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Generate impression based on findings.
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55-year-old male with remote history of CVA, now with new right lower extremity weakness. The exam is degraded by motion. Evaluation of acute ischemia is limited secondary to extensive encephalomalacia related to prior left middle cerebral artery and right posterior cerebral artery territorial infarctions, which are grossly stable when compared to prior exam. There is associated ex vacuo dilatation of the lateral ventricles. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. No extra-axial collections are identified. There are extensive patchy and confluent areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminate small vessel ischemic changes.There is a small polyp/retention cyst in the roof of the right maxillary sinus. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable.
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1. No evidence of acute intracranial hemorrhage or mass effect. 2. Evaluation of acute ischemia is limited secondary to multiple bilateral chronic territorial infarctions, which are grossly stable. 3. Recommend MRI if clinical concern for new stroke is high.
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Generate impression based on findings.
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67-year-old male with history of ankle fracture. Overlying cast material limits fine osseous detail. Again seen is the aforementioned trimalleolar fracture appearing similar to prior.
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Trimalleolar fracture appearing similar to prior.
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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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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67-year-old male with history of ankle fractures. Overlying cast material limits fine osseous detail. Redemonstrated is the aforementioned trimalleolar fracture. There has been perhaps slight reduction, but overall this appears similar to the prior studies.
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Trimalleolar fracture as described 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 of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. The biopsy clip in the lower inner right breast is stable in position. Benign scattered calcifications are noted bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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66 years, Male. Reason: s.p DHT placement History: eval DHT Mid-lower pelvis excluded from field of view.Dobbhoff tip projects over proximal gastric body just beyond GE junction.Nonobstructive bowel gas pattern.Bone island left iliac crest.
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Dobbhoff tube tip projects over proximal gastric body.
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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, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Mental status change. Intubation.VIEW: Chest AP (one view) 2/3/15 at 433 hours ET tube terminates below thoracic inlet. NG tube is present. Vagal nerve stimulator unchanged. Cardiac silhouette size is normal. Persistent, slightly improved subsegmental atelectasis of both lung bases.
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Persistent, slightly improved subsegmental atelectasis of both lung bases.
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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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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67-year-old male with history of left ankle fracture. Overlying cast material limits fine osseous detail. Redemonstrated is a trimalleolar fracture. There has been interval reduction of the ankle joint and medial malleolar fracture fragment. There is now slight anterior angulation of the distal fibular fracture fragment.
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Trimalleolar fracture as described 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 of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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 were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Left lumpectomy and radiation in 2011. Outside imaging in Michigan. Three standard views of both breasts with spot compression view 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. An asymmetry in the lateral right breast disperses with spot compression. Architectural distortion and increased density in the left upper outer breast is compatible with post-surgical changes of prior lumpectomy, though stability of the appearance cannot be assessed. No dominant mass or suspicious microcalcifications is evident in either breast.
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Presumed post-surgical change in the left breast. Mammography is optimally performed when prior studies are available to detect changes. Comparison to the patient's prior mammograms is recommended to assess for interval changes. Findings and recommendation were discussed with the patient.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison.
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Generate impression based on findings.
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22 years, Female. Reason: Eval NGT placement History: NGT placement Surgical staple line right lower quadrant. Single dilated loop of jejunum in the midabdomen measuring 3.9 cm in diameter consistent with a focal ileus. NG tube coiled in the distribution of the gastric fundus. Osseous structures are normal.
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NG tube coiled in the distribution of the gastric fundus.
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Generate impression based on findings.
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Bilateral knee pain. Evaluate for osteoarthritis. Please note that these images are nonweightbearing.Three views of the right knee reveal marked deformity of the proximal tibia consistent with an old remote fracture. There is some medial joint space narrowing consistent with osteoarthritis.Three views of the left knee reveal medial joint space narrowing consistent with moderate osteoarthritis. No acute abnormalities.
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Posttraumatic deformity of the right knee with osteoarthritis. Osteoarthritis of the left knee.
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Generate impression based on findings.
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Reason: Evaluate for new RUE and RLE weakness and numbness Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the right vertebral artery. There is aortic arch origin of the left vertebral artery. There are calcifications present at the origin of the left vertebral artery associated with a stenosis.There is heterogeneous density of the thyroid gland. Atherosclerotic calcifications are present at the carotid bifurcations.There are degenerative changes present in the cervical spine with facet hypertrophy in the upper cervical spine and the large anterior osteophytes and mean lower cervical spine are.Findings suggest centrilobular emphysema.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.There is 50% stenosis present at the origin of the left middle cerebral artery.There is mild fusiform dilation of the left middle cerebral artery inferior division to approximately 3 mm disk distal to a 50% stenosis at the proximal left inferior division of the MCA.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right A1 segment is hypoplastic. The anterior communicating artery is relatively large. There is a fetal origin of the posterior cerebral arteries bilaterally with small P1 segments. The basilar artery is relatively small. The right vertebral artery is larger than the left vertebral artery.The right posterior cerebral artery is an narrowed at the proximal right P2 segment.There is 65% stenosis at the origin of the right superior cerebellar artery. The left superior cerebellar artery originates from the left posterior cerebral artery which has a fetal origin.There is cavernous origin of the right ophthalmic artery which enters the orbit through the superior orbital fissure.CT head:There is redemonstration of encephalomalacia involving the right superior and middle temporal gyri and the right inferior parietal lobule.Periventricular and subcortical white matter hypodensities of a moderate degree are present.Punctate hypodensities are present in the basal ganglia.The visualized portions of the paranasal sinuses demonstrate some opacities in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Atherosclerotic calcifications are present along the distal internal carotid arteries.
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1.There is 50% stenosis present at the origin of the left middle cerebral artery2.There is a 65% stenosis present at the origin of the right superior cerebellar artery.3.There is mild fusiform dilation of the left middle cerebral artery inferior division to approximately 3 mm disk distal to a 50% stenosis at the proximal left inferior division of the MCA.4.Stenosis at the origin of the left vertebral artery from the aortic arch.5.Encephalomalacia of the right temporal and parietal lobes is redemonstrated.6.Old lacunar infarcts are redemonstrated in the basal ganglia.7.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 8.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.9.Findings suggest centrilobular emphysema.10.Heterogeneous appearing thyroid gland is nonspecific on CT. Please correlate with clinical symptoms
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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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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14-year-old female with chest pain and pericardial effusionVIEW: Chest AP (one view) 02/03/15, 0017 Aortic arch, cardiac apex, and stomach are left-sided. Mild to moderate enlargement of the cardiac silhouette with straightening of the left heart border may be secondary to pericardial effusion as provided in the history. Small to moderate right and small left pleural effusions. No pneumothorax. Bibasilar lung haziness may represent mild pulmonary edema pattern. Retrocardiac opacity likely represents atelectasis.
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Pericardial and pleural effusions. Differential considerations include autoimmune, rheumatological, and infectious etiologies.
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Generate impression based on findings.
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65 years, Male. Reason: OG, Dobbhoff placement . Dobbhoff tube coiled in gastric body. NG tube tip in the distribution of proximal gastric body. LVAD and surgical clips. Right common iliac catheter.
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Dobbhoff tube is coiled in the proximal gastric body distribution.
