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Generate impression based on findings.
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A patient submitted outside study for review. Submitted for review are digital mammographic images (11/20/14) and images from stereotactic core needle biopsy of left breast with specimen radiograph and post procedural left digital mammographic images (12/16/14) performed at River Forest Breast Care Center. For comparison, digital mammographic images (3/27/12, 9/6/13) are available. DIGITAL MAMMOGRAPHIC IMAGES (11/20/14):The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are scattered benign stable calcifications in both breasts. A marker clip is identified at central posterior aspect in the left breast.There is a cluster of developing calcifications in the left breast at posterior upper outer quadrant. Those calcifications are somewhat coarse, and similar to the stable calcifications located anteriorly.No dominant mass or areas of architectural distortion are noted in either breast. IMAGES FROM STEREOTACTIC CORE NEEDLE BIOPSY OF LEFT BREAST WITH SPECIMEN RADIOGRAPH AND POST PROCEDURAL LEFT DIGITAL MAMMOGRAPHIC IMAGES (12/16/14):Stereotactic biopsy was performed for the developing calcifications at upper outer quadrant in the left breast. Specimen radiograph demonstrates multiple target calcifications within the samples.Post procedural left mammographic images show a marker clip located at the superior and posterior to the biopsy cavity. There are a few residual calcifications at the biopsy site.Per outside radiology report, the pathology results were benign, including radial scar which is a high risk lesion.
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Status post stereotactic biopsy of the left breast. The pathology results included radial scar. Surgical consultation is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.
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Generate impression based on findings.
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Status post chemoradiation for T2 N1 squamous cell cancer of the right tongue base completed in September 2013. There is decreased supraglottic mucosal edema related to treatment. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy. The salivary glands are unchanged. There is an unchanged heterogeneous nodule within the right tracheoesophageal groove that measures up to 19 mm and likely represents an exophytic thyroid nodule. There is mild atherosclerotic plaque at the carotid bifurcations. The major cervical vessels are otherwise patent. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. There is a left lens implant. The imaged portions of the lungs are clear.
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1. No evidence of measurable tumor in the right tongue base and no significant lymphadenopathy in the neck.2. Unchanged exophytic right thyroid nodule.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in mother diagnosed at age 48 and maternal grandmother diagnosed at age 43. 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. Round markers were placed on skin lesions overlying both breasts.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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Metastatic prostate cancer. Staging. CHEST:LUNGS AND PLEURA: A few micronodules described previously are stable.MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes and small calcifications are stable.CHEST WALL: Widespread bone metastases are grossly unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large right renal cyst, unchanged.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes, unchanged compared to prior CT. For reference purposes, an aortocaval lymph node (image 133; series 3) measures 1.4 x 1.2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Widespread bony metastases, grossly unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Left external iliac lymph node measures 2.0 x 1.2 cm (image 195; series 3) unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Widespread metastases are unchanged.OTHER: No significant abnormality noted
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No substantial interval change compared to prior. Widespread bony metastases and a few unchanged enlarged lymph nodes in the abdomen and pelvis.
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Generate impression based on findings.
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Fever tachypneaVIEW: Chest AP Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax.
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Bronchiolitis or reactive airway disease.
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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 an additional right CC 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 markers were placed on skin lesions overlying both breasts. Multiple groups of coarse calcifications in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable benign 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: NSB - Screening Mammogram.
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Generate impression based on findings.
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64-year-old male with history of prostate cancer. Evaluate for progression status post 4 cycles of docetaxel CHEST:LUNGS AND PLEURA: Minimal basilar scarring/atelectasis. Mild centrilobular emphysema.MEDIASTINUM AND HILA: Left chest dual lumen Port-A-Cath with tip at the superior cavoatrial junction. Heart size within normal limits, and there is no pericardial effusion. Scattered calcified hilar lymph nodes, without significant mediastinal or hilar lymphadenopathy.CHEST WALL: Left anterior chest wall port. Interval increased innumerable sclerotic foci throughout the visualized axial and appendicular skeleton.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: Reference porta hepatis lymph node (3/25) measures 18 x 13 mm, previously 16 x 10 mm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Persistent gynecomastia.OTHER: Anterior abdominal wall foci of gas and soft tissue stranding, likely related to such tenuous injections.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: Reference right inguinal lymph node (3/29) measures 17 x 11 mm, previously 17 x 12 mm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Multiple new sclerotic lesions within the pelvis, for example a left anterior focus (3/24) and a left pubic symphysis.OTHER: No significant abnormality noted
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Increasing osseous metastatic disease.
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Generate impression based on findings.
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History of RUL and RML lobectomy for adenoma, follow-up LUL nodule. LUNGS AND PLEURA: Postsurgical volume loss on the right. No pneumothorax.Ground glass density nodules and micronodules bilaterally measuring up to 6-mm (largest lesions in the left upper lobe series 5 image 59, left lower lobe series 5 image 165, right lower lobe series 5 image 150), about the same. Faint 8mm groundglass density nodule left upper lobe (5/50) probably unchanged allowing for differences in technique.Unchanged scarring in the lateral aspect of the right lower lobe (coronal image 47).MEDIASTINUM AND HILA: Rightward mediastinal shift. Small volume of loculated pericardial fluid anteriorly unchanged. No visible lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hyperattenuating nodules in the left kidney may reflect proteinaceous or hemorrhagic cysts.
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No signs of localized recurrence. Numerous subcentimeter ground glass density nodules bilaterally appear similar and may represent foci of atypical adenomatous hyperplasia but should be followed by CT annually for a total of 3 years to exclude a change in size or density. Next follow-up scan may be obtained 1/30/2016.
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Generate impression based on findings.
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16 year old male with hypoxic ischemic injury after cardiac arrest. There is diffuse mild loss of cortical and deep grey-white differentiation as well as sulcal effacement and minimal effacement of the ventricles and quadrigeminal cistern that appears to be progressed compared with the prior exam. There is no evidence of intracranial hemorrhage. There is no midline shift or herniation. There is scattered mucosal thickening throughout the paranasal sinuses The imaged mastoid air cells are clear. The skull is unremarkable. There are unchanged nonspecific partially imaged fluid collections within the posterior paraspinal musculature.
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1.Findings suggestive of global hypoxic ischemic injury. MRI is recommended for further characterization. 2.Unchanged partially imaged nonspecific posterior paraspinal musculature fluid collections may represent edema.
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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. Round marker was placed on a skin lesion overlying the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, 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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Head trauma on Xarelto. Evaluate for bleed. There is no evidence of acute intracranial hemorrhage or mass. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter. There is no midline shift or herniation. There is minimal mucosal thickening of the bilateral maxillary sinuses. The other imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There is a right lens implant. The left globe is elongated in the AP dimension, which may represent a staphyloma or axial myopia.
