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Generate impression based on findings.
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Mild prominence of ventricles and sulci is unchanged may indicate mild degree of volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. Moderate periventricular and subcortical hypoattenuation is nonspecific but unchanged and likely related to age indeterminate small vessel ischemic disease. Hypodensity in the left pons also may be related to ischemia and is unchanged. Calcification within the basal ganglia the bilateral cerebellar dentate nuclei is unchanged and may be age-related. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
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1.No acute intracranial hemorrhage. Please note that nonenhanced CT is not sensitive for the early detection of acute ischemic stroke and if there is strong clinical concern, an MRI may be considered.2.Moderate age indeterminant small vessel ischemic disease is unchanged.
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Generate impression based on findings.
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49 year old female with history of gastric bypass surgery presents with dysphagia. Evaluate for hernia. Scout radiograph showed a nonobstructive bowel gas pattern.Diagnostic sensitivity is limited due to single contrast technique without gas granules. Evaluation of the esophagus and stomach revealed postsurgical changes compatible with gastric bypass surgery and a small gastric remnant. Contrast passed from the esophagus through the gastric remnant into the small bowel without evidence of an obstructing lesion. Sliding type hiatal hernia was present measuring 2.8 cm in maximal dimension when visualized in the distal esophagus. No paraesophageal hernia was visualized.During the exam, spontaneous gastroesophageal reflux was observed to the level of the upper esophagus. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.TOTAL FLUOROSCOPY TIME: 3:52 mm:ss
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1.Postsurgical changes s/p gastric bypass surgery with sliding type hiatal hernia as described above.2.No evidence of esophageal obstruction.3.Spontaneous GE reflux to the level of the upper esophagus.
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Generate impression based on findings.
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73 year old female with history of pancreatic cancer. Baseline scan. CHEST:LUNGS AND PLEURA: No pleural effusion or consolidation in the lower lungs. Right apical ground glass nodule (12/18), nonspecific and may be followed on subsequent imaging.MEDIASTINUM AND HILA: 1.3 x 1.5 cm right hilar lymph node, nonspecific.CHEST WALL: Mild degenerative changes affect the spine. Right chest port with subcutaneous gas, consistent with recent placement.ABDOMEN:LIVER, BILIARY TRACT: Pneumobilia and biliary stent is again seen, similar to prior. No significant intra-or extrahepatic biliary dilatation. Nonenhancing right posterior hepatic lobe focus, nonspecific and likely benign cysts.SPLEEN: No significant abnormality noted.PANCREAS: Primary tumor: 2.1 x 1.9 x 1.9 cm mass in the pancreatic head.Pancreatic duct: 4 mm.Mesenteric Arteries:Arterial anatomy: Duplicated right renal artery.Arterial tumor abutment or encasement: (1) Proximal celiac artery, SMA, and hepatic artery: The celiac origin is occluded, likely related to longstanding atherosclerosis. There is distal reconstitution of the celiac trunk vie flow from the PDA/GDA. The superior mesenteric artery is within normal limits. (2) Tumor abutment or encasement of additional arteries: The GDA is encased and narrowed.Mesenteric Veins:Venous anatomy: (1) Superior mesenteric vein (SMV) first jejunal branch: Superior to SMA. SMV is within normal limits. (2) Inferior mesenteric vein (IMV) drains into the central splenic vein near the portal-splenic confluence.Venous tumor abutment or encasement: SMV-PV-splenic vein confluence: At the level of the tumor, with abutment.First jejunal vein branch: Within normal limits.SMV, PV, or segmental SMV-PV occlusion: None are occluded, however the portal vein is attenuated by tumor. Other: NonePortal venous system: No significant abnormality.Inferior vena cava (IVC): No significant abnormality.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: . The appendix is within normal limits. Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: The bladder is decompressed.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Approximately 2 cm mass in the pancreatic head, consistent with the given history of pancreatic cancer.2.Gastroduodenal artery encasement and narrowing as above.3.Portal vein abutment and narrowing as above.4.Right apical ground glass nodule, nonspecific and may be followed on subsequent imaging.
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Generate impression based on findings.
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Base of the tongue neoplasm, CRT. CHEST:LUNGS AND PLEURA: No new or suspicious pulmonary nodules. Stable 5-mm micronodule left lower lobe (5/54), presumably benign. No pleural fluid.MEDIASTINUM AND HILA: Unchanged subcentimeter mediastinal lymph nodes. Severe coronary artery calcifications and moderate cardiomegaly, about the same.CHEST WALL: Focal narrowing of the left common carotid artery due to eccentric mural plaque with lumen measuring about 4-mm (3/3). Nonspecific calcifications in the left thyroid lobe. Degenerative changes of the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypoattenuating lesion in the right posterior hepatic lobe present over multiple prior studies and not significantly changed (3/90).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Unchanged thickening of left adrenal gland.KIDNEYS, URETERS: Renal cystsPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications 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: Degenerative changes.OTHER: No significant abnormality noted.
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No signs of metastatic disease. Severe atherosclerotic disease with noncalcified plaque causing focal narrowing of the left common carotid artery.
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Generate impression based on findings.
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Colostomy with pelvic abscess status post prior drainage. Please evaluate. 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: Left lower quadrant ostomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Postsurgical changes adjacent to the stomach.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Thickwalled bladder as present previously.LYMPH NODES: Subcentimeter pelvic lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: The presacral fluid collection present on the prior examination measured approximately 7.2 x 3.2 cm (image 22; series 2; 1/13/2015 study) has undergone trans-gluteal catheter drainage and minimal residual fluid is identified (not measurable). Pigtail catheter is in the center of the collection. Inflammation has regressed but is still present.
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Status post trans-gluteal abscess drainage of a presacral fluid collection with minimal residual fluid identified.
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Generate impression based on findings.
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There is a focus of diffusion restriction in the right periventricular white matter of the frontal lobe with mild associated increased T2 signal compatible with an acute infarct. There is a more subtle focus of diffusion restriction in the left periventricular posterior frontal lobe, anterior to a large region of encephalomalacia, which is likely subacute. There is a large region of encephalomalacia involving the left parieto-occipital region with ex vacuo dilatation of the left occipital horn. There is a small focus of susceptibility associated with this region, indicating microhemorrhage. Additional scattered punctate foci of susceptibility are also present indicating microhemorrhage. Overall the ventricles and sulci are prominent suggesting volume loss. There are multiple additional scattered periventricular and subcortical T2 hyperintensities as well as a T2 hyperintensity within the left cerebellar peduncle without associated diffusion restriction which are likely related to moderate to severe small vessel ischemic disease. The left cerebral peduncle is mildly atrophic, likely the result of Wallerian degeneration.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
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1.Acute infarct in the right periventricular white matter of the frontal lobe.2.Subacute infarct in the periventricular white matter of the posterior left frontal lobe.3.Large region of encephalomalacia involving the left parieto-occipital region.4.Moderate to severe chronic small vessel ischemic disease with volume loss.
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Generate impression based on findings.
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NECK: There are postoperative findings related to partial right maxillectomy and radiation therapy. There is no significant interval change in the small amounts soft tissue along the margins of the right maxillectomy bed, without evidence of gross tumor otherwise. There is no evidence of significant cervical lymphadenopathy by size criteria. The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. The airways are patent. There is mild multilevel degenerative spondylosis. The imaged portions of the lungs are clear. Median sternotomy wires are partially imaged.HEAD: There is no evidence of intracranial mass or abnormal enhancement. There is no midline shift or mass effect. The ventricles and sulci are within normal limits. The mastoids/middle ears are grossly clear.
