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Generate impression based on findings. | Male 8 years old Reason: evaluate stool burden, other acute abdominal process History: 8 y/o M with abd pain and vomiting.VIEW: Abdomen AP (one view) 1/31/2015 There is a moderate amount of stool in the distal transverse, descending, sigmoid colons and rectum. No dilated loop of bowel, pneumoperitoneum, or pneumatosis ... | Moderate amount of stool burden in the distal colon and rectum. |
Generate impression based on findings. | Female 1 day old Reason: Ex 37 week twin, respiratory distress History: INITIAL XR - 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. No fo... | Bilateral diffuse lung haziness consistent with TTN versus RDS.Disorganized, likely age related and nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 16 years old Reason: evaluate ett and for effusions or atelectasis History: Intubated, status-post cardiac arrest due to respiratory disorder.VIEW: Chest AP (one view) 1/31/15 at 536 hours. NG tube terminates at the stomach but proximal side ports are above GE. junction. ET tube tip is below the thoracic inlet. Ca... | Misplaced NG tube as described.Interval resolution of left upper pneumothorax. |
Generate impression based on findings. | Female 17 years old Reason: left pleural effusion, chest tube placement; re eval lung fields History: chest tube dependent.VIEW: Chest AP (one view) 1/31/15 at 612 hours. Left-sided chest tube unchanged. Cardiac silhouette size is normal. Persistent left lower lobe opacity likely atelectasis or pneumonia and subsegment... | No change in lung aeration. |
Generate impression based on findings. | Male 9 years old Reason: assess ETT placement History: intubatedVIEW: Chest AP (one view) 1/31/15 at 5 o'clock hours. Central lines and ET tube unchanged. Cardiac silhouette size is normal. Worsening in bibasilar opacities likely atelectasis. No effusions or pneumothorax. | Worsening in bibasilar atelectasis. |
Generate impression based on findings. | Female 11 years old Reason: assess ETT placement History: intubated, status asthmaticusVIEW: Chest AP (one view) 1/31/15 at 543 hours. Skeletal deformities, NG tube and ET tube are again noted. Cardiac silhouette is not clearly visualized. Bibasilar opacities on some segmental atelectasis of the right upper lobe unchan... | Persistent multifocal opacities as described. |
Generate impression based on findings. | Female 7 years old Reason: assess ETT placement, interval improvement in ARDS History: ARDS, pancreatitis.VIEW: Chest AP (one view) 1/31/15 at 550 hours. ET tube tip is below thoracic inlet. Neurostimulator and NG tube as well as gastrostomy tube unchanged. Cardiac silhouette size is normal. Right upper lobe atelectasi... | Interval improvement in bilateral pleural effusions and development of right upper lobe atelectasis. |
Generate impression based on findings. | Male 53 years old Reason: r/o dissection History: uncontrolled HTN The study had to be repeated due to technical malfunction. CHEST:LUNGS AND PLEURA: Mild biapical and bibasal atelectasis/scarring.MEDIASTINUM AND HILA: Mild coronary artery calcification. CHEST WALL: No significant abnormality notedCT ANGIOGRAM:The asce... | 1. Ascending thoracic aorta dilatation at 4.3 cm. No evidence of aortic dissection. |
Generate impression based on findings. | Images are somewhat limited by patient motion. There is a focus of diffusion restriction within the right dorsal medulla, consistent with an acute infarct. There is corresponding rounded T2/FLAIR hyperintensity with minimal apparent expansion suggesting edema.The ventricles and sulci are prominent, consistent with mod... | 1. Right dorsal medulla acute infarct. Nonvisualization of the distal right vertebral artery flow void correlating with CTA findings.2. Mild-moderate underlying chronic small vessel ischemic changes. |
Generate impression based on findings. | 23 are old male with head injury, evaluate for intracranial hemorrhage. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is a chronic-appeari... | No evidence of intracranial hemorrhage. There is a small right frontal subgaleal hematoma, without underlying calvarial fracture. |
Generate impression based on findings. | Images are limited by likely pulsation artifact especially on the sagittal images. Sagittal STIR images are essentially nondiagnostic. There is focal concavity of the right superior superior endplate of L1 and to a lesser degree the right superior endplate of L2, which may relate to Schmorl's nodes. There is mild to m... | 1. Mild-moderate likely subacute compression deformity of L5 along the superior endplate with mild enhancement in the L4-L5 disk which may be reactive. No significant retropulsion of fracture fragments although mild disk bulge noted at this level with left foraminal prominence. With underlying developmental narrowing o... |
Generate impression based on findings. | 45 old male with c-spine tenderness after falling out of bed this morning. There is an obliquely oriented fracture through the spinous process of C2 extending into the inferior aspect of the lamina with mild displacement. There is questionable anterior wedging of the T1 vertebral body seen on the lateral view, but no o... | C2 posterior arch fracture and other findings as described above. We recommend a CT scan of the cervical spine for further evaluation. These findings were discussed with Mallory Geschke (PA, Pager 7942). |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. Small retention cysts in the bilateral maxillary sinuses. The mastoid air ce... | There is no evidence of intracranial flow-limiting stenosis or aneurysm. |
