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Generate impression based on findings. | The vertebral body heights are preserved. At L1-L2 and L2-L3, there are mild disc bulges that result in mild spinal canal stenosis without neural foramen stenosis. At L3-L4, there is a mild disc bulge, as well as a superimposed right foraminal herniation that results in severe right neural foramen stenosis. There are ... | 1. Postoperative findings at L4-L5 with spinal canal and neural foramen obscuration at this level secondary to streak artifact and postoperative changes. Thus, a fluid collection with spinal canal stenosis in this region cannot be excluded.2. A right neural foraminal disc herniation at L3-L4 results in severe right neu... |
Generate impression based on findings. | Reason: see above History: Clinical trial Cycle 1 Day 11RADIOPHARMACEUTICAL: 13.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 79 mg/dL. Today's CT portion grossly demonstrates left masticator space soft tissue mass and adjacent post surgical changes. Mediastinal and hilar calcified lymph nodes. Bibasilar... | 1.Stable hypermetabolic tumor in the left masticator space.2.No new foci of hypermetabolic tumor. |
Generate impression based on findings. | Reason: evaluate mass, ich, etc History: AMS In general the ventricles are enlarged whereas they sulci are not significantly widened .No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical whit... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.The lateral ventricles are generous in size and the sulci are not substantially widened. Although this could be result of brain atrophy the possibility of normal pressure hydrocephalus cannot be excluded in the appropriate clinical setting. Please c... |
Generate impression based on findings. | 89-year-old female with bilateral knee pain and bilateral shoulder pain. Right knee:Severe tricompartmental osteoarthritis affects the right knee, most pronounced in the medial compartment. Mild chondrocalcinosis. Vascular calcifications are additionally noted.Left knee:Moderate joint effusion is present. Moderate to s... | Moderate left knee joint effusion. Degenerative changes, as above. |
Generate impression based on findings. | Reason: CLL. that has transformed into a large B cell lymphoma History: 83Yrs male with a h/o HTN, CKD, and HL with CLL. that has transformed into a large B cell lymphoma (Richter's transformation). Pt. is s/p 6 cycles R CHOP and in need of end of treatment restaging.RADIOPHARMACEUTICAL: 13.7 mCi F-18 fluorodeoxyglucos... | 1.Complete resolution of hypermetabolic lymphadenopathy in the neck, chest, abdomen, and pelvis.2.Mild FDG uptake in the bilateral hila without CT correlate likely related to inflammation. |
Generate impression based on findings. | 29-year-old male with pain in right thumb and nail changes. Evaluate for psoriatic arthritis. No significant soft tissue swelling is identified. No evidence of fracture or malalignment is evident. No significant arthritic changes are present. | No significant arthritic changes present. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Dyspnea, hypoxia, rule out PE PULMONARY ARTERIES: No evidence of acute pulmonary embolism. The pulmonary artery is normal in diameter.LUNGS AND PLEURA: Bilateral basilar interstitial and airspace opacities most consistent with edema. No pleural effusions. New bronchial wall thickening, possibly due to edema but nonspec... | 1.No evidence of acute pulmonary embolism.2.Findings consistent with mild to moderate CHF.3. Mixed density 10-mm right upper lobe nodules indeterminate etiology; recommend 3 month follow-up CT.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strai... |
Generate impression based on findings. | 53 year old with history of left mastectomy for recurrent DCIS in April 2009. No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distrib... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 22-year-old male with left knee pain Alignment is anatomic. No fracture is evident. There is a small (1.5cm) lesion along the posterior distal femur with sclerotic margins which is most likely benign. | 1. No specific findings to account for the patient's knee pain.2. Small lesion with sclerotic margins along the distal femur that is most likely benign. |
Generate impression based on findings. | 57 year-old female with right hip pain status post surgery in 2010. Also has pain at base of thumb, right greater left. Right hip:Sclerosis suggests mild osteoarthritis. No significant joint space narrowing. No evidence of fracture or malalignment.Right hand:The bones of the right hand appear normal without evidence of... | Mild right hip osteoarthritis. No osseous abnormality in the hands. |
Generate impression based on findings. | Male 43 years old Reason: Patient has newly dx CLL with 17p deletion, currently screening for clinical trial protocol IRB: 14-0881 History: newly dx CLL with 17p deletion CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Extensive mediastinal adenopathy. An index pretracheal node measures 2 ... | Extensive bilateral axillary, mediastinal, retroperitoneal and pelvic adenopathy. Mild-to-moderate splenomegaly. |
Generate impression based on findings. | Female 17 years old lumbagoVIEWS: Sacroiliac joints AP and bilateral oblique (3 views) pelvis AP and frog leg lateral (two views) 1/23/2015 Partial left posterior fusion defect of L5. No acute fracture or malalignment is evident. A moderate stool burden is present within the imaged colon. | Posterior fusion defect of L5. No acute fracture or malalignment. |
