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Generate impression based on findings. | 16-year-old male with distal fibular and tibial fractures.VIEWS: Right ankle AP lateral and oblique (3 views) 1/27/2015 Overlying cast material obscures fine bone detail. A plate and screw device affixes the distal fibular fracture in near-anatomic alignment, without evidence of hardware complication. Mild periosteal r... | Distal fibular and tibial fractures as above. |
Generate impression based on findings. | 51 year-old female with ESRD. Secondary hyperparathyroidism. Three foci of increased radiotracer activity, two on the right and one on the left, are seen in the region of the thyroid gland on early SPECT imaging. Delayed SPECT images are unremarkable with complete washout of the radiotracer from the thyroid bed. While ... | Three foci of increased radiotracer activity without delayed washout, two on the right and one on the left, which may be due to atypical parathyroid hyperplasia. Suggest correlation with ultrasonographic study. |
Generate impression based on findings. | 12-year-old female with hip painVIEWS: Left hip frog leg/axiolateral (two views) 01/27/15, 1229 No acute fracture or malalignment is evident. The femoral head is smooth, round and well seated within the acetabulum. | Normal examination. |
Generate impression based on findings. | 8-year-old male status post resection of osteochondroma from left forearmVIEWS: Left knee AP/lateral (two views), left wrist PA/lateral (two views) 01/27/15 Multiple exostoses arising from the distal femoral and proximal tibial and fibular metaphyses without significant change. No fracture is evident. No joint effusion... | Multiple exostoses without evidence of fracture. Post surgical changes to the left forearm without evidence of fracture. |
Generate impression based on findings. | Bilateral knee stiffness.VIEWS: Right knee AP/lateral (two views), left knee AP/lateral (two views) 01/27/15 The knees are normal in appearance. No fracture is identified. Ossification centers of the femoral and tibial epiphyses are present. | Normal examinations. |
Generate impression based on findings. | 45 year-old female with pain, rule out fracture Left upper extremity: The humerus is intact. There is an oblique fracture through the olecranon process with approximately 5 mm separation of the proximal fracture fragment. Surgical clips are present within the soft tissues.Wrist: No fracture or malalignment. Arterial ca... | Olecranon process fracture as described above. |
Generate impression based on findings. | 38 year-old male with gastric retention of capsule. Capsule with food retained in the stomach and capsule retained x 8 hours. Assess for gastric motility. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandia... | Gastric emptying within normal limits. |
Generate impression based on findings. | Reason: evaluation preoperatively chest/goiter location History: evaluation preoperatively chest/goiter location LUNGS AND PLEURA: Scattered micronodules, some calcified. No suspicious nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Heterogeneous mass arising from the left lobe of the thyroid is compatibl... | 1. Acute pulmonary emboli involving lobar and segmental branches of the right pulmonary artery. Enlargement of the main pulmonary artery with possible mild right heart strain. 2. Substernal goiter as described above with associated tracheal deviation and narrowing.These findings were discussed with Sarah Gaines pager 3... |
Generate impression based on findings. | Shortness of breath and tachypnea, evaluate for worsening ovarian cancer ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Ill-defined left hepatic lobe lesion measures 3.5 x 3.4 cm (series 3, image 30), previously 3.8 x 3.6 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality no... | 1.Lymphadenopathy and peritoneal soft tissue metastases with variations in reference measurements as above. No evidence of disease progression. 2.No acute abnormality in the abdomen or pelvis. |
Generate impression based on findings. | 32-year-old female with history of left shoulder pain. There has been resorption of the distal clavicle which we suspect is related to the patient's hyperparathyroidism, however post traumatic osteolysis is also a differential consideration. There is also a minimally displaced fracture through an expansile lesion at th... | Findings compatible with hyperparathyroidism including a minimally displaced pathologic fracture of left fourth rib fracture through what we suspect may be a brown tumor as well as resorption of the distal clavicle. |
Generate impression based on findings. | 53-year-old male with history of prostate cancer, rising PSA. Assess for metastatic disease. Increased radiotracer activity in the left aspect of the T10 vertebral body is compatible with metastasis. Foci of increased activity are also seen in the left lateral ribs 5, 7, and 9. Only the ninth rib is visualized on today... | Findings compatible with T10 metastasis. Additional left rib metastases are likely present as well. |
Generate impression based on findings. | 35-year-old male with shoulder pain radiating down left arm Shoulder: The osseous structures appear within normal limits for the patient's age. There is no fracture or malalignment.Cervical spine: Vertebral body heights and disk spaces are maintained. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | 70 year-old male with history of lumbar decompression, worsening back pain Severe degenerative disease affects L5/S1. Moderate degenerative disk disease affects L4/L5 and L2/L3. There is grade 1 anterolisthesis of L4 on L5 which appears similar on flexion and extension views. | Degenerative disk disease and anterolisthesis of L4 on L5, without evidence of instability. |
