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Generate impression based on findings. | 39 year-old female with one-day history of palpable lump in the left breast adjacent to the nipple at the 4 o'clock position. Patient states breast pain for approximately 2 weeks. No prior mammograms. No injury is reported. Three standard views of both breasts were performed digitally with bilateral spot compression vi... | Subcentimeter lesion adjacent to the nipple seen only on ultrasound, most likely representing fat necrosis. Repeat examination in 6-8 weeks to assess for resolution was suggested to the patient. She declined this management option and prefers ultrasound-guided aspiration/ possible core biopsy to prove fat necrosis and ... |
Generate impression based on findings. | 67-year-old female with status post curettage of left tibia metachronous focus of giant cell tumor, complicated by fracture after biopsy. Please for metastasis. Again seen is a lucency within the proximal tibial diaphysis with adjacent cortical thickening, compatible with stated history of curettage of giant cell tumor... | Healing of the proximal diaphyseal fracture, as described above. We see no definite metastasis and suspect that relatively focal lucency in the medial talus is an artifact of diffuse demineralization. However if the patient complains of pain at this site, dedicated ankle radiographs would be recommended. |
Generate impression based on findings. | 22-year-old male with pain and swelling of the middle finger. Evaluate for fracture, abnormality. There is mild soft tissue swelling, particularly along the volar and ulnar aspect of the middle phalanx. We see no underlying fracture or other bony abnormality. Phalangeal alignment is within normal limits. | Soft tissue swelling without fracture. |
Generate impression based on findings. | 36-year-old female with history of sickle cell anemia. Left hip pain status post revision total hip arthroplasty. Evaluate for bone loss medially. Evaluation is limited by streak artifact related to bilateral total hip arthroplasty devices.Components of a left total hip arthroplasty device are situated in near-anatomic... | 1.Left total hip arthroplasty as described above, with defect of the medial acetabular wall and adjacent soft tissue mass/collection. Streak artifact prevents characterization of the collection with Hounsfield units. Differential diagnosis includes acetabular fracture with adjacent hematoma as well as loosening/particl... |
Generate impression based on findings. | Male 21 years old Reason: r/o gall bladder pathology History: ruq pain LIVER: The liver measures 15.4 cm in length. There is no focal liver lesion. The portal vein demonstrates normal directional flow with peak velocity of 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallston... | No evidence of gallstones or acute cholecystitis. No specific cause for patient's right upper quadrant pain is identified. |
Generate impression based on findings. | Reason: lung cancer. s/p resection and chemo. On erlotinib now. pls c/w previous study and evaluate tx response. History: lung ca CHEST:LUNGS AND PLEURA: Postoperative/postradiation changes in the right middle lobe with bronchiectasis and fibrosis not significantly changed compared to prior study. Persistent small righ... | Stable postoperative and postradiation changes in the right lung with unchanged pulmonary nodules. |
Generate impression based on findings. | Metastatic colon cancer, evaluate and compare to prior CHEST:LUNGS AND PLEURA: Right middle lobe fissural nodule measures up to 6 mm (series 4, image 60), previously 8 mm. Additional non-reference pulmonary nodules appear stable in size over the interval. No pleural effusions. Moderate to severe centrilobular emphysema... | 1.Stable or decreasing hepatic metastases.2.Stable pancreatic body mass.3.Stable or decreasing lymphadenopathy in the chest, abdomen, and pelvis.4.Stable or decreasing pulmonary metastases. |
Generate impression based on findings. | Male 59 years old; Reason: prostate cancer with bone mets compare to last bone scan History: see above Persistent abnormal osseous foci are identified at the level of T7 and T12 vertebral bodies appearing similar to prior study. Subtle focus in the right intertrochanteric hip appears similar to prior exam. Additional f... | Stable examination with no new sites of osseous metastatic disease. |
Generate impression based on findings. | 69-year-old female with syncopal episode, evaluate for intracranial hemorrhage. 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... | No evidence of intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | Metastatic nasopharyngeal cancer treated with TFHx on 7/19/14. Neck: There are post-treatment findings in the nasopharynx, without evidence of measurable tumor in this region. There are also findings related to right neck dissection. There is interval development of ill-defined heterogeneity of the inferior right stern... | 1. Post-treatment findings in the neck with interval development of an infiltrative lesion in inferior the right sternocleidomastoid muscle, which may represent tumor recurrence. Otherwise, the treated lymphadenopathy elsewhere in the neck is unchanged.2. Nonspecific partial bilateral tympanomastoid opacification. |
Generate impression based on findings. | Worst head ache of life. NONCONTRAST CT HEADNo evidence of acute intracranial hemorrhage. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection. The osseous structures are... | 1.No evidence of acute intracranial hemorrhage or mass.2.No evidence of steno-occlusive disease, occlusion or aneurysm of the intracranial arteries.3.Incidental findings of a right sided hypoplastic A1 segment of the ACA and P1 segment of the PCA. |
Generate impression based on findings. | Female 5 years old; Reason: mag3 renal scan - 5F with atrophied right kidney and grade 1 hydronephrosis in solitary left kidney History: assess for obstruction The angiographic phase demonstrates prompt uniform perfusion of only a left kidney. Patient is status post right nephrectomy.Sequential cortical images show a c... | Normal renal perfusion and function of a mildly hypertrophied left kidney, with no evidence of obstruction. |
