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Generate impression based on findings.
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58 -year-old recalled from screening for a focal asymmetry in the right retroareolar region. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The focal asymmetry in the right retroareolar region disperses with spot compression. Normal-sized intramammary lymph node again noted in the right upper breast. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. 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 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 66 years old; Reason: prostate cancer, rising psa, concern for mets No abnormal osseous foci are identified to indicate metastatic disease.Degenerative changes in the bilateral acromioclavicular joints, cervical spine, lumbar spine and knees. Fusion of the kidneys corresponds to horseshoe kidney configuration noted on CT.
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No evidence of bone metastases.
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Generate impression based on findings.
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Seven-year-old female with NG tube advancementVIEW: Abdomen AP (one view) 02/06/15 Gastrostomy tube is in place. NG tube is coiled within the stomach with tip at the antropyloric region. Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Body wall edema is again noted.Right hip dislocation is again noted. The acetabula are dysplastic. Bilateral coxa valga deformities with mild uncovering of the left femoral head.
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NG tube is coiled within the stomach with tip at the antropyloric region.
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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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Female, 66 years old, history of metastatic breast cancer and lower back pain, evaluate bony anatomy for planned kyphoplasty. The osseous structures demonstrate a mottled pattern of CT attenuation with areas of sclerosis intermixed with areas of lucency compatible with widespread metastatic disease.In the thoracic region, compression deformities of the T6 and T8 vertebral bodies are seen, both with 40 to 50% loss of vertebral body height. Mild loss of height and/or anterior wedging is seen at T5, T7, and T9. T11 shows approximately 40% loss of vertebral body height centrally.In the lumbar region, a severe compression deformity of the L1 vertebral body is seen with near complete loss of vertebral body height centrally. The remaining lumbar levels show relative preservation of height. The thoracic kyphosis is exaggerated. The lumbar lordosis is relatively smooth and physiologic. Except as discussed above, vertebral bodies are well aligned with respect to one another.Mild retropulsion and/or extraosseous tumor spread is seen at T6, T11 and L1. These findings are better assessed on prior MRI. Likewise, details of spinal canal and foraminal narrowing are better assessed on prior MRI.Multiple subcutaneous nodules are seen within the upper back. Bilateral pleural effusions are demonstrated.
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1. Diffuse osseous metastatic disease.2. Multiple compression deformities, most severely affecting T6, T8, T11 and L1.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Percutaneously placed clip is present in the left upper inner quadrant. Benign calcifications are unchanged 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: NSA - Screening Mammogram.
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Generate impression based on findings.
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Reason: assess for mass or bleed History: right sided HA for 8 days The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Incidental note is made of partial empty sella.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific.
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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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Thyroid cancer with pulmonary metastases status post thyroidectomy . HEAD: There is no evidence of intracranial mass lesion. There is mild global volume loss. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are right sphenoid and maxillary sinus retention cysts. The imaged mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants.NECK: There are postoperative findings related total thyroidectomy and left neck dissection. There is no evidence of mass lesions or significant cervical lymphadenopathy. The major salivary glands are unremarkable. There is unchanged atherosclerotic calcification of both proximal internal carotid arteries resulting in severe stenosis on the right and mild on the left. There are moderate cervical spine degenerative changes including reversal of the normal cervical lordosis and multilevel loss of disc height and endplate degenerative changes. The osseous structures are otherwise unremarkable. The airways are patent. The imaged portions of the lungs are clear. There are multiple dental caries and periapical lucencies.
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1.No evidence of locoregional tumor recurrence or significant lymphadenopathy.2.No evidence for intracranial metastases.3.Severe right internal carotid artery stenosis.4.Multiple dental caries including apical periodontitis.
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Generate impression based on findings.
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5-month-old female with fever, evaluate for opacity and evidence of aspirationVIEWS: Chest AP/lateral (two views) 02/06/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Large lung volumes and peribronchial cuffing suggestive of bronchiolitis/reactive airway disease. No focal pulmonary opacities.
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Bronchiolitis/reactive airway disease pattern.
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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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51-year-old male with history of shoulder pain. Evaluate for rotator cuff/labral tear. ROTATOR CUFF: We see no rotator cuff tendon tear; however, the supraspinatus muscle appears atrophic relative to the remaining rotator cuff (best visualized on series 80212).SUPRASPINATUS OUTLET: There is widening of the acromioclavicular joint presumably due to resection. We see no contrast within the subacromial/subdeltoid bursa. Tiny density inferolateral to the acromion process likely represents calcification and we do not suspect that this represents contrast material.GLENOHUMERAL JOINT AND GLENOID LABRUM: Blunting of the superior labrum with a small undersurface defect may represent a sublabral sulcus or SLAP tear. The anterior and posterior labrum appear intact. There is blunting of the inferior labrum from the 5 to 7 o'clock position with contrast approaching the inferior aspect of the glenoid, and hence we cannot exclude the possibility of a labral tear. There is a focal defect of articular cartilage along the posterior/inferior glenoid with underlying lucency possibly resenting a noncommunicating cyst. There is also loss of articular cartilage along the inferior and posterior aspect of the humeral head.BICEPS TENDON: The patient has undergone biceps tenodesis.
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1.Postoperative changes of prior shoulder arthroscopy including biceps tenodesis and subacromial decompression.2.Supraspinatus muscle atrophy with no evidence of rotator cuff tear.3.Glenohumeral cartilage loss posterior and inferiorly.4.Superior/inferior labral abnormalities as above of unknown clinical significance. We see no classic Bankart or posterior labral tear.
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Generate impression based on findings.
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Male; 73 years old. Reason: aspiration pna? History: new oxygen requirement, diffuse interstitial opacification on CXR, lethargy, leukocytosis LUNGS AND PLEURA: There are patchy and nodular opacities diffusely in both lungs in a peribronchial distribution with dense, confluent consolidation in the posterior left upper lobe and most of the left lower lobe. Overall, the findings are most compatible with severe multifocal pneumonia with endobronchial spread of infection. Moderate amount of debris is seen in the airways at the level of the carina extending into both the right and left mainstem bronchus. Trace right pleural effusion.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Moderate coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. NG tube in place. Cholecystectomy clips. IVC filter partially visualized.
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Findings most compatible with severe multifocal pneumonia. Debris in the airways as above may indicate aspiration as a source.
