instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings.
|
History of headache. There is no evidence of acute intracranial hemorrhage. The ventricles appear smaller than expected and there is a partially empty sella. There is no mass effect or herniation. There is moderate mucosal thickening of the left sphenoid sinus, left posterior ethmoid air cells, with resultant opacification of the left sphenoethmoidal recess. There is an air-fluid level is present in the left maxillary sinus. There is mild opacification of the left ostiomeatal complex. There is mild septal deviation to the left with a septal bony spur which touches the left inferior turbinate. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
|
1. No evidence of acute intracranial hemorrhage.2. Smaller than expected ventricular system along with a partially empty sella, is suggestive of pseudotumor cerebri. 3. Findings suggestive of acute sinusitis.4. Mild septal deviation to the left with a septal bony spur which touches the left inferior turbinate.
|
Generate impression based on findings.
|
Metastatic breast cancer. Numerous abnormal osseous foci compatible with metastatic foci are seen including throughout the spine, pelvis, bilateral ribs, sternum, calvarium, right clavicle, and right femoral neck. Many of these lesions correspond with those described on recent MR and CT.
|
Widespread osseous metastases.
|
Generate impression based on findings.
|
Reason: 71 year old female patient diagnosed with HCC is here for administration of THERASPHERES in conjunction with a nuclear medicine study Please refer to interventional radiology study for description of procedure and images.
|
Successful Y90 Therasphere administration to liver tumor via the right hepatic artery. Please refer to interventional radiology exam for description of procedure and images.
|
Generate impression based on findings.
|
Reason: 60 y.o female with Right breast cancer s/p neoadjuvant endocrine RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 1.1 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the right axilla, representing the sentinel node(s). This region was marked with an indelible marker.
|
Sentinel node identified in the right axilla.
|
Generate impression based on findings.
|
Female 65 years old; Reason: eval for PE History: new RHF The comparison chest radiograph performed on 1/29/2015 demonstrates cardiomegaly as well as bilateral pleural effusions with basilar atelectasis. The ventilation images show multiple ventilation defects on single breath images in the left lower lobe, right lung base as well as lateral aspect of left midlung. There is partial equilibration bilaterally with abnormal retention in the left lower lobe during the wash-out phase. The perfusion images show matched defects in the left lower lobe, as well as mildly decreased perfusion in the right lower lobe and lateral aspect of the left mid lung which is also matched to the ventilation images. There are no significant mismatch defects identified.
|
Low probability for pulmonary embolism.
|
Generate impression based on findings.
|
Right arm pain with passive movement. Evaluate for fracture. The bones appear demineralized, suggesting osteopenia. I see no fracture or dislocation. I see no specific findings to account for the patient's pain. Catheter tubing overlies the right hemithorax.
|
No fracture evident. Other findings as above.
|
Generate impression based on findings.
|
Injury with sprain last night playing basketball. Pain and swelling with point tenderness after fall. Evaluate for fracture of fifth metatarsal. Three views of the right ankle and 3 views of the right foot are provided. There is soft tissue swelling along the lateral aspect of the midfoot. I see no discrete fracture line. There is a poorly defined linear lucency in the base of the fifth metatarsal best seen on the oblique view of the foot, as well as a small bony excrescence/ossicle along the base of the fifth metatarsal best seen on the AP view of the ankle. These findings could conceivably reflect old trauma, but they do not have the typical appearance of an acute fracture. The distal fibula appears intact, as does the ankle joint. The remaining metatarsals and the bones of the midfoot are unremarkable.
|
Soft tissue swelling with no definite fracture; other findings as described above. If there is continued clinical concern for fracture, repeat radiographs may be obtained in 7 to 10 days, at which time a currently "occult" fracture may become visible. Alternatively, cross-sectional imaging may be considered.
|
Generate impression based on findings.
|
Pain. Rheumatoid arthritis. Four views of the right knee are provided. There is near bone-on-bone apposition of the medial tibiofemoral compartment indicating moderate to severe osteoarthritis. Relatively mild osteoarthritis affects the patellofemoral and lateral compartments. The bones appear slightly demineralized. I see no joint effusion. I see no erosions or other specific radiographic features of rheumatoid arthritis.Four views of the left knee are provided. There is moderate narrowing of the medial tibiofemoral compartment and tricompartmental osteophytes indicating moderate osteoarthritis. The bones appear demineralized, suggesting osteopenia. I see no large joint effusion. I see no erosions or other specific radiographic features of rheumatoid arthritis.
|
Osteoarthritis as described above.
|
Generate impression based on findings.
|
Status post right ankle reduction Evaluation of fine detail is limited by overlying cast material. Again seen is an oblique fracture of the distal fibula with slight posterolateral displacement of the distal fracture fragment. There is also a transverse fracture of the medial malleolus; this fracture appears to have been reduced slightly along with the talus. Alignment is near-anatomic. There is also a fracture of the "posterior malleolus" of the distal tibia, also situated in near-anatomic alignment.
|
Reduction of ankle fractures as described above.
|
Generate impression based on findings.
|
"Status post TKA" The previously seen medial compartment arthroplasty has been removed and replaced with cement. Alignment is near-anatomic. Osteoarthritic changes affect the lateral and patellofemoral compartments. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery.
|
Postoperative changes of medial compartment arthroplasty removal as described above.
|
Generate impression based on findings.
|
Swelling. Rule out fracture. Three views of the right wrist are provided. There is perhaps mild soft tissue swelling along the radial aspect of the wrist, but I see no underlying fracture. Alignment is within normal limits.Three views of the right hand are provided. I see no fracture or malalignment.
|
Mild soft tissue swelling without fracture evident.
|
Generate impression based on findings.
|
The patient submitted outside analog mammogram dated 12/3/2013 from Roseland Neighborhood Clinic in Chicago IL. Submitted outside study was compared to the current mammogram dated 1/27/2015. Scattered fibroglandular elements are unchanged in pattern and distribution. No new masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual screening mammogram is recommended.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
The patient submitted outside analog mammogram dated 12/3/2013 from Roseland Neighborhood Clinic in Chicago IL. Submitted outside study was compared to the current mammogram dated 1/27/2015. Scattered fibroglandular elements are unchanged in pattern and distribution. No new masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual screening mammogram is recommended.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Status post right total right hip replacement The AP view of the right hip shows components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of hardware complication. Drains and gas density within the soft tissues reflect recent surgery.The AP view of the pelvis reveals the aforementioned postoperative changes on the right. Mild osteoarthritis affects the left hip. Phleboliths are noted within the pelvis.
|
Postoperative changes of right total hip arthroplasty as above.
|
Generate impression based on findings.
|
Left ankle swelling and pain for two to 3 weeks. There is diffuse soft tissue swelling. A small ossicle distal to the fibular tip may reflect old trauma, but does not have the typical appearance of an acute fracture fragment. Tiny osteophytes indicate minimal osteoarthritis.
|
Soft tissue swelling and minimal osteoarthritis.
|
Generate impression based on findings.
|
Pain/edema. Fracture? I see no fracture or malalignment. There is perhaps mild soft tissue swelling along the lateral aspect of the ankle. Note is made of a normal variant accessory navicular.
|
Mild soft tissue swelling without fracture evident.
|
Generate impression based on findings.
|
Pain, decreased range of motion. Fall. I see no fracture or malalignment. Foci of mineralization superior to the greater tuberosity likely reflect calcific tendinopathy of the rotator cuff. There is an old healed fracture of the left eighth rib.
|
Calcific tendinopathy of the rotator cuff. I see no acute fracture.
|
Generate impression based on findings.
|
Pain, swelling. Fall. Small tricompartmental osteophytes indicate mild osteoarthritis. There are mild chronic appearing enthesopathic changes along the inferior margin of the patella that appear similar to the prior study. I see no fracture or malalignment.
|
Mild osteoarthritis without fracture evident.
|
Generate impression based on findings.
|
C-spine tenderness. Rule out C-spine fracture. Evaluation of the spine is limited due to inability to optimally position the patient. Evaluation of the cervicothoracic junction is limited by overlying anatomy. There is diffuse prominence of the prevertebral soft tissues which is of uncertain clinical significance, and could simply reflect the patient's large body habitus. I see no underlying cervical spine fracture. There is mild to moderate multilevel degenerative disk disease most pronounced at C5/6. There is also multilevel narrowing of the neuroforamina bilaterally which may in part be an artifact of suboptimal positioning for the examination. Cervical spine alignment is within normal limits and the vertebral body heights are preserved.
|
Degenerative arthritic changes as described above without fracture evident. There is prominence of the prevertebral soft tissues which is nonspecific and could indicate edema, although may simply reflect the patient's large body habitus. If there is strong clinical concern for cervical spine fracture, CT is recommended for further evaluation.
|
Generate impression based on findings.
|
Right knee pain status post fall. Right ankle swelling over lateral malleolus status-post fall. Rule out fracture. Four views of the right knee are provided. I see no fracture. Severe osteoarthritis affects the knee. I see no large joint effusion.Three views of the right ankle are provided. I see no fracture. Specifically, lateral malleolus appears intact.
|
Osteoarthritis of the knee. I see no fracture of the knee or ankle.
