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Generate impression based on findings.
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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 mostly fatty replaced, unchanged in pattern and distribution. Stable benign subcentimeter masses are present in the right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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: NSA - Screening Mammogram.
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Generate impression based on findings.
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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 suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts (total 8 images) were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. Multiple oil cysts are present in the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Male 50 years old Reason: s/p R hip FAI repair History: same There are postsurgical changes in the right femoral head neck junction and acetabulum. No acute fracture or dislocation.
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No acute fracture or dislocation.
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Generate impression based on findings.
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Female 68 years old Reason: evaluate for left knee pain History: left knee pain Status post total right knee arthroplasty. Moderate to severe osteoarthritis affects the left knee with near bone on bone apposition and tricompartmental osteophytes. There is a small joint effusion.No acute fracture or malalignment. As the calcifications are noted behind the knee.
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Moderate to severe left knee osteoarthritis
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Generate impression based on findings.
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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. There are two calcified oil cysts in the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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Male 65 years old Reason: evaluate for left knee pain History: left knee pain Bone mineralization is normal. Alignment is anatomic. There is severe medial compartment joint space loss. There are tricompartmental osteophytes. No joint effusion. No acute fracture or malalignment.Contralateral right knee shows moderate to severe medial compartment joint space narrowing.
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Moderate to severe left knee osteoarthritis
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Generate impression based on findings.
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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. Biopsy clips are noted in both breasts. A cluster of calcifications at posterior upper outer quadrant in the left breast is unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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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. There are scattered coarse benign calcifications in both breasts. A cluster of calcifications is present at posterior 12 o'clock position in the right breast. No suspicious masses or areas of architectural distortion are present.
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A cluster of calcifications at posterior 12 o'clock position in the right breast. Magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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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 suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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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 circumscribed mass is present at lower outer quadrant in the left breast. No suspicious microcalcifications or areas of architectural distortion are present.
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A circumscribed mass at lower outer quadrant in the left breast, for which spot compression views and possible ultrasound study are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Male 76 years old; Reason: Assess lung perfusion/ventilation - preop eval for possible surgical resection of abscess The comparison chest radiograph performed on 1/27/2015 demonstrate postsurgical changes from right upper lobectomy with marked volume loss and diffuse opacity associated with an air-fluid level in the right lower lung zone. Please refer to chest x-ray and dedicated CT chest report for additional findings.The ventilation images show near complete absence of ventilation in the right lung. Ventilation images of the left lung is heterogeneous with slight decrease in uptake along the medial aspect of the lower lung zone. There is abnormal retention of Xe-133 diffusely in the left lung. The perfusion images show near complete matched perfusion defect throughout the entire right lung. Perfusion images of the left lung is fairly uniform in appearance with similar slight decrease in uptake along the medial aspect of the lower lung zone.Quantitation of relative single breath ventilation (using the posterior image):Left lung: 95% (upper lung 27%; middle lung 43%; lower lung 25%)Right lung: 5% (upper lung 3%; middle lung 2%; lower lung 0.8%)Quantitation of relative pulmonary arterial perfusion (using anterior and posterior geometric means):Left lung: 99% (upper lung 25%; middle lung 49%; lower lung 26%)Right lung: 0.8% (upper lung 0.2%; middle lung 0.3%; lower lung 0.3%)
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There is essentially no demonstrable ventilation or perfusion in the entire right lung as quantified above.
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Generate impression based on findings.
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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.
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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.
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Generate impression based on findings.
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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. A group of calcifications in the left upper outer breast and right upper breast is unchanged.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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Female 82 years old; Reason: metastatic colon cancer History: surveillance CHEST:LUNGS AND PLEURA: Stable left apical scarring.MEDIASTINUM AND HILA: Interval decrease in size of reference left supraclavicular lymph node measuring 1.6 x 1 cm, image 3 series 3, previously measured 2.6 x 1.2 cm.CHEST WALL: As seen on prior study are multiple chest wall varices. Right internal jugular vein and innominate vein not well seen and markedly attenuated, similar to the prior study, likely reflecting chronic sequela of thrombosis. Mild calcified coronary artery disease.ABDOMEN:LIVER, BILIARY TRACT: Diffuse hepatic steatosis.SPLEEN: Splenule formation.PANCREAS: Unchanged 1 cm pancreatic body cystic focus and pancreatic parenchymal atrophy seen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right-sided extrarenal pelvis. Stable left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Underdistended gastric antrum. PELVIS:UTERUS, ADNEXA: Status post hysterectomy. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. Multilevel degenerative changes of spine. Stable grade 1 anterolisthesis of L4 on L5. Ventral abdominal postsurgical sequela.
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1. Interval decrease in size of reference left supraclavicular lymph node.
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Generate impression based on findings.
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56-year-old male with left ankle swelling There is marked soft tissue swelling, particularly about the lateral aspect of the ankle. A comminuted fracture with oblique and transverse components extends through the distal fibula to the level of the joint. Moderate joint effusion.
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Comminuted distal fibular fracture and additional findings as described above.
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Generate impression based on findings.
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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 suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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14-year-old male with right clavicle fracture, fall downstairsVIEWS: Right clavicle AP/clavicle (two views) 01/29/15 There is a predominantly transverse fracture through the middle third of the right clavicle with one full shaft width inferior displacement of the distal fracture fragment. There is also foreshortening of the clavicle by approximately 2 cm. Tenting of the skin caused by the proximal fracture fragment is noted.
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Clavicle fracture as described above.
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Generate impression based on findings.
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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.
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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.
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Generate impression based on findings.
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61 year-old male with history of kidney mass. 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: Right lower pole hypoattenuating lesion (7 slice 77) measures 2 x 2 cm, unchanged in size. There is no significant enhancement and most likely represents a benign complex cyst, may contain hemorrhagic or proteinaceous material. Additional right lower pole tiny cyst is too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes affect the lower lumbar spine.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality noted
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Right lower pole hypoattenuating lesion without significant enhancement, appearance consistent with benign complex cyst.
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Generate impression based on findings.
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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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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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. Biopsy clip in the left breast is unchanged. Scattered benign bilateral calcifications are also unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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Reason: r/o stricture, dysmotility History: hx of multinodular goiter s/p excision. now with dysphagia. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. Surgical clips noted in the neck, compatible with prior thyroid resection.Double contrast evaluation of the esophagus and gastric cardia/fundus was limited because patient not tolerating effervescent agent. There was mildly prominent aortic impression of doubtful clinical significance. Limited examination showed no morphologic abnormalities of the mucosal surfaces or mural contours. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. No evidence of hiatal hernia. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.TOTAL FLUOROSCOPY TIME: 5:29 minutes
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1.Limited double contrast study due to patient not tolerating effervescent agent. Within this limitation, no morphologic abnormalities of the mucosal surfaces or mural contours was identified.2.Normal motility.3.No evidence of reflux or hernia.
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Generate impression based on findings.
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83 year old male s/p Dobbhoff placement. Exam limited by patient motion. Dobbhoff tip in gastric fundus. Nonobstructive bowel gas pattern. Right central venous catheter tip in right atrium.
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Dobbhoff tip in gastric fundus.
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Generate impression based on findings.
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Male 12 years old Reason: evaluate scoliosis in brace History: scoliosisVIEWS: Thoracolumbar spine in brace AP (one views) 1/29/2015 Dextroscoliosis between T2 and T9 measures 51 degrees, previously 53 degrees. Levoscoliosis between T10 and L3 measures 59 degrees, previously 63 degrees. Stool is present within the rectum.
