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Generate impression based on findings.
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Distal radius fracture.VIEWS: Left wrist PA/lateral/oblique (3 views) 02/02/15 Cast has been removed. Callus formation is noted laterally and posteriorly around the radial fracture. Demineralization is noted.
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Further healing of distal radial fracture.
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Generate impression based on findings.
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T1N2bM0 squamous cell carcinoma of the left tonsil, p16+, s/p tonsillectomy in the Fall of 2013, and completed CRT on 1/17/14. Neck: There are post-treatment findings in the neck, including mild diffuse pharyngeal mucosal edema. There is no measurable residual tumor in the left palatine fossa. There is no significant cervical lymphadenopathy in the neck, based on size criteria. The salivary glands are unchanged. There is unchanged mild diffuse prominence of the thyroid gland, without discrete lesions. The airways are patent. There is a right internal jugular venous catheter in position. The major cervical vessels are patent. The osseous structures are unremarkable, aside from mild degenerative cervical spondylosis. The imaged portions of the lungs and mediastinum are unremarkable. Head: There is no evidence of abnormal intracranial enhancement or mass lesions. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1. No evidence of measurable locoregional tumor recurrence or significant lymphadenopathy in the neck.2. No evidence of intracranial metastases.
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Generate impression based on findings.
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57-year-old male with history of fever status-post transplant. Evaluate. CHEST:LUNGS AND PLEURA: Left basilar atelectasis. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Mildly enlarged AP window lymph node measuring 1.6 x 1.3 cm which does not demonstrate FDG avidity on the recent PET exam.CHEST WALL: Right sided chest port with catheter tip in the proximal SVC. Left internal jugular central venous catheter with tip in the SVC.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions or biliary ductal dilatation. Hyperattenuating debris within the gallbladder likely sludge versus punctate gallstones without pericholecystic fluid or gallbladder wall thickening.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No nephrolithiasis or hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Minimally prominent gastrohepatic and retroperitoneal lymph nodes are nonspecific and do not meet CT size criteria for pathological nodes.BOWEL, MESENTERY: No evidence of small bowel obstruction or colitis. No drainable loculated fluid collections.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of small bowel obstruction or colitis. No drainable loculated fluid collections.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No specific evidence of infection as clinically questioned.2.Gallbladder sludge versus small gallstones without evidence of complication.3.Nonspecific stable mildly enlarged mediastinal lymph node.4.Left basilar pulmonary atelectasis
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Generate impression based on findings.
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Postop prosthetic assessment Components of a right total hip arthroplasty device are situated in near anatomic alignment. A fracture through the greater trochanter is again visualized, but appears slightly less distinct on the current study than on the prior study suggesting some interval healing. Degenerative arthritic changes affect the visualized lower lumbar spine.
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Total hip arthroplasty with healing greater trochanter fracture.
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Generate impression based on findings.
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Open reduction and internal fixation.VIEWS: Left elbow AP/lateral/oblique (3 views) 02/02/15 Splint has been removed. Three K wires remain in place in distal humerus. Callus formation has developed in the interval. Alignment of distal humeral fracture is near-anatomic.
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Healing distal humeral fracture.
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Generate impression based on findings.
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Status post left total knee arthroplasty Components of a left total knee arthroplasty device are situated in near anatomic alignment without radiographic evidence of hardware complication. The previously seen skin staples and drain have been removed. There is swelling of the anterior soft tissues which limits evaluation of the extensor mechanism.Moderate to severe osteoarthritis affects the right knee as seen on the frontal view.
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Total knee arthroplasty as above.
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Generate impression based on findings.
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Status post left mastectomy for breast cancer in 2012 for DCIS and right mastopexy, presents today for routine follow up. No current 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 composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations 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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Pain. Again seen is a transcondylar fracture of the distal humerus with fracture fragments in near anatomic alignment. The portion of the fracture through the lateral condyle is less distinct on the current study than on the prior study, indicating some interval healing. The portion of the fracture through the medial condyle remains visible, although its margins are slightly indistinct. Callus formation along the fracture on the lateral view also indicates some interval healing. There is persistent elevation of the distal humeral fat pads indicating joint effusion and/or hemarthrosis.
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Healing distal humerus fracture as above.
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Generate impression based on findings.
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There is no evidence of mesial temporal sclerosis, cortical dysplasia or gray matter heterotopia. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. 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 MRI abnormality to explain the patient's epilepsy.
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Generate impression based on findings.
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9-year-old male with abdominal distention, hepatomegaly, ascites, hydronephrosis LIVER: The liver measures 13.9 cm. No focal hepatic lesions. Limited interrogation of main portal vein demonstrates increased blood flow towards the liver measuring 0.5 m/sec. This is of uncertain clinical significance.GALLBLADDER, BILIARY TRACT: Common bile duct measures 4 mm. Gallbladder sludge is present. The gallbladder wall measures 3 mm. No cholelithiasis or pericholecystic fluid. Negative sonographic Murphy sign.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. The spleen measures 8.8 cm.KIDNEYS: The right kidney measures 10.2 cm. The left kidney measures 10.7 cm. No evidence of hydronephrosis or perinephric fluid.ABDOMINAL AORTA: No significant abnormality noted. Normal Doppler waveform is present.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites is present. Left ureteral jet was visualized. Bladder is distended and within normal limits.
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1.No hepatosplenomegaly on the current exam. No hydronephrosis is evident.2.Gallbladder sludge without evidence of acute cholecystitis.
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Generate impression based on findings.
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Female 55 years old; Reason: 55 yo with right knee melanoma. Needs Lympho for sentinel node localization History: painRADIOPHARMACEUTICAL: The right knee was prepared in a sterile manner. A total of 0.6 mCi Tc-99m filtered sulfur colloid was injected around the healing excision scar site in four injections. A focus of increased activity is noted in the right groin, representing the sentinel node(s). This region was marked with an indelible marker.
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Sentinel node identified in the right groin.
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Generate impression based on findings.
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10 week old former 29 to 30 week gestational age patient with history of respiratory distress. Oxygen requirement.VIEW: Chest AP (one view) 02/02/15, 0936 Feeding tube tip is in gastric body.Lung volumes are large with hemidiaphragms between 10 and 11 posterior ribs. Coarse bilateral opacities are noted. Subsegmental atelectasis or scarring is seen in right upper lobe. Cardiothymic silhouette is mildly enlarged.
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Changes from chronic lung disease.
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Generate impression based on findings.
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65-year-old female with rectal cancer status post surgery and adjuvant chemotherapy. Follow up exam. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. Previously identified fatty liver is not as conspicuous on the current examination. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal hypoattenuating lesion consistent with a cyst is slightly larger than the prior exam.RETROPERITONEUM, LYMPH NODES: Stable unchanged small retroperitoneal lymph nodes.BOWEL, MESENTERY: There are two ventral abdominal wide mouth hernias with the cranial hernia containing loops of small bowel and caudal hernia containing small bowel loops as well as colon. No evidence of small bowel obstruction.BONES, SOFT TISSUES: Mild to moderate degenerative changes affect the visualized spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes at the anorectal junction.BONES, SOFT TISSUES: Mild to moderate degenerative changes affect the visualized spine.OTHER: No significant abnormality noted.
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1.No evidence of recurrent or metastatic disease. 2.Two anterior abdominal bowel containing hernias without evidence of obstruction.
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Generate impression based on findings.
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54-year-old male with first and second knuckle swelling. Three views of the right hand are provided. The bones appear demineralized. There is uniform narrowing of the third metacarpophalangeal joint along with an erosion along the radial aspect of the third metacarpal head and dorsal soft tissue swelling, but the remaining metacarpophalangeal joints are unremarkable. There is mild narrowing of scattered interphalangeal joints which may reflect osteoarthritis. There is soft tissue swelling about the wrist. Mixed lucency and sclerosis within the lunate may represent cyst formation or less likely avascular necrosis.