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Generate impression based on findings.
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Sepsis and bronchiolitis.VIEW: Chest AP (one view) 02/03/15, 0323 Opacities in the right upper and left lower lobes are more confluent. No volume loss is detected. Increased opacity is noted in the right infrahilar region. Cardiothymic silhouette is normal.
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Worsening lung opacities may be pneumonia complicating bronchiolitis.
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Generate impression based on findings.
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47-year-old female with history of pain. Left knee: There is a moderate-sized joint effusion. We see no discrete fracture, however there is a poorly defined bandlike lucency overlying the lateral tibial plateau which is only appreciated on the AP view. While this may be of no clinical significance, if there is strong clinical concern for a tibial plateau fracture, a CT is recommended. Mild osteoarthritis affects the knee.Left tibia/fibula: We see no acute fracture. Mild osteoarthritis affects the ankle.
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Osteoarthritis and knee joint effusion as described above. If there is strong clinical concern for a tibial plateau fracture, CT is recommended.
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Generate impression based on findings.
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Female; 48 years old. Reason: r/o PE - 1st dose pre-tx at 530pm. History: chest pain and SOB PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Multiple pulmonary nodules and masses are unchanged. No new pulmonary nodules or masses.Reference left upper lobe juxtapleural mass measures 18 x 11 mm (series 10/48), unchanged.Reference left lower lobe nodule measures 6 mm (series 10/54), unchanged.Reference right anterior juxtapleural mass measures 18 x 6 mm (series 7/163), unchanged.New small right pleural effusion with minimal adjacent subsegmental atelectasis. Stable fibrosis with traction bronchiectasis in the medial left lung base.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No visible coronary artery calcifications. Grossly stable cardiophrenic lymphadenopathy.CHEST WALL: Grossly stable left chest wall nodules. Reference lesion adjacent to the left serratus anterior muscle measures 23 x 16 mm (series 7/156), unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuating hepatic lesion in segment 5 is partially visualized. Status post cholecystectomy. Stable peri-splenic lesions. Stable gastrohepatic ligament mass.
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1. No acute pulmonary embolus.2. New small right pleural effusion.3. No significant interval change in metastatic disease in the chest and partially visualized upper abdomen.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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9-year-old male intubatedVIEW: Chest AP (one view) 02/03/15, 0424 ET tube tip is below thoracic inlet and above carina. Left central venous catheter and right upper extremity PICC tips are at the superior cavoatrial junction.Mild enlargement of the cardiac silhouette. Bilateral pleural effusions. Predominantly bibasilar airspace opacities suggestive of pulmonary edema. Retrocardiac atelectasis is also present.
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Worsening pulmonary edema pattern with retrocardiac atelectasis.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Subcentimeter mucus retention cyst in the nasopharyngeal soft tissues.
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Normal MRI brain.
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Generate impression based on findings.
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Female, 64 years old, with increased ICP s/p EVD placement. Evaluate for subdural hematoma. A large hyper attenuating hematoma is redemonstrated involving the left thalamus, basal ganglia, insula and corona radiata. The size of this hematoma has not substantially changed from the prior examination, nor has the degree of edema immediately surrounding the hematoma.However, patchy areas of hypoattenuation involving the left temporal lobe are new from the prior examination and suspicious for ischemic injury.Since the prior examination, a right frontal approach ventriculostomy catheter has been placed with the catheter tip sitting at the level of the third ventricle. Ventricular caliber has decreased since the prior examination. The quantity of intraventricular blood product is not substantially changed.Mild extra-axial blood product, probably subarachnoid, is seen along the right cerebellar hemisphere and perhaps minimally along the right cerebral hemisphere, not significantly changed from prior. No evidence of any new intracranial hemorrhage is detected.Generalized mass-effect is again seen with a midline shift to the right of approximately 12 mm, not significantly changed, along with effacement of the left lateral ventricle.
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1. Stable size of a large left cerebral hematoma.2. Interval placement of a right frontal approach ventriculostomy catheter with no evidence of complication. Catheter size has diminished and the quantity of intraventricular blood product remains approximately the same.3. Areas of hypoattenuation within the left temporal lobe are new when compared to the prior examination and are suspicious for interval development of ischemic injury. Discussed with Dr. Kim at 9:30AM on 2/3/15.
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Generate impression based on findings.
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44-year-old female with history of ankle fracture. Redemonstrated is a comminuted fracture of the distal fibular diaphysis. There are additional fractures of the medial malleolus and "posterior malleolus". There now appears to be slight lateral angulation of the medial malleolar fracture fragment and talus when compared to prior.
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Ankle fractures as above with slight lateral angulation of the medial malleolar fracture fragment and talus.
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Generate impression based on findings.
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69-year-old female with history of pain and swelling. There is a 1 cm crescentic density dorsal to the head of the talus which is suspicious for a small avulsion fracture. There is a small tibiotalar joint effusion. Mild osteoarthritis affects the midfoot.
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Talar avulsion fracture as described above. This was relayed to and acknowledged by the Emergency Department via the STAT Consult system.
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Generate impression based on findings.
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7-year-old female with swelling of the left upper extremity and fever of unknown etiology, evaluate for osteomyelitis There is significant soft tissue edema overlying the dorsum of the hand with circumferential involvement starting at the level of the radiocarpal joint and extending proximally up to the elbow joint. Small elbow joint effusion is noted. No abnormal T1 hypointense or T2/STIR hyperintense signal is identified in the bone marrow to suggest osteomyelitis. No loculated fluid collection to suggest abscess. There are an ill-defined areas of enhancement within the soft tissues along the volar aspect of the wrist on the radial side and dorsal aspect of the wrist on the ulnar side without obvious extension into the radiocapitellar joint space.
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1.Findings are compatible with cellulitis without evidence of osteomyelitis or abscess as described above.2.Small elbow joint effusion.
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Generate impression based on findings.
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Reason: assess for lymphadenopathy, new diagnosis of leukemia (hx of HNSCC, prostate CA, lung CA) History: new leukemia The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. The nasal septum is deviated towards the right side.The frontal sinuses are clear.Maxillary sinuses demonstrate mild mucosal thickening Ethmoid air cells are clear . Sphenoid sinuses are clear. Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. The right eyeball lens is thin. Atherosclerotic calcifications are present along the distal internal carotid arteries.There are degenerative changes present in the cervical spine.
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1.There is mild mucosal thickening in some of the paranasal sinuses is no evidence for acute sinusitis.2.The nasal septum is deviated towards the right side
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Generate impression based on findings.
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There are patchy periventricular and innumerable punctate bilateral subcortical white matter T2 hyperintensities, nonspecific but favored to represent chronic small vessel ischemic disease. There is no pathologic enhancement or diffusion abnormality. The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
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1. No foci of abnormal enhancement to suggest intracranial metastatic disease. 2. Moderate chronic small vessel ischemic disease.
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Generate impression based on findings.
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RSV bronchiolitis. Prior abnormal chest radiograph.VIEW: Chest AP (one view) 02/03/15, 0533 Right upper lobe atelectasis has resolved. Residual hazy opacity is noted in right perihilar region. Left lower lobe linear opacities are seen. Lung volumes are large. Cardiothymic silhouette is normal.