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Scoliosis as detail above, slightly improved.
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Generate impression based on findings.
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53 years, Male. Reason: eval NJ position History: asx NJ tube tip overlies jejunum. Retained contrast in the colon. Nonobstructive bowel gas pattern.
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NJ tube tip overlies jejunum.
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Generate impression based on findings.
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Male 15 years old Reason: evaluate kyphoscoliosis History: kyphoscoliosisVIEWS: Thoracolumbar spine PA and lateral (two views) 1/29/2015 61 degrees kyphosis of the thoracic spine. No significant scoliosis is evident. Stool is present in the rectum.
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61 degrees kyphosis thoracic spine
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Generate impression based on findings.
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5-year-old male with history of Hirschsprung's disease, evaluate stool burdenVIEW: Abdomen AP (one view) 01/29/15 Mild to moderate stool burden. Nonobstructive bowel gas pattern. No pneumoperitoneum.
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Mild to moderate stool burden.
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Generate impression based on findings.
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9-year-old male with altered mental status, status post intubation.VIEW: Chest AP (one view) 1/29/2015 The endotracheal tube tip is just below the thoracic inlet. The right upper extremity PICC tip is in the superior SVC. The left central venous catheter tip is at the cavoatrial junction.Left lower lobe opacity with air bronchograms consistent with consolidation. No pleural effusion or pneumothorax is seen. The cardiothymic silhouette is normal.Findings consistent with right hepatectomy and right nephrectomy.
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Left lower lobe consolidation.
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Generate impression based on findings.
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History of recent syncope/fall with subdural hematoma, evaluate stability. Again demonstrated is subdural hematoma along the falx, extending around the left cerebral convexity. Stable appearance of foci of intraparenchymal and subarachnoid hemorrhage in the bilateral frontal lobes, left greater than right. A trace amount of hemorrhage remains present in the right occipital horn. Isoattenuating fluid along the left frontal lobe may represent subacute hemorrhage. There has been mild interval improvement in the degree of effacement of the left lateral ventricle. The minimal rightward midline shift is stable, remeasured at 7 mm on previous exam. No acute calvarial fractures are identified. Interval decrease of the small subgaleal hematoma overlying the posterior parietal bone. There is redemonstration of postoperative findings related to right frontal pterional craniotomy and resection of right anterior temporal lobe mass, with resultant encephalomalacia. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminate small vessel ischemic changes, not significantly changed compared to prior exam. Evidence of previous bilateral cataract surgery. Small retention cysts are present in the bilateral maxillary sinuses, and there is an air-fluid level in the right sphenoid sinus. The mastoid air cells are clear.
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1. There is a grossly unchanged appearance of a subdural hematoma along the falx, extending around the left cerebral convexity, as well as unchanged minimal rightward midline shift. There is mild interval improvement of the mild left lateral ventricular effacement. 2. Stable multiple foci of intraparenchymal and subarachnoid hemorrhage with mild intraventricular extension.3. Stable postoperative findings related to right frontal pterional craniotomy and resection of right anterior temporal lobe mass.
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Generate impression based on findings.
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Reason: 14 year old female with recurring meal related abdominal pain associated with nausea. Need to evaluate for biliary dyskinesia / gall bladder dysfunction Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, gallbladder and duodenum, indicating patent common bile and cystic ducts.Following CCK administration, there was visually significant gall bladder emptying with the GB ejection fraction calculated to be 97 % (normal >40%).The patient experienced some nausea during CCK administration but no significant abdominal pain.
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1. Normal hepatobiliary imaging. No evidence of acute or chronic cholecystitis.2. Normal gall bladder contractile response to CCK. Note the patient experienced some nausea with CCK administration.
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Generate impression based on findings.
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Non-Hodgkin's lymphoma, high risk for lung cancer, history of radiation and current cigarette smoker LUNGS AND PLEURA: Right paramediastinal reticular opacities compatible with history of radiation, unchanged.MEDIASTINUM AND HILA: Reference partially calcified anterior mediastinal lymph node measures 5.4 x 2.5 cm (series 3, image 50), previously 5.4 x 3.4 cm.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy.
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1.Anterior mediastinal enlarged lymph node is unchanged as far back as at least 6/28/2007.2.Right paramediastinal radiation changes without suspicious nodules or masses.
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Generate impression based on findings.
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Left-sided testicular pain RIGHT TESTIS: Measures 5.2 x 3.6 x 2.6 cm. Parenchymal vascularity normal.LEFT TESTIS: Avascular, testis measures 4.5 x 3.9 x 3.3 cm.RIGHT EPIDIDYMIS: Unremarkable, vascularity likely within normal limits.LEFT EPIDIDYMIS: Avascular, heterogeneous and asymmetrically enlarged.OTHER: Small left-sided hydrocele, likely reactive.
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Findings compatible with left-sided testicular and epididymal torsion with small left-sided hydrocele, extratesticular fluid likely reactive. Findings discussed with ED physician Dr. Bukari at 10:35 a.m. on 1/29/15.
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Generate impression based on findings.
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60 year-old with history of left breast cancer with new right breast mass for which ultrasound guided biopsy is requested. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 11 mm at the 6 o’clock position without increased vascularity, 2 cm from the nipple. The lesion was readily visible.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a mediolateral approach, three 14-gauge core needle (Achieve) specimens were obtained of the lesion. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. No specimens floated. Specimen quality was judged excellent.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Hydromark clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital right CC and ML views revealed the percutaneously placed clip to be in the expected location in the inferior breast. Multiple attempts were made to completely visualize the clip and asymmetry on the CC view, but this could not be accomplished. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Schacht. Dr. Schacht was present during the procedure at all times.
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Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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Male 62 years old Reason: h/o mediastinal LAD History: lymphadenopathy concerning for lymphoma CHEST:LUNGS AND PLEURA: New left lower air space opacity suspicious for pneumonia. In addition there are other patchy groundglass opacities in the left lower lobe and right upper lobe which may represent infection or drug reaction.MEDIASTINUM AND HILA: Mediastinal and left hilar adenopathy has significantly decreased in size compared to previous study. The encasement of the left bronchi have also significantly decreased.Index left paratracheal node measures 8mm in short axis on image number 18, series number 3.Confluent index AP window lymph node now measures 2.8 x 2.5 cm on image number 37, series number 3. Index left para-aortic lymph node has also significantly decreased in size and now measures 1.9 x 1 cm on image number 79, series number 3.CHEST WALL: Index left supraclavicular lymph node has also decreased in size within the interval and now cannot be measured optimally.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Significant interval decrease in the size of the splenic hypodense lesions. Index lesion now measures 2 x 1.5 cm on image number 94, series number 3.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: Index aortocaval lymph node now measures 1.3 x 0.7 cm on image number 132, series number 3, decreased in size compared to previous study. Index gastrohepatic lymph node now measures 1.4 x 0.8 cm on image number 99, series number 3, decreased in size compared to previous study. Other diffuse and focal retroperitoneal adenopathy is also decreased within the interval.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: Index right external iliac lymph node is no longer visualized.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Chronic bone changes are again noted, stable.OTHER: No significant abnormality noted
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Significant interval decrease in in the size of the extensive metastatic adenopathy and splenic lesions.Left lower lobe air space opacity suspicious for pneumonia, new from previous study.
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Generate impression based on findings.
