instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings.
|
Increased work of breathing and crackles on exam.VIEWS: Chest PA/lateral (two views) 2/6/2015 Peribronchial thickening and large lung volumes are evident. Streaky retrocardiac opacity most likely reflects atelectasis. The cardiothymic silhouette is normal. Small left pleural effusion.
|
Bronchiolitis/reactive airways disease pattern and small left pleural effusion.
|
Generate impression based on findings.
|
Female; 80 years old. Reason: r/o PE History: CT chest concerning for acute infarct PULMONARY ARTERIES: Multiple nonocclusive, central filling defects predominantly in the right middle and lower lobe segmental and subsegmental arteries, compatible with acute pulmonary emboli. The most proximal embolus is seen in the distal right middle lobar artery (series 8/115). Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Marked subpleural consolidations in the right middle and lower lobes have increased since prior CT and are most suspicious for infarct/hemorrhage. Smaller scattered, subpleural patchy consolidations in the right and left upper lobes are likely due to the same. Mild nonspecific patchy atelectasis/consolidation in the left lower lobe.Mild diffuse septal thickening, suggestive of mild pulmonary edema.Moderate right and small left pleural effusions, both increased since prior study.MEDIASTINUM AND HILA: Moderate cardiomegaly. No pericardial effusion. Minimal coronary artery calcifications are seen. No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative arthritic changes of the thoracic spine. Body wall anasarca.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Dobbhoff tube tip in stomach.
|
1. Acute pulmonary emboli in the right middle and lower lobes.2. Increasing consolidations in the right middle and lower lobes, suspicious for infarct/hemorrhage. Additional scattered subpleural consolidations in the right upper and left upper lobes, suspicious for the same.3. Findings suggestive of CHF with cardiomegaly, mild pulmonary edema, pleural effusions, and body wall anasarca.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative.
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
|
No acute intracranial hemorrhage or depressed calvarial fracture.
|
Generate impression based on findings.
|
Postreduction radiograph.VIEWS: Left wrist PA lateral and oblique (3 views) 2/7/2015 Interval reduction of the distal radial metaphyseal fracture now in improved anatomic alignment. Overlying cast material obscures fine bone detail. Ulnar styloid fracture not well seen on this examination.
|
Reduction and casting of the distal radial fracture in improved anatomic alignment.
|
Generate impression based on findings.
|
12 year old female status-post fall with swelling and deformity.VIEWS: Left wrist PA lateral and oblique (3 views) 2/7/2015 There is a comminuted fracture of the distal radial metaphysis, which extends to the physis, with posterior angulation of the distal fracture fragment. There is an additional minimally displaced transverse fracture through the ulnar styloid. There is marked soft tissue swelling about the wrist.
|
Comminuted Salter-Harris type II fracture of the distal radius. Minimally displaced fracture the ulnar styloid.
|
Generate impression based on findings.
|
The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with advanced age indeterminate small vessel ischemic changes. There is a chronic lacunar infarct in the right basal ganglia. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is debris within the external auditory canals. There are bilateral lens implants. Bilateral superior ophthalmic veins are slightly prominent.
|
1. No acute intracranial hemorrhage. 2. Advanced age indeterminate chronic small vessel ischemic changes. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, MRI of the brain is recommended.3. Slight increased prominence of the bilateral superior ophthalmic veins, of uncertain clinical significance. Please correlate clinically.
|
Generate impression based on findings.
|
Mild periventricular and subcortical white matter hypoattenuation is nonspecific, however likely represents mild age indeterminate small vessel ischemic disease. The ventricles and sulci are within normal limits for the patient's age. There is no effacement of the basal cisterns. There is no evidence for intracranial hemorrhage, masses, or midline shift. The gray-white matter junction is preserved and there is no evidence of territorial infarction.There are no extraaxial fluid collections or subdural hematomas. The calvaria and skull base are normal without evidence of skull fracture. No evidence of scalp trauma.The visualized portions of the paranasal sinuses and mastoid air cells are clear. The visualized portions of the orbits are intact.
|
No acute intracranial abnormality.
|
Generate impression based on findings.
|
Newborn male with respiratory distress.VIEW: Chest and abdomen AP (two view) 2/7/2015, 04:53 Mild bibasilar subsegmental atelectasis. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is identified.The bowel gas pattern is nonobstructive. No portal venous gas, pneumatosis intestinalis or pneumoperitoneum is evident.
|
Mild bibasilar subsegmental atelectasis.
|
Generate impression based on findings.
|
Hypoxic 4-month-old.VIEW: Chest AP (one view) 2/7/2015, 06:20 The endotracheal tube has been removed. The nasogastric tube tip is in the body of the stomach.Persistent unchanged right upper lobe opacity compatible with atelectasis. Persistent left lower lobe atelectasis. No pleural effusion or pneumothorax. The cardiothymic silhouette is normal.
|
Unchanged right upper lobe atelectasis.
|
Generate impression based on findings.
|
A heterogeneously enhancing mass is now seen in the lower right neck likely representing an enlarged right level 4 lymph node. This measures 2.1 x 2.3 cm (image 199, series 3). No other enlarged lymph nodes are seen.Stable posttreatment findings are seen in the neck with diffuse supraglottic edema and airway stenosis without measurable tumor. This appears similar to the prior study. Tracheostomy is seen in place with a small of debris within the tracheostomy tube..The parotid and submandibular glands are normal in size and symmetric bilaterally without masses. There are no thyroid masses. There are no nasopharyngeal, oropharyngeal or laryngeal masses identified and there is no airway compromise. The carotid and vertebral vasculature are patent. The internal jugular veins are patent.Lower cervical/upper thoracic laminectomy with posterior spinal fixation is unchanged from the prior study. Multiple lower cervical and upper thoracic vertebral bodies are fused. The vertebral body heights are maintained and the cervical spine is in normal alignment.No significant abnormality is seen in the visualized portions of the brain and skull base. Several subcentimeter retention cysts are seen in the right maxillary and sphenoid sinuses. The remaining visualized paranasal sinuses and mastoid air cells are normally pneumatized.Large right upper lobe bullae and fibrosis appears similar to the prior study. Please see dedicated CT chest report for further details.
|
1.Enlarged right level 4 lymph node, likely metastatic given the patient's history. No other enlarged lymph nodes identified. 2.Stable post-treatment changes around the larynx without definite evidence of measurable tumor in this area.3.Please see dedicated CT chest report for further details.
|
Generate impression based on findings.
|
5-month-old female with right upper lobe atelectasis.VIEW: Chest AP (one view) 2/7/2015, 02:53 Persistent unchanged right upper and right middle lobe atelectasis with mediastinal shift to the right. Diffuse pulmonary haziness persists. The cardiothymic silhouette is normal.
|
Persistent right upper and right middle lobe atelectasis.
|
Generate impression based on findings.
|
Assess endotracheal tube position.VIEW: Chest AP (one view) 2/7/2015, 03:12 ET tube tip is below thoracic inlet and above the carina. Left central venous catheter tip and right upper extremity PICC tips are in the superior vena cava.Persistent bilateral pleural effusions and retrocardiac atelectasis. Cardiac silhouette is top normal, unchanged. Bibasilar opacities suggestive of pulmonary edema perhaps slightly improved.
|
Slightly improved pulmonary edema pattern.
|
Generate impression based on findings.
|
17 year-old female with left pleural effusion.VIEW: Chest AP (one view) 2/7/2015, 04:09 Persistent small left-sided hydropneumothorax, likely unchanged and for differences in technique. Left basilar atelectasis and right basilar subsegmental atelectasis similar to prior. Cardiothymic silhouette is normal.
|
Persistent small left hydropneumothorax.
|
Generate impression based on findings.
|
Signs and symptoms: Altered mental status, INR 11, with left ventricular assist device. Clinical question: Evaluate for intracranial bleed. Nonenhanced head CT:There is no evidence of acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Subtle periventricular and subcortical low attenuation of white matter is concerning for age indeterminant mild small vessel ischemic strokes. Mild prominence of cerebral cortical sulci for patient's stated age.Normal size of ventricular system and with maintained midline.Unremarkable visualized paranasal sinuses, mastoid air cells and middle ear cavities as well as bilateral orbits. Large left bony nasal septal spur.
