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Generate impression based on findings. | Female, 28 years old, history of melanoma, known hemorrhagic metastases, with altered mental status. Parenchymal hemorrhage within the inferior left frontal lobe has expanded somewhat since the prior examination. In the coronal plane, the hemorrhage measures 3.8 by 3.0 cm, previously 3.6 x 2.4 cm. There has been some expansion of the associated parenchymal edema as well. Hemorrhage extends up to the margin of the left frontal horn, but does not yet seem to have dissected into the ventricular system.Hemorrhage within the left parietal lobe has also expanded mildly from the prior examination. It measures 3.0 x 2.5 cm, previously 2.8 x 2.3 cm. Again, the surrounding parenchymal edema has also increased.There has been progression of generalized left cerebral mass effect with a greater degree of sulcal effacement. The left lateral ventricle remains effaced, slightly progressed from prior. Again seen is a mild shift of midline structures to the right at the level of the frontal horns. | Mild progression of parenchymal hemorrhage in the left inferior frontal and left parietal lobes with associated progression of parenchymal edema. |
Generate impression based on findings. | Malignant neoplasm corpus uteri, except isthmus. Evaluate extent of disease. ABDOMEN:LUNG BASES: 6-mm nodule laterally at the left lung base (image 6; series 4) should be followed at subsequent examinations. Consider dedicated chest CT as clinically indicated.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Air in nondilated loops of small bowel is abnormal but nonspecific finding.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is enlarged and slightly heterogeneous which may reflect the patient's underlying known neoplasm. 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 | 6-mm nodular the left lung base which should be followed. No definite additional findings to suggest metastatic disease. |
Generate impression based on findings. | 29-year-old male with left lower abdominal pain and diarrhea. Evaluate for diverticulitis. 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: Orally administered contrast passes quickly throughout the bowel without evidence of obstruction or ileus. Mild diffuse distal colonic mural thickening is suggestive of early or mild colitis. No pericolonic fluid collection. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mild diffuse distal colonic wall thickening, suggestive of uncomplicated early or mild colitis which may account for the patient's symptoms. |
Generate impression based on findings. | Fall with subsequent altered mental status. Rule out intracranial hemorrhage. There are bilateral frontal burr holes with underlying tracts of encephalomalacia extending to the basal ganglia bilaterally likely related to lead placement for deep brain stimulator unchanged from 2007 (there are no leads in place). There is bilateral periventricular and subcortical white matter hypoattenuation in keeping with sequela of chronic vessel ischemic disease. There is no acute intracranial abnormality including mass, edema, hemorrhage. Ventricular and cisternal size and morphology is normal. There is deformity of the right orbital floor likely keeping with old blowout fracture. The mastoid air cells and the visualized portion of the paranasal sinuses are unremarkable. | No acute intracranial abnormality including hemorrhage. If there is concern regarding acute ischemia, MRI could be considered. Unchanged findings including those related to prior deep brain stimulator placement and chronic right orbital blowout fracture. |
Generate impression based on findings. | Light-headedness, pre-syncope. 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 is partial opacification of the left frontal sinus. The 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. | Female 59 years old; Reason: eval for liver lesions, ascites History: ascites ABDOMEN: The absence of intravenous contrast limits evaluation of the solid organs. Given these limitations, the following observations were made:LUNGS BASES: The heart is enlarged with vascular congestion in the bilateral lung bases. 6-mm nodule is noted in the lingula.Esophageal stent seen with extensive fluid and debris in the distal esophagus.LIVER, BILIARY TRACT: Innumerable hypoattenuating lesions likely metastatic in nature are noted. These are not well characterized given the lack of IV contrast, however an index segment 6 lesion measures 3.5 x 4.0 cm. These lesions replace the entire liver. There is extensive perihepatic ascites as well as mild ascites layering in the pelvic cul-de-sac.Numerous stones are noted layering in the neck of the gallbladder. Pericholecystic fluid is likely related to the ascites.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: Calcified lesions are noted at the root of the mesentery extending into the hepatic hilum, likely treated adenopathy.BOWEL, MESENTERY: G-tube noted in the stomach fundus. No evidence of bowel obstruction, free air, or free spillage of contrast.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Body wall anasarcaPELVIS:UTERUS, ADNEXA: Atrophic or 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. | 1.Esophageal stent NG tube with innumerable metastatic lesions in the liver as referenced above. |
Generate impression based on findings. | Female 78 years old; Reason: 78yo F h/o Crohn's, h/o abdominal surgery for ?SBO, eval for obstruction History: LLQ abdominal pain, small stools, urinary frequency ABDOMEN: The absence of intravenous contrast limits evaluation of the solid organs. Given this limitation, the following observations were made:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: A low density cystic structure contiguous with the pancreas measuring 2.3 x 1.9 cm cannot be further characterized without contrast enhanced exam.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Extensive diverticulosis of the sigmoid and descending colon. No evidence of inflammation is appreciated, though early or mild diverticulitis may be radiographically occult.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy, bilateral salpingo-oophorectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Extensive diverticulosis. No evidence of inflammation, though early or mild diverticulitis may be radiographically occult.2.A 2.3 cm cystic lesion contiguous with the pancreas is incompletely characterized. If further evaluation is clinically warranted, a contrast enhanced exam would be recommended. |
Generate impression based on findings. | Altered mental status. History of Roux-en-y gastrectomy in 2000 and alcohol abuse, admitted for UGI bleed. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is perhaps mild cerebellar vermis volume loss. The ventricles and basal cisterns are otherwise 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. The patient is intubated, however. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Assess for persistent right hydronephrosis CHEST:LUNGS AND PLEURA: Multiple lung nodules in the right middle lobe. An index nodulemeasures 6-mm in diameter image number 45, series number 6.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly. Fatty infiltration of the liver. Liver, findings aresuspicious for chronic liver disease.SPLEEN: Mild splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal stone without evidence of hydronephrosis. A punctate stoneis present in the upper pole of the left kidney.There is a 5 mm stone in the right distal ureter, best seen on image number 162, seriesnumber 8, causing mild right-sided dilated ureter. Mild right-sided caliectasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large ventral abdominal hernias containing nonobstructive bowel loopsand large amount of fat.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged uterus. Pelvic ultrasound may be helpful for further evaluation.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. | Mild right-sided hydronephrosis and hydroureter caused by right distalureteral stone.Left upper pole stone without evidence of hydronephrosis.Hepatomegaly and fat infiltration. CT findings are concerning for chronic liver disease.Multiple right middle lobe nodules. Follow-up chest CT in 6 months is recommended.Enlarged uterus. Pelvic ultrasound is recommended to exclude endometrial carcinoma. |
Generate impression based on findings. | eval for vertebral artery dissection,syncope, neck pain Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.There are multilevel degenerative changes present in cervical spine with endplate and uncovertebral osteophytes at C4-5 and C5-6 and C6-7 and there is mild posterior subluxation of C6 on C7. There is a partial anterior fusion of C7 and T1Biapical scarring is present.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 left posterior communicating artery is medium sized and the right posterior communicating artery is small. This infundibulum at the origins of the posterior communicating arteries. The anterior communicating artery is medium size. The A1 segments are very similar in diameter. The left and right posterior inferior cerebellar arteries are dominant relative to the anterior/inferior cerebellar arteriesCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild degree are present. Atherosclerotic calcifications are present along the distal internal carotid arteries.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 left eyeball lens is thin. | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease. No evidence for dissection.3.Degenerative is present in the cervical spine4.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Male, 8 months old, status post fenestration of cystic lesion. Evaluate for hemorrhage and size of cystic lesion. Pneumocephalus and a small amount of intraventricular air are consistent with recent instrumentation. A right parietal approach ventricular shunt catheter is reidentified in relatively stable position with the tip situated just to the left of midline at the level of the lateral ventricular bodies.Since the prior examination, the caliber of the lateral ventricles has reduced with some reversal of parenchymal thinning most notably along the left temporal horn. There is a greater degree of extra-axial fluid along the left frontal lobe and also along the right anterior temporal lobe. These changes may reflect procedure related anatomic shifting or shift from improving ventriculomegaly. As on the prior examination, there is a small amount of blood product within the right occipital horn from prior instrumentation.There has been some expansion in the caliber of the fourth ventricle which now measures 49 x 34 mm in the sagittal plane, previously 42 x 33 mm. The third ventricle and cerebral aqueduct remain partially effaced similar to prior. Again seen is a septation within the posterior left lateral ventricle which may reflect a porencephalic cyst. The left basal ganglia/thalamic cystic lesion has increased in size slightly now measuring 25 x 20 mm in the coronal plane, previously 21 x 17 mm. | 1. Improving dilatation of the lateral ventricles with associated expansion of the cortex and the extra-axial spaces as above.2. Mild interval expansion of the fourth ventricle.3. Cystic lesion within the left basal ganglia/thalamus has increased in size slightly. |
Generate impression based on findings. | 75-year-old male with history of right upper lobe lung cancer status post lobectomy with recent pneumonia LUNGS AND PLEURA: Postoperative changes of right upper lobe lobectomy with volume loss and mediastinal shift. Persistent atelectasis and consolidation of the right lung with underlying edema and bronchiectasis. A cavitary lesion posteriorly in the right lower lobe with mild peripheral enhancement no longer contains an air-fluid level.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Extensive coronary arterial and aortic calcification is again noted. Rightward mediastinal shift.CHEST WALL: Partial collapse of multiple thoracic vertebral bodies and postsurgical rib fractures, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Renal hypodensities, too small to characterize, likely represent cysts. | Persistent atelectasis and consolidation of the residual right lung. |
Generate impression based on findings. | Reason: Evaluate for PE History: Tachycardic, hypoxic PULMONARY ARTERIES: The apices are not included in the field-of-view. Technically adequate study. There is no pulmonary embolus is noted to the subsegmental level. LUNGS AND PLEURA: No significant change in the extensive nodular opacities with coalescence in the bilateral upper lobes, right worse than left. This is on the background of innumerable pulmonary micronodules in a random distribution. Multiple scattered calcified granulomas. No interval pleural effusion.MEDIASTINUM AND HILA: The heart size remains normal. No interval pericardial effusion. Severe coronary artery calcifications moderate aortic valve calcification.Mildly enlarged mediastinal lymph nodes in the AP window and left paratracheal location. Several mediastinal lymph nodes are calcified, indicative of prior granulomatous disease. There is debris and an air-fluid level within the mid to upper esophagus. CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cystic lesion medial cortex mid left pole not included in the previous examinations. Small gastrohepatic lymph nodes unchanged. Stable nodular enlargement of the left adrenal gland. This contains internal low density, possibly fat. This can be further characterized with an in and opposed phase MRI, if clinically appropriate. Bilateral mild hydroureteronephrosis. | No pulmonary embolus. Stable but extensive nodular opacities with coalescence in the upper lobes, worse on the right. This on a background of innumerable pulmonary micronodules. Considerations continue to include sarcoidosis, severe fungal or mycobacterial infection. |
Generate impression based on findings. | Sudden onset dizziness and headache. There is no intracranial mass, hemorrhage or edema. The midline is intact. Ventricles and cisterns demonstrate normal size and morphology. Sinuses and mastoid air cells are clear. There are no bony lesions and the orbits are unremarkable. | No acute intracranial abnormality. |
Generate impression based on findings. | Weakness and intracerebral hemorrhage. There is no significant interval change in the size of the hematoma within the left thalamus, cerebral peduncle, midbrain, pons, and inferior cerebellar peduncle and the punctate focus of hemorrhage within the left parietal lobe. There is persistent hemorrhage layering within the lateral ventricles. However, hemorrhage within the third ventricle has decreased in size and the hemorrhage within the choroid plexus of the right lateral ventricle has resolved. There is also decreased hemorrhage along the ventricular shunt track. The degree of ventricular dilatation has gradually decreased with a right transfrontal ventricular shunt in position that terminates in the right lateral ventricle. There is persistent hypoattenuation within the right basal ganglia, thalamus and corona radiata. There is also unchanged patchy scattered cerebral white matter hypoattenuation that is nonspecific, but may represent microangiopathy. There is no midline shift or herniation. There is persistent opacification of the paranasal sinuses, likely related to The imaged mastoid air cells are clear. | 1. No significant interval change in the size of the hematoma within the left thalamus, cerebral peduncle, midbrain, pons, and inferior cerebellar peduncle, as well as the punctate focus of hemorrhage within the left parietal lobe. 2. Persistent layering hemorrhage within the lateral ventricles, but the hemorrhage within the third ventricle and along the ventricular shunt track have decreased in size and the hemorrhage within the right lateral ventricle choroid plexus has resolved, along with progressive decrease in size of the shunted ventricular system.3. Unchanged right basal ganglia, thalamus, and corona infarct of indeterminate age and probable cerebral microangiopathy. |
