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Generate impression based on findings.
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14-month-old male with cough, fever, fast breathing, crackles at the left baseVIEWS: Chest AP/lateral (two views) 02/04/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern. Streaky retrocardiac opacity best seen on the lateral view likely reflects atelectasis.
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Bronchiolitis/reactive disease pattern with retrocardiac atelectasis.
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Generate impression based on findings.
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23-year-old male with pain at fifth toe Alignment is anatomic. No fracture or other specific findings to account for the patient's pain. There is mild lateral soft tissue swelling.
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No specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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89 year-old female with left hip discomfort Hardware components of a right total hip arthroplasty device are situated in near-anatomic alignment without evidence of complication. A trochanteric femoral nail affixes the left hip. A nonunited lesser trochanteric fracture fragment is again noted. Severe degenerative disk disease affects the lower lumbar spine.
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Post operative and chronic post traumatic changes as described above.
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Generate impression based on findings.
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Female 67 years old; Reason: eval for stone History: flank pain 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:ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal stones, hydronephrosis or hydroureter. No significant perinephric stranding.RETROPERITONEUM, LYMPH NODES: Mild arteriosclerosis of the abdominal aorta and branch vessels.BOWEL, MESENTERY: Submucosal fat deposition along the ascending colon and terminal ileum in a pattern suggestive of chronic inflammation. Mild nonspecific mesenteric stranding about the right colon without significant wall thickening, which may reflect mild inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Presumed fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Submucosal fat deposition along the ascending colon and terminal ileum in a pattern suggestive of chronic inflammation. Mild nonspecific mesenteric stranding about the right colon without significant wall thickening, which may reflect mild inflammation.BONES, SOFT TISSUES: Nonspecific sclerotic focus within the T11 vertebral body which may represent a bone island.OTHER: No significant abnormality noted.
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1. No evidence of renal stone. If hematuria persists consider further evaluation with renal protocol CT abdomen (without the noncontrast study).2. Submucosal fat deposition along the ascending colon and terminal ileum suggestive of chronic inflammation with mild nonspecific mesenteric stranding about the right colon which may reflect mild inflammation. Correlate for any evidence of inflammatory bowel disease.
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Generate impression based on findings.
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54-year-old male status post fall Hip: No fracture or dislocation. The hip joint appears normal for the patient's age.Shoulder: No fracture or malalignment. A small ossicle inferior to the glenoid likely represents a loose body within the axillary recess.
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No fracture or dislocation.
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Generate impression based on findings.
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48 year old female status post fracture reduction Cast material obscures underlying osseous detail. A comminuted distal tibia fracture is again noted in near anatomic alignment.
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Casted distal tibia fracture as described above.
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Generate impression based on findings.
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86 year old female with pain Hips: Medial joint space narrowing consistent with mild osteoarthritis affects each hip. No fracture or dislocation.Knees: Limited nonweightbearing views demonstrate bilateral chondrocalcinosis and small osteophytes consistent with mild osteoarthritis affecting each knee.
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Mild osteoarthritis and chondrocalcinosis without fracture or dislocation.
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Generate impression based on findings.
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24-year-old female with drainage from abdominal incision. Evaluate for abdominal abscess versus fistula. ABDOMEN:LUNG BASES: Large bilateral pleural effusions with overlying atelectasis.LIVER, BILIARY TRACT: Mass effect upon the left hepatic lobe from large fluid and gas containing collection as detailed below.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating focus within the superior pole of the left kidney consistent with a simple cyst. Additional subcentimeter left hypoattenuating foci are incompletely characterized.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications affect the abdominal aortaBOWEL, MESENTERY: There is a large extraluminal contrast filled collection in the abdomen (series 3, image 79) measuring 14.5 x 3.3 cm. The region of the leak is identified to be from a small bowel loop in the right upper abdomen (series 3, image 77). The contrast filled collection is immediately beneath the midline abdominal incision (series 3, image 74 through 76) with possible fistulous communication to the skin surface.New large fluid and gas containing collection in the midline upper abdomen measuring approximately 11.0 X 7.1 Cm (series 3, image 34) with mass effect upon the liver and posterior displacement of the left hepatic lobe.Small pneumoperitoneum within the abdomen which extends superiorly to the level of the superior aspect of the liver (series 3, image 24), which may in part be secondary to the aforementioned perforation with component of postoperative air. Surgical clips within the pelvis are noted.Mild focal dilatation of the proximal small bowel measuring up to 3.3 cm in maximal dimension may represent focal ileus.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: Lucent lesion within the sacrum appears similar to the prior examination.OTHER: No significant abnormality noted
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1.Findings consistent with perforation of the small bowel in the right abdomen with contrast extravasation as detailed above.2.Possible fistulous communication of the upper abdominal contrast filled collection to the skin surface.3.Air and fluid filled collection at the upper abdomen resulting in posterior displacement of the left hepatic lobe.4.Postoperative changes within the pelvis with small amount of pneumoperitoneum which may in part be postoperative in etiology. However, component of pneumoperitoneum secondary to the aforementioned small bowel perforation cannot be excluded.5.Large bilateral pleural effusions with overlying atelectasis.
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Generate impression based on findings.
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Female, 82 years old. No unexpected radiopaque foreign body. Drain and surgical staples are noted within the soft tissues. A rectal temperature probe is in place. IVC filter.
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No unexpected radiopaque foreign body. These findings were discussed with Dr. Lee via telephone by the resident on call at 19:16 on 2/4/2015
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Generate impression based on findings.
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34-year-old female with history of left hip pain. Left hip: We see no acute fracture. Tiny ossicle adjacent to the superolateral aspect of the acetabulum likely represents an os acetabula, a normal variant. There are degenerative changes about the pubic symphysis.Left femur: We see no acute fracture. The knee joint is unremarkable.
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No radiographic findings to account for the patient's pain. If patient care warrants further imaging, an MRI may be obtained.
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Generate impression based on findings.
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50 year-old female with history of intractable epilepsy, intraoperative imaging with bodytom after frame placement. Examination is performed with a stereotactic device secured in patient's calvarium without detectable complications. Examination is performed as a guidance for treatment/surgery and is not a diagnostic test. There is slight asymmetric prominence of the left cerebral sulci related to mild volume loss. There is redemonstration of low-lying cerebellar tonsils, and crowding of the foramen magnum.Postoperative findings related to right parietal craniotomies, including expected pneumocephalus in the nondependent portions of the brain, as well as the anterior horn of the right lateral ventricle. Multiple metallic artifacts are present secondary to depth electrode placement in the middle cranial fossa, including the anterior and medial surface of the right temporal lobe. An electrode is seen entering the right posterior parietal/occipital region and traversing the trigone of the right lateral ventricle, terminating near the medial aspect of the posterior right temporal lobe. There is foci of air along the course of this electrode. There is no gross intracranial hemorrhage, significant mass effect, or midline shift. There are small subgaleal hematomas and multiple foci of air overlying the calvarium at the craniotomy sites.
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1. Surgical planning nonenhanced stealth head CT as detailed.2. Postoperative findings related to right parietal craniotomies and depth electrode placement. The appropriate placement of depth electrodes should be determined by the clinical service. 3. No gross intracranial abnormality.
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Generate impression based on findings.
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82-year-old female with incorrect needle count Drain, gas and surgical staples in the soft tissues reflect recent surgery. No unexpected radiopaque foreign body.
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No unexpected radiopaque foreign body. These findings were discussed with Dr. Lee via telephone by the resident on call at 19:16 on 2/4/2015
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Generate impression based on findings.
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Respiratory distress of the new born.VIEW: Chest and abdomen AP (two views) 2/5/15 at 530 hours. NG tube tip is at the stomach. UVC terminates at the right atrium. UAC coiled towards itself, tip is at L1 and dome at T10.Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax.Disorganized, less distended and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas.
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Misplaced UAC.There is distended but still disorganized abdominal gas pattern.
