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Generate impression based on findings. | Female, 72 years old, chronic sinusitis treated medically with worsening left facial pain and headaches. The frontal sinuses and frontoethmoidal recesses are opacified with progression on the right. The right sided ethmoid air cells are also opacified similar to prior. The right maxillary sinus is completely opacified ... | Multiple areas of sinus and sinus ostia opacification are redemonstrated with some progressive opacification as discussed above. The material filling the sinuses is hyperdense similar to prior which may reflect inspissated secretions or fungal elements.Polypoid soft tissue seems to project from the right ethmoid region... |
Generate impression based on findings. | Asymptomatic woman presents with prior mammogram showing "calcium deposits." 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. Few scattered benign-appearing calcifications are noted. No dominant ... | 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. | Female 58 years old; Reason: h/o marginal cell lymphoma and lupus c/b leukocytoclastc vasculitis on immunosuppressants, restaging lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heart borderline in size. 1.5-cm left-sided hypoattenuating thyroid nodule. Small anterior mediastinal... | 1. No pathologically enlarged adenopathy.2. Left-sided thyroid nodule. |
Generate impression based on findings. | 64 year old female with history of recurrent UTIs, dysuria, left flank pain. Obesity, hypertension. The superior most portion of the hepatic dome is not included on this exam.ABDOMEN:LUNG BASES: Left lower lobe reference pulmonary nodule (4/9) measures 5 mm, unchanged. Mild bibasilar atelectasis, likely this exam was o... | 1.No hydronephrosis or hydroureter.2.Degenerative changes of the lumbar spine with anterior listhesis as above.3.Left lower lobe pulmonary nodule, unchanged. |
Generate impression based on findings. | 17 year-old female with effusion, status post left chest tubeVIEW: Chest AP (one view) 01/27/15 , 1527 hour Interval placement of left-sided chest tube. Residual contrast is noted in the abdomen.Cardiothymic silhouette is normal. Interval decrease in left pleural effusion. No pneumothorax. Retrocardiac opacity and righ... | Moderate pleural effusion with adjacent atelectasis and/or consolidation. |
Generate impression based on findings. | The lateral and third ventricles ventricles as well as the frontal greater than parietal sulci are prominent, which is nonspecific but may relate to areas of mild volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There ... | 1. No acute intracranial abnormality. Mild volume loss suspected.2. Incidental tiny pineal cysts without significant mass-effect. |
Generate impression based on findings. | 49-year-old male with new tongue cancer. Evaluate for regional/distant disease.RADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion grossly demonstrates soft tissue mass at the base of the right tongue, compatible with stated history of new tongue cancer. Scl... | 1.Markedly hypermetabolic right base of the tongue soft tissue mass, compatible with known tongue cancer.2.Right cervical hypermetabolic lymph nodes, suspicious for regional metastases.3.Moderately hypermetabolic sclerotic lesion of the right clavicle, suspicious for additional metastases.4.Soft tissue mass in the righ... |
Generate impression based on findings. | Reason: evaluate for tumor/mass History: hoarseness, pooling of secretions in hypopharynx; possible pyriform sinus cancer LUNGS AND PLEURA: 2.7 x 2.2 cm left upper lobe mass (series 4 image 33) invades the pleura and possibly the chest wall, and is highly suspicious for primary neoplasm.Mild paraseptal apically predomi... | 1. Left upper lobe mass invading the pleura and possibly the chest wall is highly suspicious for primary neoplasm or less likely a metastasis.2. Cystic lesion adjacent to the spleen is suspicious for a pancreatic cystic neoplasm. A dedicated contrast enhanced abdominal CT or MRI is recommended for further evaluation. |
Generate impression based on findings. | 59 years, Female. Reason: 59 yo female with hypothyroidism and persistent abdominal bloating with nausea. Please assess for signs of constipation History: abdominal bloating and fullness Average stool burden. Nonobstructive bowel gas pattern. Surgical clips overly the pelvis. | Average stool burden. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Left shoulder pain. Left elbow pain. Three views of the left shoulder reveal so he angle R. I. some small osteophytes at the inferior glenohumeral joint. There also is some mild osteophyte at the acromioclavicular joint . No fractures or dislocations .Four views of the left elbow are unremarkable. No fractures or dislo... | Mild degenerative changes left shoulder. Negative left elbow exam. |
Generate impression based on findings. | Trauma.VIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), 01/27/15 , 1523 hour The aortic arch, cardiac apex and stomach are left-sided. Cardiothymic silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. Vertebral body heights and disk spaces ar... | Normal chest, cervical spine and pelvis. |
Generate impression based on findings. | Reason: advanced squamous cell lung cancer s/p palliative RT to 2 skin lesions, need to evaluate for extent of disease/new metastases History: ulcerated skin lesions s/p RT CHEST:LUNGS AND PLEURA: Extensive left peribronchovascular soft tissue thickening and groundglass opacity is consistent with lymphangitic tumor. Mu... | 1.Left lung pulmonary nodules and lymphangitic carcinomatosis consistent with the patient's known malignancy. Extensive thoracic lymphadenopathy. 2.Ulcerated cutaneous left supraclavicular metastasis.3. 10 x 9 mm cutaneous nodule in left flank soft tissues is nonspecific and may also represent metastatic disease. |