Generate impression based on findings. | 77-year-old male with chest wall mass LUNGS AND PLEURA: Large circumscribed mass in the left lower lobe measures 16.1 x 13.9 cm (image 63, series 3) and previously measured 2.0 x 12.6 cm.. Extension into the mediastinum and pericardial fat is again noted. There is compressive atelectasis of the left lower lobe. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Severe coronary artery an mitral annular calcifications, and atherosclerotic calcifications of the aorta and its branches.CHEST WALL: Multilevel degenerative change of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Atherosclerotic calcifications of the abdominal aorta and its branches. | Slight interval increase in size of recurrent left lower lobe solitary fibrous tumor, malignant transformation cannot be excluded. |
Generate impression based on findings. | Severe headache and stiff neck. There is no intracranial mass, hemorrhage or edema. The midline is intact. Ventricles and cisterns demonstrate normal size and morphology. There are no bony lesions and the orbits are unremarkable. There is mucosal retention cyst in left maxillary sinus. | No acute intracranial abnormality. |
Generate impression based on findings. | Reason: pt with small cell lung ca s/p treatment with 4 cycles of chemotherapy History: now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Left pleural catheter remains in stable position at the left lung base. Mild emphysema unchanged.Progressively improved aeration of the left upper lobe with reduction in the peripheral consolidation. Extensive interstitial and groundglass opacity does remain with considerations including lymphangitic involvement or possibly radiation pneumonitis. The circumferential nodular pleural thickening has not significantly changed. No measurable intrapulmonary mass is identified. Tubes foci of small nodularity again noted within two of the right lower lobe bronchi (series 7 image 58 and 60). These have remained stable since 7/2013.No suspicious pulmonary nodules or interval pleural effusion on the right.MEDIASTINUM AND HILA: The heart size remains normal. Stable mild to moderate coronary calcification. Pleural thickening of the left mediastinum, lateral to the left ventricle, has slightly increased, now approximately a 16 mm (series 5 image 57). Left anterior mediastinal mass not significantly changed in size, 21 x 26 mm (series 5 image 34), as compared to 26 x 22 mm.Intrathoracic lymphadenopathy has also decreased. A reference right paratracheal lymph node measures 11 mm on image 31/164, as compared to 12 mm.CHEST WALL: Left lateral rib deformity from callus of prior fracture unchanged. Multifocal osseous metastases are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.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: Precaval lymph node is slightly increased, 19 mm (series 5 image 115), as compared to 16 mm on prior study. Additional, mildly enlarged retroperitoneal lymph nodes are unchanged in size.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 size of the primary anterior mediastinal mass. Continued improved aeration of the left upper lobe with residual opacities, considerations include lymphatic tumor or radiation pneumonitis. No interval measurable mass.Two right lower lobe endobronchial nodules unchanged since first CT at this institution, 5/2013.Decreased mediastinal lymphadenopathy.Increased pleural thickening adjacent to the left lateral ventricle, measuring 16 mm in greatest width.Stable nodular left pleural thickening.Stable osseous metastases. |
Generate impression based on findings. | 24 year old female with Crohn's disease with multiple fluid collections requiring drainage and pleural effusions. CHEST:LUNGS AND PLEURA: Moderate left pleural effusion is improved. Persistent left base consolidation/atelectasis. Right lung unremarkable.MEDIASTINUM AND HILA: Multiple enlarged upper mediastinal lymph nodes. Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Interval increase in size of multi-loculated perisplenic fluid collection.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left pelvic kidney unchanged. Right kidney unremarkable.RETROPERITONEUM, LYMPH NODES: Multiple enlarged upper retroperitoneal lymph nodes.BOWEL, MESENTERY: Right lower quadrant ileostomy unchanged.Previously seen right lower quadrant fluid collection contains a percutaneous catheter and is decreased in size, currently measuring 2.4 cm, previously measured approximately 5.5 cm (series 3, image 153).The complex, multiloculated fluid collection along the left pericolic gutter and around spleen also has increased in size, especially in superior portion of this collection and in the left upper quadrant; currently measures 4.6 cm in maximal transactional dimension and 7.7 cm in craniocaudal dimension (series 3, image 121; coronal series image 27). The left lower quadrant portion of this collection has decreased. A percutaneous drain is present within the inferior portion of the collection. Multiple enlarged mesenteric lymph nodes.Postsurgical changes status post subtotal colectomy.BONES, SOFT TISSUES: Surgical staples are present in the anterior abdominal wall. Breakdown of the skin along the suture line in around the umbilicus has improved. 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: Multiple peripheral enhancing fluid collections are seen in the pelvis surrounding the adnexa; while some of these may represent hydrosalpinx, superimposed small abscesses are also suspected. This is not significantly changed since prior exam.Postsurgical changes status post subtotal colectomy.BONES, SOFT TISSUES: Surgical staples are present in the anterior abdominal wall.OTHER: No significant abnormality noted. | 1.Interval decrease in left moderate pleural effusion.2.Interval decrease in right lower quadrant abscess, with percutaneous drain in place.3.Superior portion of the complex, multiloculated left upper quadrant and left pericolic gutter abscess has increased in size. A percutaneous drain is present in the inferior, left lower quadrant aspect of this abscess, which has decreased in size.4.Multiple peripherally enhancing fluid collections in the pelvis are not significantly changed; some of these have tubular morphology which may represent hydrosalpinx although a superimposed small abscesses also suspected.Findings were discussed with Jennifer Labas at 10:30 a.m., 11/22/2013. |
Generate impression based on findings. | Unspecified cerebral artery occlusion with cerebral infarction. 59 yo female. Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. Atherosclerotic calcifications are present at the carotid bifurcations associated with mild atherosclerotic narrowing. There is no significant stenosis along the course of the vertebral arteries.The left common carotid artery originates from the innominate arteryThe distal internal carotid arteries along their cervical segments are tortuousA hypodense focus is present in the left thyroid lobe and measures 15 x 10 mm axial dimensionsThe patient is status post anterior fusion at C4, C5 and C6 with a bridging bone at C4 C5 but not at C5-C6. Patient is also status post epidural stimulator placement and a right-sided laminar surgery at the C3 - C5.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 left A1 segment is larger than the right A1 segment. The anterior communicating artery is medium size. The posterior communicating arteries are very small.There is extracranial origin of the right posterior inferior cerebellar the right posterior inferior cerebellar artery is dominant right is the left anterior/inferior cerebellar artery is dominantCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Atherosclerotic calcifications are present along the distal right vertebral artery. Atherosclerotic calcifications are present along the distal internal carotid arteries left more than right.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 eyeball lenses are thin.Incidental note is made of a torus palatini | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease.3.Status post cervical spine surgery |
Generate impression based on findings. | Reason: pt with Hnc s/p chemoradiation in 2011. please reeval and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: Left upper lobe nodularity associated with scarring is stable at 6 mm (series 6 image 12).Anterior upper lobe traction bronchiectasis compatible with prior radiation exposure. Ill-defined focus of groundglass within the anterobasal segment of the right lower lobe stable since 11/2012 without associated nodule, adjacent scar (series 6 image 78). Continued attention to this location on subsequent imaging recommended.No interval pleural fluid, bronchial thickening, or suspicious pulmonary nodule is present.MEDIASTINUM AND HILA: The heart size remains stable. No interval pericardial effusion. No mediastinal or hilar lymphadenopathyCHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT:Hyperattenuation in segment 4 without mass effect or capsularretraction. An additional smaller lesion of similar attenuation characteristics is againseen in segment 8; these are similar in size dating back to 5/2011. This is not atriphasic examination and characterization of the lesions is limited. The stability incharacter of findings is suggestive of benignity and may represent perfusion variants, ormultiple hemangiomas; less likely the larger lesion may represent an FNH. No perihepatic ascites.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of pulmonary metastasis. |
Generate impression based on findings. | Male, 14 years old, recurrent neuroblastoma. Assess disease status. Since the prior examination, there has been extensive interval progression of an infiltrating multi-spatial tumor within the left neck. Tumor involves the masticator, parotid, carotid, parapharyngeal and submandibular spaces as well as the floor of mouth from the level of the skull base down through the entire neck. The aerodigestive mucosal spaces are also infiltrated from the nasopharynx down to the hypopharynx. The left visceral space is also newly involved with infiltration of the thyroid. The tumor is inseparable here from the esophagus and prevertebral soft tissues. Tumor also extends into the retrosternal space with new compression upon the left brachiocephalic vein. Infiltration of the superficial soft tissues and sternocleidomastoid muscle on the left is also new.Accurate measurement is difficult given the ill-defined nature of the tumor. In addition, a single measurement does not adequately represent the true burden of disease. However, as an example, the submandibular component of the tumor now measures about 5.5 x 4.6 cm (image 42 series 6), previously 1.6 x 1.2 cm.Tumor related mass effect results in partial effacement of the nasopharyngeal and oropharyngeal airway. Tumor encases the left internal carotid artery from the skull base down to the bifurcation with evidence of luminal narrowing. In fact, there may even be some degree of tumor infiltration into the proximal left petrous carotid canal. The left internal jugular vein is not discretely seen.Tumor abuts the spine from the level of the skull base down to the level of the visceral space. There is mild erosion of the base the occiput on the left and likely also of the left occipital condyle. The cortex of the left anterior arch of C1 may be mildly thinned. No gross spinal canal invasion is seen. However, CT is insensitive in this regard. The vertebral arteries remain patent.The inner cortex of the left mandibular angle and ramus are newly thinned and the left mandibular condyle is mildly displaced from the mandibular fossa. Also noted is erosion of the posterior left alveolar ridge of the maxilla and sclerosis/erosion of the left pterygoid plates.There is new opacification of the left middle ear cavity and left mastoid air cells which likely reflects obstruction of the eustachian tube. | Marked interval progression of a multi-spatial infiltrating tumor which involves nearly every space of the left neck extending from the skull base down to the superior mediastinum.Mass-effect associated with this process has increased. Most notably, there is encasement and narrowing of left ICA. Areas of new osseous erosion involving the skull base and upper spine as was the mandible and maxilla are also seen. |
Generate impression based on findings. | Reason of episodic diplopia and dizziness, hx of Kawasakis disease Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right A1 segment is larger than the left A1 segment. The anterior communicating artery is small the posterior communicating arteries are very small. Incidental note is made of fenestration of the basilar artery there is extracranial origin of the left posterior inferior cerebellar artery. There is duplication of the right superior cerebellar artery.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease.3.No evidence for acute intracranial hemorrhage mass effect or edema |
Generate impression based on findings. | Female 30 years old; Reason: Stage IV gastric cancer with new right hip pain please compare to previous scans and provide index lesion measurements History: As above CHEST:LUNGS AND PLEURA: New small right and moderate left pleural effusions, with associated left-sided compressive atelectasis.MEDIASTINUM AND HILA: Anterior mediastinal soft tissue density is unchanged and likely represents thymic rebound. Mediastinal lymphadenopathy is stable with reference precarinal node measuring on 0.2 x 0.8 cm (image 29, series #3), previously 1.2 x 0.7 cm.CHEST WALL: Left axillary lymph node measures 1.5 x 1.2 cm. Direct comparison to prior study is difficult though appears mildly enlarged.ABDOMEN:LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. The gallbladder remains contracted.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: Numerous mesenteric and para-aortic lymph nodes, with reference left periaortic node unchanged, measuring 0.5 x 0.5 cm (image 107, series #3).BOWEL, MESENTERY: Stable to equivocal progression of diffuse mesenteric adenopathy. Index mesenteric lymph node measures 1.3 x 1.0 cm (image 115, series #3), not increased from previous exam, previously measured 1.7 x 1.2 cm. Extensive fatty infiltration of the mesentery, as well as omental and peritoneal nodularity are redemonstrated and not significantly worse from prior exam.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Bilateral peri-iliac lymph adenopathy, with reference left iliac node measuring 1.2 x 1.0 cm (image 153, series #3), previously 1.2 x 1.2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable to equivocal progression of scattered diffuse mesenteric adenopathy.2.Redemonstration of omental and peritoneal nodularity, not significantly worsened from prior exam.3.New bilateral pleural effusions, left greater than right. |
Generate impression based on findings. | 27 year-old male with headache and neck stiffness. NONCONTRAST CT HEADThe ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for left maxillary sinus retention cyst. CTA HEAD AND NECKThere is common aortic arch origin of the right brachiocephalic and left common carotid arteries. The left subclavian and bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through anterior circulation (bilateral petrous/cavernous/supraclinoid internal carotid arteries, anterior and middle cerebral arteries), posterior circulation (vertebral-basilar, posterior-inferior cerebellar, anterior-inferior cerebellar, superior cerebellar, and posterior cerebral arteries), and distal intracranial vasculature. There is normal contrast opacification through a complete circle-of-Willis with a patent anterior communicating artery and bilateral posterior communicating arteries. No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | 1. No acute intracranial abnormality. 2. No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation. |
Generate impression based on findings. | 79-year-old male 3 years after left upper lobectomy for management of stage IB squamous cell carcinoma LUNGS AND PLEURA: Status post left upper lobectomy without evidence of recurrent disease. Scattered foci of bronchial thickening and left basilar scar like opacity are unchanged. Unchanged right middle lobe micronodule.MEDIASTINUM AND HILA:Atherosclerotic calcifications of the thoracic aorta and coronary arteries. Scattered subcentimeter mediastinal lymph nodes are unchanged.CHEST WALL: Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hiatal hernia. | Status post left upper lobectomy without evidence of recurrent or metastatic disease. |