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Third metacarpophalangeal joint narrowing and erosion as described above could represent manifestations of gout, rheumatoid arthritis, or atypical infection.
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Generate impression based on findings.
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Ms. Mason is a 73 year old female with a personal history of left breast mastectomy in 2011 for IDC/DCIS treated with radiation, chemotherapy and an aromatase inhibitor. Family history of breast cancer in two maternal cousins. 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. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified 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. History of bilateral breast reduction surgery. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. There are extensive but symmetric bilateral postsurgical changes with distortion of the parenchymal pattern compatible with bilateral breast reduction surgery. Bilateral benign calcifications are also noted, including vascular, skin and dystrophic calcifications. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Extensive changes which are compatible with reduction surgery. 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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There is a large region of encephalomalacia involving the right frontal lobe and insular cortex which is similar in appearance the prior exam. There is a nodular and linear hyperattenuation which is more prominent than the prior exam. There is effacement of the frontal horn of the right lateral ventricle, unchanged. Periventricular and subcortical hypoattenuation is nonspecific but unchanged and may be related to age indeterminate mild to moderate small vessel ischemic disease. There is a chronic lacunar infarct in the right basal ganglia extending to the right periventricular region. No midline shift. A focus of encephalomalacia in the left inferior frontal gyrus is unchanged. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. Minimal mucosal thickening of the left maxillary sinus. Opacification of the bilateral mastoid air cells is unchanged.
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1.Subacute infarct in the right frontal lobe and insular cortex area with more prominent nodular and linear hyperdensities. These may represent either residual subcortical white matter or petechial hemorrhage. Continued follow-up is recommended.2.Mild to moderate age indeterminate small vessel ischemic disease with chronic right basal ganglia lacunar infarct, unchanged.3.Opacification of the mastoid air cells is unchanged.
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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. A focal asymmetry in the right outer breast has the appearance of overlapping normal tissues on tomosynthesis.
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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 can be 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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55 year old female with nausea and regurgitation x 3 months, weight loss. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the hypopharynx and neck did not demonstrate a Zenker's diverticulum, definite esophageal web, or cricopharyngeal bar (series 16). Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the mucosal surfaces or mural contours. No stricture or obstructing mass lesion was seen. Fluoroscopic evaluation of esophageal peristalsis demonstrated breakup of the primary peristaltic wave with some proximal escape and significant retention of ingested material in the esophagus, as well as marked delay of secondary peristalsis. Delayed emptying caused buildup of a contrast column in the distal esophagus measuring 4.2 cm, and mild occasional tertiary contractions were subsequently seen in the distal esophagus (series 26). Findings are compatible with moderate esophageal motility disorder.During the exam, no spontaneous or provoked gastroesophageal reflux was observed.TOTAL FLUOROSCOPY TIME: 6:57 mm:ss
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1.Findings compatible with moderate esophageal motility disorder as described above, with resultant marked delayed emptying of ingested contents from the esophagus into the stomach.2.No anatomic abnormality or evidence of obstruction identified.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Right breast surgical scar, benign biopsy and aspiration. 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. Bilateral benign calcifications are noted, progressed in a benign fashion.
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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: NSC - Screening Mammogram.
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Generate impression based on findings.
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Two day old male, 37 week infant of diabetic mother, with line placementVIEW: Chest/abdomen AP (2 view) 02/02/15, 1008 hours Interval retraction of UVC with tip in the left hepatic vein.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities.Disorganized bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
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UVC tip is in the left hepatic vein.
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Generate impression based on findings.
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Ms. Bian is a 30-year-old female presenting with a palpable abnormality in the right upper inner breast with associated skin thickening. She recently completed lactating in March 2014. Per patient, she does have a positive history of trauma to that area in Dec 2014. Right breast ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 2.6 x 0.9 x 3.0 cm at the 1 o’clock position with increased vascularity, 4 cm from the nipple. The lesion was readily visible.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a inferomedial to superolateral approach, three 18-gauge core needle (Achieve) specimens were obtained of the lesion. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. Specimen quality was judged excellent.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Hydromark clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital right CC and ML views revealed the percutaneously placed clip to be in the expected location in the right upper inner breast. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Sheth. Dr. Schacht was present during the procedure at all times.
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Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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51 year-old female with history of fall. Right ankle: There is a minimally displaced oblique fracture through the distal fibular diaphysis in near anatomic alignment with the distal extent of the fracture located approximately 2 cm above the level of the tibiotalar joint. No additional fractures are noted.Right knee: There are postoperative changes from ACL reconstruction including distal femur and proximal tibial tunneling and fixation devices. There is no evidence of hardware complication. Mild osteoarthritis affects the knee. There is no acute fracture or malalignment.
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1.Distal fibular fracture as above.2.Postsurgical and degenerative changes of the knee without acute fracture.
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Generate impression based on findings.
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51 year-old female with history of ankle injury. Evaluate for instability. Redemonstrated is an oblique fracture of the distal fibular diaphysis in near-anatomic alignment. There is no evidence of widening of the distal ankle syndesmosis or the medial aspect of the ankle joint.
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Distal fibular fracture as above.
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Generate impression based on findings.
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49-year-old female with history of ulnar osteotomy. There is a plate and screw device affixing a proximal ulnar osteotomy. There is no evidence of hardware complication. The osteotomy margins are slightly indistinct suggesting healing. Minimal osteoarthritis affects the elbow.
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Orthopedic fixation of healing osteotomy as above.
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Generate impression based on findings.
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Two year-old female with fractureVIEWS: Left femur AP/lateral (two views) 02/02/15 , 1045 hrs Overlying cast material obscures fine bone detail. Again seen is a fracture through the proximal femoral metaphysis in near anatomic alignment. Periosteal reaction and mild callus formation is suggestive of interval healing.
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Healing proximal femoral metaphyseal fracture in near anatomic alignment.
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Generate impression based on findings.
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60 year-old female with pain. Three views of the right wrist show resection of the scaphoid and orthopedic screws affixing the capitate-lunate and triquetrum-hamate articulations. The capitate-lunate articulation appears indistinct which may represent some fusion. The triquetrum-hamate articulation remains visible. Ossific densities along the dorsal soft tissues presumably reflects bone graft material. There is diffuse soft tissue swelling.
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Orthopedic right wrist fusion as described above.
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Generate impression based on findings.
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54 year-old female with history of recurrent metastatic ovarian cancer. Evaluate. CHEST:LUNGS AND PLEURA: Scattered stable micronodules, some of which are calcified, are unchanged. No suspicious nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: Bilateral breast prosthesis.ABDOMEN:LIVER, BILIARY TRACT: No focal suspicious hepatic lesions. Cholelithiasis.SPLEEN: Postoperative changes of splenectomy. Unchanged probable small splenule measuring 1.5 x 1.0 cm (series 3, image 86).PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple retroperitoneal and mesenteric surgical clips. Postsurgical changes of omentectomy. BOWEL, MESENTERY: Subcentimeter mesenteric lymph nodes (series 3, image 126) were not definitively appreciated on the prior examination. Given size, they are likely of no clinical significance.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Postoperative changes of hysterectomy and bilateral oophorectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Mildly enlarged bilateral inguinal nodes with fatty hilum are unchanged and likely benign.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of recurrent or metastatic disease. 2.Subcentimeter nonspecific mesenteric lymph nodes are likely of no clinical significance. However, given that they were not definitely appreciated on the previous examination, attention on follow-up examinations is recommended.
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Generate impression based on findings.
