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Generate impression based on findings. | view for retained catheter History: s/p LD placement with shearing of catheter during placementVIEW: Chest AP and Abdomen AP 1/5/15 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. No focal lung opacities or pleural effusions are seen. Intraspinal catheter noted, with ti... | 1. No kink or discontinuity noted in the radiopaque portions of the shunt catheter. 2. Retained shunt catheter tubing noted at the L3/4 level. |
Generate impression based on findings. | 56 year old female with history of worsening shortness of breath and weight loss. Evaluate for aspergillosis. LUNGS AND PLEURA: Unchanged mild to moderate centrilobular and paraseptal emphysema with scattered cysts. No significant pleural effusion. Previously described tree in bud opacities in the right upper, middle a... | 1.Previously seen cavitary lung lesions are grossly unchanged in size, with a slightly decreased soft tissue component of the wall of the largest right apical lesion, however increased intracavitary contents. Still consistent with chronic semi-invasive aspergillosis, and possible associated infectious etiology such as ... |
Generate impression based on findings. | 77-year-old male with Dobbhoff tube placement. Nonspecific distended loops of bowel without evidence of obstruction. The feeding tube tip is in the fundus of the stomach. | The feeding tube tip is in the fundus of the stomach. |
Generate impression based on findings. | Reason: mets lung cancer, s/p chemo and bhx of brain mets. pls c/w previous study and evaluate dx status. History: lung ca CHEST:LUNGS AND PLEURA: Reference left apical nodule stable to marginally increased, now measuring 6 mm on image 13/111. Aspirated debris in central airways. Right perihilar scarring and architectu... | 1. Stable to marginally increased left apex nodule.2. Stable to marginally decreased prevascular lymph node.3. Stable nonspecific pancreatic mass.4. Stable T7 sclerotic lesion.5. Stable left adrenal nodule. |
Generate impression based on findings. | Reason: history of aspergillus pna History: eval pna LUNGS AND PLEURA: Upper predominant paraseptal and centrilobular emphysema.Residual scarring is identified in left apex without evidence of cavity formation.6-mm right middle lobe subpleural nodule unchanged.No new pulmonary nodules.Mild bronchial wall thickening.No ... | Residual left apical scarring with resolution of the subpleural cavitation and associated consolidation. |
Generate impression based on findings. | t-lymphoblastic lymphoma s/p induction therapy LUNGS AND PLEURA: The pleural effusions and atelectasis have resolved. Minimal atelectasis in the right middle lobe.MEDIASTINUM AND HILA: The anterior mediastinal mass measures approximately 5.6 x 2.6 x 2.8 cm markedly decreased in size in the interval. The major airways a... | Marked interval decrease in size of the anterior mediastinal mass with no evidence of compression to the major airways as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A round marker has been plac... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 63-year-old male. Reason: check gastric tube placement History: nausea, vomiting Percutaneous feeding tube, with balloon inflated in the stomach with tip in the proximal jejunum.Nonobstructive bowel gas pattern. Surgical clips in the right upper quadrant. | Gastrojejunostomy tube with tip in proximal jejunum. |
Generate impression based on findings. | Female 65 years old; Reason: H/O DLBCL s/p 6 cycles of R CHOP in need of end of treatment imaging. Please compare to prior. History: DLBCL CHEST:LUNGS AND PLEURA: Right lower lobe calcified granuloma. No dominant lung lesion. There are a few scattered pulmonary nodules. The pleural spaces are clear.MEDIASTINUM AND HILA... | 1.Decrease in size of the referenced lymph nodes with no new sites of disease. |
Generate impression based on findings. | 77-year-old male with stool burden on previous XR now s/p enema, please check repeat XR for stool. Nonobstructive bowel gas pattern. No visible stool in the abdomen or pelvis. A gastrostomy tube overlies the body of the stomach. Again seen is a left basilar opacity and bilateral small pleural effusions. | Nonobstructive bowel gas pattern without visible stool. |
Generate impression based on findings. | 47-year-old female with history of a focal asymmetry corresponding to a probable simple cyst at the 12-1 o'clock upon sonographic exam, presenting for annual mammogram. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenc... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 52 year-old male, left wrist/elbow pain Limited examination due to patient's inability to move arm.Elbow: The bones are demineralized. The AP and oblique views are markedly limited but there is no evidence of acute fracture or malalignment.Wrist: The bones are diffusely demineralized. Alignment is anatomic. No fracture... | Diffuse demineralization without acute abnormality evident. |
Generate impression based on findings. | Subdural hemorrhage and low platelet due to ALL. There has been interval decrease in size and attenuation of the right cerebral convexity subdural hematoma, which measures up to 5 mm in thickness, previously 9 mm. There is no midline shift or herniation.There is unchanged non-specific patchy cerebral white matter hypoa... | Interval decrease in size of the right cerebral convexity subdural hematoma. |
