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Generate impression based on findings.
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Female; 80 years old. Reason: Hx lung CA, status post chemo. Pls compare to previous and measurements. History: none CHEST:LUNGS AND PLEURA: Necrotic tumor in the right upper lobe appears mildly increased since prior study with increased extension into the right superior mediastinum and increased attenuation of the right brachiocephalic vein. It measures 76 x 52 mm (series 3/35), previously 74 x 40 mm. The mass is again contiguous with the right hilum and pleura and obstructs the right upper lobe bronchus.Stable right lower lobe cavitary/cystic nodular lesion, possibly post inflammatory. Nodular opacities adjacent to the right hemidiaphragm are slightly increased, suspicious for metastases. Stable scattered pulmonary micronodules, some of which are calcified. Post-surgical changes of right middle lobectomy. Severe centrilobular emphysema.MEDIASTINUM AND HILA: Reference subcarinal node measures 25 mm (series 3/52), previously 19 mm. Right hilar subcentimeter soft tissue is unchanged and isodense to right upper lobe mass.Moderate coronary artery calcification. No pericardial effusion.CHEST WALL: Demineralized bones with mild degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small hepatic hypodensities consistent with cysts, unchanged.SPLEEN: Stable splenic lesion, nonspecific and unchanged from 4/2014.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts. Rim calcified large right renal artery aneurysm is unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of an ectatic aorta. Surgical clips in the pelvis.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Demineralized bones with mild degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
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Interval increased right upper lobe necrotic mass and mediastinal lymphadenopathy, as well as increased nodular opacities at the right lung base.
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Generate impression based on findings.
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35-year-old male with history of metacarpal fracture There is an oblique fracture of the distal diaphysis of the fifth metacarpal with marked volar angulation of the distal fracture fragment.
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Boxer's fracture with marked volar angulation of the distal fracture fragment.
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Generate impression based on findings.
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65-year-old male with history of pancreatic cancer, status post Whipple, chemo and recent disease progression. CHEST:LUNGS AND PLEURA: Mild apical fibrosis. No suspicious pulmonary masses. No pleural effusions.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, none of which are pathologic in size. No significant pericardial effusion. Heart size within normal limits. Mild coronary artery calcifications. Right chest Port-A-Cath tip is in the SVC.CHEST WALL: Chest Port-A-Cath. Mild degenerative changes of the visualized spine.ABDOMEN:LIVER, BILIARY TRACT: At least 6 hypodense small hepatic lesions are seen, unchanged from prior. A reference right posterior liver lesion (3/91) measures approximately 1.4 x 1 cm. No biliary dilatation or portal venous thrombus.SPLEEN: Post splenectomy.PANCREAS: Postoperative findings of distal pancreatectomy, with the previously seen fluid collection at the pancreatic tail surgical sites having resolved over the interval. There is some residual soft tissue stranding/scarring. No measurable mass is seen in this location. Two pancreatic duct stents are seen. No significant pancreatic duct dilatation. Soft tissue density about the hepatic artery and trifurcation, of unknown significance and may be postoperative in nature versus tumor encasement. There is no fat plane between the stomach and pancreas. The superior mesenteric vein and portal vein are patent. Splenic vein has been surgically resected with splenectomy.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Several bilateral cystic renal foci, nonspecific but most likely benign cysts.RETROPERITONEUM, LYMPH NODES: Scattered small lymph nodes are seen throughout the retroperitoneum. A single right pericaval lymph node (3/151) measures 1.3 by 1 cm, previously 1.3 x 1.3 cm on the 10/14/14 CT scan. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Approximately 4 x 2 cm right femoral neck lucency with scarring margin, nonspecific but benign in appearance and unchanged in size from prior exam.OTHER: No significant abnormality noted
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1.Postoperative findings of distal pancreatectomy with interval resolution of surgical bed fluid collection. No measurable mass to suggest recurrence.2.Soft tissue density about the hepatic artery and trifurcation, nonspecific and may be postoperative in nature, however cannot exclude tumor encasement without comparison to preoperative exam.3.Multiple hypoattenuating liver foci, nonspecific but most likely metastatic disease.
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Generate impression based on findings.
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14-year-old male with chest pain with inspiration shortness of breath x 5 daysVIEWS: Chest PA/lateral (two views) 02/05/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Streaky opacity in the right lung base best seen on lateral view likely represents atelectasis. No pneumonia.
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No pneumonia. Findings were text paged to pager 5718, Dr. Shi, on 2/5/15 at 1628.
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Generate impression based on findings.
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Reason: 46 y/o female with DCIS breast cancer; 2/6/15-right axillary SNBx with bilateral simple mastectomy; possible complete axillary dissection RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 1.1 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the right axilla, representing the sentinel node(s). This region was marked with an indelible marker.
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Sentinel node identified in the right axilla.
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Generate impression based on findings.
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Female 75 years old; Reason: new pleural effusion, assess for extent of metastatic disease. Per chart, recent malignant pleural effusion. Increased uptake at T9/T10 correlates with benign degenerative changes or conceivably diskitis on comparison CT. There is degenerative activity noted at T5/T6 and T6/T7. There is mild abnormal increased activity at the right posteriolateral aspect of the 9th rib. This is highly suspicious for bone involvement with tumor given known malignant pleural effusion.Right proximal radius lesion is seen more distal than typical for metastatic disease, and benign etiology is favored. Right mid to distal femur lesion is mild in activity and also slightly distal than what is typical for metastatic disease, and benign etiology is favored although metastatic disease cannot be excluded. There is increased activity in the region of the right pleural effusion consistent with known malignant pleural effusion.
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1. Right 9th rib lesion is very suspicious for tumor involvement.2. Right femur lesion is more likely benign, although additional metastatic disease cannot be entirely excluded.3. Consider FDG PET for further evaluation for bone and soft tissue tumor activity.
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Generate impression based on findings.
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14-year-old female with pan serositis, evaluate for lymphadenopathy/mass CHEST:LUNGS AND PLEURA: Moderate bilateral pleural effusions, left greater than right, with adjacent atelectasis. No focal nodules or masses.MEDIASTINUM AND HILA: Heart size is normal. Moderate pericardial effusion is present. Pericardial drain is present. Borderline enlarged cardiophrenic lymph nodes measuring up to 1 cm (series 3, image 69). Prominent soft tissue density mass in the anterior mediastinum measures approximately 7 0.6 x 4 x 5.8 cm and causes mass effect on the left brachiocephalic vein.CHEST WALL: No axillary or retrocrural lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. Splenule is noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating lesion in the lower pole of the left kidney measuring 1.5 x 1.8 cm likely represents a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: The bowel is within normal limits without evidence of obstruction. The appendix is well-visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate amount of free fluid.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: The bowel is within normal limits without evidence of obstruction. The appendix is well-visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate amount of free fluid.
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1.Moderate pleural effusions, left greater than right, with adjacent atelectasis.2.Moderate pericardial effusion with drain in place.3.Anterior mediastinal mass as described above is felt to represent lymphadenopathy due to mass effect from the left brachiocephalic vein.
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Generate impression based on findings.
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Evaluate feeding tubeVIEW: Abdomen AP Feeding tube tip at the pylorus of the stomach. Disorganized nonobstructive bowel gas pattern. Minimal patchy atelectasis at the right lower lobe and left lower lobe.
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Feeding tube tip at the pylorus of the stomach.
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Generate impression based on findings.
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Feeding tube placementVIEW: Abdomen AP Feeding tube tip at the body of the stomach. Disorganized nonobstructive bowel gas pattern. Minimal patchy atelectasis right lower lobe.
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Feeding tube tip at the body of the stomach.
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Generate impression based on findings.
