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Generate impression based on findings. | Male 61 years old Reason: 61M with new diagnosis of metastatic neuroendocrine tumor of unclear origin with peritoneal carcinomatosis and hepatic mets, imaging for staging. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Diffusely dilated esophagus 1.9-cm is seen on coronal image 32 in cont... | Multifocal hepatic metastases with compression of hepatic vasculature and biliary tree. Tumor extends to compress the structures in the porta hepatis and possibly extends into the pancreas. Compression of intra-and infrahepatic inferior vena cava.Carcinomatosis as detailed above.Esophageal dilatation and possible reflu... |
Generate impression based on findings. | There is artifact the skull base due to beam hardening which limits evaluation. Given this limitation, there is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is periventricular and subcortical white matter hypoattenuation consistent with known chronic microvascular ischemic changes which are b... | No acute intracranial hemorrhage, or mass effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Female 74 years old Reason: sepsis neutropenia abdominal pain History: abdominal pain. The exam is not sensitive detecting lesions in the solid organs of vasculature to the lack of intravenous contrast and in the bowel due to the lack of oral contrast. Given those limitations, the following observations are made:CHEST:... | Limited by lack of oral and intravenous contrast. No findings to explain acute abdominal pain.Eccentric aortic aneurysm. Prior exams please compare to show stability if not, follow-up should be obtained.Air in urinary bladder presumably instrumentation, correlate clinically.Left adrenal nodule does not criteria for ade... |
Generate impression based on findings. | 65-year-old male with AMS, intubated with multiple cortical strokes LUNGS AND PLEURA: Bibasilar dependent atelectasis. Within the left upper lobe, there is architectural distortion, volume loss, and emphysematous changes with interstitial thickening may be secondary to postsurgical changes or postradiation changes. No ... | 1.Status post resection of the first and second left rib with adjacent postsurgical and/or postradiation changes to the left upper lobe.2.No focal pulmonary opacities suspicious for infection or infarct. Bibasilar atelectasis.3.Thyroid nodules as described above. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is a small rounded lucency in the right subinsular region and series 5 image 12 probably volume averaging artifact from a prominent regional sulcus or possibly a dilated perivascular space. The ventricles and basal cisterns are normal in s... | No acute intracranial hemorrhage or mass-effect. |
Generate impression based on findings. | Male 75 years old; Reason: eval of ?diverticulitis History: abd pain, blood in stool, elevated lactate. The exam is not sensitive for detecting lesions in the solid organs or vasculature due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNGS BASES: Bibasilar ... | Limited by the lack of intravenous contrast believe there is a process causing thickening of long segment of distal transverse and proximal descending colon. Correlate for acute or chronic colitis. No evidence of diverticulitis. No intramural or free air.Stable bilateral renal cysts.Sigmoid diverticulosis.Atherosclerot... |
Generate impression based on findings. | Female 7 years old Reason: abd erythema, tenderness, and warmth, concerning for acute process History: concern for acute processVIEW: Abdomen AP (one view) 2/1/15 at 457 hours NG tube terminates in the stomach. Right hip dislocation and lateral uncovering of the left hip and bilateral coxa valga deformity noted. Gastro... | Soft tissue edema and minimally distended, nonspecific bowel loops as described. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage. There are new moderate areas of hypoattenuation in the right parietal lobe, and in the left insula extending superiorly into the left corona radiata via the left putamen representing age indeterminate, probably subacute strokes; these are unchanged. There is minimal que... | 1. No acute intracranial hemorrhage.2. Findings, in conjunction with provided clinical history, suggest subacute infarcts in the left MCA territory and the right parietal lobe. In the left MCA territory, there may be a an underlying chronic infarct as well. However, CT is insensitive for detection of early nonhemorrhag... |
Generate impression based on findings. | Female 7 years old Reason: ET tube in place? History: intubated sedated , history of pancreatitis.VIEW: Chest AP (one view) 2/1/15 at 357 hours. Neurostimulator, NG tube and gastrostomy unchanged. ET tube tip is below the thoracic inlet. Cardiac silhouette size is normal. Left lower lobe opacity and left-sided pleural ... | Interval improvement in right upper lobe atelectasis and worsening left lower lobe opacity and left-sided pleural effusion. |
Generate impression based on findings. | Axial images are limited due to poor signal to noise especially along the mid to lower cervical spine which may in part relate to dental amalgam susceptibility artifact. There may also be mild motion artifact.The cervical spine is in normal alignment, with a normal cervical lordosis. There is mild-moderate disk narrow... | Somewhat technically limited exam secondary to artifact especially along the mid to lower cervical spine. Within these limitations, overall mild-moderate scattered spondylotic changes as detailed above, without to moderate central spine canal stenosis at C6-C7 at C5-C6, as well as moderate bilateral foraminal narrowing... |
Generate impression based on findings. | 46 years, Male. Reason: eval for ileus History: nausea Diffusely dilated small and large bowel without transition zone. No intramural air or free air given limitation of supine view. Likely post operative ileus. Vertical staple line. Spinal hardware.Atelectasis or fibrosis left lower lobe. | Postoperative ileus. |