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1. No evidence of acute intracranial hemorrhage or skull fracture.2. Mild small vessel ischemic changes, which are age-indeterminate.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 breast cancer in mother diagnosed at age 59. 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 partially obscured focal asymmetry is present at the 3:00 position of the right breast. No suspicious microcalcifications or areas of architectural distortion are present.
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Partially obscured right breast asymmetry. 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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Male 26 years old Reason: 26 yo with cirrhosis, please screen for HCC History: none LIVER: The liver measures 18.1 cm in length. The liver parenchyma is coarsely echogenic consistent with chronic liver disease. No focal liver lesion is identified. The main portal vein is patent and demonstrates normal directional flow with peak velocity 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without evidence of gallstones, gallbladder wall thickening or pericholecystic fluid. There is no intra-or extrahepatic biliary duct dilatation.PANCREAS: The pancreas is obscured by bowel gas.KIDNEYS: The right kidney measures 11.1 cm. The left kidney measures 8.9 cm. There is no hydronephrosis.OTHER: Mild splenomegaly measuring 13.4 cm.
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Coarsened hyperechoic liver parenchyma consistent with chronic liver disease. No focal liver lesion is identified.
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Generate impression based on findings.
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Reason: head and neck cancer/ post induction scans History: see above CHEST:LUNGS AND PLEURA: No evidence of pulmonary pleural metastases.Unchanged small left peri-fissural intrapulmonary lymph node. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Dual chamber pacemaker leads are unchanged.There are no visible coronary calcifications, the heart and pericardium appear normal.CHEST WALL: Degenerative 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: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Distal aortic calcifications and mural thrombus. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild degenerative abnormalities affect the lumbar spine.OTHER: No significant abnormality noted.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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Increased oxygen requirementVIEW: Chest AP and abdomen AP Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Diffuse lung haziness bilaterally. Minimal amount of fluid in the minor fissure. No large pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum.
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Diffuse lung atelectasis bilaterally.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of cervical cancer. 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. Round marker was placed on a skin lesion overlying right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, 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 BOT ca, s/p CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No evidence of metastases.Scattered region of lower lung zone mild bronchiectasis and centrilobular opacities may be the result of chronic aspiration. MEDIASTINUM AND HILA: Dual chamber pacemaker leads in appropriate positions appear intact.There is no mediastinal or hilar lymphadenopathy.Mild coronary calcifications are present, the heart and pericardium otherwise unremarkable.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged benign-appearing hepatic cyst like hypodensities.SPLEEN: Multiple accessory splenules, normal variant.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Abdominal aortic calcifications are present.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.
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Generate impression based on findings.
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41-year-old male with ileostomy takedown, complicated by wound infection and fistula. Evaluate for intra-abdominal abscess. ABDOMEN:LUNG BASES: Basilar atelectasis regressed. Right inferior pleural calcifications are unchangedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrectomy. Atrophic left kidney with multiple calcifications. Right iliac fossa transplant kidney.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications in the aorta and its branches. Tortuosity of the abdominal aorta.BOWEL, MESENTERY: Presumed enterocutaneous fistula with enteric contrast extending from the small bowel directly onto the anterior abdominal wall wound (image 70; series 3). Small amount of fluid (image 105; series 3) measuring approximate 1.8 x 4.1 cm is identified adjacent and deep to the abdominal wound interposed between bowel loops. This is not amenable to percutaneous catheter drainage given size and location relative to adjacent bowel loops.BONES, SOFT TISSUES: Previously described right flank cellulitis has resolved. Open midline abdominal wound personally communicating with the fistula to small bowel.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality identifiedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Presumed enterocutaneous fistula fistula, as described above. BONES, SOFT TISSUES: No significant abnormality identifiedOTHER: Right iliac fossa transplant kidney.
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Enterocutaneous fistula to open abdominal wound. Small amount of fluid is identified deep to the open wound but the collection is not amenable percutaneous catheter drainage at the current time due to small size and closely opposed bowel loops.
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Generate impression based on findings.
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not moving arms or legs. No evidence of acute ischemic or hemorrhagic lesion on this scan.There are multiple radiolucent skull lesions which do not show any significant interval change since prior exam. The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The paranasal sinuses and mastoid air cells are clear.
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1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. No change of multiple radiolucent skull lesions since prior exam.
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Generate impression based on findings.
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Male, 28 years old, immunosuppressed with neutropenic fever, headache and sinus tenderness. The paranasal sinuses are clear with the exception of mild thickening along the maxillary sinus floors. The major sinus ostia are unobstructed. The nasal septum is intact with a rightward deviation anteriorly and a leftward projecting bony spur posteriorly. The turbinates and nasal cavity are unremarkable.
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No evidence of sinus inflammation or infection.
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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, unchanged in pattern and distribution. A new subcentimeter mass is present in the mid depth of the central left breast. Stable benign intramammary lymph node is present in the right upper outer quadrant.No suspicious microcalcifications or areas of architectural distortion are present.
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New left breast mass. 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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Male, 65 years old, history of stroke, now hypernatremic but on heparin for history of atrial fibrillation and DVT with worsening mental status. Hypoattenuation is seen in the left precentral gyrus compatible with known evolving infarct. Elsewhere, patchy periventricular hypoattenuation and more localized basal ganglia lesions are evident compatible with age indeterminate microvascular and lacunar ischemic disease.Asymmetric prominence of the extra-axial CSF space along the right cerebellar hemisphere is unchanged. No new extra-axial collections are detected. There is no evidence of intracranial hemorrhage. The osseous structures of the skull are intact. Patchy opacification of the paranasal sinuses and mastoid air cells is demonstrated along with evidence of endoscopic sinus surgery.
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1. No evidence of acute intracranial hemorrhage.2. Evolving left posterior frontal lobe infarct.3. Age indeterminate microvascular and lacunar ischemic disease.
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Generate impression based on findings.
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Paraneoplastic syndrome with vertical nystagmus and diplopia. Evaluate for occult malignancy. Recent CT negative.RADIOPHARMACEUTICAL: 15.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 83 mg/dL. Today's CT portion grossly demonstrates a mucus retention cyst or polyp in the left maxillary sinus. Multiple sharply margined hypodense hepatic lesions are likely cysts.Today's PET examination demonstrates a small moderately hypermetabolic anorectal focus (SUV max = 4.0). This is most commonly due to benign sphincter activity.Otherwise no focal suspicious FDG avid lesion is identified. Extensive symmetric benign brown fat hypermetabolism is seen in the neck and thorax. Benign uptake in strap muscles of the neck and diffuse prominent but benign gastric activity is also noted.