Generate impression based on findings. | HNC s/p chemoradiation, compare to baseline CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules. Reference anterior right upper lobe micronodule measures 5 mm (series 4, image 57), unchanged. Reference right lower lobe micronodule measures 2 mm (series 4, image 69), unchanged. No new suspicious nodules or masses.M... | 1.No evidence of metastatic disease. 2.The gallbladder is distended with mild common bile duct dilatation, which is nonspecific and can be better evaluated by ultrasound or MRCP if clinically warranted. |
Generate impression based on findings. | Reason: eval for chronic VTE History: pulm HTN The comparison chest radiograph performed on 1/21/2015 demonstrates cardiomegaly with bi-basilar opacities.The ventilation images show slightly decreased activity in the left hemithorax on single-breath and wash-in images. There is abnormal Xe-133 retention during the wash... | Low probability for pulmonary embolism. |
Generate impression based on findings. | HNC and CRT, cervical esophageal neoplasm post chemo RT. CHEST:LUNGS AND PLEURA: Right middle lobe opacity has cleared. Patchy peribronchial distribution nodules in the anterior right upper lobe suggestive of aspirate. Scattered micronodules unchanged. New linear opacities at the right apex suggestive of developing fib... | No specific evidence of pulmonary metastases. Decreased size of esophageal mass and thoracoabdominal lymph nodes. Interval development of bilateral rib fractures, correlate with history. |
Generate impression based on findings. | 74 of female with right shoulder pain Again seen is a transverse fracture of the humeral neck with fracture fragments in gross anatomic alignment and several small bone fragments adjacent to the medial humeral neck. Increased inferior subluxation of the humeral head, likely due to hemarthrosis. | Humeral neck fracture with increased subluxation of the humeral head, likely due to hemarthrosis. |
Generate impression based on findings. | Reason: fall on head and now with persistent pain over the top and on the right History: fall with ongoing pain 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.No abnormal mass lesions are apprecia... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.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. | 21-year-old male with right knee pain Postoperative changes of ACL repair. Alignment is anatomic. No fracture or joint effusion. | Status post ACL repair without acute abnormality evident. |
Generate impression based on findings. | Recent sinus infection, now refractory periorbital pain, and history of underlying inflammatory orbital pseudotumor (IGG4 disease). There is decreased thickening of the right lateral and inferior rectus and inferior oblique muscles with mild surrounding stranding of the orbital fat. Likewise, there is diminished swelli... | Continued interval decreased inflammatory changes in the right orbit related to IGG4 disease. |
Generate impression based on findings. | Klebsiella pneumonia, evaluate for interval progression LUNGS AND PLEURA: Irregular left apical opacity measures 3.7 x 1.8 cm (series 4, image 62), previously 4.0 x 2.8 cm, now with central cavitation. Multiple new irregular airspace opacities are noted predominantly at the apices. Small left pleural effusion is largel... | 1.Overall increase in ill defined pulmonary nodules consistent with infection. 2.Stable mediastinal lymphadenopathy.3.Stable cardiomegaly, pericardial and pleural effusions. |
Generate impression based on findings. | 30 years old, Female, Reason: RUQ liver and biliary u/s with dopplers, rule out biliary path or clot History: factor V leiden, abd pain PORTAL VENOUS: Main portal vein is patent with a 0.1 m/sec with hepatopetal flow. The right portal vein measures 0.2 m/sec. The left portal vein measures 0.1 m/sec entire portal venous... | Hepatic vasculature within normal limits. No evidence of inflow or outflow thrombosis. |
Generate impression based on findings. | Reason: 50 yo male with history of leukemia; pre-allo SCT evaluation History: evaluate LUNGS AND PLEURA: Punctate calcified granulomas, benign.No evidence of infection, or other significant pulmonary or pleural abnormality.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.No visible coronary calcifica... | No significant abnormality. Specifically, no sign of infection. |
Generate impression based on findings. | Newly diagnosed CLL with 17p deletion currently screening for IRB014-0881. There is extensive cervical lymphadenopathy. For example, a left level 1B lymph node measures 20 x 32 mm, a left level 2A lymph node measures 33 x 53 mm, a right level 5A lymph node measures 15 x 24 mm, and a left supraclavicular lymph node meas... | 1. Extensive cervical lymphadenopathy compatible with leukemia. Please refer to the separate chest CT report for additional details.2. Nonspecific subcentimeter right thyroid nodule. |
Generate impression based on findings. | COPD. 6 month follow-up visit for EMPROVE clinical trial IRB#13-0530, please link to research account #1053580. LUNGS AND PLEURA: No pneumothorax. Severe centrilobular emphysema unchanged. The left upper lobe remains collapsed and its airways contain endobronchial valves which appear unchanged in position. Lung volumes... | Severe centrilobular emphysema without acute change. The left upper lobe remains collapsed, with endobronchial valves in place. Coronary artery calcifications.: |
Generate impression based on findings. | Reason: Evaluate for areas of hypometabolism, especially in right occipital area History: Intractable epilepsy, Vagus Nerve Stimulator, possible focality on EEGRADIOPHARMACEUTICAL: 1.7 mCi F-18 fluorodeoxyglucose (FDG)BLOOD GLUCOSE (FASTING): 93 mg/dL Today's CT portion demonstrates no gross intracranial pathology.Toda... | Hypometabolism in the bilateral medial temporal lobes. |