Generate impression based on findings. | History of stage III lung adenocarcinoma. Restaging examination. CHEST:LUNGS AND PLEURA: Spiculated mass in the superior segment of the right lower lobe consistent with the patient's known malignancy measures 3.1 x 2.0 cm (series 4 image 37). There is mild adjacent pleural thickening/fluid.Subsegmental left basilar ate... | 1.Spiculated mass in the superior segment of the right lower lobe is consistent with the patient's known malignancy.2.Mildly enlarged right hilar lymph node.3.Small pericardial effusion.4.No specific evidence of metastatic disease in the upper abdomen. Other findings as described above. |
Generate impression based on findings. | Male, 79 years old. RFO trigger: Multiple surgical teams. Attending physician: Dr. Eggener. No unexpected radiopaque foreign body seen. Nonobstructive bowel gas pattern. | No unexpected radiopaque foreign body. Findings discussed with OR resident Patel at the time of the exam and with the attending physician, Dr. Eggener, via telephone on 1/26/2015 at 12:45. |
Generate impression based on findings. | Male, 71 years old, with acute stroke, right MCA syndrome, TPA given 1/25. A hyperdense segment of one of the right M2 MCA branches is redemonstrated. When compared to the prior examination, hypodensity within the right insula and basal ganglia has become slightly more conspicuous.Encephalomalacia in the right frontal ... | 1. Findings compatible with acute right MCA distribution ischemia are again seen including mild hypoattenuation within the right insula and basal ganglia.2. Scattered areas of chronic cortical ischemia and age indeterminate microvascular ischemic disease are unchanged.3. No evidence of intracranial hemorrhage. |
Generate impression based on findings. | Reason: hx breast ca and NSCLC with left pleural effusion. s/p pleurax. assess disease vs. priro scan, placement of pleurax, and effusion History: pleural effusion LUNGS AND PLEURA: Spiculated left upper lobe mass measures 2.0 x 1.9 cm (series 5 image 31) unchanged. Numerous pleural-based nodules, with mild interval in... | 1.Stable size of spiculated left upper lobe mass.2.Interval decrease in loculated left pleural effusion, but slight interval increase in size of some of the pleural based nodules. The pleurX has been removed in the interval.3.Interval increase in size of some mediastinal lymph nodes, allowing for limitations of noncont... |
Generate impression based on findings. | Female 71 years old; Reason: Bladder cancer. Compare to previous. 13-0311 protocol. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Multiple subcentimeter mediastinal lymph nodes. Severe calcified coronary artery disease. Calcified atherosclerotic thoracic aorta.CHEST WALL: Right chest wa... | 1. As seen on prior imaging is distal right ureteral soft tissue focus and pelvic soft tissue mass, without significant change. 2. Bilateral hydronephrosis, similar to prior study, see discussion above. |
Generate impression based on findings. | Reason: h/o hnc and crt, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Right apical scarring, unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Left chest wall port with tip at RA/SVC junction.Metastases in right ninth rib and scapula unchanged. T6 lytic lesion unchan... | Interval increase in hepatic mass highly suggestive of metastatic disease. Osseous metastases grossly stable. |
Generate impression based on findings. | History of bladder cancer status post radical cystectomy, evaluate for metastatic disease with delayed imaging ABDOMEN:LUNG BASES: No suspicious pulmonary nodule.LIVER, BILIARY TRACT: No focal hepatic lesion. No biliary ductal dilation.SPLEEN: No significant abnormality noted.PANCREAS: Punctate low attenuation focus in... | 1.The left collecting system does not opacify beyond the renal pelvis on the delayed images limiting evaluation for urothelial recurrence.2. No evidence of distal metastases3. Findings consistent with left gonadal venous thrombosis.4. Postsurgical changes and chronic obstruction of the left kidney, similar in appearanc... |
Generate impression based on findings. | History of relapsed AML and neutropenic fever, now presenting with word finding difficulties. Interval resolution of previously described right cerebral convexity subdural hematoma. There is no midline shift or herniation. There is unchanged non-specific patchy cerebral white matter hypoattenuation. There is unchanged ... | Interval resolution of previously described right cerebral convexity subdural hematoma. |
Generate impression based on findings. | 50 year-old with history of cysts. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. There are multiple masses bilaterally, including enlarge... | Multiple cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains stable, bilateral screening mammogram is recommended annually. If any of the cysts are larger when the patient will have her next mammogram, then it would be reasonable to just come directly to diagnostic mammo... |
Generate impression based on findings. | All of the paranasal sinuses are clear as are the right mastoid air cells and middle ear cavities and there are no air-fluid levels. Opacification is noted within a few left mastoid air cells. The bilateral maxillary sinus ostia are patent as are the bilateral frontoethmoidal and sphenoethmoidal recesses. Note is made... | 1.Opacification is noted within a few left mastoid air cells. 2.The nasal septum is S-shaped. |
Generate impression based on findings. | Reason: Has pulmonary nodular opacity changed since Oct 2014 CT scan. She had TB in the past and I suspect she has Post TB bronchiectasis. Sputm cultures for MAI have been negative History: morning cough with expectoration LUNGS AND PLEURA: Stable scarring, volume loss and bronchiectasis in the right upper lobe. No cha... | Stable scarring, volume loss and bronchiectasis in the right upper lobe. No change in multiple irregular nodular opacities with surrounding areas of scarring and bronchiectasis. No new areas of opacity. These findings are suggestive of atypical mycobacterial infection. Connective tissues disorders such as Wegener granu... |