|
1. No evidence of acute intracranial hemorrhage.2. Mild age indeterminate small vessel ischemic strokes.
|
Generate impression based on findings.
|
34 with history of HIV presenting with shortness of breath. LUNGS AND PLEURA: Marked diffuse miliary pattern with innumerable micronodules in a predominantly centrilobular pattern. No pleural effusions.MEDIASTINUM AND HILA: Mild right hilar lymphadenopathy. Normal heart size. No pericardial effusion. No visible coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
|
1. Diffuse miliary pattern with differential including disseminated mycobacterial infection, histoplasmosis, or pneumocystis pneumonia.2. Mild right hilar lymphadenopathy, likely reactive.
|
Generate impression based on findings.
|
19-month-old male with ARDS.VIEW: Chest AP (one view) 2/7/2015, 04:34 Endotracheal tube tip is below the thoracic inlet and above the carina. The nasogastric tube tip projects out of the field of view inferiorly. The right internal jugular central venous catheter tip is in the SVC. Patchy diffuse airspace opacities unchanged. Bilateral pleural effusions are unchanged. No pneumothorax is evident. The cardiothymic silhouette is normal.
|
Persistent patchy diffuse airspace opacities and bilateral pleural effusions unchanged.
|
Generate impression based on findings.
|
15 year old female with flaccid paralysis. Assess right upper lobe opacity.VIEW: Chest AP (one view) 2/7/2015, therefore: 45 ET tube tip is below the thoracic inlet and above the carina. Right internal jugular central venous catheter tip is in the SVC. Right upper extremity PICC tip is in the right atrium. Spinal rods and hooks are again seen, unchanged in position. The soft tissue drain has been removed. NG tube tip terminates in the body of the stomach.Cardiothymic silhouette normal. Bilateral pleural effusions right greater than left not significantly changed. Right upper lobe atelectasis has resolved. The small right apical pneumothorax has resolved. Left lower lobe opacity, unchanged.
|
Resolved right upper lobe atelectasis and right apical pneumothorax. Bilateral pleural effusions and left lower lobe opacity persist.
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. There is absence of the nasal septum and turbinates. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. The intracranial internal carotid arteries are normal in course and caliber. The A1 segment of the right anterior cerebral artery is hypoplastic. The middle and remaining portions of the anterior cerebral arteries are unremarkable. The V4 segment of the right vertebral artery is hypoplastic. The left vertebral artery, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.CTA NECK
|
1. Hypoplastic right V4 and right A1 segments. No evidence of intracranial stenosis or aneurysm. 2. No evidence of flow limiting stenosis of the bilateral internal carotid arteries.3. Subcentimeter nodules are noted in the left thyroid gland. Thyroid ultrasound may be considered as clinically warranted.4. Absent nasal septum and turbinates.
|
Generate impression based on findings.
|
Pericardial and pleural effusions.VIEW: Chest AP (one view) 2/7/2015, 06:19 Right upper extremity PICC tip is at the cavoatrial junction. Pericardial drain is in place. Left-sided pleural catheter position unchanged. Cardiothymic silhouette remains enlarged. Layering left pleural effusion perhaps slightly improved. Persistent left basilar opacity suggests compressive atelectasis, unchanged.
|
Layering left pleural effusion perhaps slightly improved from the prior examination.
|
Generate impression based on findings.
|
The ventricles and sulci are prominent for the patient's age, likely related to volume loss and unchanged from the prior study. Diffuse subcortical and periventricular hypoattenuation of the white matter is also unchanged and compatible with moderate to advanced age indeterminate small vessel ischemic disease. There is no effacement of the basal cisterns. There is no evidence for intracranial hemorrhage, masses, or midline shift. The gray-white matter junction is preserved and there is no evidence of territorial infarction.There are no extraaxial fluid collections or subdural hematomas. The calvaria and skull base are normal without evidence of skull fracture. No evidence of scalp trauma.Mucosal thickening is seen in the visualized paranasal sinuses with frothy material within several of the mucosal sinuses and an air fluid level in the left maxillary sinus. These findings may be due to sinusitis or related to placement of Dobbhoff tube and recent extubation. The mastoid air cells are clear. The visualized portions of the orbits are intact.
|
1.No acute intracranial hemorrhage.2.No change in age indeterminate small vessel ischemic disease and resultant volume loss.3.Diffuse opacification of the paranasal sinuses with air-fluid level in the left maxillary sinus is likely iatrogenic, however sinusitis cannot be entirely excluded.
|
Generate impression based on findings.
|
Preterm infant with hypoxemia.VIEW: Chest AP (one view) 2/7/2015, 08:03 The nasogastric tube terminates in the body of the stomach. The UVC catheter has been removed. Bibasilar opacities suggests atelectasis, not significantly changed. No pleural effusion or pneumothorax. The cardiothymic silhouette is normal.
|
Bibasilar atelectasis not significantly changed.
|
Generate impression based on findings.
|
Female 13 years old with hand pain for one month.VIEWS: Left wrist AP and oblique (two views), left hand PA oblique and lateral (3 views) 2/6/2015 No acute fracture or malalignment identified. Apparent cortical thickening along the anterior aspect of the distal radial diaphysis may reflect a healed fracture. No significant soft tissue swelling is seen.
|
No acute fracture or malalignment. Suggestion of a healed distal radial diaphyseal fracture as above.
|
Generate impression based on findings.
|
Redemonstrated are postoperative changes from a right parietal temporal craniotomy and a left frontal craniectomy. There is extensive streak artifact from scattered aneurysm clips. There are also additional smaller surgical clips in the right temporal occipital region relating to previous AVM resection, with underlying encephalomalacia and ex vacuo dilatation of the right occipital horn. There is mild interval increase in size of the ventricles.The left frontal temporal extra-axial/extracranial collection continues to decrease in size, now measuring up to 8 mm compared to previous 10 mm at its mid section. The hypodense subdural collection along the left frontoparietal convexity is also decreased in size, measuring 4 mm, previously 13 mm. There is no midline shift.There is no intracranial hemorrhage. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
|
1. Interval decrease in size of hypodense left frontotemporal extracranial fluid collection.2. Interval decrease in size of left frontoparietal convexity hypodense subdural fluid collection. 3. Mild interval increase in size of the ventricular system.
|
Generate impression based on findings.
|
Male; 75 years old. Reason: 75 yo M hx of gastroesophageal cancer presenting with weakness, eval for progression History: weakness and weight loss LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules. No suspicious pulmonary nodules or masses. Minimal linear scarring or subsegmental atelectasis in the left lower lobe. No pleural effusions.MEDIASTINUM AND HILA: Mild retrocrural lymphadenopathy. Otherwise, no mediastinal or hilar lymphadenopathy. Normal heart size. No pericardial effusion. Mild coronary artery calcifications.CHEST WALL: Right chest wall Port-A-Cath with catheter tip near the superior cavoatrial junction. Degenerative arthritic changes of the lumbar spine.UPPER ABDOMEN: See report from CT abdomen and pelvis performed concomitantly for further details, including about bilateral adrenal nodules and renal cysts.
|
Mild nonspecific retrocrural lymphadenopathy, but otherwise no evidence of malignancy in the chest. See report from CT abdomen and pelvis performed concomitantly.
|
Generate impression based on findings.
|
Desaturations.VIEWS: Chest AP (one views) 2/6/2015 Tracheostomy cannula in place, position unchanged.The cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Diffuse chronic coarse lung opacities unchanged. Right middle and left lower lobe atelectasis is present.
|
Right middle and left lower lobe atelectasis on a background chronic lung disease.
|
Generate impression based on findings.
|
27 year old female with history of abdominal pain, assess for hernia versus infection versus perforation in a transgender anatomic male. Diffuse pain in lower abdomen/pelvis with diaphoresis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Multiple enlarged pelvic lymph nodes are seen, including iliac and inguinal nodes. A reference left inguinal lymph node (3/136) measures 2 x 2.9 cm. A reference right iliac lymph node (3/119) measures 5.0 x 2.1 cm.BOWEL, MESENTERY: No small bowel obstruction or free air. The appendix is within normal limits.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Lymphadenopathy in the pelvis as above, without significant abnormality otherwise. Follow up is suggested.