Generate impression based on findings. | Abdominal distention.VIEW: Abdomen AP (one view) 1/23/2015 The stomach is distended with three air/fluid/fluid levels, which may represent a bezoar. Clinical correlation is recommended. Nonspecific generalized gaseous distention of the bowel is seen without evidence of obstruction or pneumoperitoneum. | 1.Air/fluid/fluid levels in the stomach suggestive of bezoar. Clinical correlation recommended. 2.Generalized nonspecific gaseous distention of the bowel without evidence of obstruction or pneumoperitoneum. |
Generate impression based on findings. | 69 year old with history of ovarian cancer and uptake in a right axillary lymph node who presents for ultrasound guided biopsy. Right ultrasound re-identified the target node for biopsy in the inferior right axilla. PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expe... | Successful ultrasound-guided core biopsy of the right axillary node and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 3-year-old male with cough and mild hypoxia.VIEWS: Chest AP/lateral (two views) 1/23/2015 Streaky retrocardiac opacity suggestive of atelectasis. The aortic arch, cardiac apex and stomach left-sided. The cardiothymic silhouette is normal. | Streaky retrocardiac opacity suggestive of atelectasis. |
Generate impression based on findings. | Lung cancer with malignant effusion; indwelling right pleural catheter with poor drainage, dyspnea. Please evaluate if the pleurx catheter communicates with the fluid collections. LUNGS AND PLEURA: Large and oh flexion with interval development of a thickened pleural rind measuring up to 12-mm (3/45). The Pleurx cathet... | Large right pleural fluid collection is now loculated, with development of a thick pleural rind suspicious for empyema in the appropriate clinical setting. Tumor may also produce pleural thickening though it is usually more nodular in appearance. The Pleurx catheter is partially embedded within the pleural rind but the... |
Generate impression based on findings. | Staging for newly diagnosed esophageal squamous cell carcinoma, weight loss, dysphagia CHEST:LUNGS AND PLEURA: Moderate to severe centrilobular emphysema. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No lymphadenopathy. Heart size is normal without pericardial effusion. Mild coronary artery calcifica... | 1.Wall thickening of the distal esophagus/ gastric cardia with reference measurements as above.. 2.No evidence of metastatic disease. |
Generate impression based on findings. | 69 year old with abnormal PET uptake in the right axilla presents for imaging evaluation of the right breast and axilla. Three standard views of the right breast and repeat MLO view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and... | Abnormal lymph node in the right axilla. This is amenable to ultrasound guided biopsy.Biopsy and post-biopsy mammogram were subsequently performed the same day. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Rule out solid mass. Abdominal swelling. Isoechoic lesion in the cortex the left kidney. 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 ... | Nonobstructive left lower pole renal calculus. |
Generate impression based on findings. | Reason: 43 yo f w/ metastatic breast cancer restaging. Attention spine lesion. History: bone pain. New foci of increased radiotracer uptake in the right T6 and T7 vertebra compatible with metastases. | New right T6 and T6 osseous metastases. |
Generate impression based on findings. | Severe odynophagia in the setting of AIDS not on HAART. The images are degraded by patient motion. There is mild asymmetry of the oropharyngeal tonsils without evidence of a discrete abscess. There is no evidence of significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are u... | 1. Mild asymmetry of the oropharyngeal tonsils may represent a tonsillitis, without evidence of a discrete abscess. However, direct endoscopic inspection may be useful for further evaluation.2. Bubbly secretions within the nasopharynx may be related to an inflammatory process.3. Multiple dental caries. |
Generate impression based on findings. | 45 year-old female with left knee pain. The bones are severely demineralized, limiting sensitivity for fracture. Below the knee amputation is noted. There is a transverse distal metaphyseal fracture of the left femur with minimal impaction. No significant joint effusion. No osteolysis to suggest osteomyelitis. Dense va... | Distal metaphyseal fracture of the left femur. |
Generate impression based on findings. | 31-year-old with palpable lump in the right breast presents for mammographic examination. Three standard views of both breasts with two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and d... | No mammographic evidence of malignancy. Palpable concern should be managed clinically. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually at age 40. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: C - Clin... |
Generate impression based on findings. | New diagnosis lung cancer with confusion and visual changes. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cel... | No evidence of intracranial or orbital metastases. However, CT is less sensitive than MRI for the detection of metastases. |