Generate impression based on findings. | There is a stable left basal ganglia/thalamic hyperattenuating hematoma measuring 58 x 44 mm on series 5 image 15 with surrounding vasogenic edema and mass effect. There is persistent 8mm midline shift to the right. The regional sulci and left lateral ventricle remain nearly effaced. There is mild intraventricular hem... | 1. Stable large intraparenchymal hematoma in the left basal ganglia/thalamic region with unchanged mild intraventricular hemorrhage, mass effect, midline shift and prominent ventricular caliber.2. Mildly progressive small focus of subarachnoid hemorrhage in the right cerebral hemisphere. |
Generate impression based on findings. | 40 years, Female. Reason: sbo vs severe constipation History: N?V. Normal bowel gas pattern. No evidence of obstruction. Average stool burden in colon.Osseous and soft tissue structures are unremarkable.Single-lead ICD chest. Sternotomy wire and plate. | No evidence for obstruction. Average stool burden in colon. |
Generate impression based on findings. | Right chest wall pain No acute or subacute rib abnormality observed, particular attention was placed in the area of the patient placed markers. Underlying chest is clear. Moderate degenerative changes of the right shoulder are partially observed. Suspected partial scoliosis and cholecystectomy clips. | No acute rib abnormality |
Generate impression based on findings. | Male 16 years old Reason: pna, atelectasis History: new tachypneaVIEW: Chest AP (one view) 1/31/15 at 1052 hrs Central lines unchanged. Interval NG tube removal. Cardiac silhouette size is normal. Right lower lobe opacity, likely atelectasis or pneumonia. Interval resolution of left lower lobe atelectasis. | Right lower lobe opacity, likely atelectasis or pneumonia |
Generate impression based on findings. | 50 year-old female with pain and swelling of right clavicle LUNGS AND PLEURA: There is a large left upper lobe nodule measuring 1.5 x 2.0 cm (series 7, image 19), similar to the prior exam. There are numerous additional nodules in bilateral lungs consistent with history of metastases. No pneumothorax.MEDIASTINUM AND HI... | 1.Expansile, lytic lesion in the right clavicular head with surrounding inflammatory changes is compatible with a metastatic lesion.2.Innumerable pulmonary nodules and lymphadenopathy consistent with metastatic lesions of patient's known RCC.3.Left posterior T6 lytic rib lesion is unchanged. |
Generate impression based on findings. | 55 years, Male. Reason: Assess pain pump History: bacteremia with implanted hardware. Diffusely dilated small bowel particularly in the right abdomen. Mildly dilated colon but no discrete transition zone. Average stool burden. No intramural air or free air evident.Spinal hardware. Spinal implanted hardware and catheter... | Generalized ileus. |
Generate impression based on findings. | NONCONTRAST: There is a stable left basal ganglia/thalamic hyperattenuating hematoma measuring 58 x 44 mm on series 5 image 15 with surrounding vasogenic edema and mass effect. There is persistent 8mm midline shift to the right. The regional sulci and left lateral ventricle remain nearly effaced. There is mild intrave... | 1.Mild intracranial atherosclerosis without flow-limiting stenosis, or vascular malformation. However, evaluation after resolution of hematoma would be advised for follow-up. 2.Stable large intraparenchymal hematoma in the left basal ganglia/thalamic region with unchanged mild intraventricular hemorrhage, mass effect, ... |
Generate impression based on findings. | Post operative changes are seen from previous anterior cervical fusion of C6 and C7, with resultant susceptibly artifact from the instrumentation limiting evaluation of surrounding structures. Axial images are somewhat limited by patient motion an unusual angulation of the gradient echo images.The cervical spine is in... | Postoperative changes relating to previous C6-C7 fusion, with mild-moderate spondylotic changes as detailed above with findings most probably C4-C5 where there is moderate spinal canal stenosis as well as moderate-severe right and mild to moderate left foraminal narrowing. |
Generate impression based on findings. | Left wrist reduction Cast material obscures detail, however the comminuted intra-articular distal radial fracture appears to improved in overall orientation, the dorsally angulated fragment currently is minimally impacted and angled in a more routine position. | Improved alignment of the distal radial interarticular fracture, see detail provided |
Generate impression based on findings. | 56 years, Male. Reason: s/p g tube reinsertion, please shoot high History: see above Percutaneous G-tube overlies gastric body.Normal bowel gas pattern. Osseous and soft tissue structures are otherwise unremarkable. | G-tube projects over gastric body. |
Generate impression based on findings. | Male 17 years old Reason: Nasal bone fracture? History: fallVIEWS: Nasal bones AP and right and left lateral 1/31/15 (3 views) Minimally displaced nasal bone fractures. Visualized paranasal sinuses are normally aerated. | Minimally displaced nasal bone fractures. |
Generate impression based on findings. | 37 years, Male. Reason: concern for obstruction, ileus. History: abdominal pain, constipation, distention Minimally prominent loops of small bowel in the right upper quadrant. Normal gas distribution in colon. Less than average stool burden. No intramural air or free air.Osseous and soft tissue structures and lung base... | Mild ileus right upper quadrant. |