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History of left lumpectomy 3/2013 for DCIS with microinvasion. Patient received radiation and is currently on tamoxifen. No new breast complaints. History of breast cancer in sister diagnosed at the age of 35. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts, two right spot compression views and two left 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. A linear marker was placed on the scar overlying the left breast. Stable postsurgical volume loss, architectural distortion and surgical clips are present in the lumpectomy bed. Scattered calcifications are unchanged. Focal asymmetry in the right retroareolar region disperses on spot compression imaging. Stable subcentimeter mass is present in the mid depth of the right breast at the 12 o'clock position. Stable benign lymph nodes project over both axillae.No new masses or suspicious microcalcifications are present in either breast. RIGHT BREAST ULTRASOUND: On physical examination, no palpable masses were present of the right breast. A targeted right breast ultrasound was performed for the mammographic area of concern. At the 12 o'clock position of the right breast, 1 cm from the nipple, a 0.3 x 0.4 x 0.2 cm simple cyst is present. No suspicious solid masses are present in the right retroareolar region by ultrasound.
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Stable postsurgical changes of the left breast. Stable right breast cyst. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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77-year-old male with bilateral hip pain Pelvis and hips: Mild degenerative changes affect the hips. No fracture is evident. A penile prosthesis is noted.Right knee: There are tricompartmental osteophytes and narrowing of the medial joint compartment and medial patellofemoral joint. Left knee: There is medial patellofemoral and tibiofemoral joint compartment narrowing. Tricompartment osteophytes are also noted.
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Osteoarthritis, as described above.
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Generate impression based on findings.
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3-year-old male with pelvic sarcoma NOS CHEST:LUNGS AND PLEURA: No pleural effusion. No focal pulmonary opacities.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No cardiophrenic, retrocrural, or axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. Gallbladder is within normal limits. No intrahepatic or extrahepatic biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is severe hydroureteronephrosis of the right kidney with increased parenchymal thinning. The left kidney is within normal limits.RETROPERITONEUM, LYMPH NODES: Reference lymph node (series 3, image 72) measures approximately 6 mm, unchanged since the prior exam. No significant lymphadenopathy is identified.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder wall is thickened which may be confounded by underdistention.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes and surgical clips are noted in the right hemipelvis. Ill-defined mass in the right hemipelvis within the surgical bed appears unchanged. The bowel is within normal limits without evidence of obstruction. Appendix is well-visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality is noted.OTHER: No significant abnormality noted
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1.Right pelvic mass appears unchanged in size.2.Slight interval worsening of right hydroureteronephrosis.
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Generate impression based on findings.
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Metastatic breast cancer to lung and liver CHEST:LUNGS AND PLEURA: New right fissural nodule along the right oblique fissure measures 6 mm (series 5, image 40). Additional fissural nodules appear similar in appearance to the prior exam.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications. No pericardial effusion.CHEST WALL: Status post right mastectomy. Multiple osseous metastases affect the thoracic spine appearing similar to the prior exam. Right scapula soft tissue mass with osseous destruction is incompletely visualized but measures 5 cm in diameter, compared to the prior exam where it measured 4.1 cm in maximal diameter (series 3, image 1).ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Increasing hepatic metastases. Reference segment 8 lesion measures 2.0 cm in diameter (series 3, image 66), previously 1.4 cm. Cholelithiasis. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Widespread osseous metastases.
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1.Increasing hepatic metastases.2.Increasing right scapula soft tissue mass.3.New right pulmonary nodule.4.Widespread osseous metastases.
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Generate impression based on findings.
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58-year-old female status post right TKA Hardware components of a total knee arthroplasty device are situated in near anatomic alignment without evidence of complication. Osteoarthritis affects the contralateral knee as seen on the frontal view.
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TKA without evidence of complication.
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Generate impression based on findings.
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Male 10 years old Reason: evaluate healing of fracture History: right distal tibia fractureVIEWS: Right ankle AP and lateral (two views) 1/29/2015 Again seen is an oblique fracture through the distal tibial diaphysis with lateral displacement of the distal fracture fragment. Periosteal reaction is present consistent with healing. The bones appear demineralized. Overlying cast material obscures fine bone detail.
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Oblique fracture through the distal tibial diaphysis, which is unchanged in alignment.
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Generate impression based on findings.
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57-year-old male with medial left knee pain Alignment is anatomic. No fracture is evident. The osseous structures are within normal limits for the patient's age.
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No fracture or other findings to account for the patient's knee pain.
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Generate impression based on findings.
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Nodular lymphocytic predominant Hodgkin lymphoma. There are postoperative findings in the left lower neck. There has been interval decrease in size of the cervical lymphadenopathy. For example, a right level 3 lymph node measures 11 x 12 mm, previously 16 x 25 mm. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is multilevel degenerative spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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Interval decrease in size of the lymphadenopathy in the neck.
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Generate impression based on findings.
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Axial images are somewhat degraded by motion artifact. There is minimal progression of mild anterolisthesis of L4 on L5 measuring approximately 3 mm, likely degenerative. The vertebral body heights are preserved. There is mild loss of disc height and disc desiccation at L4-L5 and L5-S1. The vertebral bone marrow signal is unremarkable. The spinal cord displays normal signal and morphology. Incidentally noted is a small right renal cyst. The paravertebral soft tissues are unremarkable.T12-L1: No significant disc bulge, herniation, spinal canal or foraminal stenosis. L1-L2: No significant disc bulge, herniation, spinal canal or foraminal stenosis. L2-L3: Thickening of the ligamentum flavum and bilateral facet arthropathy. No significant disc bulge, herniation, spinal canal or foraminal stenosis. L3-L4: Disc bulge, thickening of the ligamentum flavum and bilateral facet arthropathy, contributing to mild spinal canal stenosis and mild left foraminal stenosis.L4-L5: Disc bulge, thickening of the ligamentum flavum and bilateral facet arthropathy, contributing to moderate to severe spinal canal stenosis, slightly progressed, and mild to moderate right and mild left foraminal narrowing. L5-S1: Disc bulge and bilateral facet arthropathy, contributing to mild bilateral foraminal narrowing. No significant central spinal stenosis.
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1. Degenerative spondylosis of the lumbar spine, most prominent at L4-L5, with slightly progressed moderate to severe spinal canal stenosis and mild to moderate right and mild left foraminal narrowing. 2. Minimal progression of mild anterolisthesis of L4 on L5, likely degenerative.
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Generate impression based on findings.
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Male 24 years old; Reason: hx of testicular cancer, evaluate for metastatic disease History: see above ABDOMEN:LUNGS BASES: No significant abnormality noted.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: Previously seen right nephroureterostomy catheter has been removed. There is no evidence of hydronephrosis or hydroureter. No focal renal lesions.RETROPERITONEUM, LYMPH NODES: Surgical previously seen aortocaval node is resected. There is new soft tissue density to the left of the aorta, inseparable bowel which may be distorted secondary to the surgery. The new left para-aortic component is measured on series 4 image 54 as 2 x 1.1 cm. Follow-up CT should include excellent oral contrast in the duodenum and jejunum for better delineation. If there is a need to better clarify residual or recurrent lymphadenopathy, an MRI is another option.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Previously seen nephroureterostomy catheter has been removed.LYMPH NODES: Small right external iliac, small bilateral obturator and small inguinal nodes. Only the inguinal nodes is slightly more prominent than on the prior exam.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted.
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1.New postoperative changes in the retroperitoneum with question of new lymphadenopathy versus distorted small bowel. This could be clarified with either MR or excellent bowel opacification of the entire duodenum and proximal jejunum on abdominal CT.2.Small pelvic nodes.3.Discussed with Dr. Scott Eggener.
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Generate impression based on findings.