Generate impression based on findings. | NONCONTRAST: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. 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.... | 1.No acute intracranial hemorrhage, mass effect or midline shift. 2.No flow-limiting steno-occlusive lesions in the head or neck. No intracranial aneurysm.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 52 years old Reason: r/o acute abnormalities, r/o PE History: shortness of breath PULMONARY ARTERIES: No evidence of pulmonary embolism. Pulmonary artery caliber is normal without evidence of right heart strain.LUNGS AND PLEURA: No consolidation, pleural effusion, or pneumothorax. No suspicious nodules or masses... | No evidence of pulmonary embolism. No acute cardiopulmonary abnormalities to explain patient's shortness of breath.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 44-year-old female with progressive posterior headache and syncope. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial sof... | No evidence of intracranial abnormality. |
Generate impression based on findings. | Axial T2 star images are somewhat degraded by artifact. The cervical spine is in normal alignment, with trace reversal of the normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal.A... | No evidence of cord compression. Mild to moderate scattered spondylotic changes as detailed above. Specifically at the C5-C6 level, there is moderate left foraminal narrowing. |
Generate impression based on findings. | Elevated lipase and abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable bilobar hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: Subtle increased prominence of pancreatic head and uncinate process with mild peripancreatic soft tissue infiltration in this area. ... | Subtle prominence of pancreatic head and uncinate process associated with mild peripancreatic infiltration in this area consistent with uncomplicated pancreatitis.Prominent endometrial cavity for age; GYN consult suggested. |
Generate impression based on findings. | 22-year-old male status post reduction of fifth metacarpal fracture. Splint material obscures underlying osseous detail. Again seen is a fifth metacarpal fracture, the angulation of which has been reduced slightly, now with approximately 30 to 40 degrees volar angulation of the distal fragment. | 5th metacarpal fracture as above. |
Generate impression based on findings. | 22-year-old male with pain and decreased range of motion There is a comminuted, predominantly transverse fracture of the fifth metacarpal neck with approximately 40 degrees volar and radial angulation of the distal fracture fragment. Overlying soft tissue swelling is noted. | Boxer's fracture as described above. |
Generate impression based on findings. | 57 year-old female with persistent tachycardia; has CT A/P findings of significant tumor burden; concern for PE History: as above The exam is limited secondary to suboptimal opacification of the pulmonary arteries.PULMONARY ARTERIES: Limited exam with no evidence of saddle pulmonary embolism. Pulmonary artery is normal... | 1. Limited exam with no evidence of saddle pulmonary embolism however PE beyond the level of the main pulmonary arteries cannot be excluded.2. Right lower lobe spiculated mass with peribronchial lymphangitic process and hepatic and skeletal lesions consistent with primary lung cancer with widespread metastasis.PULMONAR... |
Generate impression based on findings. | Feeding tube placement Distal end of feeding tube within first portion of duodenum. Mild ileus pattern unchanged. | Distal end of feeding tube within first portion of duodenum. Mild ileus pattern unchanged. |
Generate impression based on findings. | Feeding tube placement Distal end of the feeding tube within gastric antrum. No bowel obstruction. | Distal end of feeding tube within gastric antrum. No bowel obstruction. |
Generate impression based on findings. | Nausea and vomiting Residual contrast within the colon. No bowel obstruction. | Residual contrast within the colon. No bowel obstruction. |
Generate impression based on findings. | NG tube placement Distal end of the NG tube within gastric antrum. Multiple dilated loops of centrally located small bowel suggestive for small bowel obstruction. | Distal end of the NG tube within gastric antrum. Multiple dilated loops of centrally located small bowel suggestive for small bowel obstruction. |
Generate impression based on findings. | Rule out RFO.; increased BMI No unexpected radiopaque foreign body | No unexpected radiopaque foreign body. Dr.Eggener informed of results 1/30/2015; 9:05pm |
Generate impression based on findings. | There is evidence of prior bilateral uncinectomy and right-sided ethmoidectomy.Frontal sinus: There has been interval improvement of mucosal thickening in the right frontal sinus. The left frontal sinus remains near-completely opacified.Anterior/Posterior ethmoids: Mild interval improvement of opacification of the eth... | 1. Moderate/severe pan-sinus disease, which is mildly improved from recent CT of the sinuses dated 1/19/15.2. New fluid within the left middle ear cavity is nonspecific, but please correlate for acute otitis media.3. There is a stable appearance of focal dehiscence in the cribriform plate and fovea ethmoidalis on the l... |
Generate impression based on findings. | Abdominal pain; history metastatic tanker carcinoma No bowel obstruction or free air | No bowel obstruction or free air |
Generate impression based on findings. | Esophageal SCC presenting with cough assess for pneumonia and interval progression of cancer. Motion artifact degrades image quality.CHEST:LUNGS AND PLEURA: Small pleural effusions with associated atelectasis. Patchy areas of groundglass opacity as well as signs of bronchiolitis, suggestive of aspiration bronchiolitis ... | 1. Exam limited due to motion and image noise. Development of upper abdominal ascites with dilated proximal bowel and collapse of distal small bowel in the left upper quadrant with apparent transition point as annotated on the images. As no oral contrast was utilized is unclear if this is from an extrinsic compression ... |