Generate impression based on findings. | Reason: eval for progression History: prostate cancer, rising PSA Innumerable foci of activity are again seen throughout the axial and proximal appendicular skeleton, decreased in size and number, however new foci are seen in the lower thoracic and lumbar spine.Activity in the right femoral neck now appears now conflue... | 1. Widespread osseous metastases, overall decreased in size and number, but several new foci. This likely represents a mixed response.2. Right femoral neck activity appears more confluent and an impending fracture cannot be excluded. Consider orthopedic consultation. |
Generate impression based on findings. | 38-year-old female with back pain Alignment is within normal limits without evidence of instability on flexion or extension views. Vertebral body heights are maintained. Mild degenerative disk disease affects L5/S1 | Normal lumbar spine alignment. |
Generate impression based on findings. | 57-year-old with partially calcified mass in the left breast noted on screening mammography. Presents for additional evaluation. No family history of breast cancer. MAMMOGRAM: An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast pare... | Partially calcified mass lesion in the left lateral breast likely represents a fibroadenoma, however close interval follow-up with repeat diagnostic mammogram and possible ultrasound in 6 months is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 74 year old female with history of chest pain and breast cancer. Evaluate for pulmonary embolus. PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Scattered bilateral pulmonary nodules, not significantly changed from prior. Reference right apical nodule (10/24) measures 9 x 7 mm, previously 9 x 8 mm. No new su... | 1.No pulmonary embolus.2.Scattered bilateral pulmonary micronodules, and other findings of metastatic breast cancer, are unchanged when compared to prior.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 54-year-old female with history of reversed Bennett fracture Deformity of the base of the fifth metacarpal is consistent with the patient's history of fracture. Interval decrease in soft tissue swelling about the hand. | Unchanged deformity of the base of the fifth metacarpal. |
Generate impression based on findings. | Reason: h/o met thyroid ca, compare to previous, measurements pls, eval response to therapy History: none CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules stable in size and number.Reference nodule in the right upper lobe measures 4-mm, unchanged (image 35/100).MEDIASTINUM AND HILA: Mass in thyroid resection bed con... | Reference measurements grossly stable with no new sites of disease. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is likely an incidental cavum vellum interpositum with slight splaying of the internal cerebral veins just inferiorly. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnorm... | Unremarkable noncontrast MRI brain. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. There is no extra-axial fluid collection. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. Mild patchy hypoattenuation in the periventricular and subcortical white matter and a more focal area of hypoattenuation in the left insul... | No evidence of acute intracranial hemorrhage or acute intracranial abnormality. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended. |
Generate impression based on findings. | 57-year-old male with history of emphysema and fibrosis. Evaluate for interstitial lung disease. "...PMHx of HTN, developmental delay, pulmonary fibrosis, pulmonary hypertension who presented from an OSH as a transfer for further evaluation/treatment of his ILD and treatment of his acute exacerbation. " LUNGS AND PLEUR... | 1.Diffuse severe emphysema, similar to prior.2.New scarlike opacities and subsegmental atelectasis in the lower lungs bilaterally, may represent sequela of prior infection or inflammation.3.No findings of interstitial lung disease/pulmonary fibrosis. |
Generate impression based on findings. | Evaluate for foreign bodyVIEWS: Right foot AP and lateral The radiopaque foreign body in the subcutaneous tissue at the plantar aspect of the calcaneus again noted and unchanged. | Radiopaque foreign body at the plantar aspect of the calcaneus unchanged. |
Generate impression based on findings. | Male 53 years old; Reason: metastatic prostate cancer, evaluation of disease after 3 cycles of investigational therapy. History: metastatic prostate cancer CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change, no suspicious lung nodule or mass delineated. No pleural effusion.MEDIASTINUM AND HILA: M... | 1. Diffuse skeletal sclerotic foci compatible with metastatic disease. Please refer to concomitant nuclear medicine bone scan from same day for additional findings. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | 71-year-old female. Reason: recurrent aspiration. Evaluate for structural abnormality. Exam was severely limited due to patient's inability to tolerate lying flat for extended period of time, and inability to stand. Unable to ingest sufficient quantity of barium for complete exam.Scout radiograph of the chest showed no... | High grade stricture at the level of the hypopharyngeal-esophageal junction with mild diffuse bulging proximal to the stricture. No Zenker's diverticulum.Findings discussed via telephone with Dr. Merling at 2:40 PM. |
Generate impression based on findings. | metastatic Prostate cancer, evaluation of disease after 3 cycles of investigational therapy. Please complete PCWG2 form Increased foci of activity in the humeri, bilateral ribs, spine, and pelvis are again compatible with osseous metastases. New foci of activity in the right L1 pedicle, right T3 transverse process, and... | Diffuse osseous metastases with several new metastases in the spine and left ilium/sacrum. |