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified. 5 mm right choroid plexus lipoma is unchanged in the atrium.Paranasal sinuses are clear. Rightward deviation of the nasal septum. Enhancing focus in the left frontal calvarium measures 7 mm and is nonspecific. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
|
1.No specific findings to account for patient's symptoms.2.Nonspecific enhancing focus in the left frontal calvarium.
|
Generate impression based on findings.
|
Elbow pain I see no fracture, malalignment, or joint effusion. There may be a small osteophyte projecting from the lateral aspect of the olecranon, but no I see no specific findings to account for the patient's pain.
|
Possible small olecranon osteophyte, but otherwise no specific findings to account for the patient's pain.
|
Generate impression based on findings.
|
20 year-old female with history of left staghorn renal calculus, status post PCNL, now increasingly febrile with leukocytosis and tachycardia. Please note lack of IV and oral contrast limits evaluation of solid organ pathology, and also of the GI tract. Additionally, this exam is limited by excess noise artifact.ABDOMEN:LUNG BASES: Elevation of the left hemidiaphragm, with associated left lower lung subsegmental atelectasis. There is no significant pleural effusion.LIVER, BILIARY TRACT: Small amount of perihepatic ascites, may be related to the patient's VP shunt. No significant abnormality noted.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Limited evaluation of the kidneys without contrast. Interval placement of left percutaneous nephroureterostomy, with multiple foci of gas in the left kidney consistent with recent procedure. Ureteral stent terminates in the left distal ureter near the anterior abdominal wall ureterostomy. The previously seen staghorn calculus has been fragmented over the interval. No significant hydronephrosis or hydroureter. No perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: Multiple mildly enlarged retroperitoneal lymph nodes, similar to prior. No appreciable retroperitoneal fluid collections or abscess.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: VP shunt catheter within the anterior subcutaneous tissues, terminating within the pelvis.Two orphaned catheters are seen in the anterior abdominal wall. PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Kyphoscoliosis fracture visualized lower spine, similar to prior.OTHER: Moderate amount of pelvic ascites. VP shunt catheter terminates within the pelvis.
|
1.Limited kidney evaluation reveals postprocedural changes of interval left percutaneous nephroureterostomy insertion.2.Left staghorn calculus fragmentation.
|
Generate impression based on findings.
|
Prominent ventricles and sulci are unchanged and may reflect a mild degree of volume loss. The cisterns remain patent. There is no midline shift or mass effect. No abnormal signal or enhancement is evident. There is no 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.
|
No specific findings to account for the patient's symptoms.
|
Generate impression based on findings.
|
46 year old female with a history of right mastectomy for breast cancer and left breast lift in 2014.Patient feels a small lump in the left breast. Three standard views with two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A triangular marker is placed at lower outer quadrant of left breast, indicating the area of palpable concern. No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted at the area of palpable concern or elsewhere in left breast. With physical exam, no discrete mass was palpated. Focused ultrasound did not detect any abnormalities at the area of palpable concern.
|
No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
13-day-old male with abdominal distention and dilated bowelVIEW: Abdomen AP (one view) 01/30/15, 1649 hrs NG tube side-port is at the GE junction with tip in the proximal gastric body.Diffuse air distended loops of bowel in a disorganized pattern, improved compared to prior examination. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
|
Slightly improved disorganized bowel gas pattern. NG tube side-port is at the GE junction, recommend advancement.
|
Generate impression based on findings.
|
Cough and course lung sounds. VIEW: Chest AP (one view) 1/29/2015 The lungs are hyperexpanded and there is peribronchial thickening. Streaky biapical opacities consistent with subsegmental atelectasis. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal.
|
Reactive airways disease pattern/bronchiolitis pattern without superimposed pneumonia.
|
Generate impression based on findings.
|
Male 13 years old Reason: r/o neoplasm, fracture History: knee painVIEWS: Left knee AP lateral and oblique (3 views) and pelvis AP and lateral (2 views) 1/29/2015 KNEE: No acute fracture, malalignment or mass is evident. No significant joint effusion is present.PELVIS: No acute fracture or malalignment. The epiphyses are appropriately oriented in respect to the metaphyses.
|
Normal examination. MRI is a more sensitive examination for the detection of soft tissue masses and can be considered as clinically indicated.
|
Generate impression based on findings.
|
UVC placement.VIEW: Chest and abdomen AP (two view) 1/29/2015, 20:25 UVC in the right portal vein. Nasogastric tube has been repositioned with the tip terminating in the body of the stomach.No focal airspace opacity. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is seen.Nonobstructive bowel gas pattern, appropriate for age. No pneumatosis intestinalis, pneumoperitoneum or portal venous gas is seen.
|
UVC in the right portal vein. Nasogastric tube with tip in the body of the stomach
|
Generate impression based on findings.
|
15-year-old male with cystic fibrosis exacerbationVIEWS: Chest PA/lateral (two views) 01/29/15, 2040 hour Left upper extremity PICC tip is in the SVC.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Diffuse bronchiectasis is present bilaterally with increased peribronchial cuffing. Left lingular opacity.
|
Left lingular opacity may represent infection on background chronic changes of cystic fibrosis.
|
Generate impression based on findings.
|
UVC placement. VIEW: Chest and abdomen AP (two views) 1/29/2015, 19:14 UVC in the right portal vein. Nasogastric tube coiled back upon itself in the esophagus with its tip terminating in the distal cervical esophagus.No focal airspace opacity. The aortic arch, cardiac apex and stomach are left sided. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is seen.Nonobstructive bowel gas pattern, appropriate for age. No pneumatosis intestinalis, pneumoperitoneum or portal venous gas is seen.
|
UVC in the right portal vein. Nasogastric tube with tip in the distal cervical esophagus.
|
Generate impression based on findings.
|
Pain and laceration. Possible open fracture.VIEWS: Hand PA (one view) the second digit oblique and lateral (two views) 1/29/2015 A soft tissue defect along the lateral aspect of the distal second finger is present, but no underlying fracture or malalignment is seen. No radiopaque foreign body evident.
|
Soft tissue defect along the distal second finger without underlying fracture, malalignment or radiopaque foreign body.
|
Generate impression based on findings.
|
Reason: Possible SVC syndrome History: R neck vein engorgement, pain for 5 days. LUNGS AND PLEURA: Severe centrilobular and paraseptal edema. Improvement in bibasilar opacities consistent with improvement in atelectasis and/or aspiration. Trace left pleural effusion.MEDIASTINUM AND HILA: Borderline indeterminate mediastinal and hilar lymph nodes. Moderate coronary arterial calcification and cardiomegaly. No pericardial effusion.CHEST WALL: Right internal jugular vein thrombosis spanning 4 cm in craniocaudal dimension just superior to the location of catheter insertion, with asymmetric edema/soft tissue swelling of the right neck soft tissues and scattered mildly enlarged lymph nodes. This area was not included in the field-of-view of the prior examination. The right brachiocephalic vein and superior vena cava are patent.Enlarged axillary lymph nodes are not grossly changed since the prior study.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
|
1. Right internal jugular vein thrombosis just superior to the location of catheter insertion, with associated marked edema of the right neck soft tissues, possibly indicating infection.2. Severe emphysema with some improvement in basilar opacities since the prior study. Trace left pleural effusion.