Generate impression based on findings. | Feeding tube placement Distal end of feeding tube within distended stomach; no bowel obstruction. | Distal end of feeding tube within distended stomach; no bowel obstruction |
Generate impression based on findings. | Feeding tube placement Distal end of feeding tube within distended stomach. No bowel obstruction. | Distal end of feeding tube within distended stomach. No bowel obstruction. |
Generate impression based on findings. | NG tube placement Distal end of NG tube within stomach. No bowel obstruction | Distal end of NG tube within stomach. No bowel obstruction |
Generate impression based on findings. | Shock No bowel obstruction | No bowel obstruction. |
Generate impression based on findings. | NG tube placement Distal end of the NG tube within the gastric remnant with distal side port within distal esophagus. Dilated Roux limb again noted. | Distal end of the NG tube within the gastric remnant with distal side port within distal esophagus. Dilated Roux limb again noted. |
Generate impression based on findings. | Feeding tube placement Distal end of feeding tube within stomach. Distal end of the NG tube also within stomach; the distal side-port projects above the diaphragm; however it is unclear whether or not it is within the distal esophagus or within a hiatal hernia/intrathoracic stomach. | Distal end of feeding tube within stomach. Distal end of the NG tube also within stomach; the distal side-port projects above the diaphragm; however it is unclear whether or not it is within the distal esophagus or within a hiatal hernia/intrathoracic stomach. |
Generate impression based on findings. | Abdominal pain No bowel obstruction. Extensive stool throughout colon | No bowel obstruction. Extensive stool throughout colon. |
Generate impression based on findings. | Feeding tube placement Distal end of the feeding tube projects within the expected region of a right lower lobe bronchus | Distal end of the feeding tube projects within the expected region of a right lower lobe bronchus; Dr. Goodenow notified of results 1/31/2015; 10:20am. |
Generate impression based on findings. | Post stroke; NG tube placement Distal end of NG tube within stomach. No bowel obstruction | Distal end of NG tube in stomach. No bowel obstruction |
Generate impression based on findings. | History of subdural hematoma and right meningioma. The right cerebral convexity subdural fluid collection has resolved. There is an unchanged mildly hyperattenuating extra-axial right temporal convexity mass that measures up to approximately 10 mm in width. There is no evidence of acute intracranial hemorrhage. There i... | 1. The right cerebral convexity subdural fluid collection has resolved and there is no evidence of acute intracranial hemorrhage.2. A right temporal convexity mass is compatible with a meningioma, but it is better delineated on the prior MRI. |
Generate impression based on findings. | NJ-tube placement Distal end of the NJ tube projects within the left lower quadrant unchanged from prior, probably within mid jejunum. Interval placement of distal esophageal Wallstent. No bowel obstruction. | Distal end of the NJ tube projects within the left lower quadrant unchanged from prior, probably within mid jejunum. Interval placement of distal esophageal Wallstent. No bowel obstruction. |
Generate impression based on findings. | Down syndrome and choanal atresia. The images are degraded by patient motion artifact. There is near complete bony stenosis of the right posterior choana with an approximately 1 mm soft tissue gap. There is opacification of the right nasal cavity as well as the right maxillary and ethmoid sinuses. The left nasal cavity... | 1. Right choanal atresia with a predominantly osseous component and an approximately 1 mm wide membraneous component, as well as associated retained sinonasal secretions.2. Nonspecific bilateral tympanomastoid opacification, which may represent otomastoiditis. 3. Apparent midface hypoplasia, which may be related to Dow... |
Generate impression based on findings. | 37 female with history of liver transplant, altered mental status after plasma exchange. There is no evidence of intracranial hemorrhage. The ventricles and sulci are prominent, consistent with mild-moderate age-related volume loss. No extra-axial collections are identified. There is no mass effect or herniation. The i... | No evidence of intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | GJ tube placement Distal end of GJ tube projects over left mid abdomen; most probably within proximal jejunum. No bowel obstruction. | Distal end of GJ tube projects over left mid abdomen; most probably within proximal jejunum. No bowel obstruction. |
Generate impression based on findings. | Abdominal pain No bowel obstruction. | No bowel obstruction. |
Generate impression based on findings. | Nasopharyngeal mass on endoscopy; asymmetric lingual tonsil hypertrophy; globus sensation and choking for many years. Maxillofacial: There is mild diffuse prominence of the adenoids. There appear to be secretions within the left lateral nasopharyngeal recess. Otherwise, no discrete mass is discernible. The paranasal si... | 1. Diffuse nonspecific prominence of the adenoids. Although no discrete mass is discernible on CT, MRI of the nasopharynx may be useful for further evaluation.2. No evidence of sinusitis or mastoiditis.3. No evidence of significant lymphadenopathy in the neck. |
Generate impression based on findings. | SIRS and constipation No bowel obstruction. Unremarkable colon without evidence for dilatation or wall thickening/edema | No bowel obstruction. Unremarkable colon without evidence for dilatation or wall thickening/edema |