|
Generate impression based on findings.
|
Redemonstrated is a densely calcified tentorial based lesion in the right posterior fossa, that exerts slight mass effect on the adjacent cerebellum, representing a meningioma. The meningioma abuts the right distal transverse and sigmoid sinus. There is slight asymmetry in the size of the temporal horns with greater volume loss of the right mesial temporal lobe. There is slight interval increase in size of the lateral and third ventricles. The fourth ventricle and cortical sulci are unchanged in size, likely parenchymal volume loss. There is no periventricular hypoattenuation to suggest transependymal flow of CSF. There is no midline shift. There is no intracranial hemorrhage. There is no definite abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is a chronic appearing deformity of the right lamina papyracea.
|
1. No acute intracranial hemorrhage. 2. Stable right tentorial based meningioma abutting the right distal transverse and sigmoid sinus. Nonemergent MR can be considered for further evaluation, if there is no contraindication.3. Mild interval increase in size of the ventricular system, likely parenchymal volume loss.
|
Generate impression based on findings.
|
Status post foot injury. Three views of the right foot show an oblique fracture of the distal fifth metatarsal with slight medial displacement. No previous exams
|
Fracture fifth metatarsal
|
Generate impression based on findings.
|
The ventricles and sulci are normal for the patient's age. Periventricular hypoattenuation is nonspecific, however likely due to mild age indeterminate small vessel ischemic disease. There is no effacement of the basal cisterns. There is no evidence for intracranial hemorrhage, masses, or midline shift. The gray-white matter junction is preserved and there is no evidence of territorial infarction.There are no extraaxial fluid collections or subdural hematomas. The calvaria and skull base are normal without evidence of skull fracture. No evidence of scalp trauma.The visualized portions of the paranasal sinuses and mastoid air cells are clear. The visualized portions of the orbits are intact.
|
No acute intracranial hemorrhage or mass effect.
|
Generate impression based on findings.
|
Neck pain Six views of the cervical spine reveal no evidence of any fractures or dislocations. The bones are in anatomic alignment. The collar has been removed.
|
Negative cervical spine examination
|
Generate impression based on findings.
|
Female; 62 years old. Reason: 62 yo F with chronic aspiration with fevers and worsening hypoxia. Eval for worsening of pneumonia History: hypoxia, fevers LUNGS AND PLEURA: Mild to moderate subpleural consolidation in the lingula persists and is slightly increased posteriorly, though with resolution of small central cavitation. Mild subpleural consolidation in the left lower lobe has slightly decreased with resolution of small central cavitation.New moderate nodular opacities with tree-in-bud diffusely in both lower lungs and greatest in the left lower lobe with associated mild bronchiectasis and bronchial wall thickening.Mild centrilobular emphysema. No pleural effusion.MEDIASTINUM AND HILA: Mild mediastinal and left hilar lymphadenopathy is slightly increased since prior study and likely reactive. Normal heart size without pericardial effusion. Atherosclerotic calcifications of the aorta and its branches with mild coronary artery calcifications.CHEST WALL: Stable degenerative arthritic changes of the thoracolumbar spine with multilevel mild superior endplate compression deformities.. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Stable small left renal cysts with punctate calcification.
|
Findings compatible with new aspiration bronchiolitis. Subpleural consolidations in the left lung are most likely due to aspiration pneumonia and are overall stable to slightly improved.
|
Generate impression based on findings.
|
T2/FLAIR hyperintense lesions are again seen in the bilateral basal ganglia, centrum semiovale, thalami extending into the left cerebral peduncle, and pons. Restricted diffusion is again seen along the right corpus callosum with small foci in the right centrum semi-ovale, unchanged from the prior study. The left basal ganglia lesion again has intrinsic T1 hyperintensity without susceptibility weighted artifact.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There is no midline shift. The pituitary gland is normal in size. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. Small foci of susceptibility weighted artifact are seen in the subcortical white matter and in the cerebellum, unchanged from the prior study.
|
1.T2/FLAIR hyperintense lesions, some with diffusion restriction, are unchanged and thought to represent subacute/chronic lacunar infarcts.2.Scattered foci of susceptibility weighted artifact are again compatible with microhemorrhage secondary to hypertension.
|
Generate impression based on findings.
|
Radiation-induced osteonecrosis Single Panorex view of the mandible reveals no gross bone destruction.
|
No gross bone destruction
|
Generate impression based on findings.
|
The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
|
No acute intracranial abnormality.
|
Generate impression based on findings.
|
Male; 58 years old. Reason: eval possible malignancy - repeat CT scan for comparison to CT PE from 2013 showing nodule History: hx of lung CA, pt unaware of possible recurrence of lung CA LUNGS AND PLEURA: Stable 11-mm nodule in the right lower lobe (series 7/38). Additional scattered pulmonary micronodules, some of which are calcified, are unchanged. No new suspicious pulmonary nodules or masses.Bilateral upper lobectomy surgical changes with bilateral paramediastinal fibrotic changes with linear margins suggesting prior radiation, not significantly changed. Moderate emphysema. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size. No pericardial effusion. Cardiac revascularization surgical changes again noted. Moderate native coronary artery calcifications.CHEST WALL: Median sternotomy without evidence of complication.. Chronic appearing rib deformities are again noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable small nonspecific right adrenal nodule and cystic lesion in the tail the pancreas.
|
1. No significant interval change. Stable right lower lobe pulmonary nodule, for which continued follow-up is recommended. No new suspicious pulmonary or masses. 2. Stable small nonspecific right adrenal nodule and cystic lesion in the tail of the pancreas.
|
Generate impression based on findings.
|
BRAIN: The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. CERVICAL SPINE: The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. There is no pathological enhancement.There is no significant disc bulge, herniation, spinal canal or foraminal stenosis within the cervical spine.
|
Unremarkable MRI of the brain and cervical spine.
|
Generate impression based on findings.
|
Right thalamic intraparenchymal hemorrhage is again seen appearing similar in size when compared with the prior study. There is no change in mass effect and there is again approximately 12 mm of midline shift to the left. Intraventricular extension of hemorrhage and dilation of the ventricles is again present with slight increase in size of the left lateral ventricle. There is again diffuse effacement of the sulci.Left frontal approach ventriculostomy tube is again seen with its tip at the level of the left foramen of Monro. No new areas of hemorrhage are identified. The gray-white matter junction is preserved and there is no evidence of territorial infarction.Partial opacification of the right sphenoid sinus is present, however the remaining visualized portions of the paranasal sinuses and mastoid air cells are clear. The visualized portions of the orbits are intact.
|
1.No significant change in right thalamic intracranial hemorrhage with ventricular extension and left midline shift. 2.Minimal increase in size of left lateral ventricle.
|
Generate impression based on findings.
|
Male 57 years old; Reason: 57M s/p OLT Dec with acute right sided abd pain, OSH CT ?partial SBO History: abdominal pain, ?pSBO Dilated loops of small bowel measuring up to 3.8 cm with air-fluid levels. There is gas within the colon and some gas within the rectum.Multiple lines tubes and catheters are projected over the upper abdomen and pelvis. There are multiple surgical clips scattered throughout the upper abdomen.
|
1.Findings most suggestive of an ileus.
|
Generate impression based on findings.