|
Generate impression based on findings.
|
Male 14 years old Reason: r/o fracture History: swellingVIEWS: Left foot AP lateral and oblique (3 views) left ankle AP lateral and oblique (3 views) 1/29/2015 Foot: No acute fracture or malalignment. Small joint effusion.Ankle: Moderate soft tissue swelling over the lateral malleolus and associated small joint effusion. Vertically oriented lucency in the distal fibular diaphysis, which may represent a nondisplaced fracture given the degree of soft tissue swelling and joint effusion, although this is equivocal.
|
Subtle vertically oriented lucent line in the distal fibular diaphysis with associated joint effusion and soft tissue swelling suspicious for a nondisplaced fracture. Follow-up is recommended.These findings were relayed to Dr. Heilbrunn via telephone at 09:50 on 1/30/2015.
|
Generate impression based on findings.
|
new left upper and lower extremity weakness Multiple metallic artifacts on the right side of supra/para clinoid area and right frontal and temporal lobes indicating postoperative changes.Extensive encephalomalacia on the right frontal lobe and right temporal lobe.There is also right frontal and temporal craniotomy.Circumferential and linear calcifications are seen on lower midbrain and prepontine cistern area.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.Above postoperative findings are suggestive for intracranial aneurysm or AVM related surgical procedure. Therefore, for further evaluation, head and neck CTA is recommended.The paranasal sinuses and mastoid air cells are clear.
|
1. No evidence of acute ischemic or hemorrhagic lesion.2. Postoperative changes of right side of supra/para clinoid area indicating possible prior intracranial vascular lesions such as intracranial aneurysm/AVM.Rec: head and neck CT angiography to exclude possible intracranial vascular lesion.
|
Generate impression based on findings.
|
15-year-old male for PICC line evaluationVIEW: Chest AP (one view) 01/29/15 Left upper extremity PICC the tip is at the superior cavoatrial junction.Cardiothymic silhouette is normal. Left lingular opacity is present. Bilateral diffuse bronchiectasis with increased peribronchial cuffing.
|
1.PICC tip is at the superior cavoatrial junction.2.Left lingular opacity may represent infection on background chronic changes of cystic fibrosis.
|
Generate impression based on findings.
|
Male 7 months old Reason: r/o fracture History: effusion/swelling/painVIEWS: Left elbow AP and lateral (two views) 1/29/2015 Transverse supracondylar fracture again seen, with posterior angulation of the distal fracture fragment, unchanged.
|
Transverse supracondylar fracture in unchanged alignment.
|
Generate impression based on findings.
|
8-month-old female with history of liver transplant with persistent tachypnea and aspiration riskVIEW: Chest/abdomen AP (two view) 1/30/15 Left central venous catheter with tip in the left atrium. Enteric tube tip is in the third portion of the duodenum. IVC stent and right upper quadrant surgical sutures and clips are again seen. Suprapubic catheter is in place.Low lung volumes. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Retrocardiac atelectasis.Diffusely air distended loops of bowel in a disorganized pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
|
Retrocardiac atelectasis. Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
Right pain, back pain and hematuria. ABDOMEN: The following observations are made given the limitations of an unenhanced study.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 hydronephrosis or renal calculi. No perinephric fluid collections or inflammation identified. Ureter is normal in caliber.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Tiny appendicolith in the appendix (image 108; series 80516. No CT evidence of appendicitis. Correlate clinically.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Right adnexa measures 2.6 x 3.6 cm. Left adnexa measures 3.6 x 2.2 cm. Uterus is grossly within normal limits.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
|
No CT findings to explain hematuria and flank pain. Appendicolith with no evidence of appendiceal inflammation.
|
Generate impression based on findings.
|
Male 7 months old Reason: r/o occult fracture History: unexplained fractureEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (24 views) 1/29/2015 Again seen is a left supracondylar fracture with posterior displacement of the distal fracture fragment.The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal. There is no focal airspace opacity. The bowel gas pattern is nonobstructive.
|
Redemonstration of the left supracondylar fracture. No additional fractures identified.
|
Generate impression based on findings.
|
32 year old male with NK cell lymphoma and HLH (dx 9/12/14). Right lower quadrant and left lower quadrant tenderness. Evaluate for appendicitis ABDOMEN:LUNG BASES:LIVER, BILIARY TRACT: Multiple bilobar subcentimeter hepatic hypodensities are too small to characterize but may represent simple cysts, unchanged. Gallbladder is collapsed; please to recent ultrasound examination.SPLEEN: Spleen has increased in size and currently measures 16.7 cm in anteroposterior dimension (previously 12.8 cm).PANCREAS: 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. Equivocal gastric wall thickening. Correlate clinically.BONES, SOFT TISSUES: No significant abnormality noted. Appendix is normal in caliber without evidence of inflammation.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
No CT findings to explain lower quadrant pain. No evidence of appendicitis.
|
Generate impression based on findings.
|
Male 63 years old; Reason: hematuria with prostate mass and left kidney irreg shaped, eval for mass History: hematuria ABDOMEN:LUNG BASES: Bibasal atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy with expected mild extrahepatic biliary dilatation. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: There is nonspecific thickening of the left adrenal gland.KIDNEYS, URETERS: Bilateral solid renal masses. On the left there is an exophytic 9.2 x 11.7 cm cortically based mass involving the renal sinus with significant peripheral neovascularization and central necrosis. There is no evidence of macroscopic tumor in the retroaortic left renal vein. On the right side there is a cortically based 3.0 x 1.8 cm solid exophytic mass arising from the lower pole which abuts the renal sinus fat. There is no evidence of macroscopic tumor in the right renal vein. 1.6 cm left renal cyst.RETROPERITONEUM, LYMPH NODES: Suprarenal abdominal aortic aneurysm measuring 5.6 x 5.4 cm. This crosses the renal arteries. The infrarenal component measures 3.6 x 3.5 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: The prostate gland is markedly enlarged measuring 6.5 x 7.0 cm. Status post TURP.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Chronic compression deformity of the L1 vertebral body.OTHER: No significant abnormality noted.
|
1.Solid bilateral renal masses consistent with renal cell carcinoma. No evidence of macroscopic renal vein invasion or significant lymphadenopathy.2.5.6-cm abdominal aortic aneurysm.
|
Generate impression based on findings.
|
61-year-old female with history of flank pain, left greater than right. ABDOMEN:LUNG BASES: Lung bases are clear, without pleural effusion or consolidation. Small amount of pericardial fluid.LIVER, BILIARY TRACT: Cholelithiasis, without cholecystitis. No biliary dilatation or perihepatic fluid collections.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: Small fat-containing ventral hernia with subtle haziness of the mesentery in this location suggesting incarceration. No small bowel obstruction or free air. No bowel wall thickening. Diverticulosis affects the large bowel.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
|
1.No renal collecting system stones or hydronephrosis.2.Small ventral fat-containing hernia, with stranding of the mesentery suggesting omental fat incarceration. Correlate clinically.3.Cholelithiasis without cholecystitis.
|
Generate impression based on findings.
|
Left orbital fracture with periorbital pain swelling. Orbits: There is extensive left face subcutaneous, left preseptal and left intraorbital emphysema. There is a 2 mm medially displaced left lamina papyracea fracture without evidence of retrobulbar hemorrhage. There is mild left proptosis. The left globe otherwise appears intact. Likewise, left optic nerve and extraocular muscles are intact. There is a small amount of hemosinus. The right orbit is unremarkable. Head: There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. The skull appears intact. There appears to be scarring of the left frontal scalp.