Generate impression based on findings. | Assess vasculature prior to kidney transplant ABDOMEN:LUNG BASES: Cardiomegaly and small pericardial effusion.LIVER, BILIARY TRACT: No intrahepatic ductal dilation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrop... | The abdominal aorta and iliac arteries are normal in caliber. There is moderate calcification of the right external iliac artery just central to the chronic renal transplant. Otherwise, minimal vascular calcifications. |
Generate impression based on findings. | Chronic nasal congestion; possible right sided nasal polyp. There is opacification of the inferior anterior nasal cavity, left greater than right. There is minimal opacification of the maxillary sinuses and infundibula bilaterally. The paranasal sinuses are otherwise essentially clear. There is slight nasal septal devi... | 1. Nonspecific opacification of the anterior nasal cavity, which may represent polyposis or secretions related to rhinitis.2. No evidence of acute sinusitis. |
Generate impression based on findings. | Male 29 years old; Reason: Is there a entero-vesicular fistula? Pt w fistulizing Crohn's disease History: above No evidence of fistula or urinary leak. Bladder emptied promptly with un-clamping Foley. | No evidence of fistula or urinary leak. |
Generate impression based on findings. | There are multiple small foci of T2 hyperintensity in the white matter, primarily in subcortical white matter locations, not associated with mass effect, restricted diffusion, or susceptibility abnormality. Similar appearing lesions are also present within the left caudate body and right thalamus. The ventricles and s... | Chronic small vessel ischemic disease. |
Generate impression based on findings. | Prior asymmetry in the left breast. History of left breast surgeries for abscess drainage. History of breast carcinoma in maternal cousin. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, whic... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: r/o lesion, source of hemoptysis History: hemoptysis LUNGS AND PLEURA: Very mild nonspecifc bronchial wall thickening. No evidence of pulmonary hemorrhage.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast materia... | Mild bronchial wall thickening which is nonspecific but most commonly seen in asthma or bronchitis. No evidence of pulmonary hemorrhage. |
Generate impression based on findings. | 51 years, Male. Reason: Patient w/ N/V, eval for obstruction History: abdominal distension Nonobstructive bowel gas pattern. No evidence of free air. Abdominal distention noted, which may correlate with ascites seen on prior CT. | No evidence of free air or obstruction. |
Generate impression based on findings. | 33 year old female for lumbar puncture by the clinical service. C-arm fluoroscopy was used by the clinical service for image-guided lumbar puncture. One spot image was obtained, which demonstrates the lumbar puncture needle projected over the L4 vertebral body. FLUOROSCOPY TIME: 0.39 minutes | C-arm fluoroscopy used by the clinical service for lumbar puncture. |
Generate impression based on findings. | Left facial mass. There is a well-circumscribed lesion in the subcutaneous tissues in the left oral commissure region that measures up to 15 mm, although assessment is limited by dental streak artifact. There is an air-filled compartment with a few bubbly secretions in the lower right tracheoesophageal groove that meas... | 1. A well-circumscribed lesion in the subcutaneous tissues in the left oral commissure region that measures up to 15 mm may represent an inclusion cyst, although other etiologies are not excluded and assessment is limited by dental streak artifact. An ultrasound or MRI with the use of a microscopy coil may be useful fo... |
Generate impression based on findings. | 63 years, Male. Reason: assess NJT position History: J-tube clogged. Lower pelvis excluded from field of view. Distal esophageal stent is again noted. Coaxial feeding tube is coiled multiple times in the stomach with tip in the 3rd portion of the duodenum. Nonobstructive bowel gas pattern. Small left pleural effusion a... | Enteric tube tip in the 3rd portion of the duodenum. |
Generate impression based on findings. | 70 year-old female with decreased range of motion There is marked glenohumeral joint space narrowing and osteophyte formation, consistent with severe osteoarthritis. No fracture or dislocation. | Severe glenohumeral osteoarthritis. |
Generate impression based on findings. | Reason: 58 yo male with history of AML; pre-allo SCT evaluation History: evaluate for resolution of prior pneumonia. LUNGS AND PLEURA: Mild-moderate right pleural effusion has increased since the prior study. Consolidation in the superior segment of the right lower lobe appears similar to the prior study allowing for d... | 1.Mild-moderate right pleural effusion is increased since the prior study, but remains decreased in comparison to 12/12/14.2.Consolidation in the superior segment of the right lower lobe is not significantly changed compared with recent prior studies. Nodular pleural based opacity in the left upper lobe is unchanged. T... |
Generate impression based on findings. | History of chest wall angiosarcoma, evaluate for recurrence CHEST:LUNGS AND PLEURA: Left hemithorax postsurgical changes and volume loss. Scattered pulmonary micronodules without suspicious pulmonary nodule.MEDIASTINUM AND HILA: No lymphadenopathy. Mild to moderate coronary artery calcifications.CHEST WALL: Increasing ... | 1.Postoperative changes in the left chest wall, including increasing hyperattenuating pleural thickening in the upper left hemithorax measuring 9 mm in maximal thickness, previously 5; may be chronic in etiology. 2.No definite evidence of disease recurrence or metastasis. |
Generate impression based on findings. | 46 years, Male. Reason: r/o obstruction, free air History: worsening distention, pain. Lower pelvis excluded from field of view. Diffuse colonic distention with a paucity of visualized small bowel gas. Favor colonic ileus as etiology of findings given that no evidence of rectal obstruction was seen on recent prior CT. ... | Findings consistent with colonic ileus as described above. No free air. |