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Residual hazy opacity of the right and subsegmental atelectasis in left lower lobe.
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Generate impression based on findings.
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60 year-old with area of thickening and lumpiness in the left breast. Three standard views of both breasts and left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. This includes no new or suspicious finding under the palpable marker on the left inner breast.ULTRASOUND
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Skin lesion compatible with an epidermal cyst at the site of palpable concern. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal and signs and symptoms of this finding are not worsening, bilateral screening mammogram is recommended annually. Results and recommendation 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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48-year-old female with history of fall. Right ankle: There is mild soft tissue swelling about the lateral aspect of the ankle. There is a tiny ossicle adjacent to the distal fibula which may represent old trauma, but we see no acute fibular fracture. There is a minimally displaced fracture of the "posterior malleolus" of the distal tibia with minimal widening of the medial tibiotalar gutter on the stress view of questionable clinical significance. There is a tibiotalar joint effusion.Right tibia/fibula: Again seen is the aforementioned "posterior malleolus" fracture. There is also an oblique fracture through the proximal fibular diaphysis in near-anatomic alignment. Right knee: Redemonstrated is the aforementioned proximal fibular fracture in near-anatomic alignment. Mild osteoarthritis affects the knee.Right hand: We see no acute fracture or malalignment. The soft tissues are unremarkable.
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Fracture of the right "posterior malleolus" of the distal tibia and proximal fibular diaphysis as described above.
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Generate impression based on findings.
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Reason: Obtain baseline CTH prior to restart of anticoagulation History: R BG hematoma with extension in ventricles There is redemonstration of intraventricular blood and a hematoma centered in right thalamus associated with some hypodensity adjacent to the right thalamic hematoma. Compared to the prior exam there is no significant change in the extent of the hematoma. The hematoma is less dense on the current exam.CT HEAD WO, 2/3/2015 5:15 AMCLINICAL INFORMATION:Reason: Eval for baseline CTH prior to anticoagulation restart History: Eval for baseline CTH prior to anticoagulation restartCOMPARISON: 1/24/15TECHNIQUE: Contiguous axial CT images were obtained of the brain without contrast. Sagittal and coronal reconstructions were performed.
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1.Continued evolution of thalamic and intraventricular blood. Examination is otherwise stable.
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Generate impression based on findings.
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Ankle pain. Foot pain. Four views of the right foot reveal no acute abnormalities. There are some radiopaque densities seen on the AP view only along the lateral aspect of the third toe. This is most likely artifactual. Incidental note is made of a very small accessory navicular bone.Three views of the right ankle are unremarkable.
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Unremarkable examination of the right foot and ankle
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Generate impression based on findings.
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73 years, Male. Reason: 73M s/p cystectomy with abdominal pain, distension History: abdominal pain, distension Moderately dilated transverse colon with some air-fluid levels in hepatic flexure, consistent with colonic postsurgical ileus. No evidence of obstruction. No intramural air or free air.Pelvic vertical staple line. Pelvic JP drain. Surgical clips.Bilateral nephroureterostomy catheters and ileal diversion loop.Presumed ingested pills in a dilated stomach. L2-3 discogenic disease.
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Postop ileus.
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Generate impression based on findings.
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Fracture.VIEWS: Left elbow AP/lateral (two views) 02/03/15 Two screws remain in place in the medial humerus. Cast has been removed. The fracture is completely healed. Curvilinear ossification is noted along the lateral aspect of the distal humerus. This is most likely the ossification center for the lateral epicondyle. No soft tissue swelling or joint effusion is present.
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Healed fracture.
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Generate impression based on findings.
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Female; 31 years old. Reason: concern for PE History: as above, known SLE PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No acute pulmonary embolus or other acute cardiopulmonary abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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71-year-old male with malignant glucagonoma to the liver. Evaluate for Therasphere mapping. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are noted. Interval development of right lower lobe airspace and groundglass opacities which are likely infectious or inflammatory in etiology.MEDIASTINUM AND HILA: Mildly prominent anterior mediastinal lymph node measuring up to 7 mm in short axis (series 10, image 29). Heart size is normal in size without pericardial effusion. Severe coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Surgical clips in the dome of the liver are unchanged. Conventional hepatic arterial anatomy from the celiac axis. Patent hepatic veins and portal venous system. No significant interval change in the multiple hypervascular metastases.Reference caudate lobe metastatic focus measures 4.4 x 3.5 cm (series 9, image 39), previously measuring 4.5 x 3.5 cm.Reference right hepatic lobe lesion measures 2.9 x 2.0 cm (series 9, image 40), previously measuring 2.8 x 2.1 cm.Reference hepatic segment 8 lesion measures 1.8 x 1.2 cm (series 9, image 21), previously measuring 2.0 x 1.1 cm.SPLEEN: No significant abnormality notedPANCREAS: Stable atrophy of the pancreatic parenchyma with associated dilation of the pancreatic duct.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Unchanged left renal sinus cyst. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes about the bowel without evidence of small bowel obstruction.BONES, SOFT TISSUES: Mild degenerative changes about the visualized spine.OTHER: 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: Mild to moderate degenerative changes affect the visualized spine.OTHER: No significant abnormality noted
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1.No significant interval change in arterially enhancing hepatic lesions. Conventional hepatic arterial anatomy from the celiac axis. Patent hepatic veins and portal venous system. 2.Stable pancreatic atrophy and associated pancreatic ductal dilatation.3.Mildly enlarged pretracheal lymph node.4.Right lower lobe air space and groundglass opacities likely infectious versus inflammatory in etiology.
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Generate impression based on findings.
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Fracture.VIEWS: Right humerus AP/lateral (two views) 02/03/15 Callus formation is being incorporated into the cortex at the fracture of the humeral mid diaphysis. Alignment is unchanged with posterior displacement and minimal medial angulation.
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Continued healing of mid humeral fracture
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Generate impression based on findings.
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Status post surgery for hallux valgus deformity. Four views of the right foot reveal a Lapidus procedure consisting of attempted fusion of the medial cuneiform to the base of the first metatarsal fixed with two screws. There has been a medial osteotomy of the first metatarsal head. The previously seen hallux valgus deformity has been corrected.
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Status post surgery for previous hallux valgus deformity. Now in anatomic alignment
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Generate impression based on findings.
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57-year-old male with history of fall. Left shoulder: Mild osteoarthritis affects the acromioclavicular joint. We see no fracture or dislocation. Degenerative disc disease affects the visualized spine.Right wrist: Mild soft tissue swelling about the wrist, but we see no acute fracture or malalignment. Mild osteoarthritis affects the wrist.Right hand: There are mild degenerative changes affecting the hand, but we see no acute fracture or malalignment.
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Osteoarthritis without acute fracture.
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Generate impression based on findings.
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Fracture.VIEWS: Left ankle AP/lateral/oblique (3 views) 02/03/15 Cast has been removed. Three K wires in the tibia and two screws in the fibula remain in place.Alignment is anatomic. Fracture lines are not visible. Demineralization is noted.
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Healing ankle fractures.
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Generate impression based on findings.
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Status post fractureVIEWS: Right ankle AP, lateral and oblique 2/3/15 (3 views) Single screw affixing a healing fracture of the distal epiphyses of the right tibia is again noted. No evidence of hardware complications. Alignment is anatomic.