Generate impression based on findings. | Right shoulder pain Four views of the right shoulder reveal no fractures or dislocations. No significant degenerative changes. | Negative right shoulder examination |
Generate impression based on findings. | Patient in MVA. Upper lumbar midline tenderness. No neurologic complaints. Is there a lumbar fracture? The bones appear slightly demineralized, but I see no acute compression fracture. There are small vertebral body osteophytes and mild endplate cavities that I suspect are chronic; intervertebral disk spaces are within... | Minimal degenerative arthritic changes without acute fracture evident. |
Generate impression based on findings. | 23-year-old male with relapsed AML, cough x 2 weeks LUNGS AND PLEURA: There is minimal bronchial wall thickening with tree in bud nodular opacities in the right upper lobe and additional nodular opacities in the left lower lobe. No focal pulmonary consolidation.MEDIASTINUM AND HILA: Left upper extremity PICC terminates... | Minimal bronchial wall thickening with tree in bud nodular opacities in the right upper lobe and additional nodular opacities in the left lower lobe likely bronchiolitis. Atypical infection may also be considered. |
Generate impression based on findings. | There is further slight decreased prominence of intraconal fat with bilaterally. There is perhaps slight improved left greater than right exophthalmos since the previous exam. Facial subcutaneous fat is similar to perhaps minimally decreased.The extraocular muscles and optic nerves are normal in size and density. No m... | Slight further decreased orbital and stable to minimally decreased subcutaneous fat with slightly improved left greater than right exophthalmos. No evidence of orbital mass. |
Generate impression based on findings. | History of left lumpectomy in 2011 for IDC and DCIS followed by adjuvant radiation therapy. History of ovarian cancer in sister and breast cancer in first 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 het... | 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. | Lower back pain. Secondary coccygeal trauma. The sacrum appears intact. There is minimal dorsal translation of what I suspect is the second coccygeal segment with to the first coccygeal segment. I do not know if this represents a mild subluxation or simply normal anatomy for this patient. I see no discrete fracture. Mi... | Mild dorsal translation of the second coccygeal segment relative to the first coccygeal segment is of uncertain significance, and may either represent subluxation or normal anatomy for this patient. |
Generate impression based on findings. | 12-year-old female with leg pain.VIEWS: Tibia/fibula AP and lateral (two views) 1/27/2015 The acetabula is severely dysplastic. There is absence of the proximal and mid femur, with severe hypoplasia of the femoral metaphysis. No acute fracture or malalignment evident. | Proximal focal femoral deficiency and acetabular dysplasia, without acute fracture or malalignment. |
Generate impression based on findings. | Male, 82 years old, history of right mandibular ameloblastoma status post mandibulectomy with jaw pain. Findings are again seen related to right hemimandibulectomy. The resection margins remain well defined and similar in appearance to the prior examination. The right mandibular condyle is displaced anteriorly relative... | Redemonstration of findings related to the right hemimandibulectomy with no evidence of recurrent primary tumor or pathologic adenopathy. |
Generate impression based on findings. | Fatigue, chest pain CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules. Centrilobular and paraseptal emphysema. No pleural effusions.MEDIASTINUM AND HILA: Moderate coronary artery and thoracic aorta calcifications. The ascending aorta measures 4 cm just superior to the coronary ostia. No evidence of acute hematom... | No acute abnormality in the chest, abdomen, or pelvis on this noncontrast scan. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRAC... | Limited evaluation of the pelvis, without convincing evidence of metastatic disease. |
Generate impression based on findings. | 47-year-old female with history of back pain. Mild to moderate degenerative disc disease affects the mid and lower thoracic spine. We see no evidence of scoliosis. Coronal balance is within normal limits. There is approximately 2 cm of negative sagittal balance. An IUD projects over the lower pelvis. | Degenerative disc disease and slight negative sagittal balance, but no evidence of scoliosis. |
Generate impression based on findings. | Male 81 years old; Reason: evaluate L scrotal edema History: L scrotal edema. No testicular tenderness. RIGHT TESTIS: Heterogeneous right testis without focal lesions appearing similar to the prior exam. There is blood flow within the right testis. Right testicle measures 3.9 x 1.9 x 2.7 cm.LEFT TESTIS: Heterogeneous t... | 1. Testes are heterogeneous bilaterally appearing similar to the prior exam. 2. Left epididymis appears smaller than on the prior study is not significantly hyperemic. |