Generate impression based on findings. | Reason: 58 y/o with Cholangio Ca. on chemo. Compare to Prior History: Cholangio Ca CHEST:LUNGS AND PLEURA: Interval decrease in size of numerous small pulmonary basal predominant nodules since prior study. Reference nodule in the right middle lobe now measures 5 x 3 mm (series 10269 image 61) previously 7 x 7 mm, and l... | 1. Interval improvement in disease, with decrease in size of hepatic mass, lymphadenopathy, and pulmonary nodules.2. Right internal jugular thrombosis partially imaged. Findings discussed with Dr. Catenacci by phone at 1629 on 1/23/15. |
Generate impression based on findings. | 39-year-old female with a known mass in the left breast presents for follow-up study. Three standard views of both breasts with two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distri... | No mammographic or sonographic evidence of malignancy. A simple cyst in the right breast and a fibroadenoma in the left breast. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS:... |
Generate impression based on findings. | 66 year-old female with pain after fall. Moderate degenerative changes affect the cervical spine, most notably at C5-6. Posterior osteophytes significantly narrow the right neural foramen at C6-7. Partial fusion of C2 and C3 is noted, likely congenital. Alignment, vertebral body heights, and other intervertebral disk s... | No evidence of fracture or malalignment of the cervical spine. |
Generate impression based on findings. | Reason: T Cell rich DLBCL s/p 6 cycles of chemotherapy History: 38Yrs old female patient with a H/O T cell rich DLBCL, arising in the background of nodular lymphocyte predominant Hodgkin lymphoma and cycle 6/6 of R-CHOP in need of end of treatment restagingRADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLO... | Complete resolution of previously seen hypermetabolic tumor in the neck, chest, abdomen, and pelvis. |
Generate impression based on findings. | 79-year-old female with recent fall and altered mental status. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with moderate age-related volum... | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the early detection of acute non-hemorrhagic infarcts. |
Generate impression based on findings. | Female 3 months old Reason: 3 month old needing central line placement evaluation History: Broviac displacementVIEW: Chest and abdomen AP (two view) 1/23/2015 The nasogastric tube tip is in the body of the stomach. Interval retraction of the left femoral venous catheter with the tip now in the left femoral vein.Improve... | Left femoral venous catheter retraction with the tip now in the left femoral vein. |
Generate impression based on findings. | 49 year-old female with left hip pain. Pelvis:Mild osteoarthritis affects the hips and sacroiliac joints bilaterally. No evidence of fracture or malalignment in the pelvis.Left hip: Mild osteoarthritis affects the left hip. No evidence of fracture or malalignment. | Mild degenerative changes, as above. |
Generate impression based on findings. | 13-year-old female with knee pain The osseous structures appear normal for the patient's age. Alignment is anatomic. No joint effusion is noted. | No specific findings to account for the patient's right knee pain. |
Generate impression based on findings. | Reason: subdural History: fall The CSF spaces are appropriate for the patient's stated age with no midline shift. Atherosclerotic calcifications are present along the distal internal carotid arteries. Periventricular and subcortical white matter hypodensities of a moderate degree are present. This is stable when compar... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: 57 male with metastatic lung cancer, worsening abdominal pain/lipase. r/o obstruction/pancreatitis. Avoiding IV contrast given renal function History: Abdominal pain Evaluation of solid organ pathology limited without intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT:... | No substantial interval change in presumed diffuse hepatic metastases. |
Generate impression based on findings. | Reason: eval for cva History: right sided weakness 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.No abnormal... | 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. | Worsening fatigue and weight loss evaluate for status of lung cancer. CHEST:LUNGS AND PLEURA: Large left pleural fluid collection slightly increased in volume. There is minimal pleural thickening and enhancement in the cardiophrenic angle on the left, present previously.Nodular pleural thickening on the right compatibl... | Interval increase in right pleural tumor bulk. Some of the nonindex mediastinal lymph nodes are larger. Left pleural effusion is slightly larger and enhancing nodular pleural thickening on the left is consistent with contralateral pleural metastatic disease. Right hemidiaphragm is thickened by tumor. Progressive right ... |
Generate impression based on findings. | Newborn male with increased work of breathing. Evaluate line placement.VIEW: Chest and abdomen AP (two view) 1/23/2015 The umbilical venous catheter tip is in the distal umbilical vein.The aortic arch, cardiac apex and stomach are left-sided. No focal air space opacity is evident. The cardiothymic silhouette is normal.... | UVC tip is in the distal umbilical vein. |
Generate impression based on findings. | Chest discomfort, decline in lung function. Steroids tapered. Assess for evidence of return of Sweet's in lungs. LUNGS AND PLEURA: Mild subpleural reticulation in the lung periphery consistent with fibrosis, unchanged. Right upper and middle lobe lobe suture lines consistent with a previous wedge biopsies.There are a c... | 1. Stable mild subpleural reticulation consistent with pulmonary fibrosis.2. No evidence of pneumonia.3. There are a couple of very small foci of opacity which are new or slightly more prominent compared to the prior study; I am unable to entirely exclude very early recurrence of neutrophilic infiltration due to Sweet'... |