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Healing fracture, in anatomic alignment with no evidence of hardware complications.
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Generate impression based on findings.
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Dysphagia The exam was negative for penetration and negative for tracheal aspiration.
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The exam was negative for penetration and negative for tracheal aspiration.
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Generate impression based on findings.
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17 year-old male with history of sickle cell disease now with swelling, pain, warmth for assessment of osteomyelitis Scattered areas of bone infarcts are noted throughout the distal tibia, fibula and tarsal bones. Few areas of decreased T1 and increased T2 signal intensity may represent either red marrow or subacute infarcts. Small amount of fluid demonstrating rim enhancement surrounds the insertion of the Achilles' tendon. Small amount of fluid, particularly within the tibiotalar and talocalcaneal joints, is of unknown clinical significance. No osseous irregularity or bone marrow signal abnormality to suggest osteomyelitis. No abnormal areas of enhancement. The muscles are within normal limits. The soft tissues are within normal limits.
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1.Small amount of peripherally enhancing fluid anterior to the Achilles tendon insertion may represent a tenosynovitis.2.Few areas of decreased T1 and increased T2 signal intensity may represent either red marrow or subacute infarcts.3.No specific evidence of osteomyelitis.
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Generate impression based on findings.
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There is unchanged thickening of the right nasolacrimal sac and nasolacrimal duct that extends to the dermis as well as enhancement of the sac. There is mild dilation of the bony duct canal. There is also slightly increased swelling of the right lower lid. There is non-specific air within the duct and no tube is definitely identified. The extraocular muscles and optic nerves are normal in size and attenuation. There is no evidence of intraorbital mass, bone destruction or fracture of the orbital walls. There are non-specific secretions within the left sphenoid sinus.
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Unchanged thickening of the right nasolacrimal sac and nasolacrimal duct as well as enhancement of the sac. There is also slightly increased swelling of the right lower lid. The findings are non-specific and of uncertain etiology.
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Generate impression based on findings.
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Left MCA stroke NONCONTRAST CT HEADThere is a region of hypoattenuation within the periphery of the left subcortical and cortical frontal lobe and part of the left basal ganglia. This causes mild regional mass effect and sulcal effacement likely representing a subacute ischemic infarct. It measures 2.8 x 4.0 cm. No evidence of acute intracranial hemorrhage, midline shift or herniation.The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The maxillary sinuses and ethmoid air cells are opacified. The mastoid air cells are clear. Partially empty sella is incidentally noted.CTA HEAD AND NECKThe left common carotid artery arises from the brachiocephalic artery which is a normal variant. There is mild atherosclerotic narrowing of the proximal takeoff of the left vertebral artery as well as the bilateral carotid arteries near the carotid bifurcations but there is no significant steno-occlusive disease of the arteries within the neck. There is mild calcific atherosclerotic involvement of the cavernous and supraclinoid segments of the internal carotid arteries. The right MCA and ACA arteries are normal in caliber. The left MCA is tortuous and demonstrates a region of mild to moderate focal atherosclerotic stenosis of the proximal M1 segment. There is also a mild focal stenosis of M2 of the left MCA. There is a paucity of distal left MCA branches.Within the posterior circulation, the post-PICA V4 segment of the left vertebral artery demonstrates mild normal variant hypoplasia. The remaining vertebral-basilar, posterior-inferior cerebellar, anterior-inferior cerebellar, superior cerebellar, and posterior cerebral arteries are without significant steno-occlusive disease. There is normal contrast opacification through a complete circle-of-Willis with a patent anterior communicating artery and bilateral posterior communicating arteries. No evidence of aneurysm, dissection, or vascular malformation is noted.Incidental note is made of a left thyroid nodule.
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1.No evidence of acute intracranial hemorrhage.2.Findings compatible with a subacute ischemic infarct involving the left frontal lobe and partially involving the left basal ganglia.3.Mild to moderate focal stenosis of the proximal M1 segment and mild focal stenosis of the M2 segment of the left MCA . 4.Paucity of distal left MCA branches.5.Mild atherosclerotic involvement of the proximal left vertebral artery, carotid arteries at the bifurcations in the neck and intracranially in the cavernous and supraclinoid internal carotid artery segments bilaterally.
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Generate impression based on findings.
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History of benign right breast biopsy and left mastectomy. Presents with periareolar palpable mass for 1 week. Her family history is positive for breast cancer in a paternal aunt and cousin. Three standard views of the right breast with spot compression images were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution.Circumscribed subcentimeter round masses are stable in the right retro-areolar breast. Multiple benign-appearing calcifications are similar to prior. A subcentimeter circumscribed mass in the superficial right peri-areolar breast persists on spot compression imaging. No suspicious microcalcifications or suspicious areas of architectural distortion are present in the right breast. ULTRASOUND
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Complicated right breast cyst. This was not significantly enhancing on last year's MRI. Short term follow up versus fine needle aspiration will be considered by Dr. Jaskowiak. BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation.
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Generate impression based on findings.
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NONCONTRAST CT HEADThere is a region of hypoattenuation within the periphery of the left subcortical and cortical frontal lobe and part of the left basal ganglia. This causes mild regional mass effect and sulcal effacement likely representing a subacute ischemic infarct. It measures 2.8 x 4.0 cm. No evidence of acute intracranial hemorrhage, midline shift or herniation.The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The maxillary sinuses and ethmoid air cells are opacified. The mastoid air cells are clear. Partially empty sella is incidentally noted.
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1.No evidence of acute intracranial hemorrhage.2.Findings compatible with a subacute ischemic infarct involving the left frontal lobe and partially involving the left basal ganglia.
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Generate impression based on findings.
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72 years, Female. Reason: dobhoff placement Dobhoff tube is coiled in the stomach with the tip directed back into the esophagus. Additional hardware and catheters are unchanged.
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Dobhoff tube is coiled in the stomach with the tip directed back into the esophagus.
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Generate impression based on findings.
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62-year-old male with history of renal cancer who presents for restaging follow-up. CHEST:LUNGS AND PLEURA: Multiple bilateral parenchymal lung nodules consistent with metastatic disease are again seen.Reference right upper lobe nodule measures 2.4 x 1.4 cm (series 5, image 28), previously measuring 2.3 x 1.5 cm.Reference right lower lobe nodule measures 2.3 x 1.2 cm (series 5, image 64), previously measuring 2.2 x 1.3 cm.Reference left lower lobe subpleural nodule measures 0.6 cm (series 5, image 37), previously measuring 0.7 cm.MEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes with reference pretracheal lymph node measuring 1.7 x 1.4 cm (series 4, image 26), previously measuring 1.6 x 1.3 cm.Heart size is normal without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: Stable bilateral slightly prominent axillary lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: No significant change in the multiple low density lesions. No new hepatic lesions identified. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal nodule measuring 2.0 x 1.2 cm (series 4, image 103), previously measuring 1.9 x 1.3 cm.KIDNEYS, URETERS: Postsurgical changes of right nephrectomy without evidence of local tumor recurrence. Left renal hypoattenuating lesion is again noted and likely a cyst. Additional subcentimeter hypoattenuating focus (series 4, image 125) measuring approximately 80 Hounsfield units is likely a proteinaceous cyst. Punctate nonobstructive left nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant change in mildly prominent retroperitoneal lymph nodes.BOWEL, MESENTERY: Small fat containing ventral abdominal wall hernia without evidence of small bowel obstruction.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.No significant interval change in pulmonary and mediastinal metastatic disease.2.Stable left adrenal gland nodule.3.No evidence of new metastatic disease.4.Punctate nonobstructive left nephrolithiasis.