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24-year-old male with history of pain. Subtle lucency through the first distal phalanx only appreciated on the lateral view may represent a healing nondisplaced fracture.
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Subtle lucency along the distal phalanx may represent a healing nondisplaced fracture.
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Generate impression based on findings.
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37-year-old male with history of left acetabular fracture. There is a comminuted fracture along the posterior aspect of the acetabulum extending into the superior acetabulum with multiple displaced fracture fragments. Additionally, there is a 1 cm triangular interarticular fracture fragment noted within the medial aspect of the hip joint near the fovea. There is a small associated hematoma within the intergluteal fat adjacent to the sciatic nerve extending into the pelvis running along the piriformis muscle.
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Comminuted fracture of the left posterior acetabulum with intra-articular fracture fragment and small adjacent hematoma as above.
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Generate impression based on findings.
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The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is mild ex vacuo dilatation of the left occipital horn. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are numerous areas of chronic encephalomalacia again seen. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is an old right parietal burr hole.
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No acute intracranial abnormality. Redemonstration of multiple areas of encephalomalacia likely related to chronic infarcts.
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Generate impression based on findings.
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62-year-old male with history of metastatic prostate cancer, rising PSA. Assess for progressive disease. There has been significant interval progression of widespread osseous metastases in the spine, ribs, pelvis, bilateral humeri, and bilateral proximal femora, which have markedly increased in size and number.
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Significant interval progression of widespread osseous metastases.
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Generate impression based on findings.
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Female 74 years old Reason: compression fracture? kidney stone? History: back pain Vertebral body heights are anatomic. There is disk space narrowing predominantly at L2-L3, L4-L5. There are anterior osteophytes at multiple levels. There is lower lumbar facet degenerative changes.Postsurgical changes with multiple clips in the upper abdomen on the right. There are small rounded densities projected over the upper abdomen may represent nonobstructive calculi.Severe calcific arteriosclerotic disease affects the aorta.
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Lumbar spine degenerative change without compression fracture.Non specific rounded radiodensities in the upper abdomen .
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Generate impression based on findings.
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50 year-old female with multiple myeloma and right hip pain. RADIOPHARMACEUTICAL: 12.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates right hip joint effusion, vasectomy clips, orthopedic hardware in the thoracic spine, and lytic lesions in the bilateral scapulae.Today's PET examination demonstrates no suspicious FDG avid lesion to suggest tumor activity. There is significant, moderate activity surrounding the right hip joint, new from the previous exam (SUV max 3.9), which may represent infection or inflammation.
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1.No suspicious FDG avid lesion to suggest current tumor activity.2.Hypermetabolic soft tissue activity associated with a significant right hip joint effusion consistent with infection or inflammation, new from previous, and likely the cause of the patient's symptoms.
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Generate impression based on findings.
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66-year-old female with breast cancer. Innumerable foci of mottled increased radiotracer uptake in the axial and proximal appendicular skeleton, including the skull, ribs, spine, pelvis, and proximal bilateral humeri and femora.
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Widespread osseous metastases.
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Generate impression based on findings.
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2 year old male with neuroblastoma. Re-staging of disease day +30 s/p autologous stem cell transplant. Postprocessing motion correction was performed for SPECT portion of the exam, which remains slightly degraded by motion artifact. Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. There is no abnormal focus of activity to indicate current MIBG avid tumor. The skeleton specifically is unremarkable. Note that the original tumor was only weakly MIBG avid.
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No convincing evidence of MIBG active tumor currently. Previous weak MIBG tumor activity is no longer visualized.
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Generate impression based on findings.
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Severe arm pain. Evaluate for fracture. Three views of the right wrist are provided. I see no fracture. Moderate osteoarthritis affects the first carpometacarpal joint. Additionally, there is chondrocalcinosis of the triangular fibrocartilage and articular cartilage of the wrist; the possibility of pseudogout may be considered.Four views of the right elbow are provided. Evaluation of the elbow is slightly limited due to inability to optimally position the patient. I see no fracture. There is elevation of the distal humeral fat pads which indicates an elbow joint effusion or synovitis; please note that in the presence of a trauma history, the possibility of a hemarthrosis due to an occult fracture, typically of the radial head, is considered. Mild osteoarthritis affects the elbow.
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1.Chondrocalcinosis and mild osteoarthritis of the wrist as described above. I see no fracture.2.Mild osteoarthritis and elevation of the distal humeral fat pads indicating synovitis/joint effusion. While I see no fracture, the possibility of a hemarthrosis due to an occult fracture, typically of the radial head, may be considered if there is a history of trauma. If there is strong clinical concern for fracture, repeat radiographs may be obtained in 7 to 14 days.
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Generate impression based on findings.
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Knee pain. Rule out fracture. I see no fracture, malalignment, or joint effusion. I see no specific findings to account for the patient's pain.
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No fracture or other specific findings to account for the patient's pain are evident. If there is clinical concern for internal derangement, MRI may be considered.
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Generate impression based on findings.
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Leg pain. Fracture, osteoarthritis? Four views of the right knee are provided. I see no fracture. There is severe osteoarthritis of the medial tibiofemoral compartment with near bone-on-bone apposition as well as prominent osteophyte and subchondral cyst formation. Additional small osteophytes are noted affecting the patellofemoral and lateral compartments. There is a mild varus deformity of the knee.Four views of the left knee are provided. Moderate osteoarthritis affects the left knee, with narrowing of the medial tibiofemoral compartment and osteophyte formation. There is a slight varus deformity of the knee. I see no fracture.Two views of the right hip are provided. Moderate osteoarthritis affects the hip. I see no fracture.Two views of the left hip are provided. Mild osteoarthritis affects the hip. I see no fracture. Mild degenerative arthritis also affects the pubic symphysis.
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Osteoarthritis of the hips and knees as described above.
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Generate impression based on findings.
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Evaluate revision of reverse total shoulder arthroplasty Evaluation of fine detail is limited by overlying splint material. Components of a reverse total shoulder arthroplasty device are situated in near-anatomic alignment. An overlying drain and skin staples reflect recent surgery. Heterotopic ossification is again noted along the medial aspect of the proximal humerus. A cardiac conduction device is incompletely imaged on this study.
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Postoperative changes of reverse total shoulder arthroplasty revision as described above.
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Generate impression based on findings.
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History of osteomyelitis of the distal phalanx of the left great toe. Evaluate for resolution. The bones are demineralized. Again seen is irregularity of the margin of the tuft of the distal phalanx of the great toe compatible with osteomyelitis. This appears similar to that seen on the prior study and I am not convinced that there has been any further osteolysis when compared with the prior study, but I cannot exclude the possibility of residual active infection on the basis of this single exam. Erosions in the base of the first proximal phalanx and the head of the first metatarsal are again noted, possibly representing gout, unchanged. Postoperative deformity from fifth ray amputation is unchanged. There are arterial calcifications in the soft tissues.
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Overall, the findings are similar to those seen on the prior study. Although irregularity of the margin of the tuft of the distal phalanx of the great toe is compatible with osteomyelitis, I see no findings to suggest disease progression. If further imaging evaluation is clinically warranted, MRI is recommended.
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Generate impression based on findings.
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Knee pain. Osteoarthritis? Fracture? History of fall. Four views of the left knee are provided. Again seen are orthopedic screws and pins affixing what I presume to be a healed tibial plateau fracture in near-anatomic alignment. This appears similar to the prior study. I see no acute fracture. Mild deformity of the proximal tibial diaphysis likely represents an additional healed fracture. Moderate osteoarthritis affects the knee. While a subcentimeter ossicle overlying the medial joint line could represent a small loose body, its appearance is identical to that seen on the prior study.Four views of the right knee are provided. Mild osteoarthritis affects the knee. I see no fracture.