Generate impression based on findings. | T1N2b right tonsil cancer status post chemo RT completed September 2011. There are stable post-treatment findings, including minimal pharyngeal edema and stranding of the fat in the right neck. No mass lesion is identified to suggest locoregional tumor recurrence. There is no significant cervical lymphadenopathy by CT size criteria. The airways are patent. The salivary glands and thyroid glands are unchanged. The major cervical vessels appear patent. The paranasal sinuses and mastoid air cells are clear. The osseous structures are unchanged. The partially imaged intracranial structures and orbits are grossly unremarkable. There is unchanged pulmonary apical scarring and partially calcified nodularity. | No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | 68-year-old male with history of small cell cancer CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysema. Architectural distortion and scarring consistent with radiation changes on the right not significantly changed. Several previously identified ground glass and partially solid nodules have resolved. Reference nodular opacity in the right middle lobe measures 9 mm and previously measured 9 mm (image 61, series 5).MEDIASTINUM AND HILA: Reference right low paratracheal lymph node measures 6 mm and previously measured 6 mm (image 39, series 3). Previously mentioned non-index high right paratracheal lymph node is decreased in size and measures 7 mm (image 15, series 3). Severe atherosclerotic calcifications of the coronary arteries and aorta and its branches and noncalcified plaque. Left brachiocephalic vein clot is no longer visualized. Loculated fluid anterior to the heart is unchanged, consistent with seroma/hematoma. Status post CABG.CHEST WALL: Sternal fixation devices. Degenerative changes of the thoracolumbar spine and mild chronic loss of height of multiple vertebral bodies. Small sclerotic lesion in the left scapula, likely representing a bone island is unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nodular morphology without focal lesion. The hepatic vasculature is patent. The previously identified enhancing nodule adjacent to the falciform ligament is no longer visualized. Tiny hypoattenuating left hepatic lesion too small to characterize, but unchangedSPLEEN: No significant abnormality noted.ADRENAL GLANDS: Nodularity of the left adrenal gland is unchanged.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: 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: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted. | Stable reference lesions and postradiation change of the right lung. Interval resolution of previously identified pulmonary ground glass nodules. |
Generate impression based on findings. | pTxN2c cM0 SCC of unknown primary, likely head/neck origin, s/p 5 cycles TFHX completed in December 2010. There are post-treatment findings related to neck dissection and radiation therapy. There is no evidence of mass lesions -- the suspected neuroma described on clinical exam is not clearly discerned on this exam. There is no significant cervical lymphadenopathy based on the size criteria. The parotid, submandibular and thyroid glands are unremarkable. The nasopharynx, oropharynx, hypopharynx, and larynx appear unremarkable. The airways are patent. The carotid arteries and jugular veins are patent. There are unchanged findings related to chronic comminuted fracture of the medial right clavicle and multilevel degenerative spondylosis. The partially imaged intracranial structures are grossly unremarkable. There is minimal residual mucosal thickening within the maxillary sinuses. The imaged portions of the lungs are clear. | No evidence for mass lesions or significant lymphadenopathy in neck. |
Generate impression based on findings. | 53-year-old male with history metastatic renal cell carcinoma. Assess for disease status during therapy. CHEST:LUNGS AND PLEURA: There has been an overall increase in size and number of pulmonary parenchymal metastases. Reference parenchymal nodule in left lower lobe measures 1.1 x 1.9 cm on image 58/111. Reference lesion in the right lower lobe has actually decreased slightly measuring 1.0 x 1.2 cm on image 70/111.MEDIASTINUM AND HILA: Reference pre-vascular lymph node measures 1.6 x 1.9 cm on image 44/211 unchanged to slightly increased. Reference aorto -- pulmonary lymph node measures 1 x 1.9 cm on image 45/211, unchanged to slightly increased. Left hilar mass measures 3.2 x 3 cm on image 47/211 without interval change. Pericardial nodule is previously described has increased in size.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small right upper pole renal cyst without change. Post left nephrectomy with bile and pancreatic tail in the nephrectomy bed. No recurrent, focal mass.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 | Mixed response to therapy as detailed above |
Generate impression based on findings. | 76-year-old male with history of renal cancer. CHEST:LUNGS AND PLEURA: Multiple calcified and uncalcified pulmonary nodules are unchanged. No new suspicious nodules.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy. Severe coronary artery calcifications. Heart size normal.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Status post right adrenalectomy.KIDNEYS, URETERS: Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Status post L1 and L5 vertebroplasty.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: Status post L1 and L5 vertebroplasty. Severe degenerative changes affect the lower lumbar spine. Contour deformity of the right iliac bone unchanged (series 3, image 144).OTHER: No significant abnormality noted | 1.Status post right nephrectomy.2.Stable calcified and noncalcified lung nodules.3.Stable appearance of right iliac bone contour deformity. |
Generate impression based on findings. | Aphasia.Exudative senile macular degeneration of retina 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.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The right eyeball is hyperdense probably related to prior procedure The visualized portions of the orbits are intact. The eyeball lenses are thin. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic CVA |
Generate impression based on findings. | 52 year-old female, lung nodule of evaluation LUNGS AND PLEURA: Peripheral nodule in the posterior right lower lobe measures 2.0 x 1.2 cm and previously measured 2.0 x 1.4 cm (image 67, series 4). Peribronchialvascular nodules extending within the superior segment of the right lower lobe appear similar to the prior study. Few additional micronodules are unchanged. No new nodules or masses.MEDIASTINUM AND HILA: Several unchanged prominent, subcentimeter mediastinal lymph nodes. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Peripheral right lower lobe nodule with additional smaller nodules in a peri-bronchovascular distribution are unchanged and most likely represent sequelae of granulomatous/atypical infection. |
Generate impression based on findings. | 56-year-old male with history of bladder cancer. CHEST:LUNGS AND PLEURA: Groundglass nodule in right middle lobe measures 6 mm, not significantly changed since 12/2011. No new suspicious nodules. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Minimal coronary artery calcifications. No lymphadenopathy. Heart size normal.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating foci are unchanged, most compatible with cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating lesions in both kidneys, most likely benign cysts. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post partial colectomy.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: Status post partial colectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Stable right middle lobe groundglass nodule. No new nodules.2.No specific evidence of metastatic disease. |
Generate impression based on findings. | 63-year-old male patient with history of head and neck cancer. Compared to previous examinations and provide measurements. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Mild coronary artery calcifications.Small mediastinal lymph nodes are stable compared to prior exam. Reference anterior mediastinal lymph node measures 15 x 9 mm (series 3 image 47), stable.Variant anatomy with common ostium of the left sided pulmonary veins. Left vertebral artery arises directly from aortic arch, normal variant.CHEST WALL: Multiple degenerative changes with S-shaped scoliosis in the thoracic and lumber spine. Right clavicular complex head and neck fracture with partial resorption of some of the osseous fragments. Surrounding soft tissue hypoattenuating to muscle is unchanged. Osseus nonunion and intervening soft tissue between the fracture fragments has decreased compared to 4/19/2013.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: Right hypoattenuating renal lesions consistent with cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastases or other significant abnormality. |
Generate impression based on findings. | 72-year-old male with squamous cell carcinoma of the cricoid status post chemoradiation therapy, reevaluate Limited intracranial and orbital views are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.No measurable hypopharyngeal mass is present on the current examination. The cricoid and thyroid cartilage appear intact. The upper trachea and esophagus are unremarkable. No exophytic mass or focal effacement of the aerodigestive tract. The parotid, submandibular and thyroid glands are free of focal lesions.No lymphadenopathy by CT size criteria. Reference left level 2 lymph node measures approximately 3 x 3 mm (series 6 image 31), previously measured 3 x 3 mm. Reference right level 2 lymph node measures approximately 3 x 5 mm (series 6 image 32), previously measured 2 x 5 mm.The major cervical vasculature is patent. Diffuse atherosclerotic vascular calcifications with extensive atherosclerotic calcifications at the carotid bifurcations with some component of noncalcified plaque on the left. Very diminutive right vertebral artery similar to the prior. Multilevel degenerative changes of the visualized cervicothoracic spine without evidence of suspicious lesions.The lung apices are clear. Please see dedicated chest CT from today's date for further details. | Stable size of small reference lymph nodes. No measurable hypopharyngeal mass is present. |
Generate impression based on findings. | 77-year-old female with history of GIST tumor. CHEST:LUNGS AND PLEURA: Bilateral lung micronodules are unchanged. No new suspicious nodules. Mild basilar scarring/atelectasis and associated mild traction bronchiectasis.MEDIASTINUM AND HILA: No pathologically enlarged mediastinal lymph nodes; borderline enlarged right paratracheal node unchanged (series 8, image 29). Heart size normal. Mild coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Enhancing, heterogeneous lesions in both lobes of the liver not significantly changed; reference right lobe lesion measures 2.3 x 4.0 cm, previously measured 2.4 x 4.0 cm (series 7, image 34). No new lesions identified.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating lesions in both kidneys, most likely benign cysts and unchanged. RETROPERITONEUM, LYMPH NODES: Stable multiple mildly enlarged lymph nodes; reference left para-aortic node measures 9 x 11 mm, previously measured 9 x 12 mm (series 8, image 94).BOWEL, MESENTERY: Status post partial gastric resection; no evidence of abnormal soft tissue adjacent to surgical site to suggest local recurrence.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Heterogeneous pelvic mass is difficult to measure but not significantly changed; overall mass-like pelvic soft tissue, which likely encompasses uterus, measures approximately 14.2 x 9.4 cm, previously measured 14.0 x 10.1 cm (series 8, image 150). BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable hyper-enhancing liver lesions consistent with metastases. No new lesions identified.2.Stable heterogeneous pelvic mass.3.Multiple mildly enlarged retroperitoneal lymph nodes are not significantly changed. |
Generate impression based on findings. | Female, 93 years old, status post fall, on Coumadin. No intracranial hemorrhage, abnormal extra-axial fluid collections or other definite acute intracranial findings are seen. Ventricles and sulci are mildly prominent, somewhat more so than on the prior exam, likely reflecting parenchymal volume loss. There is relatively mild periventricular hypoattenuation which likely indicates age indeterminate small vessel ischemic disease. In addition, there is a region of encephalomalacia involving the left middle frontal gyrus which is unchanged and likely represents an old cortical stroke.Bones of the skull base are somewhat osteopenic in appearance but this finding is unchanged. No evidence of fracture or discretely destructive osseous lesion is seen. The paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. No evidence of intracranial hemorrhage. |
Generate impression based on findings. | previous parathyroid surgery Now has recurrence Please loalize There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 seconds, 85 seconds):Right thyroid (image # 286 ):: 138.71, 220.86, 194.31, 168.96Right Carotid artery (image # 214 ):: 24.0HU, 231.07, 125.14HU, 110.20HURight Jugular vein (image # 131 ):: 36.9HU, 230.7HU, 144.69HU, 141.56HURight submandibular gland (image # 148 ): 1.06HU, 67.03HU, 88.88HU, 76.83HURight sternocleidomastoid muscle: (image # 119 ): 70.52HU, 50.19HU, 55.08HU, 43.87HULymph node (image # 128 ): 33.7HU, 19.59HU, 57.75HU, 76.68HUNodule 4x7mm behind right lobe of the thyroid image 257: 39.92HU, 112.46HU, 83.2 HU, 75.9 HUNodule 4x7mm (image 306): 55.84HU, 204.55HU, 145.68HU, 103.95HUPlease not that there is a significant amount of noise on the images related to x-ray attenuation due to patient's body mass.CT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact. Surgical clips are present at the thyroid bedThe airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses are intact. The mastoid air cells are clear. There is mucosal thickening in the right maxillary sinus. The ethmoid air cells and frontal sinuses and the upper parts of the maxillary sinuses are not included on this exam.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There degenerative changes present with uncovertebral osteophytes at the C3-4 where there is a narrowing of the right neural foramen.Parathyroid sampling:Intraprocedural images demonstrate the location of venous sampling.Reported PTH, Intact values (REF 15-75 pg/mL):FEMORAL VEIN: SUPERIOR VENA CAVA: INNOMINATE VEIN JUNCTION: LEFT INNOMINATE VEIN:LEFT INTERNAL JUGULAR VEIN, LOWER: LEFT INTERNAL JUGULAR VEIN,MID: LEFT INTERNAL JUGULAR VEIN, UPPER: RIGHT INTERNAL JUGULAR VEIN, LOWER: RIGHT INTERNAL JUGULAR VEIN, MID: RIGHT INTERNAL JUGULAR VEIN, UPPER: | 1.There is a small nodule immediately inferior and posterior to the right lobe of the thyroid. It is not adequately visualized on the 4D CT to a large degree due to artifact.2.There is a nodule visually contiguous with the posterior aspect of the right thyroid. Although it may represent adenoma it is not adequately visualized on the 4D CT to a large degree due to artifact.3.Parathyroid venous sampling. Results were not available at the time of this dictation. |
Generate impression based on findings. | 96-year-old female with GI bleeding, source unclear. ABDOMEN:LUNG BASES: Mild basilar atelectasis and trace pleural effusions.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Multiple splenic granulomas.PANCREAS: No significant abnormality notedADRENAL GLANDS: Stable nonspecific left adrenal thickening.KIDNEYS, URETERS: Hypoattenuating lesions in both kidneys, most likely benign cysts. RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications in aorta and its branches.BOWEL, MESENTERY: Severe colonic diverticulosis without evidence of diverticulitis or contrast extravasation to suggest active hemorrhage.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: Severe colonic diverticulosis without evidence of diverticulitis or contrast extravasation to suggest active hemorrhage.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Extensive diverticulosis without evidence of contrast extravasation to suggest active hemorrhage. |