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No definitive FDG avid tumor. Focal anorectal activity is more commonly benign although given the history, tumor cannot be entirely excluded. Further evaluation including with digital rectal exam may be performed as clinically warranted.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal aunt. Two standard digital views, 2 additional MLO 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. Two centimeter partially obscured mass is present in the lateral inferior left breast.No suspicious microcalcifications or areas of architectural distortion are present.
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Left breast mass. Spot compression imaging and 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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Spinal stenosis There is mild multilevel degenerative disk disease as well as small osteophytes projecting from the anterior aspects of the lumbar vertebrae. I see no compression fracture and alignment is within normal limits. Surgical clips are noted in the upper abdomen. Surgical suture material is noted in the pelvis.
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Mild degenerative disk disease and other findings as above.
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Generate impression based on findings.
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Male 27 years old; Reason: hx of testicualr cancer, evaluate for metastatic disease History: see above 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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Changes in the retroperitoneum related to prior lymph node dissection. No definitively enlarged lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Female 0 days old Reason: newborn with respiratory distress History: no lines - increasing respiratory distress; increasing O2 requirementVIEW: Chest and abdomen AP (two views) 1/30/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Diffuse lung haziness consistent with TTN versus RDS. No focal lung opacities. No effusions or pneumothorax.Disorganized, slightly distended and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas.
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Diffuse lung haziness consistent with TTN versus RDS with no focal opacities.Disorganized, slightly distended and nonspecific abdominal gas pattern.
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Generate impression based on findings.
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Pain. Follow-up fracture. Again seen is a transverse fracture of the proximal fibular diaphysis with fracture fragments in near-anatomic alignment. This appears similar to the prior study accounting for slight positional differences. There is mild soft tissue swelling of the lower leg and ankle.
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Proximal fibular fracture appearing similar to the prior study.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of bilateral breast surgery. History of breast cancer in mother and paternal cousin. Two standard digital views and additional CC views of both breasts and 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. Linear markers were placed on scars and round markers were placed on skin lesions overlying both breasts. Postsurgical architectural distortion and skin thickening are present bilaterally, left greater than right. Circumscribed mass overlying the left inferior pectoralis muscle may represent a low lying lymph node.No suspicious microcalcifications or areas of architectural distortion are present.
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Probable low lying left lymph node. Comparison to outside mammograms is recommended to document stability.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON
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Generate impression based on findings.
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Left foot pain since injury a few weeks (5) ago, rule out fracture There is a transverse fracture through the base of the proximal phalanx of the fifth toe. The fracture remains visible, although a small amount of adjacent callus indicates an attempt at healing. Small ossicles adjacent to the medial malleolus and base of the fifth metatarsal may represent old fracture fragments. There are small talonavicular joint osteophytes indicating mild osteoarthritis.
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5th toe fracture as described above. This was relayed to Dr. Cotts at the time of dictation.
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Generate impression based on findings.
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Status post traumaVIEWS: Left forearm AP and lateral 1/30/15 (two views) There is a buckle fracture of the distal metadiaphyses of the left radius. Alignment is anatomic.
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Left radius buckle fracture as described.
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Generate impression based on findings.
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Female 52 years old; Reason: please re-evalutate following additional systemic therapy and provide bi-dimensional measurements per RECIST v1.1 thank you History: NSCLC ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Unchanged right hepatic lobe hemangioma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis 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 in the abdomen or pelvis.
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Generate impression based on findings.
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Follow-up healing fracture. The previously seen distal radius fracture is less distinct on the current study than on the prior study, replaced by a poorly defined sclerotic band indicating some interval healing. Alignment is anatomic. Degenerative arthritic changes affecting the wrist appear similar to those seen on the prior study. Degenerative arthritic changes also affect the visualized metacarpophalangeal joints and interphalangeal joint of the thumb.
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Healing distal radius fracture.
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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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable calcifications are present bilaterally. 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: NSB - Screening Mammogram.
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Generate impression based on findings.
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Wrist pain for many months. Evaluate for fracture. There is swelling of the soft tissues along the radial aspect of the wrist which is nonspecific but can be seen in patients with DeQuervain tenosynovitis. I see no underlying fracture. Alignment is normal.
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Soft tissue swelling along the radial aspect of the wrist without fracture evident.
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Generate impression based on findings.
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51 year old female with persistent memory difficulty after motor vehicle accident. There is no evidence of intracranial hemorrhage. 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.
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No evidence of intracranial hemorrhage or skull fracture.
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Generate impression based on findings.
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Pain. Follow-up fracture. Again seen is a plate and screw device affixing a comminuted fracture of the distal humeral diaphysis in near-anatomic alignment. I see no hardware complications. The fracture lines remain visible, although there appears to be some new callus along the fracture indicating an attempt at healing.
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Orthopedic fixation of distal humerus fracture.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in daughter diagnosed at age 46. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying both breasts. Stable benign circumscribed mass is present at the 6 o'clock position of the left breast. Benign calcifications are present bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable left breast mass. 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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89-year-old man with right hip pain, limited external rotation on exam. Evaluate for degree of osteoarthritis, rule out fracture. The proximal femur appears slightly demineralized, suggesting osteopenia. Thickening of the cortex and coarsening of the trabeculae of the visualized portions of the right innominate bone suggest Paget's disease. I see no fracture. Minimal if any osteoarthritis affects the right hip.
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Paget disease of the right innominate bone with minimal if any osteoarthritis of the right hip. I see no fracture.
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Generate impression based on findings.
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Pain. Evaluate right hand. Deformity of the distal radius indicates a healing/healed fracture. There is also a mildly displaced ununited fracture of the ulnar styloid. There is perhaps slight widening of the scapholunate interval, but this is equivocal. Mild osteoarthritis affects the first carpometacarpal and first metacarpophalangeal joint. Overall, the bones appear slightly demineralized, but the demineralization is most notable at the MCP and PIP joints; this pattern is nonspecific but can be seen in patients with reflex sympathetic dystrophy. There is mild soft tissue swelling of the thumb and index finger.
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Subacute/chronic fractures of the distal radius and ulnar styloid with other findings as described above.
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Generate impression based on findings.
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74 year old male with T3N2b right tonsillar SCC status post induction chemotherapy. HEAD: There is no evidence of intracranial hemorrhage or mass. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is mild maxillary sinus mucosal thickening. The imaged mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants.NECK: The right palatine tonsillar mass has decreased in size and currently measures 15 x 21 mm, previously 32 x 36 mm. There is been improvement in the right-sided cervical lymphadenopathy. For example, the largest lymph node conglamorate is located at right level 2A and measures 18 x 7 mm, previously 32 x 16 mm. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There are moderate degenerative changes of the cervical spine most severe at the C6-C7 level where there is partial vertebral body fusion, grade 1 anterolisthesis, and fusion wires within the spinous processes. The osseous structures are otherwise unremarkable. The airways are patent. The imaged portions of the lungs are clear.