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Osteoarthritis an old posttraumatic deformities as described above. I see no acute fracture.
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Generate impression based on findings.
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Alignment is anatomic. There is a stable mild chronic L5 compression fracture dating back to 6/21/2014 with small Schmorl node involving the superior endplate. No osseous retropulsion. Interval development of mild (approximately 40 percent) loss of height of the T12 vertebral body, new since prior CT from 12/12/14. There is also mild worsening of L1 compression fracture also now with approximately 40 percent loss of height. There is also new L3 compression fracture with approximately 25 percent loss of height centrally. There is some edema involving the T12, L1, and L3 vertebral bodies, and no edema within the chronic L5 compression fracture. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.T12/L1: No significant spinal canal or neuroforaminal stenosis.L1/2: No significant spinal canal or neuroforaminal stenosis.L2/3: No significant spinal canal or neuroforaminal stenosis.L3/4: Mild facet hypertrophy and ligamentum flavum thickening with minimal central canal stenosis and minimal neural foraminal narrowing. L4/5: Mild disc bulge, moderate facet hypertrophy and ligamentum flavum thickening resulting in moderate spinal canal stenosis. Mild bilateral neuroforaminal stenosis.L5/S1:Left greater than right eccentric disc bulge, mild to moderate facet hypertrophy and ligamentum flavum thickening with mild right and moderate to severe left neuroforaminal stenosis. SI Joints: The SI joints are unremarkable.
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1.Multilevel degenerative changes with moderate spinal canal stenosis at L4-5. There is moderate to severe left L5-S1 neural foraminal narrowing which may be impinging on the left L5 nerve root. 2.Compared to CT 12/12/2014, interval development of compression fractures involving the T12, L1, and L3 vertebral bodies with edema in the marrow. Stable chronic L5 compression fracture without edema. Findings are compatible with osteoporotic basis, with no findings to suggest pathologic fractures. No osseous retropulsion or spinal canal stenosis related to the compression fractures.
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Generate impression based on findings.
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61 year old female with history of abdominal pain. Evaluate for partial small bowel obstruction. Lack of intravenous contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Minimal bibasilar subsegmental atelectasis. Calcified right lung base anterior granuloma. No significant pericardial effusion. At least moderate coronary artery calcifications.LIVER, BILIARY TRACT: Persistent pneumobilia and postoperative findings of cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal parenchymal calcification, may represent nonobstructing stone. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications are noted about the aorta and its branches, particularly the distal aorta and common iliac arteries.BOWEL, MESENTERY: Persistent diffuse mild small bowel dilation and small bowel feces sign, slightly improved but similar to prior. No distinct transition point is visible. No free air or bowel wall thickening. Surgical sutures noted from prior partial small bowel resection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild diffuse small bowel dilation, similar to prior. The large bowel contains gas and stool.BONES, SOFT TISSUES: Sclerotic changes within the sacrum, in the setting of presacral soft tissue thickening and gas, may represent chronic osteomyelitis due to blind ended enteric sinus tract.OTHER: Foci of gas in the presacral soft tissues, which is in the expected location of the prior rectal surgery operative bed and may represent a blind ending sinus tract, unchanged.
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1.Partial small bowel obstruction, slightly improved but similar to prior.2.Persistent small foci of gas in the presacral surgical bed with associated soft tissue thickening, likely blind ending sinus tract possibly representing chronic sacral osteomyelitis.
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Generate impression based on findings.
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Reason: eval for evidence of elevated ICP prior to LP History: AMS There is redemonstration of a calcific lesion adjacent to the temporal horn of the right lateral ventricle anterior aspect of the right temporal lobe. This currently measures 18 x 13 mm axial dimensions and previously measured 14 x 12 mm axial dimensions there are some associated calcifications. There is a prior CTA from 3/22/2007 indicating this is not an aneurysm.Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Since the previous exams a partially calcified mass in the right temporal lobe has continued to slowly increase in size. One possibility is that this represents a primary brain neoplasm such as oligodendroglioma in a periventricular region.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 4.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.
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Generate impression based on findings.
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Male 52 years old; Reason: r/o hydronephrosis/bladder mass History: abd pain and lt flank pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter hypodensities are too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal, ureteric or bladder stones. No hydronephrosis or perinephric stranding. Symmetric excretion of contrast into the collecting system on delayed phase images without focal lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: The prostate gland is enlarged and heterogeneous. It measures 6.5 x 4.8 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without CT evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No focal lesion within the collecting system. No hydronephrosis. No specific cause for patient's abdominal/flank pain is identified.
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Generate impression based on findings.
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altered mental status Left skull base sphenoid wing calcified meningioma and right middle cranial fossa meningioma with surrounding encephalomalacia, no change since prior exam.Left fronto-temporal craniotomy was seen, no change since prior exam.Slightly enlarged ventricular system, no change since prior exam.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The paranasal sinuses and mastoid air cells are clear.
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No evidence of acute ischemic or hemorrhagic lesion.Bilateral meningiomas with associated encephalomalacia, no change since prior exam.
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Generate impression based on findings.
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MCA aneurysm clipping follow up Evidence of right pteryonal craniotomy with surgical clip on the right side sylvian fissure indicating post right MCA aneurysm clipping.Associated pneumocephalus and subtle low attenuations on the right inferior frontal lobe area are representing post operative changes.No evidence of significant hemorrhagic or ischemic lesion.Metallic artifacts on basilar artery area indicating post coiling status.The ventricles, sulci, and cisterns are symmetric and unremarkable. The paranasal sinuses and mastoid air cells are clear.
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Post right MCA aneurysm clipping status, no unusual finding.No evidence of acute ischemic or hemorrhagic lesion.
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Generate impression based on findings.
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Female 46 years old; Reason: bowel obstruction History: vomiting, abdominal pain CHEST:LUNGS AND PLEURA: Scattered micronodules are nonspecific but stable.MEDIASTINUM AND HILA: Reference prevascular/para-aortic lymph node is unchanged. It measures 0.9 x 0.8 cm (3, image 20), previously 0.9 x 0.8 mm. New prevascular lymph node is identified inferior to the reference node. Stable appearance of antero mediastinal soft tissue attenuation. Right-sided chest port with tip at the cavoatrial junction. Trace pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Segment 2/3 lesion measures 1.0 x 0.8 cm (series 3, image 7 to 9), previously 1.0 x 0.8 cm. Additional subcentimeter hepatic hyperattenuating foci are subjectively unchanged. For example series 3, image 88.SPLEEN: No significant abnormality noted.PANCREAS: Stable subcentimeter hypoattenuating focus in the uncinate process measures 10.6 cm (series 3, image 105), previously 0.9 x 0.6 cm. Again this may represent a side branch IPMN. There is no pancreatic duct dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is asymmetric hypoenhancement of the right kidney with mild hydronephrosis and hydroureter. The ureter remains dilated to the level of the below described right adnexal mass with suspicion for compression/invasion.RETROPERITONEUM, LYMPH NODES: Stable position of caval filter. Shotty retroperitoneal lymph nodes.BOWEL, MESENTERY: Contrast passes without evidence of obstruction to the distal small bowel. Stable right-sided mesenteric mass which measures 2.0 x 1.6 cm (series 3, image 131), previously 2.0 x 1.6 cm. A second reference right lateral mesenteric nodule has increased in size measuring 1.9 x 1.5 cm (series 3, image 133), previously 0.9 x 0.6 cm. Multiple new additional mesenteric nodules are identified throughout the abdomen, for example in the right upper quadrant (series 3, image 98, image 119). There are also new peritoneal implants, particularly the left upper quadrant (series 3, image 90).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Right adnexal mass has significantly increased in size and measures 7.4 x 1.8 cm (series 3, image 159), previously 2.4 x 1.4 cm. This is indistinguishable from the right lateral wall of the rectosigmoid colon. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: New large left pelvic mesenteric nodule ( series 3, image 144).BONES, SOFT TISSUES: Ventral abdominal wall hernia is unchanged. Sclerotic focus in the L3 vertebral body and S1 vertebral body worrisome for metastatic disease.OTHER: No significant abnormality noted.
