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Generate impression based on findings. | 54-year-old female with wrist pain, tenderness on distal radial styloid. Assess for bony abnormality. There is mild soft tissue swelling along the radial aspect of the wrist. We see no evidence of fracture or malalignment. Tiny osteophytes project from the trapezium and scaphoid, indicating minimal osteoarthritis. | Soft tissue swelling and minimal osteoarthritis. |
Generate impression based on findings. | 10-month-old female with hip clickVIEW: Pelvis AP (one view) 02/03/15 The femoral heads are not ossified. Ossification of femoral heads at 7 months is in the 95% percentile. The metaphyses are well positioned with respect to the acetabula. Acetabular configuration is normal. No acute fracture or malalignment is evident... | Delayed skeletal maturation. No evidence of developmental hip dysplasia. |
Generate impression based on findings. | Post treatment changes from prior left partial mandibulectomy, right neck dissection, and left buccal mucosal tumor resection and regional radiation therapy are again seen. The mandible and instrumentation appear to be intact. There is further decreased left cheek subcutaneous fat stranding and skin thickening. The fa... | 1. Stable postoperative and posttreatment changes within the neck with further improved appearance of left cheek soft tissues in area of previous cellulitis. No definite evidence of local regional tumor recurrence.2. Redemonstration of multiple dental caries with now increasing rind of soft tissue along the left poster... |
Generate impression based on findings. | Intoeing.VIEW: Pelvis AP (one view) 02/03/15 Femoral head ossification centers are symmetric and well directed into normally formed acetabula. No fracture is present. | Normal examination. |
Generate impression based on findings. | Pain Three views of the right hip again show severe osteoarthritis of the hip joint with flattening of the superior articular surface of the femoral head that appears similar to that seen on the prior study accounting for slight technical differences.The AP view of the pelvis shows the aforementioned severe right hip o... | Severe right hip osteoarthritis as above. |
Generate impression based on findings. | Status post urethroplasty Scout film reveals the course of the suprapubic catheter.Cystografin was administered by gravity via the suprapubic catheter. The patient began to urinate involuntarily at a volume of 300 mL.There is a small contrast filled collection along the left anterolateral wall of the prostatic and poss... | Contained leak involving the left anterolateral wall of the prostatic and possibly membranous urethra. |
Generate impression based on findings. | Status post right total knee arthroplasty Components of a right total knee arthroplasty device are situated in near anatomic alignment without radiographic evidence of hardware complication. Skin staples and foci of gas density in the anterior soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | Status post left total knee arthroplasty Components of a left total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | Hip pain in runner. Rule out stress fracture. I see no stress fracture or other specific findings to account for the patient's hip pain, although there is perhaps mild degenerative arthritis of the visualized left sacroiliac joint. | Possible mild left sacroiliac joint osteoarthritis, but no stress fracture or other specific findings to account for the patient's left hip pain. If further imaging evaluation is clinically warranted, MRI of the left hip may be considered. |
Generate impression based on findings. | Female 57 years old; Reason: eval fluid collection, infectious process, obstruction History: abd pain, n/v, leukocytosis, s/p diverting ostomy ABDOMEN:LUNG BASES: Left hilar adenopathy. Soft tissue nodule in the lingula measures 1.5 x 1.1 cm (image 6/series 4). Multiple pulmonary nodules in the lung bases. Trace left p... | 1.Progression of the hepatic metastases. 2.Increase in the necrotic mass adjacent to the cecum.3.Increasing ascites. Consider aspiration for evaluation of infection.4.Bowel wall thickening of unclear etiology. |
Generate impression based on findings. | Bilateral high probability benign focal asymmetries. Possible isoechoic fibroadenoma or fat lobule in the medial superior left breast. Bilateral diagnostic mammogram in 6 months was recommended. No new breast complaints. Three standard views of both breasts and bilateral spot compression views were performed digitally ... | Stable focal asymmetries bilaterally. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Follo... |
Generate impression based on findings. | Male, 54 years old, history of T1N1 oral tongue SCC, completed FHX CRT 1/4/2008, s/p recurrence with multiple lung mets and a L chest wall mass in 5/14, started on carbo/docetaxel on 5/16/14, s/p 2 cycles, and now enrolled in the MK3475 (IRB 130311) clinical study. Head:No mass effect, focal edema or suspicious enhance... | 1. No evidence of recurrent primary tumor or pathologic adenopathy in the neck.2. Left axillary adenopathy is unchanged relative to the immediate prior examination, but does show some slow increase relative to older exams.3. Multiple lung lesions are better assessed on dedicated chest imaging.4. No evidence of intracra... |
Generate impression based on findings. | Male 67 years old; Reason: metastatic prostate cancer, evaluation of disease after 12 month of investigational therapy. Patient notes history of multiple falls as well as temporomandibular joint arthritis. Please complete PCWG form There is new increased activity in the posterolateral aspect of the right 10th rib with ... | 1. No evidence of osseous metastases.2. New right 10th rib fracture. |