Generate impression based on findings. | 20 year-old male, follow-up exam A side plate with screws affixes the base of the first metatarsal, medial and middle cuneiforms as well as the navicular bone without evidence of hardware complication. Two screws transverse the base of the proximal first phalanx. Two K wires affix each of the second, third, fourth, and... | Orthopedic fixation as described above in near-anatomic alignment. |
Generate impression based on findings. | 22-year-old male with hip subluxationVIEWS: Pelvis AP/frog leg (two views) 01/27/15, 1141 hour Bilateral coxa valga is unchanged. There is minimal, 30%, uncovering of the femoral heads bilaterally. The femoral heads are well seated in the acetabula. No acute fracture or malalignment is evident. | Bilateral coxa valga without acute fracture or malalignment. |
Generate impression based on findings. | 59-year-old with history of right breast LCIS. 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... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 55-year-old female with bilateral knee pain Knees: There is mild sharpening of the tibial spines bilaterally indicating minimal osteoarthritis. No joint effusion.Ankle: The distal fibular fracture line is longer visualized, indicating healing. Alignment is anatomic. | Minimal osteoarthritis and healed distal fibula fracture. |
Generate impression based on findings. | Chest tube removal. Five day old former 31 week gestational age patient with pneumothorax.VIEW: Chest AP (one view) 01/27/15, 1307 Endotracheal tube tip is below thoracic inlet. Feeding tube tip is distal to GE junction and not included in image. Umbilical venous line tip is in right atrium.Right chest tube has been re... | No pneumothorax after chest tube removal. |
Generate impression based on findings. | 44-year-old male with history of chronic low back pain. Moderate degenerative disc disease affects L5-S1. There is no evidence of spondylolisthesis. | Degenerative disc disease at L5-S1. |
Generate impression based on findings. | Fracture.VIEWS: Left forearm AP/lateral (two views) 01/27/15 Cast has been removed. The both bones fracture of the mid forearm is in near anatomic alignment. Callus formation surrounds the fractures of the distal and mid ulna and radius. | Continued healing of both bones fracture. |
Generate impression based on findings. | 50 year-old female with history of right thumb swelling. There is perhaps mild soft tissue swelling about the thumb, but there is no evidence of acute fracture or dislocation. | Soft tissue swelling without fracture. |
Generate impression based on findings. | 87 year-old male with history of bladder cancer, evaluate and compare prior ABDOMEN:LUNG BASES: Scattered micronodules, some calcified, measuring up to 5 mm in the right middle lobe.LIVER, BILIARY TRACT: No focal hepatic lesions. Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormali... | Postsurgical changes without evidence of disease recurrence. |
Generate impression based on findings. | Male 78 years old; Reason: s/p OLT with recurrent HCV, also with HBV, eval for radiographic evidence of cirrhosis and portal HTN History: s/p OLT ABDOMEN:LUNG BASES: Coronary artery and valvular calcifications. Bibasilar atelectasis and trace left pleural effusion with adjacent compressive atelectasis.LIVER, BILIARY TR... | 1.No suspicious hepatic lesions. |
Generate impression based on findings. | 56 year old male with history of stage III colon cancer. Evaluate for disease recurrence. CHEST:LUNGS AND PLEURA: Unchanged left major fissure intra-pulmonary lymph node, without new suspicious nodules or masses. No consolidation, and no pleural effusion.MEDIASTINUM AND HILA: Heart size within normal limits, no pericar... | Inferior right hepatic lobe hypoattenuating focus has increased in size, and given the patient's history is most consistent with metastatic disease. |
Generate impression based on findings. | Reason: hx of tonsil ca, s/p CRT 12/13, eval for dz. compare to previous History: as above CHEST:LUNGS AND PLEURA: Scattered micronodules, compatible with previous infection.Mild upper zone emphysema.No suspicious nodules.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No visible coronary artery calcifica... | No evidence of metastatic disease and no significant change. |
Generate impression based on findings. | 1-year-old female for evaluation of pneumoniaVIEWS: Chest AP (one views) 01/27/15 , 1232 hour Tracheostomy tube is in place. Cardiothymic silhouette is moderately enlarged. Bibasilar opacities may represent atelectasis and/or consolidation. No pleural effusion or pneumothorax. | Bibasilar atelectasis and/or consolidation. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Unchanged calcified right upper lobe subpleural nodule (series 7 image 42). Additional smaller calcified micronodules are also unchanged.A triangular shaped smoothly marginated nodule along the left major fissure (series 7 i... | 1.No specific evidence of metastatic disease.2.Calcified pulmonary nodules and lymph nodes consistent with prior granulomatous disease. Smoothly marginated nodule along the left major fissure is most compatible with an intrapulmonary lymph node. |
Generate impression based on findings. | CLINICAL DATA: Age: 56 years. Sex : Male. Indication: Reason: iliac aneurysm` History: same. LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Hypoattenuating focus in the right inferior liver parenchyma, likely a cyst but too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No ... | 1.Aortobiiliac stent graft, with thrombosed right common iliac artery aneurysm as above.2.Stable postoperative findings of cystectomy/neobladder construction. |