Generate impression based on findings. | Male 80 years old; Reason: lymphoproliferative dz (B cell), complete staging History: sore throat 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: A few too small to characterize lesions in the kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left inguinal hernia containing loops of bowel noted without evidence of obstruction.BONES, SOFT TISSUES: Degenerative changes noted throughout the spine, with mild wedge compression deformities less than 25% at numerous levels.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left inguinal hernia containing loops of bowel noted without evidence of obstruction.BONES, SOFT TISSUES: Degenerative changes noted throughout the spine, with mild wedge compression deformities less than 25% at numerous levels.OTHER: Left inguinal hernia containing loops of bowel. | 1.No significant adenopathy suggest recurrent or metastatic lymphoma.2.Left inguinal hernia containing loops of bowel without obstruction |
Generate impression based on findings. | Female 57 years old; Reason: Pt is a 57 y/o female with met melanoma, evaluate for progression of disease History: met melanoma CHEST:LUNGS AND PLEURA: Multiple lobulated nodules are again seen in all lobes, appearing similar to the prior exam. The reference left upper lobe nodule is unchanged at 1.9 x 1 .3 cm, previously 1.7 x 1.2 cm (9/51). The reference left lower lobe nodule measures 2.9 x 1.7 cm, previously 2.9 x 1.9 cm (9/49). No new nodules or masses.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Stable size and appearance of a left thyroid nodule, measuring 2.5 x 1.7cm previously 2.2 x 1.8 cm (7/7).CHEST WALL: No significant abnormality noted.ABDOMEN: LIVER, BILIARY TRACT: Unchanged punctate hepatic foci, which are too small to fully characterize.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Stable cystic lesion in the uncinate process measuring 1.1 x 1.1cm previously 1.4 x 1.0 cm (7/107), likely representing an IPMN. There is no pancreatic ductal dilatation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: Mild to moderate degenerative changes of the lumbar spine.OTHER: No significant abnormality noted.PELVIS: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 | Stable pulmonary metastases. No evidence of disease progression. |
Generate impression based on findings. | 67 year old male. Reason: please evaluate etiology of hematuria. please perform a CT urogram. History: gross hematuria. ABDOMEN:LUNG BASES: Status post median sternotomy. Mediastinal calcification is probably due to lymph node. No infiltrates, nodules or effusions. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Hiatal hernia. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Delayed views show contour abnormality at the right trigone suspicious for a bladder wall lesion there. Axial image 124, series 9. No hydroureter. LYMPH NODES: Prominent left greater than right obturator, external iliac and common iliac lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left lateral thigh muscle calcification at image 116, series 4 compatible with myositis ossificans. OTHER: No significant abnormality noted | Right bladder wall contour abnormality near the ureteral orfice without associated hydroureter. Prominent pelvic lymph nodes bilaterally, left greater than right. No other evidence for metastatic disease. |
Generate impression based on findings. | Mesothelioma status post-pleurectomy decortication CHEST:LUNGS AND PLEURA: Bilateral pleural thickening and fluid consistent with mesothelioma. Left hemithorax volume loss has progressed compared to the previous examination with development of significant paramediastinal tumor causing extrinsic compression of the left mainstem bronchus and its branches. The entire lingula appears to have been replaced by tumor as no air bronchograms are present in this region. Post obstructive pneumonia cannot be entirely ruled out. Within the remaining aerated left lung, septal thickening is present and somewhat nodular in some areas. On the right, nodular thickening of the fissures is compatible with visceral pleural tumor involvement. Small right and trace left pleural fluid collections are present. Left diaphragmatic graft.Reference measurements on the left as follows:Level of the aortic arch (3/24): Two o'clock position 8 mm, previously 6-mm.The level of the aortopulmonary window (3/29): Three o'clock position a 14 mm, now extending through the bony thorax, previously 8-mm.Level of the left pulmonary artery (3/35): Tumor is confluent at this level. The a small lucency centrally indicative of aerated lung. Measuring from that point to the lateral chest wall is 28-mm compared to 9-mm previously.MEDIASTINUM AND HILA: Left mediastinal tumor inseparable from the main pulmonary artery and the left ventricle which are likely compressed. Small volume of pericardial fluid seen inferior to the right atrium increased in volume. Mediastinal and hilar lymphadenopathy is present bilaterally with both new and enlarging lymph nodes. Extensive pericardial tumor.CHEST WALL: Left chest wall deformity. Multi-level extension of tumor through the rib interspaces not significantly changed.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Mild intrahepatic biliary ductal dilatation.SPLEEN: Spleen appears at least upper normal in size.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney is mildly malrotated. Perinephric fat stranding with areas of nodularity noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal fat stranding and small retroperitoneal lymph nodes are present. Several small subcentimeter lymph nodes are are seen near the esophageal hiatus. Interval development of tumor anterior to the aorta at the level of the diaphragm (3/73)BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Diffuse mesenteric and peritoneal stranding and nodularity consistent with intra-abdominal spread of disease.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Intra-abdominal spread of tumor, contralateral disease and subjective worsening of tumor burden in the left hemithorax. The left mainstem bronchus is compressed by tumor, consider consultation with pulmonary medicine for possible palliative stent placement. |
Generate impression based on findings. | Metastatic prostate carcinoma. Evaluate disease after 6 cycles of investigational therapy. ABDOMEN:LUNG BASES: Note that the upper lobe reference nodule and adenopathy cannot be assessed on this exam.LIVER, BILIARY TRACT: Stable bilobar hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hydronephrosis has resolved.RETROPERITONEUM, LYMPH NODES: Previously described reference lymph nodes have completely resolved.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Increasing bony sclerosis; whether this represents progression or healing is unclear given interval regression of adenopathy.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Interval regression of adenopathy.. Reference left internal/external iliac bifurcation lymph node measures 0.9 x 0.9 cm (image 117; series 3), markedly decreased in size.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is a bony sclerosis have increased since the prior examination. As noted above, whether this represents progression of disease or healing is unclear given the regression of adenopathy.OTHER: No significant abnormality noted | Marked regression of adenopathy. Increasing and enlarging areas of bony sclerosis throughout the spine and pelvis; whether this represents progression of disease or healing is unclear given regression of adenopathy. |
Generate impression based on findings. | Reason: h/o HNC, CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Interval appearance of focal bronchial wall thickening, mucoid impaction and ground glass within the right upper lobe this appears inflammatory in nature.No interval pleural effusion.MEDIASTINUM AND HILA:. Dense mitral annular and aortic valvular calcification. Severe new coronary artery calcification. No pericardial effusion. No mediastinal or hilar lymphadenopathy.Hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Several hypodensities are stable, likely cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Multilevel degenerative changes of the thoracic spine with intervertebral calcification compatible with DISH.OTHER: No significant abnormality noted. | Bronchial wall thickening and mucoid impaction within the right upper lobe favoring inflammatory etiology. No evidence of metastatic disease. |
Generate impression based on findings. | Lung nodule, preop eval. CHEST:LUNGS AND PLEURA: Dense pleural nodule at the apex of the left lung measuring 18 x 35mm (3/18), previously 18 x 31 mm although measurement at an identical anatomical level is not possible due to differences in scan variability regarding orientation of the lesion relative to the scan plane. On the coronal sequence, the lesion measures 22-mm transversely by 21 mm CC, previously 23 x 19 mm. On the sagittal series the lesion measures 22-mm AP compared to 26-mm (sagittal image 68) The extrapleural fat plane beneath the lesion appears intact over its majority however portion of the nodule does extend into the paraspinal fat on the left (3/17).Scattered calcified micronodules, most likely granulomas, unchanged.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and coronary arteries. No significant lymphadenopathy. No pericardial fluid. CHEST WALL: No intercostal lymphadenopathy. No significantly enlarged lymph nodes elsewhere in the chest wall. Degenerative changes of the spine. The left apical nodule extends into the left paraspinal fat at the level of T2 with mild periosteal thickening of the vertebral body adjacent to the lesion. No osseous erosion. No evidence of extension into the neural foramina. Punctate sclerotic focus in the T1 vertebral body (2/45) is unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Two soft tissue nodules in the left upper quadrant inferior to the spleen (3/108 and 3/106) are most likely splenulus but are too small to definitively characterize. These are unchanged from 5/14/13 abdominal CT.ADRENAL GLANDS: No significant abnormality noted..KIDNEYS, URETERS: No significant abnormality noted..PANCREAS: No significant abnormality noted..RETROPERITONEUM, LYMPH NODES: New surgical dissection clips adjacent to the right iliac artery (3/125-134), too small to characterize. A small left common iliac lymph node is unchanged in size at 6-mm however has increased in density compared to the previous examination of 5/14/13 and should continue to be monitored to differentiate a reactive from metastatic lymph node.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.9 x 7 mm lipoma in the gastric antrum (3/107)..BONES, SOFT TISSUES: Grade 1 anterolisthesis of L4 on L5..OTHER: No significant abnormality noted.. | Indeterminate dense pleural-based nodule in the left apex which may demonstrate either calcification or enhancement (this cannot be determined without an unenhanced scan or conventional radiograph). It is not possible to provide comparable measurements of the lesion however there is no conclusive evidence of significant change in size. The lesion does extend into the left paraspinal fat at the level of the T2 vertebral body, causing mild periosteal reaction but no evidence of cortical erosion. 3-month follow-up is suggested given history of known neoplasm. |
Generate impression based on findings. | 53 year old male. Reason: h/o B side pain evaluate acute abnormalities. History: Side pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis. OTHER: No significant abnormality noted | No specific abnormality was found to explain bilateral flank pain. |
Generate impression based on findings. | Metastatic medullary thyroid carcinoma s/p total thyroidectomy and central neck dissection. The patient was on cabozantinib and has recently started vandetinib. There are postoperative findings related to total thyroidectomy and central neck dissection. There is no significant interval change in size of the heterogeneously enhancing mass in the region of the thyroidectomy bed, including a soft tissue with a hypoattenuation focus that overall measures 16 AP x 9 RL mm in the left thyroid bed, another focus of enhancing soft tissue in the left thyroid bed that measures 12 AP x 6 RL mm, a 6 AP x 3 RL mm nodule in the wall of the left lateral aspect of the trachea, and a 7 AP x 6 RL nodule in the right tracheoesophageal groove. The cervical lymph nodes are unchanged and there is no significant cervical lymphadenopathy by CT size criteria. The parotid and the submandibular glands appear unremarkable. The major cervical vessels appear intact. There are no suspicious lytic or blastic lesions. There is a periapical lucency affecting the lingual root of ADA 14. The partially imaged intracranial structures are grossly unremarkable. The partially imaged paranasal sinuses and mastoid air cells are clear. A right apical lung nodule appears to have increased slightly in size. | 1.No significant interval change in the numerous subcutaneous nodules in the neck and scalp, which likely represent metastases.2.No significant interval change in the appearance of the thyroidectomy bed.3.The cervical lymph nodes are unchanged and there is no significant cervical lymphadenopathy by CT size criteria. 4.A right apical lung nodule appears to have increased slightly in size. Refer to the separate chest CT report for additional detail. |
Generate impression based on findings. | Male, 6 months old, trigonocephaly. Preoperative planning for synostosis reconstruction. The metopic suture is fused resulting in a trigonal configuration of the frontal bone. The coronal, sagittal and lambdoid sutures as well as the squamosal and skull base sutures remain patent.Shading of the posterior aspect of the brain is a common CT artifact seen in this age group. Intracranial structures are otherwise unremarkable. | Synostosis of the metopic suture resulting in trigonocephaly. |
Generate impression based on findings. | Male, 60 years old, history of tongue and lung cancer, status post surgery. Evaluate for recurrence. The left fossa of Rosenmueller is effaced without evidence of discrete mass. This may represent adherent secretions and is similar to the prior study.The oral tongue and floor of mouth are unremarkable. The pharyngeal mucosa is free of suspicious mass lesions. Hyperemia of the soft palate is similar to prior and may reflect a treatment related finding. The right piriform sinus and right laryngeal ventricle are larger than the left, again a stable finding. These can be secondary signs of vocal cord dysfunction. The glottis itself and the subglottic airway are unremarkable.No pathologic adenopathy is detected by size criteria. The salivary glands and thyroid are free of suspicious lesions. The cervical vessels remain patent. There is extensive atherosclerotic disease at the right carotid bifurcation.Lung apices demonstrate evidence of emphysema and a suspicious spiculated lesion on the right.Evaluation of the bony structures is significant for evidence of old rib fractures bilaterally. No concerning or focally destructive osseous lesions are seen. | 1. No evidence of recurrent disease in the neck.2. A suspicious lesion in the right lung apex is better assessed on the separately dictated chest CT. |
Generate impression based on findings. | 72-year-old male with prostate cancer. Reason: prostate cancer with recurrence; lung lesions. History: prostate cancer rising PSA LUNGS AND PLEURA: Lingular nodule measures 16 x 17 mm (series 4, image 42), larger. Left upper lobe nodule measures 9 x 15 mm (series 4, image 38), larger.Left lower lobe nodule measures 5 x 4 mm (series 4, image 61), smaller.Right upper lobe nodule measures 6 x 7 mm (series 4, image 26), smaller.No new pulmonary nodules identified.The lingular nodule has grown from 12 x 13 mm to 16 x 17 mm since 1/18/2013.MEDIASTINUM AND HILA: Mild coronary artery calcifications. No hilar or mediastinal lymphadenopathy.CHEST WALL: New mid-sternal fracture is minimally displaced, extends from axial images 40-46, series 3.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Stable mild aortic ectasiaBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Increase in size of left lingular and left upper lobe pulmonary nodules. New mid-sternal fracture.No new lesions. Otherwise stable exam. |