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The liver measures 19.9 cm in length and demonstrates appropriate parenchymal echogenicity without evidence of intrahepatic or extra hepatic biliary ductal dilatation. The right kidney measures 12.1 cm in length and the left kidney measures 11.3 cm in length. There is no evidence of hydronephrosis. The spleen measures 9.3 cm in length.DOPPLER
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Enlarged liver without evidence of venoocclusive disease.
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Generate impression based on findings.
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Male 83 years old Reason: eval for mets History: prostate cancer, rising PSA 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: Status post prostatectomy. There is asymmetric fullness in the region of the left seminal vesicles around the clips. This may represent postsurgical changes or residual seminal vesicle, however, recurrence cannot be excluded.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Asymmetric fullness around the surgical clips in the region of the left seminal vesicle. MRI of the pelvis may be helpful for further characterization.
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Generate impression based on findings.
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GE junction mass, probable leiomyoma, evaluate change in lesion CHEST:LUNGS AND PLEURA: No suspicious nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No lymphadenopathy. Mild coronary artery calcifications. No pericardial effusion.CHEST WALL: Small left Bochdalek hernia.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter segment 7 hepatic hypodensity is too small to further characterize, but appears similar to the prior exam.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Lobulated soft tissue mass centered around the GE junction with pedunculation into the gastric fundus measures approximately 5.7 x 4.0 cm (series 3, image 86), previously approximately 6.3 x 5.0 cm.BONES, SOFT TISSUES: Stable sclerotic foci in the L2-4 vertebral bodies.
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Decreasing intraluminal soft tissue mass centered at the GE junction compatible with patient's history of leiomyoma. No evidence of metastases.
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Generate impression based on findings.
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Male 78 years old Reason: S/P THERASPHERE ADMINISTRATION, HCC History: S/P THERASPHERE ADMINISTRATION, HCC CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Patient's known mass compatible with hepatocellular carcinoma now measures 8 x 6.3 cm on image number 41, series number 9, not significantly changed from previous study. There are geographical hypodense areas posterior to this lesion and confluent with this lesion. There represent post treatment changes. Multiple subcentimeter hypodense lesions throughout the liver are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral adrenal nodules are unchanged. Left adrenal nodule measures 1.4 x 1.3 cm on image number 90, series number. On the one second of dateKIDNEYS, URETERS: Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Infrarenal abdominal aortic aneurysm measuring 3.3-cm in largest AP dimension.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple healed rib fractures are unchanged.OTHER: 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
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No significant change from previous study.
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Generate impression based on findings.
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There is mild ventricular and sulcal prominence likely indicating mild global volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are a two punctate subcortical T2 hyperintensities without enhancement or diffusion restriction. Overall there is no abnormal enhancement or diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is a small nonenhancing linear structure along the anterior aspect of the posterior pituitary bright spot, which most likely represents a pars intermedia cyst. Left maxillary and left ethmoid mucous retention cyst. Areas of focal T2 hyperintensity within the bodies of the bilateral pterygoids drop out in signal on fat saturated post-contrast images, corresponding to lucency on CT and non-hypermetabolic on FDG-PET likely represents focal fat.
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There are two nonenhancing punctate subcortical white matter T2/FLAIR hyperintensities which are nonspecific.
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Generate impression based on findings.
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Female 17 years old Reason: please eval for picc line placement History: as aboveVIEW: Chest AP (one view) 1/29/2015 Left upper extremity PICC terminates has been retracted, with the tip now in the the confluence of the right innominate and superior vena cava. No focal air space opacity is seen. The cardiothymic silhouette is normal. No pneumothorax or pleural effusion evident.
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Left upper extremity PICC terminates at the confluence of the right innominate vein and the superior vena cava.
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Generate impression based on findings.
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Male 4 months old Reason: Intubated, abdominal distension History: distensionVIEW: Chest and Abdomen AP (two view) 1/29/2015 Endotracheal tube tip terminates just above the carina. The NG tube tip is in the body of the stomach.New right middle and right lower lobe atelectasis with associated mediastinal shift. Lucency seen between the right 10th and 11th ribs is presumably pulmonary etiology, although this cannot be confirmed on this examination. Streaky left lower lobe opacity likely reflects additional atelectasis. Background diffuse course pulmonary opacity unchanged.Disorganized nonobstructive bowel gas pattern. No portal venous gas or pneumatosis intestinalis seen. Foci of gas projecting over the right upper quadrant is presumably pulmonary in etiology, although could conceivably represent pneumoperitoneum.
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1.Right lower right middle lobe atelectasis with unchanged chronic diffuse course opacities.2.Focus of air between the right 10th and 11th ribs is presumably pulmonary in etiology, although pneumoperitoneum cannot be excluded.These findings were relayed to Dr. Jones via telephone at 13:15 on 1/29/2015.
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Generate impression based on findings.
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55-year-old male with left diabetic foot ulcer Amputations are noted through the first and second proximal phalanges and through the fifth proximal metatarsal. The osteotomy margins appear sharp. There is no bone destruction or other specific radiographic evidence of osteomyelitis.
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No specific radiographic features of osteomyelitis. If further evaluation is clinically warranted, MRI may be considered.
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Generate impression based on findings.
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Male 40 years old Reason: history of allogeneic transplant for MDS with rising EBV viremia-evaluate for PTLD. Also with anorexia History: EBV viremia. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: 13.2 cm length as measured on coronal image 23. No focal lesions.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Contour of both kidneys appears slightly scarred correlate for infections.Several small hypodensities in the right kidney too small to characterize likely cysts and likely unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Lap seen to be in place. On the scout view is seen in a somewhat oval configuration (sometimes associated with slippage) however no definite slippage is seen on analysis of the coronal, sagittal and axial views. The estimated angle of Phi is 48 degrees. The proximal pouch is too small to measure.BONES, SOFT TISSUES: Lap band port left abdomen.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes sigmoid colon. No bowel wall thickening or dilatation. No free or loculated fluid.BONES, SOFT TISSUES: Mild anasarca.OTHER: No significant abnormality noted
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Mild splenomegaly. Postsurgical changes. Lap band in place, without any definite slippage.
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Generate impression based on findings.
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There is avulsion of the right C8 nerve roots at the spinal cord with retraction and heterogeneous, decreased T2 signal just distal to the right C7-T1 foramen. There is a focal T2 hyperintense lesion at the right C7-T1 foramen measuring approximately 5 x 9 mm, representing a pseudomeningocele. The right cervical plexus and brachial plexus is otherwise well visualized. There are no masses or lymphadenopathy identified within limitations of this noncontrast exam. There are no compressive masses demonstrated. There is no axillary lymphadenopathy.
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Avulsion with distal retraction of the right C8 nerve root and associated pseudomeningocele at the right C7-T1 foramen.
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Generate impression based on findings.
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Reason: Rectal prolapse, possible slow transit History: constipation, rectal prolase Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was one hour ten minutes. Cecal diverticulum vs prominent sacculation measuring 4.1 x 4.4 cm was noted adjacent to the ileocecal junction (series 11). There was separation of small bowel loops with irregular mucosa, likely from prior parasitic infection and reactive fibrofatty mesenteric disease (series 12). On single spot image 15 minutes after contrast ingestion (time stamped 9:42:12), there was increased folds per length on bowel loops in the right lower or turns, presumed to be ileum. This finding did not persist on subsequent imaging. If clinical concern, serology for celiac disease can be obtained.Terminal ileum was difficult to fill with contrast with manual compression, and underlying postinflammatory changes at the terminale ileum and cannot be excluded.TOTAL FLUOROSCOPY TIME: 8:30 minutes
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1.Transit time to the colon was one hour ten minutes.2.Cecal diverticulum vs prominent sacculation adjacent to the ileocecal junction.3.Separation of small bowel loops with irregular mucosa, likely from prior parasitic infection and reactive fibrofatty mesenteric disease.4.Questionable increased folds per length of the presumed ileum at right lower quadrant. If clinical concern, serology for celiac disease can be obtained.5.Difficulty filling terminal ileum with contrast during manual compression. Underlying post inflammatory change from prior infection at the terminal ileum cannot be excluded.
