instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings.
|
Evaluate for penile implant. The bones are demineralized suggesting osteopenia. Hardware components of bilateral total hip arthroplasties are situated in near anatomic alignment without radiographic evidence of hardware complication. Components of a penile implant project over the scrotum and base of penis. Severe degenerative disease affects the visualized lower lumbar spine. There is a deformity of the right pubic bone, likely related to old trauma. There is subtle cortical irregularity of the right acetabulum. Surgical clips project over the lower abdomen.
|
Components of a penile implant project over the scrotum and base of penis. Compatibility with MRI should be correlated with implant model number.1.Cortical irregularity along the right acetabulum for which dedicated right hip radiographs are recommended.2.Other findings as above.
|
Generate impression based on findings.
|
Female 48 years old Reason: eval for pathology History: abd pain, fever ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is free intra-abdominal air in the pelvis and also around the liver. The wall of the sigmoid colon is thickened. Adjacent to the sigmoid anastomosis, there is an ill-defined air containing collection measuring 4.3 x 3.7 cm on image number 90, series number 3. In addition there are substantial inflammatory changes in that location. Small bowel loops in the pelvis cannot be separated from these inflammatory changes in the sigmoid colon. Given the history of patient's known colon neoplasm and sigmoid dilatations, these findings are suggestive of a sigmoid perforation. A fistulous communication with the small bowel loops cannot be excluded with this CT.Nonspecific mesenteric borderline enlarged lymph nodes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
CT findings compatible with sigmoid colon perforation and abscess formation. Fistulous communication between the inflammatory changes/sigmoid and small bowel loops in the pelvis cannot be excluded. Evaluation of the sigmoid colon is suboptimal. Residual/recurrent neoplasm of the sigmoid colon cannot be entirely excluded.Dr. Howes was notified and acknowledged about the above findings at the time of dictation.
|
Generate impression based on findings.
|
19 year-old female status post thorascopic resection of chest mass, now status-post chest tube removalVIEW: Chest AP (one view) 01/29/15, 0440 hour Interval removal of right chest tube. Persistent right apical pneumothorax is unchanged. Bilateral surgical sutures, right perihilar staples, and left retained central line cuff unchanged.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Mild subsegmental bibasilar atelectasis.
|
Persistent right apical pneumothorax status post removal of right chest tube.
|
Generate impression based on findings.
|
Female 0 days old Reason: 26 wk newborn, intubated, eval line and ett placement History: INITIAL XR - increasing respiratory distress; increasing O2 requirement, eval line placementVIEW: Chest and abdomen AP (two view) 1/29/2015, 04:10 The endotracheal tube tip terminates in the right mainstem bronchus. UVC tip is in the ductus venosus or hepatic vein. The UAC tip terminates at T8.There is complete opacification of the left hemithorax consistent with atelectasis likely resulting from the right mainstem bronchus intubation. The cardiac apex, aortic arch and stomach are left-sided. The cardiothymic silhouette is not well seen secondary to adjacent pulmonary opacification.The bowel gas pattern is nonobstructive. No pneumatosis intestinalis, portal venous gas or pneumoperitoneum is evident.
|
Right mainstem bronchus intubation, with near complete atelectasis of left lung.
|
Generate impression based on findings.
|
79 years, Male. Reason: Dobbhoff adjustment. Lower pelvis excluded from field of view. Dobbhoff tube tip in gastric fundus. Nonobstructive bowel gas pattern. Degenerative disease in the lumbosacral spine and mild scoliosis noted.
|
Dobbhoff tip in gastric fundus.
|
Generate impression based on findings.
|
42 year old presents for annual mammogram. 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 composed of scattered fibroglandular elements, unchanged in pattern and distribution. There is a small circumscribed mass in the left breast at upper inner quadrant. No suspicious microcalcifications or areas of architectural distortion are noted at the area of palpable concern or elsewhere in either breast. Focused ultrasound was performed for the left breast. Detected is a simple cyst, measuring 6 x 3 x 6 mm, at 10 o'clock position, 4 cm from nipple, in the left breast, corresponding to the mammographic findings.
|
No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
|
Generate impression based on findings.
|
67-year-old male with history of back pain. Evaluate for rib fracture. Right chest port with tip at cavoatrial junction. There is a side plate with screws entering the vertebral bodies of T11 and L2 with partial vertebral body resection and cage placement. Cholecystectomy clips and other surgical clips are present in the abdomen. Suture anchors are present in the right humeral head. The lateral aspect of the left 10th rib is not visualized likely due to surgical resection. There is no evidence of displaced rib fracture. There is persistent kyphoscoliosis of the thoracic spine.
|
No evidence of displaced rib fracture. Other findings as above.
|
Generate impression based on findings.
|
History of lung cancer, sepsis, chest radiograph concerning for post obstructive pneumonia LUNGS AND PLEURA: Right upper lobe mass measures 57 x 48 cm (series 3, image 34) previously measuring approximately 45 x 39 cm. Surrounding airspace abnormality has increased from the prior CT. Increasing small right pleural effusion. The left lung is unremarkable. There is a calcified granuloma at the left base.MEDIASTINUM AND HILA: Hilar / mediastinal lymphadenopathy, some of which is calcified, appears similar to the prior CT within the limitations of non-contrast technique. Moderate coronary artery calcifications. No pericardial effusion.CHEST WALL: Bilateral axillary lymph nodes are similar to prior. Lower thoracic vertebral body hemangioma.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
|
1.Increasing right upper lobe mass with increasing surrounding airspace opacity suggestive of infection, endobronchial spill of necrotic material, or less likely, hemorrhage.2.Increasing small right pleural effusion.
|
Generate impression based on findings.
|
4-year-old male intubatedVIEW: Chest AP (one view) 01/29/15 ET tube tip is in the right mainstem bronchus. Right upper extremity PICC tip is in the left atrium. G-tube is in place. There is mild leftward curvature of the thoracolumbar spine.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Left lower lung opacity may represent atelectasis.
|
1.ET tube tip is in the right mainstem bronchus, recommend retraction.2.Lower lung opacity may represent atelectasis.
|
Generate impression based on findings.
|
Seven hour old female with apnea and bradycardia.VIEW: Chest and abdomen AP (two view) 1/29/2015, 04:28 Streaky perihilar opacities suggest retained fetal fluid. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax identified.Disorganized non-obstructive bowel gas pattern without evidence of pneumatosis intestinalis, portal venous gas or pneumoperitoneum.
|
Streaky perihilar opacities suggest retained fetal fluid.
|
Generate impression based on findings.
|
38 years, Male. Reason: s/p NGT placement History: NA Enteric tube the side port is above the diaphragm. Recommend advancement of the tube. Redemonstration of gas-filled distended loops of bowel seen in the left abdomen compatible with small bowel obstruction. Pelvis is excluded from the field of view.
|
Enteric tube the side port is above the diaphragm. Recommend advancement of the tube. Findings discussed with Dr. Abdulameer (p7816) by phone on 1/29/2015 8:45AM.
|
Generate impression based on findings.
|
18 year old female with ARDS.VIEW: Chest AP (one view) 01/29/15 ET tube tip is below thoracic inlet and above the carina. Right upper extremity PICC tip is at the superior cavoatrial junction. Left central venous catheter tip is at the superior cavoatrial junction. Enteric tube tip courses below the field-of-view and is at least in the gastric antrum.Cardiac silhouette is top normal. No pleural effusion or pneumothorax. Mildly improved bilateral airspace opacities.
|
Mild improvement of bilateral air space opacities.
|
Generate impression based on findings.
|
58-year-old male with history of anterior shoulder dislocation. The previously seen anterior shoulder dislocation has been reduced. The humeral head now articulates with the glenoid in anatomic alignment. There is a Hill-Sachs deformity. There is also a minimally displaced fracture of the inferior glenoid compatible with a Bankart lesion.
|
Successful reduction of anterior shoulder dislocation in anatomic alignment with resultant Hill-Sachs deformity and Bankart lesion. If patient care warrants further imaging, an MRI should be obtained.