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1.Evidence of disease progression with enlarging right adnexal lesion and increase mesenteric soft tissue nodularity throughout the abdomen and pelvis.2. New obstruction of the right kidney secondary to distal ureteric compression and/or invasion from described right adnexal mass.3. Suspicion for sclerotic bone metastases.4. No evidence of bowel obstruction.
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Generate impression based on findings.
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2-year-old male with neuroblastoma status post transplant CHEST:LUNGS AND PLEURA: Increased diffuse bilateral patchy airspace opacities. There is relative sparing of the apical segment of the left upper lobe. No pleural effusion.MEDIASTINUM AND HILA: Moderate cardiomegaly. Minimal pericardial fluid. Foci of gas within the nondependent right atrium and ventricle is likely from injection of IV contrast. Right internal jugular central venous catheter tip is in the SVC. Left upper extremity PICC tip is in the right ventricle. Prominent right paratracheal lymph node measuring 9 mm (series 3, image 14). Additional scattered mediastinal lymph nodes. No significant hilar lymphadenopathy is noted.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly is unchanged. No focal hepatic lesions. No intrahepatic or extrahepatic biliary dilatation. Gallbladder is within normal limits.SPLEEN: The spleen is within normal limits and measures 10 cm.PANCREAS: The pancreas is within normal limits.ADRENAL GLANDS: Right adrenal gland is within normal limits. Again seen is a partially calcified left adrenal mass measuring 2.9 x 1 .5 cm, previously 2.7 x 2.2 cm (series 3, image 67).KIDNEYS, URETERS: Right kidney is within normal limits. Atrophic left kidney. No hydronephrosis or perinephric fluid collections.RETROPERITONEUM, LYMPH NODES: Scattered retroperitoneal lymph nodes not pathologically enlarged by CT size criteria.BOWEL, MESENTERY: NG tube tip is in the stomach. Bowel is within normal limits without evidence of obstruction. The appendix is not well visualized.BONES, SOFT TISSUES: No suspicious osseous lesions.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is massively distended.LYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: Bowel is within normal limits without evidence of obstruction. The appendix is not well visualized.BONES, SOFT TISSUES: No suspicious osseous lesions.OTHER: No significant abnormality noted.
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1.Left adrenal mass is slightly decreased in size since the prior exam. 2.Increased diffuse bilateral patchy airspace opacities may represent infection. A component of overlying pulmonary edema is probable. Moderate cardiomegaly with small pericardial effusion.
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Generate impression based on findings.
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59-year-old male with history of stroke, presenting with head trauma, possible loss of consciousness. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. There is a 1.5-cm lytic lesion within the left parietal calvarium which is nonspecific in appearance.
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1. No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. 1.5 cm lytic lesion in the left parietal calvarium is nonspecific. Comparison with prior studies is suggested if available. Alternatively, MRI can be considered.
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Generate impression based on findings.
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Elbow pain Again seen is a slightly impacted but essentially nondisplaced fracture of the radial neck. There is elevation of the distal humeral fat pads, likely reflecting residual hemarthrosis.
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Radial neck fracture.
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Generate impression based on findings.
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Male 4 years old Reason: concern for abscess LLQ abnormality History: abdominal distention, ab pain ABDOMEN:LUNG BASES: Lung basesLIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Several foci of free intraperitoneal air are identified. Multiple dilated loops of fluid-filled bowel are present within the abdomen measuring up to 4.4 cm in maximal diameter.A blind ending tubular structure is identified within the pelvis, which measures up to 12 mm in maximal diameter, with a discontinuous margin most likely representing the appendix, likely perforated. High-density within this tubular structure may represent an appendicolith, although this is equivocal. There is a moderate amount of periappendiceal fluid, but no loculated fluid collections to suggest abscess formation.Scattered mesenteric lymph nodes are presumably reactive in etiology.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: There is inflammatory changes within the perirectal fat.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Several foci of free intraperitoneal air are identified. Multiple dilated loops of fluid-filled bowel are present within the abdomen measuring up to 4.4 cm in maximal diameter.A blind ending tubular structure is identified within the pelvis, which measures up to 12 mm in maximal diameter, with a discontinuous margin most likely representing the appendix, likely perforated. High-density within this tubular structure may represent an appendicolith, although this is equivocal. There is a moderate amount of periappendiceal fluid, but no loculated fluid collections to suggest abscess formation.Scattered mesenteric lymph nodes are presumably reactive in etiology.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Findings compatible with perforated appendicitis without evidence of periappendiceal abscess formation.2.Dilated loops of fluid-filled bowel most consistent with ileus, presumably related to the perforated appendicitis.
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Generate impression based on findings.
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78 year-old male with history of pleural effusion and possible paraneoplastic transverse myelitis. Evaluate for malignancy. CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions with associated atelectasis. Several calcified pulmonary nodules are noted. Adherent debris in the lower trachea just superior to the carina (5/36) may represent adherent mucous/aspirated debris.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Scattered mediastinal and hilar calcified and noncalcified lymph nodes. No significant pericardial effusion.CHEST WALL: Sternotomy fixation wires are noted. Degenerative changes are noted about the upper spine and sternoclavicular joints. Soft tissue stranding/edema and mild skin thickening over the right lower thoracic wall laterally, correlate with physical exam as this may represent cellulitis.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis, without additional significant abnormality noted.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral atrophic kidneys with several punctate left renal pelvis calcifications that may be nonobstructing stones.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine, and there is a mild compression deformity of the L3 vertebral body.OTHER: Small left inguinal fat-containing hernia.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Small bilateral pleural effusions, and likely small amount of adherent debris in the inferior trachea as above.2.Right lower thoracic lateral subcutaneous edema and skin thickening, correlate with physical exam to exclude cellulitis.3.Mild L3 vertebrae compression deformity.4.No evidence of metastatic disease.
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Generate impression based on findings.
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7 year old female with trauma.VIEWS: Cervical spine lateral (one views) 2/5/2015 18:06 Evaluation limited to C1 through C6 secondary to overlying soft tissues obscuring C7 and below. No acute fracture or malalignment is evident. The prevertebral soft tissues are normal.
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Normal examination. Evaluation limited to C1 through C6 secondary to overlying soft tissue.
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Generate impression based on findings.
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Alignment of the thoracic and lumbar spine is anatomic. There are no fractures or subluxations. There are mild degenerative changes most notable at the L4-5 level with loss of disc height but no evidence of significant spinal canal stenosis. Mild scattered areas of lucencies are seen in the spine which may be related to osteopenia. No destructive osseous lesions. Incidental note is made of an enlarged left adnexal cystic structure measuring approximately 5 cm which is only partially visualized. The visualized paraspinal contents are unremarkable.T1/2-T11/12: No significant spinal canal stenosis or neuroforaminal stenosis.T12/L1: No significant spinal canal stenosis or neuroforaminal stenosis.L1/2: No significant spinal canal stenosis or neuroforaminal stenosis.L2/3: Mild disc bulge and mild spinal canal stenosis but no neuroforaminal stenosis.L3/4: Mild disc bulge and mild spinal canal stenosis but no neuroforaminal stenosis.L4/5: Mild disc bulge, loss of disc height, and facet hypertrophy with minimal spinal canal stenosis. Mild bilateral neuroforaminal stenosis.L5/S1: No significant spinal canal or neuroforaminal stenosis. Mild facet arthropathy.SI Joints: Mild degenerative changes.