Generate impression based on findings. | 58 year old female who felt a small lump in the submental area which has since resolved but is now tender There is no evidence of mass lesions. Minimally prominent left level Ib lymph node. The thyroid is obscured by artifact but no large lesions are suspected. The submandibular and parotid glands are normal. The major... | 1.No evidence of mass or significant lymphadenopathy.2.Slightly prominent left submental lymph node which appears to have a normal fatty hilum and is not pathologically enlarged by CT criteria. Correlation with physical exam findings is suggested. |
Generate impression based on findings. | Female 44 years old Reason: Subject participating in research study. Evaluate for lung disease History: History of rheumatoid arthritis. LUNGS AND PLEURA: Three benign appearing micronodules are present in the left lower lobe, the largest of which measures 7.8 x 5.4 mm (series 4, image 65). Two benign appearing microno... | 1. Scattered bilateral benign appearing micronodules. In a patient with a history of breast cancer, recommend follow-up in 6-12 months. 2. No reliable evidence of rheumatoid lung disease. Subpleural reticular opacities in the right upper lobe likely secondary to post-radiation fibrosis. |
Generate impression based on findings. | Male, 58 years old, history of AML, pre-allo stem cell transplant. The frontal sinuses are clear. Mild mucosal thickening or secretions are evident along the left frontoethmoidal recess. Minimal scattered thickening is seen through the ethmoid air cells. The sphenoid sinuses are clear and the sphenoethmoidal recesses a... | No evidence of significant active sinus inflammation. |
Generate impression based on findings. | 49 year-old female with right lower rib pain post battery Radiopaque markers were placed over the lower chest wall at the site of the patient's pain. No underlying rib fracture is identified. The lungs are clear. | No rib fracture identified. |
Generate impression based on findings. | Reason: aneurysm, abnormality History: right sided headache 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.Atherosclerotic calcifications are p... | 1.No evidence for aneurysm.2.No evidence for cerebral vascular occlusive disease3.Silent sinus syndrome involving the left maxillary sinus.4.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. | 44 year-old male with ulcer, evaluate for osteomyelitis There is marked soft tissue swelling about the middle finger with foci gas adjacent to the cortex at the volar aspect of the DIP joint. The underlying cortex is indistinct, highly suspicious for osteomyelitis. Soft tissue swelling also extends along the dorsum of ... | Findings highly suspicious for osteomyelitis involving the third finger as described above. |
Generate impression based on findings. | This patient has a new diagnosis of small cell lung CA; evaluate for brain metastases. 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.... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.No evidence for brain metastases. Please note that MRI is more sensitive in detecting brain metastases than CT. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. Enhancing focus in the left high convexity is thought to represent a vessel or small developmental venous anomaly (4/23). No definite abnormal enhancing lesions to suggest metastases. Minim... | 1.No evidence of intracranial metastases.2.Minimal periventricular and subcortical hypoattenuation is nonspecific but may be related to age indeterminate small vessel ischemic disease. |
Generate impression based on findings. | Reason: evaluate ILD History: Doe fibrosis cough LUNGS AND PLEURA: Extensive bilateral interstitial disease with a severe honeycomb pattern and traction bronchiectasis indicative of fibrosis. Distribution is somewhat peripheral and basilar predominant, with more extensive involvement of the left lung.Mild groundglass o... | Extensive interstitial fibrosis with honeycombing and traction bronchiectasis, compatible with UIP except for a slightly atypical distribution. |
Generate impression based on findings. | Multiple myeloma following chemotherapy, last 1/21/15.RADIOPHARMACEUTICAL: 12.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 94 mg/dL. Today's CT portion grossly demonstrates numerous lytic lesions throughout the visualized skeleton most notably involving the skull and pelvis. Healing fracture deformities... | 1.No FDG avid tumor currently.2.Multiple bilateral anterior rib fractures. |
Generate impression based on findings. | Male 76 years old; Reason: 76 y.o. Male with HPT. Please assess for parathyroid adenomas History: HPT There is physiologic distribution of the radiopharmaceutical. On the delayed images there is a discrete focus of persistent activity in the region of the inferior pole of the left thyroid lobe. This correlates with the... | Findings compatable with a parathyroid adenoma overlying the inferior pole of the left thyroid lobe, correlating as well with the ultrasound |
Generate impression based on findings. | 82 year old female with history of metastatic uterine cancer, SBO. Failed multiple trials of NG tube clamping and presents with abdominal pain. Scout radiograph showed a nonobstructive bowel gas pattern and cholecystectomy clips. Spot images obtained immediately following patient ingestion of contrast material demonstr... | 1.Non-obstructive left lower quadrant adhesions without evidence of gastric outlet or small bowel obstruction. 2.Normal terminal ileum. No signs of active small bowel inflammation. |
Generate impression based on findings. | Female 71 years old; Reason: history of diverticulitis, concern for diverticular abscess History: LLQ pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Stable subcentimeter anteriorly located hepatic hypoattenuating focus, too small to characterize, image 37 series 4. Common bile duct mea... | 1. Findings compatible with acute diverticulitis with small paracolic fluid and air containing collection, abscess formation related to localized perforation favored based on appearance (coronal image 72), although an inflamed diverticulum another differential consideration. Findings discussed with Dr. Weiss at 2:45 p.... |
Generate impression based on findings. | 14-year-old male with history of bladder exstrophy, neurogenic bladder, augmentation ileocystoplasty and stone removal. BLADDER Wall Thickness: Unable to assess. Contents: Collapsed. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: T... | 1.Increased right renal cortical echogenicity suggests medical renal disease.2.Nonobstructing 5-mm stone in the inferior pole of the right kidney.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pe... |