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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. Focal asymmetry in the left breast at 12 o'clock position is unchanged. 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 63 years old; Reason: Lung Transplant Evaluation History: sob The comparison chest radiograph performed on 2/6/2015 demonstrates moderate to severe emphysema. The ventilation images show heterogeneous abnormally decreased ventilation bilaterally, more prominent and in the upper and middle lungs. There is diffuse abnormal Xe-133 retention in both lungs during the wash-out phase. The perfusion images show heterogeneous abnormally decreased perfusion bilaterally more prominent in the upper and middle lungs which is matched to the defects on the ventilation images. Quantitation of relative single breath ventilation (using the posterior image):Left lung: 45% (upper lung 7%; middle lung 15%; lower lung 22%)Right lung: 55% (upper lung 7%; middle lung 22%; lower lung 26%)Quantitation of relative pulmonary arterial perfusion (using anterior and posterior geometric means):Left lung: 58% (upper lung 11%; middle lung 27%; lower lung 19%)Right lung: 42% (upper lung 6%; middle lung 27%: lower lung 9%)
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Matched ventilation perfusion defects as quantified above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard and pushback views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Bilateral retroglandular silicone implants are unchanged in position and contour. 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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60 year old male with history of manometry-proven achalasia s/p Botox injections who presents with dysphagia and chest tightness. Scout radiograph of the chest was unremarkable.Single contrast evaluation of the esophagus demonstrated a markedly distended/patulous esophagus containing debris. Tapering of the distal esophagus with narrowed channel measuring 2.3 cm in length at level of gastroesophageal junction was observed. Findings are consistent with patient's known history of achalasia. Fluoroscopic evaluation of esophageal peristalsis showed a persistently patulous, flaccid esophagus and lack of a normal primary peristaltic wave, compatible with major esophageal motility disorder. TOTAL FLUOROSCOPY TIME: 3:53 mm:ss
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1.Patulous, debris containing esophagus which terminates in a narrowed channel at the level of the gastroesophageal junction, consistent with the patient's known diagnosis of achalasia. 2.Major esophageal motility disorder as described above, also compatible with underlying achalasia.
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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. Multiple dilated veins are projected over 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: NSC - Screening Mammogram.
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Generate impression based on findings.
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Reason: 55 yo male with HCC please screen for mets No abnormal osseous foci are identified to indicate metastatic disease.Mild activity in the cervical spine, knees, right 1st MTP joint likely degenerative in nature. Two foci of minimally increased activity involving the right posterior ribs correlate with healed fractures on CT.
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No evidence of bone metastases.
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Generate impression based on findings.
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Reason: r/o mastoiditis, brain abscess; chronic otitis media and h/o mastoiditis History: seizures Temporal bones:The left mastoid air cells and middle ear are completely opacified and the septations within the left mastoid air cells are thickened. The right mastoid air cells are partially opacified and the septations within the right breast there are cells are thickened. There is no significant change in compared to 2/13/13 exam.The external and internal auditory canals are symmetric in diameter and intact. The middle ear structures are intact. The courses of the facial nerves were followed and appear intact. The vestibular aqueduct is identified and is within normal limits. The course of the eustachian tube is intact. The jugular foramen is intact. The carotid canal is intact. Foramen spinosum is identified and is intact.Head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is some mucosal thickening in the visualized paranasal sinuses. The visualized portions of the orbits are intact.
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1.No evidence for intracranial infection.2.Findings are compatible with a chronic otomastoiditis on the left side and chronic mastoiditis on the right.
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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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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. Stable lobulated mass is present in the right retroareolar region. Stable fatty mass is seen in the left lower outer quadrant, likely fibroadenolipoma.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: NSA - Screening Mammogram.
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Generate impression based on findings.
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14-year-old female with chest tube placementVIEW: Chest AP (one view) 02/06/15, 1446 hour Right upper extremity PICC tip is at the superior cavoatrial junction. Pericardial drain is in place. Left chest tube placement.Cardiothymic silhouette remains enlarged. Layering left greater than right pleural effusion and left basilar opacity is unchanged.
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Interval placement of left chest tube. Persistent layering left greater than right pleural effusion and left basilar opacity.
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Generate impression based on findings.
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65 years old Female. Reason: Restaging. History of anal cancer with liver metastases. Now with inguinal recurrence. RADIOPHARMACEUTICAL: 11.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 108 mg/dL. Today's CT portion grossly demonstrates a micronodule in the right upper lobe of the lung and new enlarged lymph nodes in the right inguinal region. Soft tissue density is seen in the right maximal sinus.Today's PET examination demonstrates intense FDG uptake is seen in the right inguinal conglomerate lymph nodes with a maximum SUV of 17.9.A focus of increased FDG uptake is seen in the left facet joints of the of the upper cervical spine and upper sacral spine.Previously identified FDG avid tumor in the liver and sigmoid colon have resolved.Physiological activity is seen in the liver, spleen, intestines and bladder. There is no abnormal FDG uptake in the soft tissue density in the right maxillary sinus. The micronodule in the right upper lobe is not seen on PET imaging, which is beyond the resolution of the FDG PET imaging.
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1.Hypermetabolic lymph nodes in the right inguinal region, consistent with the patient's diagnosis of nodal metastasis. No other definite evidence of FDG avid tumor.2.Nonspecific micronodule in the right upper lobe, suggest follow-up if clinically indicated.
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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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57-year-old female with history of fall. There is soft tissue swelling anterior to the patella. We see no acute fracture.
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Soft tissue swelling anterior to the patella without acute fracture.
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Generate impression based on findings.
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80 year old female status post Dobbhoff placement. Lower pelvis excluded from field of view. Dobbhoff tip in gastric body. Nonobstructive bowel gas pattern. Levoscoliosis again noted. Subpleural right lower lobe airspace opacity; please see same day chest radiograph for further details.
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Dobbhoff tip in gastric body.
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Generate impression based on findings.
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Male 56 years old; Reason: infection/abnormality History: swelling, cellulitis, pain to left testicle RIGHT TESTIS: The right testis has normal homogeneous echogenicity with normal vascularity and arterial waveforms identified.LEFT TESTIS: The left testis has normal homogeneous echogenicity with normal vascularity and arterial waveforms identified.RIGHT EPIDIDYMIS: The right epididymis is normal in appearance measuring 0.8 x 0.6 x 0.7 cm.LEFT EPIDIDYMIS: Left epididymis appears enlarged, heterogeneous with increased vascularity measuring 1.3 by 1.8 x 1.0 cm. Small left epididymal simple appearing cyst measures up to 4 mm.OTHER: There is a small left hydrocele.
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1.Enlarged heterogeneous left epididymis with increased vascularity consistent with left epididymitis.2.No evidence of torsion.
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Generate impression based on findings.
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33-year-old female with history of pain. There is an oblique fracture through the tip of the distal fibula extending to the tibiotalar articulation. Densities posterior to the talus likely represent small posterior malleolar avulsion fractures. Additionally, there is widening of the medial ankle mortise suggesting ligamentous injury. There is moderate soft tissue swelling about the ankle.
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Distal fibula and posterior malleolar fractures as above with widening of the medial ankle mortise suggesting ligamentous injury.
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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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40 year-old male with history of knee pain. Right knee: There are postsurgical changes of prior ACL reconstruction. Tricompartmental osteophytes and joint space narrowing most severely at the tibiofemoral articulation compatible with moderate to severe osteoarthritis.Left knee: Tricompartmental osteophytes and joint space narrowing worse in the tibiofemoral articulation compatible with moderate to severe osteoarthritis. There are enthesophytes along the inferior aspect of the patella.
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Osteoarthritis 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 heterogeneously dense, unchanged in pattern and distribution. Stable scattered benign calcifications are present in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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73-year-old male with history of shoulder pain. Mild to moderate osteoarthritis affects the acromioclavicular and glenohumeral joints. We see no acute fracture.
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Osteoarthritis as above.
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Generate impression based on findings.
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49 year old female with history of abdominal pain and nausea. History of ventral hernia. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Approximately 3 cm hypoattenuating liver dome lesion is unchanged, likely cysts. Cholecystectomy clips are seen. No significant abnormality otherwise.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No small bowel obstruction or free air. Small fat-containing umbilical hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Heterogeneous uterus consistent with fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No small bowel obstruction or free air. Small fat-containing umbilical hernia.OTHER: No significant abnormality noted
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No small bowel obstruction or bowel containing ventral hernia appreciated.
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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. Prominent vasculature in both breasts is unchanged. 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 heterogeneously dense. 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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61-year-old male with history of pain. Evaluate for first and second toe osteomyelitis. There is soft tissue irregularity and swelling about the 1st and 2nd toes. We see no radiographic findings of osteomyelitis. Moderate to severe degenerative disease affects the 1st MTP joint with relatively mild degenerative arthritic changes affecting the remaining foot. Mild hallux valgus deformity. Scattered arterial calcifications are present.
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Soft tissue swelling and irregularity with no specific radiographic findings of osteomyelitis. If patient care warrants further imaging, a triple phase bone scan or MRI may be obtained.
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Generate impression based on findings.
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History of nasopharyngeal cancer status post resection and radiation in 2000. Now with worsening dysphagia, left neck pain and left otalgia. There are post-treatment findings related to radiation therapy to the neck, right hemithyroidectomy, and neck dissection. There is unchanged soft tissue prominence of the left posterior lateral nasopharyngeal wall without definite evidence of discrete mass lesions. There is no significant cervical lymphadenopathy. For example, there is an unchanged right pretracheal lymph node that measures up to 8 mm, previously also 8 mm. The salivary glands are unremarkable. The airways are patent. There is mild atherosclerotic plaque at the right carotid bifurcation. There postoperative findings related to left carotid endarterectomy. There is extensive multilevel degenerative spondylosis. There is persistent partial opacification of the left mastoid air cells. The partially imaged intracranial bilateral medial temporal lobe volume loss. There are bilateral lens implants.
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1. Post-treatment findings with unchanged soft tissue prominence of the left posterior lateral nasopharyngeal wall without definite evidence of discrete mass lesions. However, MRI is more sensitive for the detection of nasopharyngeal tumors.2. Partially imaged intracranial bilateral medial temporal lobe volume loss, suggestive of Alzheimer disease. Please refer to the prior brain MRI report for additional details.
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Generate impression based on findings.
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Reason: eval for bleed or mass History: unrelenting headaches w/ no h/o HA The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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No evidence for acute intracranial hemorrhage mass effect or edema.
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Generate impression based on findings.
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Bilateral adnexal masses and elevated CEA 125. Assess for metastatic disease. Assess compression of IVC filter CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Presumed substernal thyroid nodule measuring 3.3 x 2.8 cm (image 13; series 3).CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: 1.8 x 1.1 cm low density nodule near the bare area of the liver posteriorly (image 91; series 3), unchanged.SPLEEN: No significant abnormality notedPANCREAS: Splenule is unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructive right renal calculus.RETROPERITONEUM, LYMPH NODES: Indwelling IVC filter with no significant compression. Multiple surgical clips noted adjacent to the filterBOWEL, MESENTERY: No significant abnormality noted. Ventral abdominal hernia containing small bowel, nonobstructive.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No measurable peritoneal disease.PELVIS:UTERUS, ADNEXA: Status post TAH/BSO.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. No significant compression on indwelling IVC filter. 2. Status post TAH/BSO. 3. No measurable peritoneal disease. 4. Nonspecific low density nodule along the liver capsule, stable. 5. Nonobstructive right renal calculus, unchanged. 5. Ventral hernia containing small bowel, nonobstructive.
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Generate impression based on findings.
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62-year-old female with history of pain. Mild osteoarthritis affects the acromioclavicular joint. The glenohumeral joint is unremarkable.
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Mild AC joint osteoarthritis.
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Generate impression based on findings.
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Female 35 years old; Reason: hematuria, renal stone or mass? History: gross hematuria ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Two subcentimeter hypoattenuating lesions are too small to characterize but likely represent cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal stones. No perinephric stranding. Subcentimeter hypoattenuating lesions are too small characterize. No focal renal mass. There is prompt uptake and excretion of contrast on delayed images without filling defect within the collecting system.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small hyperattenuating lesion which appears to be located within the distal vagina likely represents a Bartholin's gland cyst.
