 3 image 110) previously 4.2 x 2.3. Multiple other hepatic lesions appear relatively stable. No biliary ductal dilatation. Portal venous vasculature are patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal nodule measures 3.1 x 2.5 cm (series 3 image 117) previously 2.8 x 2.1cm.Left adrenal nodule measures 1.4 x 1.1cm (image 111/series 3) previously, 1.7 x 1.2 cm.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive malignant retroperitoneal lymphadenopathy which is stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate is enlarged.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Stable size of the reference hepatic lesion and non reference metastatic disease as above. |
Generate impression based on findings. | Left sided weakness. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. However, non-contrast CT is not sensitive for the detection of non-hemorrhagic acute infarction. |
Generate impression based on findings. | 56-year-old female with history of rectal cancer, multiple abdominal surgeries, cholecystectomy, appendectomy, TAH-BSO, worsening right upper quadrant pain, assess for metastatic disease ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild intrahepatic biliary ductal dilatation is unchanged from prior study. This could be sometimes seen in the setting of cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensity in the right kidney is unchanged from prior study and most represent a cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild osteoporosis with degenerative changes.OTHER: No significant abnormality noted | No definite CT findings to explain patient's right upper quadrant pain.No evidence of metastatic disease. |
Generate impression based on findings. | 26 year old female with tachycardia, shortness of breath, concern for PE PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: Scattered bilateral ground glass and tree in bud opacities as well as consolidation, right greater than left, suspicious for infection.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy (right greater than left) which may be reactive in etiology.CHEST WALL: Small axillary nodes.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Technically adequate study without evidence of pulmonary embolus.2. Findings suspicious for infection, possibly atypical. |
Generate impression based on findings. | Follow-up scan. History of metastatic disease and ICH. There is been interval stability in the size of the two left hemispheric masses which are associated with layering hyperdense material, edema and mass effect. The left frontal mass measures up to 4.0 x 3.4 cm and the left parietal mass measures up to 2.8 x 2.4 cm in maximum axial dimension. There is 3 mm of midline shift. There is crowding of the left suprasellar cistern without herniation. There are no bony fractures. On limited assessment, the visualized portions of orbits and sinuses are unremarkable. | Interval stability in the left frontal and parietal masses which most likely represent hemorrhagic melanoma metastases with associated mass effect including 3 mm of midline shift. |
Generate impression based on findings. | History of metastatic disease to the brain. AMS. There are two left hemispheric masses associated with hyperdense material, a portion of which is layering dependently. There is associated edema and mass effect including sulcal effacement and 3 mm of rightward midline shift at the level of the septum pellucidum. A right frontal mass measures 4.2 x 3.7 cm in maximum axial dimension while a left parietal mass measures 2.7 x 2.1 cm. There are no additional masses noted, though sensitivity is limited in this respect by lack of contrast administration. There is no hydrocephalus or herniation. There is fluid layering within the right maxillary sinus and fluid or soft tissue thickening within the left maxillary and left sphenoid sinus. Ethmoids and right sphenoid sinus are clear. | Two left hemispheric masses associated with hyperdense material most likely representing hemorrhagic metastatic disease in this patient with known metastatic melanoma. Mass effect including 3 mm of rightward midline shift. |
Generate impression based on findings. | LVAD There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Reason: lung nodules, f/u History: lung nodules LUNGS AND PLEURA: New moderate right pleural effusion. Minimal basal atelectasis on the right. Linear atelectasis or scarring in the lingula and right middle lobe.Previously reference right perifissural nodule is now seen on image 54/100 and appears to be an area of scarring. Other scattered punctate micronodules are stable and presumably postinflammatory.MEDIASTINUM AND HILA: Coronary calcification. Scattered small subcentimeter lymph nodes are stable.CHEST WALL: Degenerative change involving the thoracic spine. Gynecomastia.The abdomen will be reported separately. Please see separate report. | 1. No suspicious pulmonary nodules. The previously reference subcentimeter right sided nodular opacity now appears to represent an area of scarring.2. New moderate right pleural effusion with minimal compressive atelectasis.3. The abdomen will be reported separately. Please see separate report. |
Generate impression based on findings. | 57-year-old female with swelling of the left leg and concern for bleeding. Subcutaneous edema and skin thickening in the left lower extremity, most prominent around the ankle. The subcutaneous fluid is nonspecific, though no high density fluid collection is noted to suggest a hematoma.Well corticated ossific densities in the anterior subcutaneous tissues are consistent with dystrophic calcifications. No acute fracture or malalignment. No osteolysis to suggest osteomyelitis. Mild osteoarthritis affects the knee. | Soft tissue edema and skin thickening in the left lower extremity. No high density fluid collection to suggest hematoma. |
Generate impression based on findings. | 29 year female history of ventricular shunt now with shunt infection and vision changes. A right parietal approach ventriculostomy catheter courses in the right lateral ventricle with the tip unchanged in position. There has been a minimal interval increase in size of the lateral ventricles which remain slit-like. There are no subdural collections and the position of the cerebellar tonsils is unchanged. There is no acute intracranial hemorrhage, mass, edema, or midline shift. The partially visualized paranasal and mastoid air cells are unremarkable. | Unchanged right ventriculostomy catheter with minimal interval increase in size of lateral ventricles which remain slit-like. |
Generate impression based on findings. | Cardiac arrest, likely due to respiratory failure. There is interval increase in the degree of diffuse cerebral edema with complete to near complete effacement of the third and lateral ventricles and sulci, as well as approximately 5 mm of inferior tonsillar herniation. There is also more pronounced hypoattenuation within the bilateral basal ganglia and cerebral white matter. There is no midline shift. There is no evidence of acute intracranial hemorrhage. There is increased opacification of the paranasal sinuses and nasopharynx related to intubation. There are partially imaged periodontal lucencies. | Interval progression of diffuse cerebral edema with 5 mm of inferior tonsillar herniation related to hypoxic-ischemic injury.Discussed Dr. Mendelson at 8:55 AM on 11/18/13. |