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Generate impression based on findings.
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Dysphagia with multiple ENT scopes. Evaluate for obstructing goiter. There is circumferential narrowing at the level of the supraglottic larynx without apparent extrinsic mass. The airways are otherwise patent. There is no evidence of mass lesions or significant cervical lymphadenopathy. The thyroid gland is mildly prominent particularly the right thyroid lobe and isthmus and containing multiple nodules without mass effect on the trachea. The major salivary glands are unremarkable. There are atherosclerotic calcifications of the cavernous portions of the internal carotid arteries, bilateral carotid bifurcations and aorta. The major cervical vessels are otherwise patent. There is straightening of the usual cervical lordosis. There is mild degenerative changes of the cervical spine. The osseous structures are otherwise unremarkable. The imaged intracranial structures are unremarkable. There are bilateral lens implants. The imaged portions of the lungs are clear.
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1. Mild circumferential narrowing at the level of the supraglottic larynx without extrinsic mass.2. Multinodular goiter without associated compression of the adjacent trachea.
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Generate impression based on findings.
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85-year-old female history of right total knee revision. Hardware components of the long stem total right knee arthroplasty are situated in near-anatomic alignment without radiographic evidence of hardware complication. Severe osteoarthritis affects the left knee as seen on the frontal view.
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Total knee arthroplasty as above.
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Generate impression based on findings.
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History of left breast cancer status post left mastectomy in 2011. Patient received chemotherapy and hormonal therapy. No new 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 density, unchanged in pattern and distribution. No new masses, suspicious microcalcifications or areas of architectural distortion are present. Stable lymph nodes are projected over the right axilla.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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History of metastatic breast cancer presents with shortness of breath, evaluate for pulmonary embolism versus progression of disease PULMONARY ARTERIES: No evidence of acute pulmonary embolism. Flow related artifact is noted in the right main pulmonary artery extending into the lobar branches.LUNGS AND PLEURA: Right paramediastinal fibrosis compatible with radiation changes. Right perihilar tumor with associated right lower lobe atelectasis. The right inferior pulmonary vein is markedly attenuated, grossly stable. New left pleural effusion. Increasing right pleural effusion. Reference right middle pulmonary lobe nodule measures 33 x 11 mm (series 9, image 47), unchanged. Reference left lower lobe nodule adjacent to the fissure measures 31 x 22 mm (series 9, image 51), previously 31 x 24 mm. Additional pulmonary nodules appear grossly stable. New ground glass opacity in the left upper lobe may represent infection or hemorrhage.MEDIASTINUM AND HILA: Increasing superior mediastinal lymphadenopathy with a left paratracheal lymph node measuring 17 mm in short axis (series 7, image 36), previously 13 mm. Reference prevascular lymph node conglomerate measures 28 mm in short axis (series 9, image 38), unchanged. Heart size is large without pericardial effusion. Mild coronary artery calcifications. Right IJ catheter Port-A-Cath tip at the superior cavoatrial junction.CHEST WALL: Bilateral mastectomies with saline implants, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Previously described right hepatic lobe metastases are not in the current examination's field-of-view. Prominent upper abdominal lymph nodes.
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1.No evidence of acute pulmonary embolism.2.Increasing right pleural effusion. New left pleural effusion.3.Increasing superior mediastinal lymphadenopathy.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
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Generate impression based on findings.
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Female 64 years old Reason: patient with recurrent endometrial cancer, now on hormonal therapy, assess for disease status History: none CHEST:LUNGS AND PLEURA: Scattered micronodules unchanged. For example, left apex series 5 image 18.Left lung nodule abutting mediastinum is less well defined and possibly smaller, series 5 image 26, 6 x 4 mm. Previously 7 x 5 mm.Right basilar groundglass opacities and some bronchiectasis may be present. The appearance is unchanged.No effusions.No new nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Postsurgical changes right lower chest upper abdominal wall..ABDOMEN:LIVER, BILIARY TRACT: Focal thickening of scarring along the anterior margin of the liver on the 2013 exam is no longer visible.SPLEEN: No significant abnormality noted.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable lung findings as above.No measurable abdominal or pelvic disease.
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Generate impression based on findings.
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47-year-old female with history of pain and discomfort. There is no acute fracture or subluxation. Intervertebral disc spaces and vertebral body heights are well-maintained. Alignment is anatomic.
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No radiographic findings to account for the patient's pain.
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Generate impression based on findings.
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71 year old with known left breast cancer. The patient presents for research biopsies of the known cancer. Left ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 20 mm at the 11 o’clock position with increased vascularity, 5 cm from the nipple. The lesion was readily visible.PROCEDURE: The procedure and its risks, including bleeding, infection, and clip removal and need for replacement, and expected benefits of ultrasound-guided core biopsy for research purposes were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The left breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a lateromedial approach, five 14-gauge core needle (Achieve) specimens were obtained of the lesion. Targeting was judged excellent. Specimen quality was judged excellent. The first two cores were placed in formalin, the next 3 cores were placed in RNAlater. These solutions were both provided by the clinical research service. The research service also was paged to pick up the specimens. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure ultrasound demonstrated that the Hydromark clip remained in the breast. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Schacht. Dr. Schacht was present during the procedure at all times.
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Successful ultrasound-guided core biopsy of the left breast lesion for research purposes. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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Male 67 years old Reason: pt with a hx of prostate cancer; now with biochemical recurrence, needs surveillance CT scans History: urinary incontinence CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Mild scoliosis.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Calcific granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Minimal atherosclerotic calcifications.BOWEL, MESENTERY: Scattered colonic diverticulosis. No evidence of ascites.BONES, SOFT TISSUES: Degnerative changes. No sclerotic or lytic lesions.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: Lymph node dissection clips. No pathologic size nodes.BOWEL, MESENTERY: Colonic diverticulosis. No evidence of ascites.BONES, SOFT TISSUES: Mild situs ossificans in the region of the low pelvis probably related prostatectomy and lymph node dissection.Small fluid density structure anterior to the left femoral head in the iliopsoas muscle series 3 image 185 measuring 2.2 x 1.5 cm. Could represent a small hematoma or cystic structure. This of doubtful clinical significance.OTHER: No significant abnormality noted
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No measurable disease. Postsurgical changes. Small near fluid density in the left distal iliopsoas muscle.
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Generate impression based on findings.
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76-year-old with history of left lumpectomy for DCIS in 2012. No current complaints. Three standard views of both breasts, repeat left CC view and lumpectomy in 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Postsurgical distortion, density, volume loss and multiple surgical clips are present in the left lumpectomy bed. Bilateral benign calcifications are noted. Repeat left CC view confirms that the left retroareolar asymmetry on the initial view is in fact the nipple.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Male 62 years old Reason: 62 year old man with history of T cell NHL s/p allo transplant in suspected CR. Compare to prior scans. History: None CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Mild splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal nonobstructing stones and right renal cyst, unchanged.RETROPERITONEUM, 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
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No significant change from previous study.
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Generate impression based on findings.