Generate impression based on findings. | Male 54 years old; Reason: h/o met base of tongue cancer, compare to previous, measurements pls CHEST:LUNGS AND PLEURA: Posterior pleural-based mass in left hemithorax without significant change in size, measuring 4.2 x 2.4 cm on image 27 series 4, interval progression of internal cavitation seen. Left basilar extensiv... | 1. Interval increase in size of right upper lobe lung nodule and left lower chest wall mass, suspicious for metastatic disease, additional pulmonary findings as above.2. New T6 vertebral body lytic lesion, compatible with osseous metastatic disease. |
Generate impression based on findings. | Leukocytosis status post Hartmann procedure for perforated diverticulitis ABDOMEN:LUNG BASES: Interval decrease in small bilateral pleural effusions.LIVER, BILIARY TRACT: Stable subcentimeter segment 7 right lobe hypo-attenuating focus; favor benign etiology. Stable cholelithiasis.SPLEEN: No significant abnormality not... | Loculated fluid collection within the left pelvis adjacent to the Hartman pouch staple line; an abscess cannot be excluded.Persistent dilated proximal small bowel loops associated with collapsed distal ileum. While may represent a slowly resolving ileus, an early partial small bowel obstruction should also be considere... |
Generate impression based on findings. | Two year-old female with right foot injury, not weight-bearing, no point tenderness.VIEWS: Right ankle AP/lateral/oblique (3 views) 02/03/15 No acute fracture or malalignment is evident. No significant soft tissue swelling. A joint effusion is not present. | Normal examination. |
Generate impression based on findings. | 62-year-old with history of fibrocystic breast disease. History of benign left breast biopsy. Three standard views of both breasts and a right spot view 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 ... | 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. |
Generate impression based on findings. | Male 45 years old; Reason: anal cancer, 2013 s/p chemoRT History: none CHEST:LUNGS AND PLEURA: Calcified granulomata adjacent to left major fissure and right apex.. The pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIAR... | 1.Stable exam without evidence for metastatic disease. |
Generate impression based on findings. | Reason: assess for cause of increased lightheadness and ataxia with 4 falls in a week History: ataxia and increased falls The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is iden... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic acute cerebral infarction.3.Old lacunar infarct is present in the left caudate nucleus.4.Examination is stable compared to the prior exam. |
Generate impression based on findings. | Reason: r/o ICH History: HA, hx of CVA The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hyp... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. These are unchanged since prior exam.3.CT is insensitive for the early detection of acute nonhemorrhagic cerebr... |
Generate impression based on findings. | Reason: 20F with persistent tachycardia to 140-150s, assess for PE History: 20F with persistent tachycardia to 140-150s, assess for PE PULMONARY ARTERIES: Technically adequate examination with no sign of pulmonary embolism.LUNGS AND PLEURA: Marked elevation of the left hemidiaphragm, unchanged, with overlying subsegmen... | 1. No pulmonary emboli.2. Marked elevation of the left hemidiaphragm with left basilar subsegmental atelectasis, unchanged from previous. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 37-year-old with history of right breast cancer status post mastectomy presents for unilateral follow-up. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and dis... | No mammographic evidence of malignancy. The patient is considering prophylactic left mastectomy. If that does not occur, and as long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Surveillance MRI should also be strongly considered. Results and recomm... |
Generate impression based on findings. | There is minimal residual increased density within the asymmetrically thinned subcutaneous fat along the right lateral cheek. No discrete mass or fluid collection is identified. There is persistent nonspecific hypodense material within the posterior inferior right maxillary sinus with erosion of the maxillary sinus fl... | 1. Stable rind of nonenhancing tissue which is nonspecific within the right maxillary sinus especially along the floor of the sinus which is eroded. Stable fistulous connection between the right maxillary sinus and oral cavity.2. No cervical lymphadenopathy. |
Generate impression based on findings. | Reason: h/o hnc and crt, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Subpleural area of atelectasis/consolidation posteriorly in the superior segment right lower lobe with debris identified within the segmental bronchus.Mild bronchial/bronchiolar wall thickening.Right basilar scarring/discoid... | 1.No evidence of metastatic disease.2.New subpleural area of atelectasis/consolidation in the superior segment of the right lower lobe most likely related to aspiration.3.Increasing right basilar subsegmental atelectasis and tree in bud nodules most likely related to aspiration. |
Generate impression based on findings. | Male 58 years old; Reason: Pancreatic neuroendocrine tumor on chemotherapy, evaluate for interval change CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: 1.2 x 0.7 cm reference cardiophrenic lymph node with additional smaller nodes also seen. Small calcified left hilar lymph nodes again se... | 1. Stable to mild decrease in size of solid/cystic pancreatic lesion, likely primary neuroendocrine tumor.2. Interval increase in size of hepatic segment 3 metastatic lesion as above with additional hepatic segment 3 and dominant right hepatic mass without significant change. |