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1. Post-treatment findings in the region of the right maxillary sinus without significant interval change in size in the appearance of the surgical margins with a small amount of nonspecific soft tissue, but otherwise no evidence of gross tumor recurrence.2. No evidence of intracranial metastases.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Reason: Please evaluate for posterior circulation stenosis or occlusion. History: Sudden onset vertigo. Previous cerebral aneurysm clip 1994, unsure exactly which vessel, in the R anterior circulation. Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.A hypodense focus measuring 8 mm is present in the left thyroid lobe.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.An aneurysm is present along the distal right internal carotid artery at the expected location of posterior communicating artery origin. Artifact from a near clip partially obscures small portions of the distal right internal carotid artery.There is a 2.5-mm in present the basilar tip which is directed anteriorly and towards the right. There is mild fusiform dilation of the proximal middle cerebral artery m1 segments bilaterally. There is mild narrowing at the origin of the right middle cerebral artery.The anterior communicating artery and the posterior communicating arteries are identified and are intact.There is extracranial origin of the posterior inferior cerebellar arteries bilaterally. The distal left vertebral artery and the proximal basal artery very mildly fusiformly dilated.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient is status post right-sided craniotomy. Surgical clip is present along the distal right internal carotid artery. A ventriculostomy tube courses through the right frontal lobe into the left lateral ventricle with tip near the foramen of Monro. The ventricles are not dilatedAtherosclerotic calcifications are present along the distal internal carotid arteries.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.
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1.There is a basilar tip aneurysm present2.the patient is status post ventriculostomy tube placement which is stable compared to the prior exam.3.The patient is status post aneurysm clip placement at the distal right internal carotid artery near the origin of the right posterior communicating artery.4.Some of the intracranial vasculature including proximal basal artery and the proximal middle cerebral arteries are mildly fusiformly dilated.
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Generate impression based on findings.
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Reason: thymoma. S/p chemo and RT, pls c/w previous study and evaluate dz status. History: thymoma CHEST:LUNGS AND PLEURA: Elevation of the left hemidiaphragm with mild overlying atelectasis.No suspicious nodules and no pleural effusions.MEDIASTINUM AND HILA: Soft tissue mass in the anterior mediastinum with sutures and coarse calcifications measuring 22 x 45 mm, unchanged.No significant lymphadenopathy.No visible coronary artery calcification.Very small amount of pericardial fluid, unchanged and probably not significant.CHEST WALL: Status post median sternotomy with incomplete healing of the upper sternal and manubrial incision.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small hepatic cysts, unchanged.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.
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Residual partially calcified anterior mediastinal mass, unchanged from multiple previous scans. No new findings.
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Generate impression based on findings.
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Malignant neoplasm of maxillary sinus, radiotherapy and chemotherapy follow up. CHEST:LUNGS AND PLEURA: Unchanged micronodules. No pleural fluid.MEDIASTINUM AND HILA: Cardiomegaly. No pericardial fluid. Postsurgical changes of prior CABG with severe calcification of the native coronary vasculature.CHEST WALL: Sternotomy wires.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Portal vein appears enlarged, unchanged, correlate for portal hypertension.SPLEEN: Upper normal size.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating lesions, likely cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the spine. Nonspecific iliac wing lucencies unchanged.OTHER: No significant abnormality noted.
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No signs of metastatic disease. Possible portal hypertension.
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Generate impression based on findings.
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There are unchanged postoperative findings related to prior left neck and left parotid surgery. There is no evidence of mass lesions or significant cervical lymphadenopathy. There is unchanged calcified nodule in the left lobe of the thyroid gland. The salivary glands appear unchanged. The major cervical vessels are patent. There is mild calcification at the bilateral common carotid artery bifurcations. There is unchanged multilevel cervical spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. There is left ethmoid and bilateral maxillary sinus mucosal thickening. There is a right posterior lower neck subcutaneous soft tissue attenuating focus, which is unchanged and may represent scar tissue. There are unchanged opacities in the bilateral external auditory canals, which likely represent cerumen. There is a small retention cyst in the right maxillary sinus. The imaged portions of the lungs are clear.
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1. Stable post-treatment findings without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2. Unchanged calcified nodule in the left lobe of the thyroid gland.
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Generate impression based on findings.
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Female 69 years old; Reason: r/o abdominal or pelvic pathology History: persistent, lower, abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged right lower pole calculus with mild right renal atrophy. Innumerable bilateral cysts grossly unchanged. Other subcentimeter hypodensities are too small accurately characterize.RETROPERITONEUM, LYMPH NODES: Moderate calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No acute abdominal or pelvic pathology.
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Generate impression based on findings.
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There is no intracranial hemorrhage. There is a large region of encephalomalacia in the left parieto-occipital lobes with associated dystrophic calcifications and ex vacuo dilatation of the left occipital horn. Overall there are prominent ventricles and sulci, indicating volume loss. There is moderate to severe scattered periventricular and subcortical hypodensities as well as a hypodensity in the left middle cerebellar peduncle which may reflect age indeterminate small vessel ischemic disease. There is minimal right to left midline shift from volume loss. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
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1.No acute hemorrhage.2.Moderate to severe age indeterminate small vessel ischemic disease. Please note that non-enhanced CT is not sensitive for the early detection of acute ischemic stroke and if there is strong clinical concern, an MRI may be considered.3.Large focus of encephalomalacia in the left parieto-occipital lobe
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Generate impression based on findings.
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History carcinoid. Carcinoid syndrome, bronchiectasis, without acute exacerbation. CHEST:LUNGS AND PLEURA: Numerous nodules and micronodules not significantly changed in size or number with the reference lesion in the left upper lobe measuring 7 x 9 mm (5/36), previously reported as 6 x 9mm on the last exam however measuring 7 x 9 mm on 2/2013; differences in measurements may be related to scan variability.Postsurgical changes of right middle lobectomy. Scarring and bronchiectasis in the right upper lobe unchanged. Azygos pseudo-lobe.MEDIASTINUM AND HILA: Nonspecific hypoattenuating nodules in the thyroid gland, which is mildly enlarged. Subcentimeter mediastinal lymph nodes unchanged. Hiatal hernia. Normal heart size. No visible coronary artery calcifications on this non-cardiac-gated study.CHEST WALL: Severe degenerative changes of the spine. Spinal fixation hardware. Calcifications extending into the spinal canal, probably causing stenosis at the T8/T9 level, unchanged. Unchanged. Focal areas of lucency in the spine nonspecific but unchanged and may represent osteopenia however are incompletely evaluated.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: Fatty infiltration/ replacement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Colonic diverticuli.BONES, SOFT TISSUES: Lumbar spine fusion. Severe degenerative changes.OTHER: No significant abnormality noted.
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No significant change in pulmonary nodules. Probable spinal stenosis at the T8/T9 level.
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Generate impression based on findings.
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57 year old with breast pain. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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12-year-old female with OG tube placementVIEW: Abdomen AP (one view) 01/30/15 OG tube side port and tip is within the stomach. Nonobstructive bowel gas pattern. No pneumoperitoneum.
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OG tip is in the stomach.
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Generate impression based on findings.
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Nonenhanced CT head:There is no intracranial hemorrhage. There is a large region of encephalomalacia in the left parieto-occipital lobes with associated dystrophic calcifications and ex vacuo dilatation of the left occipital horn. Overall there are prominent ventricles and sulci, indicating volume loss. There is moderate to severe scattered periventricular and subcortical hypodensities as well is a hypodensity in the left middle cerebellar peduncle which may reflect age indeterminate small vessel ischemic disease. There is minimal right to left midline shift from volume loss. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. Mild atherosclerotic calcifications of the vertebro-arteries.CTA head:The basilar artery is ectatic with a 2-mm outpouching at its midpoint directed medially and inferiorly (80917/96) which has a broad (4-mm) base, suspicious for aneurysm. There is a dominant left vertebral artery. There is a tiny outpouching along the posterior aspect of the right clinoid ICA is in the region of the origin of the PCOM, however a direct communication of the visualized distal PCOM to this region is not definitively visualized. There is mild stenosis of the right M1 segment. There is mild to moderate narrowing and mural irregularity of the distal vessels of the ACA, MCA and PCA. There is occlusion of a left M1/M2 branch. No aneurysms are identified within the middle cerebral arteries.CTA neck:No significant stenosis within the vertebral or internal carotid arteries.Severe centrilobular emphysema. Moderate degenerative changes of the visualized spine.