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Generate impression based on findings.
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83 years, Male. Reason: eval for SBO Dobhoff tube in gastric fundus. Nonspecific mildly distended small bowel loops in the left upper quadrant; favor ileus. Moderate colonic stool burden. Degenerative changes affect the lower lumbar spine.
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Nonobstructive bowel gas pattern; favor ileus.
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Generate impression based on findings.
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70 years, Male. Reason: ng tube advanced 1.5" History: above NG tube side port at the GE junction. Multiple dilated loops of small bowel suspicious for a small bowel obstruction. Scattered intraabdominal surgical clips.
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NG tube side port at GE junction; recommend advancing. Small bowel obstruction.
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Generate impression based on findings.
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Reason: assess for lymphadenopathy, new diagnosis of leukemia (hx of HNSCC, prostate CA, lung CA) History: new diagnosis of leukemia LUNGS AND PLEURA: Evidence of a right thoracotomy with volume loss and scarring presumably related to prior surgery.Scattered areas of scarring/discoid atelectasis in both lungs.Several subpleural nodules with the largest in the right upper lobe measuring approximately 9 mm (image 47 series 5).Right basilar pleural calcification identified.No evidence of a pleural effusion.Debris identified within the trachea near the carina.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Marked coronary and aortic calcification.CHEST WALL: No evidence of axillary lymphadenopathy. Prior right thoracotomy with healing rib fractures.Median sternotomy intact.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Postsurgical changes in the right hemithorax. Scattered subpleural nodules may be post inflammatory in origin, however metastatic disease cannot be excluded. Continued surveillance is recommended.
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Generate impression based on findings.
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32 day old male status post left pyeloplasty BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 1 Left: 3 Length*** Right: 5.6 cm Left: 6.2 cm Mean for age: 5 cm Range for age: 4 - 6 cmADDITIONAL OBSERVATIONS: No perinephric fluid collections.
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No evidence of postoperative complication with interval decrease in pelvicaliceal dilatation on the left.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469
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Generate impression based on findings.
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77-year-old with history of right breast cancer status post lumpectomy in 2004, status post radiation therapy. No new complaints. 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. A scar marker overlies the right upper breast. Stable postoperative changes are present in the right breast with volume loss, postsurgical distortion, and increased density. Focal asymmetry in the left upper outer breast is unchanged. Scattered benign calcifications are benign in appearance.No dominant mass, suspicious microcalcifications, or areas of architectural distortion are present in either breast.
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Stable right breast post surgical changes. 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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Multiple circumscribed masses are present bilaterally compatible with with waxing and waning cysts. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Asymptomatic female presents for routine screening mammography. Two standard and pushback 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. Bilateral retropectoral saline implants are unchanged in position and contour. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Male 56 years old; Reason: r/o blood clots History: shortness of breath The comparison chest radiograph performed on 2/3/2015 demonstrates no focal pulmonary opacities or pleural fluid. The ventilation images show decreased ventilation to the left apex as well as a small region in the right lower lobe with eventual equilibration. There is minimal retention in the left apex. The perfusion images show multiple large segmental perfusion defects in the right lower lobe which are mismatched. There is a large mismatched perfusion defect in the left lung base. There is a mismatched perfusion defect along the inferolateral aspect of the left upper lobe. There is normal perfusion to the left apex, which reflects a mismatch given decreased ventilation to this region and could represent a physiologic shunt. On review of the outside hospital CT study dated 8/29/2014, there is evidence of recanalization of the pulmonary arteries, most notably in the right suggestive of chronic pulmonary embolism with recanalization.
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1. High probability for pulmonary embolism, which can be acute and/or chronic. When comparing with outside hospital CT from 8/2014, at least some of the findings likely relate to chronic pulmonary embolism although superimposed acute pulmonary emboli cannot be excluded on the basis of this study.2. There is an additional finding of a physiologic right to left shunt in the left apex which could be exacerbating the patient's symptoms.
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Generate impression based on findings.
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Male 51 years old; Reason: pt with stage III melanoma s/p IFN please eval disease status and compare to previous imaging History: melanoma CHEST:LUNGS AND PLEURA: Stable appearance of previously described lung nodules. Left lower lobe pleural-based nodule measures 0.7 x 0.5 cm (series 4, image 59), previously 0.7 to 0.5 cm. More inferiorly located pleural-based nodule measures 0.5 x 0.5 cm (series 4, image 29), previously 0.6 x 0.5 cm. Stable 4-mm right upper lobe pleural-based nodule (series 4, image 52), previously 4 mm. The previously described 2 mm nodule posterior inferiorly in the right upper lobe is not clearly seen.Multiple additional micronodules are subjectively unchanged.MEDIASTINUM AND HILA: No significant abnormality noted. Mild coronary artery calcification.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Scattered subcentimeter hypoattenuating lesions are too small to characterize and are unchanged. Ill-defined subcapsular arterially enhancing focus in the posterior right hepatic lobe is nonspecific but is unchanged compared to prior study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Unchanged prominent portacaval and peripancreatic nodes.BOWEL, MESENTERY: Sigmoid colonic diverticulosis without CT evidence of diverticulitis.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: Previously described abnormal soft tissue in the left inguinal region is not significantly changed compared to prior. This measures approximately 4.7 cm in transverse dimension (series 3, image 213). Thoracolumbar scoliosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Stable examination.2.No new sites of disease.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Ankle pain.VIEWS: Right ankle AP/lateral/oblique (3 views), left ankle AP/lateral/oblique (3 views) 02/03/15 No soft tissue swelling is identified. A joint effusion is not detected. The bones are normal in appearance. Alignment is anatomic.
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Normal examinations.
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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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Bilateral diffuse breast pain. History of ESRD on dialysis. Three standard views of both breasts were performed digitally with additional bilateral MLO views (8 images total) and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Prominent tortuous veins are noted bilaterally. Benign calcifications, including arterial calcifications, are present bilaterally.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.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 of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. A pacemaker pack is again noted overlying the superior left breast, which limits evaluation of this area.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. Scattered benign calcifications are noted in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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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Clinical question: ICH? Signes and symptoms: Fall, intoxicated. Nonenhanced head CT:There is no detectable posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Examination demonstrates a few small foci of low attenuation in the subcortical white matter and left basal ganglia which are suspicious for mild foci of ischemic strokes which were also present on prior exam from 2014 and stable.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces otherwise.There is no evidence of mass effect or midline shift.Calvarium is intact. Unremarkable images through the orbits and paranasal sinuses.There is poor development of bilateral mastoid air cells are middle ear cavities are main well pneumatized. There is a small lipoma in the right suboccipital soft tissues measuring approximately t 17 times 11-mm.