Generate impression based on findings. | Pain. Injury.VIEWS: Left shoulder internal/external rotation (two views) 02/03/15 The humeral head is well directed to the glenoid fossa. No fracture is identified. The bones are normal in appearance. | Normal examination. |
Generate impression based on findings. | Female 58 years old; Reason: evaluate for metastasis. History: uterine leiomyosarcoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple stable bilobar hypoattenuating liver l... | 1. Stable exam as above without definite local tumor recurrence or metastatic disease. |
Generate impression based on findings. | Pain and swelling. Rule out fracture.VIEWS: Left ankle AP/lateral/oblique (3 views), left foot AP/lateral/oblique (3 views) 02/03/15 Moderate soft tissue swelling over the lateral ankle is noted. A spiral/oblique fracture of the distal fibula is present. Minimal displacement is present. A tibial fracture is not seen.Th... | Fibular fracture. |
Generate impression based on findings. | T3N2b pyriform sinus squamous cell carcinoma of the larynx, s/p CRT. There are post-treatment changes in the neck with mild residual supraglottic and hypopharyngeal mucosal edema asymmetrically greater on the right. There is no discrete mass lesion to suggest tumor recurrence. There is no significant cervical lymphaden... | 1. No evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Male 77 years old; Reason: metastatic prostate cancer on therapy with rising therapy History: metastatic prostate cancer CHEST:LUNGS AND PLEURA: Few scattered pulmonary micronodules.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: Gynecomastia.OTHER: ABDOME... | 1.Stable exam with no significant change in the soft tissue in the pelvic mesentery or left femoral neck lesion.2.Correlate with recent bone scan as it is more sensitive to detect new bone metastases. |
Generate impression based on findings. | The ventricles and sulci are progressively prominent as compared to the prior CT, consistent with further global volume loss. The extra-axial space does appear somewhat more prominent anteriorly with some areas of traversing vessels, which may indicate a component of benign enlargement of subarachnoid spaces of infanc... | 1. Interval development of focal extra-axial hyperdensity along the anterior aspect of the paramedian left frontal lobe measuring 5 mm in greatest thickness, consistent with blood products which are likely subdural in location.2. Progressive global volume loss with probable superimposed benign enlargement of subarachno... |
Generate impression based on findings. | Female, 40 years old, with history of inflammatory myofibroblastic tumor, ALK+, on AP26113, evaluate for treatment response. Evidence of left anterior chest wall resection is again seen involving at least the first through third ribs and most of the clavicle. The pectoralis muscles have been resected. A soft tissue fla... | Stable postoperative findings in the left anterior chest without evidence to suggest locally recurrent disease or nodal metastases. Please note that the surgical field is only partly visualized on this study, and reference should be made to the accompanying chest CT for a more complete assessment. |
Generate impression based on findings. | Metastatic colon carcinoma CHEST:LUNGS AND PLEURA: There has been little significant interval change in the overall appearance or size of the previously noted bilateral pulmonary metastatic nodules. The referenced left lower lobe nodule best seen on image 65 of series 4 measures 1.2 x 1.2 cm.MEDIASTINUM AND HILA: No si... | Segment 4a left lobe liver lesion as described. In retrospect, this lesion was present on the prior study but was significantly less conspicuous and smaller.Other bilobar hepatic metastases and bilateral pulmonary metastatic nodules relatively stable. |
Generate impression based on findings. | Female; 62 years old. Reason: HCC rule out mets History: HCC LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules. No suspicious pulmonary nodules or masses. Minimal biapical scarring. No pleural effusions.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes are seen, but there is no definite mediastinal l... | Scattered nonspecific pulmonary micronodules. No definite metastatic disease in the chest. |
Generate impression based on findings. | 39 year old with history of left breast cancer status post mastectomy. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, suspi... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Screening MRI can also be considered based on the patient's breast density and young age at cancer diagnosis. Results and recommendation were discussed wit... |
Generate impression based on findings. | Pain and swelling. Fracture? I see no fracture or malalignment. I see no specific findings to account for the patient's pain. | No fracture evident. If there is strong clinical concern for fracture, repeat radiographs may be obtained in 7 to 14 days; alternatively, CT or MRI may be considered. |
Generate impression based on findings. | Patient fell directly onto bent knee while pushing car on ice yesterday. Pain with movement and walking. Small osteophytes indicate mild osteoarthritis. I see no fracture or malalignment. | Mild osteoarthritis without fracture evident. |