|
Straightening of the normal lumbar lordosis is again seen. Grade 1 retrolisthesis of L5 on S1 is unchanged. Bone marrow edema is again seen in the bilateral L3 and L4 pedicles, left greater than right, extending into the L3 and L4 spinous processes. There is surrounding expected enhancement from degenerative changes. Disk desiccation at the L3 L4, L4-L5, and L5-S1 levels are unchanged. Loss of disk height at the L5-S1 level is unchanged. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. Scattered simple cysts are again seen in both kidneys, the largest of which is seen in the superior pole of the right kidney.T12/L1: No significant central canal or neural foraminal stenoses.L1/2: No significant central canal or neural foraminal stenoses.L2/3: Mild facet hypertrophy is present without significant central canal or neural foraminal stenoses.L3/4: New right lateral and far lateral disk protrusion extends into the right neural foramen resulting in severe stenosis. Diffuse disk bulge, facet hypertrophy, ligamentum flavum hypertrophy again causes moderate central canal stenosis, unchanged from the prior study. Mild left neural foraminal stenosis is unchanged. Bilateral facet effusions are present, new on the left.L4/5: Diffuse disk bulge with very small central annular fissure, moderate facet and ligamentum flavum hypertrophy again causes mild central canal stenosis and mild to moderate neural foraminal stenoses, unchanged from the prior study. Narrowing of the left lateral recess is again noted.L5/S1: Small left laminectomy defect with removal of the left ligamentum flavum are again seen. Moderate to severe right neural foraminal narrowing and severe left neural foraminal narrowing is unchanged.SI Joints: No significant abnormalities noted.
|
1.New L3-L4 right lateral and far lateral disk protrusion extending into the right neural foramen causing severe stenosis.2.Stable multilevel degenerative changes including moderate canal stenosis at L3-L4 and bilateral neural foraminal stenoses L4-L5 and L5-S1.
|
Generate impression based on findings.
|
Status post fall. Two views of the right hip reveal a femoral neck fracture that is slightly impacted. No other radiographic abnormalities.Two views of the right femur again reveal the femoral neck fracture. Otherwise negative.Single AP view of the pelvis again reveals a femoral neck fracture. Otherwise unremarkable.
|
Impacted femoral neck fracture
|
Generate impression based on findings.
|
Female; 35 years old. Reason: 35 y/o f with scleroderma and L pneumothorax s/p valve placement with new increased work of breathing, please eval. History: see above PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Small right left pneumothorax with left chest tube in place. Complete atelectasis of the left upper lobe. Left upper lobe endobronchial valves in place. Stable appearance of groundglass, traction bronchiectasis and bronchiolectasis, and honeycombing in the right lung and left lower lobe, compatible with known interstitial lung disease in a UIP pattern and likely related to the patient's known mixed connective tissue disease. New mild diffuse hazy groundglass opacity, likely related to differences in inflation compared to prior study. Small amount of dependent debris within the trachea noted. No pleural effusions.MEDIASTINUM AND HILA: Endotracheal tube terminates above the carina. Right chest wall Port-A-Cath with catheter tip in the SVC. Normal heart size. No pericardial effusion. No visible coronary calcifications. Patulous esophagus, compatible with known scleroderma. Moderate prevascular mediastinal and bilateral hilar lymphadenopathy, slightly increased.CHEST WALL: Moderate subpectoral and axillary lymphadenopathy bilaterally, not significantly changed.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
|
1. No acute pulmonary embolus.2. Small left pneumothorax and complete atelectasis of the left upper lobe.3. Stable chronic interstitial lung disease.4. Increased mediastinal and hilar lymphadenopathy, likely reactive.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
|
Generate impression based on findings.
|
In motor vehicle accident this a.m. Five views of the lumbar spine reveal anatomic alignment. The disk spaces are preserved. No fractures or dislocations.
|
Negative lumbar spine examination
|
Generate impression based on findings.
|
45-year-old male with history of chest pain. Evaluate for dissection. VASCULATURE:Extensive type A dissection with aneurysmal dilation of the distal aortic arch. Previously seen mural thrombus (image 60 coronal series) is unchanged in size, measuring 4.4 cm in maximum diameter. Aneurysmal dilatation of the descending thoracic aorta measures 5.2 cm (9/53) previously 5 cm. Normal variant arch with two branch vessels is noted. Postoperative findings, including a small outpouching arising from the left lateral aspect of the ascending thoracic aorta (9/44) is unchanged. Dissection flap extends from the brachiocephalic artery of the aortic arch into the iliac arteries bilaterally, unchanged. The dissection flap also extends into the external iliac on the right. The left common carotid artery and subclavian artery arise from the true lumen. The celiac artery and SMA arise from the true lumen, unchanged. The dissection flap extends into the left renal artery, unchanged. The right renal artery arises from the false lumen and is patent.CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are again seen, unchanged. No pleural effusion or consolidation.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Extensive dissection will be discussed in the vascular section.CHEST WALL: Sternotomy wires are again noted. Mild gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small bilateral hypoattenuating foci within the kidneys, unchanged and most likely benign cysts.RETROPERITONEUM, LYMPH NODES: Please see vasculature section.BOWEL, MESENTERY: Limited evaluation of the bowel without oral contrast reveals no small bowel obstruction or free air. No bowel wall thickening. No ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Aneurysmal thoracic aorta with dissection as above. Aneurysmal dilatation is grossly stable in size from prior.
|
Generate impression based on findings.
|
Status post fall 3 days ago Three views of the left shoulder reveal no evidence of any fractures or dislocations.Two views of the thoracic spine reveal disk space narrowing in the midthoracic spine with mild anterior osteophyte formation. No fractures or dislocations.Four views of the right knee are negative.
|
No fractures or dislocations. No acute abnormalities
|
Generate impression based on findings.
|
Male 49 years old; Reason: stent placement History: urinary retention, dysuria, R flank pain Right nephroureteral stent. Vascular stent projects over the left sacrum. Surgical sutures are noted in the upper abdomen.Dilatation of the large bowel and stomach without definite signs of obstruction. Average amount of colonic fecal burden.
|
1.No specific evidence of bowel obstruction.
|
Generate impression based on findings.
|
Dyspnea, clinical concern for pneumonia or pulmonary edema.VIEWS: Chest AP/lateral (two views) 2/7/2015 Streaky right upper lobe opacity may reflect atelectasis or scarring, and the left lower lobe opacity is suggestive of atelectasis. Patchy airspace suggestive of pulmonary edema. The heart is enlarged. The aortic arch, cardiac apex and stomach are left-sided.
|
Pulmonary edema pattern and cardiomegaly.
|
Generate impression based on findings.
|
Female 31 years old; Reason: 31F with history of episodes of abd pain, no clear etiology History: epigastric pain, n/v Above average colonic fecal matter. No bowel obstruction is evident.No free air is evident. No organomegaly.
|
1.Radiographic findings most suggestive of constipation.
|
Generate impression based on findings.
|
22-month-old male with pain, rule out fracture.VIEWS: Left tibia/fibula AP and lateral (two views) 2/7/2015 No acute fracture or malalignment evident.
|
Normal examination.
|
Generate impression based on findings.
|
Status post fall CT examination of the left knee was performed without contrast. There is marked osteoarthritis with medial lateral osteophyte are also osteophytes at the patellofemoral joint. There is a large joint effusion at a popliteal cyst. No fractures or dislocations.Four views of the right knee demonstrate marked osteoarthritis. No acute abnormalities.Two views of the left femur again reveal the osteoarthritis at the knee. Otherwise negative.
|
Large joint effusion and osteoarthritis at the left knee. No acute abnormalities
|
Generate impression based on findings.
|
Desaturations and chylothorax. Evaluate pleural effusion.VIEW: Chest AP (one view) 2/7/2015, 08:53 Endotracheal tube tip is below the thoracic inlet and above the carina. The NG tube tip projects out of the field of view inferiorly. The cardiothymic silhouette is normal. Increased right upper lobe opacity suggest atelectasis. Persistent left lower lobe atelectasis on a background of chronic lung disease, unchanged. There is a small left-sided pleural effusion, unchanged. No evidence of pneumothorax.
|
Multifocal atelectasis and small left-sided pleural effusion.
|
Generate impression based on findings.
|
Female 66 years old; Reason: 66 yo F hx of locally advanced pancreatic cancer with N/V, eval for SBO History: N/V A biliary stent is in place. There intrahepatic pneumobilia.Partially imaged is a vascular catheter projecting adjacent to the right heart border.Nonobstructive bowel gas pattern.