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Intracranial hemorrhage, evaluate for expansion. There is no significant change in large intraparenchymal hematoma centered within the right thalamus measuring approximately 4.8 x 3.6 x 4.1 cm in the AP, transverse, and craniocaudal dimensions (previously re-measured as 4.5 x 3.9 x 3.9 cm). Mild evolution of surrounding edema. Again seen is extension into the lateral ventricles with blood products also extending into the third and fourth ventricles. No significant change in ventricular dilatation. Interval placement of left transfrontal EVD are seen with the tip near the foramen of Monro. No significant change in leftward midline shift measuring 9 to 10 mm at the level of foramen of Monro. There is partial effacement of the suprasellar cistern. No tonsillar herniation. There is diffuse sulcal effacement similar to prior.
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1. No significant change in size of large intraparenchymal hemorrhage centered within the right thalamus with intraventricular extension.2. Interval placement of left transfrontal EVD with tip at the foramen of Monro. Unchanged ventriculomegaly.3. Diffuse sulcal effacement, leftward midline shift, and partial effacement of the suprasellar cistern indicative of downward herniation are also not significantly changed.
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Generate impression based on findings.
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Female 47 years old Reason: breast cancer History: breast cancer CHEST:LUNGS AND PLEURA: Right upper lobe groundglass opacity measuring 3.8 x 4.1 cm short 20, series number 5, likely represents early pneumonia versus less likely drug reaction. There are smaller areas of patchy groundless opacities in the left lower lobe and right lower lobe.MEDIASTINUM AND HILA: 2.3 x 1.4 cm hypodense lesion in the superior mediastinum on image number 19, series number 3. This may represent a necrotic lymph node versus small amount of fluid in a superior pericardial recess.CHEST WALL: Postsurgical changes in the right axilla.ABDOMEN:LIVER, BILIARY TRACT: Numerous hypodense lesions throughout the liver suspicious for metastatic disease. An index lesion measures 2 x 1.8 cm on image number 64, series number 3. Liver demonstrates nodular contours which may secondary to chronic liver disease versus treated metastatic disease. Clinical correlation is recommended.SPLEEN: Mild splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy likely metastatic. Index node measures 11 by 10 mm on image number 125, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse sclerotic lesions throughout the spine and pelvic bones consistent with metastatic disease. There is mild compression fracture of T6 vertebral body secondary to metastatic disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: UnremarkableLYMPH NODES: Enlarged right obturator lymph node measures 1.8 x 1.3 cm on image number 161, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Extensive bone metastases. Retroperitoneal and pelvic adenopathy.Numerous hypodense lesions in the nodular liver. These likely represent metastatic disease, however, MRI of the liver may be helpful for further characterization of these lesions. Mild splenomegaly.
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Generate impression based on findings.
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History of left lumpectomy in 2012 for invasive ductal carcinoma with mucinous features. Patient received radiation and chemotherapy. History of benign right breast biopsy. Patient being followed for right breast calcifications. No new breast complaints. History of ovarian cancer in sister diagnosed at age 69. Three standard views of both breasts and two left spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Linear markers were placed on scars overlying both breasts. Stable postsurgical architectural distortion and surgical clips are present in the left lumpectomy bed. Stable calcifications are present bilaterally, including arterial calcifications.No new masses or suspicious microcalcifications are present in either breast.
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Stable postsurgical changes of the left breast. Stable bilateral calcifications. 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 and her daughter.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Reason: hx of cobramaze right chest approach- eval effusion vs elevated diaphragm History: SOB, cough LUNGS AND PLEURA: Marked elevation of the right hemidiaphragm with overlying air is also nonobstructive subsegmental atelectasis.Minimal pleural fluid or thickening bilaterally.Thickened interlobular septa at the left lung base suggestive of mild interstitial edema.Calcified granuloma in the right lower lung consistent with previous infection.MEDIASTINUM AND HILA: Mildly enlarged nonspecific mediastinal lymph nodes, increased compared to previous, likely reactive.Severe coronary artery calcification.Mild cardiomegaly.No pericardial effusion.CHEST WALL: Degenerative disease in the spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Hemangioma in the right lobe of the liver. Multiple bilateral renal cysts.
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1. Markedly elevated right hemidiaphragm, suggestive of phrenic nerve paralysis, with overlying subsegmental atelectasis.2. Minimal bilateral pleural effusions and possible interstitial edema at the left base, suggestive of mild CHF.
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Generate impression based on findings.
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Female 34 years old Reason: Breast cancer with bone mets with acute right chest wall pain. Evaluate for rib fracture. History: Acute right low chest wall pain. Left chest wall port terminates at the cavoatrial junction. Postsurgical changes in the breasts. There are sclerotic changes of the sternum compatible with metastatic disease. The known metastatic disease to the lumbar spine and ribs are not evident on radiographs. No discrete rib fracture.
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No evidence of a rib fracture.
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Generate impression based on findings.
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Wilms tumor. Altered mental status with thrombocytopenia and anemia. There is mild global parenchymal volume loss. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a tiny mucosal retention cyst in the right maxillary sinus and trace mucosal thickening in the left. The other imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1. No evidence of intracranial hemorrhage.2. Mild global parenchymal volume loss.
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Generate impression based on findings.
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Female 66 years old Reason: unintentional weight loss History: unintentional weight loss CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Enlarged heterogeneous thyroid extending into the mediastinum.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple, subcentimeter hypodense lesions throughout the liver which are too small to accurately characterize but are most likely cysts. Mild dilatation of the common bile duct with intrahepatic biliary prominence. This very secondary to cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal nodule is unchanged measuring 2 x 1.3 cm on image number 93, series number 3. This likely represents an adenoma. Left adrenal gland is unremarkable.KIDNEYS, URETERS: 5-mm heterogeneous hypodense lesion in the posterior aspect of the midpole of the right kidney. This is too small to accurate characterize however, given its heterogeneous appearance one-year follow-up with either renal mass CT protocol renal MRI protocol may be helpful.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Presumed hemangioma involving the T3 vertebral body.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: 4.6 x 3.4 cm right adnexal cystic mass, not significantly changed from previous study. Leiomyomatous uterus and dilated endometrial stripe are also unchanged. Left ovary is unremarkable.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small amount of fluid collection in the left inguinal region of uncertain etiology and clinical significance.OTHER: No significant abnormality noted.
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Right adnexal cystic mass, not significantly changed from previous study. Endometrial stripe is dilated. Correlation with pelvic ultrasound and/or histologic sampling is recommended. Paragraph subcentimeter heterogeneous lesion in the right kidney. Follow-up with enhanced renal mass protocol CT or MRI is recommended in one year.
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Generate impression based on findings.
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History of left mastectomy in 2011 for DCIS and invasive ductal carcinoma with tubular features. No new 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 density, unchanged in pattern and distribution. Benign calcifications are present.No new masses, suspicious microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient and her husband.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Short-term follow-up for high probably right breast mass. History of breast reduction in 2005. RIGHT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Two circumscribed masses are present near the 6 o'clock position of the right breast. The more medial of these masses has decreased in size. The more lateral and posterior mass is unchanged in size.No new masses, suspicious microcalcifications or areas of architectural distortion are present. RIGHT BREAST ULTRASOUND: On physical examination, no palpable masses were present of the right breast. A targeted right breast ultrasound was performed in the area of clinical concern. At the 6 o'clock position of the right breast, 2 cm from the nipple, a 3 mm x 3 mm x 5 mm simple cyst is present. No suspicious solid masses were present in the right breast by ultrasound.