Generate impression based on findings. | Knee pain 4 views of the left knee are provided. Round/tubular lucencies in the proximal tibial metaphysis likely reflect prior orthopedic intervention. I see no hardware on the current study. Small osteophytes indicate mild osteoarthritis. I see no joint effusion. Alignment is within normal limits.The right knee appea... | Mild osteoarthritis and finding suggesting prior orthopedic intervention of the left tibia. |
Generate impression based on findings. | Female; 66 years old. Reason: Pt is a 65 y/o female with h/o aggressive RCC, evaluate for recurrence History: h/o RCC, s/p nephrectomy, evaluate for recurrence LUNGS AND PLEURA: Stable minimal scarring in the lung bases and medial right middle lobe.Stable 9 mm nodule in the left lower lobe with dense central calcificat... | Stable scattered lung nodules without evidence of metastatic disease. |
Generate impression based on findings. | Right shoulder pain putting arm behind back and raising Mild osteoarthritis affects the glenohumeral joint. There is calcification between the humeral head and the acromion process that likely represents calcific tendinopathy of the rotator cuff (posterior supraspinatus and infraspinatus). A small focus of mineralizati... | Osteoarthritis and findings suggesting calcific tendinopathy of the rotator cuff as described above. |
Generate impression based on findings. | 25 year old with palpable mass in the left breast. Targeted ultrasound was performed for the patient's area of concern in the left breast near 12 o'clock. At this site, a mixed hyperechoic and hypoechoic area was seen. A question of a few punctate calcifications was present, and this was the cause for the follow-up mam... | Findings at the site of palpable concern are suggestive of a hamartoma or focal dense parenchyma. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually at age 40. Until that time, clinical follow-up is recommended, esp... |
Generate impression based on findings. | Pain. Fracture evaluation. Again seen is an oblique fracture through the proximal diaphysis of the third metacarpal with fracture fragments in near anatomic alignment. The fracture appears similar to that seen on the prior study accounting for slight positional differences. The previously seen fracture through the base... | Distal radius and metacarpal fracture(s) as described above. |
Generate impression based on findings. | 68-year-old female with history of injury to tailbone with pain. Please evaluate for fracture. The bones appear demineralized, but I see no fracture. Moderate-severe degenerative disk disease affects L5/S1. | Degenerative disk disease; I see no fracture. |
Generate impression based on findings. | Female; 61 years old. Reason: Hx head, neck, face CA S/P CRT compare with prior scans, measurements please CHEST:LUNGS AND PLEURA: Postoperative changes from left upper lobectomy.Mild emphysema.Previously described focal nodular and airspace opacities in the right upper lobe have resolved, consistent with aspiration an... | 1. No evidence of metastatic disease in the chest and abdomen.2. Increased subsegmental atelectasis in the medial right middle lobe. |
Generate impression based on findings. | Female 40 years old; Reason: mets IMT, ALK+, on AP26113, pls c/w previous study and evaluate tx response. History: IMT CHEST:LUNGS AND PLEURA: No dominant lung lesion. Stable calcified mass at the right lung base.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST W... | 1.Stable exam without evident metastatic disease. |
Generate impression based on findings. | Back pain. Osteoarthritis? Severe degenerative disk disease affects L4/5 and L5/S1. This appears similar to that seen on the prior study. Moderate facet joint osteoarthritis affects the lower lumbar levels. Alignment is within normal limits. Vertebral body heights are preserved. | Degenerative disk disease and facet joint osteoarthritis affecting the lower lumbar spine. |
Generate impression based on findings. | 13-year-old male with left breast mass. A targeted bilateral ultrasound was performed. There is no solid or cystic mass identified. At the palpable area of concern identified by the patient in the left outer chest wall, only pectoralis muscle elements are seen. Similar but slightly less prominent muscular elements are ... | No sonographic evidence for malignancy. Findings at the site of palpable concern have the sonographic appearance of muscle tissue. Clinical correlation is recommended. The patient states that he did a large amount of pectoralis exercise some months ago and had more pain on the side of current concern. BIRADS: 1 - Negat... |
Generate impression based on findings. | 46 year old female status post cystectomy neobladder on 1/23/2015 with persistent abdominal pain. Concern for obstruction. Evaluate.Per chart review, patient with history of anterior pelvic exenteration with en bloc radical cystectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy, and bilateral sta... | 1.No findings to suggest small bowel obstruction as clinically questioned. 2.Postoperative changes of cystectomy and neobladder formation with right pelvic sidewall soft tissue attenuation which may represent an evolving hematoma.3.Interval placement of bilateral nephroureteral stents with air within the collecting sys... |
Generate impression based on findings. | Frontal sinus: Left frontal sinus is underdeveloped. The right frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is trace mucosal thickening in the maxillary sinuses. The ostiomeatal units are clear.Posterior ethmoids: The posterio... | Very minimal scattered sinus inflammatory changes. Patent bilateral ostiomeatal units. No CT evidence of chronic sinusitis |
