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Generate impression based on findings.
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Left foot laceration.VIEWS: Left foot AP, lateral and oblique 2/2/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. No radiopaque foreign bodies.
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Normal examination.
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Generate impression based on findings.
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altered mental status No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of encephalomalacia on the right MCA territory likely represent chronic ischemic infarction with ex vacuo changes of the right lateral ventricle.There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of right MCA territorial encephlalomalacia since prior exam.
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Generate impression based on findings.
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Feeding intoleranceVIEW: Abdomen AP (one view) 2/2/15 at 544 hours NG tube tip is in the stomach. Mild, nonspecific bowel distention. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. No ascites.
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Mild, nonspecific bowel distention.
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Generate impression based on findings.
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Female 21 years old Reason: PE History: hypoxia, tachycardia The study is suboptimal secondary to motion artifact.PULMONARY ARTERIES: No evidence of pulmonary embolism. The pulmonary artery is normal in caliber without evidence of strain.LUNGS AND PLEURA: Extensive bilateral mixed airspace and interstitial opacities with intralobular septal thickening and ground glass appearance. These findings are concerning for ARDS and edema. There may also be a component of the hemorrhage related to patient's SLE.Moderate bilateral pleural effusions, right greater than left.MEDIASTINUM AND HILA: Right PICC with tip in the SVC.Normal heart size with moderate pericardial effusion. No visualized coronary artery calcifications in this non-gated study.CHEST WALL: Bilateral axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of pulmonary embolism.Extensive opacities concerning for ARDS with edema. In a patient with history of SLE, a component of alveolar hemorrhage may be considered.Moderate pericardial effusion.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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Possible newborn sepsis. Esophageal temperature probe placement.VIEW: Chest and abdomen AP (two views) 2/1/15 at 1159 hrs. NG tube terminates at the stomach. UVC tip is at the right atrium. Esophageal temperature probe terminates slightly above GE junction. Cardiac silhouette size is normal. No focal lung opacities, effusions or pneumothorax.Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas.
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Interval retraction of esophageal temperature probe as described.Disorganized, nonspecific abdominal gas pattern.
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Generate impression based on findings.
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72 years, Female. Reason: balloon pump distal tip History: balloon pump repositioned. Dobbhoff tip projects over the pyloric region and is unchanged. Remaining support devices unchanged. Nonobstructive bowel gas pattern.
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Dobbhoff tip projects over pyloric region, unchanged.
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Generate impression based on findings.
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Cooling protocol. Evaluate esophageal temperature probe. Two day old twin 37 week gestation.VIEW: Chest crosstable lateral (one view) 02/01/15, 1327 Temperature probe tip is in lower esophagus. Feeding tube tip is in stomach and side-port is at GE junction. Umbilical venous line tip is in right atrium. Umbilical arterial line has its tip at T5/6. Endotracheal tube tip is below thoracic inlet.Lung volumes are large. No focal opacity is seen. Cardiac silhouette size is normal.
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Temperature probe tip in lower esophagus.
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Generate impression based on findings.
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There is soft tissue swelling and fat stranding within the left preseptal soft tissues as well as extension into the inferomedial post-septal extraconal fat. There is apparent dehiscence of the left medial orbital wall and there is near complete opacification the maxillary, ethmoid, and sphenoid sinuses. There is fluid within the right mastoid air cells and middle ear cavity. There are bilateral tonsilloliths, bilateral cervical lymphadenopathy and tonsillar enlargement. There is a retropharyngeal course of both internal carotid arteries.
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1.Paranasal sinusitis with dehiscence of the left medial orbital wall, adjacent subperiosteal phlegmon or developing abscess, and left orbital pre-septal and post-septal extraconal cellulitis.2.Probable right sided otomastoiditis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views (total of 6 images) of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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68 years, Female. Reason: abdominal distention Nonobstructive bowel gas pattern. Average stool burden. Right hip prosthesis and right sided surgical staples noted.
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Nonobstructive bowel gas pattern. Average stool burden.
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Generate impression based on findings.
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65-year-old male with elevated intracranial pressure Numerous supratentorial and infratentorial foci of restricted diffusion identified on the recent MRI are becoming more conspicuous as foci of hypodensity.No intracranial hemorrhage is identified. No intracranial mass, mass-effect or midline shift is present. The ventricles and sulci are within normal limits for age and unchanged in appearance. No extra-axial collections are identified. There is mucosal thickening of the bilateral ethmoid air cells, frontal, sphenoid and maxillary sinuses. The left mastoid air cells are underpneumatized and partially fluid-filled. An NG tube is noted. A superficial soft tissue nodule just under the skin and lateral to the right zygomatic arch, measures 8 x 13 mm, stable in appearance..
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1.Numerous supratentorial and infratentorial foci of restricted diffusion identified on the recent MRI are becoming more conspicuous as foci of hypodensity.2.No interval intracranial hemorrhage.
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Generate impression based on findings.