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1.Suspected 2-mm aneurysm arising from the midpoint of the basilar artery.2.Occlusion of a left M1/M2 branch of indeterminate age.3.Mild stenosis of the right M1 segment with diffuse mild to moderate narrowing and irregularity of distal branches of the ACAs, MCAs and PCAs.4.Small outpouching along the right para-clinoid ICA is in the vicinity of the PCOM artery origin, however a direct communication with the PCOM is not definitively visualized. This likely represents an infundibulum, with a small aneurysm considered less likely.5.Moderate to severe age indeterminant small vessel ischemic changes, volume loss and left parieto-occipital encephalomalacia are unchanged.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Keloid over sternum from heart surgery. Two standard digital views of both breasts and an additional left MLO view 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. Round marker was placed on a skin lesion overlying the left breast. Benign calcifications are present bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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History of new onset psychosis, evaluate for mass. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There is an incomplete posterior arch of C1, which is anatomic variant.
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No evidence of acute intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of intracranial mass, postcontrast imaging or MRI may be considered as clinically warranted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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76 year old female with a history of right benign biopsy and left breast cyst. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A scar marker overlies the right breast. Stable scattered calcifications are present bilaterally. A focal asymmetry noted immediately posterior to the left nipple is slightly more prominent than on prior studies. The previously seen left breast cyst is not evident today.No suspicious microcalcifications or areas of architectural distortion are present in either breast. LEFT BREAST ULTRASOUND
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Prominent left nipple complex. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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History of transient facial numbness and weakness, evaluate for intracranial hemorrhage There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. There is a partially empty sella. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There is an incomplete posterior arch of C1, which is anatomic variant.
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No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Incisional hernia without mention of obstruction or gangrene ABDOMEN:LUNG BASES: Subcentimeter micronodule versus scarring (image 8; series 5) at the right lung base.LIVER, BILIARY TRACT: No significant abnormality noted. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructive, punctate renal calculi.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Ventral hernia containing fat (image 117; series 4) roughly 7 cm in diameter extending slightly to the right of midline.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Ventral hernia containing fat. Bilateral, nonobstructive renal calculi.
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Generate impression based on findings.
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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. A focal asymmetry is present in the posterior depth of the central left breast.No suspicious microcalcifications or areas of architectural distortion are present.
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Focal asymmetry in the central aspect of the posterior left breast. Spot compression imaging and possible ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Reason: 56 year-old female with chest pain, heartburn, rare dysphagia. Esophagram to further evaluate Scout radiograph of the chest showed mild cardiomegaly.Single contrast evaluation of the esophagus showed mildly prominent cricopharyngeal impression at the level of C5/6 vertebral body. There was no functional obstruction to liquid contrast. Patient refused barium pill.No gastric cardia/fundus mucosal abnormality was identified. During the exam, there was one episode of minimal provoked gastroesophageal reflux. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.TOTAL FLUOROSCOPY TIME: 5:42 minutes
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1.One episode of minimal provoked gastroesophageal reflux.2.Normal motility.3.Mildly prominent cricopharyngeal impression without evidence of functional obstruction.
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Generate impression based on findings.
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History of acute mental status change, evaluate for intracranial hemorrhage. There is a new area of hypoattenuation in the right cerebellar hemisphere with patchy high attenuation material and sulcal effacement. There also appears to be a punctate focus of hyperattenuation in the left cerebellar hemisphere, which may represent calcification. There is unchanged linear hyperattenuation in the bilateral superior frontal lobes and medial left parietal and occipital lobes, which may represent calcification and laminar necrosis from prior ischemia. There is encephalomalacia in the right parietal, right temporal, and right occipital lobe with associated ex vacuo effect and widening of adjacent sulci. There is extensive calcification in the distal vertebral arteries and carotid siphons. Fluid is present in the right paranasal sinuses and nasopharynx, likely related to intubation. The mastoid air cells are clear. The orbits are unremarkable. There is incomplete fusion of the posterior arch of C1, which is an anatomic variant.
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1.Unchanged hypoattenuation in the right cerebral hemisphere with hyperattenuating material is suggestive of a recent infarction with superimposed hemorrhage or calcification. Vascular imaging may be useful for further evaluation.2.Large chronic right middle cerebral artery infarct and scattered gyriform calcifications in the bilateral cerebral hemisphere in watershed areas likely represent calcification laminar necrosis from prior ischemia.
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Generate impression based on findings.
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71-year-old male with history of pancreatic ganglioneuroma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Scattered punctate calcifications, consistent with prior granulomatous infection.SPLEEN: Splenic granulomata.PANCREAS: The pancreas is displaced anteriorly by a low attenuating retroperitoneal mass. However the pancreas is otherwise within normal limits.ADRENAL GLANDS: Left adrenal myelolipoma, unchanged from previous CT.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: 6.3 x 9.7 x 7.2-cm hypoattenuating retroperitoneal mass, without significant enhancement, which displaces the vena cava posteriorly, and abuts the celiac and superior mesenteric arteries. The aorta is occluded inferior to the renal arteries, with significant narrowing (greater than 50%) of the right renal artery at its origin. The right anterior subcutaneous bifemoral bypass graft is also occluded. There is reconstitution of the common femoral arteries by multiple superficial soft tissue, deep pelvic and mesenteric collaterals.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Nonspecific sclerotic foci are noted within the pelvis. Degenerative changes affect the visualized spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Aforementioned occlusion of infrarenal aorta and iliac arteries, with reconstitution of the common femoral arteries via multiple collaterals.
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1.Large hypoattenuating retroperitoneal mass without significant enhancement, consistent with patient's given history of ganglioneuroma. This likely plays a role in partial gastric outlet obstruction from extrensic compression on the duodenum.2.Occlusion of the infrarenal aorta, with an occluded right anterior subcutaneous bifemoral bypass graft, and reconstitution of the common femoral arteries via collaterals.3.Severe right renal artery narrowing as above.Findings discussed with oncology service Dr. Olugbile.
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Generate impression based on findings.
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No evidence of acute intracranial hemorrhage. There are no masses, mass effect or midline shift. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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1. No evidence of acute intracranial hemorrhage or mass.
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Generate impression based on findings.
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60 year-old male with history of increased drainage from left great toe. Evaluate for osteomyelitis. The distal phalanx of the great toe is absent, presumably due to amputation. There is soft tissue swelling about the great toe. Mild irregularity of the distal margins of the 1st proximal phalanx may reflect erosions from prior infection, but we see no progression when compared to the prior study. The amputation margins of the second and third proximal phalanges are sharp. Mild osteoarthritis affects the midfoot.
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Mild irregularity along the distal margin of the first distal phalanx appears similar to the prior study. We see no osteolysis to confirm acute osteomyelitis. If patient care warrants further imaging, an MRI may be obtained.
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Generate impression based on findings.
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History of self palpated mass in the right breast, found to be a simple cyst on ultrasound in 2013. Known bilateral calcifications. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Bilateral calcifications are progressing in a benign fashion.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Benign bilateral calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional bilateral CC views 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. Stable benign lymph node is present in the right upper outer quadrant.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Unspecified disorder of adrenal gland. Goiter. RIGHT LOBE MEASUREMENTS: 4.7 x 2.0 x 1.6 cmLEFT LOBE MEASUREMENTS: 5.4 x 2.0 x 1.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: The background thyroid gland remains homogeneous in echotexture. Subcentimeter cystic and spongiform nodules are stable, the largest of which measures 6 mm. LEFT LOBE: The background thyroid gland remains homogeneous in echotexture. Subcentimeter cystic and spongiform nodules are again seen, the largest of which measures 10 mm, unchanged. ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Bilateral subcentimeter benign-appearing thyroid nodules are unchanged.
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Generate impression based on findings.
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67 years, Female. Reason: abdominal pain, r/o constipation History: same Multiple surgical clips overlie the upper abdomen and tubal ligation clips overlie the pelvis. Moderate stool burden. Nonobstructive bowel gas pattern.