Generate impression based on findings. | History of base of tongue and breast cancers. Now with enlarging left lower lobe pulmonary nodule. Evaluate for malignancy/restaging.RADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 101 mg/dL. Today's CT portion grossly demonstrates an approximately 1 cm left lower lobe pulmonary nod... | 1.Markedly hypermetabolic left lower lobe pulmonary nodule is very suspicious for tumor, either primary lung cancer or metastatic disease.2.No suspicious FDG avid lesion elsewhere in the neck, chest, abdomen or pelvis. |
Generate impression based on findings. | Male 56 years old; Reason: Pancreas cancer please assess and compare to previous scan and provide index lesion measurements for RECIST CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change. Scattered micronodules, nonspecific. Right apical bullous disease. Small dependent bibasilar atelectasis. MEDI... | 1. New and enlarging hepatic metastases, new portal venous thrombosis. 2. Increased prominence of ill-defined pancreatic head/uncinate mass with increasing mass effect on adjacent vasculature as above.Findings discussed with research nurse Kenisha at 3:25 p.m. on 1/26/15. |
Generate impression based on findings. | Acute visual field deficit. There is a partially empty sella. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is possible flattening of the optic nerve discs. There are bubbly secretions within the le... | 1. Partially empty sella and possible flattening of the optic nerve discs may indicate pseudotumor cerebri.2. Bubbly secretions within the left sphenoid sinus may represent acute sinusitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 48 years old Reason: Patient has a TIPS with stents, possible stent clog History: fluid overload LIMITED ABDOMENLIVER: The liver measures 19.1 cm in length. Heterogeneous and coarsened hepatic echotexture. No focal hepatic lesion. BILIARY TRACT: No cholelithiasis. No biliary dilatation.PANCREAS: The pancreas is ... | Suboptimal evaluation of TIPS. The proximal portal venous portion was interrogated and is patent. The hepatic venous end is obscured. No ascites evident. |
Generate impression based on findings. | Male 70 years old; Reason: patient with a history of MS and bladder cancer now with tenderness in his left testicle History: left testicular discomfort RIGHT TESTIS: Right testicle measures 4.0 x 1.7 x 2.6 CM . Echotexture is moderately heterogeneous. Within its anterior aspect, there is a hypoechoic lesion measuring 8... | Abnormal scrotal ultrasound involving the right testicle which has heterogeneous parenchymal echotexture and a focal hypoechoic lesion. The imaging features are not entirely specific and include infection. However, neoplastic involvement is not entirely excluded and a follow sonogram in 4 to 6 weeks is suggested. |
Generate impression based on findings. | History of left lumpectomy 11/2010 for invasive mammary carcinoma with squamous differentiation. Patient received radiation and chemotherapy. Occasional bilateral breast pain. Three standard views of both breasts were performed digitally with right breast spot compression views and rolled views (13 total images) and re... | Indeterminate 11 mm right breast mass. Ultrasound-guided biopsy is recommended. Findings were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Male 57 years old; lumbar sensory radiculopathy, evaluate for lumbar plexus abnormality ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Right hepatic lobe low attenuation focus is too small to further characterize. Minimal intrahepatic biliary ductal dilation status post cholecystectomy.SPLEEN: No signifi... | 1.Extensive beam hardening artifact severely limits evaluation of the spine. Recommend dedicated spine imaging study for further evaluation of patient's symptoms.2.Right anterolateral bladder wall thickening is suspicious for underlying neoplasm. Correlate with cystoscopy. |
Generate impression based on findings. | Trouble breathing. History of right diaphragmatic hernia.VIEW: Chest AP (one view) 01/26/15, 1512 Postoperative changes are seen in the right diaphragm. Right lung volume is slightly less than expected for normal. Mild peribronchial thickening is noted. Cardiothymic silhouette is normal. | Bronchiolitis/reactive airways disease pattern. |
Generate impression based on findings. | 67-year-old female with history of metastatic breast cancer with diffuse bony metastases, now with shoulder pain. Please evaluate for metastatic disease. The bones appear demineralized, which may reflect osteopenia. No focal lesion is identified to suggest metastasis to bone. Tiny osteophytes are noted at the acromiocl... | No focal lesion to suggest metastasis to bone. If further evaluation is clinically indicated, MRI or skeletal scintigraphy may be considered. |
Generate impression based on findings. | 55-year-old female with left knee effusion and tenderness after twisting left knee and falling directly onto knees. Evaluate for fracture. Left knee: Moderate osteoarthritis affects the left knee, appearing similar to the prior study. We see no fracture. In particular, no patellar fracture is identified. Alignment is w... | Osteoarthritis, as above, without evidence of fracture. |
Generate impression based on findings. | 51-year-old with diffuse right breast pain. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of ar... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Clinical correlation is also recommended for the patient's breast pain. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDAT... |
Generate impression based on findings. | 57-year-old female with pain in knees. Evaluate for arthritis, RA progression. Right hand: Mild osteoarthritis affects the DIP joints. Slight widening of the scapholunate interval is again noted. We see no erosions or specific radiographic findings of rheumatoid arthritis.Left hand: Mild to moderate osteoarthritis affe... | Arthritic changes as described above appear predominately degenerative. Small bilateral knee joint effusions, without specific radiographic features of rheumatoid arthritis. |