Generate impression based on findings. | Hoarseness, pooling of secretions in hypopharynx. Right oropharyngeal mass, particularly piriform sinuses. Neck: Absence of contrast limits evaluation for small lesions. There is mild asymmetric fullness involving the right tonsillar fossa without discrete mass. There is effacement of the bilateral piriform sinuses als... | 1. Limited evaluation without contrast. There is effacement of the bilateral piriform sinuses without definite underlying mass. There is also asymmetric thickening involving the right tonsillar fossa/right lateral oropharyngeal wall without definite underlying mass. Correlate with endoscopic findings. Otherwise, no def... |
Generate impression based on findings. | 46 year old male with history of urothelial cancer now with persistent left lower extremity edema. There is diffuse reticulation of the subcutaneous fat of the thigh and leg compatible with edema. This edema becomes confluent in the anterolateral aspect of the lower thigh and then more distally along the anterolateral ... | 1.Extensive edema of the thigh and leg of uncertain etiology.2.Progression of left femoral head/neck sclerosis with development of an elongated lucent lesion. Differential diagnosis includes progression of avascular necrosis versus metastatic disease. Additionally, there is a small focus of sclerosis within the medial ... |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. No visible ... | No evidence of metastatic disease. |
Generate impression based on findings. | C7 spinous process fracture. Evaluate for dynamic instability. There is a fracture through the spinous process of C7 with approximately 5 mm of distraction. Alignment of the remainder of the spine is within normal limits and I see no instability between the flexion, neutral, and extension views. Vertebral body heights ... | C7 spinous process fracture, without evidence of spinal instability. |
Generate impression based on findings. | Total knee arthroplasty Two portable views of the right knee reveal a total knee arthroplasty in anatomic alignment. Note is made of surgical skin staples and surgical drains. | Total knee arthroplasty in anatomic alignment |
Generate impression based on findings. | Pain after fall. Fracture? Moderate to severe osteoarthritis affects the left hip. I see no fracture. | Osteoarthritis without fracture evident. |
Generate impression based on findings. | Frontal sinus: There is trace mucosal thickening in the right frontoethmoidal recess inferiorly. The frontal sinus and left frontoethmoidal recess are clear.Anterior ethmoids: There is trace mucosal thickening in a few anterior ethmoid air cells.Maxillary sinuses: There is mild mucosal thickening in the left greater t... | Very minimal scattered sinus inflammatory changes as detailed above. Nonspecific mastoid air cell fluid opacification bilaterally, for which clinical correlation is recommended. |
Generate impression based on findings. | Reason: Neutropenic stem cell transplant patient with new onset of SOB History: SOB LUNGS AND PLEURA: Bibasilar linear opacities consistent with atelectasis correlating with recent chest radiograph. Small bilateral pleural effusions. Stable right apical scarring. No significant air trapping on expiratory phase images.M... | 1. Bibasilar atelectasis and small pleural effusions without specific evidence of pneumonia.2. Diffuse esophageal thickening is suspicious for esophagitis. High attenuation material in the esophageal lumen is of uncertain clinical significance.3. Mixed sclerotic/lucent lesion in the T10 vertebral body with a moderate c... |
Generate impression based on findings. | 9-week-old female with bradycardia and desats after re-taping tubeVIEW: Chest AP (one view) 01/27/15, 1610 hour ET tube has been advanced with tip just above the carina. Left chest tube is in place. NG tube courses below the field-of-view.Interval aeration of the right lower lung. Persistent right upper lobe and left l... | 1.Interval decrease in right pleural effusion with improved aeration of the right lower lung. 2.Persistent right upper lobe and left lower lobe atelectasis with bilateral patchy opacities. |
Generate impression based on findings. | Inguinal pain status post hernia repair in 2011 PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Soft tissue attenuation of the right inguinal ca... | Postsurgical changes without evidence of inguinal hernia recurrence. |
Generate impression based on findings. | Female 30 years old Reason: pulmonary abnormalities History: h/o pulm nodules, cough now with blood tinged sputum LUNGS AND PLEURA: Right upper lobe airspace opacity likely secondary to infectious etiology. Moderate right pleural effusion with overlying compressive atelectasis. Scarring of the left upper lobe along the... | 1. Right upper lobe airspace opacity likely secondary to right upper lobe pneumonia.2. Large thrombus within the right atrium. Cardiac echo is recommended for better characterization.3. Moderate right pleural effusion. |
Generate impression based on findings. | Fever and 5-week-old.VIEWS: Chest AP/lateral (two views) 1/27/2015 Peribronchial thickening is present and the lungs are hyperexpanded. Streaky bibasilar opacities suggests subsegmental atelectasis. The aortic arch, cardiac apex and stomach left-sided. The cardiothymic silhouette is normal. No pneumothorax or pleural e... | Bronchiolitis/reactive airways disease pattern. |
Generate impression based on findings. | Left knee pain. Osteoarthritis? Four views of the left knee are provided. There is near bone-on-bone apposition of the medial compartment and tricompartmental osteophytes indicating severe osteoarthritis. There is also a mild varus deformity of the knee.Severe osteoarthritis also affects the right knee as seen on the f... | Osteoarthritis. |