|
Generate impression based on findings.
|
58-year-old male with history of immobility after fall. Right shoulder: There is anterior subluxation of the humeral head with respect to the glenoid. There is depression of the posterolateral humeral head compatible with Hill-Sachs deformity.Right wrist: Limited study due to suboptimal evaluation of the scaphoid and radial styloid. There is no evidence of acute fracture or dislocation. Mild soft tissue swelling about the wrist.
|
1.Anterior shoulder dislocation.2.Limited study of the wrist due to suboptimal evaluation of the scaphoid and radial styloid. Given this limitation, there is no acute fracture evident, however dedicated scaphoid radiographs are recommended.
|
Generate impression based on findings.
|
Abused sibling.EXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (24 views) 1/29/2015 No fracture or malalignment identified.Aortic arch, cardiac apex and stomach left-sided. No focal air space opacity. Normal cardiothymic silhouette.Non-obstructive bowel gas pattern.
|
Normal examination. No fracture or malalignment seen.
|
Generate impression based on findings.
|
Headache, ventricular shunt evaluation. No evidence of acute ischemic or hemorrhagic lesion.Ventricular shunt tube inserted through the left frontal lobe and the tip of the ventricular shunt is located on the left lateral ventricle around foramen of Monroe.Comparing to prior scan, the left lateral ventricle size appears to be smaller than prior exam, however, the right lateral ventricle size does not show any significant interval change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The paranasal sinuses and mastoid air cells are clear. Bilateral orbit show bilateral prosthetic globes.
|
1. No evidence of acute ischemic or hemorrhagic lesion.2. Left frontal approached ventriculostomy tube.3. Smaller right lateral ventricle but no change of left lateral ventricular size.
|
Generate impression based on findings.
|
Male 57 years old; Reason: 57 yo M with hx etoh cirrhosis s/p OLT x 2 c/b intraabdominal abscesses s/p IR drain, eval for improvement in fluid collection size, also needs routine HCC screening, perform CT liver protocol History: s/p OLT, intraabdominal abscesses ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Postoperative findings of orthotopic liver transplant. A pigtail drainage catheter is coiled dorsal to the left hepatic lobe with interval decrease in previously described loculated fluid collection which currently measures 6.3 x 1.2 cm along the contour of the posterior right hepatic lobe (series 12, image 22). No suspicious foci of hepatic arterial enhancement or washout.Hepatic artery conduit from the abdominal aorta with a significant stenosis identified, proximal to the porta hepatis on series 10, image 36 in the region of a surgical clip. There is geographic hyper enhancement of the left hepatic lobe on arterial phase imaging with early filling of the left portal vein. This is consistent with an arterioportal fistula with a possible connection identified on series 10, image 31.There is marked narrowing of the suprahepatic IVC (series 12 image 19), at the anastomosis suggestive of a stenosis.SPLEEN: Wedge-shaped hypoattenuating lesion within the spleen is unchanged and likely represents infarct. There is splenomegaly measuring 15.2 cm.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: G. J. tube in situ. Mildly dilated small loops centrally with mild mural thickening, likely secondary to portal hypertension.BONES, SOFT TISSUES: Interval removal of the left upper quadrant percutaneous drainage catheter.OTHER: Small fluid collection adjacent to the greater curvature of the stomach measuring 2.7 x 1.6 cm (series 12 , image 36), possibly post surgical seroma although superimposed infection is not excluded.
|
1.Persistent small loculated intrahepatic fluid collection, decreased in size compared to prior study.2.There is a significant stenosis of the hepatic artery conduit, proximal to the porta hepatis. 3.There is an arterioportal fistula in the left hepatic lobe as detailed above.4.There is stenosis of the suprahepatic IVC, at the anastomosis. 5.Additional postsurgical changes related to orthotopic liver transplant. Findings discussed by myself Dr. Ward with Dr. Newton 01/29/15 11:10 a.m.
|
Generate impression based on findings.
|
11 year old female intubatedVIEW: Chest AP (one view) 01/29/15 ET tube tip is at the carina. Left upper extremity terminates in the left subclavian vein.Bilateral lower lobe atelectasis is unchanged. Cardiothymic silhouette cannot be evaluated. Persistent severe levoscoliosis of the thoracolumbar spine.
|
Bibasilar atelectasis unchanged.
|
Generate impression based on findings.
|
Images are slightly limited by patient motion. There is redemonstration of postoperative changes related to multilevel midthoracic laminectomy. There is a similar appearance of long-segment T2/STIR hyperintensity and expansion of the spinal cord extending caudally from T3-T4, with focal areas of cavitation and scattered or deformity which likely relate to adhesions, as there is slightly differential T2 signal within the intradural extramedullary space at these levels. The area of abnormal signal measures up to 7 x 8 mm in greatest axial dimensions at 902/25 at the upper T8 level, unchanged.The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The conus terminates at approximate L1-L2 level.There is stable minimal scattered spondylotic changes, without significant spinal canal or foraminal stenosis.
|
Stable appearance and extent of near diffuse thoracic cord signal abnormality with probable adhesions and associated contour deformity.
|
Generate impression based on findings.
|
47-year-old male with history of IVC filter clot. Also bilateral lower extremity DVTs. Evaluate clot burden. Please note lack of oral contrast limits evaluation of the GI tract. Also, there is relatively poor opacification of the venous vasculature.ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large right renal cyst, measuring approximately 6.4 cm, is unchanged. Subtle left renal collecting system dilation, may be related to the patient's left retroperitoneal hematoma.RETROPERITONEUM, LYMPH NODES: Left paraspinal retroperitoneal hematoma is again seen (3/108) measuring approximately 8.3 x 5.2 cm, previously 7.9 x 4.1 cm. IVC filter is noted, with relative distention of the infra-filter cava/iliac veins and subtle flattening of the cava superior to the filter. There is the suggestion of lobulated clot in the IVC filter, although evaluation is limited due to lack of adequate contrast opacification.BOWEL, MESENTERY: Interval improvement/near complete resolution of previously seen ileus.BONES, SOFT TISSUES: L1 through L5 posterior rod and screw device affix the lumbar spine.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is collapsed, with Foley catheter in place.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Bilateral lower extremity edema.
|
1.There is the suggestion of lobulated IVC clot at and inferior to the level of the IVC filter, however evaluation of the inferior vena cava is limited.2.Slight interval increase in size in the left retroperitoneal hematoma.3.Interval decreased ileus.
|
Generate impression based on findings.
|
Female 65 years old Reason: eval for evidence of ischemia History: abdominal pain ABDOMEN:LUNG BASES: Bilateral dependent atelectasis. Mild cardiomegaly.LIVER, BILIARY TRACT: Cirrhotic liver. No focal lesions in the liver suspicious for hepatocellular carcinoma. Cholelithiasis. Extensive portosystemic collaterals in the anterior abdominal wall and patent para-umbilical vein consistent with portal hypertension. Nonocclusive thrombus in the main portal vein.SPLEEN: Splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Significant wall thickening involving the cecum and proximal ascending colon suggestive of colitis. Etiology is unknown. Differential diagnosis includes infection, inflammation or ischemia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Cirrhosis and portal hypertension. Nonocclusive thrombus in the main portal vein. Cholelithiasis.Wall thickening involving the cecum and ascending colon, compatible with colitis of unknown etiology. Ischemia cannot be excluded.
|
Generate impression based on findings.
|
Reason: 42F with ARDS \T\ Hx of L MCA stroke at OSH History: R sided paralysis, cognitive impairment The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense region involving gray and white matter located along the left parietal lobe. There is associated gyral pattern of hyperintensity extending along the periphery of this hypodense area. There is effacement of sulci adjacent to this area of hypodensity inThe visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
|
1.Left parietal lobe lesion in a vascular distribution (territory of the left posterior parietal artery of the middle cerebral artery) is suggestive of subacute infarction associated with some minor bleeding. There is some associated mass effect.
|
Generate impression based on findings.