|
1.Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
Female; 18 years old. Reason: r/o acute abnormalities History: CXR completed on 2/6/2015 concerning for necrotizing pneumonia LUNGS AND PLEURA: Marked consolidation in the left lower lobe with central cavitation, most compatible with necrotizing pneumonia. No suspicious pulmonary nodules or masses in the remainder of the lungs. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. No visible coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
|
Marked left lower lobe necrotizing pneumonia.
|
Generate impression based on findings.
|
Female; 72 years old. Reason: evaluate for pneumonia History: 72yo F with neutropenic fever LUNGS AND PLEURA: New moderate consolidation with air bronchograms and mild surrounding hazy ground glass opacity in the medial left upper lobe, most compatible with pneumonia. New mild patchy consolidation in the right middle lobe and left lower lobe, suggestive of multifocal pneumonia. Mild streaky bibasilar dependent subsegmental atelectasis and/or scarring. No pleural effusions. Stable right basilar calcified granuloma. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Calcified hilar mediastinal lymph nodes compatible with prior granulomatous disease.No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Marked coronary artery calcification.CHEST WALL: No axillary lymphadenopathy.Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Splenic calcifications compatible to prior granulomatous disease.
|
New multifocal airspace consolidations with the greatest opacity in the medial left upper lobe, most compatible with multifocal pneumonia.
|
Generate impression based on findings.
|
Female 37 years old; Reason: 37yoF w/ sickle cell s/p C section, downtrending hemoglobin, spiking fevers, plz eval for hemorrhage vs abscess History: downtrending hemoglobin, fevers ABDOMEN:LUNG BASES: Trace left pleural effusion.LIVER, BILIARY TRACT: Liver is enlarged. Hepatic veins are dilated. There is mild periportal edema. Hepatic and portal veins are patent. No focal hepatic lesions.Status post cholecystectomy.SPLEEN: The spleen has auto-infarcted and is calcified.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: No significant abnormality noted.BONES, SOFT TISSUES: Extensive bone infarctions.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Postsurgical changes in the uterus. The uterus is enlarged and boggy with areas of high-density fluid within the myometrium and endometrium indicating hematoma/hemorrhage. No active extravasation is evident. No significant pelvic hematoma.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the anterior abdominal wall. Extensive bone infarctions. Chronic hip changes.OTHER: No significant abnormality noted.
|
1.Postsurgical changes in the lower pelvis and uterus as detailed above.
|
Generate impression based on findings.
|
30 year-old male with history of flank pain. Evaluate for stone. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral renal parenchymal calcifications are seen, likely nonobstructing stones. No hydronephrosis or hydroureter, no perinephric stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Left hip rod and screw device is noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Bilateral nonobstructing renal stones as above.
|
Generate impression based on findings.
|
Male 33 years old; Reason: Diverticulitis; Crohn's flare History: lower abd pain; possible Crohn's ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course. Segments of the small bowel are not opacified limiting evaluation. The terminal ileum is likely seen on image 69/series 3 and is collapsed. There is slight hyperemia to a portion of colon in the pelvis with some air-fluid levels. The appendix is not definitely identified. No fluid collections.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Please see aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1.Slight hyperemia of a portion of colon in the pelvis. Further evaluation with MR enterography is suggested for evaluation of Crohn's disease.2.Appendix is suboptimally evaluated.
|
Generate impression based on findings.
|
T1N2bM0 right BOT, +p16, status post tonsillectomy, neck dissection and chemoradiation therapy. The patient has a history of therapy for lymphoma 1981 and SCCA occurred in radiated field. In addition, the patient had a papillary thyroid microcarcinoma (single focus of papillary thyroid microcarcinoma measuring 0.3 cm in the right thyroid lobe). Compare to prior study. There are post-treatment findings related to tonsillectomy, neck dissection, and right hemithyroidectomy. No significant change in the mild asymmetry of the tongue base and palatine tonsils, but no evidence of discrete mass lesions. There is unchanged size of a left lateral retropharyngeal lymph node, which measures 5 mm in short axis. There is a heterogeneous appearance of the remaining left thyroid lobe, with coarse calcifications and a dominant hyperattenuating nodule as well as a hypoattenuating nodule that are unchanged in size. Otherwise, there is no evidence of mass lesions within the right thyroidectomy bed. The remaining salivary glands appear unchanged. There is mild atherosclerotic plaque at the bilateral carotid bifurcations. There is unchanged multilevel degenerative spondylosis. There is moderate left maxillary sinus mucosal thickening. The partially imaged brain demonstrates subtle hypoattenuation at the left posterior temporo-occipital junction (series 7, image 4), which may represent ischemia. There is biapical pulmonary scarring.
|
1. Partially imaged is subtle hypoattenuation of the left posterior temporo-occipital junction, which may represent ischemia. Recommend further evaluation with CT head. Finding discussed with Dr. Chawla on 2/7/2015 at 10:45 am.2. No evidence of recurrent tumor in the right thyroidectomy bed. Heterogeneous appearance of the remaining left thyroid lobe, with coarse calcifications and dominant hyperattenuating as well as hypoattenuating nodules, which are unchanged in size. 3. Stable size of the left retropharyngeal lymph node, now measuring 5 mm in short axis.4. No evidence of mucosal mass.
|
Generate impression based on findings.
|
Pericardial and pleural effusionVIEW: Chest AP 2/7/15 Right upper extremity PICC tip is at the cavoatrial junction. Pericardial drain is in place. Left-sided pleural catheter position unchanged. Cardiothymic silhouette remains enlarged. Layering left pleural effusion improved. Persistent left basilar opacity suggests compressive atelectasis, unchanged.
|
Left pleural effusion improved.
|
Generate impression based on findings.
|
Clinical question: Chronic sinusitis, sarcoidosis. Signs and symptoms: Chronic cough, chronic sinusitis, sarcoid Unenhanced maxillofacial CT:The examination demonstrates interval decreased size of adenoid tissues since prior exam.Paranasal sinuses remain well pneumatized. There is a small retention cyst in the dependent portion of left maxillary sinus and with minimal mucosal thickening. There is interval improvement of the findings since prior exam from 2000 13. Ostiomeatal units of maxillary sinuses and the sphenoethmoidal recesses of the sphenoid sinus remain patent.Revisualization of mild nasal septum deviation to the right and unremarkable images through the nasal passage otherwise.Bilateral mastoid air cells and middle ear cavities are well pneumatized.Unremarkable images through the orbits.
|
1.Interval significant decreased size of previously noted prominent adenoid tissue.2.Small retention cyst in the left maxillary sinus and minimal mucosal thickening with interval improvement since prior exam and no evidence of sinusitis otherwise.3.Stable mild rightward deviation of nasal septum.4.Bilateral mastoid air cells and middle ear cavities are well pneumatized and unremarkable images through the orbits.
|
Generate impression based on findings.
|
Female 65 years old; Reason: cholangiitis; abscess History: AKI; AMS; hepatic encephalopathy, NASH ABDOMEN:LUNG BASES: Trace bilateral pleural effusions and bibasilar atelectasis/consolidation.LIVER, BILIARY TRACT: Diffuse severe fatty infiltration of the liver which is enlarged. Status post cholecystectomy. A common bile duct plastic stent is in place.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No bowel obstruction. Scattered mesenteric and upper abdominal ascites.BONES, SOFT TISSUES: Postsurgical changes from lumbar spine fusion and laminectomy with pedicle screws.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Urinary bladder is decompressed by a Foley catheter.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the lumbar spine. Nonspecific skin thickening involving the lower abdominal wall soft tissues with anasarca.OTHER: No significant abnormality noted.
|
1.Hepatic steatosis with hepatomegaly.
|
Generate impression based on findings.