Generate impression based on findings. | Positive ANA. Ankle swelling and pain. Evaluate for inflammatory arthritis. Three views of the left ankle are provided. Mild osteoarthritis affects the midfoot articulations and tibiotalar joint. This appears similar to that seen on the lateral view of the foot from 2009. I see no specific radiographic features of infl... | Osteoarthritis as described above without specific radiographic features of inflammatory arthritis. |
Generate impression based on findings. | 60 year-old female with endometrial cancer. Assess for metastatic disease.RADIOPHARMACEUTICAL: 14.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 119 mg/dL. Today's CT portion of the neck demonstrates no gross abnormality.Today's PET examination demonstrates symmetrical parotid gland uptake which may repre... | Moderately hypermetabolic focus posterior to the bladder is suspicious for tumor activity in the vaginal cuff or possibly bowel.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Back and bilateral leg pain. Evaluate stability of spine. Evaluate sagittal balance/abnormality. Two views of the lumbar spine are provided. The bones appear demineralized suggesting osteopenia/osteoporosis. There is moderate to severe multilevel degenerative disk disease, predominantly affecting the lower lumbar level... | Degenerative disk disease, thoracic vertebral body wedging, positive sagittal balance, and other findings as above. |
Generate impression based on findings. | 12-year-old male swallowed 1.5 cm screw 5 hours agoVIEW: Chest AP, Abdomen AP (two view) 01/27/15, 1641 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities.Stool is noted throughout the colon. Nonobstructive gas pattern. A 1.5-cm screw is seen in the midabdomen likely in... | Metallic screw is seen in the midabdomen. |
Generate impression based on findings. | Left shoulder pain I see no fracture or malalignment. I see no specific findings to account for the patient's shoulder pain. | No specific findings to account for the patient's shoulder pain. |
Generate impression based on findings. | CLINICAL DATA: Age: 59 years. Sex : Male. Indication: Reason: No contrast. This study is for liver volumetrics for OR tomorrow. LUNG BASES: Interval increased bilateral moderate, right greater than left, pleural effusions with associated atelectasis; favor postop etiologyLIVER, BILIARY TRACT: Post operative findings of... | 1. Postoperative findings from recent right hepatic lobe isolation and left segment 3 wedge resection, as above.2. Right hepatic lobe volume is 1363 cm³3. Left hepatic lobe volume is 491 cm³ |
Generate impression based on findings. | Female 71 years old; Reason: eval for progression History: metastatic RCC Multiple new abnormal lytic and blastic osseous foci are identified involving the right parietal bone, bilateral humeri, left posterior ninth rib, as well as posterior and lateral aspect of multiple right-sided ribs, bilateral iliac bones, two on... | Multifocal osseous metastatic disease as described above. |
Generate impression based on findings. | Female, 67 years old, with word finding difficulties. Assess for stroke. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is n... | No acute intracranial abnormality. |
Generate impression based on findings. | Left shoulder pain The bones appear demineralized. In particular, there is endosteal scalloping of the proximal humeral diaphysis that may reflect osteoporosis, but I cannot exclude the possibility of a marrow-infiltrating process. I see no fracture or malalignment. | Demineralized bones may simply reflect osteoporosis, although I cannot exclude the possibility of a marrow replacing process such as metastatic disease or multiple myeloma if the patient has a known primary malignancy. |
Generate impression based on findings. | 37 year old with biopsy proven IDC in the left breast, presents for ultrasound guided clip placement for the proven carcinoma, ultrasound guided biopsy with clip placement of a possible satellite lesion in the left breast and an enlarged left axillary lymph node. 1. Index lesion was re-identified at 1 o'clock position,... | Successful ultrasound-guided clip placement of the proven carcinoma, core biopsy with clip placement of the possible satellite lesion in left breast, and core biopsy with clip placement of the enlarged lymph node in the left axilla. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X ... |
Generate impression based on findings. | Pain in left hip and leg. Concern for impending fracture from osseous metastases of left femur. Again seen is widespread mixed sclerosis and lucency within the proximal femur and visualized bones of the pelvis indicating diffuse prostate cancer metastases. I see no fracture on the current study. I see no focal cortical... | Diffuse metastatic disease appearing similar to that seen on the prior study. |
Generate impression based on findings. | 89 year-old female with new onset gait disorder. Normal symmetric activity is seen in the basal ganglia. | Normal examination. No evidence of nigrostriatal dopaminergic dysfunction. Given the history, these findings are suggestive of essential tremor. |
Generate impression based on findings. | Knee pain Four views of the left knee are provided. Small osteophytes indicate mild osteoarthritis.Mild osteoarthritis affects the right knee as seen on the frontal views. | Mild osteoarthritis. |
Generate impression based on findings. | Male 14 years old; Reason: 14 year old male with fibrolamellar hepatocellular carcinoma, requesting Y90 radioembolization History: RUQ painTechnique: 1.7 mci was injected through the left hepatic artery by the interventional radiology team. Anterior and posterior planar imaging of the chest and abdomen, as well as SPEC... | Expected radiotracer distribution in the liver with a liver lung shunt fraction of 4.6%. No abnormal activity is seen outside the liver within the abdominal cavity. |