Generate impression based on findings. | 28-year-old female with pain, reduced range of motion, evaluate elbow fracture There is a comminuted fracture of the coronoid process of the ulna with mild volar displacement of the fracture fragments. No fragments have migrated posteriorly within the joint. The remainder of the proximal ulna is intact. The proximal ra... | Coronoid process fracture as described above. |
Generate impression based on findings. | Reason: history of right breast cancer with +axillary lymph nodes, initial staging exam History: none Limited examination due to patient motion artifact. CHEST:LUNGS AND PLEURA: 5 mm micronodule in the right mid lung (series 5 image 37). Calcified micronodules in the right lung base. No pleural effusions. MEDIASTINUM A... | 1. Right breast mass and enlarged right axillary lymph node consistent with the patient's known malignancy. 2. Limited pulmonary examination due to respiratory motion artifact. Scattered nonspecific micronodules, for which continued follow up is recommended. 3. Enhancing lesion in the hepatic dome is nonspecific, diffe... |
Generate impression based on findings. | 15-year-old male with long-standing cough with liquids, assess for respiration.EXAMINATION: Oropharyngeal motility study 1/26/2015 Beth Harrison, speech and language therapist, supervised the examination.59 seconds of fluoroscopy was used.PRESENTATION: The patient was presented with thin liquids via an open cup, straw ... | Penetration with thin and thickened liquids without cough or aspiration.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Esophageal mass. Initial staging esophageal cancer.RADIOPHARMACEUTICAL: 13.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 116 mg/dL. Today's CT portion grossly demonstrates a large distal esophageal mass. A smoothly marginated pleural based right upper lobe pulmonary nodule measures just over a centimeter... | 1.Large markedly hypermetabolic distal esophageal mass, compatible with esophageal cancer.2.Several hypermetabolic immediately adjacent paraesophageal/perigastric lymph nodes are suspicious for adjacent lymph node metastases.3.No evidence of more distant FDG avid metastatic disease. A right upper lobe pulmonary nodule ... |
Generate impression based on findings. | Reason: evaluate for changes in ILD recent worsenning doe History: worsejing DOE , hypoxemia LUNGS AND PLEURA: Lower lung zone predominance subpleural reticulation with mild honeycombing is unchanged.As on prior there is little groundglass opacity and lung volumes are small with traction bronchiectasis indicating archi... | Stable severity and distribution of pulmonary fibrosis in a pattern suggestive of UIP. |
Generate impression based on findings. | 65-year-old female, preoperative evaluation There is severe joint space narrowing with subchondral sclerosis and subchondral cysts affecting the left hip. Marked degenerative arthritic changes also affect the lower lumbar spine, SI joints and to a lesser extent, the right hip. A generator device is present in the poste... | Severe osteoarthritis, as above. |
Generate impression based on findings. | 37 years, Female. Reason: Abdominal distension, TTP, no BM in 9 days. Evaluate for obstruction. History: As above Non obstructive bowel gas pattern. Greater than average stool burden. Pelvic phleboliths are noted. Foley catheter partially visualized. Redemonstration of osseous abnormality. Please see recent pelvis radi... | Non obstructive bowel gas pattern. Greater than average stool burden. |
Generate impression based on findings. | Mucosal thickening is found throughout all paranasal sinuses which obstructs the ostiomeatal units, the sphenoethmoidal recesses, and the frontoethmoidal recesses. There is a small superimposed air-fluid level on the right. Several ethmoid air cells are completely opacified. Note is made of bilateral Haller cells. Bil... | Mucosal thickening is found throughout all paranasal sinuses which obstructs the ostiomeatal units, the sphenoethmoidal recesses, and the frontoethmoidal recesses. There is a small superimposed air-fluid level on the right. |
Generate impression based on findings. | Reason: eval for mass History: right sided headache for 2 days 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 ... | No evidence for acute intracranial hemorrhage, mass effect or edema. |
Generate impression based on findings. | 71-year-old female with right humerus a pathologic fracture, status post intramedullary rod. Evaluate for healing. An intramedullary rod and screw device affixes a pathologic fracture through a lytic lesion of the mid humeral diaphysis in near-anatomic alignment. There is no evidence of hardware complication. Small amo... | Orthopedic fixation of a pathologic humerus fracture, as described above. |
Generate impression based on findings. | Male 63 years old; Reason: possible metastatic prostate or testicular cancer (unknown etiology), help determine risk of fracture History: back pain, R hip and leg pain There are multiple abnormal osseous foci noted throughout the ribs, spine, pelvis, bilateral femuri, most prominent in the pelvis, which given recent ax... | Extensive osseous metastatic disease as described above. Lesion in the left sacrum is most concerning for impending fracture given findings on CT.Findings were discussed with Dr. Katelyn Good at 4:30 p.m. on 1/26/2015. |
Generate impression based on findings. | Reason: pe? History: sob, tachypnea, h/o ovarian cancer PULMONARY ARTERIES: Mildly limited examination due to motion artifact. No pulmonary embolus.LUNGS AND PLEURA: Basilar predominant dependent ground glass opacities likely secondary to examination performed in the expiratory phase. Scattered micronodules grossly unc... | 1. No pulmonary embolus or other acute abnormality to account for the patient's symptoms.2. Limited pulmonary examination due to examination performed in the expiratory phase, without new pleural effusion or airspace opacity.3. Thoracic and abdominal lymphadenopathy and hepatic metastasis without acute interval change,... |