Generate impression based on findings. | Wrist and elbow pain Elbow: Limited evaluation without evidence of radiographic abnormality, consider 4 views if suspicion remains highWrist: A comminuted intra-articular distal radial fracture is observed with moderate dorsal angulation of the distal largest fragments and associated impaction. Soft tissue swelling. Su... | Distal radial fracture |
Generate impression based on findings. | Male 5 years old Reason: Evaluate Lung Fields History: Suspected SepsisVIEW: Chest AP (one view) 1/31/15 at 1443 hrs. Lower extremity central line tip is at the RA/SVC junction. Cardiac silhouette size is normal. Small lung volumes with no focal opacities, effusions or pneumothorax. | No focal lung opacities. Persistent small lung volumes. |
Generate impression based on findings. | Patient fell. Pain Elbow: Large effusion is observed with deformity of the radial head concerning for a minimally impacted neck fracture.. Minimal osteophytes and degenerative changes. Serial imaging will help confirmWrist: No acute radiographic abnormality. Diffuse demineralization and mild scattered degenerative chan... | Questionable radial transverse neck fracture with possible mild impaction. Mild degenerative changes of the wrist |
Generate impression based on findings. | 70 years, Male. Reason: eval for ileus History: abd pain. Respiratory motion. Pelvis excluded from field of view.Dobbhoff tube overlies the gastric fundus. Nonobstructive bowel gas pattern.Opacities lung bases please refer to chest x-ray. | Dobbhoff tube overlies gastric fundus. |
Generate impression based on findings. | Pain and swelling, for two weeks. Pain worsening recently Diffuse marked swelling greater overlying the medial malleolus without underlying acute osseous abnormality. Ankle mortise remains intact and symmetric. If there is concern for ligamentous injury, stress views may be indicated | Diffuse soft tissue swelling greater medially without underlying acute osseous abnormality |
Generate impression based on findings. | Second and third digit pain with fourth digit nail bed injury check for fracture Soft tissue swelling largely observed involving the second digit without underlying osseous abnormality. The absence of osseous abnormality includes all digits. There is however a small soft tissue defect overlying the tuft on the ulnar ma... | Minimal second digit swelling and soft tissue laceration suspected involving the fourth digit. No osseous abnormality |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is periventricular and subcortical white matter hypoattenuation, likely representing age indeterminate microvascular ischemic changes. The ventricles and basal cisterns are prominent consistent with diffuse volume loss. There is no midline... | 1.No acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke.2.Moderate age indeterminate microvascular ischemic changes and diffuse volume loss.3.Extensive atherosclerosis. |
Generate impression based on findings. | Respiratory insufficiency.VIEW: Chest AP (one view) 2/1/15 at 333 hours. ET tube tip is below the thoracic inlet. A gastrostomy tube again noted. Cardiac silhouette size is normal. Persistent right upper and left lower lobe opacities as well as bronchial wall thickening. Interval improvement in left upper lobe atelecta... | Interval improvement in left upper lobe atelectasis with persistent bronchial wall thickening and multifocal opacities. |
Generate impression based on findings. | 43-year-old male with persistent tachycardia PULMONARY ARTERIES: Limited examination by suboptimal contrast opacification and streak artifacts. Within these limitations, there are a few filling defects that are concerning for pulmonary embolism although these may represent flow artifacts. For example, there is a right ... | 1.Limited examination due to suboptimal contrast opacification of the pulmonary arteries and streak artifacts. Within these limitations, there are questionable filling defects bilaterally that may represent flow artifacts. Repeat imaging may be considered for confirmation if necessary.2.Scattered micronodules bilateral... |
Generate impression based on findings. | Please evaluate hematoma involving right thigh, sudden drop in hemoglobin Mild to moderate diffuse swelling largely observed in the subcutaneous medial soft tissues throughout the groin and extending down towards the knee. No distinct focal fluid collection or hematoma is observed and only a small trace amount of fluid... | Scattered edema and diffuse swelling more pronounced over the inner thigh and groin yet without a discreet focal fluid collection to suggest a measurable hematoma. |
Generate impression based on findings. | 95 years, Male. Reason: Eval for obstruction, constipation History: 95 yo M with ?R inguinal hernia here with constipation and vomiting. Markedly dilated loops of small bowel in left lower quadrant concerning for high grade mechanical small bowel obstruction. No intramural air or free air.Postsurgical changes right fem... | Findings of high-grade mechanical small bowel obstruction. These findings were communicated by me via stat consult at 5:12 a.m. Follow-up CT is been obtained prior to the time of this dictation. |
Generate impression based on findings. | Respiratory insufficiency.VIEW: Chest AP (one view) 1/31/15 at 1825 hrs. Interval intubation of the right bronchus intermedius with complete atelectasis of the left lung and right upper lobe. Cardiac silhouette is non-sizable. | Right bronchus intermedius intubation with complete collapse of the left lung and right upper lobe |
Generate impression based on findings. | Male 7 years old Reason: lac by glass History: lacVIEWS: Left hand AP, lateral and oblique 1/31/15 (3 views) High density structure only visualized in AP view at the thenar eminence may represent hematoma or laceration. No evidence of radiopaque foreign bodies no fracture or malalignment. | No fracture or radiopaque foreign bodies. |