Generate impression based on findings. | Low back pain The bones appear demineralized, suggesting osteoporosis. There is a compression fracture of L1 with approximately 50% loss of height anteriorly. This was not evident on the chest radiographs from October. There is also loss of height of the T11 and T12 vertebral bodies which appears new when compared with... | Demineralized bones with compression fractures of L1, and to a lesser degree T11 and T12, that are new compared with prior chest radiographs. |
Generate impression based on findings. | Reason: Patient with history of VC cancer, Cough and chest tightness since 12/18/2014. Not improved despite antibiotics History: Cough and chest tightness since 12/18/2014. Not improved despite antibiotics. R/O lung lesions LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Moderate coronary arter... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 14-month-old female with lymphadenopathy and concern for mediastinal mass. CHEST:LUNGS AND PLEURA: Right upper and middle lobe atelectasis is evident as well as trace lingular atelectasis. No pneumothorax or pleural effusion is evident.MEDIASTINUM AND HILA: Prominent subcarinal lymph node measures up to 9 mm in short a... | 1.Axillary, mediastinal and inguinal lymphadenopathy as detailed above.2.Right upper and middle lobe atelectasis.3.No evidence of mediastinal mass as clinically questioned. |
Generate impression based on findings. | Headache. Evaluate for aneurysm. NONCONTRAST CT HEADNo evidence of acute intracranial hemorrhage. No mass effect, midline shift or herniation. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. No intra- or extra-axial fluid collection. The osseous struc... | 1.No evidence of acute intracranial hemorrhage or mass.2.No significant steno-occlusive disease, aneurysm or dissection of the arteries of the brain and neck. |
Generate impression based on findings. | Respiratory distress of the newborn.VIEW: Chest AP (one view) 1/27/15 at 1740 hrs ET tube terminates below thoracic inlet. NG tube tip is at the stomach. Cardiac silhouette size is normal. Persistent diffuse, granular lung haziness with development of right middle lobe opacity, likely atelectasis or pneumonia. | Interval ET and NG tube placement and development of right middle lobe opacity on a background of diffuse, granular lung haziness consistent with surfactant deficiency. |
Generate impression based on findings. | Male 8 months old Reason: assess for atelectasis, lung expansion History: 8 month old s/p ex lap and silo placementVIEW: Chest and abdomen AP (two views) 1/27/15 at 2055 hrs Tracheostomy tube terminates below thoracic inlet. NG tube tip is at the antral pyloric region. Left lower extremity central line terminates in th... | Portable postsurgical changes as described. |
Generate impression based on findings. | Male, 54 years old.RFO multiple surgical teams, BMI over 40 Enteric tube side port is above the diaphragm. Gastric band components are seen. Short segment of catheter tubing connecting the band and reservoir is not well seen, likely due to body habitus, however visualized portions of tubing appear intact. Pelvic drain ... | No unexpected radiopaque foreign body. Mild diffuse ileus. Flank regions excluded from field of view due to patient's habitus.Findings discussed by telephone with Dr. Kim, resident, and Dr. Zagaja, the attending surgeon, on 1/27/2015 5:15 PM. |
Generate impression based on findings. | 14-year-old female with questionable mediastinal mass.VIEW: Chest AP (one view) 1/27/2015, 19:27 Persistent right middle lobe atelectasis, slightly improved from the prior examination. Persistent right upper lobe and left lower lobe atelectasis. The cardiothymic silhouette is normal. | Persistent multifocal atelectasis. |
Generate impression based on findings. | Female 14 years old Reason: assess ET tube History: s/p ET tubeVIEW: Chest AP (one view) 1/28/15 at 305 hours. NG tube and nerve stimulator again noted. ET tube tip is above the carina. Cardiac silhouette size is normal. Persistent right lung base opacity with interval improvement in right upper lobe atelectasis. | Interval improvement in right upper lobe atelectasis after ET tube repositioning. |
Generate impression based on findings. | 88 years, Female. Reason: 88yo F with c diff and abdominal pain/distention. No evidence of free air. Air containing small and large bowel may reflect ileus. Rectal tube is faintly seen. Pleural effusions partially seen. Degenerative disk disease of the spine. Bones appear demineralized. | No evidence of free air. Findings suggestive of ileus. |
Generate impression based on findings. | Left forearm pain.VIEWS: Left elbow and forearm AP and lateral 1/27/15 (4 view/s) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Lung cancer and brain metastasis, altered mental status, rule out bleed/herniation. Compared to 1/25/2015, there is no significant change in multifocal areas of hypoattenuation compatible with vasogenic edema associated with multiple metastatic lesions, particularly involving the bilateral frontal and left parietal lob... | 1. No evidence of acute intracranial hemorrhage. No significant change in multifocal areas of hypoattenuation compatible with vasogenic edema associated with multiple metastatic lesions. Subtle areas of hyperdensity are again seen associated with the left frontal opercular lesion compatible with blood products within t... |