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1.Findings compatible with treatment response with a decrease in size of the right tonsillar mass and the cervical lymphadenopathy.2.No evidence for intracranial metastases
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal cousin. 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. 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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Status post T10 -- L5 posterior spine fusion with instrumentation. There is a posterior stabilization device with screws entering T10, T11, L1, L2, L4, and L5. I see no hardware complications. Amorphous bone graft is noted along the lateral aspects of the lumbar spine. Tubing noted posteriorly presumably represents a surgical drain. Mixed lucent/sclerotic lesions at T12 and L3 presumably represent metastatic breast cancer; there appear to be central superior endplate depressions of these vertebrae. There is a mild rightward curvature of the thoracolumbar spine. Gas-filled loops of bowel may reflect a postoperative ileus.
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Postoperative changes of thoracolumbar spine fusion as described above.
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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 biopsy. 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 linear marker was placed on the scar overlying the right breast. Circumscribed masses in the left upper outer quadrant are most likely intramammary lymph nodes. Calcifications are present in both breasts. No suspicious areas of architectural distortion are present.
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High probability benign left intramammary lymph nodes and bilateral calcifications. Comparison to outside mammogram is recommended to document stability. Patient states she will obtain her outside mammogram and submit it for comparison.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OC - OLD FILM FOR COMPARISON
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Generate impression based on findings.
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Status post surgery 8/10/2014. Implant position, kyphosis. C3 -- C6 laminectomy and laminoplasty. Evaluation of the cervical spine is limited due to inability to optimally position the patient. Again seen are postoperative changes of multilevel laminoplasty appearing similar to the prior study. I see no hardware complications. Severe degenerative disk disease affects C4/5 and moderate to severe degenerative disk disease affects the lower cervical levels, although the lower cervical spine is difficult to evaluate due to overlying anatomy. Relatively mild degenerative disk disease affects the upper cervical spine. There is perhaps a mild leftward curvature of the cervicothoracic spine, but otherwise alignment within normal limits. Surgical clips are noted within the base of the neck and a new left subclavian stent is also noted.
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Postoperative changes of laminoplasty as described above appearing similar to those seen on the prior study.
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Generate impression based on findings.
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Male 36 years old; Reason: Rule out malignancy History: weight loss, neuropathy, smoker CHEST:LUNGS AND PLEURA: Micronodule in the left lower lobe (3:78)MEDIASTINUM AND HILA: A few prominent and slightly enlarged cardiomediastinal lymph nodes measuring up to 1.1 cm in diameter (retrocaval pretracheal node 3:40)CHEST WALL: No significant abnormality notedOTHER: 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: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Few prominent right mediastinal lymph nodes. Pulmonary micronodule in the left lower lobe. Otherwise, unremarkable.
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Generate impression based on findings.
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Reason: ILD/polymyositis monitoring History: SOB, ILD LUNGS AND PLEURA: Very mild subpleural reticulonodular opacities in the upper and mid lung zones, not significantly changed. Small subpleural cysts and mild traction bronchiectasis at the right lung base, also unchanged, consistent with fibrosis.Micronodules compatible with intrapulmonary lymph nodes or previous infection, also unchanged.MEDIASTINUM AND HILA: Numerous mildly enlarged mediastinal lymph nodes, unchanged.Mild anterior pericardial thickening but no effusion.Moderate coronary artery calcification.CHEST WALL: Fatty atrophy of the pectoralis and several rotator cuff muscles, compatible with patient's history of polymyositis. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Relatively mild interstitial lung disease with basilar and subpleural predominance, consistent with fibrosis in a UIP pattern, likely related to polymyositis. No significant interval change.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in mother diagnosed at age 38. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable 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 77 years old Reason: 77 yo with previous history of CT PE presents for subacute chest pressures with elevated d dimer, now off of anticoagulation History: chest pressure PULMONARY ARTERIES: No acute pulmonary embolism. Normal caliber pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Scattered nonspecific bilateral micronodules which likely represent intrapulmonary lymph nodes, not significant changed. Minimal basilar atelectasis/scarring. Mild bronchiectasis of the lower lobes, right greater than left. No pleural effusions. No suspicion of nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Atherosclerotic calcifications of the aorta and its branches with mild coronary calcifications.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the right lobe of the liver is unchanged and likely represents a cyst.Hypodense exophytic lesion in the superior pole of the right kidney is also stable and likely represents a simple cyst.
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No acute pulmonary embolism. Scattered bilateral micronodules which are unchanged.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
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Generate impression based on findings.
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Right ankle pain Diffuse demineralization limits sensitivity.Right ankle: Mild degenerative changes involving the ankle with narrowing and minimal sclerosis, however no superimposed acute abnormality. Soft tissues unremarkable. Note is made of more severe osteoarthritic changes largely involving the talonavicular articulation and throughout the mid foot.Left ankle: Similar ankle degenerative changes without evidence of superimposed acute abnormality. More pronounced and again similar degenerative changes largely involving the talonavicular articulation with suspected ankylosis. If prior imaging was available, degree of interval change may be possible
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Severe osteoarthritic changes including ankylosis of the bilateral talonavicular articulations greater on the left
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Generate impression based on findings.
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5-year-old male with cough and fever, rule out pneumonia.VIEWS: Chest AP/lateral (two views) 1/30/2015 Peribronchial thickening with mild multifocal atelectasis. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is seen.
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Bronchitis/reactive airways disease pattern without superimposed pneumonia.
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Generate impression based on findings.
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Female 15 years old scoliosis.VIEWS: Lumbosacral spine AP (one views) 1/30/2015 Posterior rods that connect the posterior pedicle screws bilaterally. The nasogastric tube tip is in the antrum of the stomach.
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Interval placement of fixation rods connecting the previously placed posterior pedicle screws.
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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 biopsies. Two standard digital views of both breasts, additional bilateral CC views, one additional right MLO view, 2 additional left MLO views and a cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Multiple coarse calcifications in both breasts are most likely due to fibroadenomatous nodules. There is a group of linear morphology calcifications in the posterior depth of a central left breast for which spot magnification imaging is recommended.No suspicious masses or areas of architectural distortion are present.
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Linear morphology left breast calcifications. Spot magnification imaging is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Bilateral hip pain Pelvis: Unchanged left total hip arthroplasty, incompletely visualized the alignment appears preserved. SI joints and remainder of the pelvis unremarkableRight hip: Moderate superimposed secondary osteoarthritis with more pronounced moderate changes involving the right femoral head consistent with AVN. No distinct interval change from last November including persistent mild flattening of the femoral head superiorly
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Right hip AVN essentially unchanged. Left total hip arthroplasty stable in appearance
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Generate impression based on findings.