Generate impression based on findings. | Female 2 years old Reason: abdominal pathology History: bowel dilation noted on cxrVIEW: Abdomen AP (one view) 1/31/15 at 2229 hrs. Right middle lobe opacity and bronchial wall thickening noted.Disorganized, slightly distended and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis inte... | Disorganized, slightly distended and nonspecific abdominal gas pattern. |
Generate impression based on findings. | 56 years, Male. Reason: s/p g-tube reinsertion History: same Percutaneous G-tube overlies distribution gastric body. Contrast seen in nondilated jejunum and stomach presumably related to G-tube insertion.Lung bases are normal.Osseous and soft tissue structures otherwise unremarkable | G-tube tip overlies gastric body. |
Generate impression based on findings. | Female 2 years old Reason: lung pathology History: cough/wheeze, not responding to albuterol and O2VIEW: Chest AP (one view) 1/31/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Peribronchial thickening and right middle lobe opacity likely atelectasis or pneumoni... | Peribronchial thickening and right middle lobe opacity, likely atelectasis or pneumonia |
Generate impression based on findings. | Fever and pain, check ORIF Tibial plateau fixation with bilateral sideplates and numerous screws appears unchanged. Specifically no evidence of interval hardware complications. Underlying comminuted reconstructed bilateral tibial plateaus appears also similar with minimal interval increased healing and less well define... | Essentially stable proximal tibial reconstruction with mild changes of interval healing. No definite discrete findings to suggest underlying osteomyelitis, however swelling and effusion present are nonspecific. |
Generate impression based on findings. | Male 20 months old Reason: Finger pain History: 5th digit traumaVIEWS: Left hand AP and lateral 1/31/15 (two views) Fifth finger soft tissue swelling with no fracture or malalignment. | Soft tissue swelling of the fifth finger with no fracture or malalignment. |
Generate impression based on findings. | Male 5 years old Reason: s/p L DRF reduction History: see aboveVIEWS: 2/1/15 at 248 hours. (Two views) Cast material obscures fine bone details. Improvement in alignment of the left distal radial fracture. | Improvement in alignment of the distal fracture of the left radius after casting. |
Generate impression based on findings. | Male 5 years old Reason: wrist History: traumaVIEWS: Left wrist AP, lateral and oblique 1/31/15 (3 views) There is a dorsally displaced and impacted fracture of the distal left radius with soft tissue swelling and joint effusion. | Distal left radial fracture as described. |
Generate impression based on findings. | Female 39 years old Reason: Evaluate for intrarenal hematoma or mass History: hematuria RIGHT KIDNEY: 10.6 cm in length. No hydronephrosis or hydroureter. No evidence of perinephric hematoma. Specifically the hematoma seen on the CT scan of 2/2011 is not visible. Normal blood flow on limited color Doppler imaging.LEFT ... | Normal exam. No evidence of mass or hematoma. If hematuria persists, recommend dedicated renal CT or MR for evaluation. |
Generate impression based on findings. | Left ankle injury.VIEWS: Left ankle AP, lateral and oblique 1/31/15 (3 views) Joint effusion and soft tissue swelling with no fracture or malalignment. | Joint effusion and soft tissue swelling. No fracture. |
Generate impression based on findings. | Male 44 years old Reason: right upper quadrant pain History: right upper quadrant pain. Limited by bandages around the cholecystostomy tube.LIVER: 16.2 cm in length. No evidence of perihepatic fluid collections. No definite focal lesions.GALLBLADDER, BILIARY TRACT: Echogenic material consistent with sludge or hematoma ... | Echogenic material in the gallbladder may represent sludge and/or hematoma cholecystostomy tube. Limited visualization to the bandages. |
Generate impression based on findings. | There is no interval development of grade 1 anterolisthesis of L4 on L5 measuring 3 mm, degenerative in etiology. The lumbar spine is otherwise in normal alignment, with slight exaggeration of the normal lumbar lordosis. There is mild disk narrowing at L4-L5 as well as disk desiccation. The vertebral body and disk hei... | 1. Progression of spondylotic changes at L3-L4 where a right foraminal disk protrusion impinges upon the exiting right L3 nerve root with mild-moderate right foraminal narrowing.2. Interval development of degenerative grade 1 anterolisthesis of L4 on L5 with uncovering of the disk although without significant stenosis. |
Generate impression based on findings. | Female 22 years old Reason: Fevers of unknown origin. Had edema in previous GB examination. Even though could be due to ascites, we would like to evaluate for cholecystitis in the setting of recurrent fevers. History: Fevers of unknown origin. LIVER: Enlarged 20 2 cm in length. Echogenic consistent with fatty infiltrat... | Hepato-splenomegaly. Mild fatty liver. No findings to explain recurrent fever.Previously seen submucosal edema in the gallbladder on the prior CT scan is resolved. |
Generate impression based on findings. | Status post fall.VIEWS: Right tibia-fibula AP and lateral. Right foot and ankle AP, lateral and oblique 2/1/15 (8 views) There is an oblique, comminuted and minimally posteriorly displaced fracture of the distal metadiaphyses of the right fibula. Soft tissue swelling also noted as well as ankle joint effusion. | Comminuted fracture of the distal metadiaphyses of the right fibula with joint effusion and soft tissue stranding as described. |
Generate impression based on findings. | Male 7 years old Reason: FB esophagus History: Swallowed quarterVIEWS: Chest AP/lateral (two views) 2/1/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. No focal lung opacities. No effusions or pneumothorax.Radiopaque round metallic object is lodged at the esophag... | Foreign body ingestion as described. |