Generate impression based on findings. | Male 64 years old; Reason: r/o PE History: SOB The comparison chest radiograph performed on 1/25/2015 demonstrates bilateral pleural effusions and atelectasis with near complete left lower lobe collapse. The ventilation images show lung volumes and inhomogeneous distribution of radiotracer and little change on washout ... | Within the limitations described above and the combined constellation of findings, this is intermediate probability scan for pulmonary embolism. |
Generate impression based on findings. | 59-year-old female with persistent shoulder and neck pain after lifting Left shoulder: The bones are demineralized. There are osteophytes along the inferior glenoid, consistent with mild to moderate osteoarthritis. A band of sclerosis along the humeral neck and small cortical step-off likely are due to prior fracture.C... | Degenerative and posttraumatic changes of the shoulder as described above without acute abnormality evident. |
Generate impression based on findings. | 48-year-old with history of breast cancer status post left mastectomy. Three standard views of the right breast and spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribu... | Suspicious clustered calcifications in the right upper outer breast for which stereotactic biopsy is recommended. Findings and recommendations were discussed with the patient. She will be following up with Dr. Hahn later today.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Req... |
Generate impression based on findings. | Male 60 years old; Reason: metastatic colon cancer History: baseline scan pre-chemotherapy CHEST:LUNGS AND PLEURA: New small to moderate right pleural effusion. Biapical bullous changes. 4 mm right upper lobe lung nodule, image 95 series 7, not definitely seen on prior study. MEDIASTINUM AND HILA: Multiple small subcen... | 1. Marked ill-defined heterogeneity involving left hepatic lobe as above, suspicious for metastatic disease. Associated intrahepatic biliary duct dilatation, left portal vein branches not well seen, worrisome for underlying portal venous thrombosis. Upper abdominal lymphadenopathy. 2. New ascites. Mesenteric induration... |
Generate impression based on findings. | Abdominal pain and acute pancreatitis with shortness of breath and shock, evaluate for pancreatic necrosis and abscess CHEST:LUNGS AND PLEURA: Respiratory artifact limits evaluation of the lungs. Bilateral pleural effusions with overlying compressive atelectasis.MEDIASTINUM AND HILA: Heart size is normal. No pericardia... | 1.Findings consistent with acute pancreatitis with heterogeneous parenchymal enhancement but no frank parenchymal necrosis.2.Increasing ascites.3.Nonspecific small bowel wall thickening reflects enteritis of uncertain etiology, correlation with patient's clinical history recommended.4.Bilateral pleural effusions. |
Generate impression based on findings. | 8 year-old female with left lower quadrant abdominal mass, evaluate stool burden.VIEW: Abdomen AP (one view) 1/26/2015 A moderate amount of feces is distributed throughout the colon, with desiccated feces present within the rectum. The bowel gas pattern is nonobstructive. | Moderate stool burden with desiccated feces within the rectum. |
Generate impression based on findings. | Purulent rhinorrhea, sinus tenderness, and resistant to antibiotic therapy. There is new diffuse opacification and mucosal thickening of the paranasal sinuses including the bilateral maxillary sinuses, frontal sinuses, ethmoid sinuses and sphenoid sinus. There is also partial opacification of the nasal cavity with bubb... | 1. Diffuse paranasal sinus and nasal cavity opacification suggests rhinosinusitis, perhaps bacterial and/or fungal.2. Bilateral mastoid air cells fluid may indicated mastoiditis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 73 old female status post left TKA Hardware components of a total knee arthroplasty device are situated in near-anatomic alignment without evidence of complication. Drain, gas and surgical staples in the soft tissues reflect recent surgery. Extensive bone infarctions within the distal femur and proximal tibia are again... | TKA, as above. |
Generate impression based on findings. | 14-year-old male with right gunshot wound Two K wires affix the comminuted fracture about the MCP joint of the thumb. Status-post amputation of the fifth finger at the PIP joint. Multiple foci of metallic artifact within the first and fifth fingers are consistent with prior gunshot wound. There is adjacent soft tissue ... | Orthopedic fixation and postoperative changes as described above. |
Generate impression based on findings. | Acute visual field deficit. There is a partially empty sella. The cerebellar tonsils are mildly low-lying. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. There appears to be flattening of the optic nerve discs. There ar... | 1. The constellation of findings, including a partially empty sella and flattening of the optic nerve discs, indicate pseudotumor cerebri.2. Bubbly secretions within the left sphenoid sinus may represent acute sinusitis.Findings discussed with Debra Conti at 4:30 PM on 1/26/15. |
Generate impression based on findings. | Colorectal cancer status post chemoradiation 2001. Restaging for new baseline.RADIOPHARMACEUTICAL: 13.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 89 mg/dL. Today's CT portion of the neck demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abdomen, and pelvi... | 1.Extensive hypermetabolic metastatic disease in the chest, abdomen, and pelvis including osseous, hepatic, and lymph node metastases as well as carcinomatosis and likely right pleural tumor seeding.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 20 year-old female with injury, pain and swelling. No definite fracture line is identified. No ankle joint effusion is present. There is focal bony prominence at the plantar aspect of the proximal fifth metatarsal with questionable linear lucency, which in the correct clinical context could represent a stress fracture ... | Focal bony prominence and questionable lucency of the fifth metatarsal base may represent stress fracture or acute fracture in the appropriate clinical context. Dedicated right foot radiographs are recommended for further evaluation. |