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1.No evidence of an acute fracture or subluxation in the thoracic or lumbar spine.2.Mild degenerative changes without high grade spinal canal or neural foraminal stenosis.3.Enlarged left adnexal cystic structure is only partially visualized. Consider ultrasound follow-up for further evaluation.4.Mild scattered areas of lucencies are seen in the spine which may be related to osteopenia. No destructive osseous lesions.
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Generate impression based on findings.
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15-year-old male status post left hip I&D with increasing fevers and inflammatory markers PELVIS:Foley catheter is present. Scoliosis of the visualized lower lumbar spine. Large amount of stool in the colon. The remainder of the intrapelvic contents are within normal limits.No osseous erosions to suggest osteomyelitis. Subcutaneous reticulation and multiple foci of air within the left thigh likely reflect recent surgery. Loculated fluid is noted extending down the lateral aspect along the left anterior femoral compartment. Fluid is noted both within and outside the fascia. There is new hypodensity and enlargement of the left gluteus muscle suggestive of a fluid collections within the muscle. Hyperdense material is seen within the gluteal muscles (series 3, image 68) that may represent suture material. Soft tissue density along the medial femoral compartment appears slightly improved since the prior exam now measuring 6.3 x 4.5 cm, previously 6.7 x 5.2 cm (series 3, image 84).
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1.Interval decrease in size of soft tissue density along the left medial femoral compartment.2.New hypodensity within the left gluteal muscles represent fluid collections that extend inferiorly along the fascial lines of the anterior femoral compartment. MR may be considered for further evaluation.
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Generate impression based on findings.
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Trauma.VIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), date, time The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. Surgical staples are present in the right lung base. Vertebral body heights and disk spaces are normal. No fracture is seen. No prevertebral soft tissue swelling is identified. Evaluation limited to C1 through C6 secondary to soft tissues overlying C7 and below.No pelvic fracture is seen. There is lateral uncovering of the left femoral head by approximately 40 percent, appearing chronic.
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Evaluation of the cervical spine limited to C1 through C6 secondary to overlying tissues. No acute fracture or malalignment evident.
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Generate impression based on findings.
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Left internal jugular central venous catheter placement.VIEW: Chest AP (one view) 2/5/2015, 17:13 The left chest Port-A-Cath tip terminates at the cavoatrial junction.No focal airspace opacity is present. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal. No pneumothorax or pleural effusion.
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Left chest wall Port-A-Cath with the tip terminating in the cavoatrial junction.
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Generate impression based on findings.
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Obtunded, question head injury No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. There is mild global parenchymal volume loss.There is partial opacification of the left anterior ethmoid air cells. The visualized portions of the paranasal sinuses are otherwise clear. Mastoid air cells are clear. Calvarium is intact. Areas of thickening are noted in the scalp related to prior trauma.
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No evidence of acute intracranial hemorrhage or mass effect.
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Generate impression based on findings.
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Female 14 years old Reason: monitor pleural effusions History: tachypneaVIEW: Chest AP (one view) 2/5/2015, 18:34 The pericardiocentesis catheter tip projects over the left atrium, unchanged in position.Persistent bilateral pleural effusions, unchanged when accounting for differences in technique. Associated basilar opacities likely reflecting compressive atelectasis also unchanged. The cardiothymic silhouette is unchanged.
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Persistent bilateral pleural effusions and associated opacities likely reflecting compressive atelectasis, unchanged.
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Generate impression based on findings.
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Exam is limited secondary to lack of intravenous contrast, habitus, and streak artifact from left chest wall pacemaker. There is partial effacement of the left piriform sinus. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass. The submandibular, sublingual, and parotid glands have an unremarkable noncontrast appearance. The thyroid gland is unremarkable. The oral tongue and floor of mouth are unremarkable, within the limitations of this exam. The patient is almost completely edentulous. Enlarged bilateral level II cervical lymph nodes. Multilevel cervical spondylosis, most severely affecting the C6-C7. There are prominent atherosclerotic calcifications of the aorta and its branches in the thorax as well as at the bilateral carotid bifurcations. The right maxillary sinus is smaller than the left, but remains clear. Visualized intracranial structures are unremarkable.
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1. No evidence of discrete fluid collection, abscess, or mass.2. Enlarged bilateral level II cervical lymph nodes which are nonspecific, and may very well be reactive. However, the possibility of neoplastic process cannot be excluded. Please correlate with clinical history, symptoms and exam findings.3. Degenerative disease of the cervical spine.
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Generate impression based on findings.
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Male 66 years old Reason: Worsening hypoxia, cough. Persistent influenza in 66 yo male s/p stem cell transplant. History: hypoxia, cough LUNGS AND PLEURA: Interval development of diffuse bronchial wall thickening and bronchiolitis with tree in bud opacities, right greater than left.Mild focal bronchiectasis of the lower lobes bilaterally. New ground glass opacities in the left upper lobe.Minimal dependent atelectasis.No pleural effusion.Scattered calcified granulomas from previous granulomatous disease, unchanged.MEDIASTINUM AND HILA: Normal heart size with physiologic volume of pericardial fluid. Multiple calcified mediastinal lymph nodes likely representing prior granulomatous disease. No mediastinal or hilar lymphadenopathy.Moderate atherosclerotic calcifications of the aorta and its branches with severe coronary artery calcifications.CHEST WALL: Right chest wall port with tip in the SVC.Moderate degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Non obstructing left renal calculus.Scattered calcifications in the spleen secondary to prior granulomatous disease.
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1.Diffuse bronchiolitis likely infectious; if patient is currently immunocompromised opportunistic agents may be considered.2.Severe coronary artery calcifications again seen.
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Generate impression based on findings.
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Reason: oropharyngeal CA History: oropharyngeal CA CT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the retropharyngeal space there is some infiltration of the fat planes has been present on prior exams.Within the visceral space the thyroid gland appears intact.The airway appears patent.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are some degenerative changes present in the cervical spine worse at C5-6 where there are endplate and uncovertebral osteophytes present narrowing the spinal canalCT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No acute intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. There is left-sided ocular staphyloma present which is stable since prior exams.
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1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.No evidence for brain metastases.
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Generate impression based on findings.
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Tenderness after fall, rule out fracture.VIEWS: Pelvis AP and frog leg lateral (two views) 2/5/2015 The femoral heads are well seated within the acetabula. No acute fracture or malalignment is evident.
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Normal examination.
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Generate impression based on findings.
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Female 44 years old Reason: 44yo F with history gastric bypass, biliary leak, abdominal pain evaluate for bleed. ABDOMEN:LUNG BASES: Bibasilar scarring/atelectasis. No pleural effusions.LIVER, BILIARY TRACT: Complex fluid collection in gallbladder fossa/segment 5 of the liver is again seen and measures 2.0 x 1 .9 cm, previously 3.2 x 2.4 cm (57; series 80280).Hypoattenuating lesion in the along the left lobe measures 1.9 x 1 .5 cm, previously 1.9 x 1.4 cm series 80280; image 31.Mild intrahepatic biliary dilatation. Interval removal of the common bile duct stent with a small amount of pneumobilia.SPLEEN: No significant abnormality notedPANCREAS: No peripancreatic loculated fluid collections.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Presumed right renal cyst.RETROPERITONEUM, LYMPH NODES: Small shotty retroperitoneal nodes.BOWEL, MESENTERY: Again seen a Roux-en-Y gastric bypass changes. No evidence of obstruction. Interval removal of gastrostomy tube.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Probable calcification in the or in the region of the right ovary, unchanged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted
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Continued interval decrease in size of the reference intra- and perihepatic collections with measurements provided above. No evidence of intraabdominal hemorrhage, as clinically questioned.