Generate impression based on findings. | Reason: patient with known pulmonar nodule LUL 5mm, needs complete 2 year follow up History: none LUNGS AND PLEURA: Left upper lobe pulmonary nodule measures 5 mm (image 25, series 4), unchanged in size. MEDIASTINUM AND HILA: Calcified right thyroid nodule.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Abs... | Stable 5mm left upper lobe pulmonary nodule consistent with a benign etiology such as a granuloma or hamartoma. |
Generate impression based on findings. | 72-year-old male. Reason: s/p DHT placement History: eval placement DHT Compared with CT exam from 04/22/2013, there is a partial intrathoracic stomach. The Dobbhoff tube is curled within the intrathoracic stomach, with the tip oriented superiorly.Nonobstructive bowel gas pattern. Surgical clips in the right upper quad... | Dobbhoff tube is curled within the intrathoracic portion of the stomach, with the tip oriented superiorly. As this puts the patient at an increased risk of aspiration, recommend the tube is adjusted/advanced so the tip lies intra-abdominally.Findings discussed via telephone with Dr. Yesensky at 4:03 PM. |
Generate impression based on findings. | Metastatic melanoma s/p 4 cycles of Ipilimumab please evaluate disease status and compare to previous imaging.RADIOPHARMACEUTICAL: 13.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 90 mg/dL. Today's CT portion grossly demonstrates nodularity along the inferior aspect of the left major fissure, unchanged f... | 1.Increase in size and activity of gallbladder fossa mass compatible with melanoma metastasis.2.Increase in activity of a right glenoid lytic lesion which may represent metastatic disease. |
Generate impression based on findings. | 34-year-old female. Reason: eval for obstruction, stool burden History: SBO Paucity of small bowel gas without specific evidence of obstruction. Average stool burden. Enteric contrast within the colon from prior examination. No free air seen on upright imaging. | No evidence of small bowel obstruction. Average stool burden. No free air seen on upright imaging. |
Generate impression based on findings. | Frontal sinus: The frontal sinuses are not well pneumatized but are clear. The frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: Bilateral interosseous are present, and remain patent. The ostiomeatal units are clear.Posterior ethmoids: There been partial ... | No CT evidence of acute sinusitis, with evidence of postoperative changes. |
Generate impression based on findings. | 46-year-old female with metastatic breast cancer. This study was performed for restaging.RADIOPHARMACEUTICAL: 12.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 95 mg/dL. Today's CT portion again shows postsurgical changes in the right axilla and a right breast implant. There are hyperattenuating foci in b... | 1.Two hypermetabolic osseous lesions in the right side of the pelvis as described above appear decreased in activity.2.No new FDG avid tumors are identified. |
Generate impression based on findings. | Male 56 years old; Reason: pt with hx of anal cancer s/p 2 cycles of chemo and XRT; needs surveillance imaging CHEST:LUNGS AND PLEURA: Visualized lung fields stable in appearance with emphysematous disease present. Small air space disease, seen in right lower lobe medially, may reflect scarring but nonspecific, similar... | 1. Interval decrease in size of inguinal and pelvic lymphadenopathy.2. Mild improvement in degree of circumferential wall thickening at level of anal verge, may reflect patient's reported primary anal malignancy. |
Generate impression based on findings. | Female 64 years old Reason: status post small bowel resection 12/18, and lysis of adhesions and g-tube placement 12/29 with rising WBC ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. Unchanged... | 1.Diffuse dilatation of the small bowel with narrowing at the distal aspect of the small bowel anastomosis with associated small bowel feces sign suggestive of partial small bowel obstruction, likely secondary to adhesive disease given the adjacent tethering.2.Duodenal mass as detailed above.3.Partially loculated ascit... |
Generate impression based on findings. | 53 years old Male. Reason: IgG kappa, ISS stage II, multiple myeloma, pt in complete response hematologically, f/u on large plasmacytoma in spine and pelvis. History: IgG kappa, ISS stage II, multiple myeloma, pt in complete response hematologically, f/u on large plasmacytoma in spine and pelvis.. RADIOPHARMACEUTICAL: ... | 1.Two new hypermetabolic osseous lesions in the thoracic spine and multiple new hypermetabolic lymph nodes in the neck and the right inguinal regions are suspicious for tumor recurrence.2.Nonspecific focus of increased activity in the right face without CT correlation.3.Two stable rib lesions with increased metabolic a... |
Generate impression based on findings. | 40 year-old with history of pain and discomfort in left breast for two months. Palpable abnormality on recent clinical exam, however the patient cannot locate abnormality today. Family history of breast carcinoma in her sister diagnosed at 34 years of age. MAMMOGRAM Three standard views of both breasts were performed d... | Normal axillary lymph nodes at the site of the patient's palpable abnormality. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 ... |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage.There is slight increased conspicuity of confluent abnormal low density in the right parietal centrum semiovale. In addition, there is interval develop... | 1. New area of abnormal low density in the left precentral gyrus extending into adjacent subcortical and deep white matter, with slight associated gyral expansion. MRI with without contrast recommended for further evaluation, for a suspected underlying lesion.2. No acute intracranial hemorrhage, as clinically questione... |