Generate impression based on findings. | Worsening fatigue, metastatic pancreatic cancer CHEST:LUNGS AND PLEURA: Innumerable pulmonary metastases, increased from prior. Reference right apical nodule measures 1.3 cm (series 5, image 20), previously 0.8 cm. Reference right lower lobe pulmonary nodule measures 1.1 cm (series 5, image 62), previously 0.7 cm. Smal... | 1.Pulmonary metastases increasing in size and number.2.Increasing disease in the abdomen and pelvis with new peritoneal carcinomatosis and increasing lymphadenopathy.3.Bilateral pleural effusions. |
Generate impression based on findings. | 72 year-old female status post wide excision of right chest wall desmoid type of fibromatosis in September 2012 presents for diagnostic mammogram. 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 composed of scatter... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Posttreatment changes in the right neck from prior right neck dissection. There is been interval right parotidectomy with new surgical clips and residual mildly enhancing tissue within the resection bed, likely representing postsurgical scar. No focal enhancing lesion is evident to suggest residual or recurrent diseas... | 1.Postsurgical changes of right parotidectomy without definite evidence of residual or recurrent tumor. 2.No significant cervical lymphadenopathy.3.Findings of chronic left maxillary sinus disease. |
Generate impression based on findings. | Reason: 84 yo F with COPD, new restriction on PFTs, eval History: COPD LUNGS AND PLEURA: Image quality is limited by severe respiratory motion artifact.Focal small areas of interstitial opacity compatible with scarring and subsegmental atelectasis are largely obscured by motion artifact but likely unchanged.No large em... | 1.Limited examination due to respiratory motion artifact.2. Severe tracheobronchomalacia with almost complete collapse of the central airways on expiration. |
Generate impression based on findings. | 39-year-old female with history of pain. Left fifth toe: A lucent band separates the middle and distal phalanges of the fifth toe which we suspect represents a fracture through a prior coalition of these two bones. The fracture margins are relatively indistinct which may represent the resorptive phase of healing. There... | 1.Left fifth toe fracture as above.2.Prior bone infarction of the right femur. |
Generate impression based on findings. | Male 56 years old Reason: fever ,chills, pain, s/p transplant History: fever, RENAL TRANSPLANT: LOCATION: Right iliac fossaPERI TRANSPLANT TISSUES: No peri transplant fluid collection.KIDNEY: No significant abnormality noted. No hydronephrosis.COLLECTING SYSTEM/URETER: 1.3 x 1.4 x 1.4-cm renal cyst.URINARY BLADDER: No ... | Unremarkable appearance of the renal transplant. |
Generate impression based on findings. | 47 years, Female. Reason: concern for free air History: r/o free air Nonobstructive bowel gas pattern. No evidence of free air. | Nonobstructive bowel gas pattern. No evidence of free air. |
Generate impression based on findings. | 44-year-old male with history of T9 a multicystic mesothelioma on observation, evaluate EOD, compared to previous. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHES... | Reference hypodense lesions in the pelvis are stable in size over the interval. Non-reference lesions are also grossly unchanged. |
Generate impression based on findings. | Reason: preoperative examination for lung resection History: lung nodule CHEST:LUNGS AND PLEURA: Persistent masslike consolidation in the right upper lobe measures up to 3.5 x 2.2 cm in axial dimension (series 4 image 37), with associated peribronchial thickening and surrounding groundglass opacity. There is improved a... | 1. Left upper lobe masslike consolidation and adjacent nodularity is consistent with the patient's known tumor. Improved aeration since the prior outside CT. 2. Mediastinal lymphadenopathy correlates with increased metabolic activity on recent PET CT. 3. No evidence of metastatic disease in the upper abdomen. |
Generate impression based on findings. | 50-year-old female with history of malunion and chronic osteomyelitis. There is diffuse soft tissue swelling. There is a large soft tissue defect along the lateral aspect of the lower leg/ankle. There is deformity of the underlying fibula indicating a healing/healed fracture with the fracture fragments in near anatomic... | Soft tissue ulceration, findings compatible with chronic osteomyelitis, and healing/healed fractures as described above. If there is strong clinical concern for acute osteomyelitis, MRI may be considered. |
Generate impression based on findings. | 78-year-old woman with a diagnosis of bladder cancer, evaluate and compare to the prior examination ABDOMEN:LUNG BASES: No significant abnormality noted. Chronic deformity of several lower right ribs.LIVER, BILIARY TRACT: Scattered subcentimeter hypodensities are too small to further characterize. Status post cholecyst... | 1.No evidence of disease in the abdomen or pelvis.2.Filling defect within the ileal conduit bowel loop measures approximately 6 mm and may represent a fold within the bowel loop. Special attention should be paid to this region on subsequent exams.3.Small enhancing lesion the pancreatic head with mild dilatation of the ... |
Generate impression based on findings. | Male 46 years old; Reason: pt with a history of ureter cancer, s/p chemothearpy. please assess for disease progression History: hx ureter cancer CHEST:LUNGS AND PLEURA: Innumerable metastasis bilaterally difficult to compare. The index lesions are as follows:Right upper lobe paramediastinal lesion: 1.7 x 1.4 cm (6:31) ... | 1.Mixed response, with reference lesions measured above. |