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Generate impression based on findings.
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55-year-old with right breast mass seen on screening mammography. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. An obscured mass near the 9 o'clock position of the right breast appears largely circumscribed on spot compression imaging. No suspicious microcalcifications or areas of architectural distortion in the right breast. ULTRASOUND
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Right breast cysts. 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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. An oval asymmetry is present at lower left breast on MLO view. No suspicious microcalcifications or areas of architectural distortion are present.
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Oval asymmetry at lower left breast on MLO view, for which spot compression view and possible ultrasound study is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Respiratory insufficiency.VIEW: Chest AP (one view) 2/6/2015, 04:15 Persistent unchanged right upper and right middle lobe atelectasis with mediastinal shift to the right. The enteric feeding tube has been removed. Diffuse pulmonary haziness persists. The cardiothymic silhouette is normal.
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Persistent right upper and right middle lobe atelectasis.
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Generate impression based on findings.
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Female 50 years old; Reason: h/o colon ca, question liver mets History: RUQ pain, possible abnormal lesion on bedside ultrasound ABDOMEN:LUNG BASES: Subcentimeter left lower lobe pulmonary nodule (image 13/Series 4) measures 3-mm. LIVER, BILIARY TRACT: Liver is normal in morphology. Within segment two there is a hypodense lesion with peripheral nodular enhancement compatible with a hemangioma. In the right lobe of the liver in segment 5/6 there is a large hypodense poorly enhancing mass that likely violates the hepatic capsule measuring 4.8 x 4.4 cm (image 60/series 3). SPLEEN: Hypodense lesions within the spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild hydronephrosis in the right kidney due to obstruction of the ureter in its mid course due to retroperitoneal mass as detailed below.RETROPERITONEUM, LYMPH NODES: Extensive omental and retroperitoneal lymphadenopathy. A reference aortocaval lymph node measures 2.7 x 1.9 cm (image 78/series 3). Reference left upper abdominal mesenteric lymph node measures 4.7 x 4.1 cm (image 68/series 3). BOWEL, MESENTERY: Right colonic mass with multiple mesenteric lymph nodes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Masses on the right adnexa likely represent drop metastases to the ovary. Similarly, masses along the superior aspect of the bladder compatible with peritoneal spread of disease.Enlarged uterus.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right colonic mass with multiple mesenteric lymph nodes. Multiple cul-de-sac masses.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Findings of a right colonic mass with metastatic disease to the mesentery, liver, right ovary, retroperitoneum and peritoneum.2.Mild right hydronephrosis due to partial occlusion of the right ureter from retroperitoneal lymphadenopathy.3.Nonspecific subcentimeter pulmonary nodule.
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Generate impression based on findings.
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36-year-old male with history of nail pulled out of finger. There are small bone fragments seen along the volar/radial aspect of the head of the middle phalanx and possibly along the volar aspect at the base of the distal phalanx compatible with minimally displaced chip fractures. We see no retained foreign body.
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Small chip fractures as above.
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Generate impression based on findings.
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Male 21 years old; Reason: rule out appendicitis History: abd pain 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 significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course. There is a jejunal jejunal intussusception in the left hemiabdomen (image 68 of series 4) without obstruction or focal mass.The appendix as imaged is normal in caliber and course without surrounding inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See above; moderate colonic fecal matter.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No CT findings of acute appendicitis as clinically questioned.
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Generate impression based on findings.
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Female 31 years old; Reason: rule out dissection History: chest pain, uncontrolled HTN CHEST:LUNGS AND PLEURA: Subcentimeter nodular opacity in the left upper lobe (image 44/series 9) is nonspecific.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.Thoracic aorta is normal in caliber and course. No CT findings of dissection.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Imaged portions of the hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. Abdominal aorta is normal in caliber without dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Right adnexal cystic mass measures 4.9 x 5.6 on image 244/series 10.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.No CT findings of aneurysm or dissection of the aorta.2.5.6-cm right adnexal cystic mass for which sonographic evaluation is suggested.3.Severe fatty infiltration of the liver. Follow up with hepatology is suggested.
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Generate impression based on findings.
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19-year-old male with history of pain. We see no fracture or other radiographic findings to account for the patient's pain. There is no joint effusion.
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No radiographic findings to account for the patient's pain.
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Generate impression based on findings.
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75-year-old female with history of fall. We see no fracture or malalignment. There is trabecular and cortical thickening involving the left innominate bone indicating Paget's disease. Mild to moderate osteoarthritis affects the hips and SI joints. There are scattered arterial calcifications.
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Paget's disease and osteoarthritis as above, but no fracture is evident.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Female; 45 years old. Reason: hx of oropharyngeal CA History: hx of oropharyngeal CA LUNGS AND PLEURA: Interval resolution of ground glass opacities in the left lower lobe. Very mild centrilobular emphysema. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Right chest Port-A-Cath with catheter tip near the superior cavoatrial junction. Normal heart size. No pericardial effusion. No visible coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Very small hypodensity in the right lobe of the liver is too small to characterize but likely a cyst (series 6/81).
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1. No evidence of metastatic disease. 2. Interval resolution of aspiration pneumonitis in the left lower lobe.
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Generate impression based on findings.
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Nasojejunostomy tube repositioning.VIEW: Abdomen AP (one view) 2/5/2015, 22:58 The Dobbhoff tube has been advanced, now coiled upon itself multiple times within the stomach. The guidewire is still in place.The bowel gas pattern is nonobstructive and no pneumoperitoneum, portal venous gas or pneumatosis intestinalis is evident.
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Dobbhoff tube coiled upon itself multiple times within the stomach.
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Generate impression based on findings.
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Reason: head injury, assess for fracture, bleed History: AMS, emesis , frontal hematoma The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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No evidence for acute intracranial hemorrhage mass effect or edema.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Clusters of benign punctate calcifications in the left breast are again seen.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Epilepsy status-post intubation.VIEW: Chest AP (one view) 2/6/2015, 04:07 Endotracheal tube tip is below the thoracic inlet and above the carina. The nasogastric tube tip projects out of the field of view inferiorly. The right internal jugular central venous catheter tip is in the SVC. A gastrostomy tube is in place.Patchy diffuse airspace opacities appear slightly improved from the prior examination. Bilateral pleural effusions are unchanged. No pneumothorax is evident. The cardiothymic silhouette is normal.
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Slightly improved patchy diffuse airspace opacities, perhaps reflecting improving atelectasis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Unchanged multiple focal asymmetries in both breasts dating back to 2009.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Limited sequences of the brain are performed and examination is motion degraded. There is encephalomalacia in the right parietal lobe and in the left basal ganglia extending into the left insula and superior temporal gyrus consistent with chronic infarcts. There is associated ex vacuo dilatation of the left lateral ventricle. More superior to the left basal ganglia infarct is an area of restricted diffusion involving the left frontal corona radiata consistent with acute infarct.There is susceptibility effect in the left basal ganglia likely representing mineralization. There is a punctate focus of susceptibility in the left upper putamen with corresponding hyperdensity on prior CT favored to also represent mineralization and less likely petechial hemorrhage.No mass, mass effect, midline shift or herniation. No hydrocephalus. There are no extraaxial fluid collections or subdural hematomas.
