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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 opacifica... | 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 sen... | 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 ... | 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 li... | 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... | 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 be... | 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 archi... | 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 archi... | 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 revea... | 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 ... | 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... |
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. Specifica... | 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 ... | 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.ABDOME... | 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 demonstr... | 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... | 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... | 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 a... | 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... | 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 ... | 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 s... | 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 medias... | 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 effusio... | 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.Circ... | 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... | 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 GLAND... | 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, ri... | 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. Gallbladd... | 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 signi... | 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 si... | 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 ap... | 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 ... | 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... | 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.R... |
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 sim... | 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 s... | 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.... |
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 abnormal... | 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 exclude... | 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: In... | 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: Indetermin... |
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 bibasil... | 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 G... | 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 pneumot... | 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 densi... | 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 ... | 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 eff... | 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... |
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... | 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 effa... | 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 di... | 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 pl... | 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 calci... | 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 velo... | 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.... | 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 ... |
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... | 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 archi... | 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 ... | 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 int... |
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 s... | 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... | 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 pre... | 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 ... | 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... | 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... | 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 -... |
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 ... | 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 p... | 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 cereb... | 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... | 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 not... | 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... |
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 ov... | 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 pa... | 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.RE... |
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 alo... | 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... |
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 vel... | 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 ... | 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.PANCREA... | 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... | 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 t... | 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 carot... | 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 ext... | 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 essent... | 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 gallbl... | 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. |
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