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Reason: PE History: chest pain, tachycardia PULMONARY ARTERIES: Technically adequate to the segmental level. No acute pulmonary embolus. The main pulmonary in caliber. Reflux of contrast into the intrahepatic IVC and hepatic veins suggestive of right heart strain.LUNGS AND PLEURA: Evaluation of fine parenchymal detail is limited by motion artifact. Interstitial edema. Small bilateral pleural effusions.MEDIASTINUM AND HILA: Prominent paratracheal and right hilar lymph nodes, likely reactive. Heart size is enlarged with left atrial and ventricular enlargement. No pericardial effusion. No visible coronary calcifications.CHEST WALL: Mild degenerative in the visualized lower thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.No acute pulmonary embolus.2.Findings compatible with right heart failure including interstitial edema, small pleural effusions, left atrial and ventricular enlargement, and reflux of contrast into the intrahepatic IVC/hepatic veins. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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Female 11 years old .History: Spastic quadriplegia. Respiratory distress.VIEW: Chest AP (one view) 2/2/15 at 449 hours. Multiple skeletal deformities and ET tube are again noted. Cardiac silhouette is non-sizable. Persistent chronic atelectasis of both lung bases and small lung volumes.
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No change in lung aeration.
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Generate impression based on findings.
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21-year-old female status-post ORIF of mandible after fight and fracture There are plate and screw devices at affixing minimally displaced fractures of the left mandibular body and right mandibular ramus. There is asymmetric enlargement of the right masseter muscle with foci of gas and a more focal low attenuation collection measuring approximately 1.7 x 1.6 cm adjacent to the right ramus fracture extending inferiorly into the neck. There is soft tissue stranding throughout the masticator space involving multiple fascial planes and the the anterior junction of the sternocleidomastoid muscle. There is minimal fat stranding surrounding the carotid arteries, which are patent. The adjacent right parotid gland is uninvolved. There are enlarged jugular chain and submental nodes which are likely reactive.The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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1.Soft tissue stranding within the right masticator space with more focal low attenuation may represent postsurgical edema, however a developing phlegmon/abscess may also be considered2.Orthopedic fixation of right mandibular ramus and left mandibular body fractures.3.Cervical lymphadenopathy is likely reactive.
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Generate impression based on findings.
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27-year-old female with lower abdominal pain. Evaluate for intra-abdominal source of pain. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion or biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of small bowel obstruction or colitis. Appendix is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is a 5.6 x 5.0 cm hypoattenuating lesion as best appreciated on sagittal series, image 59 which is most likely uterine in etiology with the hypoattenuating component measuring approximately 30 Hounsfield units.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of small bowel obstruction or colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Hypoattenuating lesion as above, likely uterine in etiology and most likely degenerative fibroid. CT cannot accurately characterize uterine lesions and if there is clinical concern for better characterization, further evaluation with pelvic sonography may be considered.
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Generate impression based on findings.
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Stem cell transplant. Kidney neoplasm and Fanconi disease. Hypoxemia.VIEW: Chest AP (one view) 02/02/15, 0414 Endotracheal tube tip is above carina. Right upper extremity PICC tip is in superior vena cava. Left central line tip is at junction of superior vena cava and right atrium.A pulmonary edema pattern is present. Small bilateral pleural effusion is noted. Cardiac silhouette size is upper limits of normal to mildly enlarged.
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Worsening pulmonary edema pattern.
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Generate impression based on findings.
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80 years, Female. Reason: abdominal distention Nonobstructive bowel gas pattern with paucity of small bowel gas. Surgical staples and arterial calcifications again noted. Enteric tube has been removed.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Ms. Kauffman is a 69 year old female with a personal history of left breast lumpectomy in March 2013 for DCIS followed by tamoxifen therapy. Personal history of two benign left breast biopsies. She has no current breast related complaints. Three standard views of both breasts with two left spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Linear markers were placed on scars overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the left lumpectomy site. A percutaneously placed clip is also present in the left central breast, at site of prior benign breast biopsy. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. Benign lymph nodes are projected over both axillae.
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Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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69-year-old male with history of fall. The bones are demineralized.Right femur: Moderate osteoarthritis affects the hip. There is no acute fracture. Right tibia/fibula: Moderate osteoarthritis affects the knee. We see no acute fracture.
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Degenerative changes without acute fracture.
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Generate impression based on findings.
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24 year-old female status post fall landed on left knee. Four views of the left knee show no fracture, malalignment, or other specific finding to account for the patient's pain.
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No fracture or other specific finding to account for the patient's pain.
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Generate impression based on findings.
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87-year-old male with altered mental status, evaluate for intracranial hemorrhage/ischemia. 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 moderate age-related volume loss. No extra-axial collections are identified. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which appear to be more confluent in the left corona radiata and centrum semiovale, nonspecific, but favored to represent age-indeterminant small vessel ischemic changes. More focal hypoattenuation in the left basal ganglia represents age-indeterminate, but likely chronic, lacunar infarct. There is prominent atherosclerotic calcification of the distal vertebral and internal carotid arteries, left greater than right.There are air/fluid levels in the bilateral maxillary sinuses, concerning for acute sinusitis. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable.
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1. 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.2. Acute bilateral maxillary sinusitis. 3. Periventricular and subcortical white matter hypoattenuation is nonspecific, but likely reflects age-indeterminate small vessel ischemic disease.
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Generate impression based on findings.
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Reason: Evaluate pulmonary fibrosis History: hypoxia LUNGS AND PLEURA: Low lung volumes with peripheral and basilar predominant reticulation and traction bronchiectasis and bronchiolectasis. Mild basilar honeycombing. No pleural effusions.MEDIASTINUM AND HILA: Small nonenlarged mediastinal lymph nodes. No significant mediastinal or hilar lymphadenopathy. Heart size is normal with no pericardial effusion. No visible coronary artery calcifications. Aortic annular and aortic arch calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hepatic and splenic calcifications compatible with prior granulomatous disease.