Generate impression based on findings. | Pain, trauma to the fifth metatarsalVIEWS: Right foot AP, oblique and lateral There is mild widening to the apophysis at the base of the fifth metatarsal and likely to represent a fracture at this site. There is associated soft tissue swelling. The remainder of the examination is normal. | Probable fracture through the apophysis at the base of the fifth metatarsal. |
Generate impression based on findings. | Feeding tube placementVIEW: Abdomen AP Feeding tube tip at the pylorus of the stomach. Disorganized nonobstructive bowel gas pattern. Left lower lobe opacity noted. | Feeding tube tip at the pylorus of the stomach. |
Generate impression based on findings. | 73-year-old female status post coiling of left internal carotid artery aneurysm To maximize sensitivity of the supratentorial structures, the infratentorial structures were not omitted form the field of view given the patients size. There is mild, persistent, relatively asymmetric decreased activity in the left frontop... | Mild, relative, asymmetrically decreased activity in the left frontoparietal region is unchanged from prior post-occlusion perfusion examination 5/16/2011. |
Generate impression based on findings. | Female 39 years old; Reason: Evaluate for aortic dissection History: severe chest pain, SOB CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Ascending thoracic aorta measures 2.7 cm. No evidence of aortic dissection. No evidence of curvilinear hyperdensity on noncontrast imaging to suggest... | 1. No aortic dissection. 2. Lobulated uterus, may be related to underlying leiomyomatous disease. Dedicated pelvic sonographic imaging may be pursued for confirmation.3. Small simple pelvic free fluid, likely physiologic. |
Generate impression based on findings. | 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 overly... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 23-year-old female with knee pain after motor vehicle collision Knee: Alignment is within normal limits. No fracture is identified.Lumbar spine: Vertebral body heights and alignment are maintained. No fracture is visualized. | No acute fracture or dislocation. |
Generate impression based on findings. | 60 year-old female status post curettage of right proximal tibia giant cell tumor Sideplate and screws affix the proximal tibia with cement again noted at the site of curettage and packing within the proximal tibial metaphysis and epiphysis without evidence of complication. Lucency along the anterior aspect of the ceme... | Postoperative changes of giant cell tumor curettage and packing without evidence of recurrence. |
Generate impression based on findings. | 20 year-old female with lateral pain after injury Alignment is within normal limits. No fracture is identified. Possible small joint effusion. | No fracture or dislocation. |
Generate impression based on findings. | Female 51 years old Reason: 51 yr old patient with fallopian tube cancer, s/p 6 cycles of Gemzar/Carboplatin, evaluate disease process compare to 7-25-14 scan CHEST:LUNGS AND PLEURA: Previously described right lower lobe nodule not identified on today's examination.MEDIASTINUM AND HILA: Thyroid nodules unchanged. Marke... | Treatment response with interval decrease in size of all index and non-index lesions. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral cyst aspirations. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and dis... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 55 years old; Reason: Metastatic pancreas cancer please assess extent of disease and provide index lesion measurements for RECIST as required by study CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary lesions seen compatible with metastatic disease, stable and enlarging, additional new lesions also present. R... | 1. Numerous bilateral pulmonary metastatic lesions, stable and enlarging as well as new lesions. New small left pleural effusion and trace right pleural fluid. 2. Portacaval, peripancreatic and mesenteric lymph nodes as described with interval enlargement of peripancreatic mesenteric lymph node as described, suspicious... |
Generate impression based on findings. | 46 showed female with neck pain radiating to head Cervical spine: Alignment is within normal limits. No fracture is identified. There is no evidence of instability on flexion and extension views.Lumbar spine: Vertebral body heights and alignment are maintained. Small anterior osteophytes are noted along the lower thora... | No specific findings to account for the patient's pain. |
Generate impression based on findings. | Male 5 years old; Reason: s/p attempted left subclavian central line, femoral port placed VIEW: Chest AP (one view) 1/5/15 1447 Lower extremity central venous catheter tip in the superior cavoatrial junction. The cardiothymic silhouette is normal.The lung volumes are low, similar to prior. No focal lung opacity or pleu... | 1. Lower extremity central venous catheter tip at the superior cavoatrial junction.2. Apparent lucency along the left cardiac border may represent a pneumothorax. A cross-table lateral may be helpful to differentiate this. Findings were discussed with Dr. Carlisle at 330pm on 1/5/15. |
Generate impression based on findings. | 27-year-old male with history of comminuted, intra-articular fracture of the base of the fifth metacarpal. A comminuted, intra-articular fracture of the base of fifth metacarpal is again identified with fragments in near anatomic alignment appearing similar to the prior exam. There is mild soft tissue swelling about th... | Base of the fifth metacarpal fracture appearing similar to the prior exam. |