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50 year-old male with history of right total knee arthroplasty. Three views of the right knee show hardware components of a medial compartment arthroplasty in near-anatomic alignment without evidence of complication. Mild osteoarthritis affects the remainder of the knee. There is a moderate joint effusion. Skin staples and a surgical drain have been removed since the prior study. Moderate osteoarthritis affects the left knee as seen on the frontal view.
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Right knee medial compartment arthroplasty without evidence of complication.
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Generate impression based on findings.
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65-year-old male with clinical meningitis, multiple brain lesions. Evaluate for signs of increased intracranial pressure. Redemonstration of multiple supratentorial and infratentorial foci of hypoattenuation, corresponding to areas of restricted diffusion identified on the recent MRI, which now appear slightly more conspicuous than on most recent prior CT head. There is interval increase in associated edema, which is now causing mild mass effect on the anterior horn of the right lateral ventricle as well as the fourth ventricle. There is no evidence of acute intracranial hemorrhage or mass. There is no evidence of hydrocephalus or midline shift. There is mucosal thickening of the bilateral ethmoid air cells, frontal, sphenoid and maxillary sinuses. The left mastoid air cells are under-pneumatized 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. The skull and scalp soft tissues are unremarkable.
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1.Interval increase in the degree of conspicuity of numerous supratentorial and infratentorial hypoattenuating foci, now with increasing surrounding edema. These lesions correspond to foci of restricted diffusion identified on the recent MRI, and are suspicious for numerous tiny infarctions. 2.There is slight effacement of the right anterior horn and fourth ventricle, but no significant midline shift. 3.No interval intracranial hemorrhage.
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Generate impression based on findings.
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69-year-old male with metastatic prostate cancer, evaluation of disease during treatment with investigational therapy. CHEST:LUNGS AND PLEURA: Scarring/atelectasis at left lung base unchanged. No parenchymal lung nodules, masses or airspace disease seen. Changes of emphysema are stable. No pleural disease.MEDIASTINUM AND HILA: Stable moderate coronary artery calcifications. No adenopathy identified.CHEST WALL: No significant abnormality noted, however nuclear medicine bone scintigraphy is a more sensitive indicator of skeletal metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: Liver again is of slightly decreased attenuation and suggests possible hepatic steatosis but on contrast only enhanced images cannot be assessed definitively. No space-occupying lesions are seen other than benign perfusion abnormality (series 3, image 105) adjacent to falciform ligament. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate high density in right renal collecting system (series 3, image 129) most likely nonobstructing calyceal stone disease. No other significant abnormality seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Rounded sclerotic focus in the right lateral posterior aspect of L2 vertebral-body (series 3, image 118) is unchanged compared to 11/4/14. No other foci of suspected metastatic disease are seen, and this focus remains uncertain whether it is degenerative or metastatic in nature. Nuclear medicine bone scintigraphy is a more sensitive indicator of activity of metastatic skeletal disease. Diffuse degenerative changes again seen about the lumbosacral spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Treatment seeds from prior brachy therapy in prostate without change. No other significant abnormalities.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality noted in the internal pelvic lymph node chains. Prominent inguinal lymph nodes are seen bilaterally unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse degenerative changes but no other significant abnormality noted in pelvic skeletal system, however nuclear medicine bone scintigraphy is a more sensitive indicator of extensive potential disease.OTHER: No significant abnormality noted
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1. Stable focus of sclerosis in the L2 vertebral body. No new suspected foci of disease seen, however nuclear medicine scintigraphy is a more accurate evaluator of skeletal metastatic disease. 2. No other suspicious foci from metastatic disease seen. 3. Remainder of the examination appears stable compared to prior CT examination.
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Generate impression based on findings.
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History of lung cancer with altered mental status. Evaluate for intracranial hemorrhage. There is no evidence of intracranial hemorrhage. There is a focus of hypoattenuation in the right cerebellar hemisphere, which may correspond to the presumed metastasis on prior MRI brain. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific, but most consistent with age-indeterminate small vessel ischemic changes. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is mild mucosal thickening of the bilateral ethmoid sinuses. The other imaged paranasal sinuses and mastoid air cells are clear. There are secretions in the nasopharynx. There is debris within the right external auditory canal, likely representing cerumen. There are calcifications of the cavernous portion of the bilateral carotid arteries. The skull and extracranial soft tissues are unremarkable.
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1. No evidence of intracranial hemorrhage.2. Focus of hypoattenuation in the right cerebellar hemisphere, which likely corresponds to the presumed metastasis demonstrated on prior MRI brain.
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Generate impression based on findings.
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61 year old female status post left lumpectomy in 2009 for IDC, presents today for routine follow up. The patient received radiation and hormonal therapy. No current breast complaints. Family history of breast carcinoma in maternal cousin. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Post surgical scar is re-demonstrated at upper outer quadrant in the left breast, including surgical clips, architectural distortion, and increased density, without significant change.No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations 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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Reason: Pleural mesothelioma please compare to prior exam History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: There has been interval resolution of the small right-sided pneumothorax.Mild right pleural thickening and small right pleural effusion redemonstrated.Focal right pleural nodularity (image 26 series 5) measures 9 mm previously measuring 7 mm.Minimal right basilar subsegmental atelectasis.Nonspecific calcified and noncalcified micronodules in left lung.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Left chest Port-A-Cath with its tip in the SVC.No hilar or mediastinal lymphadenopathy.Cardiac size normal evidence of the pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Markedly elevated right hemidiaphragm with a surgical patch identified posteriorly.Status post right thoracotomy with postsurgical changes involving the right ribs.Marked degenerative changes throughout the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable hepatic hypodensities compatible with cysts.Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Postsurgical findings in the right hemithorax related to prior pleurectomy. Interval resolution of the previously noted small pneumothorax. Focal pleural nodularity on the right stable to minimally increased in size. Continued observation is recommended.
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Generate impression based on findings.
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Ms. Fan is a 59 year old female with a known diagnosis of right breast cancer. She had a recent ultrasound that showed enlarged right axillary lymph nodes. This will be the target for today's biopsy. Right axillary ultrasound re-identified either a single bilobed node or two intimately associated lymph nodes in the right axillary region. These were the most amenable to biopsy. Due to the close approximation of these nodes, it was felt that both would be in the trough of the core biopsy needle. This was in the low axillary region. Bipolar maximal dimension of both lymph nodes was 2.5 cm and marked non-hilar cortical blood flow was seen on color flow imaging. The target node/nodes were readily visible.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy of an axillary lymph node were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure. The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and lateral to medial approach, a 14-gauge core needle (Achieve) was directed into the target node and four specimens were obtained, using the open-trough technique. Samples were obtained centrally through the hypoechoic cortex and at the periphery. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. Specimen quality was judged excellent. Whitish tissue was noted throughout all specimens.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Hydromark clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. Post-procedure digital right MLO view did not show the percutaneously placed clip, which was likely too far back to be clearly visualized. However, it was seen on the last ultrasound image. No evidence of hematoma or other complication on post procedure ultrasound. The skin incision was closed with a Steri-Strip. A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Sheth. Dr. Schacht was present during the procedure at all times.
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Successful ultrasound guided core biopsy of an abnormal right axillary lymph node. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Biopsy clip in the left upper outer breast again noted. There are normal morphology and size intramammary lymph nodes in each upper outer breast. A few scattered benign calcifications are noted.
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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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61-year-old female with history of prior fracture. The bones are demineralized. Redemonstrated is a minimally displaced fracture of the radial styloid in anatomic alignment. Portions of the fracture line are slightly less distinct suggesting some interval healing. There is moderate soft tissue swelling about the wrist.