Generate impression based on findings. | Female 23 years old Reason: RUQ ultrasound History: RUQ pain Limited by difficulty suspending respiration.LIVER: 15.9 cm in length. No focal lesions. Mildly coarse echotexture.Flow in the portal vein is hepatopedal .2 m/secGALLBLADDER, BILIARY TRACT: Cholelithiasis. No evidence of tenderness to compression. No perichol... | Cholelithiasis, no evidence of cholecystitis. |
Generate impression based on findings. | 72 years, Female. Reason: Dobbhoff placement History: same Dobbhoff tube tip projects in the distribution of distal gastric body. Overlying LVAD and other catheters and tubes unchanged.Nonobstructive bowel gas pattern. | Dobbhoff tip projects over the distal gastric body. |
Generate impression based on findings. | Female 23 years old Reason: rule out mass vs obstruction History: SEVERE RUQ and epigastric pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted. Cholelithiasis was seen on ultrasound is not evident by CT and there is no pericholecystic fluid. No significant bi... | No findings to explain patient's symptoms of right upper quadrant and epigastric pain. Adnexal cysts presumably functional. |
Generate impression based on findings. | Facial traumaVIEWS: Nasal bones AP and right and left lateral 1/30/15 (3 view/s) There is no evidence of fracture, malalignment or soft tissue swelling | No fracture. |
Generate impression based on findings. | Sickle cell disease with knee pain for 5 months.VIEWS: Right knee AP, lateral and oblique 1/30/15 (3 view/s) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 15 years old Reason: s/p R ankle reduction VIEWS: Right ankle AP lateral and oblique 1/2/15 at 851 hours (3 views) Cast material obscures fine bone details. Comminuted fracture of the right fibula is unchanged in alignment. | Status post casting as described. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are areas of T2 hyperintensity within the posterior centrum semiovale bilaterally, in a near symmetric pattern. Centrally, these areas demonstrate dropout of signal on FLAIR, with retain... | 1. Minimal areas of probable cystic encephalomalacia within the centrum semiovale bilaterally likely related to previous insult of unknown etiology. A few additional nonenhancing nonspecific scattered linear foci of T2/FLAIR hyperintensity in the frontal lobe white matter.2. Findings suggestive of a borderline to mild ... |
Generate impression based on findings. | Male 4 years old Reason: Fx? History: fall from bed, L elbow painVIEWS: Left elbow AP, lateral and oblique 2/1/15 (3 views) Cortical interruption along the lateral aspect of the metaphysis of the left humerus with anterior fat-pad this placement. | Left humerus nondisplaced fracture with joint effusion. |
Generate impression based on findings. | Female 45 years old Reason: r/o appendicitis History: lower abdominal pain and persistent retching ABDOMEN:LUNG BASES: Extensive airspace disease right lung base. There is also bronchiectasis and suggestion of bronchial impaction. tree-and-bud opacities consistent with bronchiolitis. Rule out aspiration pneumonia.LIVER... | Lung findings as above consistent with infection and bronchial impaction. Rule out aspiration.No evidence of appendicitis. |
Generate impression based on findings. | Female 7 years old Reason: concern for abd concern (abscess?) History: r/o abd abscess or necrotizing cellulitis ABDOMEN:LUNG BASES: Bibasilar opacities and pleural effusions noted. ET tube and NG tube noted.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted.PANCREAS: Slightl... | Enlarged pancreas and soft tissue edema as well as ascites. |
Generate impression based on findings. | Female 87 years old Reason: Rule out pelvic mass History: Vaginal bleed, pelvic pain The exam is not sensitive for detecting lesions in the solid organs are vasculature due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality no... | Exam complicated by contrast extravasation as detailed in technique paragraph. Exam limitation due to lack of intravenous contrast.Unexplained dilatation of the left ureter. Some mild fat stranding around urinary bladder. Correlate for UTI and for partially obstructing urothelial lesion. |
Generate impression based on findings. | Female 2 days old Reason: cooling, eval esophageal probe placement History: therapeutic coolingVIEW: Chest and abdomen AP (two views) 2/1/15 at 945 hours. Interval ET tube removal. Esophageal temperature probe and NG tube terminates in the stomach. UVC tip is at the right atrium. Cardiac silhouette size is normal. No f... | Misplaced esophageal temperature probe.No focal lung opacities after ET tube removal.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 8 years old Reason: 8 yo with chronic constipation s/p bowel clean out - assess for stool burden History: chronic constipationVIEW: Abdomen AP (one view) 1/31/15 at 1531 hrs. Normal abdominal gas pattern with minimal fecal accumulation. No obstruction or free air. | No obstruction or free air. |
Generate impression based on findings. | Female 12 years old Reason: Shunt breaks/fractures, malfunction? History: HA x 5 weeks. OSH report of shunt fractureVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 1/31/15 Intracranial portion of the VP shunt looks normal. There is a fracture of the cathet... | Fracture of the catheter at the level of the soft tissues of the right sided of the neck. Findings were communicated to and acknowledged by Dr. BARRILE, ASHLEY pager number 4687 on 2/1/15 at 1016 hrs. |
Generate impression based on findings. | NONCONTRAST: There is no evidence of intracranial hemorrhage. There are new moderate areas of hypoattenuation in the right parietal lobe, and in the left insula extending superiorly into the left corona radiata via the left putamen representing age indeterminate, probably subacute strokes; these are unchanged. There i... | 1.Abrupt occlusion of the left M1 segment near the origin with a tiny stump, and asymmetric paucity of vessels in the left MCA territory as compared to the right.2.Occlusion of the left internal carotid artery from the origin to the level of the left ophthalmic segment where there is minimal retrograde filling.3.Unchan... |