Generate impression based on findings. | 43-year-old male with fever, headache, and blurry vision; evaluate for mass or or bleed. Remote history of CVA in 2001. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci ... | 1. No evidence of intracranial hemorrhage.2. Chronic lacunar infarction versus less likely prominent perivascular space in the anterior limb of the left internal capsule.3. Acute bilateral maxillary sinusitis suggested. Please correlate clinically. |
Generate impression based on findings. | Enhancing heterogeneous well circumscribed lesion in the subcortical white matter of the left frontal lobe is unchanged in size and appearance measuring 15 x 15 mm (801/19), previously 16 x 14 mm. This lesion is associated with susceptibility and patchy enhancement which is similar to the prior exam.There is a faint f... | 1.Well-circumscribed enhancing left frontal lobe mass is stable. 2.Subtle right corona radiata T2 hyperintensity and enhancement is also unchanged.3.Multiple T2 hyperintensities within the bilateral basal ganglia are stable, suggestive of FASI related to NF1. |
Generate impression based on findings. | GIST CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Interval decrease in size of reference right segment 6 liver mass as seen on image 124 series 3 measuring 6.9 x 8.6 cm; this is ... | Interval decrease in size of hepatic and mesenteric metastatic reference lesions. |
Generate impression based on findings. | Polymyositis. Scleroderma. Rule out multiple myeloma. SKULL: Two views of the skull show a subcentimeter poorly defined lucency overlying the parietal region on the lateral view that may simply represent a venous lake, with a myelomatous deposit considered less likely.CERVICAL SPINE: Two views of the cervical spine are... | A small poorly defined lucency in the skull may simply represent a venous lake. I see no definite myelomatous lesions. |
Generate impression based on findings. | 38 years with abdominal distension, evaluate gas pattern and stool burden Moderate colonic stool burden. Nonobstructive bowel gas pattern. Scattered surgical clips. Essure device in the pelvis. | Moderate colonic stool burden without evidence of bowel obstruction. |
Generate impression based on findings. | There is an oval slightly lobulated T2/FLAIR hyperintense structure along the posterior aspect of the mesial right temporal lobe, abutting the right cerebral peduncle with mild localized mass-effect and flattening. This measures 2.1 x 1.2 cm in greatest axial dimensions on 701/14, by 1.9 cm CC. The structure is also m... | 1. Minimally lobulated T2/FLAIR hyperintense structure along the mesial right temporal lobe with prominent localized mass-effect including deformity of the right hippocampus. Structure could be extra-axial although possibility of an intra-axial partially exophytic origination cannot be entirely excluded. Further evalua... |
Generate impression based on findings. | Reason: restaging EGJ cancer with supraclavicular node involvement after 2 months chemotherapy History: none Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is ... | 1.No evidence for neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy |
Generate impression based on findings. | 77 y/o male with fecal incontinence; check for fecal impaction or obstruction Nonobstructive bowel gas pattern. Moderate colonic stool burden. Retained contrast in the bladder. Degenerative arthritic changes affect the lower lumbar spine and hips. | Moderate colonic stool burden without evidence of bowel obstruction. |
Generate impression based on findings. | Female 32 years old; Reason: Right arm lymphedemaRADIOPHARMACEUTICAL: The right foot was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected subcutaneously by Dr. Chang. Following injection, intraoperative probe localization was performed. No images were acquired. | Successful right foot injection for intraoperative identification of sentinel lymph node. |
Generate impression based on findings. | Ms. Bockover is a 69-year-old female with personal history of right breast lumpectomy in 2012 for IDC (triple negative). She now presents with a palpable mass in the right cervical neck which was found to be multiple enlarged necrotic supraclavicular and lower cervical lymph nodes on ultrasound exam. She presents today... | Successful ultrasound guided core biopsy of an abnormal right supraclavicular lymph node with clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Male 77 years old; Reason: metastatic prostate cancer on therapy with rising PSA There is a left focus continues to decrease consistent with old healed metastasis. Faint focus of activity seen along the lateral aspect of the left seventh rib is stable, may represent healed metastasis or a benign process. No new suspici... | Stable exam with no evidence of progression of osseous metastatic disease. |
Generate impression based on findings. | History of assault with right mandible fracture January 30 from outside hospital. Pain. There is a mildly displaced fracture through the posterior aspect of the right mandibular body/right mandibular angle, as well as a nondisplaced fracture through the left mandibular body. The patient is edentulous. Temporomandibular... | Mandibular fractures as above. |
Generate impression based on findings. | Male 50 years old; Reason: History testicular cancer, s/p chemo and pelvic LN dissection, assess for recurrence History: none CHEST:LUNGS AND PLEURA: Few scattered pulmonary micronodules, some of which are calcified. Subcentimeter ground-glass nodule in the right lung base seen on image 84/series 4.MEDIASTINUM AND HILA... | 1.Small retroperitoneal lymph nodes. No specific evidence for metastatic disease. |