|
1. Extensive left preseptal and postseptal emphysema with a 2 mm medially displaced left lamina papyracea fracture, but no evidence of retrobulbar hemorrhage or extraocular muscle herniation. 2. No evidence of acute intracranial hemorrhage or skull fracture.
|
Generate impression based on findings.
|
12-year-old female intubatedVIEW: Chest AP (one view) 01/30/15 Interval ET tube removal. NG tube side-port is just below the GE junction, recommend advancement. Right upper extremity PICC tip is at the superior cavoatrial junction.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Patchy bibasilar airspace opacities may represent subsegmental atelectasis, improved.
|
Patchy bibasilar airspace opacities appear improved.
|
Generate impression based on findings.
|
History of bilateral breast reduction, benign left breast biopsy, and multiple keloids. History of right nipple discharge with prior ultrasound and ductogram showing duct ectasia without mass. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Multiple keloids are present over both breasts and similar to prior. Architectural distortions from bilateral breast reductions are stable. Bilateral dystrophic calcifications are stable. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
|
Stable keloids, postsurgical architectural distortion, and 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.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
Male 7 months old Reason: r/o fx History: swelling/ painVIEWS: Left humerus AP and lateral (two views) 1/29/2015 A transverse fracture through the distal humerus (supracondylar) is evident, with posterior angulation of the distal fracture fragment.
|
Transverse supracondylar fracture with posterior angulation of the distal fragment.
|
Generate impression based on findings.
|
23 year old female with fever and chest pain.VIEW: Chest AP (one view) 1/29/2015 The right upper extremity PICC tip terminates at the level of the cavoatrial junction. The left internal jugular central venous catheter tip terminates in the SVC.Streaky bibasilar opacities suggests subsegmental atelectasis, appearing similar to the prior exam. The cardiothymic silhouette is normal. No pneumothorax or pleural effusion is seen.
|
Right intrajugular central venous catheter and right upper extremity PICC unchanged.
|
Generate impression based on findings.
|
Left lung rales and wheezingVIEWS: Chest AP/lateral (two views) 1/29/2015 Hyperexpanded lungs, peribronchial thickening and multifocal streaky atelectasis. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is seen.
|
Bronchitis/reactive airways disease pattern, without superimposed pneumonia.
|
Generate impression based on findings.
|
79-year-old male with history of elevated white blood cell count, metastatic colon cancer and partial right hepatic resection. ABDOMEN:LUNG BASES: New small right pleural effusion with associated atelectasis/consolidation. Minimal left lower lung dependent subsegmental atelectasis.LIVER, BILIARY TRACT: The previously seen right posterior hepatic hypoattenuating lesion has been resected, and in the resection bed there is now approximately 13 x 10 cm low attenuation collection with internal gas foci, most consistent with an infected collection.SPLEEN: No significant abnormality notedPANCREAS: Mild fatty pancreatic atrophy.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild bilateral renal atrophy, with a right upper pole hypoattenuating focus most consistent with hemorrhagic cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Anterior abdominal wall midline surgical clips/sutures consistent with prior procedure.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postoperative findings of prior right hemicolectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1.Right partial hepatectomy with a heterogeneous collection in the surgical bed containing a site gas, likely representing infected collection/abscess. Surgical service (Dr. Posner) is aware of this finding and plan is for IR drainage today.2.New small right pleural effusion with associated atelectasis/consolidation.3.Postoperative findings from hemicolectomy and ventral hernia repairs as above.
|
Generate impression based on findings.
|
52 year old with lumbosacral back pain bilateral pain and numbness and abdominal distention. 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. Tiny fat containing periumbilical hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is enlarged and heterogeneous, presumably representing underlying fibroids, but nonspecific on CT.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Upper endplate of L5 appears compressed (approximate loss of 25% height), possibly reflecting an acute compression fracture; correlate with bone scan as clinically indicated.OTHER: No significant abnormality noted
|
Probable L5 compression fracture
|
Generate impression based on findings.
|
Rule out pneumonia, tachypnea. VIEW: Chest AP (one view) 1/29/2015 The endotracheal tube tip terminates below the thoracic inlet and above the carina. The nasogastric tube tip terminates out of the field of view.Streaky bibasilar and biapical opacities suggest atelectasis, although superimposed infection is not excluded. The aortic arch, cardiac apex and stomach left-sided. The cardiothymic silhouette is enlarged.
|
Multifocal opacities suggest atelectasis, although superimposed infection is not excluded.
|
Generate impression based on findings.
|
Reason: s/p radiation today for cervical cancer, became tachycardic and dyspneic History: dyspnea, tachycardia PULMONARY ARTERIES: Pulmonary embolus in the right posterior basilar segmental pulmonary artery. Normal pulmonary artery diameter, but possible straightening of the interventricular septum.LUNGS AND PLEURA: Increased bibasilar linear opacities consistent with scarring/atelectasis. Mild subpleural lingular interstitial opacities are not significantly changed. No pleural effusions.MEDIASTINUM AND HILA: Mild coronary artery calcifications. Normal heart size without pericardial effusion.CHEST WALL: Previously measuredlymph node measures 11 x 10 mm (series 8 image 51) unchanged. Left axillary surgical clips. Masslike soft tissue in the medial left breast with calcifications correlates with lumpectomy site on prior mammograms.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left renal scarring/atrophy with a partially calcified left upper pole cyst partially imaged.
|
1. Acute right posterior basilar segmental pulmonary embolus.2. Increased basilar scarring/atelectasis. 3. Right axillary lymph node and other findings as described above without acute interval change. PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Single.Most Proximal: Segmental.RV Strain: Indeterminate.
|
Generate impression based on findings.
|
9-year-old male intubatedVIEW: Chest AP (one view) 01/30/15 Left central venous catheter with tip in the superior cavoatrial junction. Right upper extremity PICC tip is in the SVC. ET tube is below thoracic inlet and above the carina.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Patchy bibasilar opacities likely represent atelectasis.
|
Bibasilar atelectasis.
|
Generate impression based on findings.
|
Cough and fever, rule out pneumonia.VIEWS: Chest AP/lateral (two views) 1/29/2015 Pulmonary hyperexpansion, peribronchial thickening and streaky multifocal subsegmental atelectasis. The cardiothymic silhouette is normal. No pneumothorax or pleural effusion is seen.
|
Bronchiolitis/reactive airways disease pattern without superimposed pneumonia.
|
Generate impression based on findings.
|
Left upper quadrant pain, rule out pneumonia. VIEWS: Chest AP/lateral (two views) 1/30/2015 There is peribronchial thickening, pulmonary hyperexpansion and streaky multifocal subsegmental atelectasis. The cardiothymic silhouette is normal. No pneumothorax or pleural effusion is seen.
|
Bronchiolitis/reactive airways disease pattern, but without superimposed pneumonia.
|
Generate impression based on findings.
|
Crohn's disease, lower abdominal pain, melena Following observations are made given the limitations of an unenhanced study.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: The proximal small bowel is filled with enteric contrast and grossly normal. The distal small bowel and colon are unopacified making evaluation limited. Within this limitation, there is a presumed dilated loop of bowel in the right lower quadrant with surrounding inflammatory changes, likely representing active Crohn's disease of the terminal ileum. I cannot identify associated fluid collections and as noted above, evaluation is limited without intravenous contrast. Suggest correlation with enhanced CT or MRI examination as clinically indicated.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
|
Presumed active Crohn's disease affecting the terminal ileum as described above; limited study given absence of intravenous contrast and enteric contrast in the suspicious region.
|
Generate impression based on findings.
|
9-year-old male with NG placementVIEW: Chest AP (one view) 01/29/15, 2225 hour ET tube tip is below thoracic inlet and above the carina. Right upper extremity PICC tip is in the SVC. Left central venous catheter tip is at the superior cavoatrial junction.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Left lower lobe consolidation is unchanged.NG tube is not visualized and may be coiled in the upper esophagus. Findings consistent with right hepatectomy and right nephrectomy.
|
Left lower lobe consolidation. NG tube is not visualized and may be coiled in the upper esophagus.