|
14-year-old female intubatedVIEW: Chest AP (one view) 01/29/15 ET tube tip is below thoracic inlet and above the carina. Enteric tube course below the field-of-view. Left vagal stimulator overlies the chest with leads in the left neck.Cardiothymic silhouette is normal. Layering right pleural effusion. No pneumothorax. Right retrocardiac and upper lobe opacities likely represent atelectasis.
|
Layering right pleural effusion with adjacent atelectasis.
|
Generate impression based on findings.
|
ETT repositioning. Respiratory distress.VIEW: Chest AP (one view) 1/29/2015, 08:09 The endotracheal tube tip terminates below thoracic inlet and above the carina. UVC catheter tip is in the ductus venosus or hepatic vein. The UAC catheter tip terminates at T6-7.Interval reexpansion of the left lung, with bibasilar residual streaky subsegmental atelectasis. No pleural effusion or pneumothorax is seen. The cardiothymic silhouette is normal.
|
Expansion of left lung with residual streaky subsegmental atelectasis in both bases.
|
Generate impression based on findings.
|
7-year-old female with elevated CVP, hypoxemia, ARDS appearance on previous studyVIEW: Chest AP (one view) 01/29/15 ET tube is at the thoracic inlet. NG tube side-port is in the proximal gastric body with tip below the field-of-view. Vagal stimulator device overlies the left chest with leads in the left neck. Mild rightward curvature of the thoracolumbar spine.Cardiothymic silhouette is normal. Slightly worsened bilateral layering pleural effusions. No pneumothorax. Bibasilar atelectasis.
|
Slightly worsened bilateral layering pleural effusions with adjacent atelectasis.
|
Generate impression based on findings.
|
38 years, Male. Reason: eval for free air History: diffuse abdominal pain Multiple dilated small bowel loops with differential air fluid level compatible with small bowel obstruction seen on recent prior CT. No gross intraperitoneal free air.
|
Findings compatible with small bowel obstruction. No gross intraperitoneal free air.
|
Generate impression based on findings.
|
80 year-old female with history of pain. The bones are demineralized. There is no evidence of hip fracture. Moderate degenerative disease affects the left hip and SI joints. Severe degenerative disc disease affects the visualized lower lumbar spine at L4-5 and L5-S1. There is a calcified uterine fibroid. There are atherosclerotic calcifications of the abdominal aorta and its branches. A left lower quadrant ostomy is present.
|
Degenerative disease as above without acute fracture.
|
Generate impression based on findings.
|
6-year-old female with scoliosisVIEWS: Thoracolumbar spine supine AP/lateral and pelvis AP/frog leg (4 views) 01/29/15 Bilateral coxa valga with approximately 40% lateral uncovering of the left femoral head. A cluster of well corticated radiodensities in the right hemipelvis could represent bladder stones or swallowed foreign bodies. No acute fracture or malalignment is evident. Surgical clip in left hemipelvis.There is approximately 41 degrees of levoscoliosis of the thoracic spine when measured from the superior endplate of T3 to the inferior endplate of T11. There is approximately 36 degrees of dextrorotoscoliosis of the lumbar spine when measured from the superior endplate of T12 to the inferior endplate of L5. Gastrostomy tube is in place. Better visualized on the recent CT is a hypoplastic right lung with rightward mediastinal shift and compensatory hyperexpansion of the left lung.
|
1.Scoliosis as described above.2.Bilateral coxa valga with DDH of the left hip. 3.Probable bladder stones or swallowed foreign bodies.
|
Generate impression based on findings.
|
Swelling mass or lump in the head neck. Reason: cervical spine mass The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a mass in the right C2-3 neural foramen measuring 11 x 22 mm axial dimensions. There is associated enlargement of the right neural foramen.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is mild facet hypertrophy at this level - right more than left.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is mild facet hypertrophy present at this level.At C5-6 there is no significant compromise to the spinal canal. There are endplate and uncovertebral osteophytes present at this level associated with moderate bilateral neural foramina encroachment and narrowing of the spinal canal appeared and there is loss of disk space height at this levelAt C6-7 there is no significant compromise to the spinal canal or neural foramina. There are endplate and uncovertebral osteophytes present at this level associated with bilateral neural foramina encroachment (right worse than left) and some narrowing of the spinal canal . There is loss of disk space height at this level.At C7-T1 there is no significant compromise to the spinal canal. There are small uncovertebral osteophytes present at this level mildly narrowing the neural foramina.
|
1.There is a mass present in the right neural foramen at C2-3 which in general has a benign appearance due to associated bony remodeling. If clinically appropriate an MRI of the cervical spine with gadolinium may be helpful to further assess this2.There are degenerative changes present in the cervical spine worst at C5-6 and C6-7 where there is neural foramina encroachment and narrowing of the spinal canal.3.Findings were discussed with Dr Robert James Stewart. This patient has an outside MRI already
|
Generate impression based on findings.
|
Female 23 years old Reason: eval for pathology History: abd pain, crohns ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is mild wall thickening involving the terminal ileum for approximately 10 cm. This finding may be compatible with mild active inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Irregularity involving the bilateral sacroiliac joints suggestive of bilateral sacroiliitisOTHER: No significant abnormality noted
|
Mild wall thickening of the terminal ileum which may represent mild acute inflammation.CT findings suggestive of bilateral sacroiliitis.
|
Generate impression based on findings.
|
Female 55 years old Reason: right upper quadrant pain with radiation to the back, evaluate for gallstones LIVER: The liver measures 15.2 cm in length and is coarsely echogenic. Well-circumscribed 3.1 x 3.9 cm hypovascular, predominantly hyperechoic lesion in the posterior right hepatic lobe with central hypoechoic foci with a smaller adjacent subcentimeter well-circumscribed hyperechoic focus. The larger lesion demonstrates a degree of posterior acoustic enhancement suggesting a fluid/cystic component.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones, wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: Unremarkable where visualized. KIDNEYS: The right kidney measures 9.1 cm. The left kidney measures 9.9 cm. There is no hydronephrosis.OTHER: The spleen measures 7.8 cm.
|
Nonspecific lesions in the posterior right hepatic lobe. Further evaluation with liver protocol MRI is recommended.
|
Generate impression based on findings.
|
45-year-old with history of left breast cancer status post mastectomy. Prior benign right breast biopsy and status post right breast reduction in 2013. No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
Male 64 years old Reason: r/o malignancy History: weight loss CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Mild fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Mild fatty infiltration of the liver.
|
Generate impression based on findings.
|
The ventricles and sulci are slightly prominent for the patient's stated age. There is no midline shift or mass effect. There is symmetric hyperdensity in the globus pallidus bilaterally which likely represent mineralization. There is additional asymmetric hyperdensity along the right putamen. There is focal abnormal density in the right frontal lobe subcortical and deep white matter as seen on 3/14. There is also periventricular white matter abnormal density along the frontal horns which is somewhat unusual for a patient of this age. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
|
1. Ill-defined abnormal low density in the right frontal lobe subcortical and deep white matter with additional bilateral periventricular white matter low density along the frontal horns. Asymmetric hyperdensity along the right putamen which may relate to developing mineralization versus less likely petechial blood products or proteinaceous/hypercellular material. Although nonspecific, provided the patient's history and reported outside imaging findings, contrast enhanced MRI of the brain is recommended for further evaluation, with infection being the primary concern, including both tuberculosis and cryptococcosis. Other etiologies including neoplasm are felt to be less likely.2. Mild global volume loss greater than expected for the patient's stated age.
|
Generate impression based on findings.
|
Male 25 years old Reason: evalaute for etiology History: fever,diaphoresis, abdominal pain, persistent n/v ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Unremarkable CT. No CT findings to explain patient's fever.
|
Generate impression based on findings.
|
Reason: 11 yo Female w/ new diagnosis metastatic neuroblastoma There is widespread MIBG avid lesions throughout the majority of the axial skeleton and proximal appendicular skeleton.There is a large MIBG avid left supraclavicular soft tissue mass. There are several MIBG avid anterior mediastinal lymph nodes. There is a large MIBG avid left retroperitoneal mass anterior to the left kidney as well several MIBG avid left retroperitoneal lymph nodes.Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder.