Generate impression based on findings. | 53-year-old male. Reason: urothelial cancer, recurrent hematuria, evaluate for recurrence. CT Urogram, 3D reconstruction, delayed views. History: urothelial cancer CHEST:LUNGS AND PLEURA: Mild to moderate centrilobular emphysema is stable. Scattered pulmonary micronodules are unchanged from the prior study.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. The heart size is normal and there is no pericardial effusion.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis is present without complications. Hypodense liver lesions are unchanged from the prior study, however remain too small to characterize. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Severe left hydronephrosis in a nonfunctioning kidney. There is moderate right hydronephrosis, unchanged from the prior study. Bilateral hydroureter. RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystectomy with neobladder. The neobladder is markedly distended and extends craniocaudally for more than 13 cm. LYMPH NODES: No pelvic or inguinal lymphadenopathy is identified.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic focus in the right femoral neck is unchanged. Left fat containing inguinal hernia. | 1.No change in bilateral hydronephrosis.2.No evidence of recurrent or metastatic disease.3.Marked distension of neobladder suggests outlet obstruction. 4.Stable examination. No measurable metastatic disease. |
Generate impression based on findings. | T3N1M0 SCC of the right tongue, currently on salvage therapy with cetuximab and tivantinib. Head: There is no evidence of intracranial masses or abnormal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Neck: No mass lesion is identified, although portions of the oral cavity are obscured by dental amalgam streak artifact. There is no significant cervical lymphadenopathy by size criteria. The thyroid gland and salivary glands are unremarkable. The airways are patent. The major cervical vessels are patent. The osseous structures are unremarkable. There are multiple dental carries and periodontal lucencies. The imaged portions of the lungs are unremarkable. | 1. No evidence of locoregional tumor recurrence or significant lymphadenopathy by size criteria.2. No evidence of intracranial metastases. |
Generate impression based on findings. | Female, 39 years old, history of sinus cancer status post surgery. Please note that evaluation for tumor is somewhat limited to the noncontrast technique. Within this limitation, the following observations are made.Redemonstrated are extensive post surgical changes including frontotemporal and midline craniotomies affixed with surgical plate and screw devices in near anatomic alignment without interval change. Resection of the medial orbital walls, ethmoid air cells, nasal septum, nasal turbinates, medial walls of the maxillary sinuses, and partial resection of the sphenoid sinuses is reidentified. Again seen is bony sclerosis and soft tissue thickening along the paranasal resection bed. This soft tissue is non-specific, but given its stability, most likely reflects post therapeutic changes. The soft tissue mass seen previously along the superolateral aspect of the right globe has been removed and in its place there is only subtle ill-defined thickening. However, more posteriorly within the right orbit, there is some progressive soft tissue which occupies the space between the superior and lateral recti. Along the superolateral aspect the left orbit, there is a new soft tissue lesion measuring 1.7 x 1.3 cm (image 44 series 7).Limited visualization of the soft tissues of the neck is significant for evidence of bilateral neck dissection. No pathologic adenopathy is seen within the field of view of this scan. | 1.Redemonstration of extensive facial and paranasal sinus surgical alteration. Soft tissue thickening along the walls of the sinus resection bed is nonspecific but stable and likely represents scarring or post treatment change.2.A soft tissue mass seen on the prior exam along the superolateral margin of the right orbit has been removed with only ill-defined soft tissue thickening in its place.3.New/progressive soft tissue thickening more posteriorly within the right superolateral orbit is seen. This also could reflect posttreatment change, but the interval progression in size is concerning for recurrence of disease.4.New soft tissue lesion along the superolateral aspect of the left orbit is also highly suspicious for recurrent disease. |
Generate impression based on findings. | Male 33 years old; Reason: Rectal Cancer: Restaging CHEST:LUNGS AND PLEURA: The previously referenced 13 x 10 millimeter nodule at the right lung base is stable to slightly smaller, currently measuring 11 x 10 mm (series 6 image 54). This correlates to a mild FDG avid lesion seen on the PET. A few scattered micronodules are unchangedMEDIASTINUM AND HILA: Stable prominence of the bilateral hila.CHEST WALL: No significant abnormality notedABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Spleen is top normal in size.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: Post operative changes of the right lower abdominal ostomy. Parastomal hernia, nonobstructive.BONES, SOFT TISSUES: Right lower abdominal ostomyOTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is evidence of soft tissue thickening in the presacral space with loss of the fat plane between the presacral space and posterior rectal wall. These findings appear unchanged since prior examination. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable right lower lobe pulmonary nodule.2.Interval decrease in size of the mediastinal and hilar lymph nodes.3.No new evidence of metastatic disease or local recurrence. |
Generate impression based on findings. | Lung cancer with recent finding of manubrial lytic lesion. LUNGS AND PLEURA: Postoperative volume loss on the right consistent with right upper lobectomy. The right middle lobe it is collapsed and the proximal airways of the middle lobe are markedly narrowed suspicious for stenosis. There some adjacent calcified lymph nodes in which could potentially be resulting in extrinsic compression of the airway. Scattered micronodules are most consistent with granulomas and are unchanged comparing back to 2010.MEDIASTINUM AND HILA: Small high right paratracheal lymph node unchanged compared to 2010. Atherosclerotic calcification of the aorta and its branches with stenosis of the proximal left subclavian artery.CHEST WALL: Previously seen pathologic fracture of the inferior manubrium has healed with slight deformity and anterior angulation of the distal fracture fragment. The anterior cortex in this area is no longer present and has been replaced by a fat. The margins are well-circumscribed, consistent with bone biopsy. There are a few punctate sclerotic foci in the more cranial aspect of the manubrium which are unchanged. Numerous faintly sclerotic foci in the rib cortices with several healed rib fractures on the right, present previously dating back to at least 2009 given the benefit of retrospect and unchanged. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Granulomas in the liver and spleen. The stomach is distended with fluid. Elevation of the right hemidiaphragm. | 1. Interval healing of manubrial pathologic fracture with appearance suggesting interval bone biopsy.2. Chronic collapse of the right middle lobe with stenosis of the right middle lobe bronchus which may be the result of extrinsic compression of the bronchus by calcified lymph nodes.3. No signs of localized recurrence at the lobectomy site.4. Unchanged numerous foci of cortical sclerosis in the ribs of unclear etiology but appear unchanged dating back to 2009. |
Generate impression based on findings. | 61-year-old male with non-Hodgkin's lymphoma and squamous cell carcinoma of the head and neck, follow-up pulmonary nodule LUNGS AND PLEURA: Right upper lobe subsolid nodule measures 6 mm and appears to measure 6 mm (image 33 series 4) unchanged. Interval decrease in size of left upper lobe nodule which now measures 8 mm and previously measured 9 mm (image 34, series 4), as well as a small right lower lobe nodule (image 56, series 4).MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Mild coronary arterial and atherosclerotic aortic calcifications.CHEST WALL: Unchanged fluid collection anterior to the sternum likely representing a sebaceous cyst. Bilateral sub-pectoral lymphadenopathy, unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small splenule. Fatty atrophy of the pancreas. Several prominent periaortic lymph nodes are identified appearing similar to the prior study. | Unchanged right upper lobe ground glass nodule and interval decrease in size of two additional pulmonary nodules. |
Generate impression based on findings. | Female 59 years old; Reason: Rectal cancer compare to last Ct \T\ measure 1) LLL lung lesion, 2) left axillary lymph node, 3) peri aortic lymph node, 4) level 4 node, 5) left supraclavicular mass History: post 2 cycles of therapy CHEST:LUNGS AND PLEURA: Innumerable bilateral pulmonary lesions are reidentified. The reference left lower lobe lesion is stable and measures 2.1 x 2.0 cm (image 64/series 6) previously, 2.1 x 2.0 cm.Small left pleural effusion has progressed. There are multiple enhancing lesions in the left pleural space, stable.MEDIASTINUM AND HILA: Right chest wall port terminates at the cavoatrial junction.CHEST WALL: Left axillary lymph node measures 1.3 x 1.4 cm previously 1.5 x 1.5 cm (image 30/series 4).ABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter hypodense lesion at the hepatic dome (image 74 / series 4).New subcentimeter hypoattenuating lesions are noted in segment 8 and 6, compatible with metastatic disease.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: Extensive confluent retroperitoneal lymphadenopathy is grossly stable, increasing reference lesion is difficult to measure.Focal filling defect in the IVC has progressed from previous examination, likely indicating clots.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Absent or atrophicBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Soft tissue in the presacral space is stable.L2 compression fracture with sclerotic / lytic changes is not significantly changed. Additional right sacral mixed sclerotic/lytic lesion.OTHER: No significant abnormality noted. | 1.Progression of malignant left pleural effusion with slight increase in the size of the pulmonary lesions.2.Interval increase in size and number of hepatic metastatic lesions3.IVC clot, progressed from previous4.Dr. Janisch Notified of the findings at 2:08 on 11/22/13 |
Generate impression based on findings. | Male 74 years old; Reason: pt with striuvite crystals seen on U/A History: AnuriaAdditional history: Patient presented to Elmhurst hospital 11/18/2013 with jaundice, chills. Now status post ERCP with biliary stent placement and biopsy of ampullary mass. ABDOMEN: The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:LUNGS BASES: Bilateral pleural effusions with bibasilar atelectasis versus consolidation.LIVER, BILIARY TRACT: Significant pneumobilia of the intra-and extrahepatic biliary system, with patent common duct stent. Residual contrast likely from recent ERCP is noted in the gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral round hyperdense renal lesions bilaterally are incompletely evaluated on this noncontrast exam. No nephrolithiasis or hydronephrosis bilaterally.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A 2.4-cm round, well-circumscribed hypodense lesion identified in the L3 vertebral body demonstrates peripheral cortical thickening and is likely degenerative in etiology.OTHER: No significant abnormality noted.PELVIS:Streak artifact from bilateral hip prostheses significantly limits evaluation of the pelvis.PROSTATE/SEMINAL VESICLES: Prostate beads are 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 nephrolithiasis, as clinically questioned.2.Extensive pneumobilia with patent common duct stent.3.Bilateral small pleural effusions with atelectasis/consolidation.4.Bilateral hyperdense renal lesions are incompletely evaluated. If clinically warranted, contrast enhanced exam would be recommended.5.Hypodense L3 vertebral body lesion favors degenerative etiology. |
Generate impression based on findings. | 53-year-old female with weight loss. Evaluate for cause. CHEST:LUNGS AND PLEURA: Micronodules in the right middle and lower lobe are seen.MEDIASTINUM AND HILA: Left main coronary artery stent is noted. Mild atherosclerotic calcification of the thoracic aorta.CHEST WALL: Sternotomy wires intact.ABDOMEN:LIVER, BILIARY TRACT: Intrahepatic biliary ductal dilatation is seen, left lobe greater than right lobe. Patient is status post cholecystectomy. The common duct measures 9 mm in maximal diameter (coronal image 50). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Cortical thinning and scarring of the kidneys bilaterally in a pattern suggestive of chronic reflux nephropathy.RETROPERITONEUM, LYMPH NODES: Several subcentimeter non-pathologic lymph nodes in the retroperitoneum are identified. Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Orally administered contrast passes freely throughout the bowel without evidence of obstruction or ileus. The stomach is incompletely evaluated due to lack of distention. Heavy colonic stool burden.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Intrahepatic biliary ductal dilatation of unclear etiology. M.R.C.P. is recommended for further evaluation of the biliary system.2.Pattern of cortical thinning and scarring of the kidneys bilaterally is suggestive of chronic reflux nephropathy. |
Generate impression based on findings. | 64 year old female with metastatic thyroid cancer CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary metastases. Reference left pulmonary nodule measures 1.7 cm (image 67, series 4), and previous measured 1.6 cm. No new pulmonary nodules. Probable endobronchial lesions are unchanged.MEDIASTINUM AND HILA: Status post total thyroidectomy. Extensive necrotic appearing mediastinal lymphadenopathy. Reference paratracheal lymph node measures 1.2 cm and previously measured 1.1 cm (image 26, series 20257). Reference left hilar lymph node measures 1.0 cm and previously measured 1.0 cm (image 42, series 20257). Small pericardial fluid collection is new.Bilateral soft tissue thickening along the proximal to mid bronchovascular bundles consistent with contiguous lymphadenopathy, about the same. Extrinsic compression of proximal segmental level bronchus in the right lower lobe (4/57), unchanged.CHEST WALL: Diffuse axial and appendicular mixed sclerotic/lytic lesions consistent with metastatic disease increased from the prior study. Innumerable subcutaneous soft tissue nodules are identified, presumably metastatic.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged hypodensity, too small to characterize.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left hydronephrosis and hydroureter is again noted, incompletely visualized, with delayed nephrogram also noted. Bilateral hypodensities, too small to characterize, are unchanged. Retroperitoneal soft tissue nodules posterior to the right kidney are enlarged, consistent with metastatic disease (image 123).PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Numerous small micronodules are seen along the fascial planes of the retroperitoneum, consistent with metastases.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Distended colon, the dilatation was present previously but appears progressed, now with with air fluid levels. BONES, SOFT TISSUES: Numerous mixed sclerotic/lytic lesions consistent with metastatic disease increased from the prior study.OTHER: Subtle densities extending along the spinal cord suspicious for leptomeningeal disease. Innumerable soft tissue nodules are reidentified. | 1. Extensive metastatic disease involving the chest and abdomen with interval increase in osseous and abdominal disease. Subtle densities extending within the spinal canal are too small to characterize but could reflect leptomeningeal involvement.2. Persistent left hydronephrosis and hydroureter with delayed nephrogram. Obstruction at the level of pole this cannot be excluded.3. Distended colon with air fluid levels may be the result of chronic distal colonic ileus or obstruction.4. New small pericardial effusion. |