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1.No acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.2.Small foci of low-attenuation in the left basal ganglia and left frontal subcortical white matter similar to prior exam from 2014 and suggestive of chronic stroke.3.Small lipoma in the right suboccipital soft tissues.
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Generate impression based on findings.
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Male; 56 years old. Reason: Metastatic head and neck cancer on chemotherapy. Restaging scan. Please evaluate left posterior (left chest wall) lesion. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules and left pleural metastases are stable aside from a single left upper lobe nodule which has mildly increased in size and measures 8 mm (series 4/30), previously 5 mm.Reference left upper lobe subpleural nodule measures 10 mm (series 4/27), unchanged.Reference left pleural metastasis invading the chest wall measures 24 mm (3/82), unchanged.Reference posterior right upper lobe small, ill-defined ground glass opacity appears scar-like and is grossly stable (series 4/22). No new suspicious nodules or masses. Persistent trace left pleural effusion and minimal dependent atelectasis.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Normal heart size without pericardial effusion. No visible coronary artery calcifications.CHEST WALL: Right chest wall port catheter tip near the superior cavoatrial junction.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.G-tube tip in stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Single left upper lobe nodule has mildly increased, but otherwise stable disease in the chest.2. No evidence of metastatic disease in the abdomen.
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Generate impression based on findings.
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51-year-old male with head and neck cancer, oral tongue squamous cell carcinoma, status post glossectomy and left neck dissection on 6/18/2014 with recurrence. Postsurgical changes of left partial glossectomy and selective neck dissection with left submandibular gland resection. Ill-defined midline mass in the oral tongue surgical bed appears less prominent than the prior exam and is difficult to measure as a discrete mass. A lesion at the level of the hyoid bone overlying the left strap muscles measures 6 mm (8/47), previously 17 mm. Fascial thickening extending inferiorly to the level of the hyoid has decreased.Cervical lymphadenopathy has overall decreased. A right level 4 node measures 11 x 13 mm (8/51), previously 17 x 22 mm. Left level IIb node measures 8 x 6 mm (8/35), previously 15 x 13 mm. A right level Ia node measures 6 x 8 mm (8/43), previously 13 x 15 mm.The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. Cervical spondylosis is unchanged. Mild mucosal thickening of the left maxillary sinus is unchanged. For findings in the chest, please see dedicated chest CT performed on the same day.
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1.Ill-defined sof tissue thickening within the surgical bed is reduced in bulk and is no longer discretely measurable. 2.Significantly improved subcutaneous mass in the left neck overlying the strap muscles.3.Improved cervical lymphadenopathy.4.For findings in the chest, please see dedicated chest CT performed on the same day.
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Generate impression based on findings.
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Male 67 years old; Reason: metastatic prostate cancer, evaluation of disease after 12 month of investigational therapy History: metastatic prostate cancer CHEST:LUNGS AND PLEURA: Calcified granuloma in the left upper lobe. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. There are calcified left hilar lymph nodes.CHEST WALL: Postsurgical changes in the thoracolumbar spine.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. Subcentimeter hypodense hepatic foci are unchanged. Hepatic and portal veins are patent.SPLEEN: No significant abnormality notedPANCREAS: Atrophy of the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive postsurgical changes in the lumbar spine with pedicle screw fixation. There is grade 1-2 retrolisthesis of T12 on L1 causing moderate central canal narrowing. Sclerotic lesion in the L1 vertebral body is unchanged. (please note lumbar level)OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Fluid attenuating structure in the left pelvic side wall is unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes in the pelvis from bilateral total hip arthroplasties.Postsurgical changes with a penile pump implant.OTHER: No significant abnormality noted
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1.Sclerotic lesion in the L1 vertebral body suspicious for osseous metastatic disease.2.Progressive retrolisthesis of T12 upon L1 causing central canal narrowing. If the patient has neurologic symptoms related to conus compression further evaluation with a dedicated spine study is suggested.
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Generate impression based on findings.
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Reason: ? expansion of SDH History: S/P fall, headache, known recent SDH There is redemonstration of subdural collections adjacent to the posterior aspect of the left hemisphere which adjacent to the left occipital and temporal lobes is thinner and less dense on the current exam. It measures proximally 4 mm in greatest thickness.The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present. These appear to have accumulated since 2008.An extra-axial cystic lesion is present adjacent and posterior to the left cerebellar hemisphere which is stable compared to be previous exams dating back to 2008.There is redemonstration of the calcifications along the pial surface of the medial and posterior aspect of the left superior frontal gyrus. This was present on exams dating back to 2008. They are likely dystrophic in nature.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. There are scleral calcifications present adjacent to the insertion sites of the ciliary bodies most likely representing scleral plaque.A venous channel along the left occipital calvarium is stable compared to 2008
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1.Since the previous examination the patient's subdural hematoma adjacent to the left hemisphere has regressed in size and evolved. No new hemorrhage is appreciated.2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.Arachnoid cyst is present in the posterior fossa which remains stable compared to prior exams
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Generate impression based on findings.
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52-year-old male with history bladder cancer status post radical cystectomy with orthotopic neobladder urinary diversion. Evaluate for metastatic disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant change in subcentimeter left renal hypoattenuating lesion which is likely a cyst. Stable mild left hydroureteronephrosis which is likely secondary to a 1.5-cm distal left ureteral stricture (series 8, image 103).The kidneys enhance and excrete contrast symmetrically. The distal right ureter and mid to distal left ureter is not opacified with contrast; within this limitation, no evidence of mass/lesion within the ureters.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications affect the abdominal aorta and its branches. Mildly prominent retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy with neobladder formation.LYMPH 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.Postoperative changes of cystoprostatectomy with neobladder. 2.No evidence of metastatic disease.3.Mild left hydroureteronephrosis most likely secondary to a distal left ureteral stricture.
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Generate impression based on findings.
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82-year-old male with history of HCC. Evaluate. CHEST:LUNGS AND PLEURA: Moderate emphysema. No suspicious pulmonary nodules or masses. No pleural effusions or pneumothorax. Right middle lobe subsegmental atelectasis is present.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion. Severe coronary artery calcifications.CHEST WALL: Bilateral remote rib fractures.ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes of left hepatectomy. No significant change in the fluid attenuating collection superior to the gallbladder along the resection cavity margin measuring 3.7 x 2.7 (series 11, image 34), most likely postsurgical in etiology.Reference peripherally enhancing lesion without definite washout along the resection margin measures 3.9 x 2.6 cm (series 11, image 31), unchanged when remeasured on the prior examination.Reference segment 5 lesion does not demonstrate arterial enhancement and measures 1.2 x 1.2 cm (series 11, image 48), previously measuring 2.3 x 1.6 cm; lack of contrast enhancement suggests that there is no longer viable tumor.An additional treated hepatic segment 5 lesion (series 11, image 48) does not demonstrate arterial contrast enhancement.SPLEEN: No significant abnormality notedPANCREAS: No significant change in the nonspecific minimal prominence of the pancreatic duct.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypoattenuating renal lesions compatible with cysts are stable.RETROPERITONEUM, LYMPH NODES: Again noted is aneurysmal dilatation of the infrarenal abdominal aorta measuring up to 5.6 cm in maximal dimension. Aortobiiliac stent graft is identified.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic lesions throughout the vertebral bodies are noted, not significantly changed compared to the previous exam.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: As above.OTHER: No significant abnormality noted
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1.Postsurgical findings related to left hepatectomy. 2.Hepatic dome and hepatic segment 5 lesions without evidence of residual viable tumor.3.No significant interval change in arterially enhancing lesion adjacent to the resection cavity as above.4.Stable abdominal aortic aneurysm with postoperative findings of aortobiiliac stent graft.