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Pulmonary fibrosis in a pattern consistent with UIP.
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Generate impression based on findings.
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3-year-old male with shortness of breathVIEWS: Chest AP/lateral (two views) 02/01/15 Cardiothymic silhouette is normal. Large lung volumes. No pleural effusion or pneumothorax. Mild peribronchial cuffing suggestive of bronchiolitis/reactive airway disease pattern. No focal pulmonary opacities.
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Bronchiolitis/reactive airway disease pattern.
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Generate impression based on findings.
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Two old male for evaluation of line placementVIEW: Chest/Abdomen AP (two view) 02/01/15 UVC catheter tip is at the superior cavoatrial junction.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Disorganized bowel gas pattern.
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UVC catheter tip is at the superior cavoatrial junction.
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Generate impression based on findings.
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Reason: 75F with h/o LCIS s/p lumpectomy, p/w abdominal pain/N/V, EGD with biopsy showing new gastric carcinoma, need chest imaging for malignancy staging History: 75F with h/o LCIS s/p lumpectomy, p/w abdominal pain/N/V, EGD with biopsy showing new gastric carcinoma, need chest imaging for malignancy staging LUNGS AND PLEURA: Emphysema. Scarring and atelectasis in the lingula. Scattered punctate micronodules are present and are presumably post inflammatory. No evidence of pulmonary metastases.MEDIASTINUM AND HILA: Moderate coronary calcification.CHEST WALL: Shoulder fractures on the left.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Small left renal cyst. Antral gastric thickening consistent with known carcinoma is only partially visualized. Please see recent abdomen pelvis CT report for further details. Punctate hypodensities in the spleen are too small to characterize but stable to most recent abdomen pelvis CT. Lumbar hernia incompletely visualized. Multiple upper abdominal calcifications and small nodes incompletely visualized; please see abdomen and pelvis CT report for further details.
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No evidence of pulmonary metastases.
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Generate impression based on findings.
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3 year old male with edema in the right lower face. This exam is markedly degraded by motion artifact. There is apparent fat stranding within the submental and submandibular soft tissues, right greater than left as well as within the right parapharyngeal space. There is low attenuation within the left palatine tonsil most compatible with lymphoid hyperplasia. There is marked bilateral cervical lymphadenopathy, right greater left with lymph nodes measuring up to 26 mm. There is paranasal sinus mucosal thickening. The major cervical vessels are patent. The osseous structures are grossly unremarkable although the lower cervical spine is not well assessed on this motion degraded exam. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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1.Markedly motion degraded exam. 2.Paranasal sinusitis, right neck superficial and deep space cellulitis without evidence of abscess, and bilateral cervical lymphadenopathy that is likely reactive.
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Generate impression based on findings.
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left 3rd nerve palsy There is expansile mass (25.3mmx26mm) on the suprasellar cistern with enlargement of sellar turcica. Differential diagnosis include pituitary tumor such as macroadenoma, meningioma, metastasis and craniopharyngioma.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The paranasal sinuses and mastoid air cells are clear.
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Suprasellar mass lesion as described above.No evidence of acute ischemic or hemorrhagic lesion on this scan.
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Generate impression based on findings.
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41-year-old male with pain to palpation. Four views of the left knee show swelling along the anterior soft tissues including the proximal patellar tendon. Alignment is anatomic and we see no patella alta, however a partial thickness tear of the patellar tendon cannot be excluded. There are tiny osteophytes indicating minimal osteoarthritis. There is no fracture or joint effusion.
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Anterior soft tissue swelling including the proximal patellar tendon, for which a partial thickness tear of the proximal patellar tendon cannot be excluded. If further imaging evaluation is clinically warranted, MRI may be considered.
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Generate impression based on findings.
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51-year-old male with fall, pain. A single frontal view of the right wrist with ulnar deviation is provided. There is soft tissue swelling along the radial aspect of the wrist. The distal radius fracture and suspected scaphoid fracture are not as evident as on the prior study. Again seen is an elongated sclerotic lesion along the distal radial metaphysis measuring just over 3 cm in length, which we suspect to be benign in etiology possibly representing fibrous dysplasia or chronic osteonecrosis.
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Soft tissue swelling with the distal radius fracture and suspected scaphoid fracture not as evident as on the prior study. If further imaging is clinically warranted, CT is recommended.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt, diagnosed at the age of 55. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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51-year-old male with fall, pain. Three views of the right wrist are provided. On the PA view there is a step-off along the articular surface of the distal radius suspicious for a nondisplaced fracture. An elongated sclerotic lesion along the distal radial metaphysis measures just over 3 cm in length, which we suspect is benign in etiology representing possibly fibrous dysplasia or chronic osteonecrosis. There is also focal cortical irregularity and underlying lucency in the waist of the scaphoid, and we cannot exclude a nondisplaced fracture. There is lateral soft tissue swelling.
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1.Nondisplaced fracture along the articular surface of the distal radius.2.Equivocal fracture of the waist of the scaphoid.
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Generate impression based on findings.