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1.Chronic infarct in the left basal ganglia extending into the left insula and superior temporal lobe with area of acute infarct more superiorly in the left frontal corona radiata.2.Chronic right parietal infarct.3.No intracranial mass effect.4.Susceptibility effect in the left basal ganglia likely related to mineralization and less likely hemorrhage. Minimal petechial hyperdensity seen within this region on CT from 2/1 to 2/5. 5.Please note limited sequences could be obtained due to patient motion. Dr. Veronesi discussed findings of acute stroke with Dr. Sheikh (pager # 3324) at the time of this final entry at 2/6/15 at 10:09
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Generate impression based on findings.
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Hypoxia status post intubation.VIEW: Chest AP (one view) 2/5/2015, 23:04 Endotracheal tube tip is below the thoracic inlet and above the carina. The nasogastric tube tip projects out of the field of view inferiorly. The right internal jugular central venous catheter tip is in the SVC. Patchy diffuse airspace opacities appear slightly improved from the prior examination. Bilateral pleural effusions are unchanged. No pneumothorax is evident. The cardiothymic silhouette is normal.
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Slightly improved patchy diffuse airspace opacities, perhaps reflecting improving atelectasis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Crackles in right lung base.VIEWS: Chest PA/lateral (two views) 2/6/2015 Peribronchial thickening and pulmonary hyperexpansion is present. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal. Streaky retrocardiac opacities suggest subsegmental atelectasis. No pleural effusion or pneumothorax.
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Bronchiolitis/reactive airways disease pattern without evidence of superimposed pneumonia.
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Generate impression based on findings.
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ICH follow up, increasing EVD setting Re-demonstration of right thalamic ICH, IVH with mass effects, no change in size and the degree of midline shift toward left side since prior exam.Ventricle size and the degree of dilatation also appear to be stable.Left frontal approach ventriculostomy tube position is stable with the tip in the left lateral lateral ventricle around the left side foramen of Monroe.There is no evidence of new ischemic or hemorrhagic lesion.The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No interval change of right thalamic ICH, IVH with mass effect since prior study.Stable left frontal approach ventriculostomy tube.
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Generate impression based on findings.
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Female 25 years old; Reason: intra-abdominal abscess; pancreas abnml History: Epigastric pain; persistent N/V ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: Unremarkable appearance of the pancreas. No intraabdominal collection.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.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: Increased wall thickening of the rectosigmoid and descending colon suggestive of mild colitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace adnexal free fluid is likely physiologic.
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1.No evidence of pancreatic abnormality or intra-abdominal abscess. 2.Mild wall thickening of the rectosigmoid and descending colon suggestive of a mild colitis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Percutaneously placed clip in the lower outer quadrant of the right breast is again noted. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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34-year-old female with left upper quadrant pain. ABDOMEN:LUNG BASES: Bibasilar scarring/atelectasis. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered mesenteric lymph nodes. Note is made of low attenuation debris floating within the stomach, most consistent with fatty ingested material. There is nonspecific thickening of the pylorus, which may be related to incomplete distention/peristalsis. BONES, SOFT TISSUES: Small fat-containing umbilical hernia.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Surgical clips are identified in the pelvis. Small amount of free fluid in the pelvis in nonspecific but may be physiologic.
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Nonspecific thickening of the pylorus which may be related to incomplete distention/peristalsis and clinical correlation is indicated.
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Generate impression based on findings.
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Patient with intracranial hemorrhage, right temporal and left frontal. Encephalopathy and left-sided weakness. Redemonstrated is a focus of hemorrhage in the left superior frontal gyrus, subarachnoid hemorrhage along the lateral surface of the right temporal lobe, and smaller foci of hyperattenuation in the left temporal lobe, which are grossly unchanged. Again noted are hypoattenuating foci in the bilateral thalami and basal ganglia. There are scattered punctate and confluent areas of abnormal hypoattenuation in the periventricular and subcortical white matter, consistent with stable mild chronic small vessel ischemic changes. There is slight interval increase in size of the bilateral hemispheric subdural effusions.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are atherosclerotic calcifications of the cavernous portion of the bilateral internal carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Nasogastric and endotracheal tubes are partially imaged.
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1. Stable small subarachnoid hemorrhage along the right temporal lobe.2. Stable hemorrhagic focus in the left superior frontal gyrus and smaller hemorrhagic foci elsewhere, in a pattern suggestive of amyloid angiopathy.3. Slight interval increase in size of the small bilateral subdural effusions.4. Multiple lacunar infarcts in the basal ganglia and thalami5. Mild chronic small vessel ischemic changes.
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Generate impression based on findings.
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76-year-old female with history of pain. Lumbar spine: The bones are demineralized. Mild degenerative disc disease and facet joint osteoarthritis affects the lower lumbar spine. There is a grade 1 anterolisthesis of L4. Vertebral body heights are preserved. There are calcifications of the distal abdominal aorta and its branches. The cardiac silhouette appears enlarged.Right hip: The right hip appears normal for age. We see no fracture. Left hip: Minimal osteoarthritis affects the left hip. We see no fracture.Pelvis: Mild degenerative disease affects the SI joints and pubic symphysis, but we see no fracture.
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Osteoarthritis and degenerative disc disease as described above without fracture evident
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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49 year old female with right wrist pain and swelling Left wrist: We see no erosions or other specific radiographic features of rheumatoid arthritis. Mild osteoarthritis affects the basilar joint.Left hand: We see no erosions or other specific radiographic features of rheumatoid arthritis. Tiny osteophytes along the DIP joints indicate minimal osteoarthritisRight wrist: We see no erosions or other specific radiographic features of rheumatoid arthritis. Small osteophytes at the basilar joint indicate mild osteoarthritis.Right hand: A subcentimeter, round lucency with thin sclerotic margins within the third metacarpal head may represent a cyst or less likely a chronic erosion as the remainder of the joint is unremarkable. Tiny osteophytes along the distal interphalangeal joints indicate minimal osteoarthritis.
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Mild osteoarthritis as described above without specific radiographic features of rheumatoid arthritis.
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Generate impression based on findings.
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There is evidence of prior transphenoidal pituitary surgery. Residual pituitary gland is small particularly on the left. No evidence of micro- or macroadenoma is appreciated. There is downward tenting of the optic chiasm on the left consistent with prior surgery. There is preservation of T1 hyperintensity involving the neurohypophysis. Remainder of the suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear otherwise unremarkable.Mucosal thickening is noted in the ethmoid sinus cavity. Small right maxillary mucous retention cyst. Limited visualization of the brain demonstrates a partially visualized right-sided ventriculostomy catheter with tip abutting the septum pellucidum the level of the frontal horns. There is no hydrocephalus. No extra-axial collections or midline shift.
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Evidence of prior transphenoidal surgery with small residual pituitary tissue in the sella unchanged since 7/18/2014. No evidence of micro- or macroadenoma.
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Generate impression based on findings.
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71 years, Male. Reason: Dobbhoff placement, evaluate for change Replaced enteric tube tip extends into region of gastric fundus. Right femoral venous catheter. LVAD again noted. Nonobstructive bowel gas pattern.
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Enteric tube tip in region of gastric fundus.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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66 years, Female. Reason: contrast retention Right-sided chest tube is noted. Interval enteric tube removal. Retained contrast material is seen in region of gastric pullup as well as in the colon. Nonobstructive bowel gas pattern. Please refer to dedicated chest radiographic exam from same day for additional findings.
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Retained contrast as above.
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Generate impression based on findings.
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77-year-old male with pain There is a chronic healed fracture through the surgical neck of the humerus with impaction of the humeral head, which is subluxed inferiorly and rotated relative to the glenoid. The bones are demineralized. Atrophy of the rotator cuff - particularly of the supraspinous muscle - is noted although no full thickness tear or retraction is evident within the limits of this study. Degenerative changes affect the glenohumeral joint, particularly inferiorly along the glenoid. Mild degenerative changes affect the acromioclavicular joint. Degenerative disk disease affects the visualized lower cervical and upper thoracic spine. Basilar atelectasis is noted.