Generate impression based on findings. | Male 55 years old Reason: Left cheek cancer s/p RT, evaluate for metastases LUNGS AND PLEURA: New Ill-defined, spiculated subpleural nodule measuring 3.1 x 1.7 cm in the left lower lobe (image 62 series 4). Smaller surrounding centrilobular nodules and groundglass opacity also noted. Few scattered nonspecific subcentim... | New 3cm subpleural nodular opacity in left lower lobe. The appearance and relatively rapid growth are more typical of an infarct, aspirate or infection, though metastatic disease cannot be excluded and follow up to resolution is recommended. |
Generate impression based on findings. | Male 61 years old; Reason: History of t4 mucinous appendiceal cancer evaluating for peritoneal recurrence history: Appendiceal cancer ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. The hepatic and portal veins are patent. No new solid hepatic lesions.SPLEEN: No... | 1.Right pelvic lymph node, slightly more prominent than prior exam. Follow up is suggested. |
Generate impression based on findings. | PainVIEWS: Right middle finger AP, oblique and lateral Again noted an oblique fracture involving the distal phalanx of the middle finger. The appearance is not significantly changed from prior study. There is an overlying splint in place. Diffuse osteopenia noted. | Fracture through the distal phalanx of the middle finger not significantly changed. |
Generate impression based on findings. | Fracture painVIEWS: Right elbow AP, oblique and lateral, right forearm AP and lateral Multiple fractures of the radius, ulna, and humerus remain fixed in near anatomic alignment. The metallic hardware at the proximal radius is unchanged. Two anchor sutures are present at the distal humeral epiphysis not significantly c... | Postoperative changes as described above. |
Generate impression based on findings. | Male 68 years old Reason: assess for sbo History: significant ileus, intubated for emphysematous bullae ABDOMEN: Evaluation suboptimal secondary to severe respiratory motion artifact.LUNG BASES: Severe centrilobular emphysema with bibasilar atelectasis/consolidation.LIVER, BILIARY TRACT: Hypoattenuating lesions in the ... | Examination severely limited by motion artifact.1.Findings compatible with colonic ileus as detailed above. 2.Severe emphysema and bibasilar atelectasis/consolidation. |
Generate impression based on findings. | Reason: ILD possible Fibrotic NSIP History: DOE LUNGS AND PLEURA: Patchy bilateral predominantly interstitial abnormality with traction bronchiectasis and probable honeycombing at a few locations is unchanged. No significant air trapping and expiratory phase imaging.MEDIASTINUM AND HILA: Scattered small nodes are uncha... | Chronic interstitial lung disease stable in severity and distribution. The imaging findings are consistent with known fibrotic NSIP. |
Generate impression based on findings. | 19 year-old male with sickle cell anemia. Abnormal LFTs. LIMITED ABDOMEN | 1. Normal liver Doppler study.2. Mildly coarse liver parenchyma may represent diffuse fatty infiltration and/or parenchymal dysfunction. |
Generate impression based on findings. | 19 year-old female with right middle finger pain Interval removal of surgical pins with healed deformity of the dorsal base of the distal phalanx. Alignment is anatomic. No new fracture identified. | Healed fifth finger fracture without acute abnormality. |
Generate impression based on findings. | 61-year-old female history of left leg weakness. There is no evidence of intracranial hemorrhage or mass. There is mild confluent subcortical and periventricular white matter hypoattenuation compatible with age indeterminate ischemic small vessel disease. The ventricles are normal in size and configuration. There is no... | 1. Mild age-indeterminant ischemic small vessel disease, but no evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Opacification of the left mastoid air cells may represent mastoiditis.I personally reviewed the Images and/or procedure... |
Generate impression based on findings. | Female 81 years old; Reason: breast cancer History: breast cancer per protocol CHEST:LUNGS AND PLEURA: Reference right middle lobe subpleural nodule unchanged, measuring 1.6 x 0.8 cm, image 57 series 4, previously measured 1.6 x 0.8 cm. Another index nodule seen in right upper lobe near fissure without significant chan... | 1. Not as well seen on earlier exam is pleural-based focal nodularity in region of left major fissure peripherally, nonspecific, may be related to round atelectasis or scarring but attention on follow-up recommended. Additional stable pulmonary lesions. 2. Stable to minimal interval decrease in size of right axillary l... |
Generate impression based on findings. | Female 62 years old; Reason: 62yo G3P1 s/p optimal debulking for cervical ca f/u for recurrence/mets History: none CHEST:LUNGS AND PLEURA: Subcentimeter left lower lobe pulmonary nodule. No dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.CHEST WALL:... | 1.No pelvic lymphadenopathy. 2.Nonspecific right hepatic lobe lesion which was present on the prior PET/CT and cannot be further characterized on a single phase CT. |
Generate impression based on findings. | Metastatic breast cancer with progression of several lines of therapy now on the lucitinib trial. There has been overall interval decrease in size of the extensive infiltrative lymphadenopathy in the neck and partially-imaged mediastinum. For example, a right level 5 lymph node measures 30 x 36 mm, previously 40 x 37 m... | Overall interval decrease in size of the extensive lymphadenopathy in the neck and partially-imaged mediastinum. |
