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Generate impression based on findings. | PainVIEWS: Left forearm AP and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | Evaluate ET tubeVIEW: Chest AP 2/8/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Cardiothymic silhouette normal. Perihilar and left lower lobe atelectasis not significantly changed. No pleural effusion or pneumothorax. | Bilateral atelectasis not significantly changed. |
Generate impression based on findings. | 24 year-old female with diffuse abdominal pain, mild guarding, mostly in the right lower quadrant. Evaluate for ruptured ovarian cyst versus appendicitis. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: Slight subhepatic ascites.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 significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Again noted are bilateral loculated complex fluid collections, larger and heterogeneous on the right which measures 6.5 x 4.3 cm (series 3, image 87), previously measuring 6.4 x 4.4 cm. The left adnexal fluid collection is more complex compared to previous exam and measures 5.4 x 4.2 cm (series 3, image 88), previously measuring 4.2 x 3.5 cm (series 3, image 117).BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is not well visualized; however, no secondary signs of appendicitis. Mild mesenteric haziness and pelvic ascites is again noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Bilateral complex adnexal fluid collections as above. Differential considerations include tubo-ovarian abscesses vs. pyosalpinx. Further evaluation with pelvic sonography may be considered if clinically indicated.2.Appendix is not visualized on this exam; however, no secondary signs of appendicitis. |
Generate impression based on findings. | InjuryVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | InjuryVIEWS: Left tibia and fibula AP and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | 75-year-old female with hematuria. Evaluate for biliary obstruction. ABDOMEN:LUNG BASES: Moderate right pleural effusion with overlying atelectasis. Partially visualized tree in bud opacities in the right middle lobe may be aspiration.LIVER, BILIARY TRACT: Multiple hypoattenuating foci throughout both lobes of the liver.SPLEEN: No significant abnormality notedPANCREAS: Distal pancreatic body and tail mass measuring approximately 7.0 x 4.8 cm (series 3, image 52), suspicious for primary pancreatic adenocarcinoma. Splenic and superior mesenteric venous thrombosis. The soft tissue mass abuts the celiac axis and the superior mesenteric artery on the left (series 3, image 52). ADRENAL GLANDS: Thickening of the left adrenal gland measuring up to 1.2 cm (series 3, image 50).KIDNEYS, URETERS: Left renal hypoattenuating focus measuring approximately 56 Hounsfield units (series 3, image 49) is incompletely evaluated. Additional left renal hypoattenuating focus consistent with a simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild peritoneal nodularity concerning for metastatic disease.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: Small to moderate volume pelvic ascites.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine with mild to moderate compression deformity at L1. Grade 1 anterolisthesis of L4 over L5. Multilevel vacuum disk phenomena.OTHER: No significant abnormality noted | 1.Findings concerning for primary pancreatic adenocarcinoma with thrombosis of splenic and superior mesenteric vein and with metastatic disease to the liver and peritoneum.2.Left adrenal thickening is nonspecific but raises suspicion for metastatic disease.3.Indeterminate left renal lesion.4.Small to moderate pelvic ascites.5.Moderate right pleural effusion with findings suggestive of right middle lobe aspiration. 6.Mild to moderate L1 compression deformity. |
Generate impression based on findings. | VomitingVIEW: Abdomen AP The stomach is distended. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Desaturation evaluate foreign bodyVIEW: Chest AP 2/7/15 Cardiothymic silhouette normal. Minimal peribronchial wall thickening with subsegmental atelectasis right lower lobe. No pleural effusion or pneumothorax. No radiopaque foreign body. The stomach is distended. | No radiopaque foreign body. |
Generate impression based on findings. | Reason: Eval stridor, has subglottic stenosis and R VC paralysis History: As above LUNGS AND PLEURA: Calcified granuloma left lower lobe.MEDIASTINUM AND HILA: Mild coronary artery calcification.calcified nodes consistent with healed granulomatous disease.There is a short segment subglottic stenosis causing narrowing of the trachea to an AP diameter of 7 mm (series 3/97). Asymmetric nonspecific soft tissue causing the narrowing of the airway is predominantly left-sided. This is fixed on dynamic expiration phases. A small amount of dependent debris is noted within the trachea distal to the stenosis. The lower trachea is normal.CHEST WALL: Degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. There are multiple splenic granulomas. A hypodense lesion in the right mid kidney is incompletely imaged. The imaged portion has the CT appearance of a simple cyst with a diameter of 3.3 cm. | Subglottic stenosis seen secondary to soft tissue thickening along the posterior and left lateral aspects of the airway. Is relatively fixed on dynamic phases. Please see dedicated neck CT report for further details regarding the upper airway. The lower trachea is normal.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 5-month-old female patient with nasogastric tube.VIEW: Chest AP (one view) 2/7/2015, 15:20 hours. Enteric feeding tube with tip at the gastroesophageal junction. No focal airspace opacity or evidence of pneumonia. Left-sided cardiac apex, aortic arch and stomach. | Enteric feeding tube with tip at the gastroesophageal junction. |
Generate impression based on findings. | IntubatedVIEW: Chest AP 2/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Cardiothymic silhouette normal. Perihilar and left lower lobe atelectasis minimally improved. No pleural effusion or pneumothorax. | Left lower lobe atelectasis minimally improved in the interval. |
Generate impression based on findings. | Clinical question: Patient epilepsy presenting with seizures. Nonenhanced head CT:No detectable acute intracranial, calvarial or scalp findings.Mildly prominent cortical sulci and ventricular system, consistent with parenchymal volume loss, which is greater than expected for age. Mild atrophic changes of the right occipital lobe. Unremarkable CSF cisterns and gray -- white matter differentiation.Slight prominence of cerebellar and vermian folia could be result of seizure treatment. Calvarium is intact.Mastoid air cells and middle ear cavities are well pneumatized.Minimal opacification of a right ethmoid air cell. The remaining paranasal sinuses are visualized and unremarkable. | 1. No evidence of acute intracranial findings.2. Global parenchymal volume loss, which is greater than expected for age. Correlate with history. |
Generate impression based on findings. | Gastroschisis line placementVIEW: Chest AP and abdomen AP 2/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left upper extremity PICC with tip in the left internal jugular vein. There is a urinary catheter in place. Cardiothymic silhouette normal. Patchy atelectasis in the right middle lobe. No pleural effusion or pneumothorax. There is a silo device in the midline. Paucity of bowel gas within the abdomen. | Left upper extremity PICC with tip in the left internal jugular vein. |
Generate impression based on findings. | Clinical question: Right-sided weakness. Signs and symptoms: Right-sided weakness. Nonenhanced head CT:There is no detectable acute intracranial process, CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are periventricular and to a lesser degree subcortical patchy foci of low attenuation which considering patient's stated age of 89 likely representing age indeterminate small vessel ischemic strokes. Similar findings are also present in bilateral basal ganglia and right thalamus and pons.Unremarkable cerebral cortex and the cortical sulci. Mild prominence of lateral ventricles could represent subtle underlying volume loss.No significant large vessel vascular calcification is detected.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits and paranasal sinuses. | 1.No acute intracranial process.2.Eight indeterminate small vessel ischemic strokes of mild degree. |
Generate impression based on findings. | Clinical question: Rule out intracranial hemorrhage. Signs and symptoms:? Seizure, hitting tree Nonenhanced head CT:No detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | 14-year-old female patient with panserositis and pleural effusion.VIEW: Chest AP (one view) 2/8/2015, 07:27 hours. Right upper extremity PICC tip is at the cavoatrial junction. Pericardial drain and left sided pleural catheter are unchanged in position. Left basilar opacity, compatible with pleural effusion, is not significantly changed compared examination. | No significant interval change in left pleural effusion. |
Generate impression based on findings. | Clinical question: Six hour intervals scan, evaluate etiology of intracranial hemorrhage. Signs and symptoms: Slurred speech and right-sided weakness. Head CTA:Examination demonstrates patent bilateral internal carotid arteries across the skull base and supraclinoid segments.On the right there is a wide neck aneurysm arising from the proximal supraclinoid right internal carotid artery measuring 7.4-mm in AP, 11-mm in cc and with a 5.6-mm wide neck. This aneurysm measures approximately 6.5 mm in transverse axis on coronal projection. It projects directly superior and demonstrate mild calcification of its wall.On the left side there is a similar aneurysm measuring approximately 4.8 mm in AP, 6-mm in cc and with a wide neck measuring at approximately 5 mm. There are patent bilateral prominent posterior communicating arteries.Bilateral anterior and middle cerebral arteries are patent and unremarkable.Bilateral vertebral arteries are patent although demonstrate significant tortuosity along their course. Bilateral pica branches are identified. There is a smaller than expected size of the basilar artery and if relatively uniform fashion which is believed to be secondary to presence of prominent bilateral posterior communicating arteries. There is no evidence of focal vascular lumen compromise. | 1.No evidence of significant intracranial vascular lumen compromise or stenosis.2.Bilateral supraclinoid wide neck aneurysms (7.4 x 11 with 5.6-mm neck on the right and 4.8 times 6-mm weighted 5-mm wide necked on the left) as detailed/measured above. The aneurysms project directly superiorly and demonstrate wide neck and minimal vessel wall calcification. |
Generate impression based on findings. | Line placementVIEW: Chest AP 2/7/15 ET tube tip at the level of the carina. NG tube tip in the stomach. Left upper extremity PICC with tip in the left internal jugular vein. Cardiothymic silhouette normal. Right upper lobe atelectasis new from prior study. No pleural effusion or pneumothorax. | Malpositioned ET tube and PICC with atelectasis in the right upper lobe. |
Generate impression based on findings. | Clinical question: Follow-up previous CT head. Signs and symptoms: Right-sided weakness and dysarthria improving at this point. Nonenhanced head CT:Examination demonstrate a well demarcated acute hematoma in the left thalamus measuring at 10 x 17-mm in transaxial dimensions. The finding demonstrates very minimal surrounding edema and sulcal associated mass effect. No evidence of deviation of midline. Ventricular system remains within normal size.Unremarkable cerebral cortex, cortical sulci, ventricular system is seen 7 spaces and gray -- white matter differentiation otherwise.No significant vascular calcification is detected.Unremarkable calvarium, soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells. | Left thalamic acute hematoma measuring at 10 x 17-mm and with minimal surrounding edema and regional mass-effect. |
Generate impression based on findings. | Altered mental status. There are bilateral chronic appearing subdural hematomas measuring up to 11 mm on the right and 10 mm on the left. A small amount of acute hemorrhage is noted along the right frontal convexity. A small focus of subarachnoid hemorrhage is noted along the left superior frontal gyrus. There is mild mass effect with mild flattening of the bilateral cerebral convexities. The ventricles and sulci are prominent, consistent with age-related volume loss. There are no areas of abnormal attenuation. There is no midline shift. There are layering fluid/secretions in the bilateral posterior nasal cavities and nasopharynx. Endotracheal and nasogastric tubes are partially imaged. There is diffuse mucosal thickening of the bilateral ethmoid, maxillary and sphenoid sinuses. Mastoids/middle ears are grossly clear. | 1. Bilateral chronic subdural hematomas with superimposed acute hemorrhage along the right frontal convexity. Small subarachnoid hemorrhage along the left superior frontal gyrus.2. Diffuse paranasal sinus disease.Urgent findings discussed with neuro ICU fellow by radiology resident on call on 2/8/2015 at 3:40 am. |
Generate impression based on findings. | Clinical question: Follow-up previous CT head. Signs and symptoms: Right-sided weakness and dysarthria improving at this time. Nonenhanced head CT:Examination demonstrates an acute well-demