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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. G-tube in place. Cardiothymic silhouette normal. Patchy atelectasis left lower lobe not significantly changed. No pleural effusion or pneumothorax.
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Minimal patchy atelectasis left lower lobe not significantly changed.
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Generate impression based on findings.
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Post right MCA clipping follow up NONCONTRAST CT HEADRe demonstration of postoperative status of right MCA aneurysm clipping including right pteryonal craniotomy and pneumocephalus. There are also relatively well defined low attenuation areas on the right inferior frontal lobe and right temporal lobe anterior aspect which are post surgical changes. These findings do not show any interval change since prior exam.There is, however, small extra axial fluid collections (about 9mm in thickness) under the craniotomy site comparing to prior exam which represent postop changes. Follow up examination is recommended.The ventricles, sulci, and cisterns are symmetric and unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKDue to significant metallic artifacts, precise evaluation of right MCA aneurysm is not possible.However, right MCA M1 segment and M3 segment appear to be normal luminal size.The left MCA, distal right MCA and bilateral ACAs appear to be normal.No evidence of intracranial arterial luminal narrowing or occlusion.Vertebrobasilar system appears to be normal, however, top of basilar artery cannot be evaluated precisely due to previously inserted aneurysm coils.No evidence of 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. Post right MCA aneurysm clipping and basilar tip aneurysm post coiling status, no unusual finding.2. Minimal extra axial fluid collection under the craniotomy site is a new finding comparing to prior scan but can also be a part of usual postoperative finding.
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Generate impression based on findings.
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Male 13 months old with increased work of breathingVIEW: Chest AP (one view) 2/5/2015 peribronchiolar thickening is evident. Streaky retrocardiac opacity suggests subsegmental atelectasis. The aortic arch, cardiac apex and stomach are left-sided. No pleural effusion or pneumothorax is evident.
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Bronchiolitis/reactive airways disease pattern without superimposed pneumonia.
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Generate impression based on findings.
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IntubatedVIEW: Chest AP 2/6/15 ET tube tip is below the thoracic inlet and above the carina. Right internal jugular central venous catheter tip is obscured by the spinal instrumentation. Right upper extremity PICC tip is in the left atrium. Spinal rods and hooks are again seen, unchanged in position. Tubing projecting over the right hemithorax most likely represents a soft tissue drain. Cardiothymic silhouette normal. Bilateral pleural effusions right greater than left not significantly changed. Right upper lobe atelectasis has improved in the interval. There is a small right apical pneumothorax.
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Bilateral pleural effusions not significantly changed.
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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. Arterial 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: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. 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. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Clavicular fracture, evaluate healing.VIEWS: Left clavicle AP and axial (two views) 2/6/2015 Proximal clavicular fracture with increased periosteal reaction and sclerosis compatible with healing, in near-anatomic alignment.
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Healing proximal clavicular fracture as above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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72-year-old male with history of prostate cancer with metastases. CHEST:LUNGS AND PLEURA: Persistent small left greater than right pleural effusions with associated atelectasis. Persistent pulmonary micronodules. A right lower lung pleural-based nodule (5/72) appears larger than previously seen however this may be due to the effect of pleural fluid and atelectasis.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Duplicated superior vena cava again noted. Mediastinal lymphadenopathy, with reference prevascular lymph node (3/21) measuring 4.7 x 4.4 cm, previously 4.3 x 3.5 cm. Additional non-reference lymph nodes have also increased in size. No significant pericardial effusion.CHEST WALL: Degenerative changes affect the visualized spine.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating hepatic parenchymal foci, unchanged since 2011 so likely benign. Cholelithiasis, without cholecystitis. Increased small amount of perihepatic ascites.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Reference left adrenal nodule (2/362) has increased in size over the interval, currently measuring 5.3 x 5 .3 cm, previously 3.9 x 3.5 cm.Right adrenal nodularity has also increased in size (2/324), now measuring 5.2 x 4 .3 cm, previously 3.2 x 2.1 cm.KIDNEYS, URETERS: No hydronephrosis or hydroureter. Left renal punctate parenchymal calcification, likely nonobstructing stone. Small right superior pole exophytic cyst, unchanged.RETROPERITONEUM, LYMPH NODES: Reference right periaortic/retrocaval conglomerate lymph node mass (2/353) currently measures 10.2 x 6.8 cm, previously 9.4 x 6.1 cm. Bilateral retroperitoneal lymphadenopathy encases the adjacent vasculature, including the bilateral renal arteries and veins, celiac trunk and superior mesenteric trunk, causing attenuation without frank thrombosis. SVC is also narrowed, but appears patent. Peripancreatic lymphadenopathy has increased over the interval and now is difficult to accurately measure due to lymph node mapping in this area. BOWEL, MESENTERY: Multiple mesenteric nodules, with several peritoneal enhancing nodules (2/306) there have increased in size over the interval. Increased small amount of ascites in the abdomen and pelvis.BONES, SOFT TISSUES: Multilevel degenerative changes of spine and osteopenia, including multilevel compression deformities seen. The L3 vertebral body has subtle increased sclerosis and minimal interval increased loss of height (sagittal image number 69).OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Reference left internal iliac lymph node (3/188) currently measures 3.5 x 4 cm, previously 3.4 x 3.7 cm. Additional non-reference pelvic/inguinal lymph nodes have also increased in size.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative disease and compression fractures as described above.OTHER: Small amount of pelvic ascites has increased slightly over the interval. Skin thickening and subcutaneous edema over the inferior anterior abdominal wall persists.
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1.Interval progression of metastatic disease.2.Mild increased sclerosis and subtle loss of height of the L3 vertebral body, with additional stable compression fractures as above.3.Increased peritoneal carcinomatosis with slightly increased abdominal/pelvic ascites.
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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 extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination, unchanged in pattern and distribution. There is a round asymmetry in the right posterior medial breast on CC view. Scattered calcifications are unchanged in both breasts.No suspicious microcalcifications or areas of architectural distortion are present.
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A round asymmetry in the right posterior medial breast on CC view, for which spot compression view and possible ultrasound study is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: ED - Additional Mammo/Ultrasound Workup Required.
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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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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67 year old female s/p Dobbhoff placement. Pelvis excluded from field of view. Dobbhoff tube has been pulled back with tip in gastric body. IVC filter unchanged. Nonobstructive bowel gas pattern. Osteopenia, levoscoliosis and chronic appearing right lower rib deformities are again noted.
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Dobbhoff tip in gastric body.
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Generate impression based on findings.
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66 years, Female. Reason: 66F check NG tube placement History: ng tube Enteric tube tip in the gastric fundus with side hole proximal to the gastroesophageal junction; advancement by approximately 12 cm is recommended. A midline pelvic JP drain and skin staples reflect recent surgery. Catheter in the right flank likely represents patient's IP port. Nonobstructive bowel gas pattern.
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Enteric tube side hole proximal to gastroesophageal junction, recommend advancement by approximately 12 cm.
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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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Ms. Lopez is a 17-year-old female presenting with a one-week history of right breast erythema, edema, and pain. Per mother, patient also has a thrombus recently identified in the right forearm. No history of recent trauma or pus drainage. Family history of breast cancer in maternal grandmother and maternal great aunt. Upon physical exam, there is circumferential skin thickening, erythema, and edema. No skin ulcerations or pus is identified. There is hyperpigmentation along the areas of skin thickening.A targeted right breast ultrasound was performed for the patient’s area of concern. There is diffuse skin thickening, measuring up to 5 mm, along with diffuse parenchymal edema. No discrete fluid collections or abscess are identified. There is no suspicious solid or cystic mass identified.
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Sonographic findings compatible with mastitis without discrete abscess collection. Patient should continue to follow up with her clinical team as warranted.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.
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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. Scattered benign coarse calcifications and marked arterial 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Arterial calcifications have progressed 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: NSB - Screening Mammogram.
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Generate impression based on findings.
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54 years, Male. Reason: Abdominal pain. Nonobstructive bowel gas pattern. No free air on upright views. Moderate stool burden. Median sternotomy hardware. Right hip prosthesis with adjacent heterotopic ossification.
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Nonobstructive bowel gas pattern. Moderate stool burden.
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Generate impression based on findings.
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Male; 81 years old. Reason: follow up for prostate cancer History: hx of prostate cancer CHEST:LUNGS AND PLEURA: Minimal interstitial scarring. No masses.MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes. Mild coronary artery calcifications.CHEST WALL: No significant abnormality noted. Gynecomastia. ABDOMEN:LIVER, BILIARY TRACT: Fatty liver infiltration. Stable subcentimeter hypodense nodules. Probable gallstones.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Unchanged prominent left adrenal gland.KIDNEYS, URETERS: Prominent left extrarenal pelvis described previously is slightly smaller in size on the current exam. Stable left renal hypodensity, favor cyst. No renal or ureteral calculi. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: Reference aortic bifurcation lymph node measures 1.2 x 0.8 cm (image 145; series 3), unchanged.BOWEL, MESENTERY: Colonic diverticula without evidence of complication. No bowel obstruction or free air.BONES, SOFT TISSUES: Small bowel containing umbilical hernia without evidence of obstruction.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate measuring with fiducial markers as noted previously. BLADDER: No significant abnormality notedLYMPH NODES: Reference left external iliac node is unchanged measuring 1.3 x 1.0 cm (image 170; series 3).BOWEL, MESENTERY: Colonic diverticula without evidence of complication. No bowel obstruction or free air.BONES, SOFT TISSUES: Bowel containing right inguinal hernia without evidence of obstruction.OTHER: No significant abnormality noted
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Stable exam with reference measurements given above.
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Generate impression based on findings.
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There is been interval resolution of previously described FLAIR hyperintensity. There are scattered bilateral micro-hemorrhages, non-specific. The volume in the bilateral hippocampi appears somewhat smaller than expected. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. A small left cerebellar developmental venous anomaly is present. The midline structures and craniocervical junction are within normal limits. There is scattered fluid in the left ethmoid air cells and mastoid air cells, left greater than right.
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1. Interval resolution of previously described abnormal hippocampal FLAIR hyperintensity.2. Although the bilateral hippocampi appear somewhat smaller than expected, however, there is no convincing evidence of mesial temporal sclerosis.
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Generate impression based on findings.
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68 years, Male. Reason: Repositioned Dobbhoff tube. Pelvis excluded from field of view. Dobbhoff tip in gastric fundus. Nonobstructive bowel gas pattern.
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Dobbhoff tip in gastric fundus.
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Generate impression based on findings.
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70 year old female s/p radical cystectomy and ileal conduit creation. RFO trigger: Surgery length greater than 8 hours, multiple surgical teams. No unexpected radiopaque foreign body. Nonobstructive bowel gas pattern. Enteric tube sidehole in gastric body. Cholecystectomy clips. Multiple pelvic drains and numerous pelvic surgical clips. Two catheters located more superiorly terminate in the right hemiabdomen and may traverse the ileal conduit. The more left sided of these catheters may be in the left renal collecting system but the location of the right sided catheter is unclear as it is located more inferiorly; please correlate with patient history. Right central venous catheter tip in right atrium. Low lung volumes and bibasilar consolidation; please see same day chest radiograph report for more details.
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1.No unexpected radiopaque foreign body. This result was communicated to the attending physician, Dr. Gottlieb, via telephone on 2/5/2015 at 22:37 by the radiology resident on call. 2.Two catheters terminating in the right hemiabdomen which may traverse the ileal conduit. The more left sided of these catheters may be in the left renal collecting system but the location of the right sided catheter is unclear as it is located more inferiorly; please correlate with patient history.
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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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T4aN2b supraglottic laryngeal squamous cell carcinoma status post treatment. There are post-treatment findings in the neck, including persistent pharyngeal edema, but no discernible tumor. However, there is mucosal ulceration in the right right piriform sinus with irregularity of the right right thyroid cartilage and surrounding low attenuation areas laterally, which may represent edema. There is continued increase in size of a left level 5B lymph node has increased in size, now measuring 11 mm in short axis, previously 9 mm, and there appears to be associated surrounding fat stranding. There is an unchanged necrotic appearing subcentimeter right level 3 lymph node. Otherwise, there is no significant cervical lymphadenopathy elsewhere in the neck. The thyroid and major salivary glands are unchanged. There is mild right and moderate left carotid bulb atherosclerotic plaque. The osseous structures are unchanged. The airways are grossly patent. The imaged intracranial structures and orbits are unremarkable. The imaged portions of the lungs are clear. There is a right maxillary sinus retention cyst.
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1. Persistent post-treatment findings in the supraglottic region without evidence of measurable locoregional tumor recurrence and stable treated right neck lymphadenopathy. However, a left level 5B lymph node has continued to slightly increase in size, but remains nonspecific. 2. Irregularity of the right thyroid cartilage with overlying mucosal ulceration may represent osteoradionecrosis, although superimposed infection cannot be excluded.
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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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Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her mother (diagnosed at age 48), aunt (diagnosed at age 60), and two cousins. 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. Diffuse benign calcifications in both breasts appear similar to the prior studies. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard 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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is 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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Male 79 years old; Reason: assess resolution of abscess History: as above ABDOMEN:LUNG BASES: Small right pleural effusion with atelectasis. Postsurgical changes adjacent to the right hemidiaphragm.LIVER, BILIARY TRACT: Post surgical changes from resection of the right hepatic lobe mass. A drain is in place adjacent to the hepatic surface. There is a residual gas fluid pocket measuring 2.8 x 1.1 cm adjacent to the surgical resection margin.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: There are pockets of gas within the wall of the lesser curvature of the stomach wall that dissects up to the level of the gastroesophageal junction. It has decreased from prior. The imaging findings are suggestive of either a large gastric ulcer or emphysematous gastritis confined to the lesser curvature. No frank perforation as there is no intraperitoneal free air or fluid.There are scattered clips within the abdomen.BONES, SOFT TISSUES: Postsurgical changes in the anterior abdominal wall.OTHER: No new drainable fluid collections in the upper abdomen.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Small pocket of gas within the urinary bladder probably due to recent instrumentation. There is a right posterior lateral bladder diverticulum.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine. There are sclerotic changes involving inferior endplate of L2 vertebral body.OTHER: No drainable fluid collections in the pelvis.
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1.Near complete resolution of the perihepatic abscess.2.Abnormal findings in the lesser curvature of the stomach has improved from prior with differential considerations including gastric ulcer or emphysematous gastritis as detailed above. Further evaluation with endoscopy can be performed.
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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. One of the left axillary lymph nodes has become larger.
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Enlarged left axillary lymph node. Ultrasound study is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Male 67 years old; Reason: restaging scans s/p 6 cycles of chemo therapy; please provide bi-dimensional measurements History: hx of metastatic bladder cancer CHEST:LUNGS AND PLEURA: Reference left upper lobe nodule is stable in size and measures 1.4 x 1.0 cm (series 4, image 36), previously 1.4 x 0.9 cm. No new pulmonary mass is identified. Right middle lobe scarring/atelectasis is unchanged. No pleural effusion.MEDIASTINUM AND HILA: Cardiac conduction device in situ. Severe native coronary artery calcifications are again noted. Status post coronary bypass graft.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hepatitis metastases are again noted. The reference right hepatic lesion measures 1.1 x 1.1 cm (series 3, image 134), previously 1.2 x 1.6 cm. Additional hepatic metastases are subjectively stable/mildly decreased.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic left kidney. Bilateral ureteral implantation with right lower quadrant ileal conduit. No hydronephrosis. Subcentimeter hypoattenuating foci in the right kidney is old characterize.RETROPERITONEUM, LYMPH NODES: Calcific atherosclerosis of the abdominal aorta and branch vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the bilateral glenohumeral joints. Status post surgical sternotomy changes. Small pocket of fluid immediately inferior to the stoma in the right paracentral abdominal wall measuring 2.6 x 2.0 cm, slightly increased compared to prior study.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Lucency within the T12 vertebral body and likely represents a hemangioma.OTHER: No significant abnormality noted
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1.Numerous hepatic metastases. Decrease in size of the reference lesion with additional metastatic lesions demonstrating interval stability/mild decrease in size.2.Stable left upper lobe pulmonary nodule.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her sister (diagnosed at age 36), two aunts (diagnosed at age 40), and a cousin. Family history of ovarian cancer diagnosed in two aunts. 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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TXN2B recurrent oropharynx squamous cell carcinoma treated via surgery and chemoradiation. There are post-treatment findings in the neck. There is no evidence of measurable oropharyngeal mass lesion in the or significant cervical lymphadenopathy based on size criteria. For example, a right level 1B lymph node measures 8 x 11 mm, previously 9 x 10 mm. There is an unchanged subcentimeter right thyroid nodule. The salivary glands are unchanged, including asymmetric fatty atrophy of the left parotid gland. The major cervical vessels are patent. There is unchanged mild multilevel degenerative spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. There is an unchanged 3 mm right apical lung nodule.
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1. Post-treatment findings in the neck without evidence of measurable oropharyngeal mass lesion or significant cervical lymphadenopathy based on size criteria. 2. Unchanged nonspecific subcentimeter right thyroid nodule.3. Unchanged 3 mm right apical lung nodule. Please refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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64 year old male with history of pain. Right shoulder: Moderate osteoarthritis affects the glenohumeral and acromioclavicular joints. Rounded densities along the anterior aspect of the proximal humerus likely represent loose bodies within the biceps tendon sheath. Tiny focus of mineralization adjacent to the greater tubercle may represent calcification of the rotator cuff at its insertion.Left shoulder: Moderate osteoarthritis affects the glenohumeral joint. Mild osteoarthritis affects the acromioclavicular joint. Small globular calcification above the greater tubercle likely represents calcification of the rotator cuff at its insertion.Cervical spine: The cervical-thoracic junction is obscured due to overlying anatomy on the lateral projections. There is moderate multilevel degenerative disc disease particularly affecting C4 through C7. There is mild multilevel facet joint osteoarthritis. There is neuroforaminal narrowing on the left at C3-4, C4-5, and C5-C6 and to a lesser degree at the same levels on the right. There is straightening of the normal cervical lordosis.
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Degenerative disc disease of the cervical spine and osteoarthritis at the shoulders and other findings as above.
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Generate impression based on findings.
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Male; 61 years old. Reason: Compare to last CT scans, HPV-positive locoregionally advanced T2N2B right tonsillar cancer, s/p CRT on 9/26/14 History: HPV-positive locoregionally advanced T2N2B right tonsillar cancer, s/p CRT on 9/26/14 CHEST:LUNGS AND PLEURA: Stable scattered pulmonary micronodules. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Mild coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Interval removal of left PICC.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Stable small nonspecific hypoattenuating lesion in the inferior spleen, likely benign in etiology (series 5/120).ADRENAL GLANDS: Stable left adrenal nodule measuring up to 3.4-cm (series 5/111), likely benign in etiology as it was not FDG avid on prior PET/CT.KIDNEYS, URETERS: Stable small left renal exophytic cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic disease affects the aorta, with calcification.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastases or significant interval change.
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Generate impression based on findings.
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82 year-old female with history of pain. The bones are demineralized suggesting osteopenia/osteoporosis.Right wrist: We see no acute fracture. There is chondrocalcinosis noted about the wrist raising the possibility of pseudogout in the correct clinical context.Left shoulder: There is chondrocalcinosis of the articular cartilage of the glenohumeral joint. A subchondral lucency with surrounding sclerosis in the glenoid like represents a subchondral cyst or chronic erosion.
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Arthritic changes with chondrocalcinosis of the wrist and shoulder as described above.
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Generate impression based on findings.
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59-year-old female with history of pain. Right hip: Mild osteoarthritis affects the hip. We see no fracture.Right knee: Mild osteoarthritis affects the knee. There is a small to moderate-sized joint effusion. We see no fracture. Mild osteoarthritis affects the left knee as seen on the frontal view.
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Mild osteoarthritis at the hip and knees with no fracture evident.
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Generate impression based on findings.
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Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Small subpleural scar like opacities and several micronodules, unchanged, compatible with intrapulmonary lymph nodes or previous infection.No suspicious nodules and no pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No visible coronary artery calcification.No pericardial effusion.CHEST WALL: Surgical hardware in the left shoulder joint.Moderate degenerative disease in the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: 2.5 cm left adrenal nodule, unchanged from multiple previous scans, and presumably benign.KIDNEYS, URETERS: Small bilateral hypodensities consistent with cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerosis in the aorta and branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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68 year old male s/p Dobbhoff tube advancement. Lower pelvis excluded from field of view. Dobbhoff tube coiled in stomach with tip near the gastric cardia. Nonobstructive bowel gas pattern.
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Dobbhoff tube coiled in stomach with tip near the gastric cardia.
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Generate impression based on findings.
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30 year-old male with right knee pain An orthopedic screw within the lateral femoral condyle reflects prior fixation of an osteochondral fragment. There is flattening and slight depression of the lateral femoral condyle that appears similar to the prior exam. The osteochondral fragment itself is indistinct, suggesting healing. Moderate osteoarthritis affecting the knee has progressed compared with the prior exam. Postoperative changes of ACL repair and mild osteoarthritis involving the left knee are seen on the frontal view.
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Postoperative changes of osteochondral fragment fixation with progression of osteoarthritis as described above.
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Generate impression based on findings.
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T4aN2b supraglottic laryngeal squamous cell carcinoma status post treatment. There are post-treatment findings in the neck with extensive pharyngeal edema. There is mucosal ulceration in the right right piriform sinus with irregularity of the right right thyroid cartilage and surrounding low attenuation areas laterally, which may represent edema or necrotic tumor. There is continued increase in size of a left level 5B lymph node has increased in size, now measuring 11 mm in short axis, previously 9 mm, and there appears to be associated surrounding fat stranding. There is an unchanged necrotic appearing subcentimeter right level 3 lymph node. Otherwise, there is no significant cervical lymphadenopathy elsewhere in the neck. The thyroid and major salivary glands are unchanged. There is mild right and moderate left carotid bulb atherosclerotic plaque. The osseous structures are unchanged. The airways are grossly patent. The imaged intracranial structures and orbits are unremarkable. The imaged portions of the lungs are clear. There is a right maxillary sinus retention cyst.
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1. Persistent post-treatment findings in the supraglottic region with irregularity of the right thyroid cartilage that apparently corresponds to tumor recurrence based on biopsy. 2. A left level 5B lymph node has continued to slightly increase in size, but remains nonspecific.
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Generate impression based on findings.
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Evaluate liver morphology. Evaluate for fatty liver. Evaluate for cirrhosis. LIVER: Liver measures 15.6 cm in length. Echogenic and coarse in echotexture compatible with fatty infiltration. There no masses or evidence of intrahepatic biliary ductal dilatation. The portal vein is patent with flow towards the liver and color Doppler imaging.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 12.7 cm in length and the left kidney measures 14 cm in length.OTHER: The spleen measures 9 cm in length.
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Echogenic liver suggesting fatty infiltration. Status post cholecystectomy.
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Generate impression based on findings.
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57 year old female with history of fall. There is mild anterior soft tissue swelling, however we see no acute fracture.
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Soft tissue swelling without acute fracture.
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Generate impression based on findings.
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Male; 43 years old. Reason: evaluation of nodules History: evaluation of pulmonary nodules LUNGS AND PLEURA: Stable scattered calcified granulomata. Additional scattered pulmonary micronodules and intrapulmonary lymph nodes are stable. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No visible coronary artery calcifications. No mediastinal or hilar lymphadenopathy. Stable calcified mediastinal and hilar lymph nodes, compatible with prior granulomatous process. Grossly stable caliber of the ascending aorta.CHEST WALL: Stable appearance of mild superior endplate compression deformity of L1 vertebral body, partially visualized.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable calcified granulomata and scattered pulmonary micronodules. No suspicious pulmonary nodules or masses.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is a defect in the left lamina papyracea, likely chronic.
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1. No evidence of intracranial hemorrhage or mass. 2. Mild chronic small vessel ischemic changes.
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Generate impression based on findings.
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Female 64 years old; Reason: Enlarged lymph nodes on previous CT, h/o Crohn's disease, h/o lymphoma History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Stable right hepatic lobe cyst. Subcentimeter hyperattenuating left hepatic lobe is too small to characterize.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: Calcific atherosclerosis of the abdominal aorta and branch vessels. Unchanged enlargement of right abdominal mesenteric lymph nodes (series 3, image 52). The previously described enlarged presplenic node is not seen on today's study. A new parasplenic node is identified in the left upper quadrant (series 3, image 16) .BOWEL, MESENTERY: Postsurgical changes of right hemicolectomy. Four areas of short segment luminal narrowing with inflammatory changes in the adjacent mesentery and vessel engorgement. The first is in the distal ileum measuring 1.3 cm (series 3, image 22). The second is at the entero colonic anastomosis measuring approximately 4.2 cm (series 80272, image 81). The third is in the mid descending colon measuring 2.8 cm (series 80272, image 61). The fourth is at the sigmoid colon anastomosis and measures 3.8 cm (series 80272, image 66). These are consistent with skip lesions of acute on chronic colitis.There is persistent wall thickening at the anorectal junction with fibrofatty proliferation and vessel engorgement suggestive of residual proctitis. The colon is mildly distended and fluid-filled.No evidence of abscess, fistula or sinus tract.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: Postsurgical changes of right hemicolectomy. Four areas of short segment luminal narrowing with inflammatory changes in the adjacent mesentery and vessel engorgement. The first is in the distal ileum measuring 1.3 cm (series 3, image 22). The second is at the enterocolonic anastomosis measuring approximately 4.2 cm (series 80272, image 81). The third is in the mid descending colon measuring 2.8 cm (series 80272, image 61). The fourth is at the sigmoid colon anastomosis and measures 3.8 cm (series 80272, image 66). These are consistent with skip lesions of acute on chronic colitis.There is persistent wall thickening at the anorectal junction with fibrofatty proliferation and vessel engorgement suggestive of residual proctitis. The colon is mildly distended and fluid-filled.No evidence of abscess, fistula or sinus tract.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Four skip lesions of acute on chronic colitis extending from the distal ileum to the sigmoid colon.2.Persistent inflammatory changes at the anorectal junction consistent with proctitis.3.Mesenteric node enlargement, not significantly changed compared to prior study.
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Generate impression based on findings.
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22 month old male status-post injury, evaluate for bony injury.VIEWS: Right hand PA lateral and oblique (3 views) 2/6/2015 There is a soft tissue defect overlying the medial aspect of the distal fourth phalanx. There is a fracture of the distal tuft of the fourth distal phalanx with adjacent ossific density foci consistent with fracture fragments. No additional fracture or malalignment is evident.
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Soft tissue defect of the lateral aspect of the distal fourth digit, with a fracture of the underlying distal tuft and associated osseous fragments.
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Generate impression based on findings.
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Female; 57 years old. Reason: outside report with RUL "consolidation" and lingular nodule. h/o telangiectasias. evaluate for AVM History: dyspnea PULMONARY ARTERIES: No evidence of pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain. Small scattered AVMs seen in the lingula measuring 9 mm (series 7/148), right lower lobe measuring 9 mm (series 7/190), and right upper lobe measuring 11 mm (series 7/69). A very small AVM seen in the right upper lobe on image 105.LUNGS AND PLEURA: Scattered pulmonary micronodules, some of which are calcified. 37 x 39 mm part solid mass in the right upper lobe (series 8/45) contains internal cysts. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size. No pericardial effusion. No visible coronary artery calcifications. Mild right hilar lymphadenopathy. For future reference, an enlarged right hilar lymph node measures 12 mm (series 7/127).CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hypoattenuating lesions in the partially visualized right kidney, likely cysts.
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1. Right upper lobe mass with right hilar lymphadenopathy, suspicious for primary lung cancer with nodal metastasis.2. Scattered small AVMs in both lungs.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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70-year-old female with rectocele and vaginal prolapse. Assess pelvic floor function. There is prompt opacification of the rectum of normal static morphology.A 1.7 cm anterior rectocele is identified. A second smaller posterolateral right sided rectocele is also present. Moderate to severe rectal prolapse is seen. FLUOROSCOPY TIME: 3:03 minutes.
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Moderate to severe rectal prolapse.Anterior and right lateral rectoceles, as above.
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Generate impression based on findings.
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43 year old female status post Roux-en-Y gastric bypass in May 2014 with history of gastro-gastric fistula in August 2014. Please assess for persistent fistula. Scout radiograph showed moderate fecal burden with a nonobstructive bowel gas pattern. Single contrast visualization of the esophagus showed no gross morphologic abnormality or evidence of obstruction. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.Postsurgical changes compatible with Roux-en-Y gastric bypass were observed. In addition to opacifying the gastric remnant and Roux limb across a patent gastrojejunal anastomosis, contrast opacified the excluded stomach and attached bilioenteric limb. Findings are compatible with persistent gastro-gastric fistula. The fistulous tract measures approximately 6 mm in width (series 7). The excluded stomach empties into the duodenal sweep as expected. No evidence of small bowel obstruction. TOTAL FLUOROSCOPY TIME: 4:50 mm:ss
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Postsurgical changes s/p gastric bypass with persistent 6 mm gastro-gastric fistula as described above.
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Generate impression based on findings.
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Chronic nasal congestion. The paranasal sinuses are clear. The nasal cavity is also clear. There is mild S-shaped nasal septum deviation. 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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1. No evidence of sinusitis.2. Mild S-shaped nasal septum deviation.
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Generate impression based on findings.
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Frontal sinus: There is moderate mucosal thickening in the bilateral frontal sinuses, right greater than left. Anterior ethmoids: Moderate to severe mucosal thickening of the anterior ethmoid air cells.Maxillary sinuses: There is complete opacification of the right maxillary sinus, and near complete opacification of the left maxillary sinus, with layering frothy material. There is resultant opacification of the right ostiomeatal complex, the left ostiomeatal complex is narrowed, but patent.Posterior ethmoids: There is near complete opacification of the right posterior ethmoid air cells and significant mucosal thickening of the left posterior ethmoid air cells.Sphenoid sinus: There is moderate to severe mucosal thickening of the bilateral sphenoid sinuses, with internal frothy material, more prominent on the left. The left sphenoethmoidal recess is opacified, the right sphenoethmoidal recess is narrowed, but patent.There is mild leftward nasal septal deviation. The nasal turbinate morphology is within normal limits. There are mild secretions in the posterior nasal cavity.The lamina papyracea are intact. The roof of the ethmoids are relatively symmetric. There is opacification of the bilateral mastoid air cells, right greater than left. There is fluid present within the right middle ear cavity. There are calcific foci in the left parotid gland, likely representing calculi, also present on prior exam.
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1. Severe pan-sinus disease, with near-complete opacification of the majority of the paranasal sinuses, in a nonspecific pattern of obstruction.2. Opacification of the bilateral mastoid air cells, and fluid within the right middle ear cavity.
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Generate impression based on findings.
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Patient with osteosarcoma, evaluate for metastases. LUNGS AND PLEURA: Bilateral multifocal surgical changes related to wedge resections are again seen. 5-mm perifissural left upper lobe nodule (image 44, series 4) unchanged. Previously identified left lower lobe nodule also unchanged (image 54, series 4). Unchanged right pleural thickening. Unchanged pinpoint 3-mm subpleural right lower lobe nodule (image 77, series 4).MEDIASTINUM AND HILA: The heart size is normal as is the caliber the great vessels. There is no evidence of pleural or pericardial effusion. The trachea and mainstem bronchi are patent. The left chest wall Port-A-Cath has been removed.CHEST WALL: There are no lytic or sclerotic lesions identified within the imaged axial or appendicular skeleton to suggest osseous metastasis. There is no evidence of axillary, subpectoral, cardiophrenic or retrocrural lymphadenopathy on the basis of size criteria.UPPER ABDOMEN: No significant abnormality noted.
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1.Bilateral pulmonary nodules, measuring up to 5-mm unchanged from the previous examination. 2.Pleural thickening unchanged.3.Interval removal of the left chest wall Port-A-Cath.
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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 septum 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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Chronic sinusitis with nasal congestion and discharge. There are postoperative findings related to endoscopic sinus surgery, including left middle meatus antrostomy, left middle turbinectomy, and partial left ethmoidectomy. At least a portion of the left uncinate process appears to be intact, however. There is opacification of a posterior left ethmoid air cell. The paranasal sinuses are clear. The nasal cavity is clear. The nasal septum 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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Apparent postoperative findings related to endoscopic sinus surgery with opacification of a posterior left ethmoid air cell. The other paranasal sinuses and nasal cavity are clear.
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Generate impression based on findings.
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9-year-old female with distended abdomen with active bowel sounds, rectal exam negative for thecal retentionVIEW: Abdomen AP (one view) 02/05/15 Desiccated stool within the rectum and descending colon. Large amount of amorphous stool throughout the transverse and ascending colon. Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
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Above average stool burden.
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Generate impression based on findings.
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Chronic sinusitis. The paranasal sinuses are clear. The nasal cavity is also clear. The nasal septum is deviated slightly towards the left. 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. The mastoid air cells and middle ear cavities are clear. There is mild irregularity, sclerosis, and subchondral cyst formation in the bilateral mandibular condyles.
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1. No evidence of sinusitis or nasal polyposis.2. Mild bilateral temporomandibular joint degenerative changes.
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Generate impression based on findings.
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10-week-old female with increased desaturationsVIEW: Chest AP (one view) 02/06/15 ET tube is not seen and may have been removed. NG tube terminates in the stomach. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Right upper and middle lobe opacities with improvement of left basilar opacities.Gas distended loops of bowel with amorphous stool in the rectum and descending colon. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
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Right upper and middle lobe atelectasis. Disorganized bowel gas pattern.
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Generate impression based on findings.
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There are multiple T2 hyperintense lesions throughout the cervical cord . These include the left paracentral and central dorsal cord at C2, right greater than left lateral aspect of the cord at C3, ventral C4, left C5 to C6, right C7, and right C7-T1. There is abnormal enhancement involving the lesions at C2, right greater than left C5-C6, and C7 levels consistent with active demyelination.The cervical spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is no significant disk disease, spinal canal or foraminal stenosis within the cervical spine. THORACIC SPINE
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Multiple T2 hyperintense lesions throughout the cervical cord, and to a lesser degree thoracic cord, consistent with known demyelinating disease. Some of these lesions demonstrate enhancement, as detailed above, compatible with active demyelination.
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Generate impression based on findings.
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Chronic sinusitis. There is mild diffuse mucosal thickening in the maxillary, ethmoid sinuses, and sphenoid sinuses. There is also suggestion of an air-fluid level in the right maxillary sinuses. The frontal sinuses are not pneumatized. The nasal cavity is clear. The nasal septum is essentially midline, but contains a 5 mm wide defect in the cartilagenous portion. 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. The middle ear cavities and mastoid air cells are clear.
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Mild diffuse paranasal sinus mucosal thickening with suggestion of acute right maxillary sinusitis.
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Generate impression based on findings.
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66 year old female with history of left ureteral stent. Now has symptoms in the same distribution. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or hydroureter. No visible collecting system stones.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No small bowel obstruction or free air. Nonspecific short segment bowel wall thickening in the proximal jejunum, may represent peristalsis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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: No significant abnormality noted
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No hydronephrosis or hydroureter, and no other findings to explain the patient's pain.
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Generate impression based on findings.
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Stage IVA T3N2bM0 left tonsillar squamous cancer, status post induction chemotherapy with carbo/taxol and currently undergoing chemoradiation. There is no significant interval change in size of a necrotic left level 2 lymph node, which measures 9 mm in short axis, previously 9 mm. There is no evidence of measurable mass lesions in the left tonsillar region. The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. There is a right internal jugular venous catheter. The osseous structures are unchanged, including a left molar extraction cavity. The airways are patent. There is a carious tooth # 2 with periodontal disease and corresponding hypermetabolism on PET. There is partial opacification of the bilateral maxillary sinuses. The hypermetabolic lesion in the left pituitary gland is not readily apparent on CT. The imaged portions of the lungs are clear.
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1. No significant interval change in the treated left suprahyoid lymphadenopathy and no measurable tumor in the left tonsillar fossa.2. Carious tooth # 2 with periodontal disease and corresponding hypermetabolism on PET due to associated inflammation.3. The hypermetabolic lesion in the left pituitary gland is not readily apparent on CT. A dedicated pituitary MRI may be useful for further evaluation, if clinically warranted and there are no contraindications.
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Generate impression based on findings.
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Preterm infant with left lower lobe pneumonia.EXAMINATION: Oropharyngeal motility study 2/6/2015 Julie Eccelsonte, speech and language therapist, supervised the examination.39 seconds of fluoroscopy was used.PRESENTATIONS: The patient was presented with thin liquids via a slow flow nipple as well as half-strength nectar thickened liquids via a slow flow and medium flow nipple.RESULTS: Slightly decreased latching was noted initially. Penetration was evident with thin liquids via a slow flow nipple as well as half-strength nectar thickened liquids over time. Trace aspiration was evident. Nasopharyngeal regurgitation with audible congestion was evident. Decreased sucking, swallowing and bolus coordination as well as delayed airway closure with extended sucking was noted.
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Penetration and trace aspiration as detailed above.Please see the speech and language therapist's report for feeding recommendations.
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Generate impression based on findings.
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Ms. Bingmonhill is a 66 years year old female with a personal history of left breast lumpectomy in 2006 for DCIS followed by radiation therapy. She also has a benign left breast biopsy in 2013 for fat necrosis. Family history of breast cancer in mother. No current breast related complaints. Three standard views of both breasts, a laterally exaggerated left CC view, and five spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and dystrophic calcifications present within the left lumpectomy site. Just superior to the lumpectomy site is an elongated area of increased density with similar dystrophic calcifications that was biopsied in 2013 with a result of fat necrosis. In addition, just anteroinferior to the main lumpectomy site is an ovoid area of focal asymmetry with developing calcifications. The ovoid density is stable in size when compared to prior area, however, the calcifications are increased. Spot magnification views of this area were performed to confirm the presence of similar appearing calcifications as the lumpectomy site, favoring benign dystrophic calcifications. These are presumably of the same process of fat necrosis. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the right breast.
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Presumed developing fat necrosis anterior to the main lumpectomy site in the left breast. A left unilateral diagnostic mammogram is recommended in 6 months to ensure stability of these findings. All results and recommendations were relayed to the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).
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Generate impression based on findings.
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40 year-old female with patella instability There is flattening and slight convexity of the femoral trochlea superiorly, indicating dysplasia. The TT-TG distance measures 2 cm, which is abnormal. The Insall-Salvati ratio measures approximately 1.5, which is abnormal and indicative of patella alta. There slight lateral translocation of the patella with respect to the femoral trochlea. The muscles about the knee appear normal. No fracture is noted.
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Findings compatible with patellar instability including trochlear dysplasia, increased TT-TG distance and patella alta.
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Generate impression based on findings.
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58 year old female with history of metastatic breast cancer. Evaluate response to treatment and compare with previous scans. Measurements per recist criteria. Hepatic metastases. CHEST:LUNGS AND PLEURA: Left upper lung calcified granuloma. No pleural effusion or significant abnormality otherwise.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Right internal jugular vein thrombosis superior to the Port-A-Cath. Right chest dual lumen Port-A-Cath tip terminates at the superior cavoatrial junction.CHEST WALL: Right chest dual lumen port. Degenerative changes are noted about the visualized spine. Left superior lateral chest wall fluid collection in the inferior axilla (3/36) measures approximately 4.3 x 4.6 x 2 cm. Likely postoperative stroma.ABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating liver lesions are seen, corresponding with previously noted hypermetabolic lesions on PET scan, consistent with metastases. A reference left hepatic lobe metastatic lesion (3/91) measures approximately 5 x 4 cm, previously 4.1 x 3.7 cm on the 11/19/2014 CT.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate bilateral calcifications in the renal parenchyma, may represent nonobstructing stones versus arterial calcifications. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine, with mild L2 compression deformity unchanged from prior.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged, lobular uterus consistent with fibroids, some of which have coarse calcifications.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild nonspecific sclerosis of the visualized skeleton.OTHER: No significant abnormality noted.
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1.Multiple hypoattenuating liver lesions as above, with reference lesion having increased in size from prior.2.No extrahepatic metastatic lesions.
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Generate impression based on findings.
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First metacarpal fracture, evaluate healing.VIEWS: Right hand PA oblique and lateral (3 views) 2/6/2015 Interval removal of the K wire fixation devices. There is increasing indistinctness of the proximal first metacarpal fracture line with associated periosteal reaction and sclerosis compatible with healing.
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Healing proximal first metacarpal fracture as above.
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Generate impression based on findings.
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66-year-old female with bilateral knee pain, fell on knees Right knee: There is marked medial joint space narrowing with subchondral sclerosis and tricompartmental osteophytes. No discrete fracture or dislocation. No effusionLeft knee: Marked medial joint space narrowing with subchondral sclerosis and tricompartmental osteophytes. Disruption of the trabecula along the medial tibial condyle seen only on the AP view could represent a nondisplaced tibial plateau fracture in the appropriate clinical setting despite the absence of an effusion.
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Bilateral near-severe osteoarthritis. There is subtle questionable vertical disruption of the trabecular pattern along the medial tibial plateau of the left knee, which prevents exclusion of a nondisplaced tibial plateau fracture in the appropriate clinical setting. Consider CT imaging if the patient's symptoms warrant further evaluation.
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Generate impression based on findings.
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Evaluate right upper lobe atelectasis.VIEW: Chest AP (one view) 2/6/2015, 10:17 The endotracheal tube tip is below the thoracic inlet and above the carina. The nasogastric tube tip is in the body of the stomach.Improved but persistent right upper lobe opacity compatible with atelectasis. Persistent left lower lobe atelectasis, unchanged. No pleural effusion or pneumothorax. The cardiothymic silhouette is normal.
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Improved but persistent right upper lobe atelectasis.
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Generate impression based on findings.
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57-year-old male strained upper thigh while stuck in snow pile with clicking in hip There is marked joint space narrowing with subchondral sclerosis, subchondral cysts and osteophyte formation involving the hip. Given mild flattening and sclerosis of the femoral head early AVN cannot be excluded. Minimal osteoarthritic changes affect the knee.
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Severe osteoarthritis and of the hip.
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Generate impression based on findings.
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9 year old male status post osteotomy, evaluate healing.VIEWS: Left forearm AP and lateral (two views) 2/6/2015 Again seen is an osteotomy of the mid-radial diaphysis affixed by an orthopedic side plate and screw device in near-anatomic alignment. No evidence of hardware complication is seen. Increasing indistinctness of the osteotomy line is evident, compatible with healing.
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Healing radial osteotomy as above.
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Generate impression based on findings.
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58-year-old male with right leg and chest numbness for past 24 hours, causing multiple falls and. There are moderate scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes, and more than expected for patient's age. A more focal area of hypoattenuation is present in the posterior limb of the left internal capsule, concerning for age indeterminant donor infarction. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with mild age-related volume loss. No extra-axial collections are identified. There is mucosal thickening of the right sphenoid sinus. There is opacification of the left mastoid air cells. A defect of the right lamina papyracea is present, likely chronic in nature. The skull and scalp soft tissues are unremarkable.
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1. Focal hypoattenuation in the posterior limb of the left internal capsule is concerning for age indeterminant lacunar infarction. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. 2. No evidence of intracranial hemorrhage or mass effect.
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Generate impression based on findings.
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14-year-old female with pleural and pericardial effusions.VIEW: Chest AP (one view) 2/6/2015, 10:26 The pericardiocentesis catheter tip projects over the left atrium, unchanged in position. Interval placement of a right upper extremity PICC with the tip terminating in the right atrium.Persistent bilateral pleural effusions, increased on the left and perhaps slightly decreased on the right. Associated basilar opacities likely reflecting compressive atelectasis, increased on the left. The cardiothymic silhouette is unchanged.