Generate impression based on findings. | Altered mental status. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is unchanged nonspecific mild cerebral white matter hypoattenuation that may represent microangiopathy. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The imaged portions of the 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. | 65-year-old female patient with history of right IJV DVT 11/19/2013 and history of PE, on anticoagulation. Presents with shortness of breath x 1 day. Evaluate for a pulmonary embolus. PULMONARY ARTERIES: Technically adequate study and limited by patient motion. The pulmonary trunk is not enlarged. There is a nonocclusive filling defect in the superior right lower lobe artery (series 9 image 89). There are areas of hypoattenuation in the segmental branches of the right and left lower lobes (series 9 image 124) that likely represent filling defects.LUNGS AND PLEURA: New bilateral pleural effusions, left greater than right, with associated atelectasis.Interval resolution of multifocal nodular and groundglass opacities.Slight interval increase in left lower lobe atelectasis.There is a cavitary lesion in the left upper lobe (series 10 image 41), that corresponds to a previously visualized nodular lesion.MEDIASTINUM AND HILA: The right heart is dilated and there is septal straightening, which is suggestive of right heart strain. Mild cardiomegaly without pericardial effusion. Moderate coronary artery calcifications.Right-sided central venous catheter with tip at the cavoatrial junction.Moderate mediastinal and pericardiophrenic lymphadenopathy.CHEST WALL: No cervical lymphadenopathy. Scattered bilateral prominent axillary lymph nodes.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Abdominal ascites. Hypoattenuating liver with suggestive of fatty infiltration. Status post cholecystectomy. | 1.Multiple small segmental, nonocclusive pulmonary emboli.2.Right heart dilatation and interventricular septal straightening consistent with right heart strain.3.New bilateral pleural effusions.4.Interval resolution of multifocal nodular ground glass opacities with remaining cavitary lesion in the left upper lobe.Finding of segmental pulmonary emboli communicated to the ED via telephone at 3:38 PM on 11/22/2013 by Dr. McCann. |
Generate impression based on findings. | COPD now with increasing S.O.B. and respiratory failure on a ventilator. History of AFB positive. Evaluate for PE or cavitary lesion. PULMONARY ARTERIES: Technically adequate examination without evidence of pulmonary embolus.LUNGS AND PLEURA: Severe emphysema. Thick walled cavitary lesion in the right upper lobe measures 2.8 x 5.9 cm, previously 2.6 x 6.3 cm at the same level (8/35). There is new consolidation in the medial aspect of the right upper lobe, progressive consolidation in in the posterior right upper lobe abutting the fissure and significant new air space consolidation throughout the right lower lobe. Moderate right pleural fluid collection is present with subpulmonic extension. Scattered patchy opacities are seen in the left lung consistent with contralateral spread of infection.MEDIASTINUM AND HILA: Tracheostomy tube in place. The feeding tube terminates just beyond the GE junction. Normal heart size. Atherosclerotic calcification of the aorta, unchanged. Right hilar lymphadenopathy slightly worse. Mildly enlarged lymph nodes elsewhere in the mediastinum about the same. Significant amount of debris in the trachea and right mainstem bronchus consistent with aspirated secretions.CHEST WALL: Mild lymphadenopathy in the low neck bilaterally unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Trace perihepatic ascites. | No evidence of acute pulmonary embolus. Right upper and lower lobe pneumonia, probably related to superimposed aspiration. Cavitary mass in the right upper lobe not significantly changed in size and presumably represents active TB. Moderate right pleural fluid collection and a small volume of ascites. |
Generate impression based on findings. | History of sinus cancer rule out metastases LUNGS AND PLEURA: Unchanged pulmonary micronodules. No new or suspicious lesions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Stable sclerotic lesion in the cranial aspect of right scapula, unchanged over multiple scans, favoring a benign lesion. Small lymph nodes in the low neck are unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No specific evidence of metastatic disease. |
Generate impression based on findings. | Male 52 years old; Reason: pancreatitis History: pancreatitis ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: A pseudocyst measuring 12.4 x 5.8 centimeters in greatest axial dimensions, grossly unchanged in size.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Exophytic right upper pole simple cyst.RETROPERITONEUM, LYMPH NODES: Multiple subcentimeter peripancreatic lymph nodes are seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Pancreatic pseudocyst measuring 12.4 x 5.8 cm, grossly unchanged in size from prior MR exam. |
Generate impression based on findings. | Male 69 years old; Reason: h/o buccal cancer and testicular cancer History: r/o mets/recurrence CHEST:LUNGS AND PLEURA: Irregularly-shaped peripheral nodule in the lingula has increased in size since previous exam, measuring 1.1 x 1.4 cm on image 64/118, previously measuring approximately 0.5 x 0.7 centimeters on prior image 66/130.. Few other micronodules are noted throughout the lung fields. The pleural spaces are clear.MEDIASTINUM AND HILA: No adenopathy detected. Coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No obstruction noted. There is a solid -- appearing, well-defined nodule along the right peritoneal border (series 3 image 11) inferior to the liver measures 1.2 x 1.8 cm. This has not changed since previous examination.BONES, SOFT TISSUES: Patient is status post laminectomy with spinal fusion device noted in the lumbosacral spine.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: Patient is status post laminectomy with spinal fusion device noted in the lumbosacral spine.OTHER: No significant abnormality noted | 1.Enlarging and irregular pulmonary nodule is worrisome for metastatic disease vs. primary lung tumor. 2.Nonspecific stable 1.2 x 1.9 cm nodule inferior to the liver, unclear clinical significance. |
Generate impression based on findings. | Head and neck cancer and pulmonary nodules check response. Cough. CHEST:LUNGS AND PLEURA: Branching scarlike lesion at the left apex (5/12) continues to slightly increased in size and density. Right lower lobe nodule measures 5 x 5 mm (6/206), previously 5 x 4 mm on the last two scans. Additional solid and subsolid nodules, some of which are centrally lucent are unchanged. Interval resolution of aspirate in the right upper lobe seen previously. Ground glass opacity in the right middle lobe persists. A new groundglass opacity in the cranial aspect of the right middle lobe is more likely to be post infectious or metastatic.MEDIASTINUM AND HILA: Small enhancing venous varix is versus ectopic thyroid tissue in the midline beneath the manubrium sternum unchanged. Fluid in the superior pericardial recess, but no significant lymphadenopathy. No pericardial fluid.CHEST WALL: Probable vertebral body hemangiomasABDOMEN: 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: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube retention device in the stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Possible subtle increase in size in one of the right lower lobe solid nodules since prior examinations.2. Branching subselective lesion in the left apex increased in size and density and could be post inflammatory or possibly a primary pulmonary lesion. Continued follow-up recommended.3. The remainder of the lesions are not significantly changed, some of which could reflect primary adenocarcinomas and should continue to be monitored.4. Additional waxing and waning larger groundglass opacities are most likely the result of aspirated secretions. |
Generate impression based on findings. | 26-year-old male with recurrent and metastatic head and neck cancer CHEST:LUNGS AND PLEURA: Scarring and bronchiectasis of the posterior right lower lobe appear similar to the prior study. Hazy left paramediastinal and peripheral right upper lobe opacities are also unchanged. There are new right peripheral groundglass nodular opacities adjacent to the minor fissure (image 46, series 4). MEDIASTINUM AND HILA: No mediastinal or hilar lymph adenopathy. No pericardial effusion.CHEST WALL: Multiple scattered sclerotic osseous lesions and endplate deformities appear benign in etiology.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: Mildly enlarged retroperitoneal lymph nodes, which are nonspecific in etiology.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: : Multiple scattered sclerotic osseous lesions and endplate deformities appear benign in etiology.OTHER: No significant abnormality noted. | New faint nodular opacities adjacent to the right minor fissure for which continued follow-up is recommended given the patient's history of metastatic disease. No other specific evidence of metastases. |
Generate impression based on findings. | 74 year-old female with left cheek skin cancer, evaluate extent Brain:Old right cerebellar hemisphere stroke. Intracranial atherosclerotic vascular calcifications.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement.The orbits are unremarkable. The paranasal sinuses are clear. Partial opacification of the left mastoid air cells.Neck:Thickening of the skin and of density induration of the subcutaneous soft tissue along the left cheek measuring approximately 1.8 x 0.9 cm (series 7 image 49). The adjacent anterior wall of the left maxillary sinus is intact without focal erosion or sclerosis. The left infraorbital foramen is within normal limits.Scattered small cervical lymph nodes without lymphadenopathy by CT size criteria. The parotid and submandibular glands are free of focal lesions. No focal thyroid lesions are present. No soft tissue masses are present in the neck. No exophytic mass or focal effacement of the aerodigestive tract.Atherosclerotic vascular calcifications at the carotid bifurcations. Multilevel degenerative changes of the visualized cervicothoracic spine without suspicious osseous lesions.The lung apices are clear. Partially visualized postsurgical changes of a gastric pull up with some retained debris. Partially visualized right chest port catheter. Aberrant right subclavian artery, a normal anatomic variant. Please see dedicated chest CT from today's date for further details. | Limited exam due to lack of contrast. 1. Redemonstration of a left cheek soft tissue lesion without involvement of the adjacent maxillary sinus and orbit.2. No cervical lymphadenopathy. |
Generate impression based on findings. | Male, 4 years old, headache, vomiting. Evaluate for worsening hydrocephalus. A right frontal approach ventricular shunt catheter is in stable position, tip within the right frontal horn.The caliber of the ventricular system as a whole has increased mildly when compared to the prior study. For example, the left lateral ventricle measures 7 mm in the coronal plane at the level of the third ventricle, previously 4 mm. The right lateral ventricle remains smaller than the left.Parenchymal morphology is otherwise unremarkable. No loss of the gray-white distinction or parenchymal edema is seen. No intracranial hemorrhage or abnormal extra-axial collections are seen. There is no mass effect. | 1. Stable positioning of a right frontal approach ventricular shunt catheter.2. Continued mild increase in ventricular caliber. Ventricular size does, however, still fall within the range of normal. |
Generate impression based on findings. | Male 51 years old; Reason: r/o mesenteric ischemia History: abdominal pain ABDOMEN:LUNGS BASES: Bilateral basilar atelectasis.LIVER, BILIARY TRACT: A flash filling 1.4-cm lesion in the peripheral right lobe liver likely represents hemangioma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral moderate hydronephrosis, with ureters retracted into and encased by the soft tissue mass described below (image 96, series #10).RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcification of the abdominal aorta and its branches. An abdominal aortic aneurysm measures 3.4 cm in maximal axial diameter, measured in the AP dimension distally, and extends from the level of the superior endplate of L3 below the level of the renal arteries to approximately 2 cm proximal to the aortic bifurcation. Intraluminal mural thrombus is also noted. A weakly enhancing soft tissue density mass encases the distal abdominal aorta, extends to the proximal right iliac, and involves the ureters bilaterally. Findings are suggestive of inflammatory abdominal aortic aneurysm with periarteris versus primary retroperitoneal fibrosis and incidental small AAA.BOWEL, MESENTERY: Orally administered contrast passes quickly throughout the bowel without evidence of obstruction or ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Origin of the inferior mesenteric artery is encased by the retroperitoneal mass though fills normally without evidence of vascular compromise.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Moderately distended.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 mesenteric ischemia as clinically questioned.2.3.4-cm abdominal aortic aneurysm with mural thrombus and surrounding inflammatory fibrosis causing ureteral obstruction. Consider inflammatory aneurysm with periarteritis versus primary retroperitoneal fibrosis with incidental small adjacent AAA.3.Bilateral moderate hydronephrosis. |
Generate impression based on findings. | 60 year-old male with tongue and lung cancer, rule out recurrence LUNGS AND PLEURA: Status post interval right upper lobectomy with pleural fluid tracking medially along the heart border. Irregular nodule in the superiorly displaced right lower lobe measures 2.8 x 1.0 cm (image 20, series 5). This lesion may correspond to the previously identified nodule in the superior right lower lobe that was FDG avid on PET. Scarring at the right lung base. Diffuse emphysema.MEDIASTINUM AND HILA: No new mediastinal or hilar lymphadenopathy. Interval decrease in size of mediastinal lymph nodes with small residual superior mediastinal (image 18, series 3) and pretracheal lymph nodes. Coronary arterial calcifications. No pericardial effusion.CHEST WALL: Interval progression of T10 vertebral body compression fracture.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Bilateral hypoattenuating renal lesions, likely representing cysts. Atherosclerotic calcifications of the abdominal aorta and its branches. Hiatal hernia. | 1. Irregular nodule in the superior right lower lobe which may correspond to a previously identified nodule in the right lower lobe that was FDG avid on PET, suspicious for malignancy.2. Progression of T10 vertebral body compression fracture. |
Generate impression based on findings. | Colon cancer CHEST:LUNGS AND PLEURA: A index left upper lobe spiculated nodule measures 8mm in diameter (image 26; series 5) roughly stable compared to previous study and radiographically more suggestive of a primary neoplasm then a metastasis. Other bilateral smaller nodules are also stable.MEDIASTINUM AND HILA: Bilateral thyroid nodules. These were not included in the scanning range on the prior exam. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephrolithiasis, unchanged. No evidence of hydronephrosis. Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Ill-defined retroperitoneal soft tissue in the left para-aortic space is nonspecific and unchanged from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral lung nodules with largest reference nodule having a radiographic appearance more compatible with primary lung carcinoma than a metastasis. |
Generate impression based on findings. | NHL with nodule left post auricular region and T2N0 anal cancer here s/p 2 cycles of mitomycin and 5FU completed on 8/10/12. There is a new 10 x 15 mm soft tissue nodule in the subcutaneous tissues inferior to the left auricle, which extends to the surface of the parotid gland. Anterior to this is a 4 mm subcutaneous nodule. There is a 9 mm diameter nodule within the left tragus. There is also a new soft tissue mass in the right premalar fat pad that measures 24 x 13 mm and another overlying the left lateral orbital rim that measures 20 x 8 mm. There is otherwise no significant cervical lymphadenopathy in the jugular chains. The Waldeyer ting structures are not enlarged. There is an unchanged 10 x 6 mm opacity in the anterior tracheal lumen at the level of thyroid gland. The thyroid gland is unremarkable. The major cervical vessels are patent. There is a right ocular implant and prosthesis. The imaged portions of the paranasal sinuses and mastoid air cells are clear. The partially imaged intracranial structures are grossly unremarkable. The imaged portions of the lungs are clear. | 1. Multiple soft tissue masses in the subcutaneous tissues of the head and neck, including inferior to the left auricle overlying the parotid gland, left tragus, right premalar fat pad, and overlying the left lateral orbital rim, which likely represent extra-nodal recurrence of lymphoma, appear to be new since November 2012.2. Unchanged nonspecific 10 x 6 mm opacity in the anterior tracheal lumen at the level of thyroid gland, which may represent an additional focus of lymphoma. |