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Generate impression based on findings.
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Eight year-old male with ankle pain, tenderness to palpation along the medial malleolusVIEWS: Left ankle AP/lateral/oblique (3 views) 02/04/15 Soft tissue swelling over the medial malleolus. No joint effusion. No specific evidence for fracture is evident. Alignment is anatomic.
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Soft tissue swelling evidence of fracture or malalignment.
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Generate impression based on findings.
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Desaturations.VIEW: Chest and abdomen AP (two views) 2/5/15 at 637 hours. Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. No focal lung opacities. No effusions or pneumothorax.Disorganized, likely age-related and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas.
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Disorganized, age related abdominal gas pattern.
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Generate impression based on findings.
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69-year-old female with history of foot pain. Redemonstrated is an oblique fracture through the mid diaphysis of the fifth metatarsal. There is slight medial angulation of the distal fracture fragment. There is mild soft tissue swelling about the lateral aspect of the foot. There is a moderate hallux valgus deformity.
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Fifth metatarsal fracture appearing similar to prior.
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Generate impression based on findings.
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The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well maintained. Bone marrow signal is heterogeneous with small foci of focal fat and hemangiomas. No destructive osseous lesions are seen. Artifact especially on the axial sequences limits evaluation. There is subtle T2 hyperintense focus within the thoracic cord at the T10-T11 level and a slightly longer lesion extending from the T9 to T10 level seen on the sagittal sequence grossly similar to prior. There is also a right dorsolateral cord lesion at the T9 level which was present on prior from September 2013. There is subtle T1 hyperintensity at the T10-T11 level. No pathologic enhancement to suggest active demyelination is appreciated.There is mild spinal canal stenosis at the T10-T11 level related to minimal disk bulge, facet arthropathy, and ligamentum flavum thickening. There is moderate right neural foraminal stenosis and mild left neural foramina narrowing. There is also mild right T8-T9 neural foramina narrowing related to facet arthropathy.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the remainder of the thoracic spine.
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1. Artifact slightly limits evaluation. There is evidence of T2 hyperintense lesions within the lower thoracic cord compatible with chronic demyelinating plaques. No new lesion is definitively appreciated. No pathologic enhancement to suggest active demyelination.2. Degenerative changes with mild spinal canal stenosis and moderate right neural foraminal narrowing at T10-T11 similar to prior.
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Generate impression based on findings.
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34-year-old female history of fifth digit swelling. Evaluate for osseous metastasis. Overlying cast material limits evaluation of the metacarpals and wrist. There is significant soft tissue swelling about the lateral aspect of the mid fifth finger. The underlying bone is unremarkable. We see no fracture or suspicious osseous lesions.
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Focal fifth finger swelling without fracture or radiographic evidence of osseous metastasis. If patient care warrants further imaging, an MRI may be obtained.
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Generate impression based on findings.
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13-year-old male status post reductionVIEWS: Right hand PA/oblique/lateral (3 views) 02/05/15 Cast material obscures fine bone detail. Again seen is a transverse fracture through the fifth metacarpal neck with persistent volar angulation of the distal fracture fragment.
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Casting of Boxer's fracture of the fifth metacarpal with persistent volar angulation.
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Generate impression based on findings.
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65-year-old female history of right hip and low back pain. Evaluate for sacral insufficiency fracture. Redemonstrated is sclerosis and poor definition along the iliac margin of the right sacroiliac joint. There is also ill-defined sclerosis about the right sacrum. The left sacroiliac joint appears unremarkable. Moderate degenerative disc disease affects the visualized lower lumbar spine.
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Sclerosis along the iliac, and to a lesser extent, the sacral aspect of the right sacroiliac joint is favored to be degenerative in etiology although this may represent a chronic insufficiency fracture.
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Generate impression based on findings.
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Female 4 months old Reason: follow up lung fields History: respiratory distressVIEW: Chest AP (one view) 2/5/15 at 814 hours Cardiac silhouette size is normal. Worsening in right upper and middle lobe atelectasis with mediastinal shift to the right. Persistent lung haziness.
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Interval worsening in right upper and middle lobe atelectasis with mediastinal shift to the right.
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Generate impression based on findings.
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66-year-old male with history of abdominal pain and an eye on. Evaluate for pancreatitis. Please note lack of IV and oral contrast limits evaluation of solid organ pathology, and also of the GI tract.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatic steatosis is again noted. No biliary dilatation or other gross abnormality.SPLEEN: No significant abnormality notedPANCREAS: No peripancreatic stranding or fluid collections. Minimal pancreatic atrophy, consistent with patient's age.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or hydroureter. Punctate right renal parenchymal calcification in the renal pelvis, may be a nonobstructing calculus or arterial calcification.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Subtle perirectal fat stranding, nonspecific but correlate with physical exam/history exclude proctitis.BONES, SOFT TISSUES: Lumbarization of the S1 vertebral body.OTHER: No significant abnormality noted
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1.No findings of pancreatitis on this limited exam.2.Hepatic steatosis.3.Subtle perirectal fat stranding, correlate with history/exam to exclude proctitis.4.Lumbarization of the S1 vertebral body.
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Generate impression based on findings.
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13-year-old male with swelling over the fourth and fifth digitVIEWS: Right hand PA/lateral/oblique (3 views) 02/04/15 Transverse fracture through the fifth metacarpal neck with volar angulation of the distal fracture fragment. Soft tissue swelling over the medial aspect of the hand. No additional fractures are identified.
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Boxer's fracture of the fifth metacarpal.
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Generate impression based on findings.
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11 year old female with abdominal pain and vomitingVIEWS: Abdomen AP (one views) 02/05/15 Moderate amount of stool throughout the colon. Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Valgus angulation of bilateral femoral necks. No acute fracture or malalignment is evident. Cardiac apex and stomach are left-sided.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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5-month-old female with cough and feverVIEWS: Chest AP/lateral (two views) 02/05/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Large lung volumes and mild to moderate peribronchial cuffing is suggestive of reactive airway disease/bronchiolitis.
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Bronchiolitis/reactive airway disease pattern.
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Generate impression based on findings.
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Female, 52 years old, with right intraparenchymal hemorrhage, assess for interval change. There is redemonstration of the large parenchymal hematoma centered in the right thalamus, extending to the right triple peduncle, the size and density of which is not significantly changed since most recent exam. The surrounding edema is similar in geographic distribution. There is no significant change in the degree of mass effect or leftward midline shift. There is diffuse effacement of the sulci and there is persistent downward mass effect distorting the basal cisterns.A left frontal approach ventriculostomy catheter remains in place with the catheter tip situated in the body of the left lateral ventricle at approximately the level of the foramen of Monro. The ventricular caliber has again mildly increased in the interval. For example, at the level of the atrium, the left lateral ventricle measures up to 20 mm in diameter, previously 17 mm. There is dense atherosclerotic calcification of the distal left vertebral artery. The quantity and density of intraventricular blood product casting the right lateral ventricle and the third ventricle, as well as dependent blood product within the left occipital horn, is not significantly changed.
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1.Minimal increase in the caliber of the left lateral ventricle. 2.Stable size of the large parenchymal hematoma centered in the right thalamus.3.Stable surrounding edema, associated mass effect, and quantity of intraventricular blood product.
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Generate impression based on findings.
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13-month-old male with fever and coughVIEWS: Chest AP/lateral (two views) 02/05/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is top normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Large lung volumes and moderate peribronchial cuffing suggestive of bronchiolitis/reactive airway disease.
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Bronchiolitis/reactive airway disease pattern.
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Generate impression based on findings.