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Moderate stool burden. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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71 years, Male. Reason: Examine for obstruction History: abdominal distension Cardiac device partially seen. Patient is status post sternotomy. Please see same day chest radiograph report for additional details. Brachytherapy seeds noted. Enteric tube tip overlies the gastric body. Right femoral catheter noted. Nonobstructive bowel gas pattern. There is centralization of the bowel gas suggestive of ascites.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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57-year-old female history of RA. Evaluate for disease progression. Left hand: There is narrowing of the first, fourth, and fifth MCP joints with chronic erosive deformities at the first metacarpal head and triquetrum, but we see no active erosions or evidence of disease progression. Mild osteoarthritis affects the hand and wrist.Right hand: There is narrowing of the first MCP joint with irregularity of the first metacarpal head. Chronic erosions are again seen along the proximal carpal row. We see no new erosions to suggest disease progression.Left foot: There are postoperative changes at the first metatarsal. Mild osteoarthritis affects the first MTP joint. There are moderate chronic erosive deformities of the second and possibly third metatarsal heads which are unchanged. Deformities of the third and fourth middle phalanges are presumably postoperative in etiology. There is soft tissue swelling about the fourth toe. There is no evidence of disease progression.Right foot: Degenerative arthritic changes affect the first MTP joint appearing similar to prior. There is a small lucency in the head of the first proximal phalanx which likely represents a chronic erosion and is unchanged. A chronic appearing erosive deformity of the fourth metatarsal head is also stable. There is no evidence of disease progression.
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Findings compatible with rheumatoid arthritis without evidence of disease progression.
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Generate impression based on findings.
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Male 79 years old Reason: 79 y/o male with Gastric Ca on chemo. Please compare to prior CT. thanks History: Gastric Ca. CHEST:LUNGS AND PLEURA: Motion artifact. Bilateral pleural effusions and right greater than left basilar atelectasis or consolidation have resolved. Calcified right lower lobe granuloma stable mild interstitial abnormality at the left lung base can be followed. Previously described calcification seen along the right posterior and lateral pleural surfaces, unchanged. Previously described patchy airspace disease right middle lobe has resolved.MEDIASTINUM AND HILA: Post sternotomy changes. Severe coronary artery calcifications unchanged. Atherosclerotic changes aortic root. Small nonpathologic sized mediastinal nodes are stable. Granulomata right hilum are unchanged.CHEST WALL: Fatty atrophy right pectoralis muscle, unchanged. Healed right rib fracture unchanged.ABDOMEN:LIVER, BILIARY TRACT: Biliary stent in place. Pneumobilia. Reference lesion closely apposed the left lobe of the liver remains extremely ill-defined estimated at 5.0 x 3.7 cm (image 94; series 3), stable to equivocally larger. A second component or satellite lesion is again noted along the transverse colon and extending to the abdominal wall (image 102) also appears similar.SPLEEN: Mildly prominent spleen is unchanged with scattered calcific granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Scattered central calcifications right kidney likely vascular in nature. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic disease aorta and branch vessels. No evidence of aneurysm.BOWEL, MESENTERY: Nonobstructive right lateral abdominal wall hernia unchanged (image 131; series 3).BONES, SOFT TISSUES: Mild anasarca. 1.7 cm subcutaneous nodule in the anterior abdomen (image 107; series 3) stable in size and present in retrospect on the prior exam.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild anasarca.OTHER: No significant abnormality noted
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Stable nonobstructive right abdominal wall hernia. No substantial interval change in peri-hepatic mass(es). Resolution of pleural effusions. Reference measurements given above.
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Generate impression based on findings.
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The gray-white matter differentiation is age appropriate. T1 images demonstrate normal white matter myelination pattern for the patient's stated age. The signal intensity and morphology of the cerebrum, cerebellum and pons are within normal limits. There is no evidence of Chiari malformation, gray matter migrational disorder, apparent structural abnormality, intra- or extra-axial fluid collection/hemorrhage, mass, midline shift or mass effect. No diffusion weighted abnormalities are identified. There is no abnormal enhancement in the brain parenchyma or leptomeninges. The ventricles, cortical sulci and basal cisterns are normal in size and configuration. The visualized orbits are unremarkable.
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Normal brain MRI without evidence of Chiari malformation.
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Generate impression based on findings.
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80 year-old female with a proven right breast cancer presents for seed localization procedure. On review of the prior studies, A proven cancer with interna marker clip is identified at upper outer quadrant. The procedure, risks including bleeding and infection, and benefits of I-125 seed localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was placed in an alphanumeric grid using lateral to medial approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the stereotactic images, and IsoAid preloaded breast localization needle was placed adjacent to the clip. Pre-deployment images confirmed good positioning of the needle with respect to the target. The I-125 seed was then deployed. Then, the needle was withdrawn and the skin entry site was closed with steri strip.The post-deployment films confirmed that the seed was positioned near the site of the clip (inferior-medial to the clip). The digital mammogram was annotated and reviewed with Dr. Jaskowiak prior to the patient's procedure. A bracelet was placed on the left wrist labeled with the patient's name, MRN, number of seeds placed, left breast and surgical date (1/30/15). Post seed placement instructions were given to the patient. She tolerated the procedure well and left the Breast Imaging area in stable condition.Dr. Abe performed the procedure.Orthogonal digital specimen radiographs revealed the mass and clip and seed to be within the specimen.
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Successful seed localization of the right breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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58 years, Female. Reason: Hx of Whipple with constipation and unable to pass gas, eval for sbo History: constipation and nausea Multiple surgical clips seen overlying the upper abdomen. Nonobstructive bowel gas pattern. Average stool burden.
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Nonobstructive bowel gas pattern. Average stool burden.
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Generate impression based on findings.
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40-year-old male with history of pain. Left hand: Hardware components of a volar plate and screw device are seen affixing the middle phalanx in anatomic alignment. We see no evidence of hardware complication. Amorphous density within the volar aspect of the base of the middle phalanx presumably represents hamate autograft (based on prior report). The margins are less distinct suggesting some interval healing. There remains a 5-mm crescentic ossific density volar to the head of the proximal phalanx. There is irregularly of the articular surfaces of the middle and proximal phalanges appearing similar to prior. The PIP is held in flexion with slight dorsal subluxation of the middle phalanx in relation to the proximal phalanx. There are small punctate densities adjacent to the first MTP joint which presumably represent foreign bodies.Right hand: There is mild soft tissue swelling of the index finger particularly along the radial aspect. We see no fracture. The hand is otherwise unremarkable.
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1.Left middle finger postoperative changes as described above.2.Mild soft tissue swelling about the right index finger without acute fracture.
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Generate impression based on findings.
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Male 61 years old; Reason: prostate cancer History: prostate cancer ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted. Cholelithiasis.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: A few shotty retroperitoneal lymph nodes are unchanged, and not enlarged by size criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality noted.LYMPH NODES: A few small pelvic lymph nodes are stable and not enlarged by size criteriaBOWEL, MESENTERY: Scattered colonic diverticula without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of metastatic disease. Please correlate with same day bone scan.
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Generate impression based on findings.
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49-year-old male with nodular lymphocyte predominant HL. Needs additional assessment please.RADIOPHARMACEUTICAL: 15.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion of the neck demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examination demonstrates multiple bilateral, left greater than right, hypermetabolic axillary lymph nodes compatible with lymphoma activity. For reference, the most metabolically active is in the left axilla (SUV max = 8.2).No suspicious hypermetabolic tumor in the abdomen.Multiple bilateral hypermetabolic pelvic lymph nodes including the bilateral common iliac, internal iliac, external iliac, and inguinal lymph nodes. For reference, the most hypermetabolic lymph node, in the left inguinal region, measures a maximum SUV of 9.0 compatible with lymphoma activity.
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Numerous hypermetabolic bilateral axillary and bilateral pelvic lymph nodes compatible with lymphoma tumor activity.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately.
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Generate impression based on findings.