Generate impression based on findings. | 75-year-old male with history of lung cancer, restaging exam CHEST:LUNGS AND PLEURA: Increased size of left lower lobe cystic solid lesion measuring 1.6 x 4.2 cm (image 50 series 5) and previously measuring 1.6 x 3.2 cm. The solid component is also increased in size and now measures 1.1 x 1.2 cm. Unchanged mild pleural.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No pericardial effusion. Atherosclerotic calcifications of the coronary arteries.CHEST WALL: Degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted. | Increased size of cystic and part solid left lower lobe lesion with increasing solid component highly compatible with primary adenocarcinoma, likely with an invasive component. |
Generate impression based on findings. | Reason: evaluate for source of hypoxia, consolidation, infection, interstitial lung disease History: hypoxia LUNGS AND PLEURA: The examination is significantly limited by respiratory motion artifact, apparently due to the patient's inability to cooperate by suspending respiration.Dense interstitial opacity is present in a patchy distribution, affecting all lobes but most extensive in the upper lobes.Small cystic lucencies throughout the affected areas are most likely due to underlying emphysema.There is no reliable evidence of architectural distortion, traction bronchiectasis or honeycombing though the quality of the scan is markedly suboptimal due to motion artifact.No pleural effusions.MEDIASTINUM AND HILA: Visualization is limited due to lack of IV contrast and gross motion artifact.Mildly enlarged lower right paratracheal lymph nodes are present.Severe coronary artery calcifications.CHEST WALL: Degenerative disease in the spine. UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | 1.Limited examination due to the patient's inability to cooperate by suspending respiration.2.Extensive bilateral predominantly groundglass opacities with cystic areas that likely represent underlying emphysema especially if the patient is a cigarette smoker. There is no reliable evidence of fibrosis on this suboptimal scan. Depending on the clinical history the differential diagnosis is broad and potentially includes ARDS secondary to acute lung injury such as due to extensive pneumonia. In an immunocompromised patient the findings would also raise the question of opportunistic infection due to pneumocystis or viral pneumonias. |
Generate impression based on findings. | Eval integrity of sternum (instability) / Eval abdomen and pelvis for free air, bowel gas pattern, evidence of bowel wall edema and intrabdominal fluid collection Signs and Symptoms: Sternal Click / Ileus / Hypothermia following Aortic Valve Replacement and CABG Renal failure limits us to no contrast The following observations are made given the limitations of an unenhanced study.CHEST:LUNGS AND PLEURA: Calcified pleural plaques suggesting prior asbestos exposure. Atelectasis at both lung bases. There are small bilateral pleural effusions (left greater than right).MEDIASTINUM AND HILA: Left PICC line terminates in the right atrium. Pericardial catheters. Status post aortic valve replacement.CHEST WALL: Status post median sternotomy. The median sternotomy plate appears to be a in the right sternal moiety (rather than spanning the sternum) and there is slight distraction of the sternum inferiorly.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. Mild gallbladder wall thickening which is difficult to assess given motion artifact.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nonspecific 2-cm left adrenal gland nodule.KIDNEYS, URETERS: Renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild dilatation of both small bowel and colon without definite transition point suggesting a diffuse ileus.BONES, SOFT TISSUES: Degenerative changes throughout the spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Median sternotomy appears to be unstable inferiorly with the median sternotomy plate in the right sternal moiety and lower sternal wires in left sternal moiety rather than spanning the sternum . Small pleural effusions with atelectasis. Diffuse ileus. Nonspecific left 2-cm adrenal nodule.Findings discussed with the clinical service (pager 1949) at the time of dictation. |
Generate impression based on findings. | Lung cancer on treatment CHEST:LUNGS AND PLEURA: Spiculated necrotic nodule inseparable from the posterior pleural surface in the left upper lobe measures 15 x 16 mm (5/33), previously 13 x 13 mm (4/36). Cranial caudal length is 2.6-cm (coronal image 14). Nodular high density pleural thickening is present on the left with interval development of pleural calcification in the left costophrenic angle. Correlate for history of pleurodesis since the prior outside examination. Small left pleural fluid collection.Scattered micronodules bilaterally, some of which may be slightly larger compared to the prior examination. Nodular densities in the right lower lobe appear endobronchial and may be secondary to aspirated to 3 on image 5/45. Additional nodules in the right lower lobe may be larger, though the differences could be due to varying technique between the studies. No pleural nodules appreciated on the right.MEDIASTINUM AND HILA: New small 8mm lymph node near the left inferior pulmonary ligament (3/84). Small lymph nodes in the pericardial fat are unchanged. Small lymph nodes at the left hilum are too tiny to accurately characterize but do appear to enhance (3/46). There is a minimal lymphatic tissue in the left interlobar region (3/49).CHEST WALL: Lytic cortical lesion involving the anterior left seventh rib. Healing fractures of the sixth and seventh ribs near this lesion. Focal sclerosis and cortical thickening of the anterolateral right sixth rib. As these occur at the same level they maybe post traumatic rather than metastatic, correlate for history of injury. Degenerative endplate sclerosis of T11 and T12.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic lesion seen on abdominal CT earlier this month is not visible, possibly due to phase of contrast enhancement.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 15 x 16 x 26-mm necrotic left upper lobe nodule compatible with known neoplasm inseparable from the adjacent pleural surface and measures slightly larger. 2. New mildly enlarged lymph node near the left inferior pulmonary ligament and additional small mediastinal and left hilar lymph nodes should be followed, probably present previously. It is possible that these are reactive rather than metastatic if the patient had pleurodesis since the outside examination. 3. Numerous pleural nodules are seen in association with a left pleural fluid collection. The presence of high density in the pleural space is suggestive of calcification or talc. If the patient has had a left pleurodesis since the previous examination it is possible that these nodules are result of the procedure rather than metastatic. 4. Lytic skeletal lesion involving the anterior left seventh rib suspicious for myeloma or metastasis.5. Scattered pulmonary micronodules are indeterminate. Slight differences in measurements could be due to either growth or differences between scan techniques.6. Please correlate above findings with outside PET report which was not available at the time of interpretation. |
Generate impression based on findings. | Male, 62 years old, right base cancer status post chemoradiation. Also evaluate right jaw osteoradionecrosis. Lysis affecting predominantly the buccal cortex of the right mandible has slightly progressed when compared to the recent facial CT, with more substantial progression seen on comparison to the more remote neck CT. No areas of new lytic change are otherwise seen in the mandible. Elsewhere, the bony structures are free of suspicious lesions.Surgical findings in the right neck are redemonstrated including resection of the submandibular gland, absence of the internal jugular vein, and infiltration of the fascial planes.The aerodigestive mucosa is free of suspicious lesions. No pathologic adenopathy is detected by size criteria. The residual salivary glands and thyroid are unremarkable. The residual cervical vessels do remain patent. Lung apices show no significant abnormality. | 1. No evidence of recurrent malignancy in the neck.2. Slow continued progression of lysis involving the right mandible. Findings are compatible with osteoradionecrosis. |
Generate impression based on findings. | 48 year-old male with metastatic RCC. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. Small calcified pineal cyst. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. The osseous structures are unremarkable. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of intracranial metastatic disease or acute abnormality. |
Generate impression based on findings. | 69-year-old male with mucoepidermoid buccal cancer, status post surgery, reevaluate Limited intracranial and orbital views are unremarkable. Partial opacification of the ethmoid air cells. Mucosal thickening of the maxillary sinuses with associated sclerosis is compatible with chronic sinusitis. The visualized mastoid air cells are clear.In the right lateral aspect of the oropharynx, the lesion identified on the previous examination is no longer present. No CT evidence of lymphadenopathy. No soft tissue masses are present in the neck. The parotid and submandibular glands are within normal limits. Small hypoattenuating thyroid nodules. No exophytic mass or focal effacement of the aerodigestive tract. The buccal spaces are unremarkable bilaterally.Atherosclerotic vascular calcifications of the carotid bifurcations. The major cervical vasculature is patent.The visualized lung apices are clear. Please see dedicated chest CT from today's date for further details.Extensive multilevel degenerative changes of the visualized cervicothoracic spine including grade 1 anterolisthesis of C4 on C5 and C7 on T1. There is severe disk space loss and sclerotic endplate changes at C5-C6 through C7-T1 with uncovertebral hypertrophy and neuroforaminal narrowing. No suspicious osseous lesions are present. | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Female, 63 years old, nasal congestion and discharge. A left nasolacrimal tube is redemonstrated grossly stable in position extending from the region of the medial canthus directly into the left middle meatus.The frontal sinuses are clear. The left frontoethmoidal recess is occluded. The right frontoethmoidal recess is clear.Since the prior exam, endoscopic sinus surgery has been performed with partial resection of the ethmoid air cells. There is scattered opacification of the residual ethmoid air cells. Mild peripheral mucosal thickening is evident within the sphenoid sinuses. The sphenoethmoidal recesses are narrowed by this thickening.The ostiomeatal complexes have been resected bilaterally. On the right, the neo-antrum is widely patent and the maxillary sinus shows only minimal peripheral mucosal thickening. The neo-antrum is narrowed secondary to mucosal thickening but does remain patent. There is moderate peripheral mucosal thickening in the left maxillary sinus with a fluid level. Aside from the surgical changes, the overall appearance of the maxillary sinuses is similar to prior.The nasal cavity is free of occlusion. The inferior turbinates are unremarkable. The middle turbinate on the right is not clearly seen and on the left is small. | 1. Evidence of interval endoscopic sinus surgery. The neo-antra are patent. There remains moderate mucosal thickening and a fluid level within the left maxillary sinus.2. Stable left nasolacrimal duct tube. |
Generate impression based on findings. | 62-year-old male with shoulder pain. Evaluate for glenohumeral joint deformity. Dilute contrast fills the glenohumeral joint space. Contrast is not seen in the subacromial subdeltoid bursa, arguing against rotator cuff tear. However, a linear focus of contrast extending from the undersurface of the supraspinatus tendon at its insertion on the humeral head (image 47, series 80344) likely represents a partial thickness interstitial tear. The contrast does not extend through the full-thickness of the tendon. Contrast is also seen on the superior subscapular recess.Severe osteoarthritis affects the glenohumeral joint, with severe joint space narrowing, subchondral cysts, and osteophyte formation. The humeral head is mildly flattened. | 1.No full-thickness rotator cuff tear. Undersurface partial tear of the supraspinatus tendon.2.Severe osteoarthritis of the glenohumeral joint. |
Generate impression based on findings. | Left cheek skin cancer rule out chest metastases. Patient also has a history of esophageal cancer. LUNGS AND PLEURA: No pleural fluid or pneumothorax. Mild subpleural reticulation and bronchiectasis bilaterally consistent with fibrosis. In the paramediastinal region this is likely the result of RT. Debris in the right middle lobe airways. Scattered micronodules elsewhere are unchanged. Mild chronic pleural thickening adjacent to the pull-up.MEDIASTINUM AND HILA: Aberrant right subclavian artery, normal variant anatomy. Index right paratracheal lymph node has been resected with surgical clip in the area. Since her coronary artery calcifications. No significant lymphadenopathy. The pull-up is unremarkable in appearance with the limitations of unenhanced technique and the absence of oral contrast. Right jugular chest port tip at in the proximal SVC. Ascending aorta appears mildly ectatic with dilatation of the sinuses of Valsalva. AP dimension of the aorta at the level of the main pulmonary artery is 39-mm.CHEST WALL: Very small but new area of focal sclerosis in the sternum (coronal image 69). Degenerative change of the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. Adrenal gland calcifications bilaterally may be the result of prior hemorrhage, new compared to the previous examination. Atherosclerotic calcifications of the aorta and its branches. No lymphadenopathy. | 1. No signs of pulmonary metastases. 2. New small focus of sclerosis in the sternum, indeterminate. Suggest correlation with bone scan.3. Mild ectasia of the thoracic aorta.4. Interval development of the adrenal gland calcifications bilaterally suspicious for previous episode of adrenal gland hemorrhage though some types of infection can cause calcification. |
Generate impression based on findings. | 73-year-old male. Reason: Pt with metastatic melanoma, evaluate for progression. CHEST:LUNGS AND PLEURA: Scattered areas of focal ground glass opacities are seen throughout the left lung and to a much lesser degree in the right lung without solid components, stable since outside CT examination 6/14/13. Stable subcentimeter solid lung nodules seen at the left lung base, and right lower lobe are unchanged in size do not have increased activity on PET. No other solid nodules or masses are seen. MEDIASTINUM AND HILA: Normal size, lymph nodes scattered throughout. The mediastinum. Enlarged subcarinal lymph node has increased PET activity at image 56 of series 4, measuring 11 x 23 mm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenule in the left upper quadrant. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Hiatal hernia. There is stable marked wall thickening and aneurysmal dilatation of a loop of small bowel compatible with metastatic melanoma (series 4, image 152). Another loop of ileum in the right abdomen (series 4, image 168) shows nearly circumferential wall thickening and increased activity on PET. This lesion is stable since the prior exam.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: New enlarged right external iliac lymph node at image 185, series 4 measures 1.4 x 2.3 cm, with increased PET activity. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Posterior to the right femoral neck and abutting the femur (series 4, image 209) is an enhancing lymph node measuring 1.5 x 2. cm with activity on PET scan compatible with a metastatic focus of melanoma.OTHER: Left inguinal hernia containing only mesenteric fat. | 1. Two stable foci of tumor masses in the ileum, consistent with metastatic melanoma. 2. Stable enhancing lymph node about right hip, most likely, metastatic melanoma. 3. Scattered bilateral pulmonary groundglass disease and small nodules are stable. 4. New enlarged subcarinal lymph node and right external iliac node are positive on PET exam. |