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1.No renal stone or mass. No filling defect identified within the collecting system. No specific cause for patient's hematuria is identified.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Female 31 years old; Reason: neuroendocrine tumor s/p pancreatectomy and SBRT to liver metastasis. evaluate for progression. History: nausea, pain CHEST:LUNGS AND PLEURA: Stable 4-mm right lower lobe lung nodule (series 9, image 57). Additional micronodules are unchanged. Right middle lobe and right lower lobe consolidation which may represent radiation pneumonitis.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: A hypervascular metastatic lesion in segment 8 measures 2.7 x 2.4 cm (series 7, image 75), reduced compared to prior where it measured 3.3 x 2.8 cm. No new lesions are identified. Stable appearance of the left hepatic lobe hypoattenuating lesion which is nonspecific but favor benign etiology (series 6, image 14).SPLEEN: The spleen is absent. Stable appearance of enhancing nodules in the left paracolic gutter/splenic bed (series 7, image 103).PANCREAS: Postsurgical changes of prior pancreatectomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable appearance of mildly prominent retroperitoneal lymph nodes, all measuring less than 1 cm in short axis dimension.BOWEL, MESENTERY: Surgical changes of prior partial gastrectomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Continued decrease in size of previously noted segment VIII metastatic lesion.2.Right middle and lower lobe consolidation which may represent radiation pneumonitis.3.Stable nonspecific pulmonary micronodule.4.Stable appearance of nonspecific enhancing nodules in the left paracolic gutter/splenic bed.
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Generate impression based on findings.
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5-month-old male with lethargy and altered mental status. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of acute intracranial hemorrhage, edema or mass effect.
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Generate impression based on findings.
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48-year-old female with history of pain. Redemonstrated is a minimally displaced fracture of the "posterior malleolus" appearing similar to prior. Tiny fixed ossicle adjacent to the distal fibula may represent old trauma. There is a small tibiotalar joint effusion.
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Posterior malleolar fracture appearing similar to prior.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is mostly fatty replaced. 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 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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69 year old female with history of pain. Moderate to severe osteoarthritis affects the glenohumeral joint with subchondral cyst formation. Mild osteoarthritis affects the acromioclavicular joint. We see no acute fracture.
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Osteoarthritis 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 extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination. 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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Increasing swelling of the bilateral neck for 5 weeks, worse last night with SOB. Neck biopsy on 2/2/15 revealed lymphoma per patient. NECK: There is extensive bilateral cervical lymphadenopathy with multiple matted nodal masses throughout the jugular chains and posterior triangles. Exact measurements of individual lymph nodes are difficult to determine; however, a well-defined right tracheoesophageal groove lymph node measures up to 20 mm. There is also stranding throughout the superficial and deep neck spaces. There is enlargement of Waldeyer's ring structures resulting in nasopharyngeal and oropharyngeal airway narrowing. There are tonsilloliths. There is moderate atherosclerotic calcification of the bilateral proximal internal carotid arteries. There is compression and occlusion of the bilateral jugular veins due to a cluster of nodal masses. There are apparent secretions within the trachea. The thyroid and salivary glands are unremarkable. There is degenerative spondylosis of the cervical spine, which is most pronounced at C4-6. The airways are patent. The imaged intracranial structures are unremarkable. There is pulmonary emphysema and multiple bilateral solid calcified and non-calcified pulmonary nodules measuring up to 4 mm. There is also nodular pleural thickening on the left.
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1.Extensive bilateral matted cervical lymphadenopathy and enlargement of Waldeyer's ring structures that results in nasopharyngeal and oropharyngeal airway narrowing are compatible with history of lymphoma.2.Extensive edema in the neck may be related to venous hypertension from bilateral jugular vein occlusion secondary to nodal mass compression and/or lymphedema.3.Moderate bilateral carotid bifurcation artery stenosis.4.No evidence for intracranial mass.5.Non-specific pulmonary nodules. Please see report from CT chest for further details. 6. Apparent secretions within the trachea suggest aspiration.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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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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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. 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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Reason: 3 year old male with CGD, pre-transplant evaluation The patient’s weight of 13.7 kg and height of 96 cm were used for all calculations.Raw GFR = 56 mL/minBSA = 0.6 m2Estimated GFR/m2 = 89 mL/min/m2Estimated GFR/m2 * 1.73 m2 (average adult BSA) = 155 mL/min (adult GFR equivalent)
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GFR measurements as above.
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Generate impression based on findings.
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History of tonsillar squamous cell carcinoma resection with flap reconstruction in 11/2011, XRT in early 2012, and chemotherapy in early 2012. There are stable post-treatment findings related to right tonsillectomy with flap reconstruction, bilateral neck dissection, radiation therapy, and right vocal cord augmentation. There is unchanged fatty degeneration of the right hemitongue, likely related to denervation. However, there is no evidence of aerodigestive track mass lesions or significant cervical lymphadenopathy. The remaining salivary glands appear unchanged. The thyroid gland is unchanged. There is diffuse mild to moderate low attenuation plaque in the bilateral carotid arteries. The right internal jugular vein is not identified. The osseous structures are unchanged. The imaged intracranial structures and orbits are unremarkable. There is a subcutaneous lesion that measures up to 22 mm in the lower posterior neck subcutaneous tissues, which likely represents a sebaceous cyst. The paranasal sinuses and mastoid air cells are clear. There is unchanged biapical scarring.
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Stable post-treatment findings without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.
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Generate impression based on findings.
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54-year-old male with pain, evaluate for RA Right hand: There is diffuse periarticular osteopenia and small cysts or erosions within the triquetrum and metacarpal heads. Possible small erosion involve the tip of the ulnar styloid. Alignment is anatomic. Left hand: There is diffuse periarticular osteopenia and questionable erosion of the ulnar styloid.Right foot: Hallux valgus and pes planus deformities. The bones are diffusely demineralized. Mild degenerative changes affect the first MTP joint.Left foot: Hallux valgus deformity. Small possible chronic erosion involving the base of the proximal first phalanx. The bones are diffusely demineralized. No discrete erosions.
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Periarticular osteopenia and questionable small cysts or erosions as described above, the constellation of which is suggestive of underlying inflammatory arthritis.
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Generate impression based on findings.
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Male 79 years old Reason: malignancy, extent History: known malignancy, concern for change in breathing LUNGS AND PLEURA: Multiple asymmetric areas of pleural thickening and nodularity bilaterally, including left mediastinal pleural thickening. The majority have an appearance consistent with past asbestos exposure. However, the presence of pleural nodules on the mediastinal surface could indicate malignancy.Large, well defined nodule in the right lower lobe measuring 15 x 11 mm (series 8, image 80).Multiple additional nonspecific calcified and noncalcified micronodules. No pleural effusion or consolidation.Mild apical paraseptal emphysema.Mild dependent atelectasis.MEDIASTINUM AND HILA: Bilateral low cervical lymph node enlargement measuring up to 2.3 cm in short axis on the right (series 6, image 5). Mildly prominent bilateral mediastinal lymph nodes abnormal in multiplicity, with scattered enlarged lymph nodes such as a 12-mm lymph node in the lower left paraesophageal/inferior pulmonary ligament region (6/62). Mild left hilar lymphadenopathy (series 6, image 50).Normal heart size without pericardial effusion. Atherosclerotic calcifications of the aorta and its branches with mild coronary artery calcifications. Debris is noted within the trachea without evidence of significant stenosis. Distended air-filled esophagus. CHEST WALL: No axillary lymphadenopathy. Multiple sclerotic lesions in the thoracic spine, which appear degenerative in etiology.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Nonspecific nodular thickening of the adrenal glands, left greater than right (6/98) incompletely evaluated.Punctate calcifications in the pancreatic tail.Accessory splenule is noted.
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1.No acute pulmonary abnormality, except for minimal debris within the trachea. No evidence of pulmonary edema or infection. 2.Signs of asbestos exposure with nodular pleural thickening along the mediastinal pleural surface which may be an indicator of mesothelioma or other pleural neoplasm. This may be further evaluated with PET scan if required.3.Multiple nonspecific pulmonary nodules. Pulmonary involvement by lymphoma cannot be excluded.4.Mild thoracic lymphadenopathy. Per clinical service, patient has history of lymphoma.
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Generate impression based on findings.
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70-year-old male status post shoulder surgery Hardware components of a reverse ball and socket arthroplasty device are situated in near anatomic alignment without evidence of complication. The bones are diffusely demineralized. Mild osteoarthritis affects the acromioclavicular joint.
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Reverse shoulder arthroplasty without evidence of hardware complication.
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Generate impression based on findings.
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57-year-old male, evaluate for gout Right foot: Moderate osteoarthritis affects the first MTP and IP joints as well as the midfoot. Mild soft tissue swelling about the great toe. A posterior calcaneal heel spur is noted. No discrete erosions are noted.Left foot: Moderate arthritis affects the first MTP joint. Small lucencies within the distal first metatarsal may represent chronic erosions or cysts. Several anchors are noted within the posterior calcaneus, likely from prior surgical repair.Left elbow: Small ossicles adjacent to the medial and lateral epicondyles may represent old injury. There is no joint effusion or discrete erosion.
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Arthritic changes predominately affecting the first MTP joints bilaterally and additional findings as described above.
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Generate impression based on findings.
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40 years old, Female, Reason: r/o adenopathy, recurrence History: h/o thyroid cancer MEASUREMENTS: Patient status post thyroidectomy.RIGHT LOBE: Patient status post thyroidectomy. No suspicious nodules or masses.LEFT LOBE: Patient status post thyroidectomy. Very small hypoechoic focus is unchanged from prior exam measuring 0.2 x 0.1 x 0.3 cm.ISTHMUS: Patient status post thyroidectomy. No suspicious nodules or masses.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 2 benign-appearing lymph node measures 0.4 x 0.2 x 0.9 cm. Left level 2 benign-appearing lymph node measures 0.8 x 0.3 x 0.7 cm.OTHER: No significant abnormality noted.
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Stable ultrasound examination with no evidence of recurrent disease or lymphadenopathy.
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Generate impression based on findings.
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76 year old female with history of metastatic lung cancer. Shortness of breath and low back pain. LUNGS AND PLEURA: Peripheral/subpleural reticular opacities with moderate traction bronchiectasis in a pattern compatible with NSIP is similar to prior.Reference right upper lobe nodule (4/30) is unchanged in size at 20 mm.Reference right lower lobe nodule (4/81) is unchanged in size.MEDIASTINUM AND HILA: Right hilar mass (3/43) is unchanged in size at 42 mm. There is adjacent reticulation which may represent lymphatic obstruction or lymphatic spread of tumor, appearing similar to prior. There is associated attenuation of the pulmonary vessels coursing through this lesion.Reference lymph node anterior to the superior vena cava (3/29) is unchanged in size.Reference and right hilar lymph node (3/53) has increased in size, measuring 2.8 x 2.8 cm, previously 2 x 2.6 cm.Moderate coronary artery calcifications. No pericardial effusion or cardiomegaly.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst, unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerosis of the aorta and its branches.BOWEL, MESENTERY: Low-density approximately 4 x 3.4 cm rounded, well marginated collection posterior to the cecum and abutting the kidney, nonspecific and can represent a colonic duplication cyst or lymphatic malformation. This is unchanged and likely benign.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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1.Right hilar mass with reference lesions as above.2.No evidence of new metastatic disease.3.Unchanged pulmonary fibrosis.
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Generate impression based on findings.
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31-year-old male status post ankle fracture fixation Orthopedic sideplate and screws affix the distal fibula fracture in near anatomic alignment. An orthopedic screw also affixes the medial malleolus fracture in near anatomic alignment. There is no evidence of hardware complication. There is mild soft tissue swelling about the ankle.
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Orthopedic fixation of ankle fractures without evidence of hardware complication.
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Generate impression based on findings.
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56-year-old female with pain Severe osteoarthritis affects the knee. There is approximately 9 degrees varus deformity of the knee relative to the neutral mechanical axis. Moderate osteoarthritis affects the hip and mild osteoarthritis affects the ankle.
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Osteoarthritis and varus deformity.
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Generate impression based on findings.
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69-year-old female with history of pain. Moderate degenerative disc disease affects the cervical spine particularly at C6-7. The prevertebral soft tissues are within normal limits. Vertebral body heights are maintained. The neuroforamina are grossly patent.
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Moderate degenerative disc disease as above.
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Generate impression based on findings.
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Female, 63 years old, history of subglottic stenosis and right vocal cord paralysis. An 8 mm hypoattenuating collection is seen within the left palatine tonsil without significant surrounding enhancement or evidence of inflammation.The base of tongue tissues on the right are slightly more prominent than on the left, but no definite evidence of a discrete lesion is seen in this location.The epiglottis is thin and unremarkable. The right aryepiglottic fold is thicker than the left. The contour of the right vocal cord is irregular and asymmetric relative to the left.Below the level of the glottis, soft tissue thickening is seen along the posterior and left lateral aspects of the airway which narrows the airway to a diameter of approximately 7 mm. Below this level, the caliber of the trachea is normal.The salivary glands and thyroid are free of focal lesions. The cervical vessels enhance normally. Relatively mild multilevel cervical spondylosis is seen, but there are no concerning or destructive osseous lesions.