|
Six lumbar type vertebral bodies are again seen. Air within the spinal canal at the L3-L4 level and subcutaneous gas are likely postoperative. Grade 1 anterolisthesis of L4 on L5 and of L5 on L6 appear similar to the prior study. The spinal canal is diffusely narrowed, likely congenital. Atherosclerotic disease is seen throughout the aorta and its branches. IVC filter is seen in place. Colonic diverticulosis is partially visualized.T12/L1: No significant abnormality noted.L1/2: No significant abnormality noted.L2/3: Mild diffuse disk bulge is present with mild ligamentum flavum and facet hypertrophy. Mild to moderate bilateral neuroforaminal stenosis is present.L3/4: High-density material is seen within the left neural foramen which is at least partially due to a disk bulge with peripheral annular calcifications. There is loss of the normal epidural fat in the left neural foramen at this level. A left laminectomy and medial facetectomy are now present containing high density material, likely postoperative. A band of fat is seen anterior to the laminectomy defect, likely representing epidural fat. Moderate right and severe left neuroforaminal stenoses are again noted. L4/5: Diffuse disk bulge is again seen extending into the left neural foramen, however epidural fat is preserved around the exiting nerve root. A left laminectomy and medial facetectomy are now present containing high density material, likely postoperative. Moderate right and severe left neuroforaminal stenoses are again noted. Narrowing of the left lateral recess is again noted.L5/6: Mild diffuse disk bulge with facet arthropathy is again noted. Moderate central canal stenosis is again noted. Moderate right neural foraminal stenosis is present.
|
1.Evaluation of the spinal canal contents is limited on CT and postoperative complications such as epidural hemorrhage would be better assessed with MRI.2.Status post left L3 and L4 laminectomies and medial facetectomies. High-density material is seen within the left L3-L4 neural foramen with loss of normal epidural fat, partially due to disk bulge. Consider MRI of the lumbar spine for further evaluation.3.Degenerative changes as described above.
|
Generate impression based on findings.
|
Male 53 years old; Reason: NG tube placement History: same Bilateral drains are in place. Enteric tube terminates about the gastroesophageal junction. There are postsurgical changes in the chest. The heart is enlarged.There is gaseous distention of the stomach. There is gas within the transverse colon.
|
1.Enteric tube terminates about the gastroesophageal junction.
|
Generate impression based on findings.
|
Evaluate for metastatic lesions. Examination of the lumbar spine reveals vague sclerosis within the L3 vertebral body and within the superior aspect of S1. These findings correspond to the images on the CT scan from February 5 and may represent sclerotic metastases.
|
Possible sclerotic metastasis
|
Generate impression based on findings.
|
Mass over scapula. History renal cell carcinoma. Evaluate for metastatic disease Two views of the right scapula are unremarkable. Cross-sectional imaging such as CT would better evaluate the scapula
|
Two views of the scapula are unremarkable.
|
Generate impression based on findings.
|
Clinical question: CVA. Signs and symptoms: CVA. Nonenhanced head CT:Examination demonstrate a focus of low-attenuation in the right occipital lobe (at least 37 x 33-mm) containing a focus of high density measuring at 8 times 14 mm size. Finding is suggestive of acute hemorrhagic ischemic stroke. There is mild expansion of trigone of right lateral ventricle which may indicate presence of a more chronic stroke at this site as well. For complete assessment of findings recommend follow-up with a dedicated MRI exam.In addition examination demonstrate findings suggestive of mild age indeterminate small vessel ischemic strokes. The ventricular system are within normal size and with maintained midline. The CSF cisterns remain widely patent.There is heavy vascular calcification of the left vertebral artery and minimal bilateral cavernous carotid arteries.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells.
|
1.Acute ischemic stroke in the right occipital lobe with a focus of hemorrhage measuring at 8 x 14-mm as detailed. Follow-up with an MRI exam is recommended.2.Minimal age indeterminate small vessel ischemic strokes.3.No significant mass-effect, midline shift or hydrocephalus.
|
Generate impression based on findings.
|
Male 83 years old; Reason: evaluate for ileus History: abd distension Catheter type device projects over the left hemiabdomen. No significant small bowel dilatation. Moderate stool burden.Degenerative changes affects the lumbar spine and hips.
|
1.No specific evidence of ileus or obstruction.2.Moderate stool burden.
|
Generate impression based on findings.
|
Female 56 years old; Reason: Metastatic breast cancer receiving chemotherapy. Evaluate for treatment response and extent of disease. History: Pelvic and bone mets. CHEST:LUNGS AND PLEURA: Postradiation changes in the left upper lobe. Trace bilateral pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. Trace pericardial effusion. There is pericardial thickening.CHEST WALL: Extensive osseous metastatic disease.Postsurgical changes in the left breast.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. The hepatic and portal veins are patent. No new hepatic lesions. Cholelithiasis with calcified gallstones layering within a nondistended gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right hydronephrosis decompressed by ureter stent.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Thickening of the omentum and peritoneum especially at the level of the gastro-colic ligament most compatible with omental disease. Small pockets of fluid in the upper abdomen compatible with carcinomatosis.BONES, SOFT TISSUES: Osseous metastatic disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Right pelvic sidewall mass measures 5.7 x 4.8 cm (image 171/series 3) previously, 6.2 x 4.8cmBOWEL, MESENTERY: Nodularity and thickening of the peritoneum in the pelvis compatible with carcinomatosis.BONES, SOFT TISSUES: Soft tissue skin thickening in the lower pelvis. Osseous metastatic disease to the pelvic bones.OTHER: No significant abnormality noted.
|
1.No significant change in the size of the reference right pelvic lesion.2.Extensive omental, peritoneal and osseous disease.
|
Generate impression based on findings.
|
Male 57 years old; Reason: left sided abdominal pain, hernia. Evidence of obstruction? compare to prior. History: left sided abdominal and flank pain Pacer leads project over an enlarged heart. Right chest wall/body wall catheter. IVC filter, postsurgical staples project over the mid abdomen.Mild gaseous distention of the small bowel in the left hemiabdomen. There is a moderate to large amount of fecal matter in the colon.Calcific arteriosclerotic disease affects the aorta and branch vessels.
|
1.Nonobstructive bowel gas pattern.2.Moderate large amount of colonic fecal matter.
|
Generate impression based on findings.
|
Male 57 years old Reason: 57M s/p OLT with elevated AST/ALT, RUQ abd pain History: abd pain, transaminitis LIVER: The liver has a smooth contour. Liver measures 18 cm in length. The parenchyma is mildly echogenic. No focal hepatic lesions. No significant intrahepatic biliary ductal dilatation.BILIARY TRACT: The gallbladder is absent. PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 8.9 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 9.6 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 12.7 cm. in length. OTHER: No perihepatic fluid collections
|
1.Patent hepatic artery with low resistive indices and mild tardus parvus waveform from the known hepatic artery stenosis.2.Other hepatic vasculature are patent.
|
Generate impression based on findings.
|
Female 40 years old; Reason: eval for pelvic mass History: sudden BLE edema, no cardiac or renal origin ABDOMEN:LUNG BASES: Left lower lobe calcified granuloma.LIVER, BILIARY TRACT: Nonspecific 10-mm hypodense focus in segment 6 of the liver (image 61/series 3). The lesion cannot be further characterized without intravenous contrast.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: Postsurgical changes from a gastric bypass. No bowel obstruction.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine worst at L5-S1.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Left ovarian cyst measures 3.2 cm. Its internal complexity is not evaluated by noncontrast CT. Uterus and right adnexa are unremarkable.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No pelvic mass.OTHER: No significant abnormality noted.
|
1.No pelvic mass to account for the patient's bilateral lower extremity edema. Other findings are detailed above.
|
Generate impression based on findings.
|
Female 28 years old; Reason: RLQ pain, RLQ mass on exam History: RLQ pain, RLQ mass, normal pelvic ultrasound ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Within the upper abdominal mesentery there is a near purely cystic mass measuring 5.8 x 3.8 cm (image 47/series 3). No nodular enhancement. It is intimately associated with the jejunum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Contraceptive device is located within the uterine cavity. The adnexa are unremarkable.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: Appendix is normal. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1.Findings of a cystic mesenteric mass. Given the patient's age findings are most likely represents a lymphangioma. Other benign entities include duplication cyst, non-pancreatic pseudocyst, and mesothelial cyst. Follow up is suggested2.No definite pelvic mass as clinically questioned. If symptoms persist in the pelvis consider MRI for further evaluation.
|
Generate impression based on findings.