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Generate impression based on findings.
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History partial right nephrectomy for renal cell carcinoma with multiple intrinsic high attenuation left renal masses on recent CT. Scheduled for ultrasound-guided biopsy of these lesions if not shown to be cystic LEFT KIDNEY: The previously noted left renal intrinsically high attenuation lesions seen on CT demonstrate cystic characteristics by ultrasound. Specifically, the upper pole lesion measures 3.4 x 2.5 cm and is consistent with a complex cyst. A more centrally located lesion measures 2.5 x 2.6 cm and is consistent with a complex cyst. A subcentimeter cystic lesion is also noted and consistent with a complex cyst.No hydronephrosis. No renal stone.
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Previously noted left renal intrinsically high attenuation lesion seen on CT on ultrasound demonstrate characteristics consistent with multiple benign complex cysts.Accordingly, no renal mass biopsy was performed. However, given the prior history of renal cell carcinoma and the complexity of these cystic foci, would recommend continued surveillance monitoring by ultrasound.
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Generate impression based on findings.
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66-year-old male with history of multiple myeloma. 60 days post autologous stem cell transplant. SKULL: Two views of the skull show no discrete myelomatous lesions.CERVICAL SPINE: Two views of the cervical spine show no discrete myelomatous lesions. Postoperative and degenerative changes appear similar to the prior study.THORACIC SPINE: Two views of the thoracic spine show no discrete myelomatous lesions. Again seen is a compression fracture of T11 appearing similar to that seen on the prior study. LUMBAR SPINE: Two views of the lumbar spine show no discrete myelomatous lesions. Anterior wedging of L1 appears similar to that seen on the prior study. RIBS: Single view of the ribs shows a punched out lytic lesion in the mid right clavicle which may represent a myelomatous deposit and appears similar to that seen on the prior study. There is an old fracture through the left lateral ninth rib with underlying lucency that may represent another myelomatous deposit, also appearing similar to that seen on the prior study.PELVIS: Single AP view of the pelvis shows no discrete myelomatous lesions. Mild osteoarthritis affects both hips.UPPER EXTREMITY: Two views of the bilateral humeri and one view of the bilateral forearms show poorly defined lucencies within the humeri with endosteal scalloping, compatible with myelomatous deposits, appearing similar to the prior study. No discrete myelomatous lesions are seen in the forearms.LOWER EXTREMITY: Two views of the bilateral femurs and one view of the bilateral tibia/fibula show no discrete myelomatous lesions.
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Multiple myeloma as described above, with findings appearing similar to those seen on the prior study.
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Generate impression based on findings.
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History of osteosarcoma. Status post limb salvage.VIEWS: Chest PA/lateral (two views) 2/30/15 at 1020 hrs. Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax. Visualized osseous structures are intact.
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Normal examination.
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Generate impression based on findings.
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13-year-old female with sickle cell disease with left hip and groin pain over the past one month.VIEWS: Pelvis AP/frog leg lateral (two views) 02/03/15 Flattening and sclerosis of the left femoral epiphysis with widening of the joint space is suggestive of avascular necrosis. There is subchondral lucency along the anterior aspect of the epiphysis. The femoral heads are well seated in the acetabulum. No acute fracture or malalignment is evident. Stool is noted throughout the colon.
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Left Legg-Calve-Perthes disease as described above.
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Generate impression based on findings.
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Female; 69 years old. Reason: history of renal cancer, assess for recurrence History: none LUNGS AND PLEURA: Stable right upper lobe ground glass nodule again measures 5 mm (series 4/22). Stable scattered pulmonary micronodules. Stable biapical scarring. No new pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Nodular appearance of the thyroid gland, unchanged. Normal heart size. Stable mild pericardial thickening and fluid. No visible coronary artery calcifications.CHEST WALL: Bilateral mammoplasties are in place.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Stable appearance of left para-aortic surgical clips and partially visualized left nephrectomy bed. Stable incompletely characterized hepatic hypodensities.
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Stable 5mm right upper lobe groundglass nodule, which remains suspicious for atypical adenomatous hyperplasia (AAH) or adenocarcinoma in situ (AIS) and for which long-term follow-up is recommended.
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Generate impression based on findings.
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Renal cell carcinoma status post left partial nephrectomy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable 1.3 x 0.8 cm enhancing focus within segment 3 of the left lobe of liver best seen on image 45 of series 5; favor benign etiology. Stable cholelithiasis without acute inflammation or ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postsurgical contour deformities consistent with partial left nephrectomy without worrisome mass. Stable right subcentimeter renal cysts.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: Uterus absent or atrophicBLADDER: 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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Stable negative examination. No evidence for acute, inflammatory, or metastatic process.
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Generate impression based on findings.
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65 year old female status post right lumpectomy in 1995 findings for ILC, presents today for routine follow up. The patient also received radiation and chemotherapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear scar marker overlies the right breast. Stable post-lumpectomy findings are noted in the right breast, including architectural distortion and increased density. Scattered benign calcifications are also noted.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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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: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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5-year-old male with nephrotic syndrome, sepsis, pulmonary edemaVIEW: Chest AP (one view) 02/03/15, 1023 ET tube tip is below thoracic inlet and above carina. NG tube terminates in the stomach. Right internal jugular central venous catheter tip is in the right atrium.Cardiothymic silhouette is normal. Bilateral pleural effusions. No pneumothorax. Right upper lobe and bibasilar atelectasis. Mild pulmonary edema pattern.
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Mild pulmonary edema pattern with right upper and left lower lobe atelectasis not significantly changed.
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Generate impression based on findings.
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15-year-old female with history of ankle injury. Postoperative follow-up. Interval placement of a metallic plate along the lateral aspect of the distal fibula with two transsyndesmotic screws affixing the distal tibia and fibula in near-anatomic alignment. We see no hardware complications.
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Orthopedic transsyndesmotic fixation hardware as described above.
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Generate impression based on findings.
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36 year old female with neck pain C7 and the cervicothoracic junction are not well seen on the lateral views due to overlying anatomy. Alignment, vertebral body heights, and intervertebral disk spaces are preserved. Apparent narrowing of the right lower cervical neuroforamina is likely artifactual secondary to suboptimal positioning. Unerupted mandibular and maxillary molars are noted.
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No specific findings to account for the patient's pain.
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Generate impression based on findings.