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1. Subglottic stenosis is seen secondary to soft tissue thickening along the posterior and left lateral aspects of the airway. 2. Thickening of the right aryepiglottic fold and irregularity of the right vocal cord contour may be reflective of known right vocal cord paralysis. Correlation with endoscopic visualization is recommended.3. Prominence of the right base tongue tissues is likely a normal variation, but again, correlation with direct visual inspection is suggested.4. Small cystic collection in the left palatine tonsil likely represents either a tonsillar cyst or fluid within a tonsillar crypt.
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Generate impression based on findings.
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9-year-old female with history of right ankle pain. There is mild soft tissue swelling about the lateral aspect of the ankle. We see no underlying fracture or dislocation.
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Soft tissue swelling without acute fracture.
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Generate impression based on findings.
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13-year-old female jammed fingers during volleyball with pain and swelling along the index and long fingerVIEWS: Right hand PA/oblique/lateral (3 views) 02/06/15 Soft tissue swelling along the PIP joint of the index finger. No acute fracture or malalignment is evident.
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Soft tissue swelling without acute fracture.
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Generate impression based on findings.
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Eight day old female with PICC placementVIEW: Chest AP (one view) 02/06/15 ET tube tip is below thoracic inlet and above the carina. Nasogastric tube side port is at the GE junction with tip in the stomach. UVC has been removed. Left upper extremity PICC tip is in the left atrium.Diffuse bilateral granular opacities are not significantly changed since the prior exam. Cardiac silhouette is top normal. No pleural effusion or pneumothorax.
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Left upper extremity PICC tip is in the left atrium. NG tube side-port is at the GE junction, recommend advancement.
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Generate impression based on findings.
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Vomiting, abdominal pain, evaluate for obstruction, history of Turner syndrome Right lower abdominal postsurgical material. Relative paucity of bowel gas, no specific evidence of bowel obstruction.
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No evidence of bowel obstruction.
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Generate impression based on findings.
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Male 68 years old; Reason: Cancer of the parotid gland; with measurements History: as above ABDOMEN:LUNG BASES: Multiple lung nodules are identified in the lung bases. The largest is in the left lower lobe measuring 2.2 x 1.5 cm (series 4, image 12). These have increased compared to prior study and are suspicious for metastatic deposits.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion in the left lobe is too small 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: No significant abnormality noted.BOWEL, MESENTERY: Marked thickening of the gastric esophageal junction. There is bowel malrotation with the duodenojejunal junction located to the right of the spine. The transverse colon courses beneath the superior mesenteric artery.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a 4.7 x 2.2 cm soft tissue lesion ventral to the spleen which demonstrates enhancement similar to that of splenic tissue. This likely represents ectopic splenic tissue.
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1.Multiple lung nodules, increased compared to prior PET study are suspicious for a metastatic deposits.2.Thickening of the gastroesophageal junction.3.Bowel malrotation as detailed above.
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Generate impression based on findings.
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98-year-old female with history of femur fracture. The bones are demineralized. There is a displaced fracture through the femoral neck with superior migration of the distal fracture fragment.
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Right hip fracture as above.
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Generate impression based on findings.
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Reason: vertebral arery disease History: recurrent stroke MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. The right A1 segment appears to be small.There is a stenosis present at the origin of the left vertebral artery. The left vertebral artery is tortuous proximally. This stenosis was also present on the previous exam and does not appear to have changed substantially when accounting for differences in technique.There is no evidence for carotid or vertebral dissection appreciatedThere is no significant stenosis along the course of the right vertebral artery. There is mild narrowing at the origin of the right vertebral artery and does not appear to have changed substantially when accounting for differences in technique.
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There is a significant stenosis the origin of the left vertebral artery present which appears to be stable compared to the previous exam. There is only mild narrowing at the origin of the right vertebral artery.
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Generate impression based on findings.
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39-year-old female with history of shoulder pain. We see no acute fracture or dislocation. Findings suggest an os acromiale, a normal variant.
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No radiographic findings to account for the patient's pain.
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Generate impression based on findings.
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29-year-old male with history of lateral tibial plateau fracture 6 weeks ago. Evaluate for healing. We see no evidence of tibial plateau fracture. Alignment is anatomic. There is no joint effusion.
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Normal knee with no evidence of tibial plateau fracture.
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Generate impression based on findings.
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1-day-old female with umbilical line placementVIEW: Chest/abdomen AP (two view) 02/06/15, 1626 hrs UAC is at the level of T7. UVC is in the umbilical vein. Nonobstructive bowel gas pattern. NG tube side-port and tip is within a gas distended stomach. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.Cardiothymic silhouette is normal. Fine bilateral reticular opacities. No pleural effusion or pneumothorax.
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UAC to the level of T7. UVC is in the umbilical vein.
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Generate impression based on findings.
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85-year-old female with history of pain. The bones are demineralized. Moderate osteoarthritis affects the glenohumeral and acromioclavicular joints. We see no acute fracture.
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Osteoarthritis as above.
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Generate impression based on findings.
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One day old female with umbilical line placementVIEW: Chest/ abdomen AP (two view) 02/06/15, 1618 hrs UAC is at the level of T7. UVC is in the right portal vein. Nonobstructive bowel gas pattern. NG tube side-port and tip is within a gas distended stomach. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.Cardiothymic silhouette is normal. Fine bilateral reticular opacities. No pleural effusion or pneumothorax.
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UAC to the level of T7. UVC is in the right portal vein.
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Generate impression based on findings.
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42 year-old female with history of left foot pain. We see no acute fracture or dislocation. Alignment is anatomic. The soft tissues are unremarkable.
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No radiographic findings to account for the patient's pain.
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Generate impression based on findings.
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Male, 68 years old, with parotid cancer. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No pathologic enhancement is seenNo intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The visualized paranasal sinuses and mastoid air cells are clear. The bones of the calvarium and skull base are intact.
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No evidence of intracranial metastatic disease.
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Generate impression based on findings.