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Stage IV (pT4N2b) poorly differentiated cancer of parotid primary, s/p 4TFHx on 7/9/14, now with metastatic disease involving her liver. Currently receiving palliative carbo/taxol. Again seen are postsurgical findings related to left parotidectomy and left neck dissection. No significant change in heterogeneity in the surgical bed including hyperattenuating 12 mm nodular area posterior to the angle of the mandible and may represent posttreatment change. No new or enlarging mass is seen. Fat stranding and soft tissue thickening along the fat planes are compatible with posttreatment changes.No significant change in 10 mm hyperattenuating nodule in the right thyroid lobe allowing for differences in technique compared to 12/5/2014 and 8/8/2014.The submandibular glands are unchanged with treatment related changes. The left internal jugular vein is absent. There is a right internal jugular venous catheter. The osseous structures are unchanged, including an osteoma along the lateral aspect of the right mandible and torus mandibularis. Aside from effacement of the left piriform sinus likely due to treatment-related edema, the airways are patent. There is diffuse cerebellar volume loss and left occipital lobe encephalomalacia with adjacent postoperative findings from craniotomy. There is partially imaged cavitation of the left lung. There are also emphysematous changes in the right lung.
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1. Postoperative changes in the left parotid bed without definite evidence of residual or recurrent tumor.2. No significant cervical lymphadenopathy. 3. No significant change in 1 cm right thyroid lobe nodule.4. Partially imaged cavitation of the left lung presumably related to a prior infectious process. Please refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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Reason: probable presence of cancer History: dyspnea LUNGS AND PLEURA: Complete atelectasis and consolidation of the right upper lobe secondary to proximal bronchial obstruction. Many central obstructing mass, which was visible and measurable on the previous scan, is no longer visible due to the absence of intravenous contrast material. However the area of the mass appears grossly similar.Abundant secretions are present further distally in the right bronchial tree, largely obstructing the bronchus intermedius and extending into basilar bronchi.No other suspicious nodules or pleural effusions.MEDIASTINUM AND HILA: The mass, which is not clearly delineated on the current scan extends into the right paratracheal area with direct invasion, based on the previous scan. There are probably moderately enlarged right paratracheal nodes in this area.Severe coronary artery calcifications.No pericardial effusion.CHEST WALL: Dense benign type calcification in the right breast.Degenerative disease in the spine.Partially visualized multinodular thyroid.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Very limited evaluation showing bilateral adrenal nodules, indeterminate and not appreciably changed.Mild calcification in the wall of the gallbladder or possibly a large partially calcified gallstone.
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Persistent lobe atelectasis, consistent with a central obstructing mass, likely primary carcinoma with direct hilar and mediastinal invasion.
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Generate impression based on findings.
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Lymphoma. Imaging surveillance. CHEST:LUNGS AND PLEURA: Ill-defined micronodular measuring 7 mm in diameter (image 38; series 6) should be followed.MEDIASTINUM AND HILA: Enlarged presumed internal mammary lymph nodes (it is possible that these could represent dilated vascular structures which would be indistinguishable from lymph nodes on a single phase CT, but given history, lymph nodes are favored). For purposes, a right internal mammary lymph node (image 21; series 4) measures 1.6 x 1.5 cm. High left para-esophageal lymph node measures 1.7 x 1.0 cm (image 17; series 4).CHEST WALL: Bullet fragment adjacent to the right upper chest.ABDOMEN:LIVER, BILIARY TRACT: Gallstones. No focal liver lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 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: Scattered pelvic lymph nodes. For reference purposes, a left external iliac lymph node measures 1.3 x 1.1 cm (image 174; series 4).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Scattered lymph nodes reference measurements given above. Pulmonary micronodule that should be followed.
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Generate impression based on findings.
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Left knee pain Four views of the left knee are provided. There appears to be slight narrowing of the medial tibiofemoral compartment as well as tiny osteophytes, suggesting minimal osteoarthritic changes. Similar findings affect the right knee as seen on the frontal view.
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Minimal osteoarthritic changes.
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Generate impression based on findings.
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Leg length discrepancy and hip pain with gait abnormality. Status of right hip fracture repair? Two views of the right hip show a dynamic hip screw device affixing a healed intertrochanteric fracture in near anatomic alignment. There is a small amount of lucency about the threads of the dynamic screw, but this is not necessarily of any current clinical significance and I see no definite hardware complications. Mild osteoarthritis affects the right hip.Two views of the left hip are provided. Moderate osteoarthritis affects the hip.An AP view of the pelvis is provided. The bones appear demineralized suggesting osteopenia. Deformities of the obturator rings indicate old healed fractures. Severe degenerative disk disease affects the lower lumbar spine. A vascular stent overlies the right sacroiliac joint.
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Orthopedic fixation of healed right intratrochanteric fracture and other findings as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 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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59-year-old female with history of gastric cancer, status post chemotherapy. CHEST:LUNGS AND PLEURA: No pleural effusion or consolidation.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications. Atherosclerosis affects the aorta and its branches. Left IJ vein is thrombosed, peripheral to the port catheter.CHEST WALL: Left chest dual lumen Port-A-Cath with tip at the confluence of the brachiocephalic veins.ABDOMEN:LIVER, BILIARY TRACT: Persistent hepatic steatosis. No biliary dilatation. Small hepatic cyst, too small to characterize, stable since 8/1/2014.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, 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 evidence of metastatic disease.2. Left IJ vein thrombosis as above.
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Generate impression based on findings.
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Please note that axial FLAIR images and 3-D T1 postcontrast images were inadvertently not obtained.The ventricles and sulci are within normal limits. At the foramina of Monro, there is slight asymmetric prominence of enhancement on the right side with irregular appearance on the 3-D T2 weighted images, although this is felt to relate to asymmetric choroid. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is a small mucosal retention cyst in right maxillary sinus a circumferential trace mucosal thickening.
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Unremarkable contrast enhanced MRI brain.
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Generate impression based on findings.
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72 years, Female. Reason: Dobbhoff advancement History: Dobbhoff advancement LVAD, multiple mediastinal drains, and left pleuraleffusion noted; Please see same day chest radiograph report for additional details. Dobbhoff tube tip is obscured by the LVAD component. The tip is presumably in the gastric body. Pelvic vascular catheters and rectal temperature probe noted.
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Dobbhoff tube tip is obscured by the LVAD component. The tip is presumably in the gastric body.
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Generate impression based on findings.
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Hip pain. Evaluate for osteoarthritis. Moderate osteoarthritis affects the hip, appearing similar to that seen on the radiographs from 2006. Small densities seen on the frog leg view along the anterior aspect of the femoral neck may represent capsular calcifications or small intra-articular loose bodies. Mild osteoarthritis affects the left sacroiliac joint.