Generate impression based on findings. | 68-year-old female with severe pain in the left big toe. Assess for fracture. The bones appear slightly demineralized. Hammertoe deformities of the lesser toes are present. No fracture or malalignment is evident. | No fracture or other findings to account for severe great toe pain. |
Generate impression based on findings. | There is mild ventricular asymmetry, similar to the prior CT with anterior displacement of the right choroid relative to the left. Within the atrium of the right ventricle, there is no abnormal enhancement, mass or cystic lesion. The cisterns remain patent. There is no midline shift or mass effect. There are no areas ... | 1. No acute intracranial abnormality.2. Within right lateral ventricle at the site questioned on prior CTA, no concerning lesion is present. |
Generate impression based on findings. | Metastatic adenoid cystic carcinoma status post cis/navelbine and palliative radiotherapy. There is interval decrease in size of the hyperattenuating left tongue base mass that crosses the midline and extends into the left oral tongue and into the left tonsillar fossa, now measuring up to approximately 35 mm, previousl... | 1. Interval decrease in size of the mass centered within the left tongue base with extension into the left lateral floor of mouth and right tongue base and left tonsillar fossa.2. Interval decrease in size of the bilateral neck and partially imaged upper mediastinal lymphadenopathy. Please refer to the separate chest C... |
Generate impression based on findings. | 68-year-old female with 6 weeks of right lower quadrant pain. The right hip appears normal for age. No fracture or malalignment is evident. There are ovoid calcific densities overlying the right pubic bone that we suspect were present on prior lumbar spine radiographs from 2007 and hence are of doubtful clinical signif... | Mild osteoarthritis of the right sacroiliac joint and other findings as described above. If further imaging is clinically indicated, CT of the abdomen and pelvis may be considered. |
Generate impression based on findings. | Male, 51 years old, with altered mental status. Grey-white differentiation is preserved. No evidence of parenchyma edema or mass effect seen. Mild patchy white matter hypoattenuation in the right frontal lobe is seen, a nonspecific finding. A cystic structure within the left basal ganglia may represent a dilated periva... | No acute intracranial abnormality. |
Generate impression based on findings. | 97-year-old female status post fracture, evaluate for bone healing Splint material obscures underlying osseous detail. Intramedullary rods affix the distal ulna and proximal radius fractures in near-anatomic alignment. | Orthopedic fixation of both bone forearm fracture in near-anatomic alignment. |
Generate impression based on findings. | Male 54 years old; Reason: Evaluate for re-development of fluid collection in the abdomen from an anastomotic leak, Ct last week History: fatigue, abdominal pain, cramping, diaphoresis, nausea and dry heaves ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Perfusion artifact in the right hepat... | 1.Developing fluid collection in the area of prior drainage. This is suspicious for recurrent abscess. Possibly due break down of the anastomosis.2.Findings discussed with Michele Rubin and the Interventional radiology resident (Dr. Finkle) at the time of this report. |
Generate impression based on findings. | Female 63 years old; Reason: Pt with newly diagnosed ampullary carcinoma at OSH. Need staging and evaluation for resectability before tumor board on 1/27 (pancreas protocol) History: ampullary carcinoma ABDOMEN:LUNGS BASES: Extensive respiratory motion artifact, making assessment suboptimal. Mild cardiomegaly.LIVER, BI... | 1. Ill defined soft tissue attenuation seen in region of ampulla, may reflect patient's known ampullary carcinoma. 2. Mild gastric distention with underdistended pylorus and proximal duodenum seen, possible mucosal enhancement noted, correlation with patient's clinical history to exclude underlying enteritis recommende... |
Generate impression based on findings. | 20 year-old female with right foot pain. Patient fell down stairs two weeks ago and has pain and swelling along the medial side of the foot. Technologist notes that pain is located along the medial aspect of the foot. We see no findings to account for medial foot pain. There is sclerosis of the proximal diaphysis of th... | No findings to account for medial foot pain. |
Generate impression based on findings. | Bilateral hip pain Two views of the left hip are provided. Tiny osteophytes indicate minimal osteoarthritis, appearing similar to the prior study accounting for slight positional differences. There is slight prominence of the anterolateral aspect of the femoral head/neck junction, which can be associated with femoroace... | Minimal osteoarthritic changes of the hips and other findings as above. |
Generate impression based on findings. | Female 50 years old; Reason: r/o SBO History: persistent N/V, no flatus Contrast extravasation description:Supervising radiologist: Dr. ShethMinor or major extravasation: MinorContrast type: 120 cc of Omnipaque 350 were administered. Amount extravasated: 18 ccLocation of extravasation: Right antecubital fossaSigns and ... | 1.Contrast extravasation as detailed above.2.No evidence of small bowel obstruction. No specific cause for patient's symptoms is identified.3.3.0 cm cystic right adnexal lesion. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. No focal mass effect, midline shift or herniation. 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 mastoid air cells are clear. | No evidence of acute intracranial hemorrhage or mass. If there is continued suspicion for intracranial pathology, consider MRI for further evaluation. |
Generate impression based on findings. | Female 57 years old; Reason: r/o appendicitis History: RUQ/RLQ abd pain The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Airspace opacities with a tree in bud appearance in the right mi... | 1.No evidence of appendicitis.2.Mild prominence of the common bile duct. Consider right upper quadrant ultrasound for further evaluation as CT is insensitive for the detection of gallstones.3.Right middle lobe opacities are suggestive of infection and are better evaluated on recent CT chest. |
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