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Male 47 years old Reason: r/o thrombus History: edema LIVER: The liver demonstrates cirrhotic morphology. It measures 13.4 cm in length. No focal liver lesion is identified. The main portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones or gallbladder wall thickening.PANCREAS: The pancreas is obscured by bowel gas.KIDNEYS: The left kidney measures 11.5 cm. The right kidney measures 11.5 cm. The renal parenchyma is echogenic bilaterally suggestive of medical renal disease. There is no hydronephrosis.OTHER: Mild splenomegaly measuring 13.3 cm. Diffuse abdominal ascites.
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1. Cirrhotic liver morphology without focal mass. 2. Unremarkable appearance of the main portal vein. 3. Diffuse abdominal ascites.
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Generate impression based on findings.
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69 year-old female with bilateral knee pain Right knee: Severe osteoarthritis affects the knee, particularly at the patellofemoral joint. There is slight lateral translation of the patella relative to the femoral trochlea.Left knee: Severe osteoarthritis affects the knee, particularly at the patellofemoral joint. There is slight lateral translation of the patella relative to the femoral trochlea.
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Severe osteoarthritis.
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Generate impression based on findings.
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37 year old female with history of gastric bypass presents with GERD and dysphagia. Scout radiograph of the chest demonstrated cardiomegaly and bibasilar opacities.Diagnostic sensitivity is limited due to single contrast technique without gas granules. Evaluation of the esophagus and stomach revealed postsurgical changes compatible with gastric bypass surgery without a prominent gastric remnant. Esophageal distention was seen up to a diameter of approximately 3 cm, but contrast passed from the esophagus through the surgical anastomosis and into the small bowel without evidence of an obstructing lesion. Sliding type hiatal hernia was observed which appeared to contain the gastric remnant and a portion of the gastroenteric anastomosis. During the exam, spontaneous gastroesophageal reflux was observed to the level of the thoracic inlet. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. A 13 mm barium pill was administered and passed through the esophagus and into the gastric remnant without delay.TOTAL FLUOROSCOPY TIME: 5:29 mm:ss
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1.Postsurgical changes s/p gastric bypass surgery with sliding type hiatal hernia as described above.2.Distention of the esophagus up to 3 cm without evidence of obstruction.3.Spontaneous GE reflux to the level of the thoracic inlet.
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Generate impression based on findings.
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15-year-old female with left middle finger pain with decreased movement and right thumb pain and swelling over the base of the thumb with decreased movement after catching a basketball two days agoVIEWS: Left third digit PA/oblique/lateral, right hand PA/oblique/lateral (6 views) 01/30/15 Linear lucency through the volar aspect of the base of the left third middle phalanx is equivocal for an avulsion fracture. Right hand is within normal limits without evidence of fracture or malalignment.
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Equivocal linear lucency through the volar aspect of the base of the left third middle phalanx. Clinical correlation is advised.Findings paged to pager 5718 at 1039 on 1/30/15.
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Generate impression based on findings.
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63-year-old female with history of a right breast benign biopsy. Presents for bilateral diagnostic mammogram. Left breast simple cyst seen on prior ultrasound. Family history of breast cancer in paternal aunt. Three standard views of both breasts with right breast spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A focal asymmetry in the right breast at the 12:00 position at mid depth disperses on compression views, likely representing a cyst. Multiple stable subcentimeter benign morphology masses are seen in both breasts. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable bilateral benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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44 year old female with right breast "density" presents for mammographic workup. Three standard views of both breasts with two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A triangular marker is placed at upper outer quadrant of right breast, indicating the area of concern. There is a focal asymmetry at posterior upper outer quadrant in the right breast, which disperses with spot compression. A small circumscribed mass is seen the central aspect in the left breast. No suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.Focused ultrasound was performed for right upper outer quadrant and central left breast. In the right breast, there is no solid or cystic lesions or suspicious findings at upper outer quadrant. At the central aspect of left breast, there is a circumscribed hypo-/anechoic lesion measuring 5 x 2 mm, likely a cyst. This lesion corresponds to the mass seen on the mammogram.
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No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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57-year-old female with history of back pain. Thoracic spine: There is slight rightward curvature of the mid and lower thoracic spine. Mild degenerative disc disease affects the upper and middle thoracic spine. There is no evidence of compression fracture or specific findings to account for the patient's pain.Lumbar spine: Severe degenerative disc disease affects L5-S1. The remaining intervertebral disc spaces and vertebral body heights are maintained. There are extensive calcifications within the lower abdomen and pelvis likely representing large uterine fibroids.
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Degenerative arthritic changes and other findings as above.
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Generate impression based on findings.
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As per prior radiologic report dated 11/7/2014, there are 13 rib bearing thoracic type vertebrae and 5 non-rib bearing lumbar type vertebrae. Redemonstrated is extensive multilevel spondyloarthropathy of the lumbar spine with disc height loss, vacuum disc phenomenon and endplate degenerative changes. There is unchanged grade 1 retrolisthesis of T13 on L1, measuring 3 mm. The vertebral body heights are preserved. There is no definite rim enhancing fluid collection to suggest abscess. Additional findings by level:T13-L1: Grade 1 retrolisthesis of T13 on L1 and facet arthropathy contributing to mild bilateral foraminal narrowing, but no significant central spinal stenosis.L1-L2: Posterior decompressive laminectomy. Marginal osteophyte formation with moderate bilateral facet arthropathy, contributing to severe spinal canal stenosis and moderate bilateral foraminal stenosis. L2-L3: Posterior decompressive laminectomy. A disc bulge and bilateral facet arthropathy, contribute to moderate bilateral foraminal stenosis.L3-L4: Posterior decompressive laminectomy. A disc bulge and bilateral facet arthropathy, contribute to severe right and moderate left foraminal stenosis.L4-L5: Posterior decompressive laminectomy. A disc bulge and bilateral facet arthropathy, contribute to moderate to severe bilateral foraminal stenosis.L5-S1: Posterior decompressive laminectomy. A disc bulge and bilateral facet arthropathy, contribute to moderate bilateral foraminal stenosis.
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1. Postsurgical findings related to multilevel decompressive laminectomy from L1-L2 through L5-S1, but no rim-enhancing fluid collection to suggest abscess. However, delineation of the intraspinal contents is limited and MRI may be useful for further evaluation, if there is no contraindication.2. Extensive multilevel spondyloarthropathy throughout the lumbar spine with multilevel foraminal stenosis and severe spinal canal stenosis at L1-2. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of left breast abscess drainage. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Arterial calcifications are present. Stable benign masses are present bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable benign bilateral masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Female 10 years old Reason: please evaluate for bony deformity History: acute pain in R knee with limpVIEWS: Right knee AP lateral and oblique (3 views) pelvis AP and frog leg lateral (two views) 1/30/2015 KNEE: No acute fracture or malalignment. No significant soft tissue swelling or joint effusion is seen.PELVIS: No acute fracture or malalignment.
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Normal examination.
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Generate impression based on findings.
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40 year-old female with history of lumbar pain. Small osteophytes project anteriorly from the vertebral body of L3. There is mild facet joint osteoarthritis of the lower lumbar spine. Surgical clips project over the upper abdomen.
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Mild degenerative arthritic changes as above.
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Generate impression based on findings.
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68-year-old female with lumbar pain There is mild levoscoliosis of the thoracolumbar spine. Severe degenerative disk disease affects L5/S1 and L1/L2. Mild to moderate degenerative disk disease affects the remaining lumbar levels. There is multilevel facet joint osteoarthritis. Grade 1 anterolisthesis of L4 on L5 is noted. There are atherosclerotic calcifications within the distal aorta.
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Degenerative disk disease, facet joint osteoarthritis and other findings as described above.
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Generate impression based on findings.
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51-year-old female with history of swollen knee. We see no fracture. There is a moderate-sized joint effusion. Alignment is anatomic. There are mild enthesopathic changes along the anterior aspect of the patella. The left knee is unremarkable as seen on the frontal views.
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Joint effusion without acute fracture.
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Generate impression based on findings.