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Osteoarthritis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts 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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No evidence of acute intracranial hemorrhage. There are no areas of abnormal attenuation or pathological enhancement. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. Redemonstration of extensive right frontotemporal encephalomalacia and associated ex vacuo dilatation of the right later ventricle, consistent with chronic infarction. Patient is status post right frontal and temporal craniotomy. The ventricles and sulci are prominent consistent with mild age related volume loss. Multiple metallic artifacts in the right supra/paraclinoid area and right frontal and temporal lobes are indicative of postoperative changes. CTA HEAD
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1. A nonenhancing tubular structure centered on the right cerebral peduncle with calcified rim may represent a thrombosed aneurysm, calcified venous drainage structure, or possibly an extra axial mass within the interpeduncular cistern. Further characterization with MRI of the brain with contrast is recommended. 2. Evidence of prior instrumentation (clipping) of the right common carotid artery in the neck as well as of a right supraclinoid internal carotid artery likely represent aneurysm surgery. There is resultant absence of visualization of the right common carotid , cervical, petrous, cavernous and paraclinoid segment of right ICA, with reconstitution of the right distal ICA beyong ophthalmic artery, right middle and anterior cerebral arteries via the anterior communicating artery.3. Diminutive appearance of the right middle cerebral artery is likely secondary to negative remodeling.4. A small outpouching of the distal left ICA may represent the infundibulum of the left anterior choroidal artery versus a small aneurysm.5. Redemonstration of extensive right frontotemporal encephalomalacia is consistent with chronic infarction.
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Generate impression based on findings.
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27 years, Male. Reason: History of retroperitoneal lymph node dissection on 11/26/14, now with persistent abdominal bloating. Nonspecific bowel gas pattern with paucity of visualized small bowel loops. No free air on upright view. Numerous surgical clips project over the mid abdomen.
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Nonspecific bowel gas pattern with paucity of visualized small bowel loops. No free air.
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Generate impression based on findings.
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Reason: prostate cancer History: prostate cancer Previously identified increased radiotracer activity in the lower cervical spine is less prominent than priors and may be resolving degenerative changes. Otherwise, no changes or abnormal radiotracer uptake to indicated bone metastases.
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No current evidence of osseous metastatic activity.
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Generate impression based on findings.
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Male 56 years old; Reason: see above History: appendiceal cancer C1 D 11 clinical trialRADIOPHARMACEUTICAL: 11.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 106 mg/dL. Today's CT portion grossly demonstrates a left chest wall port catheter with tip in SVC. There are multiple surgical clips throughout the abdomen and pelvis. There is a left lower quadrant colostomy. There is nodular soft tissue density in the right lower quadrant. There is an enlarged right inguinal lymph node. Today's PET examination demonstrates persistent and extensive markedly hypermetabolic soft tissue implants throughout the abdomen and pelvis, bowel wall, liver capsule and mesentery consistent with carcinomatosis which have not significantly changed in size, number or metabolic activity. For reference, a large tumor implant in the rectosigmoid has an SUV max of 15.9 previously 15.0.There is a hypermetabolic lymph node within the right inguinal region as well as several mesenteric and retroperitoneal sites consistent with additional tumor not significantly changed. For reference, right inguinal lymph node has an SUV max of 9.9, previously 9.7. There are no suspicious FDG avid lesions within the neck or chest.
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1. Widespread hypermetabolic abdominopelvic lymph node metastases and carcinomatosis not significantly changed.2. There is no suspicious FDG avid activity above the diaphragm.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of basal cell carcinoma. 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, unchanged in pattern and distribution. Round marker was placed on a skin lesion overlying the right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, 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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History of acute onset left-sided numbness. No definite intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with mild age-related volume loss. No extra-axial collections are identified. Focal hyperdensity in the right globus pallidus likely represents punctate calcifications. There is no surrounding parenchymal edema. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes. The paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable.
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No evidence of 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.
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Generate impression based on findings.
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24-year-old male, hit by car one week ago, assess for injury Artifact is noted from overlying bandages. Glenohumeral alignment is within normal limits. There is no fracture or other osseous abnormality.
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No specific findings to account for the patient's limited range of motion.
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Generate impression based on findings.
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19-year-old male with history of exquisite pain over cuboid. Evaluate for cuboid fracture. We see no fracture. Specifically, the cuboid and calcaneus appear normal.
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There is no fracture or other specific findings to account for the patient's pain. If clinical concern for stress fracture persists, repeat radiographs may be taken in 10 to 14 days. Alternatively, MRI may be obtained.Findings discussed with Dr. Asbury at 1340 on 1/30/15.
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Generate impression based on findings.
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Female 67 years old; Reason: Eval for areas of GIB, patient with Crohns disease requiring 2 U PRBC weekly also with NSCLC metastatic. No overt blood in stools. The angiographic phase images are unremarkable. On sequential imaging, there is an abnormal focus of RBC accumulation identified in the lower midabdomen which is tubular in configuration and proceeds throughout the remainder of the colon consistent with active GI bleed most likely originating from the distal small bowel.
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Active gastrointestinal hemorrhage most likely originating from the distal small bowel.Findings were discussed with Dr. Andres Yarur by telephone on 1/30/2015 at 2:05 PM. Findings were also discussed with Interventional Radiology, and decision was made to transport patient directly to Interventional Radiology department for possible intervention.
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Generate impression based on findings.
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61 year old female with occasional tenderness to the left axilla and lateral left breast presents for routine screening mammography. Personal history of lung cancer. 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, unchanged in pattern and distribution. Stable focal asymmetries and calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable focal asymmetries 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: NSC - Screening Mammogram.
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Generate impression based on findings.
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Shoulder pain status post MVA in 2012; demineralization as can be seen in CRPS. I see no frank demineralization. I see no fracture or malalignment. A small ossicle is noted within the soft tissues along the lateral aspect of the acromion process which may reflect old trauma but is of doubtful current clinical significance. I see no arthritic changes.
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No specific findings to account for the patient's pain. Bone mineralization appears normal.
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Generate impression based on findings.
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55-year-old female with HPT. Please assess for parathyroid adenomas. There is physiologic distribution of the radiopharmaceutical. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. The right thyroid lobe appears to measure 2.3 cm and the left lobe 2.9 cm in length.
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No scintigraphic evidence for parathyroid adenoma.
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Generate impression based on findings.