Generate impression based on findings. | 91-year-old female with history of distal radius and ulnar fractures. Evaluation of the bones is limited due to overlying cast material. The previously seen distal radius and ulnar styloid fractures are barely visible. Alignment is near-anatomic. | Distal radius and ulnar fractures are poorly visualized due to overlying cast material, but alignment is anatomic. |
Generate impression based on findings. | 61-year-old male with history of C5/6 pain. Moderate to severe degenerative disc disease affects C5-6 with anterior and posterior osteophytes. There are anterior and posterior osteophytes projecting from C3-6. There is minimal retrolisthesis of C5 on C6. There appears to be multilevel neuroforaminal narrowing including... | Degenerative disc disease and neuroforaminal narrowing as described above. If patient care warrants further imaging, MRI may be obtained. |
Generate impression based on findings. | 44 year old female with worsening neck pain and gas in soft tissues on x-ray. History of cervical cancer status post recent pelvic exenteration in cystectomy and ileal conduit CT HEAD:The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There ... | Multiple foci of air in the epidural space in the cervical spine extending into the right paraspinal tissues of the neck are likely related to recent epidural catheter. No findings to suggest soft tissue infection within the neck. If there are focal neurologic deficits and suspicion of epidural hematoma, an MRI may be ... |
Generate impression based on findings. | 54-year-old female with history of bilateral knee pain. Left knee: Moderate to severe osteoarthritis affects the knee with near bone-on-bone apposition in the medial compartment. There is a slight varus deformity. There is perhaps a small joint effusion.Right knee: Moderate to severe osteoarthritis affects the knee wit... | Osteoarthritis as above. |
Generate impression based on findings. | Male 51 years old Reason: known partial portal vein thrombosis, rule out extension of clot in setting of new onset encephalopthy History: as above LIMITED ABDOMENLIVER: The liver measures 20.1 cm in length and demonstrates cirrhotic morphology. The main portal vein is patent and demonstrates normal directional flow.BIL... | 1. The main portal vein is patent with normal directional flow.2. Cirrhotic liver morphology. |
Generate impression based on findings. | Reason: patient with a history of urothelial cancer, please assess for disease progression. **PLEASE NOTE:CT UROGRAM, 3D IMAGING, DELAYED VIEWS** History: history of urothelial cancer LUNGS AND PLEURA: No suspicious nodules or masses. Basilar subsegmental atelectasis. No pleural effusions.MEDIASTINUM AND HILA: No media... | 1. No evidence of thoracic metastatic disease. 2. See separately dictated CT of the abdomen and pelvis for description of abdominal findings. |
Generate impression based on findings. | Male 39 years old; Reason: hyperparathyroidism, eval for adenoma History: hypercalcemia There is physiologic distribution of the radiopharmaceutical. There is a discrete focus of persistent radiotracer activity on delayed images inferior to the right thyroid lobe which correlates with the solid hypoechoic lesion noted ... | Findings consistent with parathyroid adenoma inferior to the right thyroid lobe. |
Generate impression based on findings. | History of left breast DCIS status post lumpectomy 3/2014 followed by radiation. 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. Post surgical changes are ... | Post-surgical changes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Status post bilateral VDRO procedures.VIEW: Pelvis AP (one view) 1/27/2015 Overlying cast material obscures fine bone detail. Plate and screws devices affix the bilateral osteotomies of the proximal femurs, in unchanged alignment. The femoral heads are well directed into the acetabula. The left acetabulum is dysplastic... | Bilateral VDRO procedures, with femoral heads well directed into acetabula. |
Generate impression based on findings. | 27-year-old male with acute myeloid leukemia for evaluation prior to bone marrow transplant. LUNGS AND PLEURA: The left pleural effusion has resolved. Scattered pulmonary micronodules are again seen (image 24, 37, 63, 66, 73, 85 of series 5), which overall, are not significantly changed from the prior examination. Howe... | 1.Marked interval decrease in size of the dominant left lower lobe pulmonary nodule suggesting an inflammatory or infection etiology, with the remaining scattered pulmonary micronodules unchanged.2.Resolution of the left pleural effusion.3.No focal airspace opacity to suggest active infection. |
Generate impression based on findings. | Male 39 years old Reason: history of ALL s/p allogeneic stem cell transplant, consider epididymitis History: right testicular pain RIGHT TESTIS: The right testis measures 4.3 x 2.5 x 2.9 cm. There is a solid, vascular, 0.7 x 0.5 x 0.8 cm well-circumscribed hypoechoic lesion centrally within the inferior right testis. A... | Right testicular mass. A neoplastic origin should be considered as primary testicular neoplasm or leukemic infiltrate could have this appearance. Infection is felt much less likely. |
Generate impression based on findings. | 55-year-old male with history of urothelial cancer, evaluate and compare to prior CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules without suspicious nodules or masses.MEDIASTINUM AND HILA: No lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions.SPL... | 1.Postsurgical changes without evidence of disease in the abdomen or pelvis. |