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Female 51 years old; Reason: spine mets (breast CA) eval change History: surveillance imaging There are two foci of increased activity involving the bilateral mid ribs which correlate with lytic lesion on CT suspicious for metastatic disease. There are two foci of increased activity in the skull base which are also suspicious for additional metastatic disease, one of which was seen on prior MRI brain 2/2/2014 in the right greater wing of the sphenoid bone. There are multiple foci of increased activity in the left hemipelvis which correlate with lytic lesions seen on CT as well as a subtle increased focus of activity in the right acetabulum which correlates with lytic lesion seen on CT and are suspicious for metastatic disease. There is increased activity in the mid cervical spine which correlates with compression deformity MRI spine 10/4/2014 and may be due to tumor involvement. There is increased uptake in T5 and L1 which correlates with lytic lesions on CT and are also suspicious for metastatic disease.
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Multifocal osseous metastatic disease as described above.
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Generate impression based on findings.
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Female 2 years old; Reason: Follow-up study; history of ureterocele puncture. Left Duplex kidney with VUR. History: recurrent UTI The left kidney is enlarged. There is decreased cortical uptake in the upper moiety of the duplicated left kidney and minimally decreased uptake in the lower moiety. There is normal cortical uptake in the right kidney.Perfusion analysis: Left kidney: 51.3 % (Upper segment 23.4%; Lower segment 27.9%) Right kidney: 48.7% (Upper segment 27.1%; Lower segment 21.6%)
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Decreased function of the upper moiety of the left duplicated kidney as quantified above.
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Generate impression based on findings.
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Reason: 44 y/o woman with breast cancer. Evaluate for osseous metastases. History: Possible calvarial mets on last bone scan. Focus of increased activity in the left calvarium has slightly decreased from prior study. There is a new focus of increased activity in the left iliac bone suspicious for metastatic disease. Focus of increased activity in the left sternoclavicular joint and T7 likely degenerative in nature.
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1. Slight interval decrease of activity in the left calvarium is nonspecific. Correlation with CT can be performed to exclude metastatic diease if clinically warranted.2. New focus of increased activity in the left iliac bone is suspicious for osseous metastatic disease.
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Generate impression based on findings.
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Clinical question: History of CVA with right-sided weakness, increasing weakness since yesterday. Signs and symptoms: Right upper and lower extremity weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT however these insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are periventricular and subcortical patchy foci of white matter low-attenuation suggestive of age indeterminate small vessel ischemic strokes. There is resultant mild expansion of lateral ventricles.Unremarkable exam otherwise for patient's stated age of 83.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells.
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No acute intracranial process. Age indeterminant small vessel ischemic strokes.
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Generate impression based on findings.
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Clinical question: Rule out intracranial hemorrhage, history of seizure day zero. Signs and symptoms: Persistent headache after seizure. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF and spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Mastoid air cells and middle ear cavities are rather pneumatized.Extensive pansinusitis is noted.
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1.Unremarkable nonenhanced head CT.2.Extensive chronic pansinusitis.
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Generate impression based on findings.
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Clinical question: Rule bleed, infection. Signs and symptoms: Rule out infection. Nonenhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass, mass effect, midline shift or hydrocephalus. As the there is no indirect signs all an infectious process on this study nonenhanced head CT cannot exclude possibility of an infectious process.Unremarkable cerebral cortex, cortical sulci, ventricular system, cisterns and spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp, unremarkable orbits, paranasal sinuses and mastoid air cells.
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Negative nonenhanced head CT.
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Generate impression based on findings.
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Clinical question: Assess for cause of left-sided phase pelvis pain and numbness for two weeks. Signs and symptoms: Left-sided phase to pelvis pain and numbness. Examination demonstrate no detectable acute intracranial process. CT however is seen sensitive for early detection of acute non-hemorrhagic ischemic strokes.There are periventricular and subcortical low-attenuation of white matter which are nonspecific, however considering patient's stated age of 36 possibility of demyelinating disease should be considered. There are no prior exams available for comparison. Findings results in sulcal prominence of ventricular system and cortical sulci for patient's stated age representing volume loss.Examination also demonstrates complete opacification of paranasal sinuses with resultant expansion of sinuses and evidence of bony remodeling and extensive surrounding sclerosis. There is suggestion of a slight expansion of content of the sinus through a small bony defect into the left orbit which is only partially visualized (axial series 3 image one on coronal reformatted series 80293 image 19). The contents of the sinuses demonstrate patchy regions of high density which may be result of long-standing chronic sinusitis however possibility of fungal sinusitis should also be considered. The visualized retro-orbital space demonstrate no evidence of fatty stranding or mass effect. Recommend follow-up with dedicated CT of paranasal sinuses. The mastoid air cells and middle ear cavities are well pneumatized and unremarkable.
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1.Periventricular and subcortical low attenuation of white matter with underlying parenchymal volume loss concerning for demyelinating disease considering patient's stated age of 36. There are not prior exams. 2.Extensive pansinusitis with evidence of extensive bony remodeling and erosive changes as detailed above. Recommend dedicated imaging for more complete further assessment..
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Generate impression based on findings.
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Hypoxia and congestion, rule out pneumonia.VIEWS: Chest AP/lateral (two views) 2/6/2015 Complete opacification of the right upper lobe with air bronchograms and without significant elevation of the minor fissure compatible with consolidation. Peribronchial thickening and streaky multifocal subsegmental atelectasis is present. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal.
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Bronchiolitis/reactive airways disease pattern with right upper lobe opacity compatible with pneumonia.
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Generate impression based on findings.
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Left thumb pain in the interphalangeal joint.VIEWS: Left thumb PA and lateral (two views) left hand PA (one view) 2/7/2015 Asymmetry of the physis of the distal first phalanx with surrounding soft tissue swelling suggests possible type I Salter-Harris fracture.
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Possible type I Salter-Harris fracture of the distal first phalanx.
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Generate impression based on findings.
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Four year old male with abdominal pain after esophagogastroduodenoscopy.VIEWS: Abdomen AP supine and upright (two views) 2/6/2015 Multiple dilated loops of bowel are present within the mid abdomen with at least two air-fluid levels present, with gas and stool present within the rectum. No pneumoperitoneum, portal venous gas or pneumatosis intestinalis is evident.
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Multiple dilated loops of bowel in the mid abdomen, which may reflect postprocedural ileus or possibly partial small bowel obstruction, although this is felt less likely.
