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Generate impression based on findings. | Male 81 years old; Reason: restaging scans s/p 12 weeks of investigational therapy; please compare to previous scans History: hx of metastatic renal cancer The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:... | 1.Progression of pulmonary disease with increase in size of multiple metastatic deposits and new right pleural effusion.2.No evidence of local recurrence in the right nephrectomy bed.3.Nonspecific splenic and bone lesion are unchanged. |
Generate impression based on findings. | 66-year-old female with history of hip pain. Evaluate for fracture. The bones are demineralized suggesting osteopenia/osteoporosis.Right hip: Mild osteoarthritis affects the hip.Pelvis: Evaluation of the sacrum is limited due to overlying bowel gas. Mild osteoarthritis affects both hips. Degenerative disc disease affec... | Osteoarthritis as above. |
Generate impression based on findings. | Redemonstrated are extensive T2 hyperintensities, most prominent in the periventricular white matter, corpus callosum and more peripherally and to a lesser degree in the brainstem and bilateral cerebellar hemispheres. There is progression of abnormal T2 signal in the right middle frontal gyrus and posterior limb of th... | 1. Extensive predominantly periventricular T2 hyperintensities, compatible with multiple sclerosis. Progression of and/or new abnormal T2 signal in the right middle frontal gyrus and posterior limb of the right internal capsule with associated foci of enhancement. 2. Significant parenchymal volume loss. |
Generate impression based on findings. | Breast cancer and supraclavicular node please assess response to therapy. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. There is mild to moderate plaque at the carotid bifurcations. There is a right... | No evidence of residual left supraclavicular lymphadenopathy, indicating treatment response. |
Generate impression based on findings. | There is a stable thin left frontal parietal extra-axial collection measuring up to 4 mm. There has been interval development of an additional right frontal parietal extra-axial collection measuring 3 mm. This remains greater than CSF density without definite intrinsic hyperdensity. There is a mildly heterogeneous app... | 1. No acute intracranial hemorrhage. Interval development of very thin right frontoparietal subdural collection which is slightly greater than CSF density, in addition to stable appearance of previously seen left frontal parietal subdural collection.2. Similar pattern of bilateral mastoid air cell and middle ear fluid ... |
Generate impression based on findings. | 35-year-old female with history of shoulder pain. Evaluate for avascular necrosis. The bones are slightly demineralized. There are no specific radiographic findings of avascular necrosis. The distal clavicle remains slightly elevated in relation to the acromion which may represent chronic separation, although this appe... | No radiographic evidence of avascular necrosis or other specific findings to account for the patient's pain. If further imaging is required, MRI may be considered. |
Generate impression based on findings. | 50 year old female s/p gastric bypass in 2014, presents with nausea and vomiting and intolerance to solids. Scout image showed a nonobstructive bowel gas pattern, lumbar spinal hardware, and a presumed spinal nerve device projected over the left hemipelvis. Single contrast visualization of the esophagus showed no gross... | 1.Expected postsurgical changes s/p gastric bypass, without evidence of anastomotic stricture, fistula, or leak. 2.Spontaneous GE reflux to the level of the thoracic inlet. |
Generate impression based on findings. | 62-year-old male with history of ankle fracture. There is an oblique fracture through the distal fibula extending to the level of the tibiotalar joint with slight lateral translation of the distal fracture fragment. Tiny density distal to the medial malleolus could conceivably represent a small avulsion fracture fragme... | Distal fibular fracture and other findings as above. |
Generate impression based on findings. | Male 46 years old Reason: 46yM w hx of IBD and disseminated histo, repeat CT for fu History: as above LUNGS AND PLEURA: Interval improvement in right middle lobe solid nodule seen on previous exam (Series 5, image 53), now measuring 0.4 x 0.4 cm, previously measuring 1.1 x 0.9 cm. The nodule is now well-defined and wit... | Interval decrease in size in the right middle lobe solid nodule with resolution of hilar/mediastinal adenopathy. In an immunocompromise patient, the findings likely represent resolving fungal or mycobacterial infection with a healing granuloma. |
Generate impression based on findings. | 19 year-old male with history of fifth finger fracture. Redemonstrated is a fracture through the proximal phalanx of the fifth finger with slight dorsal angulation of the distal fracture fragments appearing similar to the prior study. | Fifth finger fracture as above. |
Generate impression based on findings. | Call back from screening mammogram for a mass in the right breast.. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. There is a circumscribed mass in the 9 o'clock position of right breast.Focus ultrasound of this area detects a simple cyst... | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 69 year old female with history of acute onset of lower back pain. The bones appear demineralized suggesting osteopenia/osteoporosis. Moderate degenerative disc disease affects L5-S1 with grade 1 anterolisthesis of L5 which is new when compared to the prior study. Moderate degenerative disc disease also affects the rem... | Degenerative disc disease as above with mild anterolisthesis of L5 which is new when compared to prior. |
Generate impression based on findings. | 11-year-old male with hip issueVIEWS: Pelvis frog leg (1 views) 02/04/15 The femoral heads are well seated in the acetabula. There is apparent slight medial displacement of the right femoral epiphysis and slight widening of the associated physis. Stool is present within the rectum. | Findings suggestive of possible early slipped capital femoral epiphysis.These findings were discussed with Dr. Sullivan via telephone at 15:13 on 2/4/2015, and a plan was made for further follow up. |