Generate impression based on findings. | Female 56 years old; Reason: Hx of Bladder Cancer s/p cystectomy with neobladder. Eval for recurrent or metastatic disease History: See above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Fatty liver. Cholelithiasis.SPLEEN: Unchanged splenic appearance.PANCREAS: No significant abnormality n... | 1.No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 68-year-old female status post lung transplant. PTLD small bowel.RADIOPHARMACEUTICAL: 14.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 115 mg/dL. Today's CT portion grossly demonstrates a large anterior mediastinal mass. Severe volume loss of the native right lung, with likely compensatory overinflation ... | 1.Anterior mediastinal conglomerate lymph node mass with central necrosis demonstrates markedly hypermetabolic activity, compatible with lymphomatous involvement.2.At least 4 foci of hypermetabolic activity associated with bowel loops (small bowel, ascending colon, sigmoid colon) are compatible with stated diagnosis of... |
Generate impression based on findings. | 59-year-old female with right fifth digit nondraining ulcer and diffuse erythema. There is a possible soft tissue defect along the radial aspect of the fifth finger but we see no findings to suggest osteomyelitis. We see no subcutaneous gas. Mild osteoarthritis affects the hand and wrist. Small peri-articular ossicles ... | 1. 5th finger ulcer without evidence of osteomyelitis. 2. Osteoarthritis, as above. |
Generate impression based on findings. | 72-year-old with history of right breast cancer status post mastectomy and reconstruction. No current complaints. Three standard views of the left breast 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 dist... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 9-week-old female with increased bradycardia and desaturationsVIEWS: Chest and abdomen AP (two views) 01/27/15 , 1418 ET tube tip is above the thoracic inlet. Left chest tube is in place. NG tube terminates in the stomach. Nonobstructive bowel gas pattern.Complete opacification of the right hemithorax. Left lower lung ... | Reaccumulation of right pleural effusion is likely. |
Generate impression based on findings. | 30 year-old male with previous facial fractures, evaluate resolution There is a lucency through the right body of the mandible representing a nondisplaced fracture which is similar in orientation to the prior exam. There is a small amount of callus and the fracture line may be slightly less distinct, indicating healing... | 1.Healing right mandibular body fracture.2.Healed left mandibular subcondylar fracture. |
Generate impression based on findings. | Stigmata of agenesis of the corpus callosum are again noted. There is bilateral colpocephaly, with slight increased caliber of the atrium and occipital horn bilaterally since the previous exam. For example, on coronal images, the left atrium measures 2.3 cm in width as compared to previous 1.6-cm. At the same level, t... | 1. Slight interval increase in caliber of measurements of colpocephaly with complement increased in size, although overall ventricular caliber is similar including stable temporal horns. Nondilated fourth ventricle is unchanged, with conspicuous prominence of the cerebral aqueduct.2. Expected resolved benign enlargemen... |
Generate impression based on findings. | Male 51 years old Reason: evaluate for cholecystitis History: Abdominal pain, hx gallstones/biliary colic LIVER: The liver measures 21.9 cm in length. Hyperechoic hepatic parenchyma suggestive of fatty infiltration. The hypoattenuating segment 6 lesion identified on prior CT is not visualized on today's study. Hepatic ... | 1. Cholelithiasis without acute cholecystitis.2. Fatty infiltration of the liver. |
Generate impression based on findings. | Male, 27 years old, history of adenoid cystic carcinoma of the left external auditory canal, parotid and temporal bone, status post CRT. Postoperative findings are redemonstrated including left parotidectomy, resection of the bony and cartilaginous external auditory canal, and resection of the middle ear structures and... | Extensive postoperative and treatment related findings are redemonstrated. Heterogeneously enhancing soft tissue in the left parotidectomy bed appears slightly less bulky but overall very similar in appearance to the prior exam and probably represents the presence of the soft tissue graft.No definite findings are seen ... |
Generate impression based on findings. | Weakness, drooling, tingling of tongue No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Again seen is encephalomalacia involving the right frontal, inferior parietal, and superior temporal lobes con... | 1. No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. Chronic right middle cerebral artery territory infarct. |
Generate impression based on findings. | Pubic ramus fracture.VIEW: Pelvis AP (one view) 01/27/15 Fractures of the right pubic bone and right inferior pubic ramus are again seen. Alignment is anatomic. The fracture lines are less distinct. | Healing fractures of right pubic bone and right inferior pubic ramus. |
Generate impression based on findings. | 43-year-old female, rule out myeloma or compression fracture Thoracic spine: The bones are slightly demineralized, but we see no focal myelomatous lesions. There is mild multilevel degenerative disease without compression fracture.Lumbar spine: Again seen is a compression fracture of the L1 vertebral body appearing sim... | Chronic L1 compression fracture and possible L5 myelomatous lesion appearing similar to the prior exam. |