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Female 11 years old Reason: h/o injury of right thumb History: injuryVIEWS: Right hand AP, first digit PA and lateral (two views) 1/30/2015 2-mm linear ossific density which projects off the lateral aspect of the first proximal phalanx epiphysis likely represent a small avulsion fracture.
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Avulsion fracture along the lateral aspect of the first proximal phalanx as described above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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57-year-old female with pain, preoperative evaluation Right knee: Severe osteoarthritis affects the right knee with bone on bone apposition of the medial tibiofemoral joint compartment and tricompartmental osteophytes. Hardware components of a left total knee arthroplasty device are situated near anatomic alignment as seen on the frontal view.Mechanical axis exam: There is approximately 10 degrees varus alignment of the knee relative to the neutral mechanical axis. Mild sclerosis along the endosteum of the medial distal femoral diaphysis is of uncertain etiology, but may be of no clinical significance..
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Osteoarthritis and varus deformity as described above.
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Generate impression based on findings.
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63-year-old female with history of shoulder pain. We see no acute fracture or dislocation. Mild osteoarthritis affects the acromioclavicular joint. There is slight anterior spurring of the acromion process. Again seen is a 3-mm ossicle within the acromiohumeral interval which may represent a loose body or chronic ossification of the rotator cuff. Mild osteoarthritis affects the glenohumeral joint.
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Osteoarthritis without acute fracture.
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Generate impression based on findings.
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41-year-old female with history of motor vehicle accident in 2000 Pelvis: An orthopedic screw transverses the left SI joint. A plate and screw device coursing along the posterior aspect of the sacrum and SI joints is noted. A fractured screw overlies the left SI joint, which we suspect is associated with this plate. A metallic ring overlies the right iliac wing near the other end of the plate. A second plate and screw device spans the left lateral aspect of the sacrum. A third plate and screw device affixes the left superior pubic ramus in near-anatomic alignment. Deformity of the left superior pubic ramus indicates a healed fracture. There is mild sclerosis along the SI joints, which may reflect healed fractures and/or degenerative arthritic changes. Surgical clips overlie the pubic bones. Small densities along the left superior acetabulum may represent calcifications of the capsular margin. A T-shaped contraceptive device projects over the mid pelvis.Lumbar spine: The aforementioned orthopedic fixation of the pelvis is again noted. Ossicles along the lateral aspect of the lower lumbar spine presumably represent old displaced transverse process fractures. Moderate to severe degenerative disk disease affects L5/S1. Mild facet joint osteoarthritis affects the lower lumbar spine. Disk spaces and vertebral body heights are preserved. Surgical clips project over the right upper quadrant, presumably from prior cholecystectomy. There is no spondylolisthesis or evidence of instability on flexion and extension views.
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Postoperative changes of pelvic fracture fixation and lower lumbar degenerative arthritic changes as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable focal asymmetry is present at the 9 o'clock position of the right.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable right focal asymmetry. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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68-year-old female with pain, follow up for fracture Again seen is a plate and screw device affixing a proximal humerus fracture in near anatomic alignment without evidence of hardware complication. The fracture margins appear indistinct, suggesting some interval healing. There has been some interval maturation of heterotopic bone formation along the medial aspect of the proximal humerus. Glenohumeral alignment is within normal limits. Mild-moderate osteoarthritis affects the glenohumeral and AC joints. The bones are demineralized suggesting osteopenia.
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Orthopedic fixation of proximal humerus fracture as described above.
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Generate impression based on findings.
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75-year-old female with knee pain Right knee: Moderate osteoarthritis affects the knee. Extensive chondrocalcinosis particularly affects the lateral meniscus. No joint effusion.Left knee: Moderate osteoarthritis affects the knee. There is chondrocalcinosis of the menisci. No large joint effusion. Small foci of calcification within the distal femoral diaphysis likely represent chronic bone infarction.
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Osteoarthritis and chondrocalcinosis affecting each knee.
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Generate impression based on findings.
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18 year-old male with shoulder dislocation No fracture is evident. Glenohumeral alignment is within normal limits.
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No fracture or dislocation.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of benign right breast cyst aspiration. History of breast cancer in sister diagnosed in her 50s. 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. Round markers were placed on skin lesions overlying both breasts. Stable benign masses and calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable benign masses and calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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41-year-old male with history of fracture. Again seen is a plate and screw device affixing a fracture of the right acetabulum/ilium. The fracture line is indistinct suggesting some healing. There is no evidence of hardware complication.
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Orthopedic fixation of healing fracture as above.
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Generate impression based on findings.
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46-year-old male with pain, evaluate for arthritis Mild osteoarthritis affects the hip. Slight prominence of the femoral head-neck junction is consistent with a CAM deformity.
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Osteoarthritis and other findings as described above.
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Generate impression based on findings.
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Nodular lymphocyte predominant Hodgkin's lymphoma. Needs initial assessment CHEST:LUNGS AND PLEURA: Calcified granuloma at both lung bases.MEDIASTINUM AND HILA: No significant abnormality noted. Mild coronary artery calcifications.CHEST WALL: Right chest port. Left axillary lymphadenopathy. For reference purposes, a left axillary lymph node measures 2.4 x 1.7 cm (image 23; series 701). Tiny nodes in the right axilla are not enlarged by CT size criteria.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bilateral pelvic adenopathy. For reference purposes, a left external iliac lymph node measures 3.0 x 2.4 cm (image 194; series 701).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Left axillary and bilateral pelvic adenopathy with reference measurements given above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Round marker was placed on a skin lesion overlying the right breast. Scattered benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. Screening mammography is most sensitive when evaluating for interval changes. If patient submits outside mammogram, comparison will be made. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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History of known cerebellar hemorrhage, evaluate for stability. There is unchanged linear hyperattenuation in the high right frontal gyri and parafalcine left parieto-occipital lobe, which may represent calcification and laminar necrosis from prior ischemia. There is also unchanged hypoattenuation in the right cerebellar hemisphere with patchy central high attenuation material. There is encephalomalacia centered in the right inferior parietal lobule extending to the adjacent right temporal lobe, right occipital lobe and right parietal lobe. There is associated ex vacuo effect and widening of adjacent sulci. There is extensive atherosclerotic calcification in the distal vertebral arteries and carotid siphons. Fluid is present in the right paranasal sinuses and nasopharynx, likely related to intubation. The mastoid air cells are clear. The orbits are unremarkable.
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1.Unchanged hypoattenuation in the right cerebral hemisphere with hyperattenuating material is suggestive of a recent infarction with superimposed hemorrhage or calcification. Vascular imaging may be useful for further evaluation.2.Large chronic right middle cerebral artery infarct and scattered gyriform calcifications in the bilateral cerebral hemisphere in watershed areas likely represent calcification laminar necrosis from prior ischemia.
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Generate impression based on findings.
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Renal calculi. The 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: Bilateral renal calculi. Right hydronephrosis which was present previously has resolved. In the right kidney there is a conglomeration of stones at the lower pole measuring 9 x 12 mm (image 54; series 80248). These are not obstructive. In the left kidney there are scattered punctate calculi with the largest located at the upper pole (image 43) measuring 4 x 6 mm. These are also not obstructive at the current time.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Status post hysterectomy. Posterior left pelvic fluid collection measuring 5.9 x 3.1 cm it is of unclear etiology or significance. It could be related to the left adnexa. Correlate with gynecologic history and exam as clinically indicatedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Bilateral nonobstructive renal calculi with measurements given above. Small fluid collection in the left posterior pelvis of unclear etiology and significance; correlate with gynecologic surgical history and exam as clinically indicated.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of benign right breast cyst aspiration in 2013. Two standard digital views and tomosynthesis of both breasts and an additional left MLO view 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. Stable benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Female 49 years old; Reason: Chronic n/v and abdominal pain, esophagitis. Pt has a h/o TE fistula repair as a infant. Noted annular pancreas and chronic pancreatitis. Need to evaluate gastric transit. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 71.9 % of peak activity (normal >70 %)1 hour: 42.1 % of peak activity (normal 30-90 %) 2 hours: 19.1 % of peak activity (normal <60 %) 4 hours: 1.4 % of peak activity (normal <10 %)
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Gastric emptying within normal limits.