Generate impression based on findings. | Male 59 years old Reason: adenoid cystic carcinoma with lung mets. Please measure reference RML lung lesion and compare to last CT History: post 2 cycles of therapy CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules consistent with metastases are not significantly changed in size. Reference right middle lobe nodule me... | No change in pulmonary metastases. |
Generate impression based on findings. | Metastatic lung cancer status post neck radiation therapy and 4 cycles of chemotherapy. There is continued interval decrease in the lymphadenopathy in the neck. The lymph nodes within the neck are no longer significantly enlarged. For example, a left level 2A lymph node measures 4 mm in short axis, previously 16 mm. Li... | 1. Interval decrease in size of numerous cervical lymph nodes, which are no longer significantly enlarged.2. Interval decrease in size of a right supraclavicular subcutaneous mass, without measurable residual tumor.3. Interval decrease in size of metastases in the imaged portions of the lungs and a partially imaged sma... |
Generate impression based on findings. | Female 23 years old; Reason: 23 yo with AML, imaging for fever of unknown origin and pre SCT work-up. CHEST:LUNGS AND PLEURA: Small right pleural effusion. Bibasilar subsegmental atelectasis, right greater than left.MEDIASTINUM AND HILA: Normal sized heart without pericardial effusion. No mediastinal or hilar lymphaden... | 1. Small right pleural effusion with overlying subsegmental atelectasis.2. Lytic appearing regions of the lumbar spine and sacrum likely reflect bone marrow changes seen on the prior MRI.3. Haziness of the right groin subcutaneous fat may reflect prior procedure or possible soft tissue edema. Correlation with physical ... |
Generate impression based on findings. | Male 58 years old Reason: Please eval for progression or improvement in presumed fungal pneumonia. History: Pneumonia (likely fungal) in immunocompromised patient (AML) LUNGS AND PLEURA: Interval decrease in right pleural effusion, with small residual. Masslike consolidation in the superior segment of the right lower l... | Interval decrease in the masslike consolidation in the superior segment of the right lower lobe, with interval improvement of central necrosis. Interval decrease in size of right pleural effusion, with small residual pleural effusion. |
Generate impression based on findings. | 68y/o female with Right breast cancer; please page Dr. Jaskowiak-2440 prior to injecting patient; surgery 1/6/15 at 710am for Right SNBx, mast with recon RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 1 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A... | Sentinel node identified in the right axilla. |
Generate impression based on findings. | Female 49 years old Reason: metastatic breast cancer - evaluate response to treatment, compare to baseline exam uploaded in system with measurements per recist 1.1 History: lymphadenopathy - patient also having CT of neck CHEST:LUNGS AND PLEURA: Nonspecific 4-mm left lower lobe nodule unchanged.MEDIASTINUM AND HILA: Pr... | Postsurgical changes related to left mastectomy with bilateral axillary masses consistent with nodal metastases. Additional soft tissue mass anterior to the left clavicular head and within the prevascular space as detailed above. |
Generate impression based on findings. | 78 years old female with a History of right lung adenocarcinoma s/p resection in 2010, please evaluate lymph nodes and lesion noted on CT chest. RADIOPHARMACEUTICAL: 15.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 89 mg/dL. Today's CT portion grossly demonstrates a small right pleural effusion and multi... | 1.Multiple hypermetabolic lymph nodes in the mediastinum in the right paratracheal, prevascular, pericardial and peri-aortic regions as well as in the right retrocrural space, suspicious for nodal metastasis.2.Bilateral hilar mildly hypermetabolic lymph nodes, which are nonspecific. |
Generate impression based on findings. | 57-year-old male with gastric cancer. This study was performed for initial staging.RADIOPHARMACEUTICAL: 14.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 69 mg/dL. Today's CT portion of the neck demonstrates enlarged, enhancing parotid glands may be inflammatory in etiology. No significant lymphadenopathy... | 1.FDG avid gastric antrum mass compatible with malignancy.2.Increased activity in the right lobe of the liver and midline anterior abdominal wall compatible with biopsy and postsurgical changes, respectively. However, metastasis in the right perihepatic space cannot be excluded.Diagnostic CTs of the chest, abdomen, and... |
Generate impression based on findings. | 36 year old woman with 3 month history of low back pain radiating down the lateral thigh and leg. There appear to be 5 lumbar vertebrae with partial sacralization of L5. There is slight rightward curvature of the lumbar spine. The spinal curvature slightly limits assessment of intervertebral discs, but we suspect moder... | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 65 year-old woman with history of hip pain. A single modified Dunn view of the left hip is provided. Severe osteoarthritis affects the left hip with bone-on-bone apposition superiorly. There is prominence of the anterolateral aspect of the femoral head and neck junction with an alpha angle of approximately 60 degrees. | Osteoarthritis as described above. |