Generate impression based on findings. | Please note lack of IV contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: New small right pleural effusion with associated atelectasis. Heart size within normal limits. Moderate coronary artery calcifications. Bilateral calcified hilar lymph nodes.LIVER, BILIARY TRACT: Innumerable hypoattenuating ... | 1.No small bowel obstruction or free air.2.Innumerable hepatic metastases, incompletely evaluated on this noncontrast exam.3.Transverse colon mass, and other reference lesions as above.4.Moderate ascites, and new small right pleural effusion. |
Generate impression based on findings. | Pain status post fall. Rule out fracture. I see no fracture or malalignment. I see no specific findings to account for the patient's pain. | No fracture or other specific findings to account for the patient's pain are evident. |
Generate impression based on findings. | 66 years, Male. Reason: 66 male with bladder cancer, s/p endoscopy. Now with abdominal pain, evaluate for free air/perforation, please perform upright view History: Abdominal pain No evidence of free air. Nonobstructive bowel gas pattern. Bilateral nephroureteral tubes are partially visualized. IVC filter overlies L2 v... | No evidence of free air. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Reason: eval for endovascular leak. h/o hemi arch repair, aortic valve replacement, ascending aneurysm repair 9/2014 History: chest pressure left sided radiates to back. VASCULATURE: Redemonstration of a type A aortic dissection flap, with the true lumen giving rise to the great vessels. Variant anatomy of the aortic a... | 1. Type A aortic dissection and aortic valve/arch repair without acute interval change since the prior study. Narrowing of the origin of the right main coronary artery is of uncertain current clinical significance, and correlation with clinical and cardiac catheterization history is recommended. 2. Other findings as de... |
Generate impression based on findings. | 14-month-old female with failure to thrive, diffuse lymphadenopathy and question of mediastinal mass.VIEWS: Chest AP/lateral (two views) 1/27/2015, 17:05 Right middle and upper lobe opacities suggest atelectasis. Streaky left lower lobe opacities suggests subsegmental atelectasis. No pneumothorax or pleural effusion is... | Multifocal atelectasis as detailed above. |
Generate impression based on findings. | BRAIN: No restricted diffusion to indicate an acute infarct. No susceptibility weighted abnormalities to indicate hemorrhage. No focal mass effect, midline shift or herniation. Scattered periventricular and subcortical T2/FLAIR hyperintensities are nonspecific but compatible with chronic small vessel ischemic changes.... | 1.No acute brain abnormalities. Scattered chronic small vessel ischemic changes.2.Limited cervical spine evaluation secondary to motion. Degenerative changes of the cervical spine, especially at C4-5 and C5-6, where there is moderate-severe spinal canal stenosis at C5-C6. Moderate-severe to severe foraminal narrowing a... |
Generate impression based on findings. | 53 years, Male. Reason: to verify NGT tip location after adjustment History: NGT in place Motion artifacts limits evaluation.Large loculated right pleural effusion and left chest tubes are again seen. Please see recent chest CT report for additional findings.Enteric tube tip overlies the gastric fundus. No significant ... | Enteric tube tip overlies the gastric fundus. No significant change from prior study. |
Generate impression based on findings. | 17 year-old female with effusion status post left chest tube placementVIEW: Chest AP (one view) 01/28/15, 0557 hour Left chest tube is in place.Cardiothymic silhouette is unchanged. Low lung volumes. Persistent left pleural effusion with adjacent atelectasis. New patchy opacity in the right lower lung. | Persistent left pleural effusion with bibasilar pulmonary opacities. |
Generate impression based on findings. | Reason: 55 male with mediastinal lymphoma. Needs port-a-cath placement, please assess current status of vasculature to determine potential need for stenting first History: SVC syndrome LUNGS AND PLEURA: Right upper lobe pulmonary nodules and patchy ground glass opacity, decreased compared to prior PET/CT. For reference... | 1.Large conglomerate mediastinal and right pericardial lymphadenopathy compatible with patient's history of lymphoma. Lymphadenopathy encases and attenuates the SVC.2.Interval decrease in right upper lobe nodularity in ground glass opacity, more likely infectious/inflammatory in etiology.3.Decreasing right small pleura... |
Generate impression based on findings. | 71 year-old female with bone spur on the fifth phalanx These non weight bearing views demonstrate no significant osseous abnormality. No fracture is evident. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 4-year-old male with Darvet's syndrome.VIEW: Chest AP (one view) 1/28/2015, 03:21 The endotracheal tube tip terminates just above the carina. The right upper extremity PICC tip terminates at the cavoatrial junction. Gastrostomy tube in place.Resolved left upper lobe atelectasis, with persistent but improved left lower ... | Improved atelectasis and persistent small bilateral pleural effusions. |
Generate impression based on findings. | Male, 73 years old. RFO trigger: Organ transplant surgery. Attending: Dr. Becker No unexpected radiopaque foreign body seen. Diffuse mild bowel loop dilatation likely represents postoperative ileus. Multiple surgical clips and staples as well as a right nephroureteral stent are identified. | 1.No unexpected radiopaque foreign body. 2.Postoperative ileus pattern. Findings were discussed with the attending surgeon Dr. Becker via telephone on 1/27/2015 at 22:26 by the radiology resident on call. |