Generate impression based on findings. | Female 6 months old Reason: PNA? History: CoughVIEWS: Chest AP/lateral (two views) 1/31/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Peribronchial thickening O. lung volumes and subsegmental atelectases of the left normal . No effusions or pneumothorax. | Bronchiolitis pattern with subsegmental atelectasis of the left lower lobe |
Generate impression based on findings. | 22-year-old male with right knee pain and swelling, no injury. Four views of the right knee are provided. I see no fracture, malalignment, or large joint effusion. I see no specific findings to account for the patient's pain.A small bony excrescence projecting from the medial aspect of the distal left femoral metaphysi... | I see no specific findings to account for patient's pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Esophageal cancer status post esophagectomy with acute desaturation and arrhythmia requiring reintubation. PULMONARY ARTERIES: Technically excellent quality contrast infusion. No evidence of pulmonary embolus. No signs of right heart strain.LUNGS AND PLEURA: Small left pleural effusion. Diffuse interstitial and air spa... | No evidence of acute PE. Severe interstitial and airspace opacities consistent with acute interstitial pneumonia/ARDS; drug reaction cannot be excluded. Pneumomediastinum. Small right pneumothorax. Trace pneumoperitoneum.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proxi... |
Generate impression based on findings. | Metastatic rectal carcinoma CHEST:LUNGS AND PLEURA: Interval increase in size of several of the previously noted bilateral pulmonary metastatic nodules. Reference right lower lobe nodule best seen on image 64 of series 6 now measures 3.6 x 2.5 cm; this is in comparison to 2.9 x 2.5 cm on 10/11/2014.Small pleural effusi... | Interval increase in size of several of the previously noted pulmonary metastatic nodules. Slight interval increase in size of reference right hilar metastatic focus. |
Generate impression based on findings. | Female 34 years old Reason: rule out cholecystitis History: pain n/v LIVER: The liver measures 17.3 cm in length. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow with peak velocity is 0.2 m/sec. GALLBLADDER, BILIARY TRACT: Cholelithiasis. The gallbladder is collap... | Cholelithiasis, without definite evidence of acute cholecystitis. |
Generate impression based on findings. | Pain and point tenderness in anterior midfoot. Rule out fracture. History of fracture in foot. Three views of the left ankle again show a sideplate and screws affixing the distal fibula. I see no fracture line. Two screws also affix the medial malleolus. I see no fracture line.Three views of the left foot are provided.... | Fixation of the distal fibula and medial malleolus without acute fracture evident. |
Generate impression based on findings. | 65-year-old male with history of headaches, dizziness, and photophobia. No 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 within normal limits for age. No extra-axial... | 1. No evidence of intracranial hemorrhage or mass effect. The innumerable foci of diffusion restriction seen on MR brain from the same date are not appreciated on CT.2. Moderate pan-sinus disease.3. Superficial right soft tissue nodule is nonspecific, but may represent a benign sebaceous cyst; please correlate with phy... |
Generate impression based on findings. | Male 63 years old Reason: rule out pe History: palpitations, dvt The exam is limited secondary to suboptimal pulmonary opacification and motion artifact. Due to the patient's borderline GFR, the emergency department decided against repeating the examination.PULMONARY ARTERIES: No evidence of pulmonary embolism in the m... | Limited exam with no large central pulmonary embolism.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | T4aN3M1 squamous cell carcinoma of the base of the tongue with lung metastases. There is no significant change in size of the ill-defined right tongue base lesion, which measures up to approximately 20 mm. However, there is interval increase in size and heterogeneity of the adjacent left lingual tonsil, There is no sig... | 1. Although the right tongue base lesion does not appear to be significantly changed, there is interval increase in size of the left lingual tonsil, which is nonspecific, but tumor progression cannot be excluded.2. No significant interval change in the treated bilateral cervical lymphadenopathy. 3. Unchanged right apic... |
Generate impression based on findings. | Severe acute hypoxia. Acute respiratory failure. LUNGS AND PLEURA: Large pleural effusions occupying approximately two thirds of the thorax with adjacent compressive atelectasis. Motion artifact degrades image quality of the aerated lung parenchyma, however no acute abnormalities are appreciated. The suggestion of mild... | Number one. Large bilateral pleural fluid collections with associated compressive atelectasis; and bilateral lower lobe and lateral segment of right middle lobe are collapsed. Anasarca and ascites. |
Generate impression based on findings. | Productive cough, fevers and chills. HIV with a CD4 count of 122. LUNGS AND PLEURA: Motion artifact degrades image quality. Mild centrilobular and paraseptal emphysema.Diffuse bronchiolitis pattern throughout the lungs, lower zone predominant. Within the right lower lobe, peribronchial distribution airspace opacities a... | Diffuse bronchiolitis with bronchopneumonia in the right lower lobe. In an immunocompromised patient this could be of bacterial, atypical mycobacterial, fungal or viral etiology but given the presence of a splenic granuloma and the patient's low CD4 count, endobronchial spread of tuberculosis should be ruled out. Diffu... |