|
Generate impression based on findings.
|
Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex, aortic arch and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
TraumaVIEWS: Left femur AP and lateral There is an acute oblique fracture involving the mid diaphysis of the left femur. The distal fracture fragment is minimally displaced anteriorly and medially. The femoral head is seated within the acetabulum.
|
Fracture of the mid diaphysis of the left femur.
|
Generate impression based on findings.
|
52 year-old female with left knee and right foot pain Knee: There is mild narrowing of the medial tibiofemoral compartment best seen on the skier's view and tricompartmental osteophytes, indicating moderate osteoarthritis. Mild osteoarthritis affects the right knee as seen on the frontal view.Foot: Small calcific density within the soft tissue adjacent to the second metatarsal may represent a small focus of calcium hydroxyapatite deposition of uncertain clinical significance. No specific finding is noted to account for the patient's foot pain.
|
Knee osteoarthritis, as described above.
|
Generate impression based on findings.
|
16-year-old female with abdominal pain, known Crohn's disease ABDOMEN:LUNG BASES: No pleural effusions. No focal pulmonary opacities.LIVER, BILIARY TRACT: The liver is enlarged measuring 21 cm. No focal hepatic lesions. The gallbladder is within normal limits. No evidence of intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of hydronephrosis or perinephric inflammation. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is well-visualized and within normal limits. The bowel is within normal limits without evidence of obstruction. The terminal ileum wall is mildly thickened with surrounding fatty proliferation. No loculated fluid collection to suggest abscess. No free fluid. 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: The appendix is well-visualized and within normal limits. The bowel is within normal limits without evidence of obstruction. The terminal ileum wall is mildly thickened with surrounding fatty proliferation. No loculated fluid collection to suggest abscess. No free fluid. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Mild thickening of the terminal ileum wall with surrounding fatty proliferation.
|
Generate impression based on findings.
|
60 year old female with history of newly diagnosed stage IV endometrial cancer. Evaluate IVC for clot. Right lower extremity edema and significant belly mass. CHEST:LUNGS AND PLEURA: Multiple bilateral nodules, with reference left upper lobe nodule (5/23) measuring 16 x 19 mm.No consolidation or significant pleural effusion.MEDIASTINUM AND HILA: Heart size within normal limits, no pericardial effusion. No significant mediastinal lymphadenopathy. No appreciable coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Several small hypoattenuating foci within the liver, the largest of which (3/82) measures approximately 30 x 27 mm. No biliary dilatation or loculated perihepatic fluid collections.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild bilateral hydronephrosis, without renal cortical thinning.RETROPERITONEUM, LYMPH NODES: Marked retroperitoneal lymphadenopathy, with one ill-defined retroperitoneal mass-like conglomeration (3/98) measuring approximately 45 x 32 mm.The inferior vena cava is markedly attenuated (sagittal image number 53) by retroperitoneal lymphadenopathy and large pelvic mass.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No osseous lesions are identified.OTHER: Multiple masses are noted within the peritoneum, for example coronal image number 43.PELVIS:UTERUS, ADNEXA: 16 x 25 x 25 cm endometrial mass with central low attenuation and peripheral nodularity, consistent with patient's given history of endometrial carcinoma. This mass causes marked compression on the retroperitoneum, including mass effect on the vena cava and aorta. Coarse calcifications in the peripheral myometrium, likely fibroids.BLADDER: The uterine mass exerts mass-effect on the bladder, however the bladder itself is relatively normal in appearance.LYMPH NODES: Multiple enlarged lymph nodes are seen in the abdomen and pelvis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Marked body wall edema, particularly inferiorly.OTHER: Thrombus is seen within the right femoral vein and pelvic veins. Masses pelvic varicosity. Since this study was not protocoled for venography, detailed evaluation of the vasculature is limited.
|
1.Large uterine mass, with associated compression on the adjacent abdominal/pelvic structures and vasculature.2.Thrombi are noted in the pelvic veins and right femoral vein, with marked attenuation of the inferior vena cava and massive pelvic varicosities.3.Retroperitoneal lymphadenopathy, in addition to likely hepatic and pulmonary metastases.
|
Generate impression based on findings.
|
Malignant cervical neoplasm. Chemotherapy and radiation therapy. Rule out small bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions in the right hepatic lobe are too small to characterize but are unchanged.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: Small bowel is dilated measuring up to 3.5 cm, similar to the prior examination, with a transition in the right lower abdomen. The distal ileum is collapsed. No focal mass at the transition point. Pelvic ascites described previously appears to have resolved. No bowel wall pneumatosis or portal venous gas.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Please see aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
No substantial interval change in presumed small bowel structural transition point in the right lower abdomen.
|
Generate impression based on findings.
|
CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis in the left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
Reason: extension of bleeding? History: rt thalamus IPH There is redemonstration of a large hematoma centered in the right thalamus measuring 51 x 40 mm in axial dimensions and 51 x 55 mm in coronal dimensions previously measured the same. There is associated intraventricular hemorrhage ventriculomegaly and sulcal effacement. There is periventricular hypodensity present which is stable compared to previous exam. There is associated midline shift with shift of the septum pellucidum and third ventricle to the left. The third ventricle is shifted approximately 13 mm to the left of midline and has not changed since the previous exam The hemorrhage extends into the right cerebral peduncle and the midbrain. A ventriculostomy tube courses through the left frontal lobe into the left lateral ventricle with tip in the body of the left lateral ventricle. Lateral ventricles are stable in size.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.
|
1.Thalamic hemorrhage associated with intraventricular blood, midline shift and ventriculomegaly status post ventriculostomy tube placement. The examination is stable when compared to the previous exam.2.Associated sulcal effacement suggests hydrocephalus. Please correlate with clinical symptoms .
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast and ovarian cancer in a paternal cousin. Two standard digital views of both breasts were performed 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 suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Reason: Breast cancer on IRB13-0418. Need evaluation of new SOB. History: Breast cancer on IRB13-0418. Need evaluation of new SOB. LUNGS AND PLEURA: Scattered micronodules unchanged. No suspicious nodules or masses. New mild anterior subpleural interstitial opacities on the left are likely secondary to radiation. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No visible coronary arterial calcification. No mediastinal or hilar lymphadenopathy.CHEST WALL: Surgical clips in both breasts status post mastectomy and reconstruction irregular scarring in the left axillary region most likely postoperative.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
|
1. No acute abnormalities to account for the patient's shortness of breath. New mild anterior subpleural interstitial opacities on the left are likely secondary to radiation.2. Postoperative changes of mastectomies and breast reconstruction.
|
Generate impression based on findings.
|
Female 64 years old; Reason: Evaluate for unintentional weight loss History: Evaluate for unintentional weight loss CHEST:LUNGS AND PLEURA: Emphysematous changes are predominating in both lung apices. Scarring predominates in the right lung apex.MEDIASTINUM AND HILA: Tiny left thyroid nodule. Mild coronary artery calcifications. No significant adenopathy. A few subcentimeter mediastinal modes can be followed. Atherosclerotic calcifications of the aorta.CHEST WALL: No significant abnormality notedABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Stable subcentimeter hypodensity in the posterior right hepatic lobe. Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: 9-mm pancreatic hypodensity remains unchanged (image 96; series 10). Second tiny cystic lesion is also stable. Both been discussed on prior CT examinations. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right nephroureteral stent catheter is in place with tip in a distended bladder. Status post left nephrectomy.RETROPERITONEUM, LYMPH NODES: Juxtarenal aortic aneurysm as noted previously, unchanged in size measuring 4.9 x 4.0 cm immediately below the right renal artery (image 102; series 10). Concentric mural thrombus again noted. Adjacent surgical clips also noted. Status post aortobifemoral bypass with a right femoral-popliteal graft. Narrowing of the superior mesenteric artery, just pass its ostium, as noted previously. BOWEL, MESENTERY: Ventriculoperitoneal shunt tip terminates in the right upper quadrant.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of free fluid in the cul-de-sac also seen on prior scan, nonspecific.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Right femoral bypass graft remains occluded. Both common femoral arteries motley aneurysmal but unchanged compared to prior with the right measuring approximately 1.8 cm in diameter and the left measuring approximately 1.7 cm in diameter
|
No substantial interval change compared to prior. Chronic mesenteric ischemia is a possible etiology for weight loss given SMA stenosis; consider mesenteric angiography with possible stenting in Interventional Radiology.