Generate impression based on findings. | 7-year-old female status-post bowel cleanoutVIEW: Abdomen AP (one view) 01/28/15, 0608 hour Cecostomy tube is present. Surgical sutures are noted within the left lower quadrant.Small amount of amorphous stool is seen within the rectum and left lower quadrant. Gas distended loops of colon nonobstructive bowel gas patter... | Small stool burden. |
Generate impression based on findings. | History of status post fall/syncope. HEAD: There is subdural hematoma along the falx, measuring up to 9 mm, and extending around the left cerebral convexity, measuring up to 5 mm. There are foci of intraparenchymal and subarachnoid hemorrhage in the bilateral frontal lobes, left greater than right. A trace amount of bl... | 1. There is subdural hematoma along the falx, extending around the left cerebral convexity, measuring up to 9 mm, with resultant mild effacement of the left lateral ventricle and 1-cm rightward shift of the midline.2. Multiple foci of intraparenchymal and subarachnoid hemorrhage in the bilateral frontal lobes, left gre... |
Generate impression based on findings. | 4-year-old male with Darvet's syndromeVIEW: Chest AP (one view) 1/27/2015, 19:27 Interval placement of an endotracheal tube with the tip terminating just below thoracic inlet. The right upper extremity PICC tip terminates at the cavoatrial junction. Gastrostomy tube in place.Increased left upper lobe atelectasis, with ... | Increased left-sided atelectasis. Endotracheal tube tip just below the thoracic inlet. |
Generate impression based on findings. | 58-year-old man with right wrist injury following punch. Evaluate for dislocation or fracture. There is mild deformity of the proximal diaphysis of the fourth metacarpal associated with an obliquely oriented poorly defined linear lucency. This is most compatible with a healing or healed fracture rather than an acute fr... | Findings suggestive of old trauma to the fourth and fifth metacarpals and possibly the hamate bone. I see no definite acute fracture. If there is strong clinical concern for acute fracture, CT may be considered. |
Generate impression based on findings. | Male 79 years old Reason: assess for PE History: RV dilation on CT, shock PULMONARY ARTERIES: Technically excellent quality infusion of the pulmonary vasculature. No evidence of acute pulmonary embolism. Pulmonary artery is enlarged measuring up to 33 mm suggestive of pulmonary hypertension.LUNGS AND PLEURA: Moderate c... | 1. No acute pulmonary embolism.2. New trace ascites, with gallbladder neck thickening and enlargement. Mild enlargement of the left adrenal nodule, which does meet CT create criteria for adenoma, and could represent an atypical adenoma or malignancy. Recommend dedicated abdominal CT imaging when clinically feasible. 3.... |
Generate impression based on findings. | 4-year-old male with Darvet's syndromeVIEW: Chest AP (one view) 1/27/2015, 18:23 The right upper extremity PICC tip terminates at the cavoatrial junction. Gastrostomy tube in place.Persistent left lower lobe atelectasis. No pneumothorax. The cardiothymic silhouette is normal. | Persistent left lower lobe atelectasis. |
Generate impression based on findings. | 19 year-old female with chest tubeVIEW: Chest AP (one view) 01/28/15, 0747 hour Right chest tube and bilateral surgical sutures and staples are again seen. The anterior fifth and sixth ribs have been resected. Tubular, subcentimeter, density likely representing a retained cuff from a prior central line overlies the lef... | Persistent right pneumothorax. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. No mass effect, midline shift or herniation. Scattered periventricular and subcortical white matter hypoattenuation is nonspecific but compatible with small vessel ischemic changes. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or s... | 1.No evidence of acute intracranial hemorrhage or mass.2.Scattered periventricular and subcortical white matter hypoattenuation is nonspecific but compatible with small vessel ischemic changes of indeterminate age. |
Generate impression based on findings. | 48 years, Male. Reason: GJ tube placement check. Gastrojejunostomy tube tip in the proximal jejunum at the ligament of Treitz. Nonobstructive bowel gas pattern. Scattered surgical clips and staples. | GJ tube tip in proximal jejunum at ligament of Treitz. |
Generate impression based on findings. | 16 month old female with headaches, question of shunt malfunction.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 1/27/2015 Right parieto-occipital ventriculostomy catheter with tip extending past midline. The strata valve is set at a performance level of ... | No evidence of extracranial shunt malfunction. |
Generate impression based on findings. | Deep neck infection/abscess/fistula. There are postoperative findings related to deep neck incision and drainage and tonsillectomy with persistent foci of air and fluid centered in the left parapharyngeal space. There is now a fistulous track that extends from the overlying skin to the left lateral wall of the orophary... | Postoperative findings related to deep neck incision and drainage and tonsillectomy with interval development of an orocutaneous fistula that traverses the residual abscess centered in the left parapharyngeal space, but decrease in surrounding inflammatory changes. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. No mass effect, midline shift or herniation. The ventricles and sulci are normal in size. Normal gray-white differentiation. There are no extraaxial fluid collections. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | No evidence of acute intracranial hemorrhage or mass. |