Generate impression based on findings. | There is mild motion artifact degrading image quality. There is an hyperattenuating parenchymal hematoma centered in the left thalamus/posterior limb of the left internal capsule extending superiorly into the left corona radiata measuring 18 x 16 mm in oblique axial dimensions (axial image 16), and up to 31 mm in obli... | 1.Acute parenchymal hematoma centered in the left thalamus/internal capsule extending superiorly into the left corona radiata with local mass effect causing partial effacement of left lateral ventricle. No midline shift.2.Underlying mild age indeterminate small vessel ischemic changes with probable chronic bilateral la... |
Generate impression based on findings. | Immunocompromised patient with history of heart transplant and prostate cancer. Malaise and fatigue, diarrhea. LUNGS AND PLEURA: No signs of pneumonia. Extensive dependent atelectasis in the posterior lung fields. The patient's known right upper lobe nodule has increased in size, measuring 18 x 22 mm, previously 12 x 1... | Interval increase in size of right upper lobe pulmonary nodule suspicious for primary pulmonary neoplasm. Recommend correlation with PET scan. Finding and recommendation discussed with the admitting clinical service at the time of dictation. |
Generate impression based on findings. | Male 26 years old Reason: eval for infection, h/o fungal pneumonia History: ALL, pretransplant LUNGS AND PLEURA: Interval development of right lower lobe cavity at site of prior bronchiectasis with internal filling defect consistent with mycetoma formation, measuring 14 x 22 mm (series 4, image 63). Persistent diffuse ... | Interval development of right lower lobe cavity containing a filling defect most consistent with mycetoma as above.Nonspecific diffuse bronchiolitis pattern, which could be inflammatory or secondary to infection. Resolution of small right pleural effusion. |
Generate impression based on findings. | There are postoperative changes related to sinonasal debridement with marked improvement in the degree of opacification of the frontal ethmoid sinuses with moderate opacification of a few scattered ethmoid air cells on the left and mild mucosal thickening still present in the right. There is significant improvement in... | Significant interval improvement with scattered mild/moderate areas of persistent mucosal thickening in paranasal sinuses as described above. No air-fluid level to suggest acute sinusitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Pain along lateral joint line. Evaluate for osteophytes, osteoarthritis. Moderate to severe osteoarthritis affects the knee, particularly the patellofemoral joint, with tricompartmental osteophytes. There is also a moderate-sized joint effusion. There also appears to be meniscal chondrocalcinosis. | Osteoarthritis and joint effusion as above. |
Generate impression based on findings. | Postoperative changes are again seen from T11 laminectomy, including along the epidural space at this level although without focal fluid collection or hematoma. There is a nodule of enhancement within the central spinal canal spanning the T11 level which measures 0.8-cm transverse by 0.6-cm AP by 1.2 cm CC. This is gr... | 1. No significant interval change in postoperative changes centered at the T11 level. Compared to preoperative imaging, persistent focal enhancing nodule which reportedly is epidural in location although difficult to delineate on MR images, best seen on sagittal T2 weighted images. Resultant persistent mass effect upon... |
Generate impression based on findings. | Metastatic lung cancer to the right neck with vocal cord paralysis, status post Radiesse paste injection into right vocal cord. There is interval decrease in size of an ill-defined conglomerate of right level 4 lymph nodes, which measures up to 12 x 16 mm, previously 14 x 20 mm. However, there is no significant interva... | 1.Interval decrease in size of an ill-defined conglomerate of right level 4 lymph nodes, but other cervical and upper mediastinal lymphadenopathy are not significantly changed.2.Partially-imaged right lung mass. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | AML, fever of unknown origin, and pre SCT work-up. The paranasal sinuses are clear. The nasal cavity is also clear. There is mild nasal septal deviation towards the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, a... | No evidence of sinusitis. |
Generate impression based on findings. | History of rhinorrhea, decreased sense of smell and taste. Assess for chronic sinusitis. There is minimal scattered ethmoid sinus mucosal thickening. The other paranasal sinuses are clear. There are minimal secretions within the nasal cavity. There is no significant nasal septal deviation. The lamina papyracea are inta... | Minimal scattered ethmoid sinus mucosal thickening. The other paranasal sinuses are clear. |
Generate impression based on findings. | LVAD on coumadin with MAPs in the 130s and prior hemorrhagic CVA. There are postoperative findings related to right frontal craniotomy. There is no evidence of intracranial hemorrhage or mass. There is extensive hypoattenuation in the right frontal lobe, which is appears slight more hypoattenuating than on the prior ex... | 1. No evidence of acute intracranial hemorrhage with evolution of the prior right frontal hemorrhage and postoperative alterations.2. Chronic left cerebellar hemisphere infarct. |
Generate impression based on findings. | Palpable lymph node as well as possible lesion on the PET from 2012. History of a left thyroid colloid nodule and hypophosphatemic rickets. There is no evidence of significant cervical lymphadenopathy based on size criteria. There is a left thyroid nodule that measures up to 10 mm. The major salivary glands are unremar... | 1. No evidence of significant cervical lymphadenopathy based on size criteria. 2. A left thyroid nodule that measures up to 10 mm likely corresponds to the previously biopsied colloid nodule.3. Partially-imaged cavity lesion or bronchiectasis in the left lower lobe. Please refer to the separate chest CT report for addi... |