Generate impression based on findings. | 23 year-old woman with history of hip pain status post arthroscopy. A single modified Dunn view of the left hip is provided. There is minimal prominence of the anterior/superior aspect of the femoral head/neck junction with a mild cam deformity and an alpha angle measuring approximately 55 degrees. The hip otherwise ap... | Minimal cam deformity as described above. |
Generate impression based on findings. | Reason: 53 yo male with history of AML; pre-allo SCT evaluation History: evaluate LUNGS AND PLEURA: Previously noted groundglass opacities have resolved. No acute findings.MEDIASTINUM AND HILA: Right PICC tip at RA/SVC junction.CHEST WALL: Degenerative change involving the spine.UPPER ABDOMEN: Absence of IV and enteric... | No acute cardiopulmonary abnormality. |
Generate impression based on findings. | 59-year-old female with pain status post fall Wrist: Alignment is anatomic. No fracture is identified. Small metallic object volar to the metacarpals is of unclear etiology.Hip: There is marked superior joint space narrowing, subchondral sclerosis and osteophyte formation about the hip. No fracture is visualized.Knee: ... | 1. No acute fracture or dislocation.2. Metallic object volar to the metacarpals, of unclear etiology, correlate clinically. 3. Severe degenerative changes of the left hip. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis 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. Arterial calcifications are p... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 6 mo ex 24wk male with previous OPM failureEXAMINATION: Oropharyngeal motility study 1/5/15 Julia Ecclestone, speech and language therapist, supervised the examination.45 seconds of fluoroscopy was used.Thin liquids were administered via medium flow nipple. Half strength nectar was administered via slow flow nipple. Ne... | Aspiration identified.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | 49-year-old female, evaluate for left fifth toe osteomyelitis There is osseous destruction about the distal aspect of the proximal phalanx, which extends distally to the DIP and PIP joints. There is deformity and postoperative changes/amputations of the second through fourth digits. Marked soft tissue swelling. | Osseous destruction involving the fifth digit as described above, highly suggestive of osteomyelitis. |
Generate impression based on findings. | 60-year-old female with history of pain and swelling Alignment is anatomic. No significant joint space narrowing or erosions involving either knee. Ossification is partially visualized along the distal aspect of the right femoral diaphysis, suggestive of heterotopic ossification. | Partially visualized focus of likely heterotopic ossification along the distal right femoral diaphysis and additional findings as above. |
Generate impression based on findings. | 83-year-old male with bruising and tenderness Alignment is anatomic. No fracture is visualized. Degenerative arthritic changes affect the knee. | No fracture or dislocation. |
Generate impression based on findings. | LUNGS AND PLEURA: Significant interval decrease in the size and number left upper lobe lesions.Left apical nodule (image 15 series 6) now measures 9 mm x 8 mm previously measuring 12 mm x 7 mm.Additional left upper lobe lesion (image 17 series 6) now measuring 6 mm x 10 mm previously measuring 10 mm x 13 mm.Left super... | Continued interval decrease in the pulmonary nodules and mediastinal lymphadenopathy. |
Generate impression based on findings. | T2N0M0 squamous cell carcinoma of the tongue status post right partial glossectomy and bilateral selective neck dissection on 6/21/12. New suspicious 1 cm x 1 cm left lateral tongue lesion, indurated, slightly rough and firm. There post-treatment findings in the neck related to neck dissection and partial glossectomy. ... | 1. Post-treatment findings in the neck with an apparent ill-defined lesion in the posterior left lateral tongue that may represent recurrent tumor, although the lesion is partially obscured by dental amalgam. 2. No significant cervical lymphadenopathy. |
Generate impression based on findings. | Left breast cancer status post mastectomy and chemo/XRT and recurrent sarcoma left neck status post excision and XRT with chronic left sided facial numbness, now with hoarseness. There is persistent in the ill-defined soft tissue in the region of the left lung apex and supraclavicular fossa, as well as the subcutaneous... | 1. Persistent nonspecific soft tissue in the left supraclavicular fossa region and anterior left chest wall may be treatment-related. Nevertheless, underlying tumor recurrence cannot be entirely excluded and FDG-PET or MRI with contrast may be useful for further evaluation, if clinically warranted. 2. The upper airways... |
Generate impression based on findings. | New left-sided weakness. Question of stroke. There is no evidence of acute intracranial hemorrhage. The grey-white matter differentiation appears to be intact. There is mild to moderate periventricular white matter hypoattenuation which is nonspecific but may represent small vessel ischemic disease. There is a partiall... | 1. No evidence of acute intracranial hemorrhage.2. Probable age indeterminate small vessel ischemic disease. CT is insensitive for the detection of nonhemorrhagic, acute ischemic infarcts. If clinical concern for ischemia persists, MRI may be obtained. |
Generate impression based on findings. | 59-year-old woman status post spinal stimulator placement. A spinal stimulator device is seen posterior to the left ilium with wires entering the spinal cord at the level of T12. The terminal leads of one wire lie at T7-T9 and the terminal leads of the other wire lie at T8-T10, appearing similar to the CT from 4/25/14.... | Spinal cord stimulator placement and degenerative arthritic changes as described above. |