Generate impression based on findings. | Reason: assess for metastatic disease. 6 mm nodule found on CT abdomen, pelvis. Endometrial cancer History: none LUNGS AND PLEURA: Scattered punctate nonspecific pulmonary nodules measuring up to 6 mm (right middle lobe image 52/93). The reference pulmonary nodule is unchanged in the short interval.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Coronary calcification. Scattered small nonspecific subcentimeter lymph nodes are present.CHEST WALL: Minimal degenerative change involving the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left adrenal nodule, partially visualized. Please see dedicated abdomen and pelvis CT report for further details. He is a | Scattered punctate nonspecific pulmonary nodules measure up to 6 mm. While these more likely represent benign postinflammatory nodules than metastases, continued follow-up (3 to 6 months CT) is recommended, as malignancy cannot be excluded. The nodules are too small for high yield PET or needle biopsy. |
Generate impression based on findings. | Female 62 years old; Reason: Hx of multiple myeloma and amyloidosis with peritoneal involvement s/p two transplants. Please assess for disease. History: None The exam is not sensitive for detecting lesions in the bowel or solid organs dueto lack of oral or intravenous contrast. Given those limitations, the followingobservations are made:ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver enlarged at 20.3 cm in length coronal image 48/78. Givenlimitations of no IV contrast, no focal lesions identified. No evidence of fatty liver. No calcification seen in the liver.SPLEEN: Normal sized spleen with no focal lesions given limitation of no IV contrast.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted. Surgical clips in the distribution of the iliac vasculature in the visualized pelvic inlet. Borderline retroperitoneal adenopathy is stable..BOWEL, MESENTERY: Interval decrease in the marked ascites previously noted. Trace ascites is still seen layering in the paracolic gutters and cul-de-sac. Previously seen soft tissue components in the distribution of the omentum are not visualized on this exam. No measurable solid carcinomatosis.BONES, SOFT TISSUES: Stable incisional hernia noted. Numerous lytic lesions in the spine are unchanged.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Surgically absentBLADDER: 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. | Limited by lack of intravenous contrast. Decrease in the amount of ascites without measurable solid carcinomatosis. |
Generate impression based on findings. | 67-year-old male with abdominal pain, nausea, vomiting. ABDOMEN:LUNG BASES: Mild right basilar atelectasis.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: Punctate hypodense focus in tail of pancreas is nonspecific and may represent small focus of intrapancreatic fat or alternatively a cystic pancreatic neoplasm such as IPMN (series 3, image 41).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications in aorta and its 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: Bullet fragment noted in L4 vertebral body.OTHER: No significant abnormality noted | 1.Cholelithiasis without other findings to account for patient's symptoms.2.Punctate hypodense focus in tail of pancreas is nonspecific and may represent small focus of intrapancreatic fat or alternatively a cystic pancreatic neoplasm such as IPMN |
Generate impression based on findings. | 37-year-old female with history of PE, intraoperative, tachycardia PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: Bilateral basilar atelectasis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart size is normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered foci of free intraperitoneal air likely relate to recent surgery. | No evidence of pulmonary embolus. |
Generate impression based on findings. | Female 33 years old; Reason: 16 cm ovarian cyst h/o endometriosis History: as above 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: Moderate ascites noted in the upper abdomen.PELVIS:UTERUS, ADNEXA: Large cystic lesion likely arising from the left adnexa measures 7.2 x 14 .6 x 16cm in largest AP x transverse x CC dimensions. No soft tissue or nodular components noted in the cyst. No fat or hemorrhage seen. Physiologic fluid noted in the endometrial canal.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.Large left ovarian cystic lesion without soft tissue components and adjacent ascites. Differential includes, large ovarian cyst, endometrioma, hydatid cyst, cystic neoplasms such as mucinous cystadenomas cannot be excluded. And given its size, and adjacent ascites surgical consultation advised. |
Generate impression based on findings. | 57 year old female with acute drop in hemoglobin. Evaluate for hematoma. Left femoral venous catheter and right femoral arterial and venous catheters. Mild surrounding fat stranding is likely secondary to the recent procedure. No hematoma or fluid collection is evident. Soft tissue swelling and fat stranding in the left upper thigh is nonspecific. Foley catheter in the bladder. Excreted contrast in the bladder. Please see dedicated CT abdomen and pelvis for additional findings. | No evidence of hematoma. |
Generate impression based on findings. | 23 year old male status post exploratory laparotomy 13 days ago for lysis of adhesions. ABDOMEN:LUNG BASES: Trace bilateral pleural effusions/pleural thickening.LIVER, BILIARY TRACT: Nonspecific calcifications again noted in the caudate and left lobes. No significant abnormalities.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple mildly dilated jejunal loops measuring up to 3 cm in diameter. There is suggestion of transition point in the lower midabdomen (series 80244, image 48). Given patient's recent surgery, this may be due to mild postoperative ileus or mild partial small bowel obstruction. No wall thickening, pneumatosis, or free intraperitoneal air.BONES, SOFT TISSUES: Postsurgical changes in the anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of free fluid in the pelvis.BONES, SOFT TISSUES: Multiple metallic bullet fragments are present in the left hemipelvis and thigh. Postsurgical changes in anterior abdominal wall.OTHER: No significant abnormality noted | Mild dilation of jejunal loops with suggestion of transition point in the lower midabdomen; findings may represent mild postoperative ileus or low grade partial small bowel obstruction. |
Generate impression based on findings. | Reason: please assess extent of metastatic disease; please compare to previous scans History: hx of head and neck cancer LUNGS AND PLEURA: Emphysema. Scarring at left base. Post op change left lower lobectomy.New 8mm nodule in subpleural posterior left upper lobe (image 47/105). There is also a smaller irregular roughly 5 mm nodule more centrally located in left upper lobe (image 44/105).Other small nodules, some of which are calcified, are stable.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Stable small nodes, many of which are calcified and presumably related to healed granulomatous disease.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hiatal hernia. Splenule. Splenic granuloma. Stable small nonspecific hypodensities in liver are presumably benign. | New 8mm nodule in left upper lobe suspicious for malignancy. |