Generate impression based on findings. | Metastatic medullary thyroid carcinoma. Neck: There are postoperative findings related to thyroidectomy and neck dissection. There thyroidectomy bed appears unchanged. However, there has been continued interval increase in size of lower neck and partially-imaged mediastinum. For example, a left lower neck mass now meas... | 1. Continued tumor progression in the lower neck and upper mediastinal lymph nodes.2. Metastases within the partially-imaged lungs. Please refer to the separate chest CT report for additional details.3. No evidence of intracranial metastases. |
Generate impression based on findings. | Significant interval increase in the size of the intraparenchymal hematoma centered in the left thalamus/internal capsule, now measuring 56 x 39 mm in the axial dimension (series 4, image 18), previously 18 x 16 mm, and up to 49 mm in oblique CC dimension (coronal image 50), previously 31 mm. There is resultant 8 mm r... | 1.Significant interval increase in the acute parenchymal hematoma centered in the left thalamus/internal capsule, with new intraventricular extension, rightward midline shift, near-complete effacement of the left lateral ventricle, and partial effacement of the basilar cisterns. 2.Mild prominence of the ventricular sys... |
Generate impression based on findings. | Progression of intracranial stenosis? New pulsatile tinnitus. There is paucity of flow-related enhancement throughout the intracranial right internal carotid artery, with reconstitution at the circle of Willis. There is also lack of flow-related enhancement throughout the bilateral intracranial vertebral arteries, with... | 1. Occlusions of the right internal carotid artery and bilateral vertebral arteries appear to be unchanged since 2005, but a high-grade stenosis of the basilar artery appears to be new or markedly progressed since 2005.2. A wide-neck outpouching along the inferolateral aspect of the left cavernous carotid artery that m... |
Generate impression based on findings. | There are postoperative findings related to right neck dissection with no recurrent mass or significant cervical lymphadenopathy. There is effacement of the right carotid space fat planes within the suprahyoid neck, without change and likely post-treatment related. The thyroid and major salivary glands are unremarkabl... | Posttreatment findings are without locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | T3N2c/N3 right-sided hypopharyngeal mass treated with chemotherapy. There is residual asymmetric effacement of the left piriform sinus associated with diffuse swelling in the hypopharyngeal region. However, the assessment is limited by the lack of intravenous contrast. There is no definite evidence significant cervical... | 1. Residual asymmetric effacement of the left piriform sinus associated with swelling in the hypopharyngeal region, which likely represents the treated tumor, although the assessment is limited by the lack of intravenous contrast. Therefore, endoscopy may be useful for further evaluation.2. No evidence of significant l... |
Generate impression based on findings. | Recurrent left parotid gland adenoid cystic carcinoma status post total parotidectomy and radiation therapy at another hospital in 2005 and completed palliative chemotherapy on August 22, 2014. There are postoperative findings related to left neck dissection, including parotid and submandibular gland resection, with fl... | 1. Post-treatment findings in the neck with persistent nonspecific ill-defined soft tissue in the region of the left parotidectomy bed.2. No significant lymphadenopathy in the neck.3. Chronic thrombosis of the right internal jugular vein. 4. A subcentimeter left lung nodule is compatible metastatic disease. Please refe... |
Generate impression based on findings. | Concern for brain metastases. Right sided tremors/visual disturbance. There is a new mass in the left frontal lobe that measures up to 18 mm with surrounding mild vasogenic edema, adjacent to an area of encephalomalacia. There is also a new mass within the right cerebellar hemisphere that measures up to 20 mm with surr... | New mass lesions within the left frontal lobe and right cerebellar hemisphere are compatible with metastases.Discussed with Dr. Nabhan at 8:30 AM on 1/2/15. |
Generate impression based on findings. | History of antiphospholipid syndrome and previous PEs. Hypoxia. PULMONARY ARTERIES: Suboptimal contrast opacification and severe motion artifact both from patient respiration and tachycardia limit evaluation. Chronic thrombus in branches of the right descending pulmonary artery and left lower lobe pulmonary artery are ... | 1. Limited examination with no acute pulmonary embolus to the lobar level. 2. Chronic pulmonary emboli bilaterally with signs of right heart strain, unchanged. Signs of chronic thromboembolic disease, but no acute pulmonary abnormality. 3. Enlargement of pericardial fluid collection, now moderate. 4. Left breast mass, ... |
Generate impression based on findings. | 59-year-old male with history of rectal cancer and new altered mental status. There is no evidence of intracranial hemorrhage. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The sk... | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Head and neck cancer and CRT. CHEST:LUNGS AND PLEURA: Minimal scarring in the right middle lobe unchanged. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Left subclavian catheter tip in the SVC. Very faint coronary artery calcifications and a distal branch of the left anterior descending coronary artery. Normal ... | No signs of metastatic disease. Right -sided gynecomastia, please refer to prior mammography report for management recommendations. Very mild coronary artery calcification. |