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Increased left pleural effusion and associated compressive atelectasis. Right upper extremity PICC with tip in right atrium.
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Generate impression based on findings.
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53 year-old female shoulder pain Joint space narrowing with small glenohumeral osteophytes and subchondral cysts within the glenoid, consistent with osteoarthritis. No fracture or dislocation.
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Moderate to severe glenohumeral joint osteoarthritis.
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Generate impression based on findings.
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53-year-old female with elbow pain since 12/14, concern for lateral epicondylitis Small osteophytes along the proximal ulna indicate mild osteoarthritis. No fracture or dislocation. No joint effusion.
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Mild osteoarthritis.
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Generate impression based on findings.
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75-year-old female with pain, follow-up fracture Again seen is a comminuted fracture through the surgical neck and greater tuberosity. There is mild inferior subluxation of the humeral head suggesting hemarthrosis. Callus formation along the fracture line suggests an attempt at healing.
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Healing surgical neck and greater tuberosity fracture as described above.
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Generate impression based on findings.
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76-year-old female with left hip pain Lumbar spine: Moderate degenerative disk disease at L5-S1 and mild to moderate degenerative disk disease at L4-L5. There is grade 1 anterolisthesis of L4 onL5 and L5 on S1. Moderate facet joint osteoarthritis affects the lower lumbar spine.Left hip: Mild osteoarthritis affects the hip and left SI joint.
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Osteoarthritis and degenerative disk disease as described above.
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Generate impression based on findings.
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55 year old male with a new onset occipital head ache with chest pain, evaluate for for vascular cause or dissection. The patient is a weight lifter and brick layer. CT HEAD: There is no evidence of acute intracranial hemorrhage. There is no mass effect, midline shift or herniation. Scattered periventricular and subcortical white matter hypoattenuation is noted and is nonspecific, but compatible with small vessel ischemic changes. The ventricles, sulci, and cisterns are symmetric and unremarkable. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECK: There is extensive quantum mottle in the lower neck and suboptimal bolus distribution, which limits assessment. Within this limitation, there appears to be a short-segment filling defect in the proximal right vertebral artery with suggestion of mild luminal distention. Otherwise, the remainder of the right vertebral artery opacifies. There is a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. There is no significant stenosis of the bilateral common carotid arteries, carotid bifurcations, cervical internal and external carotid arteries, and left vertebral artery. There are mild calcifications at the right carotid bifurcation. There is normal contrast opacification through anterior intracranial circulation, including the internal carotid arteries and anterior and middle cerebral arteries. There is no evidence of cerebral aneurysm.
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1. The CTA is limited due to technical factors. Within this limitation, there appears to be a short-segment filling defect in the proximal right vertebral artery with suggestion of mild luminal distention, which may represent a dissection. 2. No evidence of acute intracranial hemorrhage or mass.Discussed with Dr. Buerki at 11:55 AM on 2/6/15.
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Generate impression based on findings.
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59-year-old female with pain There is subtle lucency and disruption of the trabecula extending beneath the greater trochanter suggesting a nondisplaced fracture. Small osteophytes indicate mild osteoarthritis affecting the hip. Arterial calcifications.
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Findings suggestive of a nondisplaced fracture through the greater trochanter, correlate clinically. Findings discussed with Dr. Dirschl at the time of dictation.
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Generate impression based on findings.
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71-year-old female with hand pain at the base Right hand: The bones are slightly demineralized. Mild to moderate osteoarthritis affects the right basilar joint. Mild narrowing of scattered metacarpophalangeal and interphalangeal joints, predominantly involving first two digits.Left hand: Mild osteoarthritis affects the left basilar joint. There is narrowing of scattered metacarpophalangeal and interphalangeal joints consistent with osteoarthritis. Mild deformity of the second PIP joint may reflect old trauma.
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Mild to moderate osteoarthritis, appearing similar to the prior exam.
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Generate impression based on findings.
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31-year-old female with tenderness over fifth MTP Alignment is anatomic. The osseous structures are within normal limits for the patient's age.
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No specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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Evaluate feeding tube placement.VIEW: Abdomen AP (one view) 2/6/2015 There is an enteric feeding tube in place, with the tip terminating in the second part of the duodenum. Interval removal of the nasogastric tube. Gastrostomy tube in place.The bowel gas pattern is disorganized and nonobstructive. No pneumoperitoneum, pneumatosis intestinalis or portal venous gas is evident.Right hip dislocation and lateral uncovering of the left hip again seen. The acetabula are dysplastic. Bilateral coxa valga deformities are unchanged.
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Enteric feeding tube with tip in the second part of the duodenum.
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Generate impression based on findings.
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53-year-old female with pain, evaluate for fracture There is a transverse fracture of the mid humeral diaphysis with approximately 1 shaft width medial displacement of the distal fracture fragment and small associated osseous fragments. Glenohumeral alignment is within normal limits. Mild osteoarthritis affects the glenohumeral joint.
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Mid humeral diaphyseal fracture as described above.
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Generate impression based on findings.
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24 year-old female with history of pain. There is a small plantar calcaneal spur of questionable clinical significance. We see no fracture or specific radiographic findings to account for the patient's pain.
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Small plantar calcaneal spur of questionable clinical significance, otherwise we see no specific radiographic findings to account for the patient's pain.
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Generate impression based on findings.
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Male; 66 years old. Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Calcified right lung granulomas are unchanged. No suspicious pulmonary nodule or mass. No pleural effusion.MEDIASTINUM AND HILA: Interval removal of Port-A-Cath. No mediastinal or hilar lymphadenopathy. Normal heart size. Small amount of pericardial fluid, similar to prior study. Mild coronary artery calcifications.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small splenule medial to the spleen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral hypodense renal lesions are incompletely characterized but are unchanged and likely represent benign cysts. Retroaortic left renal vein.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Interval removal of G-tube.BONES, SOFT TISSUES: Degenerative changes are seen throughout the spine.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Male 36 years old; Reason: metastatic testes cancer needs follow up exam History: metastatic germ cell tumor CHEST:LUNGS AND PLEURA: Parenchymal scarring most marked in the left upper lobe is not a change compared to prior study. There is a new 1.2 x 1.0 cm the nodule in the right lower lobe (series 5 and image 73) which is suspicious for a metastatic lesion.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Right-sided Port-A-Cath with the tip in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypoattenuating liver lesions are too small to characterize. For example series 3, image 89.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral nephrostomy tubes in situ. The right nephrostomy tube has been repositioned since prior study. The right kidney is severely atrophic with a delayed nephrogram. There is moderate/severe left hydronephrosis.RETROPERITONEUM, LYMPH NODES: Multiple large confluent masses and loculated fluid collections , some containing dystrophic calcifications, are again seen within the retroperitoneum and pelvis. These are consistent with lymphadenopathy and metastatic disease. The IVC is occluded with marked dilatation of the lumbar vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is again noted to be severely dilated.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Multiple large masses and loculated fluid collections are identified throughout the pelvis. Right pelvic sidewall mass measures 7.1 x 7.4 cm (series 3, image 166), remeasured on prior study at 7.5 x 6.0 cm. Additional non-reference lesions are also suggested, increased in size. Multiple new solid lesions are identified throughout the pelvis impressing on the posteroinferior aspect of the bladder.BONES, SOFT TISSUES: Stable non-specific sclerotic foci which likely represent bone islands.OTHER: Diffuse anasarca.
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1.New right pulmonary nodule, suspicious for a metastatic deposit.2.Persistent large multiloculated fluid collections and solid masses of the abdomen and pelvis with interval increase compared to prior study.Findings are concerning for disease progression.
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Generate impression based on findings.
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22-year-old male with history of fracture. Again seen is a fracture through the neck of the fifth metacarpal. There is approximately 40 to 50 degrees of volar angulation of the distal fracture fragment which subjectively appears to have increased when compared to prior.
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Fifth metacarpal fracture as described above.
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Generate impression based on findings.
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Female 68 years old Reason: evaluation of lung nodules History: evaluation of lung nodules CHEST:LUNGS AND PLEURA: Focal lower lobe bronchiectasis, right greater the left. Interval development of a part solid nodule in the right upper lobe with adjacent ground glass opacity (series 7, image 33). New part solid nodule in the superior right lower lobe with adjacent ground glass opacity (series 7, image 50).New part solid nodule in the superior right lower lobe with adjacent ground glass opacity (series 7, image 60).Unchanged right upper lobe micronodule (series 7, image 18), stable since 2006.Mild dependent atelectasis. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Moderate atherosclerotic calcifications of the thoracic aorta with severe coronary artery and mitral valve calcifications.Asymmetric thickening of the distal esophagus which is increased from prior study. While this finding may suggest a small hiatal hernia, esophageal malignancy cannot be excluded.CHEST WALL: Hardware from midline sternotomy, unchanged. Moderate degenerative changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine with loss of height of the superior endplates of the L1 and L4 vertebral bodies, unchanged.OTHER: Atherosclerotic calcifications of the abdominal aorta.
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1. Multiple new part solid nodules with adjacent ground glass opacity in the right lung which are suspicious for malignancy and should have close interval follow-up. Recommend repeat thoracic CT imaging in 3 months or alternatively a PET study.2. Asymmetric thickening of the distal esophagus which has increased since prior exam. This finding may suggest a small hiatal hernia, however, esophageal malignancy cannot be excluded, and endoscopy or an upper GI study is recommended. 3. Development of lower lobe bronchiectasis.
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Generate impression based on findings.
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34-year-old male with history of pain. There are two orthopedic screws affixing bone material, presumably from the coracoid, to the anterior/inferior glenoid. There is no evidence of hardware complication. Margins of the graft are slightly less distinct suggesting some interval healing.
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Postoperative changes of Latarjet procedure as above.
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Generate impression based on findings.
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70-year-old female with history of left ankle pain. Again seen is an oblique fracture through the distal fibular diaphysis in near anatomic alignment. Callus formation indicates interval healing.
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Healing distal fibular fracture as above.
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Generate impression based on findings.
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60-year-old male with history of patella fracture. Again seen are tension wires affixing a transverse fracture of the patella in near anatomic alignment. The fracture line remains visible and perhaps slightly wider on the lateral view, but we suspect that this may be artifactual due to positioning. Mild osteoarthritis affects the knee.
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Orthopedic fixation of patellar fracture as above.
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Generate impression based on findings.
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Polydactyly.VIEWS: Right hand PA lateral and oblique (3 views) left hand PA lateral and oblique (3 views) 2/6/2015 Right Hand: Findings consistent with post-axial polydactyly. Normal formation of the first 5 metacarpals and digits. There is an additional digit arising medially near the PIP joint of the little finger which contains one small ossific density. Interval development of two carpal bones.Left Hand: Findings consistent with post-axial polydactyly. Normal formation of the first 5 metacarpals and digits. There is an additional digit arising medially near the PIP joint of the little finger which contains two small ossific densities. Interval development of two carpal bones.
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Bilateral postaxial polydactyly with normal formation of the metacarpals and first 5 digits. No significant interval change.
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Generate impression based on findings.
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87 year old female with history of pain. The bones are demineralized suggesting osteopenia/osteoporosis. Moderate osteoarthritis affects the glenohumeral and acromioclavicular joints. There is an os acromiale, a normal variant.
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Osteoarthritis and other findings as above.
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Generate impression based on findings.
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Female; 75 years old. Reason: assess ground glass opacities on CT in November History: Abnormal cT scan in 11/2014 LUNGS AND PLEURA: Previously seen ground glass nodule in the right middle lobe and groundglass density in the left lower lobe have both resolved, most compatible with post inflammatory etiology.Stable focal ground glass opacity in the right upper lobe, which has been present since at least 2009 and may be secondary to prior radiation (series 5/65).Stable 15-mm rounded ground glass opacity in the left cardiophrenic angle, which again is likely a benign area AAH (series 5/197).Stable mild basilar scarring.No new suspicious pulmonary nodule mass.No pleural effusions.MEDIASTINUM AND HILA: Stable goiterous enlargement of the thyroid with substernal extension.Mitral annulus prosthesis and calcifications of the aortic annulus and valve. Metallic or calcific density at the level of the left atrial appendage may represent exclusion device/sutures, correlate with surgical history. Coronary artery calcifications. Left ventricular apex again appears dilated and measures up to 4.8-cm, incompletely assessed without IV contrast but suspicious for aneurysmal dilatation.No mediastinal or hilar lymphadenopathy, though evaluation is mildly limited without IV contrast.CHEST WALL: Status post median sternotomy. Degenerative arthritic changes of the thoracic spine and left glenohumeral joint.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Interval resolution of ground glass nodule in the right middle lobe and groundglass density in the left lower lobe, most compatible with post inflammatory etiology. Otherwise, no interval change or evidence of metastatic disease in the chest.
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Generate impression based on findings.
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Female 78 years old; Reason: compare to prior History: metastatic lung cancer, malignant pleural effusion, PET after thoracentesisRADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 101 mg/dL. Today's CT portion grossly demonstrates large right-sided pleural effusion which has increased from prior outside hospital pet scan. There is an adjacent patchy basilar opacity in the right lower lung. There are surgical sutures in the right upper lung. There are right paratracheal and subcarinal some small lymph nodes. There are surgical clips in the pericardium. There are post cholecystectomy clips noted.Today's PET examination is slightly limited due to diffuse muscle activity. There are 3 new foci in the right paratracheal region (SP Max 3.9), subcarinal region (SUV max 3.9), and right perihilar region (SUV max 3.2) which correlate with lymph nodes noted on CT and are suspicious for nodal metastatic disease.There is minimally to the in the patchy right lower lung opacity consistent with inflammatory change.
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Findings suspicious for nodal metastatic disease in the right paratracheal, subcarinal and right perihilar regions.
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Generate impression based on findings.
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left side numbness NONCONTRAST CT HEADNo change of right internal capsule and left centrum semiovale since prior exam.No evidence of acute hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKBilateral carotid bifurcations show wall thickening with calcification indicating atheromatous plaques. Especially on the left side there is about 40% of luminal stenosis on extracranial left ICA just above the bifurcation. The right side extracranial ICA shows less than 10% of luminal stenosis with wall calcification.Aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries appear to be patent without any significant luminal stenosis but the courses are tortuous. The bilateral vertebral artery origins are normal.There is normal contrast opacification through bilateral ICAs, MCAs and ACAs.Acom artery is patent and the left Pcom artery is patent but the right Pcom artery is not seen.No evidence of 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. Extracranial arterial wall calcifications with tortuosity indicating atherosclerotic changes.2. Identified calcified carotid atheromatous plaques on bilateral carotid bulbs with about 40% of luminal stenosis on the left and less than 10% luminal stenosis on the right.3. Normal intracranial arterial system without evidence of intracranial arterial aneurysm or significant luminal stenosis.
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