Generate impression based on findings. | 40-year-old female with hip/pelvis pain. Pelvis: No fracture or malalignment in the pelvis. Sacroiliac joints and hip joints are normal bilaterally. Deformity of the right iliac wing is compatible with prior biopsy or donor site.Right hip: No significant degenerative changes of the right hip are identified. | No findings to account for pain. |
Generate impression based on findings. | Reason: Patient with metastatic esophageal CA, now with right upper quadrant pain \T\ elevated LFTs, please evaluate for obstruction, cholecysitis, cholelithiasis History: RUQ pain, elevated LFTs ABDOMEN:LUNG BASES: New small left pleural effusion.LIVER, BILIARY TRACT: Interval increase in size of marked confluent mese... | 1. Marked interval progression of mesenteric lymphadenopathy, now invading the porta hepatis and resulting in biliary ductal dilation and portal venous thrombosis. There is also encasement and significant attenuation of the celiac axis, superior mesenteric axis, IVC, and left renal vein, which appear to remain patent.2... |
Generate impression based on findings. | Tachypnea and tachycardia evaluate pleura and mediastinum status post esophageal perforation. LUNGS AND PLEURA: Small bilateral pleural fluid collections with associated compressive atelectasis. 7-mm groundglass density nodule in the left upper lobe (4/30) appears slightly increased in density compared to the exam of 1... | 1. Distal esophageal collection has increased in density, consistent with complex fluid and could be due to blood products or an infected collection; abscess cannot be excluded.2. Two indeterminate ground glass density nodules left upper lobe may be followed by CT in 6 to 12 months.3. The superolateral anterior left ch... |
Generate impression based on findings. | 59-year-old female with possible breakage Bilateral deep brain stimulator devices with leads are visualized with their tips projecting intracranially. No lead fracture is noted. | Bilateral deep brain stimulator leads as described above without evidence of lead fracture. |
Generate impression based on findings. | 17 year-old male status post second toe reductionVIEWS: Right foot AP/lateral (two views) 01/23/15, 2243 hrs Interval reduction of a distal phalanx subluxation of the second toe with mild swelling of the soft tissues. No fracture is evident. Alignment is anatomic. Hallux valgus deformity. | Reduction of second distal phalanx subluxation now in anatomic alignment. |
Generate impression based on findings. | Extensive restricted diffusion is noted within the bilateral cerebral hemispheres, pons, occipital lobes and temporal lobes. There is corresponding dark signal on ADC indicating acute ischemic infarct. Susceptibility weighted abnormalities are noted within the posterior medial aspect of the right cerebral hemisphere a... | 1.Bilateral cerebellar, pontine, occipital lobe and temporal lobe infarcts with evidence of blood product in the right cerebellar hemisphere and pons.2.Flow void in the basilar artery may represent thrombus.3.Chronic small vessel ischemic disease, particularly in the centrum semiovale bilaterally. |
Generate impression based on findings. | 17 year-old male with toe injury on exam, swelling, tender with angulationVIEWS: Right foot AP/oblique/lateral (3 views) 01/23/15, 1647 hrs There is lateral subluxation of the distal phalanx of the second toe with the medial border of the distal phalanx overlying the lateral fourth of the middle phalanx. No fracture is... | Lateral subluxation of the distal phalanx of the second toe. |
Generate impression based on findings. | 13-year-old female status post trauma, evaluate for fractureVIEWS: Cervical spine AP/lateral, chest AP, pelvis AP (4 views) 01/23/15 Vertebral body heights, disk spaces, and alignment are preserved. No prevertebral soft tissue thickening. Left cervical rib is present. Mild to moderate enlargement of the adenoids causin... | Normal examinations. |
Generate impression based on findings. | Female 34 years old; Reason: Eval for PE History: Tachycardia, SOB PULMONARY ARTERIES: Technically adequate study. No filling defects suggest acute pulmonary embolism. Main pulmonary artery caliber is 3.0 cm, upper limits of normal. No evidence of right heart strain.LUNGS AND PLEURA: There is a new nodule in the right ... | 1. No evidence of acute pulmonary embolism.2. Findings compatible with mild edema with atelectasis.3. New nodule in the right upper lobe which appears flat on coronal images and is contiguous with the adjacent fissure, indeterminate but may represent a benign intrapulmonary lymph node. Follow up CT scans are recommende... |
Generate impression based on findings. | 12-year-old male with left ankle painVIEWS: Left ankle AP/oblique/lateral (3 views) 01/23/15, 1855 No acute fracture or malalignment is evident. The bones are normal. No joint effusion or soft tissue swelling is present. | Normal examination. |
Generate impression based on findings. | 34-year-old female patient postoperative day two status post retroperitoneal mass resection, IVC tumor thrombus resection, IVC resection with Gore-Tex graft reconstruction presents with hemoglobin drop. ABDOMEN:LUNG BASES: Small bilateral pleural effusions with overlying compressive atelectasis. Central venous catheter... | 1.Gas and induration surrounding the IVC graft without active extravasation. While findings may be postoperative in etiology, continued follow-up imaging is recommended as superimposed infection cannot be excluded.2.Intraperitoneal collection in the pelvis may represent developing abscess given foci of air. Follow up i... |