Generate impression based on findings. | Status post fracture.VIEWS: Right ankle AP, lateral crosstable and oblique 2/1/15 at 952 hours (3 views) Cast material obscures fine bone details. Oblique/comminuted fracture of the distal fibula with minimal posterior displacement is unchanged in alignment. | Fibular fracture unchanged in alignment. |
Generate impression based on findings. | Female 37 years old Reason: Rule out appendicitis History: Abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, ... | Short segment thickening neoterminal ileum correlate for any signs of symptoms of inflammatory bowel disease.Noncalcified rounded, uterine mass lower uterine segment. Correlate clinically. (This addition to Stat consults was discussed with Dr. Cannon pager 6112, by ROC at 12 noon.) |
Generate impression based on findings. | Images slightly limited by patient body habitus. There is trace degenerative grade 1 anterolisthesis of L4 on L5. The lumbar spine is otherwise in normal alignment, with exaggeration of the normal lumbar lordosis. The vertebral body heights are well-maintained. There is mild scattered disk narrowing, most prominent at... | 1. Overall, moderate spondylotic changes most significant at L4-L5 and L5-S1 as detailed above, with moderate to severe central spinal canal stenosis at L4-L5, significant narrowing of both lateral recesses, as well as moderate-severe right foraminal narrowing at this level. Additional large left paracentral/foraminal ... |
Generate impression based on findings. | Male 2 days old Reason: are the lungs clear is there a left anterior pneumothorax History: respiratory distress, left pneumothoraxVIEW: Chest AP (one view) 2/1/15 at 444 hours. NG tube terminates in the stomach. Cardiac silhouette size is normal. Small , lineal left-sided medial pneumothorax with no effusions. Right up... | Small left-sided medial pneumothorax, left upper lobe subsegmental atelectasis on the bottom of diffuse haziness. |
Generate impression based on findings. | Female 42 years old Reason: evaluate for periumbilical mass; patient has cyclic appearance of a mass and bleeding from umbilicus History: Pain and bleeding ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No signi... | Nonspecific small soft tissue density with central hypoattenuation within the umbilicus. No intraperitoneal abnormalities. |
Generate impression based on findings. | Male 2 days old Reason: are the lung fields clear History: no lines - increasing respiratory distress; increasing O2 requirementVIEW: Chest and abdomen AP (two views) 1/31/15 at 2101 hrs. Proximal side-port of NG tube is above GE junction. The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette siz... | Possible small left-sided pneumothorax on a background of diffuse lung haziness. |
Generate impression based on findings. | Male 4 months old Reason: where is the PICC History: Respiratory distress. Stenosis of the larynx.VIEW: Chest AP (one view) 1/31/15 at 2235 hrs Left neck central line terminates at the confluence of both innominate veins. ET tube tip is at the carina. Cardiac silhouette size is normal. Persistent complete right lung co... | Multifocal opacities as described. Possible mucous plugging of the right main bronchus.Central line positioning as described |
Generate impression based on findings. | Male 77 years old Reason: esophageal cancer on chemotherapy please assess response and compare to previous imaging History: esophageal cancer. CHEST: Some blurring due to the respiratory motion.LUNGS AND PLEURA: Index nodule left lobe series 4 image 50, 5 mm diameter. Previously 4 mm. Nodules in the right lower lobe un... | Progression of disease with new evidence of carcinomatosis. Index lung nodules and lymph nodes as measured.Other findings unchanged including thyroid nodules, gallstone, dilated esophagus with patent stent in place. |
Generate impression based on findings. | Female 14 years old Reason: assess lung felids History: EncephalopathyVIEW: Chest AP (one view) 2/1/15 at 344 hours. ET tube tip is above the carina. NG tube terminates in the stomach. Cardiac silhouette size is normal. Right lower lobe opacity, likely atelectasis development. | Interval development of right lower lobe opacity, likely atelectasis. |
Generate impression based on findings. | Female 17 years old Reason: left pleural effusion, chest tube; re eval lung fields History: chest tube dependentVIEW: Chest AP (one view) 2/1/15 at 414 hours. Left-sided chest tube again noted. Cardiac silhouette size is normal. Left retrocardiac opacity unchanged. Interval improvement in right lung base subsegmental a... | Interval worsening in right-sided pleural effusion. |
Generate impression based on findings. | Male 0 days old Reason: are the lung fields clear History: INITIAL XR - increasing respiratory distress; increasing O2 requirementVIEW: Chest and abdomen AP (two views) 2/1/15 NG tube terminates in the stomach. UVC tip is at the right atrium. UAC terminates at T7. Aortic arch, cardiac apex and stomach are left-sided. C... | NG tube and umbilical lines positioning as described.Bilateral diffuse lung haziness consistent with TTN versus RDS. |
Generate impression based on findings. | Female 11 years old Reason: intubated, plan to extubate today History: Respiratory distress.VIEW: Chest AP (one view) 2/1/15 at 428 hours. ET tube tip is at the carina. Cardiac silhouette is non-sizable. Chronic atelectasis of both lung bases are again noted. No new focal opacities, effusions or pneumothorax. Multiple ... | Persistent bibasilar atelectasis. |