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Generate impression based on findings.
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63-year-old male with history of Crohn's disease, ileal disease status post resection in 1982. Right flank pain, musculoskeletal versus nephrolithiasis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholecystectomy clips.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small right renal cysts, and an approximately 7 cm left lower pole hypoattenuating focus, nonspecific but likely also a cyst. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Mild dilatation of the terminal ileum at approximately 3 cm. Small bowel feces sign in this area is suggested stasis. The ileocecal valve appears patent. No adjacent inflammation or fluid collections. No free air. Equivocal duodenum/D2 segment wall thickening (3/38), nonspecific. No pneumatosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate enlargement, with slight protrusion of the bladder.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Anterior abdominal wall midline sutures, and right inguinal hernia mesh repair/plug.OTHER: No significant abnormality noted
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1.No hydronephrosis or hydroureter, and no renal calculus are seen.2.Mild dilatation of the terminal ileum, with small bowel feces sign which is suggestive of stasis.
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Generate impression based on findings.
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64 year old male with abdominal distention. Nonobstructive bowel gas pattern. No free air on upright view. Residual contrast material has progressed into the colon from recent OPM. Gastrostomy tube in place.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Gastric cancer restaging after chemotherapy. CHEST:LUNGS AND PLEURA: Bilateral tiny pleural effusions appear stable. Since prior examination, there is interval development of bilateral patchy ground glass opacities predominating around the airways (right greater than left--images 27 through 44; series 5). These are concerning for incipient fungal pneumonia, particularly if the patient is neutropenic. This finding was discussed with Dr. Catenacci at the time of dictation.MEDIASTINUM AND HILA: Thyroid nodules unchanged. Calcified lymph nodes from prior granulomatous disease. No other lymphadenopathy or mass is identified. Mild dilation of the ascending aorta is stable.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Presumed hepatic cysts are stable. No enhancing lesions or intrahepatic ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign simple cysts bilaterally. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Prior gastric surgery changes again seen with no change in appearance. Omental masses are again seen in the mesentery unchanged, greatest in the right abdomen anterior to the right colon (series 3, image 110). Diffuse haziness in mesentery seen most likely from small amount of scattered ascites is also unchanged.BONES, SOFT TISSUES: No abdominal enhancing masses consistent with metastatic disease are seen. Reference lesion (series 3, image 122) left anterior abdomen is unchanged measuring 3.9 x 3.6 cm. Other intra-abdominal mass is subjectively appears similar in size as well. Generalized anasarca in the subcutaneous tissues.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted. Large prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Stable pelvic ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. New ground glass opacities concerning for incipient fungal pneumonia; finding discussed with Dr. Catenacci. 2. Omental/mesenteric metastases and right abdomen unchanged. 3. Multiple soft tissue anterior abdominal wall enhancing metastatic lesions unchanged.
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Generate impression based on findings.
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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, unchanged in pattern and distribution. Bilateral calcifications are present including a calcified hyalinized fibroadenoma in the central left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable bilateral calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Speech disturbance. Evaluate for CVA. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter. There is also a more focal subcentimeter hypoattenuating area in the right basal ganglia. There is no evidence of intracranial hemorrhage or mass. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1. No evidence of acute intracranial hemorrhage or mass.2. Moderate small vessel ischemic changes and right basal ganglia lacunar infarct of indeterminate age. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and no contraindication, MRI of the brain is recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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72 years, Female. Reason: Status post Dobbhoff placement. Lower pelvis excluded from field of view. Dobbhoff tube tip in gastric body. Nonobstructive bowel gas pattern. LVAD, multiple mediastinal drains, and left pleural effusion noted; please see same day chest radiograph report for further details.
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Dobbhoff tip in gastric body.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable lymph node projects over the left axilla.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Male 65 years old; Reason: Pt is a 65 y/o male with met prostate cancer, evaluate for progression History: met prostate cancer, back pain Again seen is widespread multifocal increased radiotracer uptake involving the right scapula, cervical, thoracic and lumbar spine as well as bilateral ribs, sacrum and pelvis, consistent with osseous metastases. These are not significantly changed compared to prior study.
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Stable widespread osseous metastatic disease.
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Generate impression based on findings.
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chronic mouth breathing/OSA VIEWS: Soft tissue neck lateral There is marked enlargement of the adenoids resulting in moderate nasopharyngeal airway obstruction. The subglottic airway is patent. No prevertebral soft tissue swelling.
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Marked adenoid enlargement with moderate nasopharyngeal airway obstruction.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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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, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Reason: Please assess for recurrence of thymoma History: N/A LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Status post thymectomy with surgical clips but no specific evidence of recurrence.Regarding previously noted mediastinal nodules which were PET negative, the superior most one likely is a parathyroid gland, and the one along the right anterior pericardium is no longer visible.Aortic valvular calcifications are present, but there is no visible coronary calcification.CHEST WALL: Renal osteodystrophy is most visible in the thoracic vertebra, which are otherwise unremarkable. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Hepatic and splenic cyst like hypodensities are unchanged.Scattered splenic calcifications are stable.
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No evidence of recurrence, or other significant abnormality.
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Generate impression based on findings.
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History of right breast lump in 2010 with biopsy results of fat necrosis. History of benign left breast biopsy in 2004. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally, compatible with hyalinizing fibroadenomatous changes and calcified oil cysts. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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Hit by bus 4 days ago now with limp, rule out fracture.VIEWS: Left knee AP oblique and lateral (3 views) 1/30/2015 Moderate joint effusion. No acute fracture or malalignment.
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Moderate joint effusion without underlying fracture or malalignment.
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Generate impression based on findings.
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Dizziness. Evaluate for stroke. There are a few scattered patchy areas of hypoattenuation in the cerebral white matter. There is no evidence of acute intracranial hemorrhage. There is a calcified or ossified extra-axial mass along the left parietal convexity that measures up to 8 mm without significant mass effect upon the brain. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants.
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1. A few scattered patchy areas of hypoattenuation in the cerebral white matter are nonspecific. No evidence of acute intracranial hemorrhage, mass, or cerebral edema. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and no contraindications, MRI of the brain is recommended.2. A calcified or ossified extra-axial mass along the left parietal convexity that measures up to 8 mm without significant mass effect upon the brain. An MRI of the brain is also recommended for further evaluation if there are no contraindications.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Cough and fever for one week, evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 1/30/2015 Peribronchial thickening evident as well as streaky bibasilar opacities suggestive of atelectasis. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is seen.
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Bronchiolitis/reactive airways disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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History of tonsillar squamous cell carcinoma status post induction chemotherapy. There measurable residual left palatine tonsil mass. There is no evidence of residual significant lymphadenopathy in the neck. For example, the reference left level IIb lymph node now measures 4 mm in short axis, previously 8 mm. There are unchanged subcentimeter thyroid nodules. There is reflux of air into the left parotid ducts due to puffed cheek technique. There is multilevel degenerative spondylosis and likely congenital fusion of C6 and C7. There is a left cardiac pacer device. There is a right internal jugular venous catheter. There are mild calcifications of the bilateral carotid and dictation, without significant stenosis. The imaged portions of the intracranial structures are unremarkable. There is a persistent left maxillary sinus retention cyst and partially imaged opacification of the ethmoid sinuses. The imaged portions of the lungs are unremarkable.
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No evidence of measurable residual left palatine tonsil mass or residual significant lymphadenopathy in the neck.
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Generate impression based on findings.
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Headache, altered, relative hypotension after hypertensive emergency. There is diminished conspicuity of disproportionately pronounced white matter hypoattenuation in the bilateral occipital and parietal lobes. Otherwise, the background of diffuse hypoattenuation in the cerebral white matter is unchanged. There is unchanged encephalomalacia in the bilateral anteroinferior frontal lobes, left greater than right. There is a left frontal bone defect with multiple small bony fragments in the region of encephalomalacia. There is associated ex vacuo dilatation of the frontal horns of the lateral ventricles. No acute intracranial hemorrhage or mass lesion is identified. The imaged portions of the paranasal sinuses and mastoid air cells are clear. The imaged portions of the orbits are intact.