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Chronic impacted proximal humerus fracture as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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57-year-old male with left hip pain Findings compatible with severe osteoarthritis affecting the left hip have progressed compared with the prior exam. Sclerosis and lucency within the superior aspect of the femoral head may represent progression of degenerative arthritic changes but we cannot exclude avascular necrosis. Moderate osteoarthritis affects the right hip. The pelvis is within normal limits.
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Progression of severe osteoarthritis affecting the left hip as described above.
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Generate impression based on findings.
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22-year-old male with history of pain. Evaluate for avascular necrosis. Dense bones are noted compatible with sickle cell disease. Right hip: We see no frank avascular necrosis of the femoral head.Left hip: Minimal patchy sclerosis within the left femoral head may represent minimal avascular necrosis, but this is equivocal. We see no evidence of subchondral collapse.Pelvis: Again seen are the aforementioned findings of sickle cell disease. A single surgical clip projects over the pelvis.
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Questionable minimal avascular necrosis of the left femoral head and dense bones compatible with sickle cell disease. If patient care warrants further imaging, MRI may be obtained.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Mammogram works best when searching for changes. Submission of prior mammogram is, therefore, recommended for future reference. If the patient submits her old mammograms, we can compare them with the current study to establish stability.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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59-year-old female with pain and limited range of motion Deformity of the distal tibial diaphysis is compatible with old healed fracture. Round defect within the calcaneus from prior external fixation is again noted. Moderate to severe osteoarthritis affects the talonavicular joint. Prominent plantar calcaneal spur.
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Talonavicular joint osteoarthritis and old post traumatic deformity of the distal tibia.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
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Increased oxygen requirementVIEW: Chest AP 2/5/15 Tracheostomy tube in place. G-tube in place. Cardiothymic silhouette normal. Patchy atelectasis in the perihilar region and left lower lobe. No pleural effusion or pneumothorax.
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Patchy atelectasis in the perihilar region and left lower lobe.
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Generate impression based on findings.
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25 years, Female. Reason: ngt position Suboptimal exam due to overlying leads. Enteric tube tip in the gastric body. Multiple surgical drains. Cholecystectomy clips. Nonobstructive bowel gas pattern. Retained enteric contrast material. Lower lobe consolidation/atelectasis.
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Enteric tube tip in the gastric body.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense. Scattered benign calcifications are noted in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
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IntubatedVIEW: Chest AP 2/6/15 ET tube tip below thoracic inlet and above the carina. Right upper extremity PICC in the right atrium. Cardiothymic silhouette normal. G-tube in place. Patchy atelectasis in the right lower lobe and left lower lobe not significantly changed. No pleural effusion or pneumothorax.
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Patchy atelectasis bilaterally not significantly changed.
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Generate impression based on findings.
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10 month old female status post trauma, rule-out fracture. VIEWS: Cervical spine AP and lateral (two views) 2/6/2015 No acute fracture or malalignment is evident. The prevertebral soft tissues are normal.
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Normal examination.
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Generate impression based on findings.
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Chronic sinusitis with sinus pain and drainage since 12/14. Currently sinus pain bilaterally and green color drainage. There are postoperative findings related to endoscopic sinus surgery, including bilateral uncinectomy and partially ethmoidectomy. There is moderate mucosal thickening in the left maxillary sinus with suggestion of an air-fluid level. There is also mild diffuse mucosal thickening in the right maxillary sinus. There is partial opacification of the bilateral neo-infundibulae. There is scattered opacification of the remaining ethmoid air cells. There is mild mucosal thickening in the left sphenoid sinus. The right sphenoid sinus and frontal sinuses are clear. The left nasal cavity is largely opacified. The nasal septal is deviated towards the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable.
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Postoperative findings related to endoscopic sinus surgery, with evidence of cute upon chronic rhinosinusitis.
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Generate impression based on findings.
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54-year-old female status post L5 to S1 fusion Posterior rods with screws entering the L5-S1 vertebral bodies along with an intravertebral disk spacer device are are again seen without evidence of hardware complication. Moderate to severe degenerative disk disease affects L4/5 and moderate degenerative disk disease affects L2/3, unchanged from the prior exam.
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Postoperative changes of lumbosacral fusion and degenerative disk disease as described above, appearing similar to the prior exam.
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Generate impression based on findings.
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Seven year old female with pneumonia and pleural effusions.VIEW: Chest AP (one view) 2/6/2015 The endotracheal tube has been removed. The right internal jugular central venous catheter tip is in the right internal jugular vein. The enteric feeding tube tip projects out of the field of view inferiorly. The nasogastric tube has been removed. Vagal nerve stimulator device overlies the left chest with leads in the left neck.The cardiothymic silhouette is normal. Improved left lower lobe opacity, likely reflecting resolving atelectasis. Improved aeration is noted in the right lung as well. No pneumothorax. Mild rightward curvature of the thoracic spine.
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Improved left lower lobe opacity and aeration in the right lung.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
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IntubatedVIEW: Chest AP 2/6/15 ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. Cardiothymic silhouette normal. Right upper lobe atelectasis has increased. Interval improvement in the atelectasis at the left lower lobe. No pleural effusion or pneumothorax.
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Right upper lobe atelectasis has increased in the interval.
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Generate impression based on findings.
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Multifocal bifrontal and left parietal ischemic infarctions. NONCONTRAST CT HEADRe demonstration of subtle low attenuations on bilateral frontal lobes indicating acute ischemic infarctions. There is no evidence of hemorrhagic transformation.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThe left carotid bulb shows wall thickening especially on the posterior aspect with irregularity on the luminal side indicating carotid plaque with minimal to mild ulceration.However, there is no evidence of significant luminal stenosis.There is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the right common carotid arteries, right carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, ACAs, and MCAs. Vertebrobasilar system appears to be normal.Acom artery is patent and bilateral Pcom arteries are small but identified.No evidence of intracranial aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage.
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1. Posterior wall irregularity of the left extracranial ICA just above the left carotid bifurcation bulb indicating plaque ulceration without significant luminal stenosis.2. Otherwise unremarkable.Rec: for further evaluation of vulnerable/acutely ruptured plaque, focused plaque imaging using dedicated MR sequence using MR micro-coil is recommended.
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Generate impression based on findings.
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There is redemonstration postoperative changes related to right frontal craniotomy and resection, including right frontal encephalomalacia. There are several focal subependymal calcifications in the bilateral ventricles, as well as focal calcification in the right parietal lobe and left frontal lobe, compatible with tuberous sclerosis. There is FLAIR hyperintensity along the surgical margins in the right frontal lobe, in the right inferior and opercular temporal lobe and the left midbrain, which are not significantly changed from prior exams. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
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1. Findings compatible with tuberous sclerosis are not significantly changed when compared to prior exam, including: cortical and subcortical hamartomas as well as subependymal and right parietal calcifications. 2. Stable appearance of right frontal encephalomalacia.
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Generate impression based on findings.
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50 year-old female assess for lesions of fourth and fifth fingers, numbness Elbow: There is a tiny enthesophyte at the triceps insertion along the posterior olecranon. The elbow otherwise appears normal.Hand: Mild osteoarthritis affects the basilar joint. The hand otherwise appears normal.
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Minimal degenerative arthritic changes as described above without specific findings to account for the patient's numbness.
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Generate impression based on findings.
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Chest tube placementVIEW: Chest AP 2/6/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left chest tube in place. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally in a background of chronic lung disease. No pleural effusion or pneumothorax.
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Diffuse patchy atelectasis bilaterally in a background of chronic lung disease.
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