Generate impression based on findings. | Female 71 years old Reason: 71F admitted with UTI and AMS who has h/o renal cyst and current flank pain. History: flank pain on R, renal cyst RIGHT KIDNEY: Status post right nephrectomy.LEFT KIDNEY: The left kidney measures 13.2 cm. There is a solid exophytic mass measuring 4.5 x 4.4 x 4.6 cm arising from the lower pol... | Solid exophytic mass arising from the left kidney, increased in size compared to a remote study from 2012. Renal protocol CT is recommended for further evaluation.Findings discussed with Dr. Stier by myself Dr. Ward 01/27/15. |
Generate impression based on findings. | Hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Multiple bilobar subcentimeter low attenuation foci; favor benign etiology.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 0.5 cm nonobs... | Nonobstructing 0.5-cm left renal calculus; new since 2005. Multiple bilateral benign-appearing cysts; a few have increased in size since 2005 but maintain benign morphology without evidence for enhancement or complexity. No worrisome mass or acute inflammatory process. |
Generate impression based on findings. | History of tonsillar cancer, status post chemoradiation 12/13. Streak artifact emanating from dental amalgam obscures surrounding structures. Within this limitation, there is no residual or recurrent measurable oropharyngeal tumor. Treatment-related findings are seen including mild infiltration of the fascial planes an... | No measurable residual or recurrent oropharyngeal tumor or significant cervical lymphadenopathy. |
Generate impression based on findings. | Evaluate mandible distraction Again seen is an external fixation device with screws entering the anterior aspect of the mandible as well as the calvarium. Also again seen are osteotomies of the mandibular rami. On the left, the osteotomy margins appear less distinct than on the prior study, suggestive some interval hea... | Orthopedic fixation of mandibular distraction surgery with findings suggestive of some interval healing of the osteotomy on the left. |
Generate impression based on findings. | 35-year-old female with lumbar back pain and radiculopathy There is minimal leftward curvature of the lumbar spine. Moderate disk space narrowing is noted posteriorly at L5/S1. The vertebral body heights are preserved. Linear metallic densities in the pelvis presumably reflect a sterilization procedure. | L5/S1 degenerative disk disease. |
Generate impression based on findings. | 61-year-old female, evaluate for progression of osteoarthritis Right knee: Severe osteoarthritis affects the knee with near bone-on-bone apposition of the medial compartment as well as tricompartmental osteophytes, perhaps progressed slightly from the prior exam. A 2cm loose body noted along the posterior aspect of the... | Osteoarthritis of both knees, progressed compared with the prior exam. |
Generate impression based on findings. | Male 83 years old; Reason: metastatic Prostate cancer, evaluation of disease during treatment with investigational therapy. Please complete PCWG form. Increased activity in the right calvarium is nonspecific and unchanged. There is new focal activity in the right eighth rib at the costochondral junction which is diffic... | 1. New focus of activity in the right eighth rib more likely represents a fracture, and less likely tumor activity. 2. No new suspicious osseous foci to suggest new metastatic disease. |
Generate impression based on findings. | 6-year-old female status post fall/head trauma. A punctate hyperdensity is located in the right frontal lobe, which is favored to represent a small intraparenchymal calcification. There is no associated edema, mass effect, or significant midline shift. The ventricles and basal cisterns are normal in size and configurat... | 1. Punctate hyperdensity in the right frontal lobe, which is favored to represent small intraparenchymal calcification. There is no edema, mass effect, or midline shift.2. Small right frontal subgaleal hematoma, without underlying calvarial fracture. |
Generate impression based on findings. | Male 70 years old Reason: please ultrasound the chest hematoma at site of subclavian balloon pump History: hematoma at site of subclavian, with fever Circadian balloon pump wire is identified in the right anterior chest wall without evidence of fluid collection. | No evidence of fluid collection surrounding the subcutaneous portion of the balloon pump. |
Generate impression based on findings. | Male 62 years old Reason: abdominal pain with early satiety History: abd pain LIVER: The liver measures 17.8 cm in length and is heterogeneously hyperechoic consistent with chronic liver disease. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0 .4 m/sec.GALLBLADDER, BILIAR... | 1. Heterogeneously hyperechoic hepatic parenchyma consistent with chronic liver disease.2. Solid hypoechoic pancreatic mass requires further evaluation with pancreatic protocol CT.Findings discussed by myself Dr. Ward with Dr. Singh 01/27/15 at 3:51 p.m. |
Generate impression based on findings. | Hip pain Two views of the right hip show severe osteoarthritis of the hip. Geographic lucency within the superomedial aspect of the acetabulum presumably represents a large degenerative cyst.The AP view of the pelvis reveals the aforementioned severe right hip osteoarthritis. Moderate osteoarthritis affects the left hi... | Osteoarthritis and other findings as described above. |