|
Generate impression based on findings.
|
25-year-old male with right knee pain. The patient has undergone ACL reconstruction as evidenced by tunnels within the proximal tibia and distal femur. Tiny osteophytes indicate minimal osteoarthritis. Alignment is within normal limits. No joint effusion. The left knee appears normal as seen on the frontal view.
|
Postoperative changes of ACL reconstruction and minimal osteoarthritis.
|
Generate impression based on findings.
|
Female 58 years old Reason: hep c, screen for hcc History: same LIVER: The liver measures 19.3 cm in length and has a coarsened echotexture consistent with chronic liver disease. There is no focal liver mass or nodularity of the capsule. Main portal vein is patent and demonstrates normal directional flow with peak velocity 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No intra-or extrahepatic biliary dilatation.PANCREAS: Poorly visualized but unremarkable where seen.KIDNEYS: The right kidney measures 8.4 cm. There is a 1.2-cm right mid pole cyst. The left kidney measures 9.2 cm. Both kidneys demonstrate markedly hyperechoic renal parenchyma consistent with medical renal disease.OTHER: The spleen measures 11.6 cm in length.
|
1. Coarsened hepatic echotexture consistent with chronic liver disease. No focal liver lesion.2. Renal cortex is hyperechoic bilaterally consistent with medical renal disease.
|
Generate impression based on findings.
|
Female 88 years old Reason: eval for PE History: chest pain, sob PULMONARY ARTERIES: No evidence of acute pulmonary embolism. Pulmonary artery is mildly enlarged measuring 30 mm which is suggestive of pulmonary arterial hypertension. No evidence of right heart strain.LUNGS AND PLEURA: Small bilateral pleural effusions. Mucoid debris in the left lower lobe bronchus with left lower lobe collapse. Severe compressive atelectasis of the right lower lobe due to the right-sided hiatal hernia. No suspicious nodules or masses.MEDIASTINUM AND HILA: Nonspecific mildly enlarged mediastinal lymph nodes. Mild cardiomegaly without pericardial effusion. Moderate atherosclerotic calcifications of the aorta and its branches with moderate coronary calcifications.CHEST WALL: Moderate degenerative changes in the thoracic spineUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Right- sided herniation of stomach into the thorax.
|
1. No acute pulmonary embolism.2. Small bilateral pleural effusions with left lower lobe collapse and severe compressive atelectasis of the right lower lobe due to the hiatal hernia. Left lower lobe bronchus contains debris and collapse may be secondary to impaired clearance of secretions related to anatomic deviation of the mediastinum from right sided hernia.3. Large right hiatal hernia.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
|
Generate impression based on findings.
|
88-year-old female, follow-up exam Again seen is an intramedullary rod and screw device attempting to affix a comminuted intertrochanteric fracture of the femur. There has been lateral retraction of the proximal screw with the tip now overlying the superior aspect of the femoral head and neck. Resultant varus deformity at the fracture is noted. Skin staples are present in the lateral soft tissues.
|
Attempted orthopedic fixation of a comminuted intertrochanteric fracture with lateral retraction of the proximal screw and its the tip now overlying the superior aspect of the femoral head and neck.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
Reason: evaluate for ich on Coumadin/therapeutic History: h/a The patient is status post recent left-sided parietal craniotomy for removal of an extra-axial mass. There is a vasogenic pattern of hypodensity present along the left parietal lobe subcortical and periventricular white matter which remains stable. There is an extra axial collection at the craniotomy site measuring approximately 9 mm in thickness which is unchanged compared to the prior exam. Scalp staples have been removed since the prior exam. There is persistent intracranial air which has a mildly regressed.The visualized portions of the paranasal sinuses demonstrate partial opacification of the maxillary sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Atherosclerotic calcifications are present along the distal internal carotid arteries.
|
1.Status-post recent left parietal craniotomy for tumor removal. There are attendant postoperative changes which continue to evolve. Examination is essentially stable when compared to the exam from 1/18/15 as detailed above.2.There is persistent intracranial air which has a mildly regressed . The persistence of the intracranial air and is of uncertain significance. Please correlate with clinical exam.3.There is a persistent extra-axial collection at the craniotomy site which is stable.
|
Generate impression based on findings.
|
Reason: 9 years s/p right upper lobectomy for T2N0 adenocarcinoma History: surveillance imaging LUNGS AND PLEURA: Postoperative changes of right upper lobectomy are again noted. Basilar predominant interstitial/groundglass opacities most prominent in the lingula and right middle lobe are increased compared with prior studies. No new suspicious nodules or masses. Calcified granulomas in the lingula and lung base are unchanged. No pleural effusions.MEDIASTINUM AND HILA: Prominent nonspecific superior mediastinal lymph node unchanged. No new adenopathy. Severe coronary arterial calcification. Normal heart size without pericardial effusion. Mediastinal suture material on the right.CHEST WALL: Severe thoracic spine degenerative changes appear stable.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. Colonic diverticulosis.
|
1. Postoperative changes of right upper lobectomy without evidence of recurrent disease.2. Increased basilar predominant interstitial/groundglass opacities, which may represent developing NSIP or other interstitial lung disease.
|
Generate impression based on findings.
|
Rule out dental fracture. Pain. VIEWS: Mandible Panorex (one views) 1/29/2015 No acute fracture or malalignment is evident.
|
Normal examination.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign bilateral breast biopsies. History of breast cancer in paternal aunt diagnosed at the age of 83. Two standard digital views and tomosynthesis of both breasts were performed 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 the right breast. A percutaneously placed clip is present in the left upper outer quadrant. Wire sutures project over the inferior aspect of the right axilla. Stable benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
IntubatedVIEW: Chest AP 1/30/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. The vagal stimulator device is in place. Cardiothymic silhouette normal. Patchy atelectasis right lower lobe and left lower lobe improved in the interval. Probable small right pleural effusion.
|
Bilateral patchy atelectasis improved in the interval.
|
Generate impression based on findings.
|
Reason: Right clamshell incision with transverse tenotomy and short extension to left; Resection of the anterior mediastinal mass History: 6 wk f/u CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules, with the largest in the right costophrenic angle measuring 20 mm in diameter, not significantly changed. A previously measured nodule in the right base is not clearly identified due to adjacent atelectasis.Postsurgical scarring and atelectasis with pleural thickening in the right hemithorax.MEDIASTINUM AND HILA: Interval resection of a large mediastinal mass.No significant lymphadenopathy.No visible coronary artery calcification.No pericardial effusion.CHEST WALL: Port catheter with its tip in the SVC.Status post clam shell sternotomy with incomplete healing at the sternotomy site.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: 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: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1.Status post resection of a large anterior mediastinal mass.2.Multiple pulmonary nodules compatible with metastases, unchanged.
|
Generate impression based on findings.
|
56-year-old male with history of knee pain and swelling. There is faint mineralization in the soft tissues along the medial femoral condyle which could represent early post traumatic calcification of the medial collateral ligament. There is a small cyst present within the tibial plateau which is likely degenerative in etiology. We see no fracture.
|
Faint calcification in the expected location of the MCL suggesting injury to this structure. This can be further evaluated with MRI if clinically warranted.
|
Generate impression based on findings.
|
7-week-old male with left neck mass Again seen is a 3.1 x 1.1 x 2.4 cm lobulated soft tissue mass in the left mid neck, previously 3.0 x 1.0 x 2.5 cm. The mass is heterogeneous in echotexture and appears similar to the prior exam. There is demonstrable blood flow within this mass not significantly changed. No drainable fluid collection is evident to suggest abscess formation. There are adjacent soft tissue masses that likely represents lymph nodes measuring up to 5 mm.