|
There are diffuse osseous metastases involving the T9, T11, L1, L5 vertebral bodies and S1 segment. At the T9 level, there is metastatic involvement of the body, bilateral pedicles and facets. There is circumferential epidural tumor spread at the level of the mid body, contributing to moderate to severe spinal canal stenosis at this level. There is inferior extension of the epidural tumor predominantly at the dorsal and left aspect of the spinal canal at the T10 level, which causes significant mass effect and rightward displacement of the spinal cord, resulting in cord compression and cord edema at this level. There is tumor extension into, with complete filling of, the left T10/11 neural foramen. The dorsal epidural component at the T10 level is well demarcated and ovoid in configuration, raising the possibility of dural metastasis.At the T11 level, there is metastatic involvement of the body, bilateral pedicles and facets. At the L1 level, there is metastatic involvement of the body, bilateral pedicles and right facet. At the L4 level, there is metastatic involvement of the right pedicle. At the S1 level, there is metastatic involvement of the body with prevertebral and epidural components. There are mild anterior wedge compression fractures of the T9 and T11 vertebral bodies and possibly at the superior endplate of L1. Additional metastatic lesions are noted in the C5, T10, and L2 vertebral bodies and left hemipelvis. Partially imaged are several large masses in the liver, right para-aortic region and possibly the right lung base.
|
1. Diffuse osseous metastases of the lower thoracic spine, lumbar spine, upper sacrum and left hemipelvis with epidural tumor spread at the T9/10 and T10/T11 levels causing cord compression and cord edema, most severe at the T10 level, with tumor spread into the left T10/11 neural foramen.2. Pathologic compression fractures of the T9 and T11 vertebral bodies and possibly at the superior endplate of L1. 3. Partially imaged masses in the liver, right para-aortic region and possibly the right lung base. CT of the chest, abdomen and pelvis can be performed for further evaluation when the patient is able.Urgent findings discussed with Dr. Pettit on 2/7/2015 at 12:19 pm.
|
Generate impression based on findings.
|
Clinical question: Evaluate for right posterior ischemic stroke. Signs and symptoms: Left days deviation, left-sided weakness acute on chronic worsening. Pre-and post enhanced neck CTA:The visualized aortic arch and the origins of major vessels are unremarkable.Brachial cephalic branch and bilateral subclavian arteries are unremarkable.Vertebral arteries demonstrate no stenosis at their origins. There is a larger left dominant left vertebral artery and a small right vertebral.Bilateral vertebral arteries remain patent throughout their cervical course and through the skull base.Bilateral common carotid arteries are patent and unremarkable.Bilateral carotid bifurcations as well as bilateral internal and external carotid arteries are unremarkable and without evidence of vascular lumen compromise.Head CTA: Bilateral vertebral arteries are patent in their intracranial components. The dominant left vertebral artery demonstrates heavy vascular calcification however without detectable vascular lumen compromise. The right vertebral artery is uniformly small in size and representing a congenital anatomical variation. Bilateral pica branches are identified and unremarkable.Basilar artery is widely patent and unremarkable.Bilateral aica branches are identified.Bilateral superior cerebellar arteries are patent.Bilateral posterior cerebral arteries are patent. Distal branches of bilateral posterior cerebral arteries are identified and patent. There is over mild irregularity and decreased caliber of right right occipital branch.Bilateral carotid arteries are patent across to skull base and in their supraclinoid segments without stenosis.Bilateral ophthalmic arteries are identified on source images.There are small patent bilateral posterior communicating arteries.Bilateral anterior and middle cerebral arteries are patent and without evidence of any vascular lumen compromise or stenosis.3-D reformatted images were not acquired at the time of interpretation. When the 3-D images are acquired an addendum to this report will be submitted after review.
|
1.Unremarkable pre-and post enhanced neck CTA.2.Unremarkable pre-and post enhanced head CTA. Mild vascular lumen compromise and irregularity of the right parietal occipital branch of posterior cerebral artery is noted.
|
Generate impression based on findings.
|
Brain: The ventricles and sulci are normal for the patient's age. There is no effacement of the basal cisterns. There is no evidence for intracranial hemorrhage, masses, or midline shift. Periventricular hypoattenuation is nonspecific, but likely due to minimal age indeterminate small vessel ischemic disease. The gray-white matter junction is preserved and there is no evidence of territorial infarction.There are no extraaxial fluid collections or subdural hematomas. The calvaria and skull base are normal without evidence of skull fracture. Soft tissue density and swelling over the parietal calvarium, left greater than right, is compatible with scalp hematoma.The visualized portions of the paranasal sinuses and mastoid air cells are clear. The visualized portions of the orbits are intact.Cervical spine: Alignment is anatomic. There are no fractures or subluxations. No pre-vertebral soft tissue swelling. There is normal coverage of the articular facets without facet joint widening. The visualized intracranial and paraspinal contents are unremarkable. Lucencies in C2 and C5 vertebral bodies are unchanged from the prior study and may be secondary to a hemangioma. Degenerative changes are seen between C1 and C2. Posterior osteophyte is noted at the C4-C5 level. Degenerative disease is noted at C5-C6 with loss of disk height. Minimal right apical lung scarring is present.
|
1. Scalp hematoma over the parietal calvarium without acute intracranial abnormality.2. No acute fracture or subluxation of the cervical spine.
|
Generate impression based on findings.
|
Male 74 years old; Reason: h/o renal transplant c/b CKD, now with Acute on CKD; r/o hydronephrosis History: AKI RENAL TRANSPLANT: Right iliac fossa renal allograft measures 10.1 cm in length. The parenchymal echotexture is echogenic.LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedCOLLECTING SYSTEM/URETER: Mild pelvic caliectasis which is unchanged.URINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Right iliac artery peak systolic velocity of 1.6 m/secAnastomosis peak systolic velocity 1.3 m/secMid renal artery peak systolic velocity 1.6 m/secHilum peak systolic velocity 0.9 m/secIntrarenal resistive indices varies between 0.74 and 0.81There is a slight delayed upstroke in the intrarenal waveforms.Renal vein is color Doppler patent.OTHER: No significant abnormality noted
|
1.Echogenic renal cortex compatible with medical renal disease.2.Borderline elevated resistive indices and slight abnormal intrarenal waveforms. Further investigation for renal artery stenosis is suggested.
|
Generate impression based on findings.
|
Clinical question: Evaluate for right posterior ischemic stroke. Signs and symptoms: Left days deviation, left-sided weakness acute on chronic worsening. Pre-and post enhanced neck CTA:The visualized aortic arch and the origins of major vessels are unremarkable.Brachial cephalic branch and bilateral subclavian arteries are unremarkable.Vertebral arteries demonstrate no stenosis at their origins. There is a larger left dominant left vertebral artery and a small right vertebral.Bilateral vertebral arteries remain patent throughout their cervical course and through the skull base.Bilateral common carotid arteries are patent and unremarkable.Bilateral carotid bifurcations as well as bilateral internal and external carotid arteries are unremarkable and without evidence of vascular lumen compromise.Head CTA: Bilateral vertebral arteries are patent in their intracranial components. The dominant left vertebral artery demonstrates heavy vascular calcification however without detectable vascular lumen compromise. The right vertebral artery is uniformly small in size and representing a congenital anatomical variation. Bilateral pica branches are identified and unremarkable.Basilar artery is widely patent and unremarkable.Bilateral aica branches are identified.Bilateral superior cerebellar arteries are patent.Bilateral posterior cerebral arteries are patent. Distal branches of bilateral posterior cerebral arteries are identified and patent. There is over mild irregularity and decreased caliber of right right occipital branch.Bilateral carotid arteries are patent across to skull base and in their supraclinoid segments without stenosis.Bilateral ophthalmic arteries are identified on source images.There are small patent bilateral posterior communicating arteries.Bilateral anterior and middle cerebral arteries are patent and without evidence of any vascular lumen compromise or stenosis.3-D reformatted images were not acquired at the time of interpretation. When the 3-D images are acquired an addendum to this report will be submitted after review.
|
1.Unremarkable pre-and post enhanced neck CTA.2.Unremarkable pre-and post enhanced head CTA. Mild vascular lumen compromise and irregularity of the right parietal occipital branch of posterior cerebral artery is noted.