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Metastatic papillary thyroid cancer, compare to previous study. Neck: There are postoperative findings related to total thyroidectomy and neck dissection. There is no interval change in the ill-defined nonspecific soft tissue within the surgical bed. There is an unchanged subcentimeter right level 4 lymph node and partially imaged upper mediastinal lymphadenopathy. There are unchanged lytic lesions within the bilateral scapulae, left humeral head, T2 vertebra, clivus, right occipital condyle, and left lateral mass of C1. There are a few small nodules in the imaged portions of the lung. The salivary glands appear unchanged. The right internal jugular vein does not opacify, which is unchanged. Otherwise, the carotid arteries are patent. The airways are patent.Head: There is interval decrease in size of a right occipital scalp nodule that measures up to 3 mm, previously 5 mm. There is interval decrease in size of the dural-based lesions along the right planum sphenoidale and adjacent to the left superior orbital fissure. For example, the right planum sphenoidale lesion measures up to 1 mm in thickness, previously 2 mm. There are no enhancing lesions within the brain parenchyma. There is unchanged mild prominence of the lateral ventricles. There is persistent partial opacification of the right mastoid air cells.
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1. Post-treatment findings in the neck without evidence of measurable tumor recurrence within the thyroidectomy bed and no significant change in the right level 4 lymph node.2. Slight interval decrease in size of the presumed intracranial metastases.3. Continued interval decrease in size of the right occipital scalp metastasis. 4. Unchanged metastatic bone lesions.5. Pulmonary nodules and partially imaged upper mediastinal lymphadenopathy are compatible with metastases. Please refer to the separate chest CT report for additional details.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 re-evalutate following additional systemic therapy and provide bi-dimensional measurements per RECIST v1.1 thank you History: NSCLC LUNGS AND PLEURA: Right upper and middle lung dense consolidation with fibrosis and architectural distortion consistent with radiation reaction in postsurgical scarring.1. Reference right upper lobe nodule adjacent to radiation reaction (series 4/33) measures 36 x 30 5 mm, increased from 27 x 22 mm. 2. Reference right middle lobe nodular opacity (series 4/37) measures 24 x 21 mm, increased from 22 x 19 mm.3. Left upper lobe subpleural part solid nodule with the solid portion measuring 8 mm, unchanged.4. Adjacent left upper lobe solid nodule (series 4/40) measures 10 mm, increased from 8 mm previously.Multiple additional solid and non-solid nodules of also increased in size.MEDIASTINUM AND HILA: No significant lymphadenopathy.No visible coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Unchanged hepatic hemangioma in the right lobe.
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Interval increase in multiple pulmonary nodules.
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Generate impression based on findings.
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52-year-old female with pain and swelling after twisting injury two weeks ago Alignment is anatomic. We see no fracture. Mild osteoarthritis affects the knee. A small likely osteochondroma is noted along the antero-lateral distal femur. No joint effusion is visualized.
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Degenerative arthritic changes without 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 inflammatory breast carcinoma diagnosed in mother at age 66. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying the left breast. Stable benign left intramammary lymph nodes and bilateral axillary lymph nodes 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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Male 26 years old Reason: elevated transaminitis, hx of hep B, pleases assess for possible leukemic infiltration and portal vein thrombosis History: elevated transaminitits LIMITED ABDOMENLIVER: The liver measures 16.5 cm in length and demonstrates mildly hyperechoic hepatic parenchyma. There is no focal liver lesion. BILIARY TRACT: Unremarkable appearance of the gallbladder. There are no gallstones, no gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: The pancreatic head is unremarkable. The body and tail are largely obscured by bowel gas.SPLEEN: Mild splenomegaly measures 13.4 cm in length. RIGHT KIDNEY: The right kidney measures 10.7 cm. the left kidney measures 11.3 cm.OTHER: No significant abnormalities noted.
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1. Patent hepatic vasculature.2. Hyperechoic hepatic parenchyma. This may represent fatty infiltration however other infiltrative processes can have this appearance.
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Generate impression based on findings.
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Bilateral breast cysts. History of benign bilateral breast biopsies. No new 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. There as been interval decrease in size of multiple cysts in both breasts.No dominant mass, suspicious microcalcifications or areas of architectural distortion is present 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 recommendation 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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58 year old female with right knee swelling Moderate joint space narrowing and tricompartmental osteophytes particularly affecting the patellofemoral joint consistent with moderate to severe osteoarthritis, mildly progressed from the prior exam. Chondrocalcinosis is noted. No joint effusion.
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Moderate to severe osteoarthritis with findings raising the question of underlying CPPD arthropathy.
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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. 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 change. 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: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts 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. Benign calcifications are present, including arterial calcifications.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 bilateral breast FNAs, bilateral surgical excisions, and right breast abscess. Three standard views of both breasts with additional images in all views bilaterally (12 images total) 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. Stable benign circumscribed masses and benign calcifications are present bilaterally. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable benign circumscribed masses and calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were sent to 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. Personal history of vaginal cancer diagnosed at the age of 47. History of breast cancer in sister. Two standard digital views and tomosynthesis 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. Benign calcifications are present, including arterial calcifications.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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69-year-old male with a history of left groin inguinal hernia. Please evaluate for recurrence. No evidence of recurrent or residual hernia is identified. There is a dilated varix at the site of the patient's pain which cannot be followed; consider correlation with cross-sectional imaging as clinically indicated. Small inguinal lymph nodes also noted.
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No evidence of hernia. There is a dilated varix the site of the patient's pain which can be better evaluated with cross-sectional imaging as noted above.
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Generate impression based on findings.
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Reason: h/o BOT ca, s/p CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Mild paraseptal emphysema and unchanged left basilar scarring and pleural thickening, probably from prior pleuritis or empyema.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Severe coronary artery calcifications are present as well as what appears to be a coronary stent. A right jugular catheter terminates at the SVC/RA junction region. CHEST WALL: Degenerative abnormalities affect the thoracolumbar spine, where there is internal stabilization hardware.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Very small hepatic cyst like hypodensities are stable and likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Vascular calcifications affect the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube present.BONES, SOFT TISSUES: See above thoracic section.OTHER: No significant abnormality noted.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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13-year-old female with pain/edemaVIEWS: Right ankle AP/oblique/lateral (3 views) 1/30/15 No acute fracture or malalignment is evident. No significant soft tissue swelling.
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Normal examination.
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Generate impression based on findings.
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Right hand numbness, evaluate for CVA No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. There is slitlike encephalomalacia involving the left external capsule related to remote hemorrhage seen on prior study from 2003. There is interval development of extensive areas of hypoattenuation involving the bilateral periventricular and subcortical white matter, which are nonspecific, but favored to represent chronic small vessel ischemic disease. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. Prominent vascular calcifications. Left maxillary sinus mucous retention cyst is seen. Mastoid air cells are clear. Calvarium is intact.
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1. 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.2. Moderate chronic small vessel ischemic disease which has significantly progressed since 8/22/2003.3. Slit-like encephalomalacia involving the left external capsule related to remote intraparenchymal hemorrhage.
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Generate impression based on findings.