|
Left mid neck heterogeneous mass is relatively unchanged since the prior exam.
|
Generate impression based on findings.
|
66 year old with right fungating mass presents for imaging work up. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. Mammogram for right breast was not performed due to the presence of fungating mass. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There is an oval mass at left upper outer quadrant, which is slightly larger than one on the prior study, suggesting benign lesion. New small round mass is present at posterior inner aspect on CC view. This is likely a projection of lymph node located superiorly. Scattered benign calcifications are seen in the left breast.Limited ultrasound of right breast, bilateral axillae, bilateral infra/supraclavicular regions were performed. In the right breast, a large fungating mass is identified. Limited ultrasound of this mass shows solid hypoechoic mass with increased blood flow. No cystic component is detected. Measurement of this mass cannot be obtained due to its large size. Multiple satellite lesions are present around this index mass.In the right axilla, there are multiple abnormally enlarged lymph nodes from level 1 to level 3. The largest node is present at level 1, measuring 30 x 25 mm. In the right supraclavicular region, there are at least 3 abnormal lymph nodes. The largest abnormal supraclavicular lymph node is located laterally, measuring 18 x 20 mm. In the left axilla, there is one abnormally enlarged lymph node, measuring 26 x 28 mm. This lymph node is also visualized on the mammogram. There is another abnormally enlarged lymph node at level 2 of left axilla, measuring 14 x 17 mm. There are at least three abnormally enlarged lymph nodes in the left supraclavicular region; the largest lymph node is located centrally, measuring 13 x 10mm.
|
1. Highly suspicious solid mass in the right breast at lateral aspect with multiple probable satellites. Multiple abnormally enlarged lymph nodes in both axillae and both supraclavicular regions.2. No mammographic evidence for malignancy in the left breast.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: T - Take Appropriate Action - No Letter.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. History of breast cancer in maternal grandmother diagnosed in her 40s. Two standard digital views of both breasts were performed 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, including arterial calcifications. A benign right intramammary lymph node is present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Reason: lung cancer, on Erlotinib therapy. Pls c/w previous study and evaluate dz status and tx response. History: lung cancer, on Erlotinib therapy. Pls c/w previous study and evaluate dz status and tx response. CHEST:LUNGS AND PLEURA: Status post left upper lobectomy. Redemonstration of multiple bilateral non-solid pulmonary nodules, with reference measurements as follows:Right middle lobe lesion measures 17 mm (series 4 image 56) previously 17 mm.Left basilar nodule measures 14 mm (series 4 image 76) previously 14 mm, but is more confluent with adjacent non-solid masses superiorly with increased size of adjacent masses in the left lower lobe.Numerous additional nodules without significant interval change since the prior study but are slowly growing since 2012.MEDIASTINUM AND HILA: Unchanged hypoattenuating lesion in the thyroid. Lower left paratracheal lymph node measures 11 mm (series 3 image 36) previously 11 mm. Severe coronary calcification. Normal heart size without pericardial effusion. Stenosis of the left innominate vein with prominent intercostal and azygous veins.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypoattenuating hepatic lesions are unchanged and most likely benign.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: Mildly prominent retroperitoneal and gastrohepatic lymph nodes unchanged. Severe atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1. Stable size of pulmonary reference lesions, however there has been interval growth of some of the lesions in the left lung base since the prior study. 2. Additionally, many of the other pulmonary lesions have grown slowly since 2012.
|
Generate impression based on findings.
|
Reason: eval s/p aneurysm clipping History: same Since the prior exam there is no significant interval change. The patient is status post right-sided craniotomy. There are 4 aneurysm clips present one at the anterior communicating artery region, one at the right carotid terminus region and two at the right middle cerebral artery bifurcation region. Some hypodensity adjacent to the right middle cerebral artery aneurysm clips is present at the posterior aspect of the right orbital gyrus which is stable compared to the previous exam. There is redemonstration of intracranial air and a small subdural collection at the craniotomy site. The amount of intracranial air has mildly regressed.A hypodense focus at the right precentral gyrus subcortical white matter was not present on the preoperative exam and is stable.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
|
1.The patient is status post right-sided craniotomy from multiple aneurysm clip placement. There are evolving postoperative changes present. Otherwise there is no interval change as detailed above.
|
Generate impression based on findings.
|
Reason: Eval for baseline CTH prior to anticoagulation restart History: Eval for baseline CTH prior to anticoagulation restart There is redemonstration of intraventricular blood and a hematoma centered in right thalamus associated with some hypodensity adjacent to the right thalamic hematoma. Compared to the prior exam there is no significant change in the extent of the hematoma appeared the hematoma is less dense on the current exam.Atherosclerotic calcifications are present along the distal internal carotid arteries.A punctate calcification is present along the posterior aspect of the pons.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
|
1.Continued evolution of thalamic and intraventricular blood. Examination is otherwise stable.
|
Generate impression based on findings.
|
15-year-old male with a neck one and severe substernal and epigastric pain is episodic. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. Gallbladder is within normal limits. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No evidence of hydronephrosis or perinephric inflammation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The duodenum was followed and it is difficult to see it crossing the midline. Therefore, malrotation cannot be excluded.BONES, SOFT TISSUES: Left greater than right enhancing nodularity to the of lower lumbar L2, L3, and L4 nerve roots bilaterally.OTHER: No significant abnormality noted.
|
1.Left greater than right enhancing nodularity to the lower lumbar nerve roots bilaterally compatible with known diagnosis of NF1.2.Difficulty visualizing the duodenum crossing the midline retroperitoneum raising suspicion for malrotation. Therefore, an upper gastrointestinal study is recommended to exclude malrotation.Findings discussed with Dr. Tonsgard in person on 1/30/15 at 2:45p.m.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Three standard digital views of both breasts were performed 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 round marker was placed on a skin lesion overlying the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Small grouped calcifications in the left upper outer quadrant posterior depth seen on screening mammogram. ML and spot magnification CC and ML views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The grouped calcifications in the left lateral breast at posterior depth demonstrate layering on ML views, compatible with benign milk of calcium.No discrete masses, suspicious microcalcifications or areas of architectural distortion are present in the left breast.
|
Left lateral breast calcifications compatible with benign milk of calcium. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
|
Generate impression based on findings.
|
Reason: 42F with L MCA stroke eval for stability History: R hemiparalysis The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense region involving gray and white matter located along the left parietal lobe. There is associated gyral pattern of hyperintensity extending along the periphery of this hypodense area. There is effacement of sulci adjacent to this area of hypodensity .The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
|
1.Left parietal lobe lesion in a vascular distribution (territory of the left posterior parietal artery of the middle cerebral artery) is suggestive of subacute infarction associated with some minor bleeding. There is some associated mass effect which has regressed since the 1/10/15 exam. There is no significant change when compared to previous exam
|
Generate impression based on findings.
|
Female 26 years old Reason: evaluate gallbladder History: RUQ abd pain, N/V LIVER: The liver measures 16.7 cm in length and demonstrates echogenic parenchyma which is suggestive of fatty infiltration. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones, gallbladder wall thickening or pericholecystic fluid. There is no intra-or extrahepatic biliary duct dilatationPANCREAS: Limited visualization of the pancreas however where seen is unremarkableKIDNEYS: The right kidney measures 10.6 cm. The left kidney measures 10.2 cm. There is no hydronephrosis.OTHER: The spleen measures 9.7 cm.
|
1. Unremarkable appearance of the gallbladder without gallstones or acute cholecystitis. 2. Echogenic hepatic parenchyma suggestive of fatty infiltration.
|
Generate impression based on findings.