Generate impression based on findings. | Colon cancer and chemotherapy, evaluate and compare to prior CHEST:LUNGS AND PLEURA: Right perihilar nodule measures 0.8 x 0.8 cm (series 5, image 37), previously 0.8 x 0.8 cm.Scattered pulmonary micronodules are stable. No pleural effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Minimal coronary artery calcificatio... | Stable exam without significant interval change in reference measurements or new sites of disease. |
Generate impression based on findings. | 29-year-old male with pain to dorsal foot and third toe after injury yesterday Diffuse soft tissue swelling without fracture evident. Alignment is within normal limits. | Soft tissue swelling without fracture. |
Generate impression based on findings. | 11 year old female with Blount's disease status post osteotomy.VIEWS: Left tibia/fibula AP and lateral (two views) 1/27/2015 A new osteotomy is seen through the proximal tibial diaphysis and an external fixation device is in place. Skin staple lines are present in the lower leg. Reticulation of the subcutaneous fat lik... | Postsurgical changes related to osteotomy and external fixation as above. |
Generate impression based on findings. | Reason: 69 y/o M with dysphagia, compare to prior esophagram which noted stricture (on Plavix for recent drug eluting stent so hoping to delay endoscopy) Scout radiograph of the chest showed increased interstitial opacities predominantly lung bases compatible with history of pulmonary fibrosis.Fluoroscopic evaluation o... | 1.Mild to moderate hypomotility of the esophagus with proximal escape. 2.Esophageal stricture. Esophageal diverticulum and mild dilatation proximal to the stricture. 3.Barium pill does not pass the stricture, but liquid contrast passed freely.4.Mild provoked gastroesophageal reflux. 5.Thick linear filling defects at th... |
Generate impression based on findings. | Reason: cognitive impairement/dementia History: cognitive impairement/dementia 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.Perivent... | 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. | 49 year old female status post fall, complaining of right forearm pain Wrist: There is a poorly defined fracture extending across the distal radial metaphysis with early callus formation along the medial aspect of the fracture. Fracture fragments are in near-anatomic alignment. There is no evidence of extension to the ... | Distal radius fracture as described above. Findings text paged to Debra Conti (pager 6193) at the time of dictation after attempts were made to discuss by phone. |
Generate impression based on findings. | 4-year-old male with pain and swelling in the right second and third digits.VIEWS: Right hand PA lateral and oblique (3 views) 1/27/2015 Diffuse mild soft tissue swelling of the index and ring fingers is evident, but no underlying fracture or malalignment is seen. | Mild soft tissue swelling of the second and third digits without fracture. |
Generate impression based on findings. | GIST CHEST:LUNGS AND PLEURA: Stable micronodules. Stable calcified pleural plaques.MEDIASTINUM AND HILA: Triple vessel coronary calcifications again noted.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Previously noted hypervascular focus within segment two of the liver is less conspicuous on... | Previously described enhancing foci within the liver not appreciated on current examination. No evidence for acute, metastatic, or inflammatory process. |
Generate impression based on findings. | The frontal sinus and frontoethmoidal recesses are clear. There is mild mucosal thickening involving the bilateral anterior and posterior ethmoid air cells. There is mild mucosal thickening involving the bilateral maxillary sinuses, particularly along the superior aspect of the left maxillary antrum, with small polyps... | 1. Mild mucosal thickening involving the paranasal sinuses as described above.2. Lobulated areas of opacification adjacent to the anterior aspects of the bilateral middle turbinates, left worse than right, which may be related to polyposis. |
Generate impression based on findings. | Left breast lumpectomy in 2014. History of chemotherapy and radiation. 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. Scar markers overlie the left upper outer breast and right axilla. Post sur... | Left breast post surgical changes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 54 years old; Reason: Stem cell transplant patient with BK viurea. Hx of recurrent e.coli bacteremia. Need CT to rule out stone formation History: dysuria The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were m... | 1.No evidence of renal or ureteric stones.2. Diffuse infiltrative process throughout the retroperitoneum, most prominent in the pelvis. The appearance is predominantly nonspecific bland fluid without loculation. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage. No enhancing mass is identified. There is redemonstration of encephalomalacia/volume loss involving the left frontal lobe middle fontal and precentral gyri, left angular gyrus, precuneus and cuneus, as well as ex vacuo dilatation of the left lateral ventricle, suggestiv... | 1.Redemonstration of findings suggestive of chronic infarctions in portions of the left middle cerebral artery territory and left posterior cerebral artery territories. 2.CT is insensitive for the early detection of non-hemorrhagic acute infarct.3. No evidence for acute intracranial hemorrhage, enhancing mass, or mass ... |
Generate impression based on findings. | 44 years, Male. Reason: Patient with continued abdominal pain, want to evaluate for obstruction/fluid air levels/ perforation History: Abdominal pain Nonobstructive bowel gas pattern. No evidence of free air. | Nonobstructive bowel gas pattern. No evidence of free air. |