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11-year-old male with hand injury status post fallVIEWS: Left hand AP/oblique/lateral (3 views) 02/01/15 No acute fracture or malalignment is evident.
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Normal examination.
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Generate impression based on findings.
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Female 15 years old Reason: PICC placement - tip location? History: PICC placement, acute flaccid paralysisVIEW: Chest AP (one view) 2/2/15 at 746 hours. Spinal rods and residual thoracic dextroscoliosis unchanged. Right upper extremity PICC terminates at the right atrium. A catheter overlies the right hemithorax and may represent either chest tube, soft tissue drain or the epidural catheter.Cardiac silhouette size is normal. Bibasilar opacities likely atelectases on the bicoronal diffuse lung edema.
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Portable postsurgical changes as described.Bibasilar opacities on a background of diffuse lung edema.
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Generate impression based on findings.
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52 year old female with intracranial hemorrhage Redemonstrated is a large hematoma centered in the right thalamus, decreased in size, with a maximal transverse dimension measuring 48 mm (previously 51 mm). Additionally, there has been some clearance of intraventricular hemorrhage, especially notable in the fourth ventricle. The lateral ventricles are smaller, the third ventricle remains effaced, and the fourth ventricle is unchanged (normal in size). Mass-effect remains with midline shift to the left measuring 13 mm (unchanged) and there is persistent sulcal effacement. There is periventricular hypodensity present which is stable compared to previous exam. A ventriculostomy tube courses through the left frontal lobe into the left lateral ventricle with tip in the body of the left lateral ventricle, unchanged in position.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.
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1.A large hematoma centered in the right thalamus has decreased in size with a maximal transverse dimension measuring 48 mm (previously 51 mm). 2.There has been some clearance of intraventricular hemorrhage, especially notable in the fourth ventricle. 3.The lateral ventricles are smaller, the third ventricle remains effaced, and the fourth ventricle is unchanged (normal in size).4.Mass-effect remains with midline shift to the left measuring 13 mm (unchanged).
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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3-year-old male status post reduction of forearm fractureVIEWS: Right forearm AP/lateral (two views) 02/02/15 , 0000 and 47 seconds Overlying cast material obscures fine bone detail. Interval reduction of transverse fracture through the mid ulnar diaphysis and greenstick fracture through the mid radial diaphysis now in near anatomic alignment.
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Reduction of both bones fracture now in near anatomic alignment.
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Generate impression based on findings.
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3-year-old male with right arm deformity status post fallVIEWS: Right forearm AP/lateral, right elbow AP/lateral, right wrist PA/lateral (6 views) 02/01/15, 2050 hrs Transverse fracture through the mid diaphysis of the ulna and greenstick fracture through the mid diaphysis of the radius with slight dorsal angulation is seen.No radiocapitellar dislocation is seen. No elbow joint effusion. The wrist is within normal limits without evidence of fracture or dislocation.
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Transverse fracture through the mid diaphysis of the ulna and greenstick fracture through the mid diaphysis of the radius with slight dorsal angulation.
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Generate impression based on findings.
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left 3rd nerve palsy NONCONTRAST CT HEADRedemonstration of the suprasellar mass lesion, no change since prior scan.No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins appear to be normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through anterior circulation, posterior circulation and distal intracranial vasculature. Acom artery and bilateral Pcom arteries are seen without evidence of aneurysm. No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage.
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1. Suprasellar mass lesion as described above.2. No evidence of intracranial aneurysm. No intracranial and extracranial arterial luminal stenosis or occlusion.
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Generate impression based on findings.
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Reason: prior to bronchoscopy 2/2/15: concern for possible obstruction of Right main stem bronchus due to mass? pna? mucous? 57FNSCLC s/p endobronchial stent of R main stem bronchus 12/14. Now with hypoxia History: hypoxia; increased O2 demands LUNGS AND PLEURA: Right bronchial stent in expected location. Soft tissue density within right main bronchial lumen, extending into the stent lumen may represent neoplastic invasion or aspirated debris and is slightly increased. Slightly increased endobronchial plugging in subsegmental bronchi in the right lower lobe with associated centrilobular nodularity/bronchiolitis.Apical predominant paraseptal emphysema, with multiple apical bullae and peripheral scarring.Reference right lower lobe mass is largely obscured by radiation reaction but grossly stable. Consolidation/atelectasis, traction bronchiectasis, and surrounding ground glass opacities in the superior right lower lobe is compatible with radiation reaction.MEDIASTINUM AND HILA: Left chest port terminates at the cavoatrial junction.The heart size is within normal limits, no significant pericardial effusion. Mild coronary artery calcifications.Reference left paratracheal lymph node is no longer measurable.Enlarged subcarinal and right hilar nodes are not well demarcated the absence of IV contrast.Partially calcified mediastinal lymph nodes may represent previous adenomatous disease versus treated metastases.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. Moderate hiatal hernia.
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Soft tissue density within right main bronchial lumen, extending into the stent lumen may represent neoplastic invasion or aspirated debris and is slightly increased. Slightly increased endobronchial plugging in subsegmental bronchi in the right lower lobe with associated centrilobular nodularity/bronchiolitis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt and two maternal cousins. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign-appearing calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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37 female with history of liver transplant, nonresponsive; evaluate for CVA. 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. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes.The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign right breast biopsy with keloid formation. Two standard digital views, additional left MLO view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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History of left mastectomy for IDC in 2012. Patient taking tamoxifen. No new breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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15-month-old male with cough and feverVIEWS: Chest AP/lateral (two views) 02/01/15, 2118 hrs Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Moderate peribronchial cuffing and large lung volumes suggestive of bronchiolitis/reactive airway disease. No focal pulmonary opacities.