|
Generate impression based on findings.
|
WheezingVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
Increased oxygen requirementVIEW: Chest AP 2/7/15 Cardiothymic silhouette normal. G-tube in place. Bronchiectasis and left lower lobe atelectasis not significantly changed. Right upper lobe opacity minimally increased in the interval. No pleural effusion or pneumothorax. Right upper extremity anomalies unchanged.
|
Right upper lobe opacity minimally increased in the interval and may represent infection.
|
Generate impression based on findings.
|
PainVIEWS: Right hand AP, right index finger oblique and lateral No acute fracture or dislocation.
|
Normal examination.
|
Generate impression based on findings.
|
Increased oxygen requirementVIEW: Chest AP 2/8/15 Tracheostomy tube in place. Marked dextroscoliosis of the thoracic spine. G-tube in place. Cardiothymic silhouette normal. Left lower lobe opacity likely atelectasis. No pleural effusion or pneumothorax.
|
Left lower lobe atelectasis without pleural effusion.
|
Generate impression based on findings.
|
RSV tachypneaVIEW: Chest AP 2/8/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
IntubatedVIEW: Chest AP 2/8/15 ET tube tip below thoracic inlet and above the carina. There are two NG tubes in place. There is a new right internal jugular central line with tip in the caval atrial junction. Cardiothymic silhouette at the upper limits of normal. Left lower lobe and perihilar atelectasis not significantly changed. Probable small left pleural effusion unchanged.
|
Left lower lobe atelectasis not significantly changed.
|
Generate impression based on findings.
|
Omphalocele CDHVIEW: Chest AP and abdomen AP 2/7/15 NG tube tip in the stomach at the left upper quadrant. Cardiothymic silhouette at the upper limits of normal. Cardiac apex and stomach left-sided. Large opacity present at the right hemithorax likely representing the diaphragmatic hernia. Mildly dilated bowel loops in the abdomen without evidence of obstruction. The known history of omphalocele is not clearly identified. No pneumatosis or pneumoperitoneum.
|
Large opacity at the right hemithorax likely representing the diaphragmatic hernia.
|
Generate impression based on findings.
|
GastroschisisVIEW: Chest AP and abdomen AP 2/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the GE junction. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. Large gastroschisis in the abdomen. There is paucity of bowel gas within the abdomen. No evidence of pneumoperitoneum.
|
Large gastroschisis as described above.
|
Generate impression based on findings.
|
IntubatedVIEW: Chest AP 2/8/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right central line, epicardial pacer leads and multiple surgical clips in the left superior mediastinum are unchanged. Cardiothymic silhouette at the upper limits of normal. Patchy atelectasis left lower lobe without pleural effusion or pneumothorax.
|
Patchy atelectasis left lower lobe without pleural effusion or pneumothorax.
|
Generate impression based on findings.
|
ET placementVIEW: Chest AP 2/8/15 ET tube tip below thoracic inlet and above the carina. Right internal jugular central line and right PICC again noted. The posterior spinal rods are unchanged. Cardiothymic silhouette normal. Bilateral atelectasis improved in the interval. Bilateral small pleural effusions unchanged. Linear radiopaque density projected over the left apical thorax likely external in location.
|
Bilateral atelectasis improved in the interval.
|
Generate impression based on findings.
|
ET placementVIEW: Chest AP 2/8/15 ET tube tip below thoracic inlet and above the carina. Cardiothymic silhouette normal. Minimal patchy atelectasis left lower lobe. No pleural effusion or pneumothorax.
|
Minimal patchy atelectasis left lower lobe.
|
Generate impression based on findings.
|
Evaluate pleural effusionVIEW: Chest AP 2/8/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Cardiothymic silhouette normal. Bilateral patchy atelectasis on a background of chronic lung disease increased in the interval. There is a small left-sided pleural effusion increased in the interval.
|
Bilateral atelectasis and small left pleural effusion increased in the interval.
|
Generate impression based on findings.
|
27-year-old female with right lower quadrant pain and tenderness. Evaluate for appendicitis ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No intra-or extrahepatic biliary ductal dilatation. No focal hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive inflammatory changes and wall thickening affect approximately 8 cm of the terminal ileum as well as the cecum. Additionally, there is a pericecal phlegmon which measures 3.7 (series 3, image 87) x 3.1 x 2.7 cm (coronal series, image 53). Moderate free pelvic fluid with peritoneal inflammation is noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 2.2 cm right adnexal cyst is present.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1.Extensive inflammatory changes affect the terminal ileum and the cecum which are most likely inflammatory in etiology such as Crohn's disease. There is an associated pericecal phlegmon measuring up to 3.7 cm, possibly secondary to fistulous connection from the bowel.2.Further evaluation with MR enterography is suggested.3.Moderate pelvic ascites with peritoneal inflammation concerning for peritonitis.
|
Generate impression based on findings.
|
PainVIEWS: Left hand AP and lateral No acute fracture or dislocation.
|
Normal examination.
|
Generate impression based on findings.
|
PainVIEWS: Left forearm AP and lateral No acute fracture or dislocation. Diffuse soft tissue swelling about the forearm.
|
No acute fracture or dislocation.
|
Generate impression based on findings.
|
TachypneaVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
HypoxiaVIEW: Chest AP 2/7/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis right middle lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
Abdominal distentionVIEW: Chest AP and lateral and abdomen AP Cardiothymic silhouette normal. NG tube removed in the interval. No focal lung opacity. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum.
|
Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
PainVIEWS: Left wrist AP, oblique and lateral There is a buckle fracture involving the metaphysis of the distal radius. There is minimal volar angulation. The distal ulna is normal.
|
Buckle fracture distal radius as described above.
|
Generate impression based on findings.
|
TachycardiaVIEW: Chest AP 2/8/15 Feeding tube tip in the stomach. The stomach is distended. There is mediastinal shift from left to right unchanged. Cardiothymic silhouette normal. Right upper lobe and right lower lobe atelectasis not significantly changed.
|
Right lung atelectasis not significantly changed.
|
Generate impression based on findings.
|
82 year-old female with back pain radiating to chest and syncope. Evaluate for dissection. CHEST:CT ANGIOGRAM: Mild to moderate atherosclerotic calcifications at the origins of the brachiocephalic, left common carotid, and left subclavian arteries, which are all patent without evidence of dissection or thrombus. Moderate calcifications affect the thoracic aorta as well as the visualized abdominal aorta without evidence of dissection. Mild to moderate atherosclerotic calcifications at the origins of the celiac and SMA; the visualized portions of the celiac axis and SMA are patent without evidence of dissection or thrombus.LUNGS AND PLEURA: Severe centrilobular emphysema. Scattered pulmonary micronodules, some of which are calcified suggestive of prior granulomatous disease. Calcified right upper lobe nodule likely secondary to prior granulomatous disease. No pulmonary opacities to suggest infection. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Moderate cardiomegaly with evidence of severe coronary artery calcifications. No pericardial effusion. Calcified mediastinal and hilar lymph nodes suggestive of prior granulomatous disease.CHEST WALL: Moderate degenerative disease affects the thoracic spine.UPPER ABDOMEN: Hepatic and splenic granulomata. Mild distal esophageal thickening. Partially visualized nonspecific pancreatic ductal dilatation.
|
1.No evidence of thoracic or visualized abdominal aortic dissection.2.Severe centrilobular emphysema without evidence of infection.3.Cardiomegaly.4.Mild distal esophageal thickening may be inflammatory in etiology. Underlying neoplasm cannot be excluded. Further evaluation with endoscopy may be considered if clinically indicated. 5.Nonspecific pancreatic ductal dilatation.
|
Generate impression based on findings.
|
Feeding tube placementVIEW: Abdomen AP 2/7/15 Feeding tube tip in the duodenal bulb. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. Right lower lobe atelectasis again noted.
|
Feeding tube tip in the duodenal bulb.
|
Generate impression based on findings.
|
PainVIEWS: Left elbow AP, oblique and lateral No acute fracture or dislocation.
|
Normal examination.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.