Generate impression based on findings. | Female 6 years old Reason: eval stool burden History: incontinence and diarrhea.VIEW: Abdomen AP (one view) 2/1/15 Normal abdominal gas pattern. No evidence of obstruction, free air or significant stool burden. | Normal examination. |
Generate impression based on findings. | Exam is somewhat limited due to patient motion. The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild disk narrowing L4-L5 and moderate disk narrowing L5-S1. There is also disk desiccation at these levels, as well as at L3-L4 and along the visualized lower thoracic spine. The vertebral ... | 1. Diffuse abnormal marrow signal consistent with patient's known history of metastatic disease, with a few focal areas of abnormal signal suggesting more focal metastases. No evidence of compression deformity.2. Significant mid-to distal lumbar spinal canal developmental narrowing with superimposed lower lumbar spondy... |
Generate impression based on findings. | Male 54 years old Reason: pt with met melanoma s/p 4 cycles of Ipi please asses response to therapy and compare to previous imaging History: met melanoma. CHEST:LUNGS AND PLEURA: Micronodule right upper lobe pleural-based, unchanged. No suspicious lesions.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL... | Stable micronodule. No evidence metastatic disease. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is an old left temporal and parietal lobe infarct with encephalomalacia in the left MCA territory, unchanged with mild expected location of the left lateral ventricle. There is persistent hypoattenuation probably representing mild chronic ... | No acute intracranial hemorrhage or mass effect. Chronic left temporoparietal infarct with encephalomalacia, with other mild chronic small vessel ischemic changes. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Male 64 years old Reason: history of testicular cancer s/p adjuvant chemotherapy, assess for recurrence. CHEST:LUNGS AND PLEURA: Calcific granulomata right upper lobe, unchangedMEDIASTINUM AND HILA: Calcified azygos node.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Punctate hypodensity late... | Granulomatous disease right lung. No evidence of metastatic disease. |
Generate impression based on findings. | Male 64 years old; Reason: 64 yo males s/p APR with colostomy and left nephrectomy about 2 months ago for rectal cancer and renal cell carcinoma. Pt with continued abdominal pain and episode of rectal bleeding. Evaluate for tumor recurrence History: Abdominal Pain ABDOMEN:LUNGS BASES: No significant abnormality noted.L... | 1.Postsurgical changes right rectal fossa and pre-sacral space.2.Early or incomplete small bowel obstruction probably due to adhesions in the pelvis. Correlate for obstructive symptoms. 3.New index retrocaval lymph node provided slightly increased in size compared to the prior exam.Findings discussed by ROC Dr. Erick B... |
Generate impression based on findings. | The thoracic spine is in normal alignment, with slight straightening of the normal thoracic kyphosis. 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. There is no pathological enhancement.There is no s... | 1. No MR evidence of metastatic disease to the thoracic or lumbar spine.2. Minimal lower lumbar spondylotic changes with up to moderate right and mild to moderate left foraminal narrowing at L5-S1. |
Generate impression based on findings. | Please note that the exam was converted to a protocol for facial soft tissues rather than specifically for evaluation for encephalocele. 3-D T2 weighted images and other thinner section high-resolution imaging through the area of interest is therefore not available.Within the limitations, there is extensive pansinus o... | 1. Suboptimal exam secondary to incorrect protocol with absence of thinner section imaging through the area of concern. However, area of focal thinning/absence of medial left ethmoid roof just anterior to the crista galli suggested with no definite MR evidence of encephalocele or meningocele. No adjacent dural abnormal... |
Generate impression based on findings. | There are unchanged posttreatment findings without evidence of recurrent mass or significant cervical lymphadenopathy. There are unchanged reference left level Ia and Ib lymph nodes measuring 6 mm, and 4 mm respectively. The left submandibular gland is absent. The thyroid and the remaining major salivary glands are un... | 1.No locoregional tumor recurrence or pathologic cervical enlargement.2.Significant narrowing of the right internal carotid artery with calcified and noncalcified plaque, similar to prior study.3.Left upper pleural nodularity, incompletely evaluated. Please refer to dedicated accompanying CT chest report for further de... |
Generate impression based on findings. | Male 70 years old; Reason: hematuria, evidence of renal disease? tumor? History: hematuria. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Two small hypointense nonenhancing lesions in the liver consistent with cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormal... | 1.No findings to explain hematuria.2.Postsurgical changes.3.Right adrenal nodule consistent with adenoma.4.Solitary, small, nonspecific sclerotic focus L1 vertebral body. |
Generate impression based on findings. | Female 46 years old Reason: 46-year-old female with rectal pain and drainage with sensation of an abscess forming. Rule out rectal abscess History: anal pain, drainage and recurrent abscess formation ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No sig... | Decrease in size of perianal collection in tract right greater than left. No evidence of abscess.Expected postsurgical changes. |