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Bronchiolitis/reactive airway disease pattern.
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Generate impression based on findings.
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35-year-old male with new onset seizures. 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. Punctate hyperattenuation in the bilateral basal ganglia, left greater than right, likely represents senescent mineralization.The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally. Benign lymph nodes project over the axilla.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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65-year-old male with history of known cerebellar hemorrhage, now experiencing altered mental status. Redemonstrated is linear hyperattenuation in the high right frontal gyri and parafalcine left parieto-occipital lobe, which may represent calcification and laminar necrosis from prior ischemia. There is also unchanged hypoattenuation in the right cerebellar hemisphere with patchy central high attenuation material. There is encephalomalacia centered in the right inferior parietal lobule extending to the adjacent right temporal lobe, right occipital lobe and right parietal lobe. There is associated ex vacuo effect and widening of adjacent sulci. There is extensive atherosclerotic calcification in the distal vertebral arteries and carotid siphons. Fluid is present in the paranasal sinuses and nasopharynx, likely related to intubation. Fluid is also present in the left mastoid air cells.
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1.Unchanged hypoattenuation in the right cerebral hemisphere with hyperattenuating material is suggestive of a recent infarction with superimposed hemorrhage or calcification.2.Large chronic right middle cerebral artery infarct and scattered gyriform calcifications in the bilateral cerebral hemisphere in watershed areas likely represent calcification laminar necrosis from prior ischemia.3.No interval acute intracranial hemorrhage.
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Generate impression based on findings.
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Reason: ILD PROTOCOL: evaluate for pulmonary fibrosis. 67F stage IV follicular lymphoma; evaluate ground glass opacities and presumed pulmonary fibrosis History: ground glass opacities LUNGS AND PLEURA: Patchy faint basilar predominant groundglass opacity with no evidence of significant traction bronchiectasis, pleural effusion, or nodularity. Scattered thin-walled cysts are seen. No significant air trapping on expiratory phase imaging.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Small right thyroid hypodense nodule.CHEST WALL: Nonspecific heterogeneous sclerosis involving the manubrium, while this may be posttraumatic metastatic disease cannot be excluded. Scattered areas of nonspecific calcification involving the breasts.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hiatal hernia. Extensive retroperitoneal soft tissue thickening encasing the aorta, incompletely visualized. This is presumably related to the known lymphoma.
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1. Faint basilar predominant groundglass opacity but no evidence of significant traction bronchiectasis, pleural effusion, or nodularity. This could be seen more acutely with aspirate or infection, or more chronically with interstitial disease such as NSIP or, given the presence of a few thin-walled cysts, LIP (which is associated with lymphoma and lymphoproliferative or autoimmune disorders).2. Extensive retroperitoneal soft tissue thickening encasing the aorta, incompletely visualized. This is presumably related to the known lymphoma. Nonspecific heterogeneous sclerosis involving the manubrium, while this may be posttraumatic metastatic disease cannot be excluded.
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Generate impression based on findings.
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66-year-old male with history of pain. Right ankle: There is moderate soft tissue swelling about the ankle. Round ossicles adjacent to the medial and lateral malleoli suggest chronic trauma. Arterial calcifications are present within the soft tissues. Moderate degenerative disease affects the midfoot.Right knee: There is no acute fracture or malalignment. There are enthesopathic changes along the anterior patella. There is no joint effusion. Mild to moderate osteoarthritis affects the knee.
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Soft tissue swelling about the ankle without evidence of acute fracture. Round ossicles adjacent to the malleoli likely represent chronic trauma however if clinical concern for acute fracture persists, follow up radiographs may be obtained in 10 to 14 days.
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Generate impression based on findings.
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80 years, Female. Reason: check OG placement Enteric tube tip in antropyloric region. Nonobstructive bowel gas pattern. Cardiomegaly and possible bilateral pleural effusions; please see same day chest radiograph report for further details.
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Enteric tube tip in antropyloric region.
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Generate impression based on findings.
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No acute intracranial hemorrhage. Postsurgical changes of left sided craniotomy is is unchanged. There are multiple bullet fragments or primarily in left parietal and occipital lobes with extensive streak artifact which appear similar to the prior exam. There is encephalomalacia in the left frontal, parietal and temporal lobes which are unchanged. Focal hypoattenuation within the left basal ganglia likely represents lacunar infarcts and is unchanged. There is ex vacuo dilatation of the left ventricle. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
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1.No acute intracranial hemorrhage.2.Stable postsurgical changes, bullet fragments and encephalomalacia.
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Generate impression based on findings.
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60 year-old male with history of left shoulder pain. There is no acute fracture or malalignment. The acromiohumeral distance is slightly narrowed suggesting a chronic rotator cuff injury. Moderate to severe degenerative disease affects the glenohumeral joint.
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Degenerative changes at the shoulder without acute fracture.
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Generate impression based on findings.
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11-year-old male with history of pain. There is no acute fracture or malalignment. There is swelling and irregularity about the soft tissues along the dorsomedial aspect of the foot.
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Soft tissue swelling without acute fracture.
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Generate impression based on findings.
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27-year-old female with point tenderness to palpation. Three views of the right ankle show no fracture or other findings to account for the patient's point tenderness. There is minimal soft tissue swelling along the lateral aspect of the ankle.
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Minimal soft tissue swelling without fracture.
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Generate impression based on findings.
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52 year old female with history of pain. We see no acute fracture or subluxation. Alignment is anatomic. Mild degenerative disc disease affects the mid thoracic spine. Intervertebral disc spaces and vertebral body heights are maintained.
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Mild degenerative disease without acute abnormality.
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Generate impression based on findings.
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Reason: 66 y/o hx of large cell carcinoma with malignant effusions, CT to eval placement of R pleurex catheter History: SOB LUNGS AND PLEURA: Large right pleural effusion with pleurx catheter in the pleural space posteriorly at the base. One sidehole is within the soft tissues. Complete consolidation of the right lung with complete obstruction of the right mainstem bronchus with either debris or tumor. There is presumably a large central tumor amidst the consolidated lung but it is poorly evaluated without IV contrast.MEDIASTINUM AND HILA: Port tip in SVC.CHEST WALL: Right chest wall port. Degenerative change involving the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Large right pleural effusion with pleurx catheter in the pleural space posteriorly at the base. One sidehole is within the soft tissues. Complete consolidation of the right lung with complete obstruction of the right mainstem bronchus with either debris or tumor.
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Generate impression based on findings.
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53-year-old female with history of fall. There are two orthopedic screws across the first MTP joint. Lucencies surrounding the phalangeal portions of the screws raise the question of hardware loosening. There has been surgical resection of the trapezium. There are surgical clips within the soft tissues along the radial aspect of the wrist.
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Postsurgical changes with findings concerning for hardware loosening.
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Generate impression based on findings.
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60 year-old female with pain, fall. Three views of the right knee are provided. The bones appear demineralized. There is no fracture or malalignment. There is no joint effusion.
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No fracture or other findings to account for the patient's pain.
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Generate impression based on findings.
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21-year-old female with pain of the right fifth digit after slamming it in a door. Three views of the right fifth toe show an obliquely oriented fracture of the proximal phalanx which appears comminuted and extends to the distal articular surface. There is mild lateral displacement and angulation of the distal fracture fragment.
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Fifth toe fracture as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign left cyst aspiration. Family history of breast cancer in maternal great aunt, diagnosed at ages 65. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable focal asymmetry in the left outer breast, posterior depth.
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Stable asymmetry in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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34-year-old female with left knee patellar instability. CT of the left knee was performed without intravenous contrast. There are tiny patellofemoral osteophytes indicating minimal osteoarthritis. There is also mild medial compartment narrowing and sclerosis of the medial tibial plateau, as well as mild subchondral sclerosis within the posterior aspect of the medial femoral condyle.The superior aspect of the femoral trochlea is abnormally shallow with asymmetry of the trochlear facets (lateral greater than medial) indicating trochlear dysplasia. The Insall-Salvati ratio is approximately 1.4, suggesting a mild patella alta deformity. The tibial tuberosity-trochlear groove distance is approximately 13 mm which is within normal limits. There is no joint effusion. The musculature of the knee is within normal limits.
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Findings consistent with femoral trochlear dysplasia and a slight patella alta deformity as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign right breast excisional biopsy. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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49-year-old female with history of total hip arthroplasty. Hardware components of a left total hip arthroplasty device are situated in anatomic alignment without radiographic evidence of hardware complication. The surgical drain has been removed. Severe osteoarthritis affects the right hip. Moderate degenerative disc disease affects the visualized lumbar spine.
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Total hip arthroplasty as above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of bilateral retropectoral saline implants. Two full field and two implant displaced digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Bilateral retropectoral saline implants are unchanged in position and contour. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Male 43 years old Reason: ro PE with possible PE read in previous CT PE History: Same History of persistent tachycardia. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolism. The pulmonary is normal in caliber without evidence of right heart strain.LUNGS AND PLEURA: Scattered micronodules are again seen bilaterally, the largest measuring up to 5 mm in the left upper lobe (series 10, image 23). No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Heart size is normal without pericardial effusion. Hypodense nodules in the left thyroid lobe is not well visualized on this study. No hilar or mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of pulmonary embolism.Scattered micronodules again seen without significant interval change.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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87 years, Female. Reason: DHT replacement Lower pelvis and right lateral abdomen excluded from field of view. Dobbhoff tip in gastric antrum. Nonobstructive bowel gas pattern. Spinal degenerative changes. Left retrocardiac opacification and mediastinal clips; please see same day chest radiography for further details.
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Dobbhoff tip in gastric antrum.
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Generate impression based on findings.
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Reason: 76 year old male with left breast cancer RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the left axilla, representing the sentinel node(s). This region was marked with an indelible marker.
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Sentinel node identified in the left axilla.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views, additional bilateral MLO views, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally. Stable focal asymmetry in the left medial breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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71 years, Female. Reason: rule out obstruction given history and ongoing abdominal pain, no BM Prominent ascending colon without evidence of obstruction. Average stool burden.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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66 years, Male. Reason: evaluate for bowel obstruction History: constipation and vomiting. Nonobstructive bowel gas pattern. No free air on decubitus view. Below average stool burden. Left upper quadrant surgical clips and scattered vascular calcifications noted.
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Below average stool burden. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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ILC and LCIS in the left breast status post left mastectomy 3/2014. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Low lying left axillary lymph node is unchanged.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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46 years, Male. Reason: eval ileus Diffusely dilated small bowel loops without significant rectal or colonic gas is consistent with an obstructive pattern but is most likely secondary to postoperative ileus, not significantly changed. Midline skin staples and spinal hardware unchanged.
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No significant interval change in postoperative ileus.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Focal asymmetry in the right lower inner breast is identified. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast.
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Focal asymmetry in the right breast. Attempts to obtain patient's prior mammograms for comparison purposes are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OC - OLD FILM FOR COMPARISON
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Generate impression based on findings.
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52 years, Female. Reason: abdominal distension, r/o obstruction Above average stool burden, primarily seen in the right colon. Nonobstructive bowel gas pattern. Spinal stabilization hardware.
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Nonobstructive bowel gas pattern. Above average stool burden.
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Generate impression based on findings.
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1-day-old female, 31 week with respiratory distress, evaluate line placement and lung fieldsVIEW: Chest/abdomen AP (two view) 02/01/15 ET tube tip is at the thoracic inlet. Enteric tube tip is in the gastric antrum. UAC tip is at T9 level. UVC tip is in the left atrium.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Diffuse lung haziness.Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or venous gas.
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Diffuse lung haziness may represent RDS.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Left submandibular swelling level 1 lymph node tenderness. There is an apparent nodular area that measures approximately 15 mm in the left submandibular gland with similar attenuation features are the rest of the gland. There are no surrounding inflammatory changes, hyperattenuating calculi, and ductal dilatation. The right submandibular gland and parotid glands appears grossly unremarkable. There is no evidence of significant cervical lymphadenopathy. There are a few punctate foci of hypoattenuation in the thyroid gland. The major cervical vessels are patent. The osseous structures are unremarkable. There is mucosal thickening in the right maxillary sinus. The airways are patent. The imaged intracranial structures are unremarkable. There are bilateral lens implants. The imaged portions of the lungs are clear.
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A nodular area in the left submandibular gland may represent a neoplasm versus sequela of focal sialoadenitis. A dedicated MRI with contrast is recommended for further evaluation, if there are no contraindications.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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There is a lobulated, intradural extramedullary T2 hypointense lesion at the left lateral aspect of the spinal canal at the level of C1, measuring approximately 12 x 8 mm, previously 12 x 8 mm. This demonstrates homogeneous enhancement and effaces a portion of the CSF, but does not cause mass effect on the cervical cord. There is also a 6 x 5 mm round extradural component at the left C1-2 foramen. There is normal cord signal without abnormal enhancement. There is exaggeration of the usual cervical lordosis, which is most likely positional. The vertebral body heights are preserved. There is mild loss of disc height at C5-6 and C6-7 with endplate degenerative changes at C6-7. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. Again noted is a mildly prominent, and heterogenous thyroid gland.C2-C3: No significant disc bulge, spinal canal or foraminal stenosis.C3-C4: No significant disc bulge, spinal canal or foraminal stenosis.C4-C5: No significant disc bulge, spinal canal or foraminal stenosis.C5-C6: Disc osteophyte complex. No significant spinal canal or foraminal stenosis.C6-C7: Disc osteophyte complex. No significant spinal canal or foraminal stenosis. C7-T1: No significant disc bulge, spinal canal or foraminal stenosis.
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Stable bilobed extramedullary intradural lesion adjacent to C1 with an extradural round component in the left C1-2 foramen. MR features suggest meningioma versus nerve sheath tumor.
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Generate impression based on findings.
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26-year-old male with pain, scaphoid fracture. Five views of the right wrist show an orthopedic screw affixing a fracture of the scaphoid waist in near anatomic alignment. We see no hardware complication. The fracture line remains visible. Amorphus density along the radial aspect of the scaphoid may represent bone graft material. Lucency along the distal radius likely represents the bone graft donor site.
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Scaphoid fracture orthopedic fixation as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother (diagnosed at the age of 61) and grandmother (diagnosed at ages 65). Two standard digital views of both breasts with additional bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign-appearing calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister and ovarian cancer in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.In light of her strong family history, consultation at the cancer risk clinic is recommended.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of throat cancer. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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67 yo F with AMS, status post intubation, eval for bleed. 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 collections are identified. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes. Hyperattenuation in the bilateral basal ganglia is compatible with senescent mineralization. There is prominent atherosclerotic calcification of the distal vertebral arteries.There is mild sphenoid sinus mucosal thickening. The mastoid air cells are mildly hypoplastic. The skull and scalp soft tissues are unremarkable. An NG tube is noted.
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No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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69 male with metastatic prostate cancer, evaluation of disease during treatment with investigational therapy. There is a persistent small focus of increased activity along the posterior aspect of L2 vertebral body slightly to the right of midline which is unchanged. This correlates with the sclerotic lesion on comparison CT at the right posterior aspect of the L2 vertebral body and remains suspicious for metastatic disease. Additional faint foci of some suspicion are unchanged. There are no new abnormal osseous foci identified to indicate metastatic disease.