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Healing distal radius fracture as above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views 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 morphology masses, microcalcifications or areas of architectural distortion are present. There are multiple bilateral benign morphology masses, all subcentimeter in size. Normal-sized lymph nodes project in each 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.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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27-year-old male with chronic nasal congestion and deviated nasal septum, evaluate sinuses The frontal sinuses are clear. There is bilateral mucosal thickening within the frontal recesses.There is mild mucosal thickening of the anterior ethmoid sinuses.There is minimal mucosal thickening of the sphenoid sinus. There is mucosal thickening within the left sphenoethmoidal recess. The right sphenoethmoidal recess is patent. There is mild mucosal thickening of the bilateral maxillary sinuses, left greater than right, with the left maxillary mucous retention cyst/polyp along the medial wall. The right ostiomeatal unit is clear. There is mild mucosal thickening within the left infundibulum. A small Haller cell is present on the right.There is rightward deviation of the nasal septum with a left-sided spur and thickening of the left nasal cavity. There is a left conchal bullosa.
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1.Mild mucosal thickening of the paranasal sinuses with moderate to severe mucosal thickening within the left nasal cavity.2.Rightward deviation of the nasal septum with a left-sided spur.
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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. Bilateral benign morphology calcifications are noted. Normal morphology axillary lymph nodes are symmetric.
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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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Pain A sclerotic focus with minimal expansion and periost reaction is observed involving the proximal left tibial diaphysis correlating with the MR findings. In addition, comparison with prior knee plain films in 2014 although incomplete demonstrate a similar appearance.No discrete soft tissue components or evidence of a definite aggressive process. Fibula unremarkable. Minimal degenerative changes in both knee and ankle partially visualized.
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Plain film focal and an unchanged geographic lesion involving the proximal tibial diaphysis and again most suggestive of an enchondroma, however correlation with a more sensitive MR is recommended.
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Generate impression based on findings.
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CT HEAD: There postoperative findings related to right frontoparietal craniotomy for resection of a subjacent cavernous malformation. There is further evolution of encephalomalacia along the surgical tract. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. CTA HEAD: The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.CTA NECK: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. There is no evidence of flow-limiting stenosis or occlusion. There is an apparent subcentimeter nodule in the left thyroid lobe.
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1.Postoperative findings related to resection of a right frontal cavernous malformation with further evolution of encephalomalacia along the surgical tract. 2.No evidence of aneurysm, vascular malformation, or significant steno-occlusive lesion.
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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 repeat 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. Bilateral benign morphology calcifications are again noted. Normal-sized lymph nodes project in each 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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign calcifications in the left breast are again noted, not significantly changed.
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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 13 months old Reason: fracture VIEWS: Left tibia-fibula AP and lateral 2/2/15 (two views) Cast material obscures fine bone details. Periosteal reaction is noted on the proximal and distal tibia. Alignment is anatomic.
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Healing fracture in anatomic alignment.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history breast cancer in her 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, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign appearing calcifications bilaterally. Prominent veins noted 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: NSC - Screening Mammogram.
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Generate impression based on findings.
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Male 62 years old; Reason: HCC, on therapy, evaluate for disease, compare to previous, please assess with triphasic liver/thickness: 2.5 mm or less and provide index lesion measurements for RECIST as per clinical trial CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change, no pleural effusion. Previously seen right-sided jugular and subclavian venous thrombus not as well seen.MEDIASTINUM AND HILA: Hypoattenuated appearance of intracardiac blood pool on noncontrast imaging compatible with underlying anemia. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Postablation cavity in hepatic segment VIII without significant change with internal increased attenuation seen and stable adjacent nodular arterial enhancement along superomedial margin, cavity measures approximately 3.1 x 1.6 cm. Peripherally located postablation cavity in segment V seen, image 37 series 9. Again seen is hepatic segment II arterially enhancing 1.2 x 1.2 cm focus without definite washout, image 22 series 9, without significant change.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease.BOWEL, MESENTERY: Postsurgical changes.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel postsurgical spinal changes with beam hardening artifact related to hardware seen, making evaluation of adjacent structures suboptimal. Multilevel degenerative changes of spine. Ventral abdominal subcutaneous nodularity, likely reflecting sequela from prior injections.
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1. Stable exam as described.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Prior benign biopsy in 2009. Two standard digital views of both breasts, repeat right MLO view and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is an obscured mass in the left breast 6 o'clock position. Biopsy clip in the left central breast from the prior benign biopsy as well as bilateral stable benign morphology calcifications noted. No suspicious microcalcifications or areas of architectural distortion are present.
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Left breast mass near 6 o'clock for which further evaluation with spot compression and ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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44 year old male status post biliary drainage, pancytopenic, abdominal pain, constipation. Rule-out hematoma, obstruction, cholecystitis. Within the limits of a non-IV contrast-enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: Since prior CT examination 1/18/15 has been the interval development of a moderate-sized right pleural effusion and right basilar atelectasis with left basilar atelectasis as well.LIVER, BILIARY TRACT: No significant abnormality noted in liver parenchyma, although examination limited by lack of IV contrast. Cholecystostomy tube is unchanged in position and appearance coiled in the gallbladder. Small amount of fluid is now seen adjacent to the gallbladder and about the liver which is new since prior examination.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted in the gastrointestinal tract. Small amount of ascites is seen about the liver and haziness in the mesentery new since prior examination. Larger amount of ascites is seen accumulating in pelvis, discussed below..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted in the larger of small bowel. Residual opacification of high density material is seen in the colon from prior examinations. Increase in ascites is seen layering in the dependent pelvis. There is high density layering in the dependent ascites collection (series 3, image 138) suggestive of blood products.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. New right pleural effusion and atelectasis since prior CT 1/18/15. 2. Increasing peritoneal fluid with non-loculated fluid seen about liver, gallbladder and in the dependent pelvis. 3. High density fluid fluid level seen in dependent pelvis suggestive of small amount of blood products. 4. No evidence of large, contained hematoma.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign morphology mass in the right central breast. Stable normal-sized lymph nodes in each 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Call back from screening mammogram for markedly dilated duct in right retroareolar region. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. Dilated duct is again present in the right retroareolar region without significant changes.Focused ultrasound was performed for right retroareolar region. The duct dilates up to 13 mm. No intraductal lesions are detected.
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No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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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 almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. A few 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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Reason: bladder cancer, resected, now restage History: bladder cancer, resected, now restage LUNGS AND PLEURA: Scattered linear scars, but no sign of pulmonary or pleural metastases. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.There are no visible coronary calcifications, and the heart and pericardium appear normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Slightly nodular adrenal glands, benign in appearance.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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There is near complete opacification of the right maxillary sinus with a combination of mucosal swelling and fluid secretions. There is sclerosis and thickening of the right maxillary sinus walls. There are also bubbly secretions in the left maxillary sinus. There is mild scattered opacification of the right anterior ethmoid air cells and left anterior and posterior ethmoid air cells. There is minimal mucosal thickening of the left sphenoid sinus. The right sphenoid sinus and bilateral frontal sinuses are clear. There is no evidence of sinonasal mass lesions or facial abscess. The imaged portions of the mastoid air cells and middle ears are grossly clear. The imaged portions of the intracranial structures and orbits are unremarkable.
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Findings indicative of acute upon chronic sinusitis. 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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46-year-old female with history of appendiceal neoplasm. Please evaluate for abnormalities in recurrence. 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, URETERS: No significant abnormality noted -- large right renal cyst is unchanged and stable in appearance.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted in the uterus. Continued involution of the prior noted right adnexal cyst with no residual now seen. Adnexa now appear normal.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Surgical clips from prior appendectomy with no evidence of recurrent or residual tumor in surgical bed. Visualized gastrointestinal tract large and small bowel all appears normal. No mesenteric tumoral mass is seen. Small amount of free fluid in the dependent pelvis at the level seen physiologically in female patients of this age.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Involution of prior noted right adnexal cyst with no residual. 2. No evidence for recurrent or metastatic disease seen.
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Generate impression based on findings.
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Male 62 years old; Reason: 61 y/o man with T cell NHL s/p 6 cycles of CHOEP chemotherapy in 11/2013. Compare to prior exams. CHEST:LUNGS AND PLEURA: Small dependent bibasilar atelectasis.MEDIASTINUM AND HILA: Small anterior mediastinal soft tissue/predominately fat attenuation, unchanged in appearance, may reflect fatty involution of residual thymic tissue.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis, making assessment for underlying lesion less ideal. Unchanged 1.1 cm hepatic segment 5 hypoattenuating focus, image 87 series 3, with associated Hounsfield units compatible with simple fluid and lesion may be a cyst. Additional more posteriorly located tiny focus seen, image 89 series 3, too small to characterize. Vague ill-defined hypoattenuation seen alongside middle hepatic vein, image 78 series 3, of uncertain clinical significance but stable.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Symmetric renal parenchymal enhancement.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic calcifications.BOWEL, MESENTERY: Underdistended portions of ascending and transverse colon, making assessment for underlying wall thickening suboptimal.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Better distention of bladder on current exam, no significant wall thickening delineated.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance, including subcentimeter sclerotic focus in right iliac bone, image 152 series 3. Multilevel degenerative changes of spine.
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1. Stable exam as described. No enlarged lymphadenopathy seen.
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Generate impression based on findings.
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Pain following a fall Knee: Moderate to near severe osteoarthritis with a questionable small effusion, details and mildly of secured by batting. Please consider follow up for need imaging if there remains suspicion for an acute process. Detail is limitedPelvis: Moderate bilateral hip osteoarthritis with more mild degenerative changes at both SI joints. The pelvis is otherwise intactHip and femur: Acute comminuted butterfly fragment fracture of the proximal diaphysis with mild displacement and overlap of approximately 2 to 3 cm. No discrete underlying changes to suggest a pathologic source, however again follow up imaging may be helpful if of concern.
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Acute comminuted fracture of the proximal right femur
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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 benign calcifications are again noted.
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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. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. An obscured mass in the left upper breast posterior depth is present. No suspicious microcalcifications or areas of architectural distortion are present. Elsewhere, areas of asymmetry in each breast are stable bilaterally.
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Obscured left breast mass may represent a normal lymph node, though this is not certain without further evaluation. Spot compression with 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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76-year-old male with metastatic prostate cancer. CHEST:LUNGS AND PLEURA: Scattered micronodules seen on the MIP images unchanged. No new nodules or masses are seen suspicious for metastatic disease. No pleural disease.MEDIASTINUM AND HILA: Severe coronary artery calcifications again seen and post surgical changes from cardiac surgery. Normal sized small subcentimeter mediastinal nodes are unchanged.CHEST WALL: Right anterior chest wall Port-A-Cath with tip of the catheter located in the distal superior vena cava unchanged. Healed right seventh rib fracture unchanged. Subtle sclerosis in the left 10th rib of uncertain significance unchanged. No new foci of suspicious skeletal lesions seen, however nuclear medicine scintigraphy is a more sensitive and accurate indicator of potential skeletal metastatic disease.ABDOMEN: Within the limits of a non-IV contrast-enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:LIVER, BILIARY TRACT: No significant abnormality noted in liver parenchyma, however examination is limited due to lack of IV contrast. Gallbladder again shows gallstones without other biliary tract complication.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Lack of IV contrast limits ability to evaluate renal parenchyma. The bilateral perinephric nodules are seen either stable in size or minimally increased. The prior reference left perinephric nodule (series 3, image 120) measures 1.6 cm, previously 1.3 cm. The reference right perinephric nodule (series 3, image 111) measures 2.2 cm, unchanged. The other nodules appear unchanged.RETROPERITONEUM, LYMPH NODES: No enlarged retroperitoneal lymph nodes seen. Prior reference to perinephric nodules are described in kidneys section above.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Mildly enlarged right internal iliac/obturator lymph node is slightly increased in size (series 3, image 182) measuring 1.3-cm in diameter compared with 1.0-cm previously. No new or other foci of enlarged lymph nodes are seen.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic appearance is to the left sacrum and right iliac bones are unchanged. No new foci of focal lesions suspicious for metastatic disease are seen. The lucent lesion with sclerotic rim in the left femoral head is unchanged. Nuclear medicine scintigraphy is a more accurate indicator of extensive skeletal metastatic disease.OTHER: No significant abnormality noted
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1. Slight increase in size of one reference perinephric nodule with stability in the remaining multiple nodules. 3. Stable sclerotic foci in the skeletal system described above -- nuclear medicine scintigraphy is a more sensitive and accurate indicator of metastatic disease. 3. Slight increase in size of the prior reference right internal iliac/obturator lymph node. 3. No other foci of suspicious abnormalities to suggest metastatic disease.
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Generate impression based on findings.
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Male 45 years old; Reason: restaging scans s/p 9 cycles of investigational immunotherapy History: hx of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change, no suspicious lung nodule or mass seen.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left-sided nephroureteral stent seen extending into neobladder. Left-sided percutaneous nephrostomy present. Small foci of air in left intrarenal collecting system, most likely postprocedural in etiology. Interval improvement in previously seen left-sided hydronephrosis. Areas of left renal cortical thinning seen. Delayed left-sided nephrogram. Again seen ill-defined soft tissue attenuation in region of mid to distal left ureter, image 173 series 80424, without significant change accounting for differences in technique, measuring approximately 3 x 1.9 cm, image 172, previously measured 3 x 2 cm.RETROPERITONEUM, LYMPH NODES: IVC filter. Stable reference left paraaortic lymph node adjacent to left renal vein seen, image 130 series 80424, measures 1.3 x 0.9 cm.BOWEL, MESENTERY: Postsurgical sequela involving bowel.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Increased prominence of left pelvic soft tissue mass, measuring 6 x 2.9 cm, image 192, previously measured 5.6 x 2.6 cm. Again seen subcortical erosive changes of the adjacent left acetabulum, suspicious for associated osseous involvement. Visualized osseous structures stable in appearance. Multilevel degenerative changes of spine.
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1. Improved left-sided hydronephrosis. 2. Increased prominence of left pelvic soft tissue mass as above with adjacent left acetabular erosive changes again seen. Additional reference lesions stable.
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Generate impression based on findings.
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Patient with pain for 3 days following fall Minimal degenerative changes the radiocarpal joint, however no underlying osseous abnormality is observed, specifically no fracture or malalignment. No definite effusion although a small wrist effusion can't be excluded. Specifically the scaphoid is intactHand: No radiographic abnormality other than minimal soft tissue swelling
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Minimal soft tissue swelling and questionable small wrist effusion without underlying osseous abnormality
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of benign right breast biopsies. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Questionable area of architectural distortion seen on the left CC view centrally at posterior depth. This finding projects at approximately mid height in the breast on tomosynthesis. There are several benign morphology masses elsewhere in the breasts, some with coarse calcifications suggesting fibroadenomas. No suspicious masses or microcalcifications are present.