|
1. Large MIBG avid left retroperitoneal mass anterior to the left kidney consistent with neuroblastoma.2. Retroperitoneal, mediastinal and left supraclavicular MIBG avid metastatic lymph nodes.3. Widespread MIBG avid osseous metastatic disease.
|
Generate impression based on findings.
|
Female 37 years old; Reason: epigastric pain and irregular periods in obese woman ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate intrarenal calculi, for example, in lower pole of right kidney, image 62 series 80296. Symmetric renal parenchymal enhancement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Underdistended colon, particularly portions of left colon, proximal transverse colon and cecum, making assessment for underlying wall thickening suboptimal, mild cecal wall thickening not entirely excluded, coronal image 80, however no significant paracolic stranding seen.PELVIS:UTERUS, ADNEXA: Right greater than left adnexal prominence, likely related to underlying physiologic follicles. No pelvic free fluid.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Metallic densities seen in vaginal/perineal area anteriorly, correlate with patient's history and physical examination. Some degenerative disease seen with intervertebral disk space narrowing and osteophyte formation noted particularly at L5/S1 and T9/T10 levels.
|
1. Nonobstructing intrarenal nephrolithiasis. 2. Underdistended colon, particularly portions of left colon, proximal transverse colon and cecum, making assessment for underlying wall thickening suboptimal, mild cecal wall thickening not entirely excluded, coronal image 80, however no significant paracolic stranding seen.3. Normal appendix.
|
Generate impression based on findings.
|
Male 74 years old Reason: 74 yo with cirrhosis, please screen for HCC LIVER: The liver measures 16.3 cm in length and demonstrates diffusely coarsened hyperechoic and heterogeneous echotexture consistent with history cirrhosis. The main portal vein demonstrates decreased velocity of 0.1 m/sec. There is suggestion of a filling defect within the distal main portal vein which is dilated raising the possibility of nonocclusive portal vein thrombus. Bulbous appearance of vein at this level may be due in part to underlying varix or adjacent adenopathy. GALLBLADDER, BILIARY TRACT: The gallbladder is surgically absent. The common duct measures 0.5 cm. There is mild intrahepatic biliary duct dilatation.PANCREAS: Unremarkable where visualized.KIDNEYS: The left kidney measures 11.1 cm. The right kidney measures 9.1 cm. There is no hydronephrosis.OTHER: Marked splenomegaly measuring 23.7 cm. The splenic artery waveform is somewhat abnormal with diminished diastolic flow and loss of the normal brisk systolic upstroke. Findings raise possibility of a proximal stenosis.
|
1. Heterogeneously hyperechoic coarsened hepatic parenchyma consistent with cirrhosis.2. The distal main portal vein demonstrates reduced peak velocity with suggestion of a filling defect raising the possibility of nonocclusive portal vein thrombus. Liver protocol CT/MRI is recommended for further evaluation. Bulbous appearance of vein at this level may be due in part to underlying varix or adjacent adenopathy. 3. Abnormal splenic artery waveform raising the possibility of a proximal stenosis. This will be evaluated with CT/MRI.
|
Generate impression based on findings.
|
CLINICAL DATA: Age: 51 years. Sex : Female. Indication: Reason: Evaluate for appendicitis, free fluid History: 51 yo F with hx of ovarian cyst and fibroids p/w lower quadrant abdominal pain. LUNG BASES: Mild centrilobular emphysema. No significant pleural effusion or lower lung consolidation.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Moderate right hydronephrosis to the distal one third of the ureter. The ureter cannot be traced completely to its insertion on the bladder. No hyperattenuating stones are seen. Left kidney within normal limits.RETROPERITONEUM/LYMPH NODES: Small retroperitoneal lymph nodes are seen.BOWEL, MESENTERY: Several loops of dilated distal small bowel are seen in the right lower quadrant, up to approximately 3.8 cm (coronal image number 65). These dilated loops of small bowel are proximal to a several centimeter segment of distal ileum that demonstrates bowel wall thickening (axial image number 102), and this is likely a transition point. The appendix appears normal. No pneumatosis or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER:No significant abnormality noted.PELVIS:UTERUS/ADNEXA: There is an approximately 3 x 1.8-cm cystic structure at the right adnexa which may represent a physiologic cyst if the patient is premenopausal, however cannot completely exclude the possibility of ovarian neoplasm, particularly if the patient is postmenopausal.BLADDER: No significant abnormality noted.BOWEL, MESENTERY: Several loops of distended distal small bowel in the right lower quadrant proximal to a segment of distal ileum with bowel wall thickening. This is likely partial obstruction proximal to an inflamed loop of distal ileum.BONES, SOFT TISSUES: Bilateral inguinal lymphadenopathy.
|
1.Short segment of distal ileum wall thickening, with associated upstream small bowel dilation and partial obstruction. Favor inflammatory/infectious etiologies.2.Moderate right hydronephrosis, to the level of the noted small bowel wall thickening.
|
Generate impression based on findings.
|
positive lumbar puncture, headache. NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.No change of non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD There is normal contrast opacification through bilateral ICAs, MCAs and ACAs.Acom artery is patent but bilateral Pcom arteries are not seen.There is no evidence of intracranial arterial aneurysm, arterial luminal stenosis or occlusion.Vertebrobasilar system appears to be normal.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage.
|
1. No evidence of acute ischemic or hemorrhagic lesion.2. No CT angiographic evidence of intracranial arterial aneurysm, or arterial luminal narrowing or occlusion.
|
Generate impression based on findings.
|
History of right lumpectomy in 2013 for ADH bordering on DCIS. Patient received radiation therapy. No new breast complaints. Three standard views of both breasts, a laterally exaggerated right CC view and two right spot magnification views 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. Linear marker was placed on the scar overlying the right breast. Stable postsurgical increased density, architectural distortion, surgical clips and volume loss are present in the lumpectomy bed. Scattered benign calcifications are present.No new masses or suspicious microcalcifications are present in either breast. Benign lymph nodes project over the left axilla.
|
Stable postsurgical changes of the right breast. 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.
|
48 years, Female. Reason: stent evaluation History: stent in throat after sneezing Enteric tube tip overlies the gastric antropyloric. Residual contrast material seen in the colon. Nonobstructive bowel gas pattern. There is linear catheter projecting over the left hemi-abdomen, likely representing G-tube tubing per ED resident. G-tube balloon is projected over gastric body.
|
Enteric tube tip overlies the gastric antropyloric. Nonobstructive bowel gas pattern. There is linear catheter projecting over the left hemi-abdomen, likely representing G-tube tubing. G-tube balloon is projected over gastric body.
|
Generate impression based on findings.
|
Male 12 years old; Reason: eval hardware History: s/p leg lengthening Postsurgical changes from epiphysiodesis. Status post lengthening of the femoral component.There is lucency at the distal aspect of the tibial component near the bone prosthetic interface. No acute fracture is evident.
|
1.Postsurgical changes as detailed above.2.Stable lucency at the distal aspect of the tibial component.
|
Generate impression based on findings.
|
Peritonsillar drainage 6 weeks ago who presented on 1/28 with 5 days of worsening sore throat & odynophagia, admitted for + rapid strep tonsillitis & peritonsillar cellulitis. There is enlargement of the left palatine tonsil with surrounding stranding. In addition, there is an ill-defined area of low attenuation in the left peritonsillar region without discernible rim-enhancement. There is also mild prominence of the right palatine tonsil, which otherwise appears unremarkable. There is moderate oropharyngeal airway narrowing. There are enlarged left suprahyoid lymph nodes. The retropharyngeal space is unremarkable. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The imaged intracranial structures are unremarkable. There is scattered paranasal sinus opacification. The imaged portions of the lungs are clear.
|
Findings compatible with left palatine tonsillitis and what may represent residual peritonsillar phlegmon or residual fluid with moderate oropharyngeal airway narrowing and reactive lymphadenopathy, but no evidence of a well-formed abscess.
|
Generate impression based on findings.