Generate impression based on findings. | Acute liver failure mental status change 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 intracranial vasculature is mildly hyperintense. The patient did have a the abdomen with contrast earlier in the day.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.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of a nonhemorrhagic CVA |
Generate impression based on findings. | History of seizure and altered mental status. There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. There is diffuse prominence of ventricles and sulci in related to cerebral volume loss. There is encephalomalacia within the right middle frontal gyrus. There is also patchy cerebral white matter hypoattenuation, most likely related to chronic small vessel ischemic disease. The imaged paranasal sinuses and mastoid air cells are clear. There is chronic right frontal craniotomy defect. There is a right lens implant. | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. Unchanged right middle frontal gyrus encephalomalacia likely related to remote surgery and cerebral white matter hypoattenuation likely related to chronic small vessel ischemic disease. |
Generate impression based on findings. | 56-year-old female. Pain around stoma and purulence. Evaluate for infection/abscess. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ileostomy in the right lower quadrant. Subcutaneous gas is noted in the region of the ostomy, likely representing postoperative changes, with no identifiable fluid collection. Status post subtotal colectomy with residual rectum and sigmoid. Submucosal edema the rectum is noted. Multiple duodenal diverticula are noted. BONES, SOFT TISSUES: Mild degenerative changes of the lumbar and sacral spine are noted.OTHER: Mild atherosclerotic calcification of the abdominal aorta is noted.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: As above.OTHER: No significant abnormality noted | 1.No fluid collection in the area of the ostomy, as clinically questioned.2.Multiple duodenal diverticula. |
Generate impression based on findings. | LVAD with possible thrombus. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are intradural vertebral artery and carotid siphon calcifications. The imaged mastoid air cells are clear. There is partially imaged partial opacification of the right maxillary sinus. The skull and extracranial soft tissues are unremarkable, including bilateral lens implants. | No evidence of intracranial hemorrhage, mass, or cerebral edema. However, non-contrast CT is not sensitive for acute non-hemorrhagic infraction. |
Generate impression based on findings. | 86-year-old female with history of lung cancer and DVT, rule out pulmonary embolus PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: Marked centrilobular and paraseptal emphysema. Reference right lower lobe nodule measures 1.7 x 0.8 cm and previously measured 1.4 x 0.7 cm (image 85, series 6).MEDIASTINUM AND HILA: Mediastinal and right hilar adenopathy is again identified with reference precarinal lymph node measuring 1.2 cm (image 99, series 5) and previously measuring 1.2 cm.CHEST WALL: Large left chest wall/axillary mass is again identified, measuring 5.9 x 17.2 cm and previously measuring 4.3 x 16.4 cm (image 79, series 4).UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Subcentimeter hypodensities in both kidneys are again identified and incompletely, characterized on this study. | 1. Technically adequate study without evidence of pulmonary embolus.2. Right lower lobe nodule suspicious for lung cancer as well as hilar and mediastinal lymphadenopathy and large left chest wall/axillary mass. |
Generate impression based on findings. | 56 year old female with acute onset chest pain radiating to back, hypertension, shortness of breath. CHEST:LUNGS AND PLEURA: No focal air space opacities or pleural effusions.MEDIASTINUM AND HILA: There is a classical configuration of the aortic arch without evidence of aortic dissection or aneurysm. The heart size is within normal limits. No pericardial effusion is present.Severe coronary arterial calcifications are noted.Although this examination was not protocoled for the evaluation of pulmonary arteries, there are apparent small filling defects in segmental branches of the right and left lower lobe pulmonary arteries which may be artifactual in etiology, however pulmonary embolism is not excluded.No mediastinal or hilar lymphadenopathy is present.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in size and attenuation. No focal hepatic lesions are identified. SPLEEN: The spleen is normal in size and attenuation. A small accessory spleen is present anteriorly.PANCREAS: The pancreas is normal in size and attenuation. There is no pancreatic ductal dilatation.ADRENAL GLANDS: The adrenal glands are symmetric in size and attenuation.KIDNEYS, URETERS: The kidneys are symmetric in size and attenuation.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications affect the abdominal aorta and its branches. There is no retroperitoneal hematoma present. There is no retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Interval closure of the patient's previously noted large ventral hernia. No bowel obstruction. BONES, SOFT TISSUES: Degenerative disk disease affects the visualized 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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of aortic dissection is clinically questioned.2.Apparent small symmetric filling defects in segmental branches of the right and left lower lobe pulmonary arteries which may be artifactual in etiology, however pulmonary embolism is not excluded. If there is continued clinical concern for pulmonary embolism, a dedicated pulmonary embolism protocol CT is recommended.3.Severe coronary arterial calcifications and atherosclerotic disease of the abdominal aorta and its branches. |
Generate impression based on findings. | Right sided jaw swelling. There is streak artifact related to dental amalgam, which obscures surrounding anatomy. Within this limitation, there is diffuse skin thickening, fat stranding and swelling of the musculature in the right face overlying the mandible, where there is a carious ADA 29 with dental filling and periodontal lucency. There is also a cavity and periodontal lucency affecting ADA 1 and 20. A sheet of fluid attenuation material measuring up to 8 mm in thickness extends along the thickened platysma in the right submental space. However, assessment for soft tissue abscess is limited due to the lack of intravenous contrast. There is no significant cervical lymphadenopathy. The major salivary glands are unremarkable. The thyroid gland appears heterogenous. The imaged portions of the paranasal sinuses are clear with the exception of a 5 mm left ethmoid sinus osteoma. There is mild multilevel degenerative spondylosis. The airways are patent. The imaged portions of the lungs demonstrate moderate emphysema. There is a partially imaged left chest pacer device. | 1. Diffuse skin thickening, fat stranding and swelling of the musculature in the right face overlying the mandible, where there is a carious ADA 29 with dental filling and periodontal lucency is compatible with cellulitis and myositis, perhaps odontogenic in origin. A sheet of fluid attenuation material measuring up to 8 mm in thickness extends along the thickened platysma in the right submental space is also present. However, assessment for a soft tissue abscess is limited due to the lack of intravenous contrast. Further evaluation via ultrasound may be useful.2. Cavity and periodontal lucency at ADA 1 and 20. |