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Questionable area of distortion in the left 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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Check for fracture, pain from falling Severe osteoarthritic changes with marked hallux deformity and bunion of the first digit with associated hammertoe deformities of the remaining toes. Diffuse demineralization is otherwise observed without evidence of associated acute process, specifically no fracture or dislocation. Soft tissues appear intact
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Minimal scattered degenerative changes with more severe changes involving the first MTP with a large bunion. No superimposed abnormality
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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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign morphology masses in the left breast, right inner breast asymmetry and bilateral benign calcifications. Normal-sized lymph nodes project in each 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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History of thyroid cancer metastatic to the skull s/p thyroidectomy and resection of the skull lesion. Neck: The thyroidectomy bed appears unchanged. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The major cervical vessels are patent. There is a retropharyngeal course of the right carotid artery. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There are bilateral pulmonary nodules.Head: There are stable postoperative findings related to cranioplasty and debulking of the large calvarial lesions. There is no significant interval change in the expansile calvarial metastases with associated mass effect upon the underlying the brain parenchyma. For example, the left frontal lesion measures 34 x 59 mm, previously 35 x 59 mm and the left occipital lesion measures 37 x 68 mm, previously 38 x 66 mm. Otherwise, there is no evidence of abnormal intraparenchymal enhancement. The ventricles are unchanged in size and configuration. There is a partially empty sella. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear.
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1. No evidence of measurable tumor recurrence in the neck.2. No significant interval change in the skull metastases.3. Lung metastases. Please refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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Check for fibular fracture. Tenderness laterally Minimal soft tissue swelling without underlying osseous abnormality. Mortise intact.
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Minimal soft tissue swelling without additional abnormality
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Generate impression based on findings.
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Patient fell. Pain Mild osteoarthritic changes with minimal narrowing and sclerosis. No superimposed acute abnormality, specifically no fractures or dislocation.
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Mild osteoarthritic
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Generate impression based on findings.
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Check right small finger, pain Interval removal of the extra of fixation of the distal components demonstrating interval fusion and healing of the proximal middle fifth phalanx fracture extending to the volar surface with persistent mild deformity. The small dorsal evulsion fragment remains unchanged in position with new subluxation of the PIP joint volarly. Mild diffuse soft tissue swelling
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Interval removal of the external fixation with partial healing of one fracture yet the absence of the other more dorsal fragment and fracture plane. See detail provided
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Generate impression based on findings.
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Male 4 months old Reason: ETT location History: Seizures. Apparent life threatening eventVIEW: Chest AP (one view) 2/2/15 at 1214 hrs. ET tube tip is below the thoracic inlet. NG tube terminates at the stomach. Cardiac silhouette size is normal. Right upper and left lower lobe opacity development, likely atelectases. No effusions or pneumothorax.
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Multifocal opacity development after ET and NG tube placement.
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Generate impression based on findings.
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Male 3 years old Reason: s/p LIJ port History of leukemia.VIEW: Chest AP (one view) 2/2/15 at 1220 hrs. Interval removal of right upper extremity central line and placement of left internal jugular Port-A-Cath, deep is at the RA/IVC junction.Cardiac silhouette size is normal. Ill-defined right upper and lower lobe patchy opacities, likely atelectasis or pneumonia. No effusions or pneumothorax.
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Interval right upper extremity PICC removal and placement of left IJ Port-A-Cath as described.Multifocal opacities as described.
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Generate impression based on findings.
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Follow up of left basal ganglia and thalamic ICH Re-demonstration of the left thalamic and basal ganglia ICH, IVH and right hemispheric SAH with mass effects.The maximum measured size of the ICH, extent of IVH and SAH do not show any significant interval change since prior exam. The degree of midline shift toward right side was measured about 11mm which is a bit increased than prior exam (9.4mm), thus clinical correlation is recommended.The ventricle especially right lateral ventricle occipital horn and temporal horn appear to be enlarged but the degree appear to be not significantly changed.The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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1. Re demonstration of left basal ganglia and thalamic ICH with mass effects, no significant interval change since prior exam.2. IVH with right lateral ventricle enlagement and right hemispheric SAH extent appear to be stable since prior exam.
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Generate impression based on findings.
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72-year-old female. Rectal carcinoma on chemotherapy. Please compare to prior. CHEST:LUNGS AND PLEURA: Right lower lobe reference nodule (series 5 , image 75) has not significantly changed and measures 1.2 cm compared with 1.3-cm most recently. The other small parenchymal nodules are unchanged. No new nodules are seen. No pleural disease. MEDIASTINUM AND HILA: Heterogeneous multinodular thyroid is again seen unchanged. No mediastinal or hilar lymphadenopathy is seen. Right anterior chest wall Port-A-Cath system with tip of catheter in the proximal right atrium is again seen.CHEST WALL: Clusters of small bilateral axillary lymph nodes are again seen unchanged. The prior referenced left axillary lymph node (series 3, image 17) is not significantly changed in size measuring 1.1 x 0.6 cm compared with 0.9 x 0.6 cm previously. Known new enlarged lymph nodes are seen.ABDOMEN:LIVER, BILIARY TRACT: Multiple mass lesions are seen throughout the liver which have increased in size since previous exam. Reference measurements are provided as below:1. Segment 8 liver lesion (series 3, image 92) measures 4.6 x 3 .6 cm, previously 3.8 x 3.8 cm.2. Segment 5 liver lesion (series 3, image 107) now measures 6.6 x 5 .0 cm, previously 5.0 x 4.0 cm.3. Segment 5/6 liver lesion (series 3, image 122) measures 7.2 x 6 .3 cm, previously 5.5 x 4.7 cmVascular structures appear normal. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted -- benign cysts unchanged..RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast rapidly progresses through normal stomach and small bowel to the colon without obstruction or intrinsic abnormality. Colon shows fecal material throughout in left lower quadrant descending colostomy. No mesenteric masses or free mesenteric fluid is seen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast rapidly progresses through small bowel to the colon without obstruction or intrinsic abnormality. Colon shows fecal material throughout in left lower quadrant descending colostomy. No mesenteric masses or free mesenteric fluid is seen. Rectal mass with wall thickening and enhancement is again seen (series 3, image 176) with wall thickness measuring approximately 1.9 cm, compared with 1.7-cm previously, however direct comparison is difficult to make due to relative collapse state of the rectum. Posterior presacral edema is again seen unchanged with inflammatory changes encircling about the rectum, most likely relating to prior radiation. Infero-anterior extension towards the vagina is again seen on sagittal images. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Stable appearance to suspected pulmonary metastatic lesions. 2. Substantial increase in diffuse hepatic metastatic disease. 3. Rectal mass with circumferential wall thickening with minimal change. 4. No new sites of suspected metastatic disease seen.
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Generate impression based on findings.
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Reason: Metastastic thyroid cancer History: Metastastic thyroid cancer CHEST:LUNGS AND PLEURA: Bilateral pulmonary metastases, no new pulmonary nodules. The reference lesions have shown stability versus marginal interval increase in size measuring 18 mm in the right middle lobe (image 58/90, 17 mm on prior) and 14 mm in the left lower lobe (image 68/90, 13 mm on prior). MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Punctate hypodensity in right lobe (image 97/128) stable but too small to characterize and presumably benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval left nephrectomy.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Colonic diverticulosis.BONES, SOFT TISSUES: Degenerative change involving the spine.OTHER: No significant abnormality noted.
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Stable to marginal interval increase in size of reference pulmonary nodules. No new pulmonary nodules or new sites of disease
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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.Patchy high attenuation lesions within the suprasellar mass may indicate possible intra-tumoral hemorrhages.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 with possible intratumoral hemorrhage 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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Postsurgical changes are present including partial left ethmoidectomy and middle turbinectomy with a suggestion of left infundibulectomy.Mucosal thickening is present within both maxillary sinuses (right greater than left), obstructing bilateral sinus outlets.Mucosal thickening is present within the right sphenoid sinus anteriorly which obstructs the right sphenoethmoidal recess. Moderate mucosal thickening is present within the left sphenoid sinus with a small superimposed air-fluid level. A postoperatively widened left sphenoethmoidal recess is patent.Mucosal thickening is present throughout bilateral ethmoid air cells.Minimal mucosal thickening is present within the inferior right frontal sinus which narrows the right frontoethmoidal recess. Minimal mucosal thickening is also present within the inferior left frontal sinus, and a surgically widened frontoethmoidal recess is patent.The visualized bilateral mastoid air cells are clear. The lamina papyracea are intact bilaterally. The floor of the anterior cranial fossa and cribriform plate region are unremarkable. The nasal septum is deviated leftward. Bilateral orbits and the posterior nasopharynx appear unremarkable.
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Mucosal thickening throughout the paranasal sinuses obstructing sinus outlets with a superimposed air-fluid level in the left sphenoid sinus.
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Generate impression based on findings.
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TxN2cM0 squamous cell carcinoma status post chemo/RT followed by right neck dissection with right vocal cord paralysis. Neck: There are post-treatment findings in the neck, including prior right neck dissection and persistent marked supraglottic mucosal edema with associated airway narrowing. There are also a few punctate calcific foci along the epiglottis and diffuse stranding of the subcutaneous fat in the anterior neck related to treatment effects. However, there is no evidence of measurable residual mass lesions or significant lymphadenopathy in the neck. For example, a left supraclavicular lymph node measures 6 mm in short axis. There is unhanged mild narrowing of the right carotid artery associated with a small amount of residual ill-defined soft tissue, which is otherwise not readily measurable. There is a central venous catheter, but the inferior left jugular vein and much of the right internal jugular vein are inapparent. The parotid and submandibular glands are heterogeneously hyperattenuating, likely due to treatment effects. The thyroid appears unremarkable. The osseous structures are unchanged. There is pulmonary emphysema and micronodules.Head: There is no evidence of intracranial mass or abnormal enhancement. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is mild scattered paranasal sinus opacification. The skull and scalp soft tissues are unremarkable.
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1. No definite evidence of measurable residual mass lesions or significant lymphadenopathy in the neck amidst extensive post-treatment effects with persistent markedly edematous tissue in the supraglottic region associated with airway narrowing, as well as a small amount of residual ill-defined soft tissue associated with mild narrowing of the carotid artery. 2. No evidence of intracranial metastases.3. Pulmonary emphysema and micronodules. Please refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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Sickle cell anemia. Swollen ankle and distal tibia-fibula. Assess for osteomyelitis.VIEWS: Left tibia-fibula AP/lateral (two views), left ankle AP/lateral/oblique (3 views) 02/02/15 Tibia and fibula are normal in appearance. No fracture is identified. No bone destruction is seen.Soft tissue swelling is noted over the medial malleolus. A joint effusion is not present. No bone destruction or fracture is observed.
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Soft tissue swelling over medial malleolus.
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Generate impression based on findings.
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Left parotitis. Neck: There is marked diffuse enlarged and enhancement of the left parotid gland with associated surrounding inflammatory changes. There are no discernible radioattenuating calculi or significant ductal dilatation. The right parotid and bilateral submandibular glands are unremarkable. There is a mildly prominent left level 2A lymph node, which is likely reactive. There is no evidence of measurable mass lesions or discrete rim-enhancing fluid collections. The thyroid gland appears unremarkable. There is mild atherosclerotic plaque at the carotid bifurcations. There is multilevel degenerative cervical spondylosis, which is most pronounced at C6-7. There is diffuse osteopenia and mild deformity of the superior endplate of T4 vertebral body. The airways are patent. The imaged portions of the lungs are clear.Head: There is no evidence of acute intracranial mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is a probable retention cyst in the left sphenoid sinus. The skull and scalp soft tissues are unremarkable. There are bilateral lens implants.
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1. Findings compatible with acute left parotitis without evidence of abscess or radioattenuating calculi.2. Diffuse osteopenia with a mild compression fracture of T4 vertebral body.
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Generate impression based on findings.
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Reason: head and neck cancer/ per protocol scans History: see above CHEST:LUNGS AND PLEURA: Previously noted new nodular opacity in right upper lobe has significantly decreased and measures 6 x 5 mm on image 35/116. It likely represented an area of aspirate or infection. Additional smaller surrounding nodular opacities in the right lung have also shown improvement. No new pulmonary nodules are seen. Postop change right lower lobectomy. Emphysema.MEDIASTINUM AND HILA: Extensive postop change involving the neck. Please see dedicated neck CT report for further details. Port tip at RA/SVC junction. Moderate coronary calcification.CHEST WALL: Left chest wall port.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable renal hypodensities most likely cysts. Mild caliectasis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.G tube tip in stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval decrease in right-sided nodular opacities likely resolving aspirate or infection. No new pulmonary nodules.
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Generate impression based on findings.
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Ms. McDonald is a 65 year old female with a personal history of right breast lumpectomy in 1993 followed by radiation and tamoxifen therapy. Personal history of bilateral benign breast biopsies. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear markers were placed on scars overlying the right breast. There are stable postsurgical changes including architectural distortion and increased density present within the right lumpectomy site. Stable benign calcifications are present bilaterally. Percutaneously placed clips, from prior benign breast biopsies, are seen bilaterally. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast.
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Stable postsurgical changes of the right 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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52-year-old male with history of prostate cancer. Staging examination. This examination was performed per the research protocol after administration of 120 cc's of intravenous Omnipaque 350.
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This examination was performed for research purposes only.
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Generate impression based on findings.
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Male 76 years old; Reason: metastatic prostate cancer evaluation of disease after 3 cycles of investigational therapy. please complete PCWG2 form Persistent uptake in the Left sacral, right iliac and left 10th rib foci are unchanged. These foci correlate with sclerotic osseous lesions seen on same day CT scan. Left mid to distal humerus lesion is stable in appearance. No new suspicious osseous lesions.
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Stable appearance of multifocal osseous metastatic disease, with no new abnormal foci identified.
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Generate impression based on findings.
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Two -year-old male with coarse breath soundsVIEWS: Chest AP/lateral (two views) 02/02/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No peribronchial cuffing suggestive of bronchiolitis/reactive airway disease. No pulmonary opacities.
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Bronchiolitis/reactive airway disease pattern.
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Generate impression based on findings.
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3-year-old male with fever, cough, prematurityVIEWS: Chest AP/lateral (two views) 02/02/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Mild peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern.
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Reactive airway disease/bronchiolitis pattern.
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Generate impression based on findings.
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44-year-old male with metastatic renal medullary carcinoma. Assess for ongoing response to therapy. CHEST:LUNGS AND PLEURA: Persistent bilateral basilar ground glass opacities consistent with scarring. Three to 4-mm nodule in the right upper lobe near previously noted region of bronchiectasis is nonspecific (series 5, image 26).MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable hypoattenuating lesion in the superior pole of the right kidney, presumably a high attenuating cyst.RETROPERITONEUM, LYMPH NODES: Reference right retrocrural lymph node measures 1.4 x 0.7 cm (series 4, image 83), previously measuring 1.9 x 0.6 cm.Reference left retrocrural lymph node measures 0.9 x 0.6 cm (series 4, image 83), previously measuring 1.1 x 1.3 cm.Reference retroperitoneal lymph node measures 1.6 x 0.9 cm (series 4, image 105), previously measuring 1.6 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Continued interval decrease in size of lymphadenopathy. 2.No definite evidence of new sites of disease.3.No significant interval change in appearance of scarring at the lung bases with a new right upper lobe nodule which may be part of the scarring; however, a new nodule cannot be entirely excluded and attention on subsequent follow-up examinations is recommended.
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Generate impression based on findings.
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Male 73 years old; Reason: hx of left temporal scalp melanoma, identify sentinel lymph nodes RADIOPHARMACEUTICAL: The left temporal scalp was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected in four perilesional injections. A focus of increased activity is noted in the preauricular lymph node, representing the sentinel node(s). This region was marked with an indelible marker.
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Sentinel node identified in the left preauricular lymph node.
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Generate impression based on findings.
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13-year-old male with right femur lesion with adjacent stress reaction, evaluate for interval change/healing. Four views of the right femur demonstrate a lucent lesion in the lateral distal femoral metadiaphysis which abuts the lateral cortex and results in mild expansile remodeling. The majority of the lesion has a thin sclerotic margin and measures approximately 7.5 cm in craniocaudal dimension and up to 3.5 cm in transverse dimension. We see no fracture or periosteal reaction.
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Benign-appearing lesion of the distal femur most likely represents a large nonossifying fibroma. Alternatively this could represent a focus of fibrous dysplasia, but this is considered less likely. We see no fracture.
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Generate impression based on findings.
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Male 27 years old; Reason: gastric emptying for gastroparesis Visually there was persistent abnormal retention of radiotracer in the stomach with delayed emptying.Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 90.3 % of peak activity (normal >70 %)1 hour: 88.8 % of peak activity (normal 30-90 %) 2 hours: 89.6 % of peak activity (normal <60 %) 4 hours: 80.9 % of peak activity (normal <10 %)
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Findings consistent with marked gastroparesis.
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Generate impression based on findings.
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There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is mild mucosal thickening within the maxillary sinuses. The mastoid air cells are clear. However, there are opacities within the bilateral external auditory canals, which likely represent cerumen. The skull and scalp soft tissues are unremarkable. There is incomplete fusion of the posterior arch of C1, which is an anatomic variant.CTA HEAD
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1. No evidence of acute intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. No evidence of significant cerebrovascular steno-occlusive lesions.
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Generate impression based on findings.
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Stage III melanoma of the left neck. There are post-surgical findings related to a left neck dissection. There are scattered subcentimeter subcutaneous nodules in the posterior neck, which likely represent occipital lymph nodes. There is no evidence of significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is reversal of the usual cervical lordosis. There is cervical spondyloarthropathy with mild to moderate bilateral foraminal stenoses at C3-4, C4-5, C5-6, and C6-7. The osseous structures are otherwise unremarkable. The airways are patent. The right maxillary sinus is hypoplastic. The imaged intracranial structures are unremarkable. The imaged portions of the lungs demonstrate scattered micronodules.
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1. Post-surgical findings related to a left neck dissection. No significant mass lesion or cervical lymphadenopathy.2. Scattered nonspecific pulmonary micronodules. Please refer to the separate chest CT report for additional details.3. Cervical spondyloarthropathy with mild to moderate bilateral foraminal stenoses at C3-4 through C6-7, but no significant spinal canal stenosis.
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Generate impression based on findings.
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16-year-old male with osteosarcoma treated with allograft reconstruction. Two views of the left tibia/fibula show two plate and screw devices affixing allograft between the native proximal tibial epiphysis and proximal tibial diaphysis in near anatomic alignment. The proximal osteotomy margin is indistinct suggesting healing. There is apparent bridging of bone along the distal osteotomy appearing similar to the prior study without evidence of hardware complication.A bone length study of the lower extremities was obtained with measurements as follows:Length of the left femur: 44.8 cm.Length of the left tibia: 34.2 cm.Length of the left leg: 79.7 cm.Length of the right femur: 46.3 cm.Length of the right tibia: 35.8 cm.Length of the right leg: 82.7 cm.Estimated leg length discrepancy: 3 cm.
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1.Orthopedic fixation of left tibial allograft reconstruction without evidence of complication.2.Leg length discrepancy as described above.
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Generate impression based on findings.
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66 years, Male. Reason: please confirm placement of J-tube (contrast given) History: please confirm placement of J-tube (contrast given) GJ tube tip in the jejunum. Contrast noted within the small bowel and ascending colon. Nonobstructive bowel gas pattern. No free intraperitoneal air. Scattered abdominal surgical clips. Right basilar consolidation / effusion.
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GJ tube tip in the jejunum.
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Generate impression based on findings.
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Dobhoff placement Dobhoff tip in the region of the gastric antrum / pylorus. Nonobstructive bowel gas pattern. Retained contrast in the colon.
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Dobhoff tip in the region of the gastric antrum / pylorus.
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Generate impression based on findings.
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25-year-old male with history of palpable mass. Right wrist: There is poorly defined soft tissue fullness along the lateral epicondyle of the distal humerus presumably representing the patient's palpable mass. This lesion measures approximately 2 cm in greatest dimensions. There is no evidence of joint effusion or underlying bone abnormality.Left elbow: There is focal soft tissue prominence along the dorsal aspect of the wrist presumably representing the patient's palpable mass. This is nonspecific, but may represent a cyst or ganglion. This lesion measures approximately 2.5 cm in its greatest dimension. The underlying bones are are unremarkable.
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Soft tissue masses of the wrist and elbow as described above. These can be further evaluated with MRI or ultrasound if clinically warranted.
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Generate impression based on findings.
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Dobhoff placement Dobhoff tube tip in the region of the gastric pylorus / duodenum. Nonobstructive bowel gas pattern. Peritoneal calcifications consistent with history of peritoneal dialysis. The bones are demineralized. Vascular calcifications and calcified fibroids.
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Dobhoff tip in the pylorus / duodenum.
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Generate impression based on findings.
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58-year-old female with history of metastatic breast cancer on hormonal therapy. Evaluate for treatment response and extent of disease. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Small amount of pericardial effusion is stable. No significant interval change in the aortic valve.CHEST WALL: Postoperative changes of left mastectomy and left axillary node dissection. Subcentimeter soft tissue attenuation in the left axilla is unchanged compared to prior examination. No subpectoral or internal mammary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Postoperative changes of cholecystectomy without significant biliary ductal dilatation. No focal hepatic lesions.SPLEEN: An accessory splenule is again noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple punctate non-obstructing renal stones. Multiple hypoattenuating foci within the kidneys bilaterally are too small to characterize and unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat containing anterior abdominal wall hernia without evidence of small bowel obstruction.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: 2.5 cm hypoattenuating focus measuring approximately 10 Hounsfield units which is likely adnexal in etiology and a cyst is stable compared to the 2012 examination.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable sclerotic osseous lesions. L4 vertebral body hemangioma is stable.OTHER: No significant abnormality noted.
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1.Stable osseous sclerotic lesions suggestive of metastatic disease. Please refer to concurrent nuclear medicine bone scan for report for more sensitive evaluation of osseous metastatic disease.2.No additional evidence of metastatic disease.
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Generate impression based on findings.
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Nasal congestion and post nasal drip. There is minimal mucosal thickening in the alveolar recess of the right maxillary sinus. The other paranasal sinuses are clear. The nasal cavity is clear. The anterior nasal septal is deviated towards the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There is incomplete fusion of the anterior and posterior C1 arch elements.
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Minimal mucosal thickening in the alveolar recess of the right maxillary sinus. The other paranasal sinuses and nasal cavity are otherwise clear.
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Generate impression based on findings.
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NJ not functioning please evaluate for position NJ tube in the region of the ligament of Treitz without evidence of kinking or discontinuity. Percutaneous pigtail catheter in the left hemiabdomen. Nonobstructive bowel gas pattern. Left basilar opacity.
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NJ tube in the region of the ligament of Treitz without kinking or discontinuity.
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Generate impression based on findings.
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37 year old male with history of giant cell tumor. Redemonstrated are postoperative changes in the right distal femur of giant cell tumor curettage and packing with cement. Bone formation along the lateral aspect of the cement appears similar to prior. There are no specific radiographic findings of tumor recurrence.
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Postoperative changes of giant cell tumor curettage and packing without specific radiographic findings of tumor recurrence.
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