|
Female 64 years old; Reason: r/o grave's vs multinodular goiter. R/o cold nodules History: hyperthyroidism The thyroid images demonstrate heterogeneous activity in a gland of normal size and configuration. There is a small hyperfunctioning nodule in the mid to lower pole of the right thyroid lobe. There are additional areas of decreased and increased activity which likely represent nodules of varying function. There is no dominant suspicious cold nodule identified. The 4-hour radioactive iodine uptake is 10% and the 24-hour uptake is 25% (normal range 10-30% at 24-hours) which is in the elevated in the setting of a suppressed TSH level.
|
Findings consistent with toxic multinodular goiter.
|
Generate impression based on findings.
|
88-year-old female history of left hip pain. The bones are demineralized.Left hip: There is no evidence of acute fracture or subluxation. Moderate degenerative disease affects the hip and pubic symphysis. There are scattered arterial calcifications.Pelvis: There is no evidence of acute fracture. Moderate osteoarthritis affects both hips and the pubic symphysis. There is a calcified uterine fibroid. Severe degenerative disc disease affects the visualized lower lumbar spine. Scattered arterial pulsations are present.
|
Degenerative disease without acute fracture.
|
Generate impression based on findings.
|
Cough, wheezing, evaluate for interstitial lung disease or left lung mass LUNGS AND PLEURA: Small lung volumes with multifocal linear opacities with scattered bilateral subpleural opacities. Bronchial wall thickening. No pleural effusions. No evidence of air trapping, fibrosis, or mass.MEDIASTINUM AND HILA: No lymphadenopathy. No coronary artery calcifications. No pericardial effusion.CHEST WALL: Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hepatic steatosis. Mildly prominent gastrohepatic lymph nodes.
|
1.Multifocal linear opacities, the morphology of which favors a chronic process and can be seen in postinfectious scarring, organizing pneumonia, or less likely, chronic eosinophilic pneumonia. The differential diagnosis for the subpleural opacities includes pulmonary infarctions from prior PE.2.No evidence of air trapping, fibrosis, or mass.
|
Generate impression based on findings.
|
Reason: intracranial lesion History: seizure and AMS CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There are calcifications present at the the globus pallidi bilaterally.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Incidental note is made of a small medial deviation of the left lamina papyracea which probably represents a medial orbital blowoutCT cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine.Note is made of a nasogastric tube which is looped in the hypopharynx and the its tip is located in the oral pharynx.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there are endplate osteophytes present associated with loss of disk space height and a disk bulge and narrowing of the spinal canal and left neural foramen.At C6-7 there is a disk bulge present narrowing the spinal canal .At C7-T1 there is no significant compromise to the spinal canal or neural foramina.
|
1.No evidence for cervical spine fracture.2.The patient's nasogastric tube loops in the hypopharynx and has its tip is in the oropharynx .3.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of nonhemorrhagic cerebral infarction.4.There are degenerative changes present in the cervical spine associated with the findings suspicious for spinal stenosis into C5-6 and left neural foramen encroachment. There is a also some narrowing of the spinal canal at C6-7 due to disk bulge.5.Findings were reported to the resident taking care of the patient via pager 3681.
|
Generate impression based on findings.
|
78 years, Male. Reason: eval for asymptomatic kidney stones, hyperparathyroidism History: hyperparathyroidism Nonobstructive bowel gas pattern. Above average stool burden. Calcification is seen overlying the right kidney, but cannot confirm location on radiograph.
|
Nonobstructive bowel gas pattern. Above average stool burden. Calcification is seen overlying the right kidney, but cannot confirm location on radiograph.
|
Generate impression based on findings.
|
79 year old male s/p OG tube placement. Lower pelvis excluded from field of view. Enteric tube tip just past GE junction with sidehole in distal esophagus. Nonobstructive bowel gas pattern. Degenerative disease in the lumbosacral spine and mild scoliosis noted.
|
Enteric tube tip just past GE junction with sidehole in distal esophagus, recommend advancement.
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. There is mild mucosal thickening in the left maxillary sinus. The remainder of the visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
|
No acute intracranial abnormality.
|
Generate impression based on findings.
|
76-year-old female with recent craniotomy and meningioma resection, now with headache and clinical concern for postsurgical infection. Status post bicoronal craniotomy and resection of large right frontal meningioma. There has been no significant interval change in the subjacent dural flap and heterogeneous air-filled material, likely representing surgical Gelfoam. The multiple foci of frontoparietal subarachnoid and intraparenchymal hemorrhage appear less hyperdense when compared to prior, consistent with evolving blood products. There is a stable appearance of the thin left frontal extra-axial heterogeneous fluid collection. No new significant hemorrhage is identified. There is persistent hypoattenuation in the bilateral anterior cerebral artery territories, which likely represents evolving ischemia with associated edema. There is no significant change in the degree of downward mass effect on the right lateral ventricle. The small subdural along the falx appears to be resolving. There is stable trace midline shift to the left. There is no foci of abnormal enhancement on the postcontrast images. A curvilinear enhancement in the left cerebellar hemisphere is compatible with a developmental venous anomaly. There is no definite pathological enhancement.Interval improvement of right frontoparietal subgaleal hematoma, measuring 8 mm, previously greater than 12 mm. Fluid is again noted within the craniotomy sites. Calvarial screws/fixation hardware and scalp staples are unchanged. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. NG tube is noted.
|
1. Evolving postsurgical changes related to recent craniotomy and resection of right frontal meningioma, including hypoattenuation in the bilateral anterior cerebral artery territories, suspicious for evolving ischemia. There is bilateral frontoparietal edema, right greater than left, which is not significantly changed. There is no significant effacement of the suprasellar cistern. 2. Interval expected evolution of frontoparietal subarachnoid and intraparenchymal blood products.3. No evidence of major intracranial infection. 4. Interval decrease of subgaleal hematoma.
|
Generate impression based on findings.
|
79 years, Male. Reason: OG tube placement. Lower pelvis excluded from field of view. Enteric tube tip just past GE junction with sidehole in distal esophagus. Nonobstructive bowel gas pattern. Degenerative disease in the lumbosacral spine and mild scoliosis noted.
|
Enteric tube tip just past GE junction with sidehole in distal esophagus, recommend advancement.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts ( total 9 images) were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
|
Generate impression based on findings.
|
79 year old male s/p Dobbhoff placement. Lower pelvis excluded from field of view. Interval removal of OG tube and placement of Dobbhoff tube with tip at the GE junction. Nonobstructive bowel gas pattern. Degenerative disease in the lumbosacral spine and mild scoliosis noted.
|
Dobbhoff tip at GE junction, recommend advancement.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard and pushback 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 elements, unchanged in pattern and distribution. Retroglandular saline implants appear intact. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
History of right lumpectomy for IDC and axillary lymph node dissection with adjuvant radiation and chemotherapy in 2002. Benign MRI guided biopsy of the right breast in 2004. History of left breast reduction and right breast reconstruction in July 2013. 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, which may obscure small masses, unchanged in pattern and distribution. Linear marker was placed on the scar overlying the right breast. Stable postsurgical architectural distortion is present. Percutaneously placed clip in the right upper outer quadrant is unchanged in position.No new masses or suspicious microcalcifications are present in either breast. Surgical clips project over the right axilla. Stable lymph nodes project over the left axilla.
|
Stable postsurgical changes of the right breast. 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.
|
There are bilateral predominately iso- to minimally hyperdense chronic subdural fluid collections at the convexities bilaterally with areas of globular and linear high density indicating more recent but likely nonacute component of blood clots/hemorrhage. They each measure approximately 4 mm in greatest thickness. Trace blood is also visualized along the tentorium extending inferiorly from the falx and within the posteroinferior aspect of the posterior fossa. There is slight convexity of the anterior fontanelle. The ventricles and sulci are normal in size. Patchy opacities are noted diffusely in the paranasal sinuses. No definite calvarial fracture is seen.
|
1.Bilateral 4 mm predominately iso- to minimally hyperdense likely late subacute to chronic subdural hematomas with globular and linear higher density components, indicating more recent blood clots/hemorrhage that are likely subacute. 2.Trace layering of blood product along the tentorium extending inferiorly from the falx as well as within the inferoposterior posterior fossa.3.No significant mass effect on the brain, midline shift or herniation.