Generate impression based on findings. | 66-year-old male status post PEA arrest, plan to restart anticoagulation, evaluate for intracranial hemorrhage. No 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 prom... | No evidence of intracranial hemorrhage. Minimal age-indeterminate small vessel ischemic changes. |
Generate impression based on findings. | History of head face and neck neoplasm (ACC), solitary pulmonary nodule, RT follow-up. CHEST:LUNGS AND PLEURA: Surgical clips caudal to the right hilum with associated bronchiectasis and architectural distortion.Pleural thickening and nodularity on the left not significantly changed. Atelectasis at the left lung base. ... | Stable exam. No new sites of disease. |
Generate impression based on findings. | Back pain. Evaluate status post fusion, tumor resection There is a posterior stabilization device with screws entering the L1-L5 vertebrae. I see no hardware complications. Amorphous bone graft material is seen along the lateral aspects of the lumbar spine. Skin staples and foci of gas density in the posterior soft tis... | Postoperative changes of lumbar spine fusion and other findings as above. |
Generate impression based on findings. | 72-year-old male with speech disturbance, evaluate for CVA. No 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 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. |
Generate impression based on findings. | 85 year-old female status post fall. No 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 collect... | 1. No evidence of intracranial hemorrhage or calvarial fracture. 2. Stable chronic small vessel ischemic disease. |
Generate impression based on findings. | There is an oblique fracture at the base of the C2 spinous process, with slight distraction of the fracture fragments. There is mild adjacent soft tissue swelling including decreased fat planes and mild edematous appearance of the paraspinal muscles. The vertebral column alignment is within normal limits. There is a n... | 1. There is an oblique, slightly distracted fracture through the base of the C2 spinous process, with mild adjacent soft tissue swelling.2. A partially-calcified left level IV lymph node may represent post-treatment effects of a previously pathologic lymph node related to patient's known esophageal cancer. |
Generate impression based on findings. | 71-year-old female with intermittent blurry vision. No 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 to moderate age-related volume l... | 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. |
Generate impression based on findings. | Reason: eval for CVA History: increasing difficulty walking, loss of memory and new incontinence. No 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, consist... | 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. |
Generate impression based on findings. | There is no acute intracranial hemorrhage. The area of prior infarct at the left pontomedullary junction is not conspicuous on this exam. There are mild patchy foci of hypoattenuation in the periventricular white matter. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There... | 1. High-grade steno-occlusive disease of the distal cervical and intracranial portions of the left vertebral artery.2. Severe stenosis at the right carotid bifurcation and moderate stenosis at the left carotid bifurcation.3. No evidence of acute intracranial hemorrhage, but mild patchy white matter may represent small ... |
Generate impression based on findings. | The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild disk narrowing at L4-L5. The vertebral body and disk heights are otherwise well-maintained. There is mild disk desiccation at L2-L3 through L4-L5. No worrisome focal marrow signal abnormality is appreciated. There is mildly heterogen... | Very minimal spondylotic changes most on its L4-L5 where there is mild central spinal canal stenosis and mild and moderate right and mild left foraminal narrowing.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Images are limited by patient motion. The cervical spine is in normal alignment, with a normal cervical lordosis. There is minimal disk narrowing at C5-C6. The vertebral body and disk heights are otherwise well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal calibe... | 1. No MR evidence of metastatic disease or infection within the cervical or thoracic spine, although evaluation is limited secondary to extensive motion artifact.2. Very minimal cervical spondylotic changes essentially at C5-C6 without significant foraminal narrowing. Mild central spinal canal stenosis.3. Incompletely ... |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage, mass, or cerebral edema. There is minimal thickening of the interhemispheric falx inferiorly (series 2 image 6) likely representing the crista galli. There is prominence of the extra-axial spaces anteriorly and the ventricles. There is no midline shift or herniati... | 1.No acute intracranial hemorrhage or mass effect. 2.Prominence of extra-axial spaces and the ventricles which is most commonly secondary to benign extra-axial hydrocephalus of infancy which should resolve by two years of age. If clinically indicated, follow-up imaging can be obtained.3.Opacification of the mastoids an... |