Generate impression based on findings. | There has been a mixed response to interval therapy with new lesions, as well as both increased size and decreased size of previous lesions in the neck. There has been interval increased size of a now 28 x 24 mm mass on series 7 image 34 (previously measuring 17 x 11 mm) in the left level 2 chain with mass effect medi... | 1. Mixed response to interval therapy with new pathologic appearing lymph nodes, as well as interval increased and decreased size of previous pathologic lymph nodes in the neck as described above.2. Postoperative changes involving the right maxillary sinus, without definite recurrent mass. |
Generate impression based on findings. | Male 60 years old; Reason: 60M s/p open ureteral reimplant now with concern for evisceration History: evisceration Exam is not sensitive for detecting lesions in the solid organs of vasculature due to the lack of IV contrast and in the GI tract into the lack of oral contrast. Given nodes limitation the following observ... | 1.Small nonobstructive incisional hernia. Expected postsurgical changes.2.Air space disease right middle lobe and both lower lobes. Rule out pneumonia. 3.Fluid collection left pelvic sidewall as described above. |
Generate impression based on findings. | 41 years, Male. Reason: ? ileus History: Distension, no flatus or BM POD#6 Generalized ileus. No obvious intramural air or free air. Vertical and transverse staple lines. Suture lines right lower quadrant.No visible stool. | Mild generalized ileus. |
Generate impression based on findings. | 72 years, Female. Reason: Dobbhoff placement History: same Dobbhoff tube as been advanced. The tip is overlies the pyloric area.Remainder of the visualized structures are unchanged. | Dobbhoff tube advanced with tip now overlying the pyloric area. |
Generate impression based on findings. | 64 years, Male. Reason: 64 yo m with abdominal distension, eval for ileus History: as above Dialysis catheter overlies pelvis. Right-sided iliac catheter tip in the distribution of right common iliac vasculature.Multiple dilated loops of small bowel without a discrete transition zone most consistent with a generalized ... | Generalized ileus. |
Generate impression based on findings. | 46-year-old female with right hip pain, evaluate for FAI MEASUREMENTS: CAM location : Right femoral head-neck junction.Alpha angle : Approximately 69 degreesCoronal center-edge angle : 20 degreesSagittal center-edge angle : 58 degreesFemoral neck-shaft angle : 136 degreesAcetabular version (1 o’clock) : 19 degreesAceta... | 1. Findings consistent with again CAM deformity and femoral acetabular impingement including subchondral cysts and prominence of the femoral head-neck junction.2. Measurements provided above. |
Generate impression based on findings. | 26 year-old female with right hip pain, assess for FAI MEASUREMENTS: CAM location : Minimal CAM deformity at the femoral head neck junction. Alpha angle : 61 degreesCoronal center-edge angle : 39 degreesSagittal center-edge angle : 69 degreesFemoral neck-shaft angle : 130 degreesAcetabular version (1 o’clock) : 3 degre... | Minimal CAM deformity with acetabular and femoral version measurements, as described above. |
Generate impression based on findings. | left thalamic and basal ganglia ICH follow up. Left basal ganglia and thalamic ICH with mass effects and IVH, no change since prior study.Midline shift to the right side was measured about 9mm and the maximum size of the ICH is about 46mm x 59mm. No significant interval change of minimal acute SAH on the right hemisphe... | No change of IVH, left basal ganglia and thalamic ICH with mass effects with midline shift toward right side since prior scan.No change of right hemispheric SAH since prior scan. |
Generate impression based on findings. | 44-year-old male with history of thymic cancer with new right upper quadrant and right lower quadrant abdominal pain, jaundice, and left lung mass on admission chest radiograph. Evaluate for liver and lung metastatic disease. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules and masses, significantly greater... | 1.Findings consistent with diffuse hepatic metastatic disease without biliary obstruction.2.Findings consistent with pulmonary metastatic disease.3.Soft tissue attenuation in the anterior mediastinum highly suspicious for disease recurrence.4.Hypoattenuating focus in left kidney. Differential considerations include hig... |
Generate impression based on findings. | Reason: Eval for position of chest tube and pneumothorax History: s/p MVA with persistent pneumothorax LUNGS AND PLEURA: Moderate to large left pneumothorax. Left chest tube appears to perforate the left upper lobe with tip in the medial apex. Small amount of loculated left pleural fluid.10 x 11 mm right upper lobe pul... | 1.Moderate to large left pneumothorax. Left chest tube appears to perforate the left upper lobe with tip in the apex. 2.Small loculated left pleural effusion.3.A few right upper lobe pulmonary nodules. The largest 11 mm nodule is partially calcified consistent with a granuloma. |
Generate impression based on findings. | 57-year-old male with prostate cancer, known brain metastases; presenting with worsening headache and vomiting. Hypodensity in the right temporal lobe, consistent with known metastatic lesion and surrounding edema, which appears to have mildly increased in size, now measuring 34 x 35 mm, previously 28 x 31 mm. Mild int... | Redemonstration of right temporal lobe hypoattenuating metastatic lesion, with mild interval increase in the degree of associated edema, which may be in part related to posttreatment effect. There is mild regional mass-effect, but no significant midline shift, evidence of herniation, hydrocephalus, or acute hemorrhage. |
Generate impression based on findings. | Chest pain.VIEWS: Chest PA/lateral (two views) 2/2/15 at 049 hours. Cardiac silhouette size is normal. No focal lung opacities, effusions or pneumothorax. Visualized osseous structures are normal. | Normal examination. |
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