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Stable exam with no new additional osseous metastases are identified.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Multiple benign calcifications are present in both breasts.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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14-year-old male with history of fractureVIEWS: Right wrist AP/lateral (two views) 02/02/15, 0904 Healed torus fracture of the distal radial metaphysis. No cortical buckling is present. No malalignment.
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Healed torus fracture of the distal radial metaphysis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in her mother. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. An area of focal asymmetry in the left upper outer breast is noted. Mildly prominent left axillary lymph nodes are seen, but likely not significantly changed allowing for differences in the axillary visualization between this and prior studies. Several scattered benign calcifications are noted. No suspicious microcalcifications or areas of architectural distortion are present.
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Focal asymmetry in the left upper outer breast for which further evaluation with spot compression and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Abdominal distention. Rule-out obstruction.VIEW: Abdomen AP (one view) 02/02/15, 0430 A gastrostomy tube is present. A plate and screws devices are incompletely visualized in the proximal femurs. The femoral heads appear well directed into acetabula. A spica obscures detail. Left lower lobe airspace disease is noted.Mildly dilated bowel loops are present. Bowel gas pattern is slightly disorganized. A small amount of feces is present in the colon.
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No evidence of bowel obstruction.
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Generate impression based on findings.
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38-year-old male with history of colon cancer. Follow up exam. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Stable triangular soft tissue density in the anterior mediastinum, likely represents residual thymic tissue.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions or biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Nonspecific minimally prominent retroperitoneal lymph nodes are not changed.BOWEL, MESENTERY: Status post colectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Status post colectomy with anastomotic changes in the region of the rectum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Postoperative changes of colectomy without evidence of local disease recurrence or metastatic disease.
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Generate impression based on findings.
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Ms. Avila is a 50 year old female with a personal history of left breast mastectomy in 2009 for IDC. Family history of breast cancer in sister. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the right breast. Scattered benign calcifications, including arterial calcifications, are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Intubated. Respiratory distress. Pancytopenia.VIEW: Chest AP (one view) 02/02/15, 0428 Endotracheal tube tip is between thoracic inlet and carina. Right upper extremity PICC tip is at junction of superior vena cava and right atrium. A gastrostomy tube is present. A spica cast is visualized.Focal opacity in medial left lower lobe containing air bronchograms is noted. Mild peribronchial thickening is present bilaterally. Cardiac silhouette size is normal.
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Persistent left lower lobe opacity which may be atelectasis or pneumonia.
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Generate impression based on findings.
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Reason: restaging scans s/pCRT, compare to previous, provide measurments History: as above CHEST:LUNGS AND PLEURA: Stable focal nodular ground glass opacity in the peripheral right upper lobe (image 39 series 5). Mild emphysema with scarring in both bases. No evidence of metastatic disease.MEDIASTINUM AND HILA: AP window node is stable at 10 mm (image 39/164). Small hiatal hernia. Coronary calcification.CHEST WALL: T7 compression deformity unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule unchanged.KIDNEYS, URETERS: Stable presumed renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral areas of focal asymmetry, bilateral benign calcifications and benign morphology right breast masses are stable.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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There is significant motion degradation. There are no areas of abnormal signal. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Coronal images of the temporal lobes demonstrate the temporal horns, hippocampal formations and parahippocampal gyri to be normal in size and symmetric bilaterally without signal abnormalities or masses identified within the medial temporal lobes on either side. There is no evidence of mesial temporal sclerosis and there are no foci of heterotopic gray matter.
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No areas of abnormal signal or structural lesions are identified.
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Generate impression based on findings.
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63-year-old male with acute ischemia Redemonstrated are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter. Recent brain MRI demonstrated multiple small foci of acute ischemia in the bifrontal white matter and corpus callosum body, which are not well appreciated with the current CT technique. There is no evidence of intracranial hemorrhage or mass. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1.Redemonstrated are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter. Recent brain MRI demonstrated multiple small foci of acute ischemia in the bifrontal white matter and corpus callosum body, which are not well appreciated with the current CT technique.2.No interval hemorrhage.
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Generate impression based on findings.
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Status post fracture.VIEWS: Left AP third digit AP and lateral 2/2/15 (two views) Cast material obscures fine bone details. Assessment of anatomic alignment or changes of healing fractures are not possible.
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No visible third digit due to overlying cast.
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Generate impression based on findings.
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Pain. Evaluate left wrist/forearm. Three views of left wrist again show an orthopedic screw affixing a fracture of the radial styloid in near-anatomic alignment. The fracture line is indistinct suggesting some healing, appearing similar to the prior study. Two orthopedic pins also affix the scapholunate and scaphocapitate articulations in near-anatomic alignment. A fracture through the base of the fifth metacarpal is slightly less distinct on the current study than on prior studies, suggesting some interval healing. There may also be a small fracture fragment along the radial aspect of the base of the fourth metacarpal. There is mild diffuse soft tissue swelling. Mild osteoarthritis affects the first carpometacarpal joint.Two views of the forearm reveal the aforementioned postoperative and posttraumatic changes of the wrist. The proximal radius and ulna appear normal, and alignment of the elbow joint is within normal limits. The coronoid process fracture seen on prior studies is not well seen on the current study. There is mild soft tissue swelling along the dorsal aspect of the elbow.
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Postoperative changes of distal radius fracture fixation other findings as above.
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