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Two high probability benign circumscribed masses in the right breast. If patient's physical examination is unremarkable, bilateral diagnostic mammogram in 6 months is recommended. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).
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Generate impression based on findings.
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Female 34 years old Reason: intermittent gross hematuria History: intermittent gross hematuria 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: Punctate stone in the right kidney on image number 49, series number 3. No evidence of hydronephrosis. No left renal stones. Subcentimeter hypodense lesion in the lower pole of the right kidney, best seen on image number 15, series number 6. This lesion is too small to accurately characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 3.9-cm in diameter left ovarian cyst.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Punctate right renal stone. Left ovarian cyst. No evidence of hydronephrosis.
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Generate impression based on findings.
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Male 51 years old; Reason: 51 yo male with hx of retroperitoneal ganglioneuroma; please evaluate for changes and or abnormalities History: retroperitoneal ganglioneuroma ABDOMEN:LUNGS BASES: No significant abnormality noted.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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Hypodense mass inseparable from and anterior to the inferior vena cava, at the level of the inferior mesenteric artery. No calcifications or visible septations. For baseline purposes measured on series 3 image 62/158, 4.6 x 2.3 cm. Density is 34 Hounsfield units. The appearance and density are consistent with a ganglioneuroma. The lesion demonstrates some mass effect on the third portion of the duodenum and also abuts the inferior mesenteric artery. Please see coronal image 47No other lesions are seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Solitary retroperitoneal mass as described consistent with retroperitoneal ganglioneuroma.
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Generate impression based on findings.
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Reason: copd,gerd, lung transplant eval History: shortness of breath LUNGS AND PLEURA: Severe emphysema, centrilobular predominant, not significantly changed since the prior CT study.Lingular scarring and possible surgical clips or calcification unchanged.Borderline lower lung zone bronchiectasis.MEDIASTINUM AND HILA: Heterogeneous thyroid enlargement.There is no mediastinal or hilar lymphadenopathy, although there are calcified lymph nodes from prior granulomatous disease. Moderate coronary artery calcifications are present, the heart and pericardium otherwise unremarkable.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Numerous splenic and hepatic granulomata, consistent with prior histoplasmosis.Cholelithiasis.
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Unchanged severe centrilobular predominant emphysema. No acute abnormality, however.
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Generate impression based on findings.
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Female 62 years old Reason: Renal CT Protocol. Pre-Kidney Transplant Evaluation History: Previous CT scan noting renal lesion see comment section 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: 2 x 1.2 cm enhancing exophytic mass in the midportion of the right kidney compatible with renal cell carcinoma, possibly papillary subtype.Calcified cyst in the lower pole of the right kidney is unchanged. Other numerous bilateral cysts are stable.Bilateral atrophic kidneys. Bilateral punctate stones are unchanged.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications throughout the aorta and iliac vessels.BOWEL, MESENTERY: No significant abnormality noted.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
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Right renal enhancing mass suspicious for papillary cell carcinoma.
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Generate impression based on findings.
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Female 61 years old Reason: right hip pain History: right hip pain; right knee pain Right hip: There are mild degenerative changes of the right hip with small osteophytes. There is mild joint space loss. No acute fracture or malalignment.Single view of the pelvis shows aforementioned right hip degenerative change. Additionally, there is mild lower spine degenerative change. No acute fracture or malalignment.Right knee: Four views of the right knee shows moderate medial compartment right knee joint space narrowing. There is subtle sclerosis of the medial femoral condyle from underlying cartilage wear and developing osteoarthritis.There are small tricompartmental osteophytes. There is a small to moderate joint effusion. Sclerotic changes in the distal femur likely osteonecrosis, unchanged.
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1.Mild right hip degenerative change.2.Mild to moderate right knee osteoarthritis.
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Generate impression based on findings.
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Pain and thickening in the right upper inner breast. Milky right nipple discharge. Patient stopped lactating 11 months ago. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and two right spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. A triangular marker was placed on the skin at the site of clinical concern. Focal asymmetry at this site disperses into normal breast parenchyma with spot compression imaging.No discrete masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. RIGHT BREAST ULTRASOUND: On physical examination, the patient has firm thickening in the right upper inner breast. Milky discharge could be expressed from the right nipple. A targeted right breast ultrasound was performed for the area of clinical concern. At the one o'clock position of the right breast, 4 cm from the nipple, a 1.5 x 0.6 x 1.2 cm mixed echogenic mass is present.
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Nonspecific mixed echogenic mass in the right upper inner breast, at site of thickening and pain. This may represent a galactocele, posttraumatic hematoma, inflammatory process or less likely malignancy. Ultrasound guided core needle biopsy is recommended. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.
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Generate impression based on findings.
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Reason: evaluate ILD History: cough sob fibrosis LUNGS AND PLEURA: Peripheral ground glass opacities effect both upper and lower lung zones, but reticulation, scarring and traction bronchiectasis is basilar predominant.Status post right-sided wedge resection.Although there is a subtle mosaic pattern, expiration series show no evidence of air trapping.A moderate right pleural effusion is present. MEDIASTINUM AND HILA: No significantly enlarged mediastinal or hilar lymph nodes are present.There are no visible coronary calcifications, although the heart is mildly enlarged. Unremarkable pericardium.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Groundglass opacities with basilar fibrosis is most consistent with NSIP, chronic hypersensitivity or DIP still in the differential diagnosis.2. Right pleural effusion unknown etiology, but the heart is mildly enlarged and could be the cause of this.
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Generate impression based on findings.
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Female 70 years old Reason: 70F w/ perforated diverticulitis now s/p sigmoid colectomy on 1/24 (POD#5), Hartmann's and end colostomy now with ileus and rising leukocytosis History: ileus, leukocytosis. ABDOMEN:LUNG BASES: Nonspecific small soft tissue density in the left lower breast is unchanged.There are new moderate sized bilateral pleural effusions with associated bibasilar atelectasis or consolidation, left greater than right.LIVER, BILIARY TRACT: Probable cholelithiasis. No biliary dilatation. No focal liver lesions.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: Postsurgical changes. Small amount of free fluid. No loculation to suggest abscess. Generalized small bowel dilatation consistent with postsurgical ileus. No intramural air or free air.BONES, SOFT TISSUES: Scoliosis and degenerative changes.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: Air in the urinary bladder presumably from instrumentation. Correlate clinically.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall. Right hip prosthesis. OTHER: No significant abnormality noted
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Postsurgical ileus and other postsurgical changes. Minimal ascites no evidence of loculation to suggest abscess.New moderate-sized bilateral pleural effusions and bibasilar atelectasis or consolidation. Rule out infection.Cholelithiasis.Stable small left breast nodule.
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Generate impression based on findings.
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Male 34 years old Reason: tongue cancer s/p RT with worsening sweling - post RT inflam vs infection vs POD History: tongue pain/swelling CHEST:LUNGS AND PLEURA: Right apical ill-defined nodule measuring up to 10 mm (series 5, image 45) which is suspicious for primary lung malignancy or metastasis. Additional nonspecific right apical nodule with adjacent ground glass opacity measuring up to 7 mm (series 5, image 64). Two nonspecific left upper lobe nodules with adjacent ground glass opacity (series 5, image 73 and 121). No pleural effusion.MEDIASTINUM AND HILA: No evidence of venous stenosis. No hilar or mediastinal adenopathy. Normal heart size without pericardial effusion. No evidence of coronary arterial calcifications.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted. KIDNEYS, URETERS: Hypodense lesions in the kidneys bilaterally likely representing simple cystS.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube with tip in the stomach. Multiple air-filled loops of small bowel and colon. BONES, SOFT TISSUES: No evidence of bony metastasis.OTHER: No significant abnormality noted.