Generate impression based on findings. | Corresponding to the area of abnormal low density on CT, there is T2/FLAIR hyperintensity within a mildly expanded left precentral gyrus. There is an underlying irregularly-shaped T1 hypointense and T2 hyperintense lesion, which does not suppress on FLAIR and remains isointense to white matter. This corresponds to the... | 1. Confirmation of parenchymal lesion centered at the gray-white junction in the left precentral gyrus with associated vasogenic edema and mild gyral expansion. This is a peripheral enhancement and possible internal septation. This is suspicious for a metastasis, although the differential diagnosis includes a primary b... |
Generate impression based on findings. | 20 year-old male with midline spinal pain after MVC, rule out fracture Lumbar and thoracic vertebral body heights and alignment are maintained. No fracture is evident. | No fracture or malalignment. |
Generate impression based on findings. | 62-year-old male with knee pain Alignment is anatomic. No fracture is evident. Small osteophytes are noted along the tibiofemoral joint compartments. A focus of ossification adjacent to the proximal fibular diaphysis likely represents heterotopic ossification | No fracture or dislocation. |
Generate impression based on findings. | 76-year-old female with lung cancer. Follow up after chemotherapy. Clinical trial. ABDOMEN:LUNG BASES: Small pericardial effusion, unchanged.LIVER, BILIARY TRACT: Slightly nodular contour. No focal mass.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abno... | Stable exam. No evidence for metastatic disease in the abdomen or pelvis. |
Generate impression based on findings. | ET placementVIEW: Chest AP ET tube tip in the right mainstem bronchus. NG tube and left central line unchanged. Cardiothymic silhouette normal. Left lower lobe atelectasis new from prior study. Minimal atelectasis in the right lower lobe. | Malpositioned ET tube. |
Generate impression based on findings. | 12-year-old boy with history of fracture and pain. An orthopedic pin affixes the Salter-Harris type II fracture of the proximal phalanx of the right fifth finger in near anatomic alignment. The pin extends across the fifth metacarpophalangeal joint and through the physis of the fifth metacarpal head. There is callus fo... | Orthopedic fixation of a healing proximal phalanx fracture. |
Generate impression based on findings. | Male 71 years old; Reason: right thigh mass History: mass CHEST:LUNGS AND PLEURA: Left upper lobe pulmonary lesion measures 1.3 x 1.1 cm (image 14/series 4). There a few scattered micronodules in the right lung (image 36 series 4)MEDIASTINUM AND HILA: Heart size is normal. Small right hilar and mediastinal lymph nodes.... | 1.Lesions in the lung, retroperitoneum and right peritoneum suspicious for metastatic disease |
Generate impression based on findings. | Rhabdomyosarcoma, off therapy for 3 yearsVIEWS: Chest PA/lateral (two views) 1/5/15 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal.No focal lung opacities or pleural effusions are present. | No evidence of metastatic disease. |
Generate impression based on findings. | 67 year-old female with abdominal pain and fatty liver on an outside hospital study. Concern for mesenteric ischemia. LIMITED ABDOMENLIVER: The liver is normal in morphology, echogenicity and size, measuring 19 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified... | 1. Patent hepatic vasculature with diminished diastolic flow with corresponding increased resistive indices which is nonspecific, but may be seen in the setting of hepatic venous congestion due to heart failure.2. Moderate volume ascites and bilateral pleural effusions.3. Echogenic renal cortices, compatible with medic... |
Generate impression based on findings. | Female 70 years old Reason: r/o PE History: shortness of breath PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Biapical scarring is again noted. Elevation of the left hemidiaphragm, with persistent left basilar atelectasis/consolidation.MEDIASTINUM AND HILA: Right ... | No evidence of PE.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 71-year-old female with multiple past surgeries, prior abdominal fluid collection drainage and acute renal failure. Evaluate stability. Evaluation of the abdomen and pelvis is limited by lack of IV contrast as well as body habitus.ABDOMEN:LUNG BASES: Bilateral pleural effusions with atelectasis appears slightly increas... | Further regression of a small amount of right lower quadrant fluid with drainage catheter.No significant change in ascites.Slight increase in pleural effusions.Stable abdominal/pelvic adenopathy.Small bowel wall thickening as well as gastric wall thickening. |
Generate impression based on findings. | Reason: right tongue with a new lesion on the left tongue History: r/o lung mets LUNGS AND PLEURA: Linear scarring and atelectasis at the lung bases. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative change involving thoracic spine.UPPER ABDOMEN: Absence of ... | No evidence of pulmonary metastases. |
Generate impression based on findings. | 83 male with history of chest pain and arm numbness. LUNGS AND PLEURA: Minimal right lower lobe subsegmental atelectasis or scarring. Left lower lobe groundglass nodule (image 35/94), nonspecific and may be postinflammatory/infectious in etiology.MEDIASTINUM AND HILA: Small precarinal lymph node measures approximately ... | Right superior sulcus tumor highly suggestive of malignancy. Multiple other findings described above.Findings discussed with Dr Vinci at the time of report. |
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