Generate impression based on findings. | 14 month old female with increased laxity of the hips.VIEWS: Pelvis AP and frog leg lateral (two views) 1/27/2015 The femoral heads are well directed into the acetabula bilaterally. The acetabular angles are normal. Bilateral coxa valga deformities are noted. There is a large umbilical hernia. | Bilateral coxa valga deformities without evidence of subluxation or dislocation. |
Generate impression based on findings. | 89-year-old male with right lower lobe nodule.RADIOPHARMACEUTICAL: 14.1 5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 81 mg/dL. Today's CT portion grossly demonstrates moderate to severe cardiomegaly, moderate left and small right pleural effusions with compressive atelectasis at the lung bases, mildly a... | 1.Moderately hypermetabolic right lower lobe nodule, highly suspicious for primary lung malignancy.2.Symmetric hilar FDG-avid foci favor benign/granulomatous process, though ipsilateral right hilar metastases cannot be entirely excluded.3.3.8-cm abdominal aortic aneurysm with findings raising question of focal dissecti... |
Generate impression based on findings. | Reason: rule out tonsillar abscess. Current everyday smoker History: pain and tenderness with swallowing CT neck:There is a soft tissue mass in the left oro pharyngeal mucosal space at the expected location of the oropharyngeal adenoids which measures 26 x 22 mm axial dimensions and extends up to the level of the soft ... | 1.There is a left-sided oropharyngeal mass present. One possibility is that this represents a tonsillar abscess with reactive adenopathy. The possibility that this represents a neoplastic process cannot be excluded on this exam though. It is not depicted on a prior brain MRI from 8/28/15. Please correlate with clinical... |
Generate impression based on findings. | 12 year old female with history of rhabdomyosarcoma of the pelvis, now with pelvic pain.VIEWS: Abdomen supine and upright (two views) 1/27/2015 The bowel gas pattern is nonobstructive. A moderate stool burden is distributed throughout the colon, slightly improved from the prior examination. No pneumoperitoneum, portal ... | Nonobstructive bowel gas pattern and improved moderate stool burden. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: Bilateral small mucosal retention cysts are unchanged. The ostiomeatal units are clear although the infundibulum remain narrowed by bilateral Haller cells, partially op... | 1. Stable scattered small mucus retention cysts in the bilateral maxillary and left sphenoid sinuses.2. Previously described cervical lymphadenopathy is not appreciated on this exam. |
Generate impression based on findings. | Reason: s/p MALS 2 weeks ago, no w/ N/V, imaging shows dilated duo, eval for SMA syndrome History: n/v, D1/D2 dilation. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. Small transient hiatal hernia was noted. The esophagus and stomach were otherwise morphologically norm... | 1.Findings consistent with SMA syndrome.2.Normal motility of the esophagus and stomach.3.Possible small transient hiatal hernia. |
Generate impression based on findings. | Male 53 years old Reason: 53M with hx right ureteral injury, now status post ureteral stent removal with right flank pain, assess for hydro History: 53M with hx right ureteral injury, now status post ureteral stent removal with right flank pain, assess for hydro RIGHT KIDNEY: The right kidney measures 11.3 cm. There is... | Minimal left hydronephrosis. No evidence of right hydronephrosis. |
Generate impression based on findings. | 9-year-old female with stool impactionVIEWS: Abdomen AP (one views) 01/27/15, 1453 hour Small amount of desiccated stool is noted within the rectum. Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. | Small stool burden. |
Generate impression based on findings. | There is redemonstration of postoperative changes from bilateral antrostomies.Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is trace mucosal thickening in the right maxillary sinus with a focal polyp or mucos... | No significant interval change in appearance of paranasal sinuses. Postoperative changes as detailed above. |
Generate impression based on findings. | 83-year-old male with history of disseminated prostate cancer. Investigational therapy. CHEST:LUNGS AND PLEURA: Reference right upper lobe nodule with associated scarring (5/41) measures 7 mm, previously 9 mm.Reference right lower lobe nodule adjacent to the fissure (5/45) measures approximately 5 mm, previously 6 mm.R... | Subtle interval decrease in size of the previously described lung lesions and lymph nodes, as above. No new evidence of metastatic disease. |
Generate impression based on findings. | Metastatic renal cell carcinoma CHEST:LUNGS AND PLEURA: Relatively stable pulmonary metastatic nodules. Reference left upper lobe nodule best seen on image 24 series 4 measures 1.1 x 1 cm. Left lower lobe reference nodule best seen on image 43 of series 4 measures 1.1 x 1.2 cm.Interval increase in size of right pleural... | Metastatic disease progression manifest by interval increase in size of bilateral hilar adenopathy, right pleural-based metastatic mass and significant interval increase in extensive bilobar bulky hepatic metastases. Slight interval increase in severity of pelvic lytic bony metastatic lesions. |
Generate impression based on findings. | Male 58 years old with HCV cirrhosis. LIVER: The liver measures 15.9 cm in length. Coarsened hepatic echotexture compatible with history of liver cirrhosis. Stable appearance of an anechoic cyst in the right hepatic lobe which measures 1.8 x 0.8 x 0.6 cm, allowing for differences in imaging technique. The portal vein d... | Cirrhotic liver morphology. Unchanged simple cyst. |
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