Generate impression based on findings. | Female 61 years old; Reason: History of metastatic breast cancer on treatment. Compare to prior imaging, evaluate for response and extent of disease. There are stable areas of slight decrease in decrease activity along the left femur consistent with prior bone metastasis and orthopedic procedure. No new abnormal osseou... | Stable exam with no evidence of progression of osseous metastatic disease. |
Generate impression based on findings. | Two year-old female with right foot injury, partial weight-bearingVIEWS: Right foot AP/oblique/lateral (3 views) 02/03/15 No acute fracture or malalignment is evident. No joint effusion. No significant soft tissue swelling. | Normal examination. |
Generate impression based on findings. | There is asymmetric mild effacement of the anterior horn of the right lateral ventricle, but no definite mass is identified. The right lateral ventricle in general is smaller than the left, likely a normal variant. There is no midline shift. There is no intracranial hemorrhage, within the limitations of only postcontr... | Mild asymmetric effacement of the right frontal horn, which may be secondary to normal variant coarctation. However, the possibility of a mass lesion is not excluded. Further evaluation with MRI brain is recommended for confirmation. |
Generate impression based on findings. | Renal cell carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedA... | Stable negative examination. No evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | 72-year-old male with esophageal carcinoma and chemotherapy. Evaluate. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified, most likely secondary to prior granulomatous disease. No suspicious pulmonary nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Subcen... | 1.Distal esophageal wall thickening as above most likely consistent with patient's known esophageal carcinoma. 2.Enlarged gastrohepatic lymph node as above highly suspicious for metastatic disease.3.Significant interval regression in size of the left supraclavicular and retroperitoneal lymphadenopathy. |
Generate impression based on findings. | 44-year-old female with history of swelling and pain. There is a comminuted fracture of the distal fibular diaphysis with minimal posterior angulation of the distal fracture fragments. Additionally, there is a transverse fracture of the medial malleolus with mild medial displacement of the distal fracture fragment. The... | Distal tibia/fibular fractures as above. |
Generate impression based on findings. | 70 years male, evaluate broken Dobhoff tube Approximately 12 cm length of fractured Dobhoff tube terminates in the gastric fundus, unchanged. | Fractured Dobhoff tube in the gastric fundus, unchanged. |
Generate impression based on findings. | Right breast lump for 2 weeks, previously larger with more pain, now decreased in size. Left breast aspiration in 2010. History of breast cancer in mother. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibrogland... | Focal heterogenous hyperemic soft tissue, likely representing fat necrosis or inflammatory changes given the history of significant improvement. Given the decreasing symptoms, cancer is very unlikely. Clinical correlation and management are recommended and the patient will see Dr. Jaskowiak today. If symptoms worsen or... |
Generate impression based on findings. | 64 year old male with new vomiting with oral intake, refractory to treatment, leading to malnutrition. Evaluate for gastroparesis. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculat... | Gastric emptying within normal limits. |
Generate impression based on findings. | Evaluate NG tube placement NG tube tip in the region of the gastric antrum / pylorus. Persistent dilated small bowel loops with air in the colon suspicious for at least a partial small bowel obstruction. | NG tube tip in the region of the gastric antrum / pylorus. |
Generate impression based on findings. | Male; 55 years old. Reason: mesothelioma History: mesothelioma CHEST:LUNGS AND PLEURA: Moderate predominantly posterior and basilar right loculated pleural effusion. There are subtle, ill-defined areas of increased right pleural thickening and nodularity, particularly superiorly (e.g. series 3/images 27 and 32). Howeve... | Right loculated pleural effusion with subtle areas of increased right pleural thickening and nodularity, compatible with stated history of mesothelioma. |
Generate impression based on findings. | There is a punctate focus of increased DWI signal without corresponding T2 hyperintensity in the right inferior midbrain which is favored to represent artifact. There are a few scattered T2 hyperintensities in the subcortical and periventricular white matter, the largest in the left parietal lobe measuring 11 x 9 mm (... | 1.Posterior pituitary lesion is mildly larger than on the prior exam. Differential includes a microadenoma, perhaps with proteinaceous/hemorrhagic degeneration, or a proteinaceous/hemorrhagic Rathke's cleft cyst.2.Periventricular and subcortical T2 hyperintensities are nonspecific but unchanged and may be related to mi... |
Generate impression based on findings. | Dobhoff position Dobhoff tip in the gastric fundus. Bilateral percutaneous nephrostomy tubes. Mildly prominent small bowel loops in the right lower quadrant; favor ileus. Retained contrast in the colon. Surgical clips in the pelvis. | Dobhoff tip in the gastric fundus; recommend advancing. |
Generate impression based on findings. | Unstable fracture.VIEW: Left ankle with varus stress (one view) 02/03/15 Fracture of distal fibula at and soft tissue swelling are again seen.The distance between the fibula and talus is increased. | Probable unstable ankle fracture with ligamentous injury of talofibular ligaments and/or syndesmotic ligaments. |