Generate impression based on findings. | Unresponsive with history of aneurysm. Hemorrhagic stroke versus subarachnoid hemorrhage. There are postoperative changes including a left suboccipital craniotomy with underlying encephalomalacia within the left cerebellar hemisphere and burr hole is in the right frontal and parietal bones. A tract of encephalomalacia extends from the right frontal burr hole to the right frontal horn. There is dolichoectasia of the basilar artery. CT angiogram would better delineate any underlying aneurysm.There is prominence of ventricular and CSF spaces. There is patchy periventricular and subcortical hypoattenuation most likely keeping with sequela of chronic small vessel ischemic disease. There is no focal intracranial mass, hemorrhage or midline shift. Orbits and paranasal sinuses are unremarkable. There are multiple partially visualized lucencies within the alveolar ridge of the maxillary bone including the most prominent anteriorly which causes bony remodeling measuring 2.8 x 2.0 cm axially. These most likely represent dental abscesses. | 1.Findings related to prior neurosurgical procedures as described.2.Suspected dolichoectasia of the posterior circulation. 3.Multiple lucencies in the alveolar process of the maxilla most likely representing dental abscesses.4.Nonacute findings including postoperative and chronic sequela of small vessel ischemic disease.5.No acute pathology including intracranial hemorrhage or edema demonstrated. |
Generate impression based on findings. | 66-year-old male with abdominal pain, truck in hemoglobin, and history of GI bleeding. ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Complete consolidation of left lower lobe, and partial consolidation in right lower and left upper lobes.Scattered foci of ground glass opacity in both lungs likely represent edema or inflammatory change.New small pericardial effusion.LIVER, BILIARY TRACT: Small amount of ascites fluid around the liver. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable hypoattenuating lesion in the inferior left kidney, most likely benign cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of fluid in left paracolic gutter. No bowel obstruction.BONES, SOFT TISSUES: Significant thickening and infiltrative change of the anterior abdominal wall, increased since prior exam.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left hip prosthesis.OTHER: No significant abnormality noted | 1.No evidence of hematoma.2.New small amount of ascites fluid, small pericardial effusion, small pleural effusions, and increased infiltrative/edematous change in the anterior abdominal wall; findings likely due to volume overload. Superimposed cellulitis in anterior abdominal wall is also possible given extensive skin thickening.3.Consolidation in left lower, left upper, and right lower lung lobes; this may represent combination of atelectasis, pneumonia, and/or aspiration. |
Generate impression based on findings. | 62-year-old male with intra-abdominal abscess, elevated WBC. ABDOMEN:LUNG BASES: Interval increase of large loculated complex collection in the left pleural space, now measuring 16.7 x 15.1 cm. Cephalic aspect not visualized on this exam. Multiple right-sided pulmonary nodules, consistent with known metastatic disease, are increased in size.LIVER, BILIARY TRACT: Hypodense segment 4b lesion is unchanged in size measuring 1.5 x 1.9 cm (series #3, image 34). A second hypodense segment 4a lesion demonstrates interval increase in size, now measuring 1.2 by 1.7 cm (series #3, image 22). Several other lesions are probably unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Moderate left hydronephrosis and hydroureter (1.4 cm coronal image 49) is unchanged, with narrowing of the distal left ureter near the anastomosis site.No significant abnormality of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.PELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Interval increase in size of deep pelvic reference lymph node, measuring 6.2 x 4.9 cm. Interval development of other pelvic adenopathy (image 96, series #3).BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: Gas and fluid is seen tracking along the pelvic sidewalls and dependent portion of the pelvis. For baseline purposes the fluid collection in the deep pelvis persists, measuring 5.1 x 2.2 cm (series #3, image 103), and demonstrates slight interval increase in size. Fluid collection adjacent to the right external iliac vessels has very slightly decreased in size, now measuring 0.9 by 5.0 cm (series #3, image 92), previously measuring 1.1 x 5.8 cm. A percutaneous drain terminates immediately cephalad to this collection. | 1.Increased large loculated complex collection in the left pleural space. Slight increase of the deep lower pelvis fluid collection.2.Fluid and gas tracking along pelvic sidewalls. Slight decrease of the upper pelvis fluid collection.3.Evidence of worsening metastatic disease, including pulmonary disease, segment IVa hypodensity, and pelvic adenopathy.4.Unchanged left hydronephrosis and hydroureter. |
Generate impression based on findings. | TxM3M1 left salivary parotid gland ductal carcinoma androgen +, H2N+, receiving palliative chemotherapy with carbo/taxol. There is a cluster of hypoattenuating There is no significant interval change in the ill-defined heterogeneous mass with cystic and calcified components and extension to the overlying skin, which measures approximately 25 AP x 45 RL x 30 SI mm, previously also approximately 25 AP x 45 RL x 30 RL mm. However, there has been interval decrease in size of the left cervical lymphadenopathy. For example, a left parotid tail lymph node measures 15 x 15 mm, previously 19 x 19 mm, a left level 2 lymph node measures 28 x 25 mm, previously 34 x 31 mm, a left level 3 lymph node or conglomerate of lymph nodes measures 25 x 22 mm, previously 34 x 27 mm, and a left level 6 lymph node measures 11 x 6 mm, previously 13 x 8 mm. There is no significant interval change in size of a right level 6 lymph node that measures 9 x 7 mm, also 9 x 7 mm previously, although the lymph node contains a greater degree of calcification. In addition, there has been interval increase in the degree of calcification within the lymph nodes, likely in response to treatment. There has also been interval decrease in the degree of partially imaged left lower neck and upper chest and back diffuse dermal metastases. There is slightly less diffuse swelling of the left trapezius muscle. There has been interval decrease in size of partially imaged left axillary lymphadenopathy. The thyroid and other major salivary glands are unremarkable. There is partial effacement of the left piriform sinus. The airways are otherwise patent. There has been increase in size of sclerotic foci within the C6, T1, and T2 vertebral bodies and the manubrium, although these lesions did not demonstrate hypermetabolism on PET. There is a right internal jugular venous catheter. There are small retention cysts within the maxillary sinuses. The mastoid air cells are clear. The imaged intracranial structures are grossly unremarkable. There are carious ADA 18 and 19 with associated periapical lucencies. | 1. No significant interval change in the left parotid gland ductal carcinoma that infiltrates the overlying skin.2. Interval decrease in size of the multilevel left cervical lymphadenopathy and partially imaged left axillary lymphadenopathy, with generally increased calcified components likely in response to treatment. A right level 6 lymph node has not significantly changed in size, but demonstrates increased calcification.3. Interval decrease in the degree of left lower neck, and partially imaged upper chest and back dermal metastases.4. Increase in size of sclerotic foci within the C6, T1, and T2 vertebral bodies and the manubrium, although these lesions did not demonstrate hypermetabolism on PET. |