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34-year-old male with history of seminoma status post chemotherapy. Evaluate response. CHEST:LUNGS AND PLEURA: No significant interval change in the right lower lobe nodule measuring 1.4 x 0.9 cm (series 5, image 50), previously measuring 1.4 x 0.8 cm (series 3, image 29); there are associated micronodules which are also unchanged. No new pulmonary nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Mildly prominent nonspecific mediastinal lymph nodes, not significantly changed compared prior examination. Right hilar adenopathy measures 2.4 x 2.4 cm (series 3, image 51), previously measuring 2.8 x 2.6 cm (series 2, image 28).CHEST WALL: Nonspecific mildly prominent right axillary lymph nodes are unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right upper pole hypoattenuating focus consistent with a cyst. An additional subcentimeter right hypoattenuating focus is too small to characterize but stable compared to previous exam.RETROPERITONEUM, LYMPH NODES: Interval decrease in size of retroperitoneal lymphadenopathy. Reference lymph node anterior to the IVC at the level of the IMA measures 0.9 x 0.7 cm (series 3, image 147), previously measuring 1.7 x 1.2 cm (series 2, image 86).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Mild interval decrease in size of the pelvic lymph nodes. Reference right iliac chain lymph node measures 1.0 x 0.6 cm (series 3, image 183), previously measuring 1.3 x 0.7 cm (series 2, image 108).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Interval decrease in size of hilar, retroperitoneal, and pelvic lymphadenopathy.2.Stable right basilar nodule with associated micronodules.
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Generate impression based on findings.
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15-year-old male with pain over the lateral malleolusVIEWS: Left ankle AP/lateral/oblique (3 views) 02/04/15 No acute fracture or malalignment is evident. No soft tissue swelling. No joint effusion.
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Normal examination.
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Generate impression based on findings.
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5-year-old male status post Broviac placementVIEW: Chest AP (one view) 02/04/15 Broviac line tip projects over the right atrium.Cardiothymic silhouette is unchanged. No pleural effusion or pneumothorax. No focal pulmonary opacities.
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Broviac line tip projects over the right atrium
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Generate impression based on findings.
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46 year old male with longstanding history of dysphagia and eosinophilic esophagitis, now presents with worsening bloating and postprandial abdominal pain. Scout radiograph of the chest was unremarkable.Double contrast evaluation of the esophagus demonstrated mild ridging and persistent faint scalloping along the mid and distal esophageal contours. Findings are suggestive of eosinophilic esophagitis and not significantly changed since the prior exam. No evidence of high grade stricture or obstructive lesion, as contrast passed freely into the stomach. No esophageal ulcerations. The stomach was normal in appearance.Double contrast visualization of the hypopharynx did not demonstrate webs, bars, or Zenker's diverticulum. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. The 13 mm barium pill passed through the esophagus and into the stomach without incident. TOTAL FLUOROSCOPY TIME: 4:22 mm:ss
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1.Faint scalloping and ridging along the mid and distal esophagus, not significantly changed and compatible with the patient's known history of chronic eosinophilic esophagitis. 2.No new mucosal abnormality, obstructive lesion, or evidence of GE reflux.
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Generate impression based on findings.
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45 years, Female. Reason: constipation vs obstruction History: constipation Nonobstructive bowel gas pattern. Moderate to large amount of stool throughout the colon.Small right pleural effusion/thickening.
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Nonobstructive bowel gas pattern. Mild to moderate constipation.
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Generate impression based on findings.
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4-month-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is below thoracic inlet and above the carina. NG tube terminates in the stomach.Cardiothymic silhouette is normal. Small left pleural effusion. Increased right upper lobe atelectasis with elevation of the minor fissure likely represents atelectasis. Retrocardiac opacity persists. No pneumothorax.
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Increased right upper lobe and and persistent left lower lobe atelectasis.
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Generate impression based on findings.
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68 years, Male. Reason: NG verification History: adjusted NG tube NG tube with tip in the proximal stomach and sidehole adjacent to the GE junction. Nonobstructive visualized bowel gas pattern. Note the lower abdomen and pelvis are out of the field-of-view.Left lower lung scarring/atelectasis.
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NG tube with tip in the proximal stomach and sidehole adjacent to the GE junction. Recommend advancement.
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Generate impression based on findings.
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T1N0 right parotid adenoid cystic carcinoma, status post radiation therapy and surgery with right jaw pain. Evaluate for right jaw osteomyelitis. There are stable postoperative findings related to right parotidectomy and right face and neck radiation therapy. There is no evidence of measurable mass lesions. There are unchanged mildly prominent left level 4 and upper mediastinal lymph nodes. The major cervical vessels are patent. There is straightening of the cervical lordosis. There is interval increase in size of the lucency within the right mandibular ramus, now including the retromolar trigone area, which may reflect excision and curettage. The osseous structures are otherwise unchanged and there is no evidence of fluid collections. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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1. Postoperative findings related to right parotidectomy without evidence of measurable mass lesions. 2. No definite significant lymphadenopathy to suggest metastatic disease. 3. Interval right mandibular ramus debridement, with a new defect in the retromolar trigone area, which may reflect excision and curettage, and otherwise persistent lucencies more posteriorly, which likely represent sequela of osteomyelitis or osteonecrosis, but no evidence of fluid collection to suggest abscess. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Frequent headaches, short term memory problems, and visual disturbances. Evaluate for space occupying lesion. There is no evidence of intracranial mass or abnormal intracranial enhancement. There is no intracranial hemorrhage within limitations of post-contrast technique. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial mass.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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61-year-old male with history of multiple myeloma. SKULL: Ovoid lucencies in the skull are favored to represent venous lakes versus myelomatous deposits. Overall, these appear similar to the prior study.CERVICAL SPINE: No discrete myelomatous lesions. There is moderate multilevel degenerative disc disease.THORACIC SPINE: Minimal superior endplate depression of the T7 vertebral body and mild anterior wedging appears similar to prior. No discrete myelomatous lesions. Left chest port with tip in SVC. LUMBAR SPINE: There are posterior stabilization rods with screws entering the vertebral bodies of L2 and L3. There is an intervertebral disk spacer device present at L2-3. No evidence of hardware complication. Severe degenerative disc disease affects remaining lumbar spine. No discrete myelomatous lesions.RIBS: Healing right fifth and ninth rib fractures appear similar. No discrete myelomatous lesions.PELVIS: Moderate osteoarthritis affects the hips bilaterally. No discrete myelomatous lesions.UPPER EXTREMITY: No discrete myelomatous lesions.LOWER EXTREMITY: No discrete myelomatous lesions.
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No discrete myelomatous lesions. Interval postsurgical changes in the lumbar spine.
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Generate impression based on findings.
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72 years, Female. Reason: Dobbhoff placement History: Dobbhoff placement Dobbhoff tube tip in the pyloric region. Remainder of the visualized structures are not significantly changed. See same day dedicated chest radiograph report for further details regarding chest.
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Dobbhoff tube tip in the pyloric region.
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Generate impression based on findings.
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Female 24 years old Reason: PA malformations, PE History: behcet's disease PULMONARY ARTERIES: No acute pulmonary embolus. Pulmonary artery is normal in caliber without evidence of right heart strain. No evidence of pulmonary arterial malformations.LUNGS AND PLEURA: No focal consolidation to suggest infection. No suspicious pulmonary nodules or masses. No pleural effusion. No pneumothorax.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Heart size is normal without pericardial effusion.No visualized coronary arterial calcifications in this non-gated study.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of pulmonary embolus. No acute cardiopulmonary abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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74-year-old with history of dense breasts, breast calcifications and bilateral breast reduction. Three standard views of both breasts and cleavage views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Bilateral benign calcifications and breast reduction changes, including scattered bilateral asymmetries, are again noted.Benign appearing lymph nodes are projected over both axillae.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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73-year-old male with history of metastatic prostate cancer. Bone pain. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules are again seen, with reference lesions as follows:- Right upper lobe nodule (5/31) measures 0.9 x 1 .4 cm, unchanged from prior.- Left upper lobe nodule (5/25) measures 0.6 x 0.5 cm, unchanged.Additional pulmonary nodules, and right lower lobe scarring/bronchiectasis appear stable.MEDIASTINUM AND HILA: Reference mediastinal lymph node (4/48) measures 2.5 x 2 .7 cm, slightly increased in size from previous 2.4 x 2.2 cm. There is mild associated narrowing of the right mainstem and lower lobe bronchus. Additional mediastinal lymph nodes have increased in size.Severe coronary artery and mitral annulus/valvular calcifications. Heart size within normal limits, and there is no significant pericardial effusion.CHEST WALL: Multiple sclerotic bone lesions, grossly similar to prior exam. Refer to bone scan from today for more detailed evaluation of the skeleton.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Pancreatic head coarse calcifications, unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral punctate calcifications, likely nonobstructing stones versus arterial calcifications. No hydronephrosis or hydroureter. Small right renal cyst, unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the aorta and its branches. Dense calcifications at the right renal artery ostium.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple sclerotic bone lesions are again noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy, with multiple surgical clips and penile implant/right lower quadrant pump again noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Multiple sclerotic bone lesions again noted. Refer to same day bone scan for more detailed evaluation.OTHER: No significant abnormality noted
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1.Multiple pulmonary nodules without significant change in size.2.Interval increase in size of mediastinal lymph nodes.3.Multiple sclerotic bone lesions appear grossly stable, however refer to same day bone scan for more detailed evaluation.