Generate impression based on findings. | 15-year-old male with abdominal pain, history of appendicitis two weeks ago ABDOMEN:LUNG BASES: No pleural effusion. No focal pulmonary opacities.LIVER, BILIARY TRACT: No focal hepatic lesions. The gallbladder is within normal limits. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abno... | Right lower quadrant phlegmon is decreased in size since the prior exam. Continued cecal and terminal ileal wall thickening. Proximal dilation of the distal ileum due to partial small bowel obstruction. Differential considerations include perforated appendicitis, inflammatory bowel disease, or infectious etiology inclu... |
Generate impression based on findings. | Female 85 years old; Reason: eval for pneumonia vs malignancy given LLL mass History: AMS, nausea, hyponatremia LUNGS AND PLEURA: There is a residual small left pleural effusion with adjacent compressive atelectasis which accounts for the opacity seen on recent chest radiograph, which is improved from prior radiographs... | 1. New incidental subpleural spiculated nodule in the lingula is highly suspicious for neoplasm given size, morphology and associated enlarged aorticopulmonary lymph node. 2. Residual trace left pleural effusion with adjacent compressive atelectasis corresponds to the findings on recent radiographs with interval improv... |
Generate impression based on findings. | 18 year-old female for ET tube assessment. Bone marrow transplant and lymphoma. VIEW: Chest AP (one view) 01/24/15, 0547 ET tube tip is below thoracic inlet and above the carina. Right upper extremity PICC with tip in the atrium. Left subclavian central venous catheter with tip at the superior cavoatrial junction.Low l... | Mild interval increase in bilateral multifocal lung opacities for which pulmonary edema is a consideration. |
Generate impression based on findings. | Female 57 years old; Reason: 57 female with metastatic breast cancer, known lung mets. Now with new SOB/hypoxia/tachycardia. r/o PE History: Hypoxia, tachycardia PULMONARY ARTERIES: Technically adequate study. There are no filling defects to suggest an acute pulmonary embolism. Main pulmonary caliber measures up to 2.9... | 1. No evidence of acute pulmonary embolism.2. Interval development of ground glass opacities in the left lung and right apex is highly suspicious for a drug reaction and less likely hemorrhage or atypical infection such as viral or pneumocystis jiroveci pneumonia.3. Diffuse pulmonary metastatic disease with definite in... |
Generate impression based on findings. | Female 43 years old; Reason: chest pain, ro pe History: chest pain PULMONARY ARTERIES: Technically adequate study. There are no filling defects to suggest an acute pulmonary embolus. Main pulmonary artery caliber measures up to 2.5 cm. There is no evidence of right heart strain.LUNGS AND PLEURA: No significant abnormal... | No evidence of pulmonary embolism.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 49 years old; Reason: PE (highest priority) vs extension of traumatic aortic dissection History: pleuritic chest pain on right PULMONARY ARTERIES: Technically adequate study. No filling defects to suggest acute pulmonary embolism. Main pulmonary artery caliber measures up to 2.1 cm. There is no evidence of right... | 1. No evidence of acute pulmonary embolism.2. Please note study is suboptimal for evaluation of aortic dissection, given the timing of the scan to maintain a diagnostic exam for evaluation of pulmonary embolism. If there is a high level of suspicion, dedicated CT aortic dissection protocol can be obtained. Previously n... |
Generate impression based on findings. | Female 40 years old; Reason: h/o PE p/w SOB r/o PE History: h/o PE and protein S deficiency p/w SOB off Lovenox PULMONARY ARTERIES: Technically adequate study. There are no filling defects to suggest an acute pulmonary embolism. Main pulmonary artery caliber measures up to 2.6 cm in diameter. There is no evidence of ri... | No evidence of acute pulmonary embolism.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 27 years old; Reason: s/p cholecystectomy, r/o PE History: CP/SOB PULMONARY ARTERIES: Technically adequate study. There are no filling defects to suggest an acute pulmonary embolism. Main pulmonary caliber measures up to 2.4 cm in diameter. There is no evidence of right heart strain. LUNGS AND PLEURA: Subpleural... | No evidence of acute pulmonary embolism.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 53 years old; Reason: hx of PE, on xarelto, here with hemoptysis History: hemoptysis PULMONARY ARTERIES: Technically adequate study. There are no filling defects suggestive of acute pulmonary embolism. The pulmonary artery caliber measures up to 2.0 cm in diameter. There is no evidence of right heart strain.LUNG... | No evidence of pulmonary embolism. PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable..Multiplicity: Not applicable..Most Proximal: Not applicable..RV Strain: Not applicable.. |
Generate impression based on findings. | 2-year-old male with coughVIEWS: Chest AP/lateral (two views) 01/24/15, 0052 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Mild to moderate bronchial wall thickening suggestive of reactive airway disease/bronc... | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. Incidental note is again made of a subcentimeter hyperdense focus along the inner table of the right parietal bone which is unchanged dating back to 2009. There are no masses, mass effect or midline shift. The ventric... | Negative unenhanced brain CT. |