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
|
No acute intracranial abnormality.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No new suspicious masses, microcalcifications or areas of architectural distortion are present. A partially obscured masses in the upper outer left breast, posterior depth, is stable from prior examinations.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Exam is limited due to portable technique and linear artifact. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. Gray-white differentiation remains maintained at this time. There is no extraaxial fluid collection. There is mild scattered mucosal thickening paranasal sinuses. The visualized portions of the mastoids/middle ears are grossly clear.There is relative increased density in the intracranial vasculature, although similar in degree of hyperdensity when comparing major arterial to venous structures, which may relate to hemoconcentration from cardiac arrest. There are partially visualized nasogastric and endotracheal tubes. Incidental note is made of prominent fluid density along the right greater than left posterior neck musculature. This measures up to 1.7 cm in thickness on the right.
|
1. Slightly limited portable exam. No acute intracranial abnormality.2. Incidental note made of prominent near fluid density in the right greater than left posterior neck musculature, for which correlation with physical exam is recommended. This could represent edema although a forming focal fluid collection or abscess cannot be entirely excluded.
|
Generate impression based on findings.
|
40 year old female with high NGT output. Enteric tube tip just past GE junction with sidehole in distal esophagus. Nonobstructive bowel gas pattern. Bilateral renal stones, right greater than left but decreased in number since the prior radiograph. Unchanged drainage tubing projects over the right hemipelvis.
|
1.Enteric tube tip just past GE junction with sidehole in distal esophagus, recommend advancement. 2.Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
Male 66 years old Reason: Ascites, jaundice, h/o colorectal cancer metastatic to liver, evaluate for bile duct obstruction, evaluate for patency of portal vein History: ascites, jaundice LIVER: The liver measures 13.2 cm in length. There is marked irregularity of the liver contour which is diffusely heterogeneous consistent with known diffuse hepatic metastases. The portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: Cholelithiasis. The gallbladder is thickened and there is moderate pericholecystic fluid. This is likely secondary to diffuse abdominal ascites.PANCREAS: No significant abnormalities noted.KIDNEYS: The right kidney measures 9.2 cm. The left kidney measures 10.9 cm. There is no hydronephrosis.OTHER: The spleen measures 13.5 cm. Diffuse abdominal ascites.
|
1. No intra- or extra-hepatic biliary duct dilatation. 2. Diffuse hepatic metastases, better evaluated on recent CT abdomen.3. Diffuse abdominal ascites.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A linear scar marker overlies the left breast scar. A circumscribed mass at 6 o'clock position in the right breast is unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
59 year old male with esophageal cancer s/p esophageal stent and GT placement, p/w dyspepsia, chest pain, early satiety, bloating, constipation. Nonobstructive bowel gas pattern. Esophageal stent and gastrojejunostomy tube noted. Again seen is a linear needle-like radiopaque foreign body projecting over the right lateral hemipelvis, unchanged from prior CT and radiograph. Degenerative changes affect the hips.
|
Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
CHEST:LUNGS AND PLEURA: Interval improved right lower lobe consolidation. Right middle lobe, right lower lobe, and left lower lobe groundglass opacities in the setting of interlobular and intralobular septal thickening. This is most consistent with mild inflammation/infection. No pleural effusion.MEDIASTINUM AND HILA: Minimal residual thymic tissue. Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Right central venous catheter tip at the right atrium.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No biliary dilatation or perihepatic ascites.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic kidneys with bilateral nonobstructing intrarenal calcifications.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lack of fusion of the posterior elements, perhaps due to partial laminectomy at approximately the S1 level.OTHER: Pelvic transplant kidney is unremarkable. Soft tissue attenuation at the celiac axis, of uncertain significance.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Lack of fusion of the posterior elements, perhaps due to partial laminectomy at approximately the S1 level.
|
1.Improved right lower lobe consolidation, however there are new and slightly increased groundglass opacities bilaterally as above.2.Bilateral atrophic kidneys, with right pelvis transplant kidney appearing unremarkable.3.No evidence of disseminated disease.
|
Generate impression based on findings.
|
40-year-old female with history of knee swelling and pain. Left knee: There is a small joint effusion. There is no evidence of acute fracture or dislocation. Alignment is anatomic.Right knee: There is a moderate joint effusion. There is no evidence of acute fracture or dislocation. Alignment is anatomic.
|
Bilateral right greater than left joint effusions without acute fracture.
|
Generate impression based on findings.
|
Reason: intracranial lesion History: seizure and AMS CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There are calcifications present at the the globus pallidi bilaterally.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Incidental note is made of a small medial deviation of the left lamina papyracea which probably represents a medial orbital blowoutCT cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine.Note is made of a nasogastric tube which is looped in the hypopharynx and the its tip is located in the oral pharynx.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there are endplate osteophytes present associated with loss of disk space height and a disk bulge and narrowing of the spinal canal and left neural foramen.At C6-7 there is a disk bulge present narrowing the spinal canal .At C7-T1 there is no significant compromise to the spinal canal or neural foramina.
|
1.No evidence for cervical spine fracture.2.The patient's nasogastric tube loops in the hypopharynx and has its tip is in the oropharynx .3.No evidence for acute intracranial hemorrhage mass effect or edema. CT is insensitive for the early detection of nonhemorrhagic cerebral infarction.4.There are degenerative changes present in the cervical spine associated with the findings suspicious for spinal stenosis into C5-6 and left neural foramen encroachment. There is a also some narrowing of the spinal canal at C6-7 due to disk bulge.5.Findings were reported to the resident taking care of the patient via pager 3681.
|
Generate impression based on findings.
|
56 years, Male. Reason: status of ileus, evaluate for obstructive bowel gas pattern, position of NJ tube tip History: NJ Kangaroo tube in place, nausea with PO intake, duodenal pSBO seen on endoscopy 1/26, pancreatitis. Significantly limited exam due to patient motion. Enteric tube coiled in the stomach with tip in proximal jejunum. Cholecystectomy clips.
|
Enteric tube tip in proximal jejunum. Limited exam due to patient motion precludes accurate assessment of bowel gas pattern.
|
Generate impression based on findings.
|
19-year-old male with history of fifth proximal phalanx fracture. Overlying splint material limits fine osseous detail. Redemonstrated is an oblique intra-articular fracture at the base of the fifth proximal phalanx in near anatomic alignment.
|
Fifth proximal phalanx fracture as above.
|
Generate impression based on findings.
|
Female 69 years old Reason: Cirrhosis for HCC screening History: HCV LIVER: The liver measures 14.5 cm in length. Hyperechoic coarsened hepatic parenchyma suggestive of chronic liver disease. There is no focal liver lesion. The portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.KIDNEYS: The right kidney measures 10.7 cm. The left kidney measures 12.3 cm with stable prominence of the parenchyma of the mid pole likely representing a prominent column of Bertin, a normal variant. There is no hydronephrosis.OTHER: The spleen measures 8.4 cm.
|
Hyperechoic coarsened hepatic parenchyma without focal liver mass.
|
Generate impression based on findings.