|
Reason: 2.5 yrs s/p right lower lobectomy for lung cancer. Possible new right GGO noticed 4/2014 History: surveillance imaging. patient with pacemaker. LUNGS AND PLEURA: Small subpleural complex nodule and cyst (series 5/32) slightly denser than previous but possibly due to mucous accumulation in a small cyst, as this has not significantly changed since last 5/3/2013.Small subpleural scar like opacity in the anterior segment of the right upper lobe (series 5/67) unchanged.Left lower lobe 6-mm sharply marginated nodule in), unchanged.Pleural scarring posteriorly at the right base, also unchanged.Mild mainly upper zone emphysema.MEDIASTINUM AND HILA: No significant lymphadenopathy.Mild coronary artery calcification.No pericardial effusion.Pacemaker device in place with leads in the area of the right atrial appendage and right ventricular apex.CHEST WALL: Degenerative disease in the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited evaluation showing focal calcification and cortical scarring in the superior pole of the right kidney unchanged since 2013.
|
Stable indeterminate small pulmonary nodules with no specific evidence of metastatic disease.
|
Generate impression based on findings.
|
TAVR. ABDOMEN:LUNG BASES: Large bilateral pleural effusions with overlying compressive atelectasis.LIVER, BILIARY TRACT: Perihepatic ascites. Vicarious excretion from the gallbladder. No enhancing liver lesions identified..SPLEEN: No significant abnormality noted. Subcentimeter partly calcified splenic aneurysm.PANCREAS: 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: Mild SMA stenosis.PELVIS:UTERUS, ADNEXA: Uterus is enlarged with central fluid density; in an 83-year-old woman this should be correlated with direct gynecologic exam and possibly pelvic ultrasound.BLADDER: Foley catheter decompresses the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Large fecal burden in the rectum.BONES, SOFT TISSUES: Left hip replacementARTERIAL DIAMETERS: *Right common iliac 5.4 x 5.5 mm, left lateral calcification*Left common iliac 4.6 x 5.8 mm, posterior calcification*Right external iliac 5.7 x 6.2 mm*Left external iliac 6.0 x 6.1 mm*Right common femoral 6.3 x 6.6 mm*Left common femoral 4.9 x 5.4 mm *Distal abdominal aorta proximal to the bifurcation 6.9 x 8.6 mm, concentric calcification
|
Small partially calcified distal abdominal aorta and pelvic arteries is measured above. SMA stenosis. Perihepatic ascites. Fluid within the uterine vault; correlate with gynecologic exam and possible pelvic ultrasound
|
Generate impression based on findings.
|
Male 76 years old; Reason: History of NSCLC with new lung lesion - restage RADIOPHARMACEUTICAL: 15.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 120 mg/dL. Today's CT portion grossly demonstrates left lower lobe consolidation. There is poor aeration of the right lung likely a combination of pleural fluid and consolidation throughout most of the right lung with an air fluid level at the right lung base. There is right upper lung bronchiectasis. There is extensive atherosclerotic calcification of the aorta and peripheral branches, including an infrarenal abdominal aortic aneurysm. Today's PET examination demonstrates markedly increased activity in the left lung base with an SUV max of 5.9 which is new from prior PET scan and corresponds to the new consolidation seen on recent Chest CT most likely inflammatory in nature. There are scattered areas of increased activity in the mid to lower right lung with prominent ringlike activity in the right lower lung surrounding the air-fluid level on CT with an SUV max of 3.6, likely infection/abscess. Previously noted right upper lobe markedly increased activity is no longer seen consistent with interval treatment. There are no suspicious FDG avid lesions identified in the abdomen, pelvis or skull.
|
No definite tumor activity is identified. Bilateral lower lobe pulmonary activity correlates with areas of consolidation on CT and likely represent infection/inflammation with likely abscess in the right lower lobe. Superimposed tumor activity cannot be entirely excluded, however.
|
Generate impression based on findings.
|
Reason: maxillary sinus involvement by right orbital fracture. History: ecchymoses and swelling and pain. Since the previous examination the patient has developed a right orbital blow out fracture which extends through the right infraorbital foramen. There is associated opacity along the extraconal space just beneath the right inferior rectus muscle probably representing blood products. There is no convincing evidence for entrapment of extraocular muscles There is opacification of the right maxillary sinus. There is an associated mild right medial orbital blowout fracture. The orbital floor fracture fragment is mildly displaced and the infundibulum of the osteomeatal complex unit is narrowed. There is opacification of the right middle and anterior ethmoid air cells and partial desiccation of the right frontal sinus. There is peri-orbital soft tissue swelling present.The skull base foramina are intact.Visualized portions of the mastoid air cells and middle ears are clear. The visualized intracranial structures are within normal limits. The eyeball lenses are thin.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present at the carotid bifurcations. Some calcifications are present at the epiglottis
|
1.There is a new right orbital medial and floor blowout fracture present associated with findings which suggest possible obstruction at the hiatus semilunaris and infundibulum of the ostiomeatal complex unit as detailed above.
|
Generate impression based on findings.
|
69-year-old male hx MGUS, r/o any lytic lesions SKULL: No discrete lytic lesions.CERVICAL SPINE: No discrete lytic lesions. Degenerative disk disease affects the lower cervical spine with slight kyphosis and multilevel facet joint osteoarthritis. Calcifications project over the lateral soft tissues, likely in the carotid vasculature.THORACIC SPINE: The bones are demineralized. No discrete lytic lesions. Mild scoliosis is noted. LUMBAR SPINE: No discrete lytic lesions. Mild facet joint osteoarthritis affects the lower lumbar spine. Atherosclerotic calcifications are noted in the abdominal aorta and common iliac arteries.RIBS: No discrete lytic lesions.PELVIS: No discrete lytic lesions. Moderate osteoarthritis affects both hips.UPPER EXTREMITY: Right humerus: A few tiny 2-3 mm lucencies within the proximal humerus are nonspecific.Left humerus: No discrete lytic lesions.Right forearm: No discrete lytic lesions.Left forearm: No discrete lytic lesions.LOWER EXTREMITY: Right femur: No discrete lytic lesions.Left femur: No discrete lytic lesions.Right leg: No discrete lytic lesions.Left leg: No discrete lytic lesions.
|
No definite myelomatous lesions. Tiny nonspecific lucencies within the proximal right humerus do not necessarily represent myelomatous deposits.
|
Generate impression based on findings.
|
No evidence of acute intracranial hemorrhage. There are no masses, mass effect or midline shift. Mild periventricular hypodensities are slightly more prominent than prior exam which is nonspecific but likely related to chronic small vessel ischemic changes. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. Mucosal thickening is noted of the ethmoid air cells and maxillary sinuses. Evidence of hyperostosis frontalis.
|
1.No evidence of acute intracranial hemorrhage or mass.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. These have progressed from the prior exam from 2007.
|
Generate impression based on findings.
|
Depressed mental status status post catheter-directed thrombolysis for pulmonary embolism management and ECMO initiation for cardiac arrest. There is no evidence of intracranial hemorrhage. The grey-white matter differentiation is difficult to assess due to portable scanner technique. However, the ventricles are essentially unchanged in size and configuration and there is no midline shift or herniation. There is diffuse paranasal sinus opacification likely related to intubation. The mastoid air cells are clear. There is now diffuse scalp edema.
|
1. No evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct, particularly using the portable CT.2. Diffuse scalp edema may be related to anasarca or spontaneous hemorrhage.
|
Generate impression based on findings.
|
Female 86 years old Reason: assess for cholangitis vs. liver disease History: as above LIVER: The liver measures 14.0 cm in length. It demonstrates coarsely echogenic hepatic parenchyma. There is no focal liver lesion. The main portal vein is patent with peak velocity of 0.5 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is absent with expected prominence of the common hepatic duct measuring 1.1 cm in transaxial dimension. There is no intrahepatic duct dilatation.PANCREAS: Largely obscured by overlying bowel gas.KIDNEYS: The right kidney measures 8.2 cm. There is a 1.3-cm renal cyst. The left kidney measures 8.3 cm. No hydronephrosis.OTHER: Diffuse abdominal ascites. Bilateral pleural effusions. The spleen measures 4.9 cm.
|
1. Coarsely echogenic hepatic parenchyma. This may represent fatty infiltration however other infiltrative liver processes cannot this appearance.2. Diffuse abdominal ascites and bilateral pleural effusions.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.