Generate impression based on findings. | There is soft tissue swelling and fat stranding of the face, right cheek greater than left. There is also right sided periorbital preseptal swelling and fat stranding. There is no evidence of acute facial bone or orbital fracture. The globes are intact without evidence of intraorbital hematoma or stranding. The tempor... | 1.No evidence of acute fracture. 2.Bilateral cheek and right periorbital pre-septal soft tissue swelling. |
Generate impression based on findings. | Bone tenderness. Evaluate for fracture.VIEWS: Right wrist PA/lateral/oblique (3 views) 01/24/15 The bones are normal in appearance. No fracture is identified. There may be a small joint effusion; the pronator quadratus fat pad is displaced. | No fracture identified. |
Generate impression based on findings. | Surgery for thoracic metastasis from clear cell sarcoma.VIEW: Chest AP (one view) 01/24/15, 0552 Right chest tube remains in place. Surgical clips and staples are noted on the right. Small right apical pneumothorax persists. A small amount of subcutaneous emphysema is noted.Anterior fifth and sixth ribs have been resec... | Continued small right apical pneumothorax. |
Generate impression based on findings. | 11 year old female with respiratory distressVIEW: Chest AP (one view) 01/24/15, 0329 hrs Persistent levoscoliosis. Low lung volumes. Right middle and lower lobe opacity likely represents atelectasis. Mild bronchial wall thickening suggestive of reactive airway disease/bronchiolitis pattern. | Right middle and lower lobe opacity likely atelectasis, unchanged. Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no masses, mass effect or midline shift. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mas... | Negative unenhanced brain CT. |
Generate impression based on findings. | Intubated. Seizure disorder. Hip surgery.VIEW: Chest AP (one view) 01/24/15, 0542 Endotracheal tube tip is above carina. Gastrostomy tube is in place. Right upper extremity PICC tip is at junction of superior vena cava and right atrium. Cast overlies the upper midabdomen.Pulmonary edema pattern is resolving. Hazy opaci... | Resolving pulmonary edema pattern. |
Generate impression based on findings. | 2-year-old female with fall, tender forearmVIEWS: Left forearm AP/lateral (two views) 01/24/15, 0353 Buckle fractures of the distal radius and ulna with mild posterior angulation. Soft tissue swelling. | Both bones fracture of distal forearm. |
Generate impression based on findings. | 1-year-old female with cough and wheezingVIEWS: Chest AP/lateral (two views) 01/24/15, 0410 Low lung volumes. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Mild bronchial wall thickening suggestive of reactive airway disease/bronchiolitis pattern. No focal pulmonary opacities. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | 27-year-old female patient with fever, diarrhea and periumbilical pain. ABDOMEN:LUNG BASES: Trace dependent atelectasis.LIVER, BILIARY TRACT: Hypoattenuating focus in the right lobe of the liver is too small to characterize and likely represents a cyst and is unchanged compared to prior examination. There is no CT evid... | 1.Enlarged right ovary may represent a physiologic cyst, however, ultrasound is recommended if there is clinical concern for ovarian torsion.2.No radiologic evidence of appendicitis.3.Slight increase in size of suspected right sacral perineural cyst. |
Generate impression based on findings. | Reason: evaluate STA-MCA bypass History: recurrent CVAs Brain CTA: There is opacification of the right internal carotid artery up to be level of the ophthalmic artery, distal to which there is no opacification of the ophthalmic segment. A branch of the right superficial temporal artery has been anastomosed to the right... | 1.A branch of the right superficial temporal artery has been anastomosed to the right angular artery via a right sided craniotomy site.2.Occlusion of the right internal carotid artery at the ophthalmic segment. The right internal artery is the supply to the right ophthalmic artery.3.Status post recent right craniotomy.... |
Generate impression based on findings. | A focus of restricted diffusion is noted along the left precentral gyrus peripherally. There is associated dark ADC signal indicating acute ischemic infarct. Additional scattered periventricular and subcortical white matter flair/T2 signal abnormalities that are nonspecific but compatible with small vessel ischemic ch... | 1.Acute ischemic infarct of the peripheral left precentral gyrus.2.Scattered small vessel ischemic changes and old parietal infarct, similar to prior exam. |
Generate impression based on findings. | 55-year-old male "status post fall" Lumbar spine: There is erosion of the posterior elements at L3 and L4, representing an erosive mass measuring approximately 9 cm in cc dimension. The anterior osseous elements including vertebral body heights and disk spaces are preserved.Knee: Small osteophytes indicate minimal dege... | Findings indicating an erosive mass involving the posterior elements of L3 and L4. See subsequent MRI for further evaluation. |
Generate impression based on findings. | Again seen is a left parietal approach shunt catheter with the intracranial tip terminating at the midline, similar to prior exam. No kinking or discontinuity is noted the visualized portions. The ventricles are partially decompressed but this is unchanged.There is no evidence of intracranial hemorrhage or edema. Ther... | Stable ventricular size, shunt catheter location and brain appearance without evidence of an acute intracranial process. |