Generate impression based on findings. | Left arm weakness, confusion, and slurred speech. There is no evidence of intracranial hemorrhage or mass. There is encephalomalacia in the left inferior frontal gyrus with mild ex vacuo dilatation of the left lateral ventricle. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells... | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. Chronic left inferior frontal gyrus infarct. Otherwise, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | MAX/FACIAL: No acute facial bone fracture is identified. The temporomandibular joints are intact. No orbital fracture is identified. The globes are intact. There is no evidence of intraorbital hematoma or stranding. There is soft tissue swelling and infiltration of the subcutaneous fat overlying the right zygomatic ar... | 1. There is soft tissue stranding overlying the right zygomatic arch, without underlying fracture, consistent with stated history of assault.2. Mild degenerative disease of the spine, not significantly changed since recent exam. No fracture is identified in the cervical spine. 3. Periapical and periradicular lucency su... |
Generate impression based on findings. | The ventricles and sulci are slit-like, with increased effacement of the fourth ventricle. There is more extensive cortical hypoattenuation especially near the vertex and along the occipital lobes, with further decreased gray-white differentiation. The deep gray nuclei are no longer delineated. The basal cisterns are ... | Expected evolution of global anoxic brain injury, with worsened diffuse cerebral edema. Stable slit like ventricles supratentorially, with worsened effacement of the fourth ventricle likely relating to downward herniation of supratentorial structures. Near complete effacement of cisterns. No acute intracranial hemorrha... |
Generate impression based on findings. | Evaluation is limited due to lack of contrast and previous postoperative changes. The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild progressive disk height loss at L2-L3. The vertebral body and disk heights are otherwise stable. No worrisome focal marrow signal abnormality is apprec... | 1. Expected evolution of postoperative changes with progressive spondylotic changes at L2-L3 where there is a slightly increased diffuse bulge with central prominence and likely annular fissure, although evaluation of postoperative is is difficult due to lack of contrast. Resultant moderate central spinal canal and lef... |
Generate impression based on findings. | There are multifocal, minimally displaced, bilateral nasal bone fractures, partially comminuted on the left, with associated superficial swelling about the nasal region, left greater than right. The temporomandibular joints are intact. No orbital fracture is identified. The globes are intact. There is no evidence of i... | There are multifocal, minimally displaced, bilateral nasal bone fractures, partially comminuted on the left, with associated superficial swelling about the left greater than right nasal region. |
Generate impression based on findings. | 23-year-old female with remote history of ependymoma resection, recent AMS, found to have left subdural hematoma; evaluate for stability. Stable appearance of trace left frontoparietal extra-axial fluid collection, which is slightly higher density than CSF, indicative of a non-acute hematoma. There is minimal mass effe... | 1. Stable appearance of trace left frontoparietal non-acute subdural hematoma, with minimal localized mass-effect and no midline shift. 2. Unchanged diffuse global volume loss as well as post-operative findings related to prior suboccipital craniotomy, including persistent ex vacuo dilatation of the fourth ventricle. |
Generate impression based on findings. | Female 21 years old Reason: rule out appendicitis History: RLQ pain Limited contrast most of the small bowel is not opacified limiting sensitivity for bowel.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Intrinsically normal. Small amount of perihepatic ascites.SPLEEN: No significant abnormal... | Findings as above favor pain related to this right adnexal cyst, hyper-enhancing wall and associated small amount of ascites and arterial blush in the right lower quadrant. Correlate with GYN pelvic ultrasound and Doppler findings in the right adnexa and right lower quadrant. |
Generate impression based on findings. | Male 95 years old; Reason: Evaluate obstruction History: 95 yo M with ?R inguinal hernia, p/w constipation and vomiting ABDOMEN:LUNGS BASES: Increasing bilateral pleural effusions and small to moderate on the right small on the left with associated basilar atelectasis superimposed on chronic fibrotic changes.Possibly s... | 1.High grade mechanical obstruction secondary to right inguinal hernia with associated pelvic ascites and fluid in the hernia sac and hyperemia of the small bowel loop within the hernia sac suggesting ischemia. Patient is at risk for perforation, although no perforation is currently seen.2.New or increased small bilate... |
Generate impression based on findings. | Exam is limited due to multiple factors leading to suboptimal opacification of the vasculature, which may in part be technical but could also relate to the patient's cardiac status.The entire right internal jugular vein does not opacify with contrast. Previously seen right internal jugular vein Permacath has been remo... | Complete right internal jugular vein thrombosis with progressive extensive surrounding likely phlegmonous change extending superiorly from C2 level to the subclavicular fossa. No drainable fluid collection or abscess. |
Generate impression based on findings. | 62 year-old female with NSCLC status post CRT and right upper lobe wedge resection on 12/12/2014 presents with fatigue/decreased P.O. intake LUNGS AND PLEURA: Postsurgical changes of an right upper lobe wedge resection is again seen. Septal thickening and architectural distortion in the remaining right upper lobe as we... | 1.Increased fluid within the right upper lobe hydropneumothorax. Superimposed infection cannot be entirely excluded.2.New, nondisplaced right ninth rib fracture.3.Unchanged 5-mm right lower lobe nodule. |
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