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1. Interval decreased prominence of edema related to posterior reversible encephalopathy syndrome superimposed upon a background of chronic hypertensive encephalopathy. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. A brain MRI may be useful for further characterization, if there are no contraindications for this modality.2. Unchanged bifrontal encephalomalacia.3. No evidence for acute intracranial hemorrhage.
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Generate impression based on findings.
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Neck: There are post-treatment findings related to right neck dissection, right submandibular gland resection and thyroidectomy, without evidence of measurable tumor. However, there is interval increase in size of a left lower level 6 lymph node, which now measures 11 x 16 mm, previously 9 x 12 mm. Other cervical lymph nodes with are not significantly changed, including a 13 x 7 mm right paratracheal lymph node, previously 14 x 7 mm, and right level Ia and Ib lymph nodes. The remaining salivary glands are unchanged. Much of the right internal jugular vein does not opacify, which is unchanged. There is an unchanged subcentimeter area of air in the right tracheoesophageal groove, which may represent a diverticulum. There are multiple subcentimeter nodules in the partially imaged lungs, the largest of which is in the left apex and measures 11 x 9 mm, previously 10 x 6 mm. There is mild degenerative spondylosis.Head: There is no evidence of intracranial mass or abnormal enhancement. The ventricles are normal in size and configuration. There is no midline shift or herniation. There are postoperative findings related to functional endoscopic sinus surgery and nasal septoplasty with a nasal septal defect and prosthesis. There is scattered mucosal thickening in the paranasal sinuses with diffuse sclerosis of the sinus walls. There are also persistent polypoid opacities in the nasal cavity.
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1. No evidence of intracranial metastases.2. No evidence of local tumor recurrence within the resection bed. However, interval increase in size of a left level 6 lymph node is suspicious for metastasis. 3. Subcentimeter nodules in the partially imaged lungs, at least one of which has increased in size in the left apex, and thus likely represents progression of pulmonary metastatic disease. Please refer to the separate chest CT report for additional details.4. Postoperative findings related to endoscopic sinus surgery with evidence of chronic sinusitis and probable sinonasal polyposis with superimposed acute sinusitis. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Focal asymmetry projects over the inferior aspect of the right pectoralis muscle.No suspicious microcalcifications or areas of architectural distortion are present.
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Focal right breast asymmetry. Spot compression imaging, laterally exaggerated CC view and possible ultrasound of the right breast are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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60 year-old female with reported ill-defined hypoenhancing lesion in the pancreatic head on CT examination from outside hospital. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver. There is fatty sparing noted in segment 4 of the liver as well as along the gallbladder fossa.SPLEEN: No significant abnormality notedPANCREAS: The previously described hypoattenuation in the head of the pancreas appears to correspond to the focal fat deposition best visualized on the sagittal sequences. No focal mass lesion identified.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No evidence of lymphadenopathy. Vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Note is made of a filling defect in the right gonadal vein consistent with thrombus. There is fat stranding and reticulation in the surrounding area.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted
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Outside exam read:1. Focal area of apparent fat deposition at the junction of the head/uncinate process of the pancreas. No focal mass lesion identified. Please refer to outside MRI exam for additional findings.2. Right gonadal vein thrombus. 3. Hepatic steatosis.
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Generate impression based on findings.
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Metastatic thyroid cancer on treatment. CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules and micronodules, some appear slightly larger.Reference left upper lobe nodule measures 9 mm, previously 5 mm (5/25).Reference left lower lobe nodule unchanged measuring 9 mm (5/74).Reference right middle lobe nodule measures 15 mm, previously 12 mm (5/56).No pleural effusions.MEDIASTINUM AND HILA: Status post thyroidectomy.Thickened hilar region, interlobar and lobar lymphatic tissue not significantly changed. Subcarinal lymph node minimally larger, now measuring up to 12-mm in short axis, previously 10-mm (3/46).Cardiac size is normal without evidence of a pericardial effusion.Interval stent placement in the distribution of the left anterior descending coronary artery. There is some adjacent new hypoattenuation in the left atrial appendage (3/48) which may represent artifact however the possibility of thrombus cannot be entirely excluded.CHEST WALL: 12-mm left supraclavicular lymph node, previously 10 mm (3/4).ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Thickening of the gallbladder wall can be seen in gallbladder adenomyomatosis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter cortical lesions too small to ask accurately characterize but unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable small soft tissue nodule anterior to the right kidney unchanged over numerous exams.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Some of the index pulmonary metastases measure larger. Nonindex subcarinal lymph node minimally and a left supraclavicular lymph node measure slightly larger, although non-index lymphatic tissue surrounding the larger airways appears similar. Interval LAD coronary stent placement ; adjacent hypoattenuation in the left atrial appendage may reflect artifact however thrombus cannot be entirely excluded on this non-gated exam due to poor contrast opacification.
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Generate impression based on findings.
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17-year-old male with ankle injury, rule out avulsion fracture.VIEWS: Right ankle AP oblique and lateral (3 views) 1/30/2015 Mild soft tissue swelling is noted over the lateral malleolus and there is a small joint effusion, but no underlying fracture or malalignment is evident.
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Soft tissue swelling and small joint effusion without underlying fracture or malalignment.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of ovarian cancer diagnosed at age 42. History of cervical cancer in paternal grandmother. Two standard digital views of both breasts and an additional left MLO view 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.
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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.
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Mitral valve preoptic examination ABDOMEN:LUNG BASES: No masses or effusions in the visualized portions of the lungs.LIVER, BILIARY TRACT: No significant abnormality noted. Portions of the right lobe are excluded from view.SPLEEN: No significant abnormality noted. Portions of the spleen are excluded from the field of viewPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 5.7-cm probable simple cyst lower pole right kidney. No hydronephrosis of either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Abdominal aorta widely patent without evidence of aneurysm or stenosis. The renal arteries, celiac axis, IMA, and superior mesenteric artery are all widely patent. Visualized portions of the iliac arteries are tortuous but widely patent.
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Limited technique CT of the abdomen as described. No significant vascular abnormality identified. Right renal cyst.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of ovarian cancer in mother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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52-year-old male with fever, gangrene There is extensive mottled lucency within the soft tissues of the forefoot along the third, fourth, and fifth metatarsals and extending into the toes, consistent with the stated history of gangrene. Additional foci of soft tissue gas are noted medial to the medial cuneiform and navicular bone, and extending proximally within the soft tissues of the ankle and lower leg. Although extensive gas limits evaluation of the bones, the margins of the head of the fifth metatarsal and base of the fifth proximal phalanx are indistinct, highly suspicious for osteomyelitis. The proximal phalanx of the fifth toe is dislocated dorsally relative to the fifth metatarsal.
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1. Extensive soft tissue gas compatible with gangrene as described above with extension from the forefoot to the lower leg.2. Findings highly suspicious for osteomyelitis of the head of the fifth metatarsal and base of the fifth proximal phalanx.
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Generate impression based on findings.
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Injury to proximal middle finger swelling at the third MCP.VIEWS: Right hand PA oblique and lateral 1/30/2015 No acute fracture or dislocation.
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Normal examination.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. BRCA 2 mutation carrier. History of breast cancer in mother diagnosed at age 44 in maternal grandmother diagnosed at age 63. Two standard digital views of both breasts and an additional right MLO view 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.
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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.
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Generate impression based on findings.
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Reason: h/o hnc and crt, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Stable right thyroid nodule.There is no mediastinal or hilar lymphadenopathy.No visible coronary calcifications, the heart and pericardium appear normal.CHEST WALL: Degenerative hypertrophic abnormalities affect the thoracic spine.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: Benign-appearing left adrenal nodule, unchanged since at least 5/24/2013.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.
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No evidence of metastases, or other significant abnormality. Stable benign appearing left adrenal nodule.
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