Generate impression based on findings. | Known bilateral breast masses and cysts. Patient had left breast core biopsy at Rush Hospital. No current 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, unchanged in pattern and distribution. Mult... | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 11 year old female status post endotracheal tube placement with congenital CMV.VIEW: Chest AP (one view) 1/28/2015, 00:38 Interval placement of an endotracheal tube with the tip below the thoracic inlet and above the carina. Left upper extremity PICC tip is in left subclavian vein.Right lower lobe atelectasis persists.... | Persistent right lower lobe atelectasis and new left lower lobe atelectasis. |
Generate impression based on findings. | 20 year-old male with pain, injury Oblique fractures of the bases of the third and fourth metacarpals without significant displacement. An additional intra-articular fracture extends through the radial styloid without significant displacement. The carpus and proximal forearm are intact. | Metacarpal and radial fractures as described above. |
Generate impression based on findings. | Male 24 years old Reason: follow up infected RP hematoma History: RP hematoma s/p IR drain ABDOMEN:LUNG BASES: Left sided pleural effusion with associated compressive atelectasis unchanged. Right basilar atelectasis also unchanged. Central venous catheter tips terminate in the inferior vena cava. IR notified; catheter ... | 1.Slight interval decrease in left retroperitoneal hematoma with interval insertion of a pigtail drainage catheter.2.Chronic ileus.3.Left pleural effusion and compressive atelectasis unchanged.4.Central venous catheter terminates in the IVC or a hepatic vein. IR was notified of this finding at the time of dictation and... |
Generate impression based on findings. | 64 years, Female. Reason: evaluate for obstruction, evaluate stool burden History: no defecation >1 week. Large stool burden. Nonobstructive bowel gas pattern. Left basilar subsegmental atelectasis. Spinal degenerative changes and right upper quadrant surgical clips. | Large stool burden. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Evaluation is slightly limited as the counting sequence was not performed.There is redemonstration of a thin T1 and T2/STIR hyperintense dorsal epidural collection. It again extends from T2 to T10 and measures 3-4 mm in greatest thickness. There is persistent thin irregular T2 hypointensity along the superficial aspec... | 1. Stable thin subacute dorsal epidural hematoma extending along the majority of the thoracic spine without significant mass effect on the thecal sac. No cord compression or cord signal abnormality.2. Small layering subarachnoid hemorrhage is suspected to be present in the upper thoracic spine, possibly related to redi... |
Generate impression based on findings. | 58-year-old man with right hand injury. Evaluate for fracture. Again seen is mild deformity of the fourth and fifth metacarpals likely representing old healed fractures. I see no definite acute fracture. Mild osteoarthritis affects the first and fifth metacarpophalangeal joints. Mild osteoarthritis also affects the dis... | Findings suggestive of old trauma to the fourth and fifth metacarpals. I see no definite acute fracture. |
Generate impression based on findings. | 11-year-old female with hypoxia, assess lung fields.VIEW: Chest AP (one view) 1/27/2015, 21:15 Left upper extremity PICC tip is in left subclavian vein.Persistent right lower lobe atelectasis unchanged. No new focal air space opacities are seen. The cardiothymic silhouette is unchanged. There is persistent levoscoliosi... | Persistent right lower lobe atelectasis. |
Generate impression based on findings. | 56-year-old male with point tenderness of the upper lumbar spine Moderate to severe degenerative disk disease and moderate facet joint osteoarthritis affect L5/S1. No compression fracture is evident. | Degenerative disk disease and facet joint osteoarthritis without compression fracture. |
Generate impression based on findings. | Evaluate for bleed, intracranial mass, acute intracranial abnormalities. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with stable chronic small vessel... | No evidence of intracranial hemorrhage, mass, or cerebral edema. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, MRI of the brain is recommended. |
Generate impression based on findings. | Reason: Stem cell transplant patient with recent xray concerning for questionable opacity in retrocardiac area of LLL History: none LUNGS AND PLEURA: Small foci of scattered bronchovascular nodularity and bronchiectasis involving the right apex and bilateral lower lobes. Bibasilar dependent atelectasis. Small bilateral... | 1.Scattered foci of bronchiectasis, peribronchovascular nodularity and ground glass opacity suspicious for atypical infection, such as viral or mycobacterial infection.2.Mildly enlarged mediastinal lymph nodes, likely reactive in etiology.3.Splenomegaly. |
Generate impression based on findings. | 17-year-old male with left thumb injury.VIEWS: Left hand AP lateral and oblique (3 views) 1/27/2015 No acute fracture or malalignment. No significant soft tissue swelling evident. | Normal examination. |
Generate impression based on findings. | 14 year old female with pain and inability to flex knee.VIEWS: Right knee AP lateral and oblique (3 views) 1/28/2015 No acute fracture or malalignment. A small/moderate joint effusion is present. | Small/moderate joint effusion without underlying fracture or malalignment seen. |
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