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Generate impression based on findings.
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67-year-old male with history of prostate cancer with rising PSA. Evaluate for recurrence. CHEST:LUNGS AND PLEURA: There are scattered micronodules, which are nonspecific. Right upper lobe pleural-based thickening measures 1.6 x 1.7 cm and measures fat attenuation, likely lipoma. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Mildly prominent right hilar lymphoid tissue measures 1.4 x 1.2 cm (series 4, image 44). No mediastinal lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable bilobar subcentimeter hypoattenuating foci. Postoperative changes of cholecystectomy without evidence of intra-or extrahepatic biliary ductal dilatation.SPLEEN: Small accessory splenule again noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable punctate right non-obstructing nephrolithiasis. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Stable mildly prominent retroperitoneal lymph nodes. IVC filter is again noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No evidence of soft tissue in the region of the prostate to suggest tumor recurrence.BLADDER: No significant abnormality notedLYMPH NODES: Minimally prominent pelvic lymph nodes are unchanged.BOWEL, MESENTERY: Suture material within the sigmoid colon from prior bowel resection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No definite evidence of tumor recurrence.2.Nonspecific mildly enlarged right hilar lymphoid tissue and scattered pulmonary micronodules.
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Generate impression based on findings.
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Dobbhoff placement Dobbhoff tube coiled in the stomach with tip directed cranially in the fundus. Remainder of the surgical drains/staples and cardiopulmonary support devices are not significantly changed. See same day dedicated chest radiograph report for further details regarding chest.Bibasilar consolidation/atelectasis.
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Dobbhoff tube coiled in the stomach with tip directed cranially in the fundus.
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Generate impression based on findings.
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There is mucosal thickening throughout the left maxillary sinus with frothy material which is nonspecific but could be an indicator of acute on chronic sinusitis. The nasal passages are near completely occluded as is the left osteomeatal complex. There is leftward nasal septal deviation which effaces the left nasal passage and contributes to the greater degree of left sided sinus disease and left osteomeatal occlusion. The right maxillary sinus contains a large mucous retention cyst and the right osteomeatal complex is open. The sphenoid sinus contains septations and some mild mucosal thickening which also could be an indicator of acute on chronic sinusitis. The mucosa of the ethmoid air cells is minimally thickened. The frontal sinuses and mastoid cells are relatively clear. The visualized facial bones and orbits are intact. The temporomandibular joints are intact. Between the superior and inferior turbinates is soft tissue density which could indicate the presence of a polyp. The lamina papyracea and ethmoid roofs are intact.
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1.Left maxillary thickening and frothy material with occlusion of the nasal passages and left osteomeatal complex. This along with septated mucosal thickening of the sphenoid sinus indicates possible acute on chronic sinusitis.2.Leftward deviation of the septum which contributes to the effacement of the left nasal passage.3.Soft tissue density in the left nasal cavity between the superior and inferior turbinates which may represent a nasal polyp.4.Large mucous retention cyst in the right maxillary sinus.5.Mild involvement of the ethmoid air cells and relatively clear frontal sinuses and mastoid air cells.
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Generate impression based on findings.
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43-year-old with personal history of breast cysts. 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. There are bilateral breast masses, at least several of which are decreasing in size, compatible with involuting cysts. The dominant lesion in the right inner breast appears slightly larger. Additionally, at approximately the left 12 o'clock, a circumscribed mass appears slightly larger. No suspicious microcalcifications or areas of architectural distortion in either breast. ULTRASOUND
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Bilateral cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Diagnostic rather than screening mammogram is recommended given the high likelihood that ultrasound will be needed next year. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Female; 22 years old. Reason: please assess for possible progression of possible fungal pna History: aml pt here for consolidation chemo LUNGS AND PLEURA: Previously seen scattered, ill-defined semi-solid nodules have resolved, likely post infectious or inflammatory in etiology. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Further improvement in mediastinal lymphadenopathy. Reference right paratracheal node measures 10 mm (series 5/20), previously 13 mm. normal heart size without pericardial effusion. No visible coronary artery calcifications. Right jugular central venous catheter tip near the superior cavoatrial junction.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality.
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1. Interval resolution of scattered semisolid nodules, likely post infectious or inflammatory in etiology.2. Further improvement in mediastinal lymphadenopathy.
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Generate impression based on findings.
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30 year-old female status post reduction Plaster material obscures underlying osseous detail. Distal radius fracture fragments are now in near-anatomic alignment. An ulnar styloid fracture is again noted.
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Distal radius fracture reduction.
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Generate impression based on findings.
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30 year-old female after FOOSH There is a comminuted, impacted fracture of the distal radius with dorsal angulation of the distal fracture fragments. A minimally displaced ulnar styloid fracture is also noted.
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Distal radius and ulnar styloid fractures as described above.
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Generate impression based on findings.
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Male 23 years old Reason: s/p ORIF History: s/p ORIF Postsurgical changes with plate and screw fixation of the distal radius and ulna fractures in near anatomic alignment. There is some bony bridging at the medial fracture line and callus formation with some sclerosis about the fracture at the ulnar fracture line. No hardware complication is evident.
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Healing distal radius and ulnar fractures as above.
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Generate impression based on findings.
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Reason: Restrictive lung physiology History: dyspnea LUNGS AND PLEURA: No significant abnormality noted. No evidence of interstitial lung disease. No air trapping identified on the expiratory imaging.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal evidence of a pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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No pulmonary or pleural abnormalities identified. No evidence of interstitial lung disease or air trapping.
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Generate impression based on findings.
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Sinusitis. There are postoperative findings related to endoscopic sinus surgery. There is moderate mucosal thickening in the bilateral maxillary sinuses, with a small amount of hyperattenuating secretions in the right maxillary sinus and diffuse sclerosis and thickening of the sinus walls. There is complete opacification of the frontal sinuses and ethmoid cavities. There is suggestion of polypoid opacities in the nasal cavity. There is moderate mucosal thickening and bubbly secretions in the sphenoid sinuses. The nasal septal is essentially midline. There is mild thinning and medial bowing of the lamina papyracea bilaterally. The ethmoid roofs are intact, but the right is slightly lower than the left. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbital contents, and imaged intracranial structures appear to be unremarkable. There is torus palatinus, which is an anatomic variant.
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Postoperative findings related to endoscopic sinus surgery with persistent pansinus opacification suggestive of acute upon chronic sinusitis and suggestion of polyposis.
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Generate impression based on findings.
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5-year-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is above the thoracic inlet. Right internal jugular central venous catheter with tip at the superior cavoatrial junction. NG tube terminates in the stomach.Cardiothymic silhouette is normal. No pleural effusions or pneumothorax. Retrocardiac opacity persists. Slight interval improvement of right upper and right basilar opacities.
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Slight interval improvement of pulmonary edema pattern with persistent retrocardiac atelectasis.
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Generate impression based on findings.
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63-year-old male with shortness of breath and recent abnormal chest radiograph with new cavitary lesion. History of metastatic lung adenocarcinoma. LUNGS AND PLEURA: New thin walled cavitary lesion in the superior segment of the left lower lobe with mild surrounding consolidation measures up to approximately 4.5 x 4.4 cm (series 7/34), with an appearance most suggestive of infectious etiology.Left upper lobe lingular nodule measures 14 mm (series 7/56), mildly increased since prior study on 1/9/15 when it measured 8 mm; this was hypermetabolic on prior PET/CT and is compatible with tumor. Stable streaky subsegmental atelectasis or scar in the left upper lobe. Upper lobe predominant centrilobular and paraseptal emphysema. Elevated of the left hemidiaphragm. No pleural effusions.MEDIASTINUM AND HILA: Stable left perihilar partially calcified mass that again appears to involve and obstruct the left upper lobe bronchus and encase and narrow the left main pulmonary artery; this was hypermetabolic on prior PET/CT and is compatible with tumor. Stable mild mediastinal lymphadenopathy.Normal heart size. Small pericardial effusion, slightly increased since prior study. Moderate coronary artery calcifications.CHEST WALL: Stable enlarged supraclavicular lymph nodes bilaterally.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. G-tube in place. Increased gastrohepatic ligament lymphadenopathy with reference lesion measuring 2.6 x 4.4 cm (series 5/93), previously 2.4 x 3.3 cm. Increased right adrenal metastasis measures 1.2 x 1.9 cm (5/99), previously 0.9 x 1.3 cm.
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1. New cavitary lesion in the left lower lobe with appearance most suggestive of infectious etiology.2. Increased lingular tumor nodule.3. Stable left hilar mass and mediastinal lymphadenopathy.4. Increased gastrohepatic ligament lymphadenopathy and right adrenal metastasis.
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Generate impression based on findings.
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48-year-old female with history of distal tibia fracture There is a comminuted fracture of the distal tibia with mild lateral displacement of the distal fracture fragments. An oblique fracture of the proximal fibula is also noted. The knee and distal femur appear intact.
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Distal tibia and proximal fibula fractures as described above.
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Generate impression based on findings.
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9-year-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is below thoracic inlet and above the carina. Left central venous catheter tip and right upper extremity PICC tips are in the superior vena cava.Persistent bilateral pleural effusions and retrocardiac atelectasis. Cardiac silhouette is top normal, unchanged. Bibasilar airspace opacities suggestive of pulmonary edema is not significantly changed.
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Unchanged pulmonary edema pattern.
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Generate impression based on findings.
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There is minimal mucosal thickening within the right sphenoid sinus. The paranasal sinuses are otherwise clear. The nasal cavity is also clear. There is mild leftward anterior nasal septal deviation. Mild irregularity involving the right nasal bone likely related to remote trauma. The lamina papyracea and ethmoid roofs are intact. The carotid groove and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There are prominent atherosclerotic calcifications of the left cervical carotid artery. There are degenerative changes of the right temporomandibular joint.
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No significant paranasal sinus disease
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Generate impression based on findings.
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5-month-old male intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip has been advanced and now is below thoracic inlet and above the carina. Gastrostomy tube is in place.Cardiothymic silhouette is normal. Large lung volumes. Blunting of the left costophrenic angle. Increasing right upper and persistent left lower lobe opacities likely represent atelectasis.
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Increasing right upper and persistent left lower lobe opacities likely represent atelectasis with unchanged left pleural effusion.
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Generate impression based on findings.
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74-year-old female with infectious endocarditis, altered mental status; concern for septic emboli. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with moderate to severe age-related volume loss. No extra-axial collections are identified. There is senescent mineralization of the bilateral basal ganglia. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes. A more focal area of hypoattenuation is present in the right corona radiata, suggestive of a chronic lacunar infarct. Atherosclerotic calcifications are present along the distal internal carotid arteries.Mild maxillary mucosal thickening is suggestive of chronic sinusitis. The left mastoid air cells are opacified. There is evidence of left chronic otitis, including retraction of the tympanic membrane and scarring of the middle ear cavity. The skull and scalp soft tissues are unremarkable.
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1. No evidence of intracranial hemorrhage or suggestion of septic emboli. Please note, non-enhanced CT is insensitive for detection of septic emboli and of acute non-hemorrhagic infarcts.2. There is evidence of left chronic otitis.
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Generate impression based on findings.
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Reason: s/p 3 yrs after LLL for T1aN0 Stage IA adenocarcinoma History: 6 mo f/u LUNGS AND PLEURA: Postsurgical volume loss in left lower lobe.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Mild coronary artery calcifications.CHEST WALL: Degenerative changes throughout the thoracic spine. Degenerative changes of the glenohumeral joints with calcified/ossified loose bodies in the left glenohumeral joint.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis.
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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15-year-old female intubatedVIEW: Chest AP (one view) 02/05/15 ET tube tip is below the thoracic inlet and above the carina. Right internal jugular central venous catheter tip is obscured by the spinal instrumentation. Right upper extremity PICC tip is in the left atrium. Spinal rods and hooks are again seen, unchanged in position. Tubing projecting over the right hemithorax most likely represents a soft tissue drain.Bilateral pleural effusions are unchanged. Cardiothymic silhouette is normal. Slight interval improvement of bibasilar opacities. Increased right upper lobe opacity with elevation of the right minor fissure likely represents atelectasis. No pneumothorax.
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Increased right upper lobe opacity with mild improvement of left basilar opacity likely reflect atelectasis although infection cannot be excluded. Persistent bilateral pleural effusions. Slight interval improvement of the pulmonary edema pattern.
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Generate impression based on findings.
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72 years, Female. Reason: Dobhoff reposition History: Dobhoff reposition Dobbhoff coiled in the stomach with tip directed cranially at the fundus. Remainder of the visualized structures are unchanged. See same day dedicated chest radiograph report for further details regarding chest.
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Dobbhoff coiled in the stomach with tip directed cranially at the fundus.
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Generate impression based on findings.
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Male; 66 years old. Reason: h/o SCT, now with persistent fevers and cough, please eval for signs of infection History: immunocompromised, URI sx, fever LUNGS AND PLEURA: Improved nodular opacities in the posterior right upper lobe. Increased mild streaky and nodular opacities in the right lower lobe with bronchial wall thickening, most compatible with recurrent aspiration. New nodular opacities in the left lower lobe are in a pattern most compatible with aspiration bronchiolitis. New mild nonspecific patchy opacities in the left upper lobe.No pleural effusions. Elevated right hemidiaphragm.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size. Small amount pericardial fluid. Severe coronary artery calcifications. CHEST WALL: Minimal degenerative changes of the thoracic spine. New moderate bilateral axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. New moderate perihepatic ascites, partially visualized. New mild retrocrural lymphadenopathy.
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1. Increased opacities and bronchial wall thickening in the right lower lobe, most compatible with recurrent aspiration. Nodular opacities in the left lower lobe are in a pattern suggestive of aspiration bronchiolitis. 2. New axillary and retrocrural lymphadenopathy is nonspecific but likely reactive.3. New moderate nonspecific perihepatic ascites.
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Generate impression based on findings.
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Male 85 years old Reason: elevated alk phos, edema LIVER: The liver measures 16.0 cm in length and demonstrates mildly hyperechoic parenchyma. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow with peak velocity 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallbladder wall thickening or pericholecystic fluid. Per ultrasound technologist, sonographic Murphy's sign negative. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.KIDNEYS: The left kidney measures 10.5 cm. The right kidney measures 10.5 cm. There is no hydronephrosis.OTHER: Bilateral pleural effusions. Spleen measures 9.4 cm in length.
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1. Mildly hyperechoic hepatic parenchyma suggestive of diffuse fatty infiltration. 2. Bilateral pleural effusions.
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Generate impression based on findings.
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Confirm NG tube placement. Interval placement of NG tube with tip in the body of the body of the stomach. Nonobstructive visualized bowel gas pattern. Note the lower abdomen and pelvis are outside the field of view.Left retrocardiac opacity.
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NG tube tip in the body of the stomach.
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Generate impression based on findings.
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59 years, Male. Reason: pain abdomen History: pain abdomen Jejunal tube tip distal to the ligament of Treitz, unchanged. IVC filter and upper abdominal skin staples, unchanged. Ileus, not significantly changed. Bibasilar consolidation/atelectasis.
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Ileus, not significantly changed.
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Generate impression based on findings.
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75-year-old male with rising PSA. Evaluate for disease. ABDOMEN:LUNG BASES: Moderate atherosclerotic calcifications.LIVER, BILIARY TRACT: Stable subcentimeter hypoattenuating liver lesion (series 3, image 27) and is too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal hypoattenuating focus consistent with a cyst. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications affect the abdominal aorta and the iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes in the thoracic and lumbar spine with high-density material within L1 and L2 vertebral bodies indicative prior spinoplasty. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post radical prostatectomy. No new soft tissue nodularity to suggest tumor recurrence.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: As above.OTHER: No significant abnormality noted
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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60 year-old male with multiple medical comorbidities representing a the days of left-sided numbness. Focal regions of hypodensity in the anterior limb of the right internal capsule and the left centrum semiovale may represent age-indeterminant infarctions. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes.No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with mild age-related volume loss. No extra-axial collections are identified. A small retention cyst is present in the roof the left sphenoid sinus. There is mild leftward nasal septal deviation. The mastoid air cells are clear. There is soft tissue density infiltrating the fat of the posterior left parietal and right suboccipital regions, which is nonspecific but may represent previous scarring. The skull is unremarkable.
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1. Focal regions of hypodensity in the anterior limb of the right internal capsule and the left centrum semiovale may represent age-indeterminant infarctions. However, CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. No evidence of intracranial hemorrhage or mass effect.
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Generate impression based on findings.
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Eight-year old male with fever, cough, and left lower lobe cracklesVIEWS: Chest AP/lateral (two views) 02/05/15 Aortic arch, cardiac apex, and stomach are left sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Large lung volumes and minimal bronchial wall thickening is suggestive of bronchiolitis/reactive airway disease.
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Bronchiolitis/reactive airway disease pattern.
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Generate impression based on findings.
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55 year old female presents for pre-kidney transplant evaluation. ABDOMEN:LUNG BASES: Right lower lung pulmonary micronodule (3/1) is partially seen, nonspecific. No pleural effusions or additional pulmonary abnormality. Extensive coronary artery and valvular calcifications affect the heart.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Undulating contour of the spleen, nonspecific but may be related to prior splenic infarcts.PANCREAS: No significant abnormality notedADRENAL GLANDS: Postoperative findings of left adrenalectomy, with multiple clips in the surgical bed.KIDNEYS, URETERS: Bilateral atrophic kidneys, consistent with medical renal disease.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy. Atherosclerosis affects the aorta and its branches, with mild super renal calcifications, and moderate infrarenal calcifications.BOWEL, MESENTERY: No small bowel obstruction or free air. Diverticulosis affects the colon.BONES, SOFT TISSUES: Diffuse sclerosis consistent with renal osteodystrophy. Mild degenerative changes affect the visualized spine, with endplate irregularities most consistent with small Schmorl's nodes.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis affects the colon.BONES, SOFT TISSUES: Renal osteodystrophy, with mild degenerative changes and grade 1 anterolisthesis of L5 on S1.OTHER: Moderate to severe atherosclerotic calcifications of the distal aorta and bilateral common iliac arteries. The left common iliac artery has near circumferential calcification extending inferiorly to the bifurcation of the internal/external iliac artery. There is mild ectasia of the left common iliac artery up to approximately 2 cm (4/88). The bilateral external iliac arteries have mild atherosclerotic calcifications.
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1.Atherosclerosis and left common artery iliac ectasia as above. 2.Left adrenalectomy findings.3.Right upper lung pulmonary micronodules partially seen.4.Severe coronary artery calcifications.
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Generate impression based on findings.
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Male; 64 years old. Reason: assess for L pneumothorax History: subcutaneous emphysema LUNGS AND PLEURA: Chest true with its tip located posteriorly at the apex.Moderate left pneumothorax, mainly located anteriorly at the left base, slightly increased from previous O8 left pleural effusion has decreased.Multiple areas of atelectasis in the left lung are present though diffuse groundglass opacity has resolved.Nodular pleural thickening, mainly located anteriorly at the level of the aortic arch may be due to residual tumor or postoperative loculated fluid.Small amounts of air located along the pleural fissures in the right lung which probably represents interstitial emphysema. A small amount of extrapleural interstitial air is also present anteriorly on the right.MEDIASTINUM AND HILA: Severe pneumomediastinum, slightly increased from previous.No visible coronary artery calcification.Catheter tip in the SVC.CHEST WALL: Extensive and severe subcutaneous emphysema, increased compared to previous.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Marked elevation of the left hemidiaphragm with overlying subsegmental atelectasis.Surgical diaphragmatic patch in place.
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1.Moderate left anterior pneumothorax, slightly increased compared to previous.2. Increased mediastinal and subcutaneous emphysema. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Right cochlear implant, but hearing and speech discrimination remaing extremely poor. Right: There are interval postoperative findings related to cochlear implantation. The device appears intact and the electrodes are positioned within the basal turn of the cochlea. However, there may be thinning or dehiscence of the cochlear wall separating the electrodes from the labyrinthine segment of the facial nerve canal. The external auditory canal is patent, but contains cerumen. The middle ear and mastoid bowl are well-pneumatized and clear. The ossicular chain is intact. The vestibule, semicircular canals, and vestibular aqueduct are unremarkable. The jugular bulb and carotid canal are intact. Left: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact.
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Interval postoperative findings related to right cochlear implantation, in which device appears intact. However, there may be thinning or dehiscence of the cochlear wall separating the electrodes from the labyrinthine segment of the facial nerve canal.
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Generate impression based on findings.
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Frontal sinus: The frontal sinuses now contain diffuse aerated secretions, with complete opacification of the frontoethmoidal recesses.Anterior ethmoids: There is moderate-severe opacification of anterior ethmoid air cells.Maxillary sinuses: There is moderate mucosal thickening in the left with moderate-severe thickening in the right maxillary sinus. Both contain air fluid levels, greater on the right. The ostiomeatal units are completely opacified.Posterior ethmoids: There is moderate opacification of posterior ethmoid air cells.Sphenoid sinus: Is mild mucosal thickening in the sphenoid sinuses with aerated secretions in the left. The right sphenoethmoidal recess is clear while the left is opacified.There is mild-moderate leftward nasal septal deviation with 6 mm leftward directed bony spur. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is slightly higher on the right. There is an impacted right maxillary molar. There is opacification of a few mastoid air cells bilaterally, as well as within the middle ears partially. There continues be minimal periapical lucency along ADA #10.
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1. Significant worsening of paranasal sinus opacification, now at least moderate in degree with complete opacification of both ostiomeatal units. Air-fluid levels in the maxillary sinuses with numerous areas of aerated secretions suggestive of acute sinusitis.2. Bilateral mastoid air cell and middle ear fluid. Please correlate clinically.
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Generate impression based on findings.
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78-year-old male with left-sided flank pain. Evaluate for kidney stone. Lack of IV and oral contrast material limits evaluation of solid organs and the bowel.ABDOMEN:LUNG BASES: Small right pleural effusion.LIVER, BILIARY TRACT: Cholelithiasis without evidence of gallbladder wall thickening or pericholecystic inflammatory changes to suggest cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Non-obstructing punctate left nephrolithiasis. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Nonspecific mildly prominent retroperitoneal lymph nodes. Mild atherosclerotic calcifications affect the abdominal aorta and its branches.BOWEL, MESENTERY: Mildly prominent loops of proximal small bowel measuring up to 2.8 cm in diameter are nonspecific. Diffuse mild mesenteric haziness may reflect edema. Small volume perihepatic and perisplenic ascites.1.2-cm focus of high density material within the distal stomach, likely medication. Small duodenal diverticulum is present.BONES, SOFT TISSUES: Moderate to severe multilevel degenerative changes. 0.6-cm (series 3, image 92) high density material within the anterior abdominal wall on the left, which may be a bullet fragment.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: Moderate to severe multilevel degenerative changes. High riding right testicle is incidentally noted.OTHER: No significant abnormality noted
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1.Mildly prominent proximal small bowel loops are nonspecific. Correlate clinically for obstructive symptoms.2.Small volume perihepatic and perisplenic ascites with diffuse mesenteric haziness suggestive of mild edema. 3.Small right pleural effusion. 4.No obstructing left nephrolithiasis as clinically questioned. 5.Punctate nonobstructive left nephrolithiasis at the lower pole.
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Generate impression based on findings.
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46 year old with known left fibroadenoma presents for annual mammogram. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Circumscribed mass at lower inner quadrant in the left breast is unchanged. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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74-year-old male status post IM nail placement An intramedullary rod affixes the pathologic proximal femur fracture with two distal fixation screws. We see no evidence of hardware complication. There is minimal surrounding osseous bridging.
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Orthopedic fixation of pathologic proximal femur fracture as described above.
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Generate impression based on findings.
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Female 63 years old Reason: evaluate for structural cause of mild hyperbilirubinemia History: mildly elevated total hyperbilirubin/unconjugated hyperbili LIVER: The liver measures 14.9 cm in length and demonstrates somewhat coarsened echotexture. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder was not visualized, correlation with patient's surgical history recommended. There is no biliary ductal dilatation.PANCREAS: Unremarkable where visualized.KIDNEYS: The right kidney measures 10.5 cm. The left kidney measures 11.5 cm. There is no hydronephrosis.
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1. Mildly coarsened hepatic echotexture which is nonspecific but may be seen in setting of chronic liver disease. 2. No evidence of intra- or extra- hepatic biliary ductal dilatation.
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Generate impression based on findings.
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62-year-old female with pain Right hand: The osseous structures are within normal limits for the patient's age. No specific findings to account for the patient's symptoms.Left hand: There is irregularity of the ulnar styloid suggesting erosion. No additional erosions or other findings to explain the patient's symptoms.
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Irregularity of the left ulnar styloid suggesting erosion, which can be seen in early rheumatoid arthritis.
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Generate impression based on findings.
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61-year-old female, rule out fracture Radiopaque markers were placed over the left lower chest wall site of patient's pain. No underlying fracture is noted. Marked colonic stool burden. The lungs are clear.
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No visualized rib fracture.
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Generate impression based on findings.
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65-year-old female with lumbar back pain Posterior stabilization rods with screws entering the vertebral bodies of L2 and L3 without evidence of hardware complication. There is minimal anterolisthesis of L3 on L4 with flexion. There is partial fusion of the L2 and L3 intervertebral body disk space anteriorly. Severe degenerative disease affects the lower lumbar spine.
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Orthopedic fixation of the lumbar spine with minimal subluxation as described above.
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Generate impression based on findings.
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2-year-old male with history of left Wilms, 12 months off therapy LIVER: Liver is normal in size and echotexture measuring 7.7 cm. Limited interrogation of the main portal vein demonstrates blood flow towards the liver measuring 0.3 m/sec.GALLBLADDER, BILIARY TRACT: No significant abnormality noted. The common bile duct measures 2 mm.PANCREAS: The body and tail of the pancreas is obscured by overlying bowel gas.SPLEEN: The spleen is normal in size measuring 6.0 cm in length.KIDNEYS: The right kidney measures 7.2 cm. Status post left nephrectomy. No residual soft tissue mass in the nephrectomy bed. ABDOMINAL AORTA: The aorta is patent and normal in caliber measuring 8 mm.INFERIOR VENA CAVA: The inferior vena cava is patent.OTHER: No significant abnormality noted.
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Status post left nephrectomy without evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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A patient submitted outside study for review. Submitted for review are right unilateral digital mammographic images (2/5/14), and ultrasound images (2/5/14) performed at The Queen's Medical Center. For comparison, digital mammographic images (7/22/13, 7/25/13) and ultrasound images (7/25/13) are available. Submitted studies are one year old at latest, and no current study is not submitted. RIGHT UNILATERAL DIGITAL MAMMOGRAPHIC IMAGES (2/5/14):The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A percutaneously placed clip from prior benign biopsy is present at 9 o'clock position.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in right breast. ULTRASOUND IMAGES (2/5/14):A round shaped simple cyst measuring 7 x 6 mm is visualized at 9 o'clock position, 4 cm from the nipple. No solid lesion is seen in submitted images. Biopsy was performed at the same site on 7/25/13, and the pathology result was benign.
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No mammographic or sonographic evidence of malignancy in the right breast for the study performed on February 2014. Annual mammogram is due for both breasts.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram.
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Generate impression based on findings.
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22 years, Female. Reason: h/o Crohn's disease with SBO worsening abdominal pain after NGT pull out History: abdominal pain Interval removal of NG tube. Several loops of dilated small bowel with air fluid levels compatible with small bowel obstruction. No pneumoperitoneum. Right lower quadrant sutures.
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Findings compatible with persistent small bowel obstruction.
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Generate impression based on findings.
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Female 39 years old Reason: BL knee pain History: BL knee pain Right knee: Bone mineralization is normal. There is moderate medial compartment joint space loss and tricompartmental osteophytes. No joint effusion is evident. No acute fracture or malalignment.Left knee: Bone mineralization is normal. There is mild to moderate medial compartment joint space loss and tricompartmental osteophytes. No joint effusion is evident. No acute fracture or malalignment.
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Moderate right knee and mild to moderate left knee osteoarthritis.
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Generate impression based on findings.
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56 years, Male. Reason: Evaluate G tube History: Status post G tube placement. Contrast injected through the G tube opacifies the gastric folds and duodenal sweep, compatible with proper positioning. Nonobstructive bowel gas pattern. Average stool burden.
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Proper positioning of G tube as described above.
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Generate impression based on findings.
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70 years, Male. Reason: eval position of broken Dobbhoff tip History: see above Dobbhoff tube with tip in the pyloric region. Fractured Dobbhoff tip is unchanged in position in the proximal stomach, slightly lateral to intact Dobbhoff tube. Nonobstructive visualized bowel gas pattern.
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Fractured Dobbhoff tip is unchanged in position in the proximal stomach.
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Generate impression based on findings.
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80 year-old female with history of bunion. There is a severe hallux valgus deformity. Moderate osteoarthritis affects the first MTP joint and sesamoid bones. Mild osteoarthritis affects the midfoot.
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Osteoarthritis and hallux valgus deformity as above.
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Generate impression based on findings.
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The lumbar spine is in normal alignment, with a normal lumbar lordosis. There is mild disk height loss at L5-S1 with disk desiccation. The vertebral body and disk heights are otherwise well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is an area of intrinsic T1 and T2 hyperintensity in the T12 vertebral body which tracks out in signal and STIR images, an area of focal fat or hemangioma. The distal spinal cord and conus are within normal limits with the conus terminating at the lower L1 level.At L5-S1, there is a right paracentral disk protrusion with posterior displacement of the descending right S1 nerve root.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the remainder of the lumbar spine. There is a partially visualized oval T2 hyperintense likely cystic structure within the right pelvis, which may relate to an ovarian cyst measuring at least 3.5 x 3.5 cm.
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1. Focal right paracentral disk protrusion at L5-S1 with posterior displacement of the descending right S1 nerve root.2. Partially visualized likely cystic structure within the right pelvis possibly arising from the right ovary measuring at least 3.5 x 3.5 cm. Follow-up ultrasound may be obtained in 4-6 weeks.
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Generate impression based on findings.
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Female 57 years old Reason: history of PE, now with DOE History: DOE PULMONARY ARTERIES: No evidence of pulmonary embolus. Pulmonary artery is normal in caliber without evidence of right heart strain.LUNGS AND PLEURA: Left lower lobe granuloma compatible with previous renal disease.No suspicious pulmonary nodules or masses.No pleural effusion.No pneumothoraxMEDIASTINUM AND HILA: Calcified hilar and mediastinal lymph nodes compatible prior granulomatous disease. No hilar or mediastinal lymphadenopathy.Normal heart size without pericardial effusion.Mild coronary artery calcifications.CHEST WALL: Mild degenerative change of the thoracic spineUPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of pulmonary embolus.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
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Generate impression based on findings.
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BradycardiaVIEW: Chest AP 2/5/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left chest tube in place. Cardiothymic silhouette normal. Patchy atelectasis bilaterally in a background of chronic lung disease increased in the interval. No pleural effusion or pneumothorax.
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Patchy atelectasis bilaterally increased in the interval.
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Generate impression based on findings.
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48-year-old female with history of total hip arthroplasty. Right hip: Hardware components of a right total hip arthroplasty device are situated in anatomic alignment without radiographic evidence of hardware complication. Surgical skin staples are noted laterally.Pelvis: Again seen are the aforementioned postoperative changes in the right hip. Minimal osteoarthritis affects the left hip.
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Right total hip arthroplasty as above.
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Generate impression based on findings.
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InjuryVIEWS: Left elbow AP, oblique and lateral The overlying cast obscures fine bony detail. Within this limitation no definite periosteal reaction or acute fracture. No elbow joint effusion.
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No definite periosteal reaction or acute fracture.
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Generate impression based on findings.
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34-year-old with history of left triple negative breast cancer. Routine follow-up. The patient admits to a 30-pound weight loss. Three standard views of both breasts, left laterally exaggerated CC view, spot magnification views of the lumpectomy site and spot compression of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, increasing in density bilaterally compared to the prior exams. There is an area focal asymmetry in the right upper breast near 12 o'clock which mostly disperses with spot compression. Postsurgical distortion and density is noted in the left breast. Left breast skin thickening and trabecular thickening are compatible with radiation therapy. No suspicious microcalcifications or areas of architectural distortion in either breast. A few bilateral benign calcifications are present.ULTRASOUND
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No mammographic evidence of malignancy. Overall increase in background parenchymal pattern could relate to weight loss. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Additionally, given the patient's history of breast cancer at a young age, MRI on an annual basis should be strongly considered. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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FractureVIEWS: Left humerus AP and lateral There is a healing acute fracture of the metaphysis of the left humerus. There is apex lateral angulation not significantly changed. There is periosteal reaction reflecting interval healing.
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Healing humeral fracture as described above.
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Generate impression based on findings.
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Reason: RUL nodule History: surveillance, annual scan LUNGS AND PLEURA: Right upper lobe subpleural nodule with internal cavitation (image 54 series 5) is unchanged over 5 years. The solid component measures 10 mm x 6 mm previously measuring 11 mm x 6 mm.The internal cavitation has not changed.Scattered calcified granulomas.No new suspicious pulmonary nodules or masses.No evidence of a pleural effusion.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Calcified mediastinal lymph nodes compatible with prior granulomatous disease.Cardiac size is normal without evidence of a pericardial effusion. No coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Stable large multiple hepatic cysts. Splenic calcified granulomas.
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Subpleural right upper lobe nodule without significant interval change over multiple exams dating back to 12/16/09. No new nodules identified.
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Generate impression based on findings.
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InjuryVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. The ankle mortise joint is normal.
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No acute fracture or dislocation.
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Generate impression based on findings.
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The right uterine artery was embolized using 500-700 micron Embospheres until near stasis was achieved. The post-embolization angiogram confirmed these findings.LEFT UTERINE ARTERY EMBOLIZATION
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1. Successful bilateral uterine artery embolization.2. Successful placement of a Denali IVC filter. The patient was entered into the IVC filter tracking database and should return to the interventional radiology department in 3 months for consultation regarding optional IVC filter removal.
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Generate impression based on findings.
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Confusion without new focal findings Right medullary infarct is better seen on prior MRI. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. There is mild global parenchymal volume loss commensurate with age with prominence of the extra-axial CSF spaces in the bilateral frontal regions. There is no midline shift or mass effect. No hydrocephalus.Moderate periventricular and subcortical hypoattenuation is nonspecific but unchanged and likely related to chronic small vessel ischemic disease. Calcification within the basal ganglia the bilateral cerebellar dentate nuclei is unchanged. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Right-sided NG tube noted.
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1. No evidence of intracranial hemorrhage or mass effect. 2. Right medullary infarct is better seen on prior MRI. Follow-up MR imaging can be considered for further assessment as clinically indicated.
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Generate impression based on findings.
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Ms. Williams is a 24 year old female presenting with unilateral right bloody nipple discharge. Recent ultrasound and MRI detected multiple intraductal masses, the largest of which was located in the right superior breast. This will be the target for today's biopsy. Right breast ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic intraductal mass measuring 1.7 cm at the 12 o’clock position with increased vascularity, 2 cm from the nipple. The lesion was readily visible.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a inferolateral to superomedial approach, four 14-gauge core needle (Achieve) specimens were obtained of the lesion. Targeting was judged excellent. Two specimens sank to the bottom of the prefilled container of 10% formalin. Specimen quality was judged very good.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Bard ribbon clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital right CC and ML views revealed the percutaneously placed clip to be in the expected location abutting against the posterior enlarged duct. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Sheth. Dr. Schacht was present during the procedure at all times.
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Successful ultrasound-guided core biopsy of the right intraductal lesion with clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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60-year-old female with mycosis fungoides who presents for staging. Evaluate for adenopathy and visceral involvement. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are noted, some of which are calcified, likely secondary to prior granulomatous disease. No suspicious pulmonary masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Stable left thyroid lobe enlargement and nodule. No mediastinal or hilar lymphadenopathy. No interval change in the subcentimeter nonspecific prevascular lymph nodes. Heart size is normal without pericardial effusion. Moderate coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver without focal hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant change in the hypodense exophytic lesion at the lower pole of the left kidney measuring approximately 1.1 cm (series 3, image 123) with Hounsfield units of approximately 19. An additional subcentimeter right renal hypoattenuating focus is too small to characterize. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Multiple stable small retroperitoneal lymph nodes with reference aortocaval lymph node measuring 1.1 x 2.7 cm (series 3, image 131), previously measuring 1.1 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Stable small retroperitoneal and mediastinal lymph nodes. 2.No evidence of new enlarged lymph nodes in the chest, abdomen, or pelvis. 3.Incompletely characterized left renal exophytic hypoattenuating lesion. Further evaluation with sonography is recommended. 4.Fatty infiltration of the liver. 5.Stable left thyroid nodule.
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Generate impression based on findings.
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Base of tongue edema on laryngoscopy and lymphadenopathy. There is apparent soft tissue thickening along the left posterior wall of the hypopharynx with a punctate calcification. Otherwise, the tongue base appears unremarkable. There is no evidence of significant cervical lymphadenopathy based on size criteria. The airways are patent. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There are multiple dental caries. There is multilevel degenerative spondylosis of the cervical spine, prominent pannus posterior to the dens, and degenerative changes affecting the glenohumeral joints, right greater than left. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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Nonspecific apparent soft tissue thickening along the left posterior wall of the hypopharynx may be inflammatory in nature, represent redundant of normal tissues, or perhaps less likely neoplasm. Otherwise, the tongue base appears unremarkable.
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