|
Male 74 years old; Reason: recurrent UTI, history of pneumaturia Evaluation of organs of abdomen and pelvis suboptimal without IV contrast. ABDOMEN:LUNGS BASES: Moderate to market cardiomegaly. New small left pleural effusion. Bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic fatty atrophy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Again seen is air in the intrarenal collecting system of right sided transplanted kidney and in the bladder, compatible with patient's history of pneumaturia. Air overall without significant change. 1.2 cm right parapelvic cystic focus, not well seen on prior study, may have been present but was smaller.RETROPERITONEUM, LYMPH NODES: Aneurysmal 2 cm left common iliac artery, similar to prior study. Extensive aortobiiliac atherosclerotic disease. BOWEL, MESENTERY: Normal appendix. Diastasis of rectus abdominis muscles. PELVIS:PROSTATE/SEMINAL VESICLES: Enlarged prostate, measuring up to 5.8 cm.BLADDER: Again seen is air in the intrarenal collecting system of right sided transplanted kidney and in the bladder, compatible with patient's history of pneumaturia. Air overall without significant change. Bladder not as well distended, making assessment suboptimal.BONES, SOFT TISSUES: Overall increased sclerosis of visualized osseous structures may be related to renal osteodystrophy. Areas of more focal heterogeneous sclerosis, for example, in right femoral head and sacrum, suspicious for metastatic disease. Site involving sacrum demonstrates interval increase in size, measuring approximately 6.5 x 3.6 cm, image 103 series 4, previously measured 6.1 x 2.4 cm. Heterogeneous and expanded appearance of incompletely imaged sternum. Additional ill-defined more radiolucent lesions seen throughout spine. Diastasis of rectus abdominis muscles.
|
1. Again visualized air in bladder and intrarenal collecting system of transplanted kidney in right iliac fossa. Differential considerations again include emphysematous pyelitis or recent instrumentation with reflux into renal collecting system and if there is clinical concern for enterovesicular fistula, further assessment with dedicated barium enema should be considered.2. Sites of abnormal osseous heterogeneity, with interval increase in size of lesion in sacrum noted, correlation with patient's clinical history recommended as brown tumor formation in setting of renal dystrophy or metastatic disease are differential considerations. Further assessment with dedicated bone scan may also be of use. 3. 1.2 cm right renal parapelvic cystic focus, not well seen on prior study, may have been present but was smaller renal cyst.4. New small left pleural effusion. 5. Stable left common iliac artery aneurysm.
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. There is a moderate-sized air-fluid level in the right maxillary sinus with additional mucosal thickening. There is also minimal scattered ethmoidal mucosal thickening. The remainder of the visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.Incidental note is made of a prominent somewhat lobular homogeneously sclerotic partially phasicity lesion arising from the inner table of the right parietal calvarium. It currently measures 1.9 x 1.9 cm in greatest axial dimensions, by 1.2 cm in greatest CC dimension.CERVICAL SPINE
|
1. No acute intracranial abnormality. Moderate-sized right maxillary sinus air-fluid level, for which clinical correlation is recommended or possible acute sinusitis.2. Incidental note made of a prominent sclerotic partially exophytic lesion off the inner table of the right parietal calvarium, with differential diagnosis including primarily osteoma and meningioma. Follow-up MRI could be obtained for further detailed evaluation.3. No acute fracture or subluxation within the cervical spine.
|
Generate impression based on findings.
|
19 year-old male with history of pain. There is a minimally displaced oblique fracture through the base of the fifth proximal phalanx with intraarticular extension. There is mild soft tissue swelling about the fifth digit.
|
5th finger fracture as above.
|
Generate impression based on findings.
|
43-year-old male with history of right ankle pain. There is mild soft tissue swelling about the ankle. There is no evidence of acute fracture or dislocation. Alignment is anatomic.
|
Mild soft tissue swelling without acute fracture.
|
Generate impression based on findings.
|
Male 74 years old Reason: questionable biliary obstruction History: diarrhea, abnormal LFTs LIVER: The liver measures 14.5 cm in length and demonstrates mildly micronodular contour and coarsened echotexture, which may be seen in the setting of cirrhosis. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: Cholelithiasis without gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: Subcentimeter hypoechoic lesion in the uncinate process measuring 0.6 x 0.5 cm, which may correspond to sidebranch IPMN identified on prior M.R.C.P.Kidneys: the right kidney measures 10.2 cm. The left kidney measures 10.4 cm. Left lower pole cyst noted. There is no hydronephrosis.OTHER: The spleen measures 10.1 cm.
|
1. Cholelithiasis.2. Micronodular contour with coarsened echotexture, which may be seen in the setting of cirrhosis. No focal liver lesion.3. Hypoechoic lesion in the uncinate process, likely corresponds to sidebranch IPMN identified on prior M.R.C.P.
|
Generate impression based on findings.
|
43-year-old male with history of foot swelling and tenderness. There is a 1 cm ovoid density dorsal to the second MTP joint which may represent a retained foreign body. There are additional punctate densities posterior to the calcaneus which are nonspecific but also may represent foreign material. There is no acute fracture or dislocation. There is significant dorsal soft tissue swelling.
|
Dorsal soft tissue swelling and possible retained foreign bodies as above.
|
Generate impression based on findings.
|
48-year-old female with history of shortness of breath. Evaluate for foreign body. The Dobbhoff tube appears to have migrated caudally with the proximal tip residing within the oropharynx. The remainder of the exam is unremarkable.
|
Caudal migration of Dobbhoff tube with proximal end residing within the oropharynx
|
Generate impression based on findings.
|
Female 45 years old Reason: renal failure History: aki RENAL TRANSPLANT:LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No perirenal fluid collection is identified.KIDNEY: The transplant kidney measures 9.0 cm. There is no hydronephrosis.COLLECTING SYSTEM/URETER: No hydronephrosis.URINARY BLADDER: The bladder is nondistended.VASCULAR DOPPLER DATA: Limited Doppler sonography of the main transplant vessels demonstrates no significant abnormality.
|
Unremarkable appearance of the right iliac fossa transplant kidney.
|
Generate impression based on findings.
|
30-year old female with history of pain. There is no acute fracture or dislocation. Alignment is anatomic. The soft tissues are unremarkable.
|
No radiographic findings to account for the patient's pain.
|
Generate impression based on findings.
|
18-year-old male with history of swelling and pain. There is mild soft tissue swelling about the ankle without underlying fracture or dislocation. The ankle mortise is intact.
|
Mild soft tissue swelling without acute fracture.
|
Generate impression based on findings.
|
44-year-old male with history of MVC. Thoracic spine: There is no acute fracture or subluxation. Mild degenerative disc disease affects the upper thoracic spine. Vertebral body heights and intervertebral disk spaces are well-maintained.Lumbar spine: There is no acute fracture or subluxation. Minimal degenerative disc disease affects L4-5. Intervertebral disc spaces and vertebral body heights are well-maintained.
|
Minimal degenerative disease without acute fracture.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Two benign circumscribed masses are present at upper outer quadrant in the right breast and a circumscribed benign mass is seen at the central aspect in the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Hemorrhagic stroke. Interval left frontal craniotomy and external ventriculostomy catheter placement, with the tip near the left foramen of Monro. The previously described intraparenchymal hematoma centered within the right thalamus appears to extend minimally more caudally, with a more confluent appearance of hyperattenuation. There appears to be slight increase in the amount of blood in the atrium/occipital horn of the right lateral ventricle. There is persistent intraventricular hemorrhage, including slight increase in the amount of blood in the atrium/occipital horn of the right lateral ventricle, casting of blood within the left lateral ventricle, and extension into the third and fourth ventricles. There is a stable appearance of acute hydrocephalus. There is persistent leftward midline shift at the level of the foramen of Monro, measuring up to 8 mm, partial effacement of the suprasellar and quadrigeminal cisterns, and mild diffuse sulcal effacement. There is interval increase in transependymal edema as well as mild edema surrounding the hematoma. There are secretions in the nasopharynx, and an air-fluid level in the right sphenoid sinus.
|
1. Redemonstration of large intraparenchymal hemorrhage centered within the right thalamus with intraventricular extension, which appears mildly increased in the craniocaudal dimension with more confluent blood products.2. Stable appearance of acute hydrocephalus.3. There is mild worsened transependymal edema, as well as edema surrounding the hematoma.4. There is unchanged appearance of mild diffuse sulcal effacement, mild leftward midline shift, and partial effacement of the suprasellar and quadrigeminal cisterns.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. An intramammary lymph node in the left upper outer quadrant is stable.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Female 4 years old Reason: Screen for tumors of the kidneys, liver, or adrenal gland History: Beckwith Wiedemann syndrome LIVER: The liver measures 11 cm in length and demonstrates appropriate parenchymal echogenicity. There is no evidence of intrahepatic or extra hepatic biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. The main portal vein is patent with hepatopetal flow at 0.3 m/sec.GALLBLADDER, BILIARY TRACT: No evidence of cholelithiasis or choledocholithiasis.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 7.9 cm in length.KIDNEYS: The right kidney measures 7.6 cm in length and the left kidney measures 7.6 cm in length. Both kidneys and is appropriate cortical echogenicity and there is no evidence of hydronephrosis. ABDOMINAL AORTA: Visualized aorta, normal.INFERIOR VENA CAVA: Visualized IVC, normal.OTHER: No significant abnormality noted.