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Generate impression based on findings.
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Assess interval improvement in pleural effusion.VIEW: Chest AP (one view) 2/7/2015, 03:04 ET tube tip below thoracic inlet and above the carina. The previously seen NG tube tip is in the antrum of the stomach. There has been interval placement of a second NG tube with the tip terminating in the fundus of the stomach. Right central venous catheter tip at the cavoatrial junction. Cardiomegaly unchanged. Left lower lobe opacity improved on the prior. Probable small left pleural effusion unchanged.
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Left lower lobe opacity persists, but improved from the prior exam.
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Generate impression based on findings.
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Clinical question: Rule out bleed. Signs and symptoms: Right hand weakness. Nonenhanced head CT:Examination demonstrate multiple round poorly demarcated foci of increased density in bilateral cerebral hemispheres some with evidence of surrounding vasogenic edema. Findings highly suggestive of hemorrhagic metastatic disease likely from patient's previously known renal cell cancer.There is resultant of focal effacement of adjacent cortical sulci however without any significant mass effect on the ventricular system and no evidence of midline shift.If clinically warranted follow-up with a dedicated pre-and post enhanced brain MRI is recommended.The CSI cisterns remain patent.Calvarium and soft tissues of the scalp as well as orbits, paranasal sinuses and mastoid air cells are unremarkable.
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1.Multiple hemorrhagic intracranial metastatic lesions primarily in the supratentorial space as detailed. Findings resulting in regional mass effect with out midline shift or hydrocephalus.2.Unremarkable exam otherwise.
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Generate impression based on findings.
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Clinical question: ICH. Signs and symptoms: Status post one-week nest fall. Nonenhanced head CT: There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Focus of encephalomalacia in the left anterior frontal lobe involving the cortex and subcortical white matter with out associated mass effect and likely representing a chronic ischemic change.Findings suggestive of mild age indeterminate small vessel ischemic strokes are also noted. A small focus of encephalomalacia along the superior aspect of right cerebellum also suggestive of a small chronic stroke in the right superior cerebellar artery territory.Unremarkable calvarium and soft tissues of the scalp as well as paranasal sinuses, orbits and mastoid air cells.
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1.No acute posttraumatic findings.2.Chronic left MCA frontal and right superior cerebellar ischemic strokes as detailed.3.Mild age indeterminate small vessel ischemic stroke is identified.4.Unremarkable exam otherwise.
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Generate impression based on findings.
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2-year-old female with respiratory distress syndrome.VIEW: Chest and abdomen AP (two view) 2/6/2015, 18:42 Interval placement of an endotracheal tube with the tip terminating below the thoracic inlet and above the carina. UAC is at the level of T7. UVC is in the umbilical vein. Nonobstructive bowel gas pattern. The NG tube has been advanced with the tip now terminating in the second portion of the duodenum. There is increased gaseous distention of the stomach, and the bowel gas pattern is otherwise disorganized. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.Cardiothymic silhouette is normal. Fine bilateral reticular opacities. No pleural effusion or pneumothorax.
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Status post intubation with ET tube in appropriate position. NG tube tip now in the second portion of the duodenum.
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Generate impression based on findings.
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Cough and history of prolonged intubation.VIEWS: Chest PA/lateral (two views) 2/6/2015 Peribronchial thickening, large lung volumes and left basilar subsegmental atelectasis is evident. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal.
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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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14-year-old male status post fall with swelling and pain.VIEWS: Left ankle AP lateral and oblique (3 views) left tibia/fibula AP and lateral (two views) 2/6/2015 There is a nondisplaced oblique fracture of the medial malleolus, which extends to the medial most portion of the physis, consistent with a Salter-Harris type III fracture. There is a transverse nondisplaced fracture through the distal mid fibular epiphysis. There is marked soft tissue swelling about the ankle, predominantly along the lateral aspect. No additional fracture or malalignment is evident.
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Bimalleolar fracture as above.
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Generate impression based on findings.
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Pain rule out fracture.VIEWS: Right hand PA lateral and oblique (3 views) 2/6/2015 No acute fracture or malalignment evident. No significant soft tissue swelling evident
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Normal examination.
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Generate impression based on findings.
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13 year old female with pain.VIEWS: Right humerus AP and lateral (two views) right shoulder internal/external rotation (two views) right forearm AP and lateral (two views) 2/6/2015 No acute fracture or malalignment. No significant soft tissue swelling evident.
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Normal examination.
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Generate impression based on findings.
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75-year-old male with history of gastroesophageal cancer, liver metastases and fatigue. Evaluate for progression of disease. Please note lack of IV contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small amount of dense material layering within the gallbladder, may be sludge/stones. No biliary dilatation. Noncontrast CT is suboptimal to evaluate for metastatic disease. The there are a few scattered subtle hypodensities which are suboptimally evaluated.SPLEEN: No significant abnormality notedPANCREAS: Fullness in the pancreatic tail, should be further evaluated with dedicated pancreas imaging.ADRENAL GLANDS: Bilateral adrenal nodularity, nonspecific and incompletely evaluated without contrast. A right adrenal nodule (5/38) measures 1.8 x 1.7 cm.KIDNEYS, URETERS: Bilateral hypoattenuating renal cysts, nonspecific and may be further evaluated with contrast exam or ultrasound. Bilateral renal pelvis calcifications, likely nonobstructing stones. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications affect the visualized aorta and its branches. Multiple mildly enlarged lymph nodes are seen, with a reference right para-aortic lymph node at the level of the diaphragm (5/28) measures 1.4 x 1.1 cm.BOWEL, MESENTERY: Thickening of the gastroesophageal junction is noted (5/30) which may represent the patient's gastroesophageal cancer. Diverticulosis affects the visualized colon. No small bowel obstruction or free air.BONES, SOFT TISSUES: Flowing anterior osteophytes with calcification of the anterior longitudinal ligament are noted along the spine. Gynecomastia.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged, with coarse calcifications.BLADDER: The bladder is decompressed.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Thickening of the gastroesophageal junction may represent the patient's known primary malignancy.2.Several mildly enlarged lymph nodes, with measurements above.3.Bilateral adrenal nodularity, nonspecific and should be compared with prior imaging.4.Incomplete evaluation of the liver without contrast.5.Fullness in the pancreatic tail, should be further evaluated with dedicated pancreas imaging.
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