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Ms. Basile is a 48 year old female with a personal history left breast mastectomy in 2012. Recent diagnostic mammogram demonstrated a new cluster of calcifications in the right superior breast. An ultrasound examination was performed to evaluate for possible sonographic correlate. If seen, then it will be biopsied under ultrasound guidance. If not, then the patient will undergo stereotactic biopsy. A right breast ultrasound was performed to evaluate for possible sonographic core for the cluster of calcifications in the right superior breast. An irregular hypoechoic area with multiple punctate, echogenic foci was identified in the right breast, 11 o'clock position. The area to be targeted measured 1.6 x 0.8 x 1.4 cm at the 11 o’clock position with increased vascularity, 6 cm from the nipple. The lesion was very subtle.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 12-gauge core needle (Celero) specimens were obtained of the lesion. Targeting was judged very good. All specimens sank to the bottom of the prefilled container of 10% formalin. The specimens were also radiographed to confirm the presence of calcifications. Two out of the three cores showed calcifications, confirming appropriate targeting. 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 just medial to the cluster of calcifications. Multiple residual calcifications are identified. 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. Abe was present during the procedure at all times.
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Successful ultrasound-guided core biopsy of the right breast calcifications with 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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Male 40 years old; Reason: STAGE IIIB COLON CANCER S/P RESECTION AND TREATMENT . EVALUATE FOR ANY INTERVAL CHANGE History: STAGE IIIB COLON CANCER CHEST:LUNGS AND PLEURA: Unchanged small air space disease in the medial aspect of right lower lobe, image 88 series 4, may be related to scarring but attention on follow-up imaging recommended. Interval removal of right chest wall portacatheter. MEDIASTINUM AND HILA: Subcentimeter mediastinal and hilar calcifications, may reflect sequela of prior granulomatous disease.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse hepatic steatosis, making evaluation for underlying small liver lesion suboptimal. Again seen prominent liver, measuring up to 20 cm in longitudinal dimension. Areas of focal sparing seen near gallbladder and in periphery of liver. Stable subcentimeter soft tissue focus alongside lateral wall of gallbladder, image 116 series 3, nonspecific/may be a vessel or related to adenomyomatosis. 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: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical colonic anastomotic suture material in pelvis.PELVIS:PROSTATE, SEMINAL VESICLES: Coarse intraprostatic calcifications.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Ventral abdominal subcutaneous induration/nodularity, likely reflecting sequela of prior injections. Mild multilevel degenerative changes of spine.
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Stable exam as above. Diffuse hepatic steatosis, making evaluation for underlying small liver lesion suboptimal. Again seen prominent liver, measuring up to 20 cm in longitudinal dimension. No definite metastatic disease.
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Generate impression based on findings.
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5-year-old female malignant neoplasm of the left femur status post excisionVIEW: Pelvis right lateral decubitus (one view) 02/03/15 The proximal left femur and overlying soft tissue of the hip have been resected. Hardware components of a hemi-arthroplasty device is seated in the left acetabulum. Right femur is within normal limits. Scattered air-fluid levels are seen in the lower abdomen.
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Left proximal femur resection.
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Generate impression based on findings.
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31-year-old male presents after fall. Rule out fracture. Left wrist: There is perhaps mild soft tissue swelling but no evidence of fracture or malalignment.Left elbow: Slight elevation of the anterior and posterior fat pads suggests hemarthrosis, though the radial head fracture is not clearly seen on these forearm views.Left forearm: There is a nondisplaced intra-articular fracture of the radial head seen on the AP view.
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Nondisplaced intra-articular fracture of the radial head.
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Generate impression based on findings.
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Postsurgical changes of left frontal craniotomy for resection of brain metastases. An extra axial fluid collection deep to the bone flap has resolved. Edema surrounding the resection cavity has decreased. There is decreased local mass effect without midline shift. Susceptibility within the resection cavity likely represents old blood product, but this is unchanged from the prior exam. Post contrast images show decreased enhancement along the resection cavity. In particular, a crescentic focus of enhancement along the posterior aspect of the resection cavity has significantly decreased. No new enhancing lesions are present.Scattered periventricular and subcortical T2 hyperintensities are nonspecific but may be related to mild chronic small vessel ischemic disease. The ventricles are within normal limits. The cisterns remain patent. There is no diffusion restriction. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Fluid within the bilateral maxillary sinuses has progressed since the prior exam. Bilateral cataracts.
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1.Postsurgical changes with improved edema and enhancement surrounding the resection cavity. No new enhancing lesions.2.Mild chronic small vessel ischemic disease.3.Increased fluid within the maxillary sinuses may suggest sinusitis.
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Generate impression based on findings.
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Male; 60 years old. Reason: paraesophageal mass History: paraesophageal mass LUNGS AND PLEURA: Stable scattered calcified granulomata. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Stable calcified subcarinal lymph nodes. No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Mild coronary artery calcifications.Stable infracardiac residual calcifications and mild soft tissue thickening in location of a previously seen cystic lesion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable infracardiac residual calcifications and mild soft tissue thickening in location of a previously seen cystic lesion.
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Generate impression based on findings.
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24 year-old female with history of left arm numbness. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1.No evidence of acute intracranial hemorrhage, edema or mass effect. 2.No specific intracranial findings to account for patient's symptoms. 3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.
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Generate impression based on findings.
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43-year-old female with pain. Tiny osteophytes indicate minimal osteoarthritis. No soft tissues swelling or joint effusion is present. No evidence of fracture or malalignment.
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Minimal osteoarthritis; otherwise normal exam.
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Generate impression based on findings.
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46 year old male status post lumbar fusion. Posterior stabilization rods are present with screws entering the L3-S1 vertebrae. We see no evidence of hardware complication. Degenerative disk disease affects the lumbar spine, mild to moderate at L1-2 and moderate to severe at L3-4 and L4-5. Note is made of multiple air-filled loops of bowel; please refer to accompanying abdominal radiograph report for better characterization.
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Orthopedic hardware and degenerative changes as described above.
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Generate impression based on findings.
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Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.Stable left basilar scarring.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.Mild coronary calcifications are identified, the heart and pericardium otherwise unremarkable.CHEST WALL: Degenerative abnormalities affect the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted; small accessory splenule noted in the splenic hilar region. 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: Unchanged mild L2 compression fracture. OTHER: No significant abnormality noted.
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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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50 year-old female with ankle pain. No significant soft tissue swelling or joint effusion is present. No evidence of fracture or malalignment.
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No findings to account for the patient's pain.
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Generate impression based on findings.
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Esophageal cancer, cough with eating The exam was positive for penetration and negative for tracheal aspiration.
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The exam was positive for penetration and negative for tracheal aspiration.
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Generate impression based on findings.
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History of left lumpectomy in 2004 for breast cancer. 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, which may obscure small masses, unchanged in pattern and distribution. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. No significant change in postoperative distortion, density and volume loss in the left upper central breast. Degree of focal asymmetry inferior to the scarring does not appear significantly changed. Stable benign calcifications in the left breast.
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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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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38 year old female with history of tarsometatarsal joint fracture-dislocation. Postoperative follow-up. There is diffuse soft tissue swelling about the foot. There has been interval placement of orthopedic hardware. A screw affixes the first tarsometatarsal joint in near-anatomic alignment. Side plate and screw devices affix fractures of the second and third metatarsal bases as well as the second and third tarsometatarsal joints in near-anatomic alignment. Two pins affix the fourth and fifth tarsometatarsal joints in near-anatomic alignment.
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Orthopedic fixation of Lisfranc fracture-dislocations, as above.
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