Generate impression based on findings. | 15-year-old male with pain and vomitingVIEW: Abdomen AP (one view) 01/24/15, 00 06 Relative paucity of bowel gas in the right lower quadrant. Gas distended loops of small bowel in a nonobstructive bowel gas pattern. Small amount of stool within colon. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 23-year-old male with pain, evaluate for fracture There is dislocation of the proximal interphalangeal joint of the little finger with dorsal and lateral displacement of the middle phalanx relative to the proximal phalanx. No fracture is visualized. | Fifth finger PIP joint dislocation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 22-year-old female with pain, worst at third digit Hand: No fracture or malalignment.Shoulder: Glenohumeral joint alignment is within normal limits. No fracture is visualized. | No fracture or other specific findings to explain the patient's symptoms. |
Generate impression based on findings. | 84-year-old female patient with abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy with expected mild common bile duct dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnorma... | No acute intra-abdominal pathology to account for patient's abdominal pain. |
Generate impression based on findings. | 67 year old male with metastatic pancreatic cancer and altered mental status. There is no evidence of abnormal enhancement. There is no midline shift or herniation. The ventricles and basal cisterns are normal in size and configuration. The skull and extracranial soft tissues are unremarkable. There are postoperative f... | No evidence of intracranial mass. Please note that MRI is more sensitive for intracranial metastases. |
Generate impression based on findings. | PICC placement. Not in the IVC. Where is it? 9-week-old former 27 week gestational age patient.VIEW: Left femur AP (one view) 01/24/15, 0130 Lower extremity PICC tip is at level of knee joint. Minimal metaphyseal irregularity is noted in the femur and proximal tibia. No fracture is seen in this single plane. | PICC tip not located centrally. Early changes from rickets. |
Generate impression based on findings. | 27-year-old male patient with left perinephric mass. ABDOMEN:LUNG BASES: Scattered dependent atelectasis.LIVER, BILIARY TRACT: Layering hyperattenuating material in the gallbladder represents sludge and/or gallstones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No ... | Given patient's clinical history of infection, the left perinephric lesion likely represents a loculated abscess with direct extension into the left kidney and resultant pyelonephritis. Infiltrative tumor is considered less likely, but consider follow up imaging to resolution. |
Generate impression based on findings. | CT HEAD:There is no evidence of intracranial hemorrhage. There are a few patchy regions of low-attenuation within the supratentorial white matter compatible with age indeterminant small vessel ischemic disease. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniat... | 1.No evidence of intracranial hemorrhage. If there is concern for acute ischemia, MRI is suggested. 2.Probable complete occlusion of the bilateral vertebral arteries (favored over bilateral hypoplasia due to normal vertebral transversarium foramen) with the posterior circulation mainly fed by large posterior communicat... |
Generate impression based on findings. | Left varus derotational osteotomy.VIEW: Left hip frog leg (one view) 01/24/15, 0822 Plate and screws device in the proximal femur is again seen. Femoral osteotomy is not seen in profile. The femoral head is well directed into the mildly dysplastic acetabulum in a single plane. | Postoperative changes. |
Generate impression based on findings. | 26 year old female patient with history of inflammatory bowel disease, likely UC, with worsening colonic dilatation and abdominal pain. ABDOMEN:LUNG BASES: Minimal dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality n... | Findings compatible with active inflammation in the proximal descending colon and splenic flexure given patient's history of IBD without evidence of obstruction. |
Generate impression based on findings. | There has been a slight increase of CSF intensity fluid within the subarachnoid spaces about the falx anteriorly and to a much lesser extent over the frontal lobe convexities. This is not associated with mass effect.. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The... | 1.There has been a slight increase of CSF intensity fluid within the subarachnoid spaces about the falx anteriorly and to a much lesser extent over the frontal lobe convexities, consistent with effusion.2.Otherwise negative noncontrast brain MRI. |
Generate impression based on findings. | 43 day old former 28 week gestational age patient with history of medical NEC. Is there pneumatosis?VIEW: Abdomen AP (one view) 01/24/15, 0524 Feeding tube tip is in stomach with side port at GE junction.Bowel gas pattern is disorganized. Few mildly dilated bowel loops are present. No fixed loop is seen. No pneumatosis... | No evidence of complication from NEC. |
Generate impression based on findings. | 43 day old former 28 week twin gestation with history of medical NEC.VIEW: Abdomen AP (one view) 01/24/15, 0528 Feeding tube tip is in stomach with side port at GE junction. Left lower extremity PICC tip is in right atrium.Less bowel gas is present than on prior exam. No dilated loops are identified. No pneumatosis int... | No evidence of complication from NEC. |
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