Generate impression based on findings. | Dysphagia to solids The exam was negative for penetration and aspiration. | The exam was negative for penetration and aspiration. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (1/5/15, 1/15/15), ultrasound images of right breast (1/15/15), images from ultrasound guided biopsy of right breast and post procedural right mammographic images (1/19/15) performed at Riverside Medical Center. For compa... | Biopsy proven invasive carcinoma in the right breast. Indeterminate calcifications are extending from the tumor to the nipple. Breast MRI may be useful in evaluating an extent of the disease. Stereotactic biopsy can also be performed for sampling the indeterminate calcifications in the right breast.BIRADS: 6 - Known ca... |
Generate impression based on findings. | dysphagia The exam was positive for penetration and aspiration. | The exam was positive for penetration and aspiration. |
Generate impression based on findings. | Evaluate clavicular fracture.VIEWS: Clavicle AP and clavicle view (two views) 2/4/2015 There is a vertically oriented fracture through the mid clavicular diaphysis with approximately 2 cm medial displacement of the distal fracture fragment, which is approximately 1 shaft width below the proximal fragment. | Clavicular fracture as above. |
Generate impression based on findings. | 70 years, Male. Reason: abdominal distention secondary to SBO, interval changes? Feeding tube tip in antropyloric region. Persistent pattern of small bowel obstruction, stable to slightly improved since prior radiograph. Cholecystectomy clips. | Persistent small bowel obstruction pattern, stable to slightly improved. |
Generate impression based on findings. | 64 years, Male. Reason: Evaluate placement of IVC filter. Interval placement of IVC filter, which projects over the L2/L3 vertebral bodies to the right of midline. NJ tube tip in the proximal jejunum at the ligament of Treitz. Unchanged left abdominal pigtail drain. Nonobstructive bowel gas pattern. | Interval placement of IVC filter which is in the expected location. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 52-year-old female with history of pain. Cervical spine: The lower cervical spine is not well visualized on the lateral projection due to overlying anatomy. There is an anterior plate with screws entering the vertebral bodies of C5 and C6. There is bone graft material present at C5-6. Prevertebral soft tissue swelling ... | 1.Postoperative changes of the cervical spine.2.Lower lumbar spine facet joint osteoarthritis as above. |
Generate impression based on findings. | 76 years, Male. Reason: Re-evaluate NG tube location History: Dysphagia, dysarthria, stroke Dobbhoff tube in the gastric fundus. Visualized bowel gas pattern is nonobstructive. Retained contrast in the colon. | Dobbhoff tube in the gastric fundus. |
Generate impression based on findings. | 27 years, Male. Reason: assess for obstipation, ileus History: 26 y.o. with family history of celiac disease and chronic right/middle upper abdominal pain, history of constipation Moderate colonic stool burden without evidence of bowel obstruction. | Moderate colonic stool burden without evidence of bowel obstruction. |
Generate impression based on findings. | 53 years, Female. Reason: assess for obstipation, ileus History: 53 y.o. woman with constipation, abdominal pain life-long, worsening symptoms Moderate colonic stool burden without evidence of bowel obstruction. Calcifications in the right upper quadrant and central pelvis suggest gallstones and uterine fibroids, respe... | Moderate colonic stool burden without evidence of bowel obstruction. |
Generate impression based on findings. | 56-year-old male with history pain. Redemonstrated is a transverse fracture though the base of the fifth metatarsal appearing similar to the prior study. The fracture fragments are in near-anatomic alignment. There are old healed diaphyseal fractures of the third, fourth, and fifth metatarsals. Moderate osteoarthritis ... | 1.Transverse fracture of the base of the fifth metatarsal with additional old postraumatic and degenerative arthritic changes as described above.2.Widening of the anterior tibiotalar articulation is of uncertain significance, but may represent capsular laxity or ligamentous disruption. |
Generate impression based on findings. | 63 years old, Male, Reason: ? masses , nodes History: thyrodi cancer s/p thryodiectomy 1974withotu any follow-up imaging MEASUREMENTS: Patient status post thyroidectomy.RIGHT LOBE: In the right mid thyroidectomy bed, in the level 6 area, there is a hypoechoic mildly heterogeneous nodule measuring 0.4 x 0.5 x 0.6 cm.LEF... | 1.Right level 6 nodule in thyroidectomy bed measuring up to 0.6 cm is concerning for possible recurrence and is amenable to biopsy.2.Right level 4 lymph node with heterogeneous appearance is suspicious for local lymphadenopathy and is amenable to biopsy.3. Nodule anterior to the left ear; nonspecific, but a benign etio... |
Generate impression based on findings. | 54-year-old male who is history of lung cancer with mediastinal adenopathy. Evaluate for disease status. ABDOMEN:LUNG BASES: There is a moderate-sized partially visualized right pleural effusion with peripheral enhancement concerning for an empyema and is unchanged compared to the previous examination. Please refer to ... | 1.Interval increase in carcinomatosis.2.Scattered sclerotic lesions within the vertebral bodies are nonspecific and may represent metastatic disease. Nuclear medicine bone scan may be considered for more sensitive evaluation of osseous metastatic disease.3.Findings suspicious for right basilar empyema, unchanged. Pleas... |
Generate impression based on findings. | 59 years, Male. Reason: DHT placement History: as above Jejunal tube tip distal to the ligament of Treitz. Surgical drains project over the abdomen. IVC filter noted. Incompletely visualized bowel gas pattern is suggestive of ileus. Left basilar consolidation. | Jejunal tube tip distal to the ligament of Treitz. |
Generate impression based on findings. | There is evidence of prior bilateral uncinectomy, widening of the maxillary infundibulae, partial resection of the ethmoid air cell complex, and widening of the left sphenoethmoidal recess. The frontal sinuses are hypoplastic. The prior mild mucosal thickening of the ethmoid air cells has resolved. The sphenoid sinuse... | Stable appearance of postoperative findings related to prior endoscopic sinus surgery with minimal residual mucosal thickening of the paranasal sinuses that is improved.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Transient right sided weakness and numbness several times a day. Evaluate left ICA stenosis due to vasospasm. CT HEAD:Again demonstrated are stable postoperative changes of a previous right-sided craniotomy for clipping of a right anterior choroidal artery aneurysm which causes artifact and obscures adjacent structures... | 1.Stable post-surgical changes from a craniotomy and clipping of a right anterior choroidal artery aneurysm without evidence of recurrence although this is limited by artifact.2.Status-post left posterior communicating artery clipping without evidence of recurrence but is again limited by artifact.3.Stable to perhaps s... |
Generate impression based on findings. | 66-year-old female with history of breast cancer who presents for staging exam. ABDOMEN: Motion artifact degrades evaluation.LUNG BASES: Large heterogeneously enhancing mass in the right breast measuring up to 9.2 x 7.1 cm (series 3, image 5) with multiple enhancing satellite foci in the right breast. These findings ar... | 1.Findings suspicious for carcinomatosis, although evaluation is limited by motion artifact.2.Diffuse osseous metastases. 3.Minimally displaced left inferior pubic ramus pathologic fracture.4.Severe L1 and moderate T10 compression deformities.5.Large right breast heterogeneously enhancing mass with multiple associated ... |
Generate impression based on findings. | 77 years old Male. Reason: Richter's transformation to DLBCL. History: 76 yo man with Richter's transformation to DLBCL with c-myc mutation by IHC now s/p 4 cycles DA -EPOCH-R. This study was performed for restaging.RADIOPHARMACEUTICAL: 9.45 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's C... | 1.Multiple hypermetabolic soft tissue masses in the abdominal wall, hypermetabolic peritoneal and retroperitoneal soft tissue densities and hypermetabolic gastrohepatic lymph node, consistent with the patient's diagnosis of lymphoma.2.No evidence of FDG avid tumor in the neck and chest.Diagnostic CTs of the chest, abdo... |
Generate impression based on findings. | 77-year-old male with lymphoma status post 4 cycles of therapy who presents for restaging. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules (series 4, images 49, 67, and 72) are stable to decreased in size. No new suspicious pulmonary nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA:... | 1.Multiple right pulmonary emboli.2.Significant interval regression of multiple large conglomerations of lymph nodes in the abdomen and pelvis.3.Interval regression of infiltration of the stomach and the bowel wall with lymphoma.4.Interval decrease in size of the pulmonary/pleural micronodules.5.Persistent mild right h... |
Generate impression based on findings. | 75-year-old male with metastatic GE junction adenocarcinoma per EMR (this is discrepant from requisition information which states "pancreatic adenocarcinoma").RADIOPHARMACEUTICAL: 9.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 102 mg/dL. Today's CT portion grossly demonstrates a right chest wall port ca... | 1.Decreased size and hypermetabolic activity of gastric cardia mass. However, new distal esophageal hypermetabolic focus is also present, which may be due to esophagitis or new tumor activity. 2.Near complete interval resolution of mesenteric and retroperitoneal lymph node metastases. |
Generate impression based on findings. | Female 36 years old Reason: 35Yrs female with a history of malignant peritoneal mesothelioma s/p exploratory laparotomy, RSO on 11/18/2011, s/p adjuvant pemetrexed and cisplatin x 6 cycles, completed mid-2012, s/p VATS and attempted pleurodesis in 10/2012 for recurrent effusion, th History: Malignant peritoneal mesothe... | 1.Interval postoperative changes with new small right pleural effusion. 2.Stable anterior mediastinal soft tissue and cardiophrenic lymph node without evidence of pleural nodularity. 3.Persistent focal defect in the left ventricular apex of uncertain etiology. Recommend echocardiogram to further evaluate. |
Generate impression based on findings. | Lung cancer, secondary malignant neoplasm of the retroperitoneum and peritoneum. Mediastinal lymphadenopathy. Pre-chemo. LUNGS AND PLEURA: Right hemithorax volume loss and near-circumferential pleural thickening. For reference, right pleural thickening measures up to 14-mm in the costophrenic angle region (4/77), not s... | 1. Pleural thickening of the right measures up to 14-mm, with an associated loculated pleural fluid collection.2. Majority of the right lung is consolidated which may be post therapeutic however extent of underlying tumor cannot be assessed. Right lower lobe collapse appears chronic, with a soft tissue density filling ... |
Generate impression based on findings. | Reason: 54 y/o with h/o CLL and t-AML, being treated for pneumonia; now for re-eval of infection History: currently being treated for pneumonia; re-eval of infection LUNGS AND PLEURA: Right upper lobe consolidation slightly decreased with demonstration new air bronchograms., However areas of consolidation noted in the ... | Multifocal areas of consolidation demonstrating interval progression since the prior exam with increasing bilateral pleural effusions compatible with infection. |
Generate impression based on findings. | infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normal uterine cavity without mucosal irregularity or filling defects. The right fallopian tube opacifies without spillage. The left fallopian tube is obstructed.TOTAL FLUOROSCOPY TIME: 2 minutes 3 seconds | 1.Obstructed left fallopian tube and no spillage on either side.2.Normal uterine cavity. |
Generate impression based on findings. | 49-year-old female with pain There is a small linear osseous fragment dorsal to the dorsal aspect of the talus, likely representing an avulsion fracture. No additional fracture of the foot or ankle. No significant soft tissue swelling about the ankle. | Dorsal talar avulsion fracture |
Generate impression based on findings. | 59 year old female with a palpable lump in the left breast presents for mammographic workup. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Scattered calcifications have mildly... | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 60 year-old male with pain, evaluate for healing Fractures of the distal fibula and medial malleolus are again visualized in near-anatomic alignment. The fracture lines are indistinct, suggesting some interval healing. There is mild soft tissue swelling about the ankle. | Healing distal fibula and medial malleolus fractures in near-anatomic alignment. |
Generate impression based on findings. | The ventricles and sulci are within normal limits, although there is minimal slight asymmetric prominence of the left cerebral sulci relate to minimal volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. No extra-axial flu... | 1. Findings suggestive of Chiari one malformation, for which clinical correlation is recommended.2. Otherwise, unremarkable limited noncontrast MRI brain. |
Generate impression based on findings. | Male, 33 years old. RFO trigger: Transplant surgery. Counts correct. No unexpected radiopaque foreign body. Feeding tube coiled in stomach with tip in gastric body. Left nephroureteral stent partially visualized. Nonobstructive bowel gas pattern. | No unexpected radiopaque foreign body. Findings discussed with the attending physician, Dr. Becker, via telephone on 2/4/2015 at 15:00. |
Generate impression based on findings. | 0-day-old male with worsening respiratory distress with umbilical line placementVIEW: Chest/abdomen AP (2 view) 02/04/15, 1508 hrs Enteric tube tip is in the gastric antropyloric region. Umbilical venous catheter tip is at the inferior cavoatrial junction. Umbilical artery catheter is coiled with tip at the T11 level.C... | Umbilical artery catheter is coiled with tip at the T11 level. Nonspecific bowel distention. |
Generate impression based on findings. | Clinical question: Patient reports gun shot wound to the abdomen with remaining bullet fragments in the spinal cord/nerve root injury status post multiple abdominal surgeries. Elucidation of the anatomy for possible epidural injections. Nonenhanced thoracic spine CT:There is normal bony density and the anatomical align... | 1.Enhanced CT of thoracic spine is within normal limits. In particular there is no evidence of bullet fragments in the field of view.2.Enhanced CT of lumbar spine demonstrate a single well demarcated round bullet fragment measuring at 10.7 x 12.6-mm lying immediately posterior to the right lamina of L2 and lateral to t... |
Generate impression based on findings. | 20-year-old male with history of right ring finger avulsion fracture. Redemonstrated is a focal lucency along the dorsal aspect of the articular surface of the base of the middle phalanx which likely represents a nondisplaced central slip avulsion fracture appearing similar to prior. There is mild soft tissue swelling ... | Ring finger avulsion fracture as described above. |
Generate impression based on findings. | 72 year-old female with recurrent breast cancer status post neoadjuvant chemotherapy.RADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 95 mg/dL. Today's CT portion grossly demonstrates stable bilateral renal cysts.Today's PET examination demonstrates interval resolution of previously ... | Interval resolution of markedly hypermetabolic activity associated with the left supraclavicular and left axillary lymph node conglomerate masses. No specific evidence of current hypermetabolic tumor activity. |
Generate impression based on findings. | There is an oblique fracture through the angle of the posterior body of the left mandible, with approximate 1 cm inferior as well as medial displacement of the distal fracture fragment. The fracture is minimally comminuted. The anterior root of ADA number 18 is identified although there may be a tiny nondisplaced frac... | Oblique minimally comminuted and displaced fracture through the posterior left mandibular body, with fractured ADA number 18. Abdomen dilute joints are intact. Fracture line extends through left mandibular canal, and correlation for inferior alveolar nerve injury is recommended. Significant left greater than right faci... |
Generate impression based on findings. | Malignancy or source of weight loss. Abdominal pain CHEST:LUNGS AND PLEURA: Several pleural-based nodules are noted, one with rim calcification measuring 2.1 x 0.8 cm (image 42; series 6). These are probably benign given appearance. No intrapulmonary masses. Minimal scarring bilaterally.MEDIASTINUM AND HILA: Coronary s... | Occlusion of the celiac axis with high-grade, calcific stenosis of the superior mesenteric artery. The findings are most suggestive of chronic mesenteric ischemia given the patient's clinical finding history. Findings were discussed with Dr. Yang at the time of dictation. |
Generate impression based on findings. | Female 25 years old; Reason: 25F s/p lap chole (1/27) c/b cystic duct leak s/p IR drainage, ERCP; low drain output, leukocytosis, and tachycardia. concern for undrained fluid collection History: tachycardia, leukocytosis ABDOMEN:LUNG BASES: Bilateral pleural effusions, left greater than right. There is bibasal atelecta... | 1. Multiloculated fluid collections throughout the abdomen and pelvis concerning for biliary ascites and consistent with provided history of bile leak. 2. Abdominal collection containing what appears to be feculent material with increasing lower abdominal/pelvic free air, raising the possibility of bowel perforation.Fi... |
Generate impression based on findings. | 45 year old male with history of ulcerative colitis s/p proctocolectomy and ileoanal J pouch creation. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 30 minutes. Fluoroscopic evaluation demonstrated postsurgical changes s/p proctocolectomy and ileoanal J pouch creation. Conver... | 1.Stable postsurgical changes as described above with possible nonobstructive adhesions in the mid abdomen. 2.No evidence of active small bowel inflammation. |
Generate impression based on findings. | Female; 25 years old. Reason: 25F s/p lap chole (1/27) c/b cystic duct leak now s/p IR drainage, ERCP; persistent leukocytosis and tachycardia; concern for PE given fam hx of hypercoaguability History: leukocytosis, tachycardia PULMONARY ARTERIES: Suboptimal opacification of the pulmonary arteries limits evaluation for... | 1. Limited study without evidence of large, central pulmonary embolus. If there is ongoing clinical concern for pulmonary embolus, repeat examination is recommended.2. Moderate nonspecific bibasilar atelectasis/consolidation and small left pleural effusion.3. See report from dedicated CT abdomen pelvis performed concom... |
Generate impression based on findings. | Clinical question: Patient reports gun shot wound to the abdomen with remaining bullet fragments in the spinal cord/nerve root injury status post multiple abdominal surgeries. Elucidation of the anatomy for possible epidural injections. Nonenhanced thoracic spine CT:There is normal bony density and the anatomical align... | 1.Enhanced CT of thoracic spine is within normal limits. In particular there is no evidence of bullet fragments in the field of view.2.Enhanced CT of lumbar spine demonstrate a single well demarcated round bullet fragment measuring at 10.7 x 12.6-mm lying immediately posterior to the right lamina of L2 and lateral to t... |
Generate impression based on findings. | Hemorrhage in the gastrointestinal tract, unspecified. Assess for mesenteric artery graft a small bowel fistula as cause of small bowel bleeding versus other wall lesion. 85-year-old with history bifurcated superior mesenteric and celiac artery bypass graft two years ago. Now with GI bleeding and red blood in small bow... | No definite CT evidence (i.e., active extravasation) of an arterial-enteric fistula as clinically queried however, the distal aspect of the bypass graft to the superior mesenteric artery exhibits a high grade stenosis and a small saccular aneurysm which is in close approximation to a small bowel loop in the mid-abdomen... |
Generate impression based on findings. | 18 year-old male baseball player with pain with flexion Osseous alignment is within normal limits. No fracture or joint effusion. | No specific findings to account for the patient's pain. If there is concern for soft tissue injury, MRI may be considered for further evaluation. |
Generate impression based on findings. | 75-year-old male with history of prostate cancer, rising PSA, concern for bone mets. No abnormal osseous foci are identified to indicate metastatic disease. Foci of increased radiotracer activity at the T9 and T10 vertebral bodies correspond with degenerative changes seen on CT, as does a small focus in the lateral asp... | No definite evidence of bone metastases. |
Generate impression based on findings. | Male; 83 years old. Reason: mets lung cancer. S/p 6 cycles of chemo with disease progression. Pls c/s previous study and evaluate dz status. History: lung ca CHEST:LUNGS AND PLEURA: Left lower lobe spiculated mass measures up to 43 x 23 mm, unchanged (series 4/52). However, the mass has mildly increased in size in its ... | 1. Mildly increased size of left lower lobe mildly spiculated mass compatible with primary lung carcinoma.2. Mildly increased nodules, as well as a new nodule, in the right lung, most suggestive of progression of disease.3. Grossly stable lymphadenopathy in the chest. |
Generate impression based on findings. | History of asymmetry in the right upper outer quadrant. No new breast complaints Three standard views of both breasts (total 10 images) were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Scatte... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: NGT placement History: as above Nasogastric tube tip projects over the gastric antrum. IVC filter projects over expected location of the inferior vena cava. Curvilinear wiring over the pelvis and right lower quadrant is indeterminate, but seen on prior study, in a similar location. Surgical staples and pelvic d... | Line and tube placement as above. |
Generate impression based on findings. | Male 67 years old; Reason: Prostate cancer, evaluation of disease as baseline for initiation of investigational therapy. please complete PCWG2 form There is widespread increased osseous activity throughout the upper cervical spine, thoracic spine, lumbar spine, multiple bilateral ribs, pelvis, right clavicle and skull ... | Widespread osseous metastatic disease as described above. |
Generate impression based on findings. | 66-year-old female with lung cancer. This study was performed for restaging.RADIOPHARMACEUTICAL: 11.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion grossly demonstrates no significant abnormality in the neck or pelvis.Today's PET examination demonstrates stable size but decrea... | 1.Decreased hypermetabolic activity associated with the right upper lobe subpleural opacity, which is unlikely to represent tumor activity.2.New hypermetabolic focus in the left lower lobe likely represents inflammatory change given the recent resolution of pneumonia in this location. Short-term 6 month follow-up CT sh... |
Generate impression based on findings. | 67-year-old female with history of ovarian cancer who presents for disease re-evaluation. CHEST:LUNGS AND PLEURA: Scattered micronodules and nodules are stable compared to previous exam. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: No significant interval change in the mediastinal lymphadenopathy. Referen... | 1.Interval increase in size and number of hepatic metastatic disease.2.New small volume abdominal and pelvic ascites.3.Stable mediastinal adenopathy and osseous metastatic disease. |
Generate impression based on findings. | Although direct comparison to prior imaging is made difficult by the time interval between scans, the degree of moderate ventricular dilatation remains stable. Flow void is visualized through the cerebral aqueduct and there is also flow artifact in the distal aqueduct and fourth ventricle indicating patency. There is ... | Stable degree of diffuse ventricular dilatation. No new abnormality. |
Generate impression based on findings. | 30 year old female with history of malrotation s/p LADD procedure in November 2014, now presents with continually worsening abdominal pain. Fluoroscopic evaluation demonstrated normal passage of contrast through the stomach into the proximal small bowel. The duodenum did not cross the midline and proximal small bowel l... | Intestinal malrotation with normal small bowel transit time. No specific findings to account for the patient's pain. |
Generate impression based on findings. | Female 70 years old; Reason: Diagnosis of severe emphysema. Lung Transplant work-up History: SOBRADIOPHARMACEUTICAL: 11.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates a right upper lobe nodule. There are emphysematous changes bilaterally. There are small b... | 1.Findings consistent with tumor activity in the right upper lobe lung nodule.2.Mild symmetric activity involving bilateral hilar as well as mediastinal lymph nodes are likely related to an inflammatory process or granulomatous disease. 3.Focal increased activity in what appears to be a focally dilated ureter or an adj... |
Generate impression based on findings. | 51-year-old male with pain, redness, status post gunshot wound Intramedullary rod with screws affixes a comminuted fracture of the distal tibial diaphysis with numerous associated osseous fragments and metallic bullet fragments. Surgical clips overlie the soft tissues. There is mild diffuse soft tissue swelling about t... | Orthopedic fixation of distal tibia fracture in near-anatomic alignment without evidence of hardware complication. |
Generate impression based on findings. | 30 year old female presents with infertility. Opacification of the uterine cavity revealed a normally oriented uterus without mucosal irregularity or filling defects. The left tube freely opacified with free spillage into the left peritoneal cavity indicating patency. The right tube did not opacify, and contrast seen w... | Findings compatible with obstruction of the right fallopian tube. Normal left fallopian tube. |
Generate impression based on findings. | Female 66 years old; Reason: chronic pancreatitis, heartburn and vomiting Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 84.2 % of peak activity (normal >7... | Gastric emptying within normal limits. |
Generate impression based on findings. | 80 year-old female with reported fracture at outside hospital There is a large joint effusion. Lucency extending between the tibial spines indicates a nondisplaced tibial plateau fracture. | Nondisplaced tibial plateau fracture as described above. Large joint effusion. |
Generate impression based on findings. | Male 71 years old; Reason: metastatic glucagonoma to liver, therasphere MAPPING There is increased activity in the right lobe liver with multiple foci of intense activity which correlates with tumor. There is free technetium in the salivary glands. There is mild activity in the stomach, proximal small bowel as well as ... | 1. No evidence of abnormal activity identified outside of the liver within the abdomen.2. Liver lung shunt fraction is 2.4%. |
Generate impression based on findings. | Male 72 years old; Reason: 2 mo. hx of pelvic pain, weight loss, and firm, fixed left inguinal mass concerning for cancer History: Left inguinal mass ABDOMEN:LUNG BASES: Emphysematous changes with bibasal atelectasis left greater than right.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant a... | 1. Masslike thickening of the bladder wall concerning for primary bladder neoplasm with extensive pelvic and retroperitoneal lymphadenopathy as well as peritoneal carcinomatosis. 2. There is hypoenhancement of the left kidney with mild left hydronephrosis and hydroureter secondary to obstruction from the above-describe... |
Generate impression based on findings. | Male 55 years old; Reason: mesothelioma History: mesothelioma The comparison chest radiograph performed on 2/4/2015 demonstrates right pleural effusion and thickening.The ventilation images show a wedge-shaped defect in the the right lower lobe which persists throughout the equilibrium phase. There is no abnormal Xe-13... | 1. Low probability for pulmonary embolism.2. Right lower lobe matched ventilation perfusion defect as quantified above. |
Generate impression based on findings. | Stricture or kinking of the ureter. Etiology of obstructive pyelonephritis. Renal failure. The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: Small bilateral pleural effusions (right greater than left) with overlying compressive atelectasis. Hiatal hernia.LIVER, BILIARY... | Bilateral nonobstructive renal calculi. Multiple distal right ureteral calculi with indwelling right ureteral stent. Perinephric inflammation compatible with right-sided pyelonephritis; no evidence of perinephric abscess. |
Generate impression based on findings. | 8-month-old male with prolonged fevers and increased work of breathing, tachypneaVIEWS: Chest AP/lateral (two views) 02/04/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Right lower lobe streaky opacity likely represents atelectasis. Large lung volumes and bronchial wall cuffing suggestive o... | Bronchiolitis/reactive airway disease pattern with right basilar atelectasis. |
Generate impression based on findings. | 18 year-old male with hemoglobin SS complaining of right hip and knee painVIEWS: Right knee AP/oblique/lateral, left knee AP//lateral, pelvis AP/frog leg lateral (8 views) 02/04/15 No acute fracture or malalignment is evident. No joint effusion. No loose bodies are present. The articular surfaces are smooth. No specifi... | Normal examination. |
Generate impression based on findings. | 39 year old female with fall two days ago, pain with thumb flexion No fracture or other specific findings to account for the patient's symptoms. | Normal exam. |
Generate impression based on findings. | Reason: 77 year old female patient diagnosed with HCC is here for a THERASPHERES MAPPING along with a nuclear medicine MAA There is increased activity in the lungs. Liver lung shunt fraction is 4.5%. There is activity in the right lobe of the liver with a focally more intense area of activity consistent with tumor in t... | 1. No evidence of abnormal activity identified outside of the liver within the abdomen.2. Liver lung shunt fraction is 4.5%. |
Generate impression based on findings. | Reason: 54 yo male with neuroendocrine tumor; please evaluate for metastatic disease There is a discrete focus of increased activity in the head of the pancreas consistent with known neuroendocrine tumor. There is focally increased activity in the bilateral lower poles of the thyroid gland. There is no additional abnor... | 1. Increased activity in the pancreatic head consistent with known endocrine tumor.2. Focally increased activity in the bilateral lower poles of the thyroid gland may be due to normal variation of the thyroid uptake or additional neuroendocrine tumor. Suggest correlation with thyroid ultrasound. |
Generate impression based on findings. | 25-year-old female with history of T-cell lymphoma status post stem cell transplant. Restaging.RADIOPHARMACEUTICAL: 8.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates symmetric soft tissue thickening of the nasopharyngeal wall and symmetric enlargement of t... | Bilateral hypermetabolic level 2 cervical lymph nodes as well as interval increase in hypermetabolic activity associated with symmetric soft tissue thickening in the nasopharyngeal wall and bilateral palatine tonsils, which may reflect inflammatory changes versus lymphomatous involvement. |
Generate impression based on findings. | 64-year-old male with duodenal mass on EGD who presents for characterization of the mass. ABDOMEN:LUNG BASES: Right basilar pleural calcification is unchanged dating back to 2012. No suspicious pulmonary nodules or pleural effusions.Trace pericardial effusion is unchanged compared to previous exam.LIVER, BILIARY TRACT:... | 1.Hypoattenuating solid mass in the second portion of the duodenum corresponds to the location of the mass identified on the EGD. 2.No evidence of lymphadenopathy or metastatic disease in the abdomen or pelvis. |
Generate impression based on findings. | cerebrovascular accident No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clea... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | head trauma No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremark... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | 23-year-old male with right lower quadrant rebound tenderness, nausea and vomiting. Evaluate for appendicitis. ABDOMEN:LUNG BASES: Left basilar streaky and nodular opacities suggestive of aspiration with associated atelectasis; superimposed infection cannot be excluded.LIVER, BILIARY TRACT: Mild periportal edema likely... | 1.Findings as above suggestive of enteritis involving the ileum without evidence of small bowel obstruction. Clinically correlate for infection; ischemia is considered less likely.2.Appendix is not identified; however, no secondary signs of appendicitis.3.Left basilar atelectasis and and opacities suggestive of atelect... |
Generate impression based on findings. | syncope No evidence of acute ischemic or hemorrhagic lesion.Diffuse mild brain atrophy which is age appropriate.Patchy bilateral periventricular white matter low attenuations indicate non specific small vessel disease. Comparing to prior study, the extent of the lesion appears to be slightly progressed.The ventricles, ... | 1. No evidence of acute ischemic or hemorrhagic lesion.2. Mild to minimal brain atrophy and mild non specific small vessel ischemic disease. |
Generate impression based on findings. | prior ischemic infarction and ICH No evidence of acute ischemic or hemorrhagic lesion.Previously shown right occipital and left temporo-occipital lobe ischemic strokes demonstrate evolution with volume loss including ex vacuo change of adjacent ventricle. No change of right thalamic chronic ischemic infarction and non ... | 1. No evidence of acute ischemic or hemorrhagic lesion.2. Normal evolution of right occipital and left temporo-occipital ischemic infarction results volume loss.3. No change of non specific small vessel disease since prior exam. |
Generate impression based on findings. | 28 year-old male with abdominal pain and ascites. History of desmoplastic small round cell tumor. Evaluate ABDOMEN:LUNG BASES: Left basilar nodule measures 2.1 x 1.4 cm (series 4, image 23), most likely metastatic in etiology. Mild bilateral basilar atelectasis. There is a cardiophrenic node which measures 4.5 x 2.6 cm... | 1.Extensive confluent peritoneal disease which results in scalloping of the liver and splenic contour as well as extensive mass effect upon the pancreas, bowel, and the pelvic structures. Reference measurements as above.2.Large volume ascites.3.Findings consistent with thoracic metastatic disease at the lung bases. Fur... |
Generate impression based on findings. | known cavernous malformation follow up Re demonstration of right deep white matter, centrum semiovale, cavernous malformation. There is no change in size and CT characteristics since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is ... | 1. No change of right centrum semiovale cavernous malformation in terms of size (10mm) and CT characteristics since prior exam.2. Otherwise unremarkable. |
Generate impression based on findings. | Male 71 years old; Reason: eval infection or other acute process History: emesis, tachy, febrile ABDOMEN:LUNG BASES: Patchy air space opacities in the right base suggestive of infection/aspiration. Incompletely imaged hilar and mediastinal adenopathy. A right hilar node measures 1.3 cm in maximum short axis dimension. ... | 1.Hyperattenuating liver lesion which is incompletely characterized on this single phase of contrast but may represent a hemangioma.2.Left adrenal nodule is nonspecific. In the absence of known primary malignancy, favor benign etiology.3.Right basal pneumonia/aspiration with nonspecific lymphadenopathy which is incompl... |
Generate impression based on findings. | 42-year-old male with history of right flank pain and small fragments in urine. History of right partial nephrectomy in 2014 for RCC. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality not... | Small fluid collection adjacent to the right kidney extending into the anterolateral abdominal wall and filling with contrast on delayed images, consistent with urinoma. |
Generate impression based on findings. | follow up of left thalamic ICH Re demonstration of the left thalamic ICH,IVH with midline shift toward right side.The degree of midline shift at the level of foramen of Monroe appears to be stable (about 11mm).The size of ICH and the amount of IVH appear to be stable.Right frontal approach ventriculostomy tube and the ... | 1. No interval change of left thalamic ICH, IVH and mass effects since prior exam.2. Stable ventriculostomy tube position. |
Generate impression based on findings. | confusion, word finding difficulties Subtle multifocal low attenuations on the left frontal lobe indicate possible ischemic lesion. No evidence of acute hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid colle... | Subtle low attenuations on the left frontal lobe indicate possible acute ischemic lesion. Brain MRI can be considered for further evaluation. |
Generate impression based on findings. | No acute facial bone fracture is identified. There is an anterior septal hematoma measuring greater than 14 mm in diameter. There is moderate to severe rightward nasal septum deviation, which contacts the middle turbinate and causes mass effect on the right inferior turbinate. There is reticulation of the subcutaneous... | 1. Anterior septal hematoma and edema of the nasal soft tissues, without definitive nasal bone fracture.2. Moderate to severe rightward deviation of the nasal septum. |
Generate impression based on findings. | Female 43 years old Reason: PE? evolution of PNA? s/p HCAP treatment. pre-LVAD eval. History: as above PULMONARY ARTERIES: No acute pulmonary embolus. Pulmonary artery is enlarged measuring up to 33 mm suggestive of pulmonary arterial hypertension. No evidence of right heart strain.LUNGS AND PLEURA: Interval decrease i... | 1.No acute pulmonary embolus.2.Interval improvement in ill-defined pulmonary nodules consistent with resolving infection.3.Improved left pleural effusion.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative. |
Generate impression based on findings. | 7-year-old female with intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is just above the carina pointing towards right mainstem bronchus. Right internal jugular central venous catheter with tip in the right internal jugular vein. Enteric tube tip is in the gastric antral pyloric region. NG tube tip is in the ga... | ET tube tip abuts the carina. Increased left lower lobe atelectasis with probable small pleural effusion. |
Generate impression based on findings. | Male, 60 years old.RFO NG tube with tip at the GE junction. Right abdominal drain. Residual contrast within the duodenum and proximal jejunum. Contrast within the bladder. Nonobstructive bowel gas pattern. No unexpected radiopaque foreign bodies.Left retrocardiac consolidation/atelectasis. | No unexpected radiopaque foreign bodies. Findings were discussed with Dr. Wyers via telephone at 17:20 on 2/4/2015 by the radiology resident on call, Dr. Westin. |
Generate impression based on findings. | 53 year old female with history of left upper quadrant pain, nausea and vomiting. Evaluate left upper quadrant fluid collection. ABDOMEN:LUNG BASES: Small left pleural effusion, minimally decreased in size from prior. Overlying associated subsegmental atelectasis, with additional subsegmental atelectasis dependently on... | 1.Slight interval decrease in size of the fluid collection in the distal pancreatectomy surgical bed, with percutaneous drain appropriately positioned in the superior portion of the collection.2.The additional, more posterior fluid collection is unchanged in size.3.Subcutaneous nodules are again noted, slightly increas... |
Generate impression based on findings. | Female 11 years old Reason: f/u exam History: intubated, epilepsy with seizures.VIEW: Chest AP (one view) 2/5/15 at 511 hours. Thoracolumbar levoscoliosis unchanged. Cardiac silhouette is not sizable. Persistent chronic atelectasis of the right lung base. Interval ET tube removal. | Interval removal of ET tube. |
Generate impression based on findings. | Male, 71 years old.RFO NG tube with tip in the body of the stomach. Surgical clips at the GE junction. Two right upper quadrant drains. Nonobstructive bowel gas pattern. Moderate amount of free intraperitoneal air, likely related to recent surgery.Sternotomy hardware. Bibasilar atelectasis/scarring and small pleural ef... | No unexpected radiopaque foreign bodies. Findings discussed with Dr. Choi via telephone at 21:13 on 2/4/2015 by the radiology resident on call, Dr. Westin. |
Generate impression based on findings. | 23-year-old male with jaw pain There is an oblique fracture of the posterior left mandibular body as seen on recent CT. Partial loss of the adjacent mandibular molar is noted. The paranasal sinuses are clear. Unerupted maxillary molars are also noted. | Left mandibular body fracture. |
Generate impression based on findings. | Female 40 years old; Reason: 40 yo F hx of multiple myeloma with diarrhea and abdominal pain. infectious work up neg. eval for possible etiology such as colitis History: abdominal pain, diarrhea ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Mild prominence of the central intrahepatic ducts,... | 1.No evidence of colitis. No specific cause for patient's abdominal pain and diarrhea is identified.2.Multiple lytic bone lesions consistent with provided history multiple myeloma. |
Generate impression based on findings. | 75-year-old male with left hip pain There is a nondisplaced, impacted fracture of the left femoral neck. A trochanteric femoral nail is noted affixing the right hip without evidence of hardware complication. There is poor visualization of the proximal femur on the crosstable lateral view. Vascular calcifications are pr... | Impacted nondisplaced left femoral neck fracture. |
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