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1. Right ill-defined apical nodule suspicious for primary lung cancer or metastasis in patient with known malignancy. 2. Three additional nonspecific nodular opacities which could also represent metastasis. 3. No evidence of venous stenosis.
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Generate impression based on findings.
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Male, 48 years old, with sinusitis, URI x 4 weeks, low grade fevers, Mild mucosal thickening is evident in the frontal sinuses, slightly progressed on the left. The frontoethmoidal recesses are narrowed by mucosal thickening.The ethmoid air cells show progressive opacification. The sphenoid sinuses show progressive peripheral soft tissue thickening and the sphenoethmoidal recesses are obscured.The maxillary sinuses are completely opacified and progressed from the prior exam. The maxillary outflow pathways are occluded.Progressive opacification of the nasal cavity with soft tissue thickening or secretions is noted as well. The nasal septum is intact deviating gently towards the right.The mastoid air cells and middle ear cavities are clear.
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Progressive paranasal sinus opacification and/or mucosal thickening which likely reflects progressive sinus inflammatory disease.
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Generate impression based on findings.
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4-year-old female with suspected sepsisVIEW: Chest AP (one view) 01/29/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. Right pleural effusion. No pneumothorax. Right basilar and upper lobe opacities likely represent infection.
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Right upper and lower lobe pneumonia with associated pleural effusion.
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Generate impression based on findings.
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7-month-old male with dysphagiaEXAMINATION: Oropharyngeal motility study 01/29/15 Julia Ecclestone, speech and language therapist, supervised the examination.82 seconds of fluoroscopy was used.Patient was given thin fluids through slow flow nipple. Half-strength nectar thick fluids was also given through slow flow and medium flow nipples. Nectar thick fluids was given through medium flow and nipple from home. Stage II purée was also given.Oral phase was remarkable for increased suck to swallow ratio.Laryngeal penetration was noted with half-strength nectar via slow flow nipple and nectar thick via standard nipple from home. No compensatory cough was noted. Tracheal aspiration was noted with thin liquids. Delayed compensatory cough was noted.
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Laryngeal penetration with half-strength nectar via slow flow nipple and nectar thick via standard nipple from home. Tracheal aspiration with thin liquids.Please see the speech and language therapist's report for feeding recommendations.
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Generate impression based on findings.
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Status post fall. Evaluate for fracture Three views of the right foot reveal an oblique fracture of the diaphysis of the fifth metatarsal. There is slight lateral displacement of the distal fracture fragment. Note is made of a hallux valgus deformity.
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Metatarsal fracture fifth digit
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Generate impression based on findings.
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79 year-old female with fall, L4/5 back pain Lumbar spine: There is compression deformity of the L5 vertebral body. Additional mild compression deformities of the upper lumbar vertebrae are also noted. Severe degenerative disk disease affects the visualized lower thoracic spine. Moderate degenerative disk disease and facet joint osteoarthritis affects the lumbar spine. Osteopenia.Hip: Mild osteoarthritis affects the hip. No fracture is noted.
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L5 vertebral body compression fracture which is age indeterminate given the lack of comparison imaging.
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Generate impression based on findings.
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History of stem cell transplant admitted for RSV, hypoxemia, rule out infection LUNGS AND PLEURA: Scattered nodular opacities, some clustered, for example in the superior segment of the right lower lobe (series 5, image 37), and the left upper lobe (series 5, image 34). Scattered pulmonary micronodules appear similar to the prior exam. No pleural effusions.MEDIASTINUM AND HILA: Enlarged AP window lymph node measures 15 mm in short axis (series 4, image 36). Mild coronary artery calcifications. Trace pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hepatic steatosis. Splenomegaly.
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1.Scattered nodular opacities, some clustered suspicious for infection, possibly atypical, including fungal and viral etiologies.2.Hepatic steatosis and splenomegaly.
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Generate impression based on findings.
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57-year-old female with hip pain after fall on ice No hip fracture is visualized. Mild degenerative osteoarthritis affects the right hip. Hardware components of a total left knee arthroplasty device are situated near anatomic alignment without fracture evident. Note is made of periosteal bone formation between the prosthesis and anterior femoral cortex. Mild degenerative changes affect the right knee as seen on the frontal view.
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No fracture evident. Left TKA in near anatomic alignment.
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Generate impression based on findings.
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28 year old male status post ORIF Sideplate with screws including two syndesmotic screws affix the distal fibula in near anatomic alignment. Two additional screws affix the medial malleolus. A fracture fragment along the medial aspect of the distal fibular diaphysis is again noted.
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Orthopedic fixation of ankle fractures as described above.
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Generate impression based on findings.
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Exam slightly limited due to slice thickness and lack of fat suppressed and thin section postcontrast images.There are postoperative findings related to sinonasal tumor excision including a left sphenoidectomy, partial resection of the nasal septum, resection of the left lamina papyracea and partial ethmoidectomy. There is increased mucosal enhancement, some of which is confluent, within the anterior ethmoid sinuses that is T2 bright and does not match the appearance of prior tumor, likely representing inflamed mucosa. No specific evidence of tumor recurrence. Intermediate T2 signal within the left posterior ethmoids on axial images likely represents volume averaging when correlated with coronal images. Mucosal thickening and enhancement within the right anterior ethmoids, right maxillary and left frontal sinuses have increased since the prior exam. There is stable moderate mucosal thickening within the left maxillary sinus and sphenoid sinus, where there are also central inspissated/proteinaceous T1 bright secretions.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. A focus of encephalomalacia in the right cerebellum appears grossly similar to the prior exam. There are scattered periventricular and subcortical T2 hyperintensities without associated diffusion restriction which are unchanged from the prior exam and likely reflect moderate chronic small vessel ischemic disease. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
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1.No definite evidence of recurrent or residual tumor.2.Increased nonspecific opacification within the left frontal, right anterior ethmoid and right maxillary sinuses.3.Moderate chronic small vessel ischemic disease.
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Generate impression based on findings.
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Injured ankle 3 weeks ago with lateral tenderness Three views of the left ankle reveal some mild lateral soft tissue swelling. No fractures or dislocations.
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No fractures or dislocations
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Generate impression based on findings.
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86-year-old female with pain, evaluate for osteoarthritis Mild to moderate arthritis affects bilateral hips. No fracture is noted.
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Osteoarthritis, as above.
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Generate impression based on findings.
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82-year-old male with right hip pain There is mild sharpening of the tibial spines, consistent with mild osteoarthritis, particularly given the patient's age. Alignment is within normal limits. No joint effusion or fracture.
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Mild osteoarthritis.
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Generate impression based on findings.
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Recurrent endometrial cancer, now on hormonal therapy, assess disease status. There are no significantly enlarged cervical lymph nodes by size criteria. There is a partially-imaged right supraclavicular lipoma. The thyroid and major salivary glands are unremarkable. There are mild atherosclerotic calcifications at the carotid bifurcations. There is multilevel spondylosis of the cervical spine and minimal anterolisthesis of C4 on C5. The airways are patent. The paranasal sinuses and mastoid air cells are clear. The imaged intracranial structures and orbits are unremarkable. There is an unchanged left apical lung nodule that measures up to 4 mm.
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1. No evidence of metastatic disease in the neck.2. Nonspecific unchanged left apical lung nodule that measures up to 4 mm. Please refer to the separate chest CT report for additional details.
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