Generate impression based on findings. | Male 65 years old; Reason: restaging CT after chemo last in 10/2014 then surgery 12/3/14 showing unresectable disease at that time. Duodenal stent occlusion 1/2/15 s/p revision. Restaging now prior to palliative chemo. History: diarrhea CHEST:LUNGS AND PLEURA: Subcentimeter nodule along the left major fissure likely re... | 1.Decrease in the size of the reference upper abdominal mass. 2.There is persistent dilatation of the biliary tree due to partial obstruction near the level of the duodenum. |
Generate impression based on findings. | Female 68 years old; Reason: PET avid paraaortic LN History: history of endometrial cancer and breast cancer, history of left lumpectomyRADIOPHARMACEUTICAL: 8.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion grossly demonstrates postsurgical changes in the the left breast. Ther... | Multiple new markedly hypermetabolic upper mediastinal lymph nodes consistent with progression of metastatic disease. There is also interval progression of metastatic disease of the abdominal retroperitoneal lymph nodes. |
Generate impression based on findings. | Fracture, post reduction Evaluation of fine detail is limited by overlying cast material. Again seen is a comminuted fracture of the distal fibular diaphysis with minimal posterior displacement of the distal fracture fragment, similar to that seen on the prior study. Also again seen is a transverse fracture through the... | Ankle fractures as described above. |
Generate impression based on findings. | Fall. Rule out fracture/dislocation. I see no fracture or malalignment. Vertebral body heights and intervertebral disk spaces are within normal limits. Tiny osteophytes project from the anterior aspects of the lumbar and lower thoracic vertebrae. There is a T-shaped contraceptive device in the pelvis. Surgical suture m... | No fracture evident. |
Generate impression based on findings. | 35 years female with cystic fibrosis, abdominal pain, nausea and vomiting, concern for DIOS Cholecystectomy clips and pneumobilia. Splenomegaly. Nonobstructive bowel gas pattern. Moderate colonic stool burden. Scattered surgical clips. | Moderate colonic stool burden without evidence of bowel obstruction. |
Generate impression based on findings. | Ms. Campos is a 31 year old female presenting with intermittent bilateral breast tenderness for the past 3 months. Per patient, she has noticed that the pain occurs cyclically q3 to 4 weeks. She denies any discrete mass. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9... | No mammographic evidence of malignancy. Patient's bilateral breast tenderness should be managed clinically. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended starting at the age of 40. All results and recommendation were discussed with the patient.BIRADS: 1 - Neg... |
Generate impression based on findings. | Status post left total knee arthroplasty Components of a total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of complication. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. Ossification adjacent to the medial epicondyle of the ... | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | Female 30 years old; Reason: abdominal pain History: abdominal pain Visually there was significantly delayed gastric emptying identified. Again seen is proximal small bowel unwinding in the right hemiabdomen consistent with known history of malrotation.Using anterior and posterior geometric means, residual gastric acti... | Significantly delayed gastric emptying. |
Generate impression based on findings. | vulvar SCC s/p radical vulvectomy / XRT and diverticular disease with colovaginal fistula s/p sigmoid resection / diverting loop ileostomy, preop assessment, evaluate for colovaginal fistula The scout film reveals a right lower quadrant ileostomy, nonobstructive bowel gas pattern, and pelvic sutures / clips.Omnipaque f... | Limited air augmented single contrast barium enema without evidence contrast extravasation or fistulous tract. |
Generate impression based on findings. | 59 year old female with history of left lower extremity pain and weakness. There are 5 non-rib bearing lumbar vertebrae in addition to a transitional lumbosacral vertebrae. Moderate facet joint osteoarthritis affects the lower lumbar spine. There is minimal anterolisthesis of L4 on L5. Moderate to severe degenerative d... | Degenerative disc disease and facet joint osteoarthritis as above. |
Generate impression based on findings. | Reason: Pt is a 66 yo male w/ hx of DLBCL and Myeloma; pre-auto sct evaluation RADIOPHARMACEUTICAL: 10.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 94 mg/dL. Today's CT portion grossly demonstrates right chest port catheter with tip in SVC as well as a left supraclavicular catheter with tip also in the ... | Progression of significantly hypermetabolic lymph nodes in the right axilla, mediastinum and left abdomen, highly suspicious for soft tissue tumor progression. |
Generate impression based on findings. | 45 year old with bilateral subcentimeter masses on prior screening exam. 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. There has been interval near compl... | No mammographic evidence of malignancy. Near complete interval resolution of bilateral breast masses. This could be due to involution of cysts or resolution of skin lesions. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation we... |