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Male 47 years old; Reason: Evaluate vasculature to support kidney transplant History: esrd 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: Bilateral atrophic kidneys with renal cysts.RETROPERITONEUM, LYMPH NODES: Abdominal aorta is normal in caliber. No calcific arteriosclerotic disease.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No calcific arteriosclerotic disease of the pelvic vasculature.
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1.No significant calcific plaque burden in the aorta or pelvic branch vessels
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Generate impression based on findings.
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52 year old with right breast IDC and right axillary lymphadenopathy on neoadjuvant chemotherapy presents for re-assessment. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The architectural distortion in the right upper outer breast compatible with malignancy is slightly decreased in size and density. A biopsy clip is noted at the anterior aspect of this lesion. ULTRASOUND
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Decreased size of the right breast mass and right axillary lymphadenopathy. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.
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Generate impression based on findings.
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No evidence of acute intracranial hemorrhage. There are no enhancing masses, mass effect or midline shift. No edema is noted. The ventricles and sulci are normal in size. Moderate periventricular and subcortical white matter hypoattenuation is nonspecific but compatible with age-indeterminate small vessel ischemic changes. 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.2. Moderate age-indeterminate small vessel ischemic disease.
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Generate impression based on findings.
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Metastatic head and neck cancer CHEST:LUNGS AND PLEURA: No pleural fluid. Subtle nodularity of the fissures and pleura noted, suspicious for early pleural or perilymphatic metastases, present previously but more pronounced on the current study. Scattered 1-3 mm micronodules, about the same.MEDIASTINUM AND HILA: Bilateral mediastinal and hilar lymphadenopathy, some of the lymph nodes appear slightly larger. Reference lesions as follows:12 mm right hilar lymph node, previously 10-mm (3/27). A second right hilar region lymph node measures 14 mm, previously 12-mm (3/23).Right paratracheal lymph node 10 mm, unchanged (3/19).AP window/subaortic lymph node 9 mm, previously 10-mm (3/21).Normal heart size. No pericardial fluid. Mild coronary artery calcifications.CHEST WALL: Surgical clip in the region of the thyroid bed. Lytic destructive metastasis involving the right scapular tip with pathologic fracture, present previously. Lytic metastases in the humeral heads bilaterally, the left scapula and the sternal body unchanged. Thoracic spine lesions involving vertebral bodies T12, T11, T8, T7 and T2 unchanged with pathologic fracture of superior endplates again seen. Scattered rib lesions, present previously.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic metastases about the same with reference lesion measuring 13 x 8 mm, previously 10 x 8mm (3/55).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland nodule 19 x 14 mm, previously 19 x 12 mm (3/80).KIDNEYS, URETERS: Hypoattenuating lesions in the left kidney, one of which is larger in the interpolar region (3/82).PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.In the level of the pelvic inlet, bowel abuts the anterior peritoneum, incompletely assessed; the should be monitored on subsequent examinations.BONES, SOFT TISSUES: Lytic metastases involving L1, L3 and the right iliac wing.. L1 spinous process lesion. OTHER: No significant abnormality noted.
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1. Subtle nodularity of the visceral pleura bilaterally suspicious for early pleural or perilymphatic metastases.2. Bilateral mediastinal and hilar lymphadenopathy with reference lesion measurements provided in the body of the report.3. Stable appearance of skeletal metastases.4. Overall appearance of hepatic metastatic disease appears similar with reference lesion measurement provided in the body of the report.5. Right adrenal gland nodules not significantly changed in size.6. Suggest that the follow-up scan include imaging of the pelvis for full evaluation of the bowel.
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Generate impression based on findings.
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12-year-old female with seizure and apparent right vertebral artery narrowing on MRA The V3 segment questioned on the prior exam is patent without evidence of dissection or aneurysm. There is a dominant left vertebral artery. There is an extracranial origin of the right PICA. The carotid arteries are also without evidence of dissection or aneurysm.A right-sided PICC line and NG tube are partially visualized.
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No evidence of arterial dissection. The previously questioned right V3 segment is patent and irregularity on the prior exam was likely artifactual.
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Generate impression based on findings.
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Male 8 years old no history providedVIEW: Abdomen right lateral decubitus (one view) 1/30/2015 There is mild gaseous distention of multiple loops of bowel with air-fluid levels and gas present in the rectum, which is nonspecific. There is no pneumoperitoneum, portal venous gas or pneumatosis intestinalis is evident. A gastrostomy tube is place.
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Nonspecific gaseous distention and air-fluid levels with gas in the rectum, which may reflect enteritis or ileus. No pneumoperitoneum.
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Generate impression based on findings.
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A 35 years old female with know atrial septal defect and normal coronary arteries referred for CT for evaluation and decision about therapeutic options.CPT Code: 75574 Left Ventricle: The left ventricular end-systolic volume is normal (LV volume 37ml).Right Ventricle: The right ventricular end-systolic volume is increased (RV volume 72ml).Atria: The left atrial volume is mildly increased (LA 120ml). There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus. All four pulmonary veins drain normally into the left atrium. The right atrium is severely dilated (RA 153ml). There is a large secundum type atrial septal defect which measures 24x21mm. There is only a minimal aortic rim present, the remainder of the rims around the atrial septal defect are adequate.Valves: There is no calcification on the aortic, mitral, or tricuspid valves. The pulmonic valve is thickened and significantly dysplastic. One of the pulmonic valve leaflets may be flail. The possibility of a pulmonic valve mass can not be completely excluded on this study, correlation with transthoracic echocardiography is suggested. Great vessels: The thoracic aorta demonstrate no evidence of dissection or aneurysm. The aortic arch has a normal brachiocephalic branching pattern. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerin was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is no calcification of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is no calcification of the LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is no calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. There is no calcification of the RCA.
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1. Large secundum type atrial septal defect is noted. 2. Severe right atrial dilation with increased right ventricular end-systolic volume. 3. Mild left atrial dilation with normal left ventricular end-systolic volume. 4. Normal pulmonary venous drainage. 5. There are no significant coronary artery stenoses present. 6. The pulmonic valve is thickened and appears to be significantly dysplastic. One of the pulmonic valve leaflets may be flail; however, the possibility that this "flail" pulmonic valve actually represents a mass can not be completely excluded on this study, correlation with transthoracic echocardiography is suggested. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in mother diagnosed at age 40, maternal aunt diagnosed at age 51 and maternal grandmother diagnosed at age 50. 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. Round markers were placed on skin lesions overlying both breasts. Subtle calcifications in the right retroareolar region may have increased since prior studies. Spot magnification imaging is recommended.No suspicious masses or areas of architectural distortion are present.
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Subtle calcifications in the right retroareolar region. Spot magnification imaging is recommended. Results and recommendations were discussed with Dr. Jaskowiak.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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