|
Normal examination.
|
Generate impression based on findings.
|
Female 4 years old Reason: Screen for tumors of kidney, liver, or adrenal gland History: MZ twin with Beckwith-Wiedemann, increased risk for tumor development LIVER: The liver measures 10.5 cm in length and demonstrates appropriate parenchymal echogenicity. There is no evidence of intrahepatic biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.GALLBLADDER, BILIARY TRACT: No evidence of cholelithiasis or choledocholithiasis.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 7.5 cm in length.KIDNEYS: The right kidney measures 7.3 cm in length and the left kidney measures 7.2 cm in length. Both kidneys demonstrate appropriate parenchymal echogenicity and are without evidence of hydronephrosis. ABDOMINAL AORTA: Visualized aorta, normal.INFERIOR VENA CAVA: Visualized IVC, normal.OTHER: No significant abnormality noted.
|
Normal examination.
|
Generate impression based on findings.
|
Female 54 years old; Reason: Primary HPT History: Primary HPT There is physiologic distribution of the radiopharmaceutical. There is persistent abnormal focus in the superior mediastinum of medium to large size consistent with ectopic parathyroid adenoma and on CT is located in the left lower paratracheal region. The right thyroid lobe appears to measure 3.8 cm and the left lobe 3.6 cm in length.On CT, in the right mid chest there is a small pleural-based smoothly marginated apparently soft tissue density which is nonspecific and incompletely evaluated.
|
1. Medium to large ectopic mediastinal parathyroid adenoma in the left lower paratracheal region.2. Nonspecific right-sided pleural-based focus is incompletely evaluated but be followed up or compared with prior dedicated thoracic CT as clinically warranted.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There are multiple waxing and waning circumscribed masses in both breasts. The largest mass is present at left upper outer quadrant. Diffuse calcifications are present in both breasts, progressing in benign fashion.No suspicious microcalcifications or areas of architectural distortion are present.
|
Large benign-appearing mass at upper outer quadrant in the left breast. Ultrasound study is recommended to confirm its benignity. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
|
Generate impression based on findings.
|
Female 60 years old Reason: 60 yo woman with 1.5 cm firm nodule of the R middle finger, r/o bony abnormalities History: 60 yo woman with 1.5 cm firm nodule of the R middle finger, r/o bony abnormalities Bone mineralization is normal. Alignment is anatomic. There is mild joint space loss compatible with mild osteoarthritis. There is a soft tissue nodule along the ulnar aspect of the middle phalanx of the third digit. It measures approximately 12 mm x 8 mm. There is no discrete underlying bony abnormality.
|
Soft tissue nodule without underlying bone abnormality as detailed above.
|
Generate impression based on findings.
|
T4aNxMx BOT p16- squamous cell carcinoma status post chemoRT with worsening swelling - post RT inflammation versus infection versus POD. There is an ill-defined lesion involving the right oral tongue and tongue base with extension across the midline and an ulcerating defect that contains air and fluid. The lesion measures up to 7.5 cm and extends into the right submandibular space, where it appears inseparable from the submandibular gland. The major cervical vessels are patent. There may be slight erosion of the right body of the hyoid, but the mandible appears to be grossly intact. There is a heterogeneous right level 2B lymph node that measures 11 mm in short axis. The airways are patent. The imaged intracranial structures are unremarkable. There are nodules within the partially-imaged lungs, including a right apical lesion that measures up to 10 mm.
|
1. An ill-defined lesion involving the right oral tongue and tongue base with extension across the midline and an ulcerating defect that contains air and fluid may represent residual or recurrent neoplasm and treatment effects, perhaps with superimposed infection. 2. A right level 2 lymph node appears pathological, but is otherwise nonspecific in this particular clinical setting.3. Nonspecific nodules within the partially-imaged lungs, including a right apical lesion that measures up to 10 mm. Please refer to the separate chest CT report for additional details.
|
Generate impression based on findings.
|
Male 54 years old Reason: right knee pain no hx of trauma History: right knee pain Bone mineralization is normal . Alignment is anatomic. There are small tricompartmental osteophytes compatible with osteoarthritis. No joint effusion, fracture or malalignment.
|
Osteoarthritis.
|
Generate impression based on findings.
|
Female 81 years old Reason: Persistent left knee pain with movement and tender to palpation, no warmth or erythema, history of OA. History: As above Left knee: Bone mineralization is decreased. Alignment is anatomic. The joint spaces are normal. No joint effusion. There are postsurgical changes along the medial aspect of the right thigh and knee. Lower extremity: Bone mineralization is decreased. Alignment is anatomic. No acute fracture or dislocation. There are vascular calcifications and postsurgical changes and clips.
|
Osteopenia/osteoporosis without fracture or malalignment.
|
Generate impression based on findings.
|
Reason: s/p ?ischemic stroke, now w/ AMS History: AMS The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild to moderate degree are present. Atherosclerotic calcifications are present along the distal internal carotid arteries. Hypodensities also present in the pons which is of increased present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Atherosclerotic calcifications are present along the distal external carotid artery branches (often seen with renal failure). Atherosclerotic calcifications are present along the distal vertebral arteries.The visualized portions of the paranasal sinuses demonstrate mucosal thickening and mucous retention cysts in the maxillary sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
|
1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3. Periventricular and subcortical white matter changes as well as changes in the pons of a mild to moderate degree are nonspecific. At this age they are most likely vascular related.
|
Generate impression based on findings.
|
Male 14 years old Reason: evaluate ankle injury History: right ankle injuryVIEWS: Right ankle AP, lateral and oblique 1/29/15 (3 views) Cast material obscures fine bone details. No fracture line or signs of healing are noted. Alignment is anatomic.
|
Status post casting as described.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. A circumscribed mass at upper outer quadrant, likely an intramammary lymph node. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Mammogram works best when searching for changes. Submission of prior mammogram is, therefore, recommended for future reference. If the patient submits her old mammograms, we can compare them with the current study to establish stability.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram.
|
Generate impression based on findings.
|
60 year-old female with MGUS SKULL: No discrete myelomatous lesions.CERVICAL SPINE: No discrete myelomatous lesions.THORACIC SPINE: Small anterior osteophytes are noted along the upper thoracic spine. No discrete myelomatous lesions.LUMBAR SPINE: No discrete myelomatous lesions. Grade 1 anterolisthesis of L4 on 5.RIBS: No discrete myelomatous lesions. Right upper quadrant surgical clips.PELVIS: No discrete myelomatous lesions.UPPER EXTREMITY: No discrete myelomatous lesions.LOWER EXTREMITY: No discrete myelomatous lesions. Moderate degenerative changes affect the hips and knees bilaterally.
|
No discrete myelomatous lesions. Degenerative arthritic changes as described above.
|
Generate impression based on findings.
|
Female 83 years old Reason: distal femur fx History: same Left knee: Bone mineralization is decreased. There is a comminuted displaced fracture at the distal femoral metaphysis with posterior displacement of the distal fracture fragment a shafts width. Proximal portion projects over the patella. There is an effusion.There are postsurgical changes from a total knee arthroplasty. There is advanced osteoarthritic changes involving the medial tibial plateau. There is likely some subsidence of the medial tibial tray.Left femur: Two views of the left femur show the aforementioned distal femoral fracture. No proximal fracture is evidentLeft tibia: Two views of the left tibia shows decreased bone mineralization. No acute fracture is evident.
|
Distal femoral fracture as detailed above.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.