Generate impression based on findings. | 66-year-old female patient with history of breast cancer, smoking, positive d-dimer with syncope and weight loss. PULMONARY ARTERIES: No evidence of a pulmonary embolus.LUNGS AND PLEURA: Moderate centrilobular emphysematous changes. Biapical bullae. Scattered bilateral nonspecific micronodules.MEDIASTINUM AND HILA: Heart size is within normal limits. No pericardial effusion.Severe atherosclerotic changes in the descending aorta.CHEST WALL: Postsurgical changes with surgical clips in the left breast and left axilla.Severe S-shaped scoliosis in the thoracic and lumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Subcentimeter hypoattenuating lesions in the bilateral kidneys are too small to characterize and likely represent cysts. | 1.No evidence of a pulmonary embolus.2.Severe atherosclerotic changes in the descending aorta.3.Moderate centrilobular emphysema.4.Scattered bilateral micronodules are nonspecific. |
Generate impression based on findings. | Female 79 years old; Reason: NHL, re-eval and compare to previous History: low back pain, NHL CHEST:LUNGS AND PLEURA: Unchanged right upper lobe 3-mm micronodule and other stable micronodules. No new nodules or mass detected.MEDIASTINUM AND HILA: Moderate to severe atherosclerotic calcifications of the coronary arteries.Moderate size hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status postcholecystectomySPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged infiltrative soft tissue in bilateral renal hilum. Mild right-sided hydronephrosis with hydroureterRETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta and branch vessels.BOWEL, MESENTERY: Unchanged large hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Right adnexal cyst measures 3.6 x 3.3 Cm (image 154, series 3), previously 3.6 x 3 cm, essentially unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: Right periureteral node measures approximately 12 x 10 mm (image 132, series 3), previously 12 x 10 mm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Unchanged moderate to severe degenerative change of the lumbar spine and sacroiliac joint.OTHER: No significant abnormality noted. | 1. Unchanged right upper lobe pulmonary micronodules. 2. Unchanged right adnexal cyst. Further evaluation with ultrasound is recommended.3. Right-sided hydronephrosis with hydroureter up to the pelvic inlet, is also unchanged |
Generate impression based on findings. | Reason: ?mai infection progression History: nsclc LUNGS AND PLEURA: Pulmonary fibrosis in a UIP pattern with peripheral honeycombing, bronchiectasis and volume loss not significantly changed compared to the most recent previous examination. Left upper lobe mass invading the left mediastinum measures 4.2 x 3.4 cm on image 37/98 (4.2 x 2.9 cm on prior). No specific signs of MAI infection.MEDIASTINUM AND HILA: The left upper lobe mass invades the mediastinum.Borderline mediastinal lymph nodes are unchanged.Atherosclerotic calcification of the aorta and its branches. Coronary calcification.CHEST WALL: Degenerative change involving the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Previously referenced right hepatic metastasis now measures 18 mm on image 76/98 (14 mm on prior) though the prior scan was without contrast which makes direct comparison suboptimal. Multiple near water density well circumscribed hepatic lesions are stable and presumably cysts however there are multiple ill-defined hypodense lesions which are consistent with metastases. Some appear new (image 91/98). Cholelithiasis. | 1. Increasing left upper lobe mass/NSCLC. No specific signs of MAI infection.2. Increased and new hepatic metastases. |
Generate impression based on findings. | Reason: Hx mycobacterial infection/bronchiectasis- Any progression? History: cough LUNGS AND PLEURA: Mild bronchial wall thickening and borderline bronchiectasis, worst in the right middle lobe and lingula, is not significantly changed. Scattered ill-defined punctate centrilobular nodules are also unchanged. No new abnormalities are identified.MEDIASTINUM AND HILA: Scattered small subcentimeter mediastinal nodes are unchanged. Coronary calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | Stable mild findings of infectious bronchiolitis. |
Generate impression based on findings. | Reason: Lung nodules since has infected pacer lead in heart History: SOB LUNGS AND PLEURA: Bilateral pleural effusions are similar in appearance to the recent chest radiograph.Bilateral basilar atelectasis.Mild patchy groundglass opacities with areas of septal thickening compatible with a mild amount of edema.Right apical scarlike opacity (image 21 series 4) may represent subsegmental atelectasis.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Left chest ICD with lead wires in expected positions.Cardiac enlargement without evidence of a pericardial effusion.Marked coronary artery and aortic calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Cardiac enlargement , minimal pleural edema, and moderate bilateral pleural effusions compatible with CHF.2.Right apical discoid atelectasis and/or scarring. No suspicious pulmonary nodules or masses.3.Marked atherosclerotic disease of the aorta and coronary arteries. |
Generate impression based on findings. | 37-year-old male with history of liposarcoma and soft tissue adjacent to right psoas, surrounding appendix. 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: Surgical clips are seen around the left kidney, consistent with resection of liposarcoma. Prominence of left renal pelvis unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The previously seen soft tissue attenuation adjacent to the appendix has resolved. Several mesenteric calcifications in the midabdomen are not significantly changed.Postsurgical changes in the left hemiabdomen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Resolution of previously seen soft tissue around appendix. No suspicious mass or soft tissue seen on current exam.2.Postsurgical changes in the left hemiabdomen. |
Generate impression based on findings. | Reason: h/o HNC, s/p CRT,compare to previous, measurements pls History: none LUNGS AND PLEURA: Punctate micronodules are stable and presumably post inflammatory. No evidence of metastatic disease. Calcified granulomas. Basilar scarring and atelectasis.MEDIASTINUM AND HILA: Borderline right paratracheal lymph node unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified granuloma in spleen. Irregularly thickened gallbladder wall consistent with adenomyomatosis, incompletely visualized. | No evidence of metastatic disease. |