Generate impression based on findings. | Pain Mild osteoarthritis affects the midfoot. Minimal osteoarthritis affects the first metatarsophalangeal joint. There are plantar and posterior calcaneal spurs. Note is made of an os peroneum, a normal variant. | Mild osteoarthritis. |
Generate impression based on findings. | 12-year-old male with painVIEWS: Right and left calcaneus axial/lateral (4 views) 02/03/15 The apophysis of the calcaneus is normal bilaterally. Subtalar joint appears normal. No acute fracture or malalignment is evident. No significant soft tissue swelling. | Normal examinations. |
Generate impression based on findings. | 35-year-old female with history of right shoulder pain. Evaluate for a rotator cuff tear. ROTATOR CUFF: There is no evidence of contrast within the subacromial or subdeltoid bursa to suggest a full-thickness rotator cuff tear. There is no evidence of muscular atrophy. There is contrast extravasating into the subscapula... | No evidence of rotator cuff tear. Other findings as above. |
Generate impression based on findings. | There is deformity involving the right medial orbital wall with mild medial herniation of the orbital fat and slight irregularity in contour of the right medial rectus muscle. Findings compatible with remote medial blowout fracture and unchanged since 2011. The frontal sinus and frontoethmoidal recesses are clear. The... | 1. Paranasal sinuses are clear without evidence of sinusitis.2. Remote right medial orbital wall blowout fracture.3. Unchanged appearance of the nasal bones and deviated nasal septum compared to 2011 without evidence of acute fracture. |
Generate impression based on findings. | Bladder carcinoma CHEST:LUNGS AND PLEURA: Bibasilar tree in bud opacities again noted consistent with chronic inflammatory process.MEDIASTINUM AND HILA: Intra-thoracic stomach.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Interval increase in size and number of confluent bilobar hepatic meta... | Interval increase in size and confluence of numerous bilobar hepatic metastatic lesions. Interval increase in size of retroperitoneal metastatic adenopathy.No change in bibasilar tree in bud opacities suggestive for chronic lung base inflammatory process. |
Generate impression based on findings. | Left breast lumpectomy in 2005. Focal pain near lumpectomy scar. 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.A linear scar marker overlies the ... | Stable post-surgical changes in the left breast. No sonographic abnormality detected. 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 - Negat... |
Generate impression based on findings. | Ms. Brown is a 60 year old female with a strong family history of breast cancer in her mother (diagnosed at the age of 75) and sister (diagnosed at the age of 39). 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... | Stable bilateral calcifications. 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. |
Generate impression based on findings. | 28-year-old female with history of MVC. Mild degenerative disc disease affects C5-6 with anterior and posterior vertebral body osteophytes. There is a slight cervical kyphosis, but we see no acute fracture or spondylolisthesis. There is apparent narrowing of the C3-4 neuroforamina bilaterally which may be an artifact o... | Degenerative disk disease without acute fracture or spondylolisthesis. |
Generate impression based on findings. | Reason: Pleural mesothelioma please compare to prior exam per recist criteria. History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: Nodular pleural thickening throughout the left hemithorax consistent with mesothelioma. Loculated pleural effusion at the left base, unchanged with increased basilar atelectasis.Reference... | Interval increase in reference and non reference tumor measurements. |
Generate impression based on findings. | 64-year-old female with history of pancreatic cancer status post percutaneous biliary catheter, now with elevated lipase. Evaluate for pancreatitis. ABDOMEN:LUNG BASES: Persistent small bilateral pleural effusions.LIVER, BILIARY TRACT: Stable percutaneous biliary drainage catheter with tip in the duodenum. Mild intrahe... | 1.Interval increase in size of the pancreatic head mass and associated diffuse pancreatic ductal dilatation.2.No definite CT findings to suggest pancreatitis. 3.No definite evidence of metastatic disease.4.Small bilateral pleural effusions. |
Generate impression based on findings. | 56 year old female with history of pain. There is poorly defined sclerosis along the medial aspect of the humeral head/neck which is of uncertain etiology or significance. The distal clavicle is slightly elevated relative to the acromion, which may represent a chronic low-grade separation, but this is equivocal. We see... | Poorly defined sclerosis in the medial aspect of the humeral head/neck which is nonspecific and may be benign in etiology possibly representing Paget's disease or bone infarction, however we cannot exclude the possibility of metastatic disease particularly in a patient with a known primary malignancy. MRI may be consid... |
Generate impression based on findings. | Female 48 years old Reason: high fluid levels in esophagus on CT done Oct 2014, evaluate for achalasia History: abnormal CT of esophagus Preliminary view of the chest is unremarkable. Double contrast, single contrast and mucosal relief views were obtained. The hypopharynx was evaluated with phonation and is grossly unr... | Severe motor abnormality of the esophagus; relatively hypoperistaltic esophagus with tertiary waves and mild dilatation throughout, complicated by a large distal esophageal pulsion diverticulum. No evidence of achalasia.Cervical esophageal web.FLUOROSCOPY TIME: 4 minutes 54 seconds. |
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