Generate impression based on findings. | Male, 32 years old, fever, leukocytosis, on ventilator. Evaluate for sinusitis. The frontal sinuses and frontoethmoidal recesses are clear. There is peripheral mucosal thickening and some frothy debris in the right sphenoid sinus with occlusion of the sphenoethmoidal recess. Minimal mucosal thickening is evident within the left sphenoid sinus with a narrow but patent sphenoethmoidal recess. Opacification of one left sided ethmoid air cell is seen.The maxillary sinuses are free of significant mucosal thickening, secretions and debris. The maxillary outflow pathways are patent bilaterally.The nasal septum is intact and demonstrates a mild S-shaped curvature in the axial and coronal planes. The turbinates are within normal limits. The nasal cavity is clear. | Relatively mild inflammatory changes in the paranasal sinuses. No |
Generate impression based on findings. | Male, 85 years old, back pain after a fall with abnormal T12 vertebral body on outside MRI. History of prostate cancer. Evaluate for benign fracture versus metastasis. There is a compression deformity of the T12 vertebral body with approximately 60% loss of height. The vertebral body itself is heterogeneous and slightly sclerotic without definite evidence for an underlying lesion. Notably, air is present within the compressed vertebral body as well as the adjacent disk spaces.A small focal lucency which seems to be fluid-filled is evident along the inferior endplate of the L5 vertebral body. There is also a focus of air within this lesion.Elsewhere, no focally destructive lytic or blastic lesions are demonstrated in the spine. The bones are osteopenic.There are mild stepwise retrolistheses of L2 on L3 and L3 on L4. There is a slight scoliotic curvature of the lumbar spine as well.Degenerative disk disease is seen at every level with loss of disk height most notably from L2-3 down. Level specific degenerative findings are as follows:T11-12: Mild retropulsion of vertebral body material from the T12 compression fracture results in a mild degree of canal narrowing. There is also a superimposed calcified bulging disk. The neural foramina are patent.T12-L1: Mild facet and ligamentum flavum hypertrophy. Mild bulging disk. No significant compromise of the spinal canal or neural foramina.L1-2: Mild facet and ligamentum flavum hypertrophy. Mild bulging disk. At most mild narrowing of the spinal canal. Mild bilateral foraminal narrowing.L2-3: Moderate facet hypertrophy. Moderately bulging disk. Mild/moderate canal narrowing. Mild to moderate bilateral foraminal narrowing.L3-4: Moderate facet hypertrophy. Moderate bulging disk. Mild to moderate canal narrowing. Moderate bilateral foraminal narrowing. L4-5: Moderate facet hypertrophy. Moderate bulging disk with osteophytic spurring. Mild/moderate canal narrowing. Moderate to severe bilateral foraminal narrowing. L5-S1: Mild facet hypertrophy. Mild bulging disk and osteophytic spurring. No significant spinal canal narrowing. Moderate to severe bilateral foraminal narrowing. The urinary bladder is fluid distended and there numerous probable bladder diverticula along its margins likely reflective of chronic bladder outlet obstruction. Also noted is extensive aortoiliac atherosclerotic disease. | 1. Compression fracture of the T12 vertebral body is likely benign given the lack of a discrete underlying lesion, presence of air within the fractured vertebral body, and lack of any other suspicious lesions in the spine.2. Small fluid-filled lesion within the L5 vertebral body is also likely benign representing a variant Schmorl's node or degenerative cyst.3. Multi-level degenerative disk disease which results in a variable degree of canal narrowing and foraminal encroachment as above.4. Evidence of chronic bladder outlet obstruction. |
Generate impression based on findings. | Male 56 years old; Reason: Assess for left hydronephrosis, abscess, s/p cystectomy/neobladder 5/2013 c/b multiple recurrent infections/abscesses History: Left flank pain, fever ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating foci with perinephric fat stranding along the left mid pole (series 3 image 60). Another focus of low attenuation in the upper pole left kidney (series 2 image 49) is also noted with subtle perinephric fat stranding. These were not evident on 8/13, suggesting rapid onset and favoring infectious etiology. No drainable fluid collections or stones detected. No hydronephrosis.Right pelvic kidney is 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: Status post cystoprostatectomy.BLADDER: Foley balloon noted in the neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Interval removal of the percutaneous drain and interval resolution of the left-sided pelvic fluid collection. | 1. Hypoattenuating foci in the midpole left kidney with perinephric fat stranding and fluid along the Gerota's fascia, consistent with multifocal pyelonephritis. No drainable fluid collections, or stones detected.. |
Generate impression based on findings. | 32 year old male. Reason: intraabdominal infection? History: fever, leukocytosis. DM, HTN and pneumomediastinum of unclear etiology. Respiratory failure. ABDOMEN:LUNG BASES: Bilateral lower lobe opacities consistent with aspiration pneumonia. Right lower lobe consolidation. Small pleural effusions. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: G-tube in the expected position.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in a decompressed urinary bladder. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Extensive vascular calcification in the iliac arteries and major branches bilaterally throughout the pelvic and proximal thighs. No specific abnormality to explain fever and leukocytosis. | Right lower lobe consolidation. Left lower lobe atelectasis. Bilateral small pleural effusions. G-tube. |
Generate impression based on findings. | Malignant neoplasm of the pancreas. Possible recurrent pancreatic cancer. Left breast lumpectomy. Abdominal discomfort CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Multiple mediastinal lymph nodes. For reference purposes, a low right paratracheal lymph node measures 1.6 x 1.3 cm. This is unchanged compared to the prior examination dated 12/6/2004 from University of Illinois (image 85; series 2). Left substernal thyroid unchanged.CHEST WALL: Right internal jugular vein chest port. Status post left lumpectomy. Possible right breast mass; correlate with mammography.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Status post partial pancreatectomy with inflammatory changes or scarring persisting in the lesser sac. Subcentimeter peripancreatic lymph nodes have regressed since the prior exam.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Infiltration of the left omentum (image 133; series 3) is less prominent compared to the prior examination (image 216; series 2).BONES, SOFT TISSUES: Sclerosis of the L1 and L2 vertebral bodies presumably represents prior vertebroplasty come unchanged compared to prior. Correlate clinically.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: Trace fluid in the cul-de-sac. | No substantial interval change compared to the prior outside examination exception of regression of omental infiltration in the left upper quadrant. Mediastinal adenopathy is stable. Status post partial pancreatectomy. Possible right breast mass; correlate with mammography. Status post left lumpectomy. |
Generate impression based on findings. | 34-year-old male with hematuria, pelvic pain and urethral pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hypoattenuating liver parenchyma consistent with hepatic steatosis. No lesions identified. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate densities in calyces of left kidney consistent with nonobstructing stones, both measuring less than 1 mm (series 3, image 57, 63). No evidence of obstructing stones, hydronephrosis, renal lesions, or perinephric fat stranding. No filling defects identified in collecting system on delayed images. 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 | Punctate non-obstructing stones in left kidney. |
Generate impression based on findings. | Chronic VAD drive line infection. Evaluate for fluid collection. CHEST:LUNGS AND PLEURA: Dense, well circumscribed micronodules appears benign and most likely represent granulomas.No pleural fluid or pneumothorax.MEDIASTINUM AND HILA: LVAD in place. There is a significant amount of streak artifact from the metallic component of the device, limiting assessment of the device below the level of the diaphragm.Small mediastinal lymph nodes are nonspecific in appearance. Left ICD with leads in the right atrial appendage and right ventricular apex. Severe multichamber cardiomegaly. High density material near the expected position a the left atrial appendage may reflect a staple line from ligation, correlate with surgical history.CHEST WALL: A subcutaneous ICD coil is in place in the soft tissues of the left lateral and posterior hemithorax. Left chest wall pacemaker generator. Healed sternotomy with wires in place.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: The majority of the liver is obscured due to streak artifact from LVAD.SPLEEN: Streak artifact from from LVAD obscures the majority of the spleen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Streak artifact obscures the pancreas.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymph nodes are probably unchanged though assessment is limited by lack of IV contrast. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Several prominent mesenteric lymph nodes are poorly seen without IV contrast but probably unchanged.BONES, SOFT TISSUES: There is streak artifact surrounding the visualized portion of the drive line. No conclusive fluid collections though a small amount of surrounding fluid may not be visible due to artifact. Diffuse skin thickening and subcutaneous edema is noted which is worst in the right hemi-abdominal soft tissues below the level of the drive line, suspicious for cellulitis or other infection in this area. OTHER: No significant abnormality noted. | Limited assessment due to significant streak artifact from metallic component of the LVAD. No large fluid collections are appreciated. Suggest abdominal wall ultrasound if there is a high level of clinical suspicion . Note is made of an asymmetric skin thickening in the right anterior abdominal wall below the level of the drive line which may be due to infection or edema. |
Generate impression based on findings. | 53-year-old female with intermittent shortness of breath, evaluate for PE PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: No focal pulmonary opacities or pleural effusions. Postsurgical change consistent with right upper lobectomy.MEDIASTINUM AND HILA: 14-mm right paratracheal soft tissue opacity suspicious for lymphadenopathy.CHEST WALL: Mild degenerative changes of the thoracolumbar spine. Small lipoma causes mass effect on the right jugular vein at the thoracic inlet.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Technically adequate study without evidence of pulmonary embolus. 14-mm right paratracheal soft tissue opacity suspicious for lymphadenopathy. Small lipoma causes mass effect on the right jugular vein at the thoracic inlet. |
Generate impression based on findings. | Female 30 years old. Reason: right renal abscess, eval for resolution. ABDOMEN: Evaluation of bowel is limited by lack of oral contrast.LUNG BASES: Moderate large bilateral pleural effusions have resolved. No infiltrates. Visualized mediastinal structures are unremarkable.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephroureterostomy stent in place with no evidence of nephrolithiasis. Striated right nephrogram. No abscess.Hypoperfused right upper pole renal cortex adjacent to a dilated calyx (image 47, series 3) may represent a focus of infarction. The left kidney is normal.RETROPERITONEUM, LYMPH NODES: Scattered small retroperitoneal nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate to marked generalized anasarca.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: Distal end of the right nephroureterostomy stent is in the urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Moderate to marked generalized anasarca has resolved.OTHER: No significant abnormality noted | Right pyelonephritis is resolving. No abscess. Hypoperfused right upper pole cortex adjacent to a dilated calyx may be an infarct. Otherwise there was marked improvement since the prior exam. Right renal stent is in the expected position.Ascites has resolved.Moderate bilateral pleural effusions have resolved. Anasarca has resolved. |
Generate impression based on findings. | 50 year old female status post two cycles of chemotherapy for primary mucinous peritoneal mesothelioma. CHEST:LUNGS AND PLEURA: Mild bilateral basilar atelectasis/scarring. No suspicious nodules, effusions, or consolidation.MEDIASTINUM AND HILA: Hypoattenuating nodule in left thyroid lobe unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Slightly increased mild dilation of right collecting system.RETROPERITONEUM, LYMPH NODES: Abnormal retroperitoneal soft tissue in right lower quadrant appears similar to prior exam (series 3, image 119).Multiple retroperitoneal surgical clips noted.BOWEL, MESENTERY: Soft tissue lesion in anterior mesentery not significantly changed, measuring 5.4 x 3 .3 cm, previously measured 5.9 x 3.8 cm (series 3, image 106). Multiple enlarged mesenteric lymph nodes not significantly changed. No evidence of bowel obstruction. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Loculated fluid collection in the pelvis a not significantly changed, measuring 10.0 x 9.0 cm, previously measured 10.0 x 9.1 cm (series 3, image 169).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No significant change in mesenteric and retroperitoneal soft tissue lesions as well as pelvic fluid collection.2.Slight increase in dilation of right collecting system. |
Generate impression based on findings. | 40 year-old female with obstructive hydrocephalus, procedural imaging Redemonstrated is a well-demarcated low attenuation (nearly CSF density) lesion/arachnoid cyst in the right thalamus with extension into the interpeduncular cistern and the third ventricle, unchanged. The lateral and third ventricles have increased in size. Periventricular hypodensity suggests transependymal resorption of CSF. Calvarial and scalp changes are consistent with prior shunt catheter placement. There is no acute intracranial hemorrhage. The visualized mastoid air cells and paranasal sinuses are clear. | 1.Redemonstrated is a well-demarcated low attenuation lesion/arachnoid cyst in the right thalamus with extension into the interpeduncular cistern and the third ventricle, unchanged.2.The lateral and third ventricles have increased in size with findings suggestive of transependymal CSF resorption. |
Generate impression based on findings. | Other primary cardiomyopathies. acute AMS, R sided weakness 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. A for melena hypodense focus is present in the right basal gangliaThe 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. There is disconjugate gaze is present | 1.No evidence for acute intracranial hemorrhage mass effect or edema. A hypodense 4-mm focus in the right basal ganglia could represent a lacunar infarct age indeterminant. There are no early stigmata for large vessel intracranial infarction compared CT is insensitive for the early detection of nonhemorrhagic CVA. |
Generate impression based on findings. | L3 lesion, hx thymoma.OPERATORS: Greg Christoforidis, Harut HaroyanEBL < 5ml Serial CT images obtained during the biopsy procedure demonstrate needle placement within the L3 vertebra. Following needle removal images obtained that demonstrate no complications . Some air bubbles are present along the biopsy tract | L3 biopsy under CT guidance. A total of 6 biopsy specimens were delivered to pathology for analysis. |
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