Generate impression based on findings. | 83 year old male with somnolence and right-sided weakness found to have left MCA ischemic stroke, evaluate for change. There is redemonstration of an infarct in the left cerebral hemisphere with affected areas including the left anterior temporal lobe, insular region, lateral anterior parietal lobe, and posterior frontal lobes which has minimally evolved compared to the 11/15/2013 exam. There is no evidence of hemorrhagic transformation. There is persistent mild mass effect on the adjacent lateral ventricle but no midline shift. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with underlying stable mild to moderate chronic small vessel ischemic changes. There is no extraaxial fluid collection.The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. A nasogastric tube is partially visualized. Extensive atherosclerotic calcification of intracranial vessels is seen.There is a stable heterogeneous lytic and sclerotic appearance of the expanded calvarium diffusely, consistent with Paget's disease. | Minimally evolved temporal/parietal lobe infarct with stable mild mass effect upon the left lateral ventricle but without midline shift or evidence of hemorrhagic transformation. |
Generate impression based on findings. | 83-year-old female with balance and gait abnormality, evaluate for vertebrobasilar stroke. Head CT: There are hypodensities within the right basal ganglia, which may represent age indeterminate lacunar infarcts or perivascular spaces. No intracranial hemorrhage is identified. There is mild periventricular white matter hypoattenuation likely representing small vessel ischemic disease, age indeterminate. The ventricles and basal cisterns are normal in size and configuration. The imaged portions of the paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Head CTA: There is no significant steno-occlusive lesion. There is no evidence of aneurysms.Neck CTA: There is mild atherosclerotic plaque involving the bilateral carotid bifurcation. There is no significant steno-occlusive lesion. There is 35 mm left thyroid nodule. There is effacement of the left piriform sinus, likely due to secretions. There is no significant cervical lymphadenopathy. There is moderate to severe degenerative spondylosis of the cervical spine. | 1.No evidence of intracranial hemorrhage, mass, or cerebral edema.2.No evidence significant cerebrovascular steno-occlusive disease.3.Mild age indeterminate small vessel ischemic disease.4.Left thyroid nodule that measures up to 35 mm. Ultrasound is recommended for further evaluation.5. Effacement of the left piriform sinus, likely due to secretions. This area may be amenable to direct inspection. |
Generate impression based on findings. | 51-year-old male with pleural mesothelioma status post 4 cycles of chemo CHEST:LUNGS AND PLEURA: Diffuse nodular pleural thickening in the right hemithorax with loculated fluid collections and pleural calcification/post pleuraldesis change. Interstitial opacity with intralobular septal thickening consistent with edema and volume loss.Reference right pleural measurements:1. At the level of the carina (image 36, series 3) 14 mm at one o'clock (previously 6 mm), increased. 9 mm at 4 o'clock (previously 9 mm), unchanged. 6 mm at 10 o'clock (previously 7 mm), unchanged. 2. At the level of the main pulmonary artery (image 45, series 3) 17 mm at one o'clock (previously 15 mm), unchanged. 9 mm at 8 o'clock (previously 8 mm), unchanged. 8 mm at 10 o'clock (previously 7 mm), unchanged.3. At the level of the left atrium in parentheses, image 55, series 3) 12 mm at 10 o'clock (previously 12 mm), not significant changed. 11 mm at 9 o'clock (previously 8 mm), not significantly changed.MEDIASTINUM AND HILA: Reference subcarinal lymph node measures 15 mm and previously measured 18 mm (image 40, series 3). Reference right hilar lymph node measures 11 mm (image 51, series 3) and previously measured 11 mm. Multiple thyroid cysts and calcifications. Right IJ thrombus is again noted.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcification of abdominal aorta and its branches.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: Surgical clips are noted in the upper abdomen. | Extensive pleural disease consistent with mesothelioma overall without significant interval change. |
Generate impression based on findings. | 45-year-old female with history of pheochromocytoma. Positive nuclear study on outside imaging. Evaluate for invading mass. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver.SPLEEN: Small splenule is noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality noted. No evidence of mass.KIDNEYS, URETERS: Simple cyst of the left kidney is noted. No significant abnormality of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status-post hysterectomy. Bilateral ovaries are identified.BLADDER: A small soft tissue mass at the superior aspect of the right dome of the bladder, best seen on coronal image number 61, measures 1.3 x 1.8 cm (series #6, image 128).LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: A small soft tissue mass at the superior aspect of the right dome of the bladder, best seen on coronal image number 61, measures 1.3 x 1.8 cm (series #6, image 128). | 1. Small soft tissue mass at the superior aspect of the right dome of the bladder is most likely corresponding to the extra adrenal pheochromocytoma corresponding to the area of increased uptake on the MIBG scan.2. Hepatic steatosis. |
Generate impression based on findings. | 42 year old female, palate cancer restaging LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Reference right hilar lymph node measures 2.0 x 0.6 cm (image 38, series 3) and previously measured 2.0 x 0.7 cm, unchanged. Additional smaller mediastinal lymph nodes appear similar to the prior study.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left hepatic meningioma appears unchanged. Multiple nonspecific splenic hypodensities are also unchanged. | No significant interval change. No new evidence of metastatic disease. |
Generate impression based on findings. | Reason: mesothelioma compare to last Ct \T\ measure 1) clavicular head 110clock, 2) aortic arch 10 oclock lesion, 3) pulm artery 4 oclock , 4) GE junction 4 oclock History: post 2 cycles CHEST:LUNGS AND PLEURA: Diffuse nodular pleural thickening consistent with mesothelioma involving the left hemithorax. Reference measurements are as follows:1. At the level of the clavicular heads (image 26 series 3), the 11 o'clock lesion measures 3.5 cm (prior measurement of 3.4 cm).2. At the level of the aortic arch (image 39 series 3) the 10 o'clock hypodense nodule is unchanged measuring 1.2 cm3. At the level of the main pulmonary artery (image 55 series 3) the 4 o'clock is stable measuring 1.8 cm.4. At the level of the GE junction (image 94 series 3) the 4 o'clock lesion measures 1.4 cm (prior measurement of 1.4 cm)Emphysema.New patchy multifocal clustered nodular opacities in the right lower lobe are suggestive of infection/aspiration though continued follow-up is recommended to exclude progression of neoplasm.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Coronary calcification. Mediastinal involvement by mesothelioma unchanged.CHEST WALL: Degenerative involving the spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable small presumed renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic location of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving lumbar spine.OTHER: No significant abnormality noted. | 1. Stable reference measurements.2. New opacities in the right lower lobe suggestive of infection/aspiration though continued follow-up is recommended to exclude progression of neoplasm. |
Generate impression based on findings. | Reason: h/o met parotid gland ca, compare to previous, measurements pls. Pt w/ ESRD, on dialysis. OK to use dye per Dr. Villaflor History: none CHEST:LUNGS AND PLEURA: Stable scattered nonspecific micronodules.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Mild cardiac enlargement without evidence of a pericardial effusion.Severe coronary artery calcification.Right chest Port-A-Cath with its tip in the SVC.CHEST WALL: Significant interval reduction in the left axilla lymph nodes. Reference left axillary lymph node (image 25 series 3) now measures 9 mm x 18 mm previously measuring 24 mm x 26 mm.Interval reduction in the left chest wall skin thickening and soft tissue edema.Gynecomastia.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable small hypo-attenuating lesion in the inferior aspect of the right hepatic lobe.Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys with diffuse cystic lesions and calcification.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease of aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Stable ascitesBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Significant interval reduction in left axillary lymphadenopathy, left chest wall skin thickening, and left chest soft tissue edema.2.No suspicious pulmonary nodules or masses.3.No new sites of disease identified.4.Stable ascites with redemonstration of end-stage renal disease. |
Generate impression based on findings. | 59-year-old male with possible left vertebral stenosis. CT: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is mild scattered paranasal sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable, including bilateral lens implants. CTA: There is non-opacification of the left vertebral artery beyond the V1 segment with reconstitution in the V3 and V4 segments. There is also mild to moderate irregular stenosis of the left V4 segment related to calcified plaque. The cervical portions of the right vertebral artery are patent, but there is irregular mild to moderate narrowing of the V4 segment due to calcific plaque. There is moderate (approximately 50%) stenosis of the proximal left common carotid artery. There is also moderate (approximately 50%) stenosis of the proximal right common carotid artery. There is mild bilateral carotid siphon mural calcification. There is a multinodular thyroid with coarse calcifications and a dominant right lobe nodule that measures 22 mm. There is a nonspecific right upper lung 3 mm nodule. | 1.No evidence of intracranial hemorrhage, mass, or cerebral edema.2. Non-opacification of the left vertebral artery beyond the V1 segment with reconstitution in the V3 and V4 segments, which may be due to atherosclerotic steno-occlusive disease or dissection. 3. Unchanged atherosclerotic disease affecting the right internal carotid artery with a short segment of 50% narrowing, but increased atherosclerotic disease affecting the left internal carotid artery, also now with approximately 50% stenosis.4. Multinodular thyroid with coarse calcifications and a dominant right lobe nodule that measures 22 mm. 5. Nonspecific right upper lung 3 mm nodule. A baseline chest CT may be performed if clinically warranted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 74-year-old male with metastatic leiomyosarcoma. CHEST:LUNGS AND PLEURA: Scattered punctate micronodules are unchanged, largest located in right middle lobe along fissure (series 5, image 48).New ill-defined opacities in right lower and right middle lobes with associated mild bronchial wall thickening, may be related to aspiration (series 5, image 67).MEDIASTINUM AND HILA: No significant mediastinal adenopathy. Coronary artery calcifications. The heart is normal in size. Trace pericardial effusion is unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Liver is enlarged with multiple heterogeneous hypoattenuating lesions, not significantly changed. Reference left lobe lesion measures 8.3 x 7.2 cm, previously measured 8.2 x 7.2 cm (series 4, image 102).Reference right lobe lesion measures 16.1 x 13.5 cm, previously measured 16.1 x 13.5 cm (series 4, image 24).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodense lesions in both kidneys are incompletely evaluated but not significantly changed and most compatible with cysts.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications in aorta and its branches. No pathologically enlarged retroperitoneal lymph nodes.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: Lytic left iliac bone lesion appears similar (series 4, image 166.OTHER: No significant abnormality noted | 1.No significant change in hepatic and left iliac bone lesions.2.New ill-defined opacities in the right middle and right lower lobes with associated bronchial wall thickening, suspicious for aspiration. |
Generate impression based on findings. | 68-year-old male with history of HN C. status post CRT, evaluate interval change. CHEST:LUNGS AND PLEURA: Few micronodules are unchanged. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Moderate coronary arterial calcification.CHEST WALL: Degenerative changes of the thoracic lumbar spine and unchanged focal sclerosis of T9.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: Separate origin of the hepatic artery. Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable interval exam without evidence of metastatic disease. |
Generate impression based on findings. | 58 year-old female with shortness of breath and ILD. LUNGS AND PLEURA: Scattered micronodules some of which are calcified consistent with prior granulomatous disease appear are unchanged. No evidence of fibrosis or interstitial disease.MEDIASTINUM AND HILA: Moderate atherosclerotic calcifications of the coronary arteries with possible stents in the LAD.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Focal calcification at origin of right renal artery is partially visualized. | No evidence of pulmonary fibrosis or interstitial lung disease. |
Generate impression based on findings. | Rectal cancer and anterior right neck pain. There is no evidence of mass, or significant lymphadenopathy in the neck. The nasopharynx, oropharynx, hypopharynx, and larynx appear unremarkable. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is unchanged mild degenerative spondylosis in the cervical spine. The partially imaged intracranial structures are unremarkable. The imaged portions of the upper lungs are clear. | No evidence of mass or significant lymphadenopathy in the neck. |
Generate impression based on findings. | T1N0 hard palate adenocarcinoma s/p wide local excision and adjuvant RT to a dose of 50 Gy to the hard palate with a boost to 60 Gy in Sept 2009. There are stable postoperative findings related to right hard palate tumor resection without evidence of recurrent mass lesions. The oropharynx, hypopharynx, larynx, and subglottic airways are otherwise unremarkable. There is no significant cervical lymphadenopathy. The major salivary and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. There are persistent small air-fluid levels in the maxillary sinuses bilaterally. The partially imaged intracranial structures are unremarkable. The osseous structures are unchanged. There is an unchanged ground-glass right apical lung nodule that measures 6 mm. | 1.Stable postoperative changes in the right hard palate without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2. Unchanged nonspecific ground-glass right apical lung nodule that measures 6 mm. |
Generate impression based on findings. | Bladder carcinoma status post cystectomy 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: Stable left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Unremarkable neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination without evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | 43-year-old endstage renal disease, prekidney transplant evaluation, assess aorta and iliac vessels for a kidney transplant 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: Multiple bilateral, hypodense lesions, mostly pressuring fluid attenuation, most likely represent cysts. No hydronephrosis. Hilar vascular calcifications noted.Vascular calcifications versus punctate stone identified in the lower pole of the right kidneyRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Minimal atherosclerotic calcifications seen at the aortic bifurcation, along the right common iliac artery and right internal iliac artery.PELVIS:PROSTATE, SEMINAL VESICLES: Calcification of the vas deferens bilaterally.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Few diverticula in the sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Minimal atherosclerotic calcifications seen at the aortic bifurcation, along the right common iliac artery and right internal iliac artery.Multiple renal hypodensities bilaterally, most representing cysts.Vascular calcifications versus punctate stone identified in the lower pole of the right kidney |
Generate impression based on findings. | Chronic sinusitis. There are postoperative findings related to bilateral Caldwell-Luc surgery with extensive irregular sclerosis of the maxillary sinus walls and narrowing of the maxillary sinus lumens. In addition, there is persistent opacification of the left maxillary sinus with moderate mucosal thickening and hyperattenuating secretions (up to ~120 HU). There is moderate circumferential right maxillary sinus mucosal thickening. There are also postoperative findings related to endoscopic sinus surgery, including uncinectomy, partial ethmoidectomy, sphenoidotomy, and middle turbinectomy. There is complete opacification of the bilateral neo-infundibula, remaining ethmoid air cells, frontoethmoid recess, and pneumatized left frontal sinus with hyperattenuation secretions and mucosal thickening. There is complete opacification of the sphenoid sinuses bilaterally, with hyperdense secretions and mucosal thickening. The carotid grooves and optic canals are covered by bone. There is dehiscence of the bilateral lamina papyracea. There is otherwise extensive neo-osteogenesis of the remaining ethmoid septations. There is minimal nasal septal deviation, perhaps related to septoplasty. There is extension of the ethmoid sinus opacification into the upper nasal cavity. The left ethmoid roof is approximately 6 mm higher than the right, but appear intact and even thickened. The partially imaged intracranial structures are grossly unremarkable. | Extensive postoperative findings with dehiscence of the bilateral lamina papyracea and evidence of chronic pansinus opacification, including hyperattenuating secretions that likely represent allergic fungal sinusitis. |
Generate impression based on findings. | History of tooth abscess. Rule out Ludwig's angina. CT head: There is a large rounded mass which is hyperdense/enhancing to adjacent parenchyma centered at the posterior floor of the anterior cranial fossa extending posteriorly to involve the anterior sella and associated with underlying hyperostosis of the right orbital roof. There is calcification in the central portion of the mass. There is resultant local mass effect including 2.4 cm midline shift at the anterior falx and right ventricular horn effacement without herniation. There is associated hypoattenuation likely representing vasogenic edema within the adjacent right frontal lobe. This mass measures 5.7 (AP) x 5.6 (trans) x 6.0 cm (CC) in maximal dimension. Orbits and mastoid cells are normal. There is a small amount of soft tissue within the left maxillary sinus. Other sinuses are clear.CT maxillofacial: Associated with the right first mandibular molar there is rounded lucency of the tooth itself as well as periapical lucency which lies adjacent to, though is not contiguous with the right mandibular canal. Laterally this lucency is contiguous with adjacent cortical dehiscence and an associated area of soft tissue thickening with stranding including fluid attenuation and early peripheral enhancement consistent with soft tissue phlegmon. The buccinator and masseter muscle belly are thickened. There is overlying stranding of the subcutaneous fat inferior to the suprahyoid muscle, though this does not extend to the neck posteriorly. There are prominent nodes which are not significant by size criteria within the visualized field. Parotid and submandibular glands are normal. | 1.Right sided soft tissue thickening/phlegmon associated with an abscess of the right first mandibular molar.2.Large intracranial lesion associated with the floor of the anterior cranial fossa with features suggestive of a meningioma. |
Generate impression based on findings. | Reason: head and neck cancer History: head and neck cancer CHEST:LUNGS AND PLEURA: Scattered punctate micronodules are stable and presumably post inflammatory. Calcified granulomas on the right are unchanged. Stable presumed intrapulmonary lymph node on right (image 40/99).MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Stable small mediastinal nodes. Small hiatal hernia. Stable calcified nodes on the right.CHEST WALL: Degenerative change involving spine. Healed rib fractures.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: Stable right renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Interval removal of G-tube.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable CT with no evidence of metastatic disease. |
Generate impression based on findings. | Reason: 80year with ?R pleural effusion notes abd ct History: abnormal ct finding LUNGS AND PLEURA: Right lower lobe mass measures 5.8 x 3.7 cm on image 65/106. It causes airway obstruction with near complete right lower lobe atelectasis. There is mild mass effect on the right atrium at its junction with the IVC and probable pericardial invasion with a small pericardial effusion.Moderate right pleural effusion with extensive nodular pleural thickening is highly suggestive of a malignant pleural effusion. Calcified granuloma left lower lobe.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Coronary calcification. Small pericardial effusion with areas of pericardial thickening, presumably a malignant effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Please see recent abdomen pelvis CT report for further details. Multiple hepatic and renal lesions are incompletely evaluated. | Right lower lobe lung mass highly suggestive of primary lung carcinoma. Associated right lower lobe atelectasis and presumed malignant moderate pleural and small pericardial effusions.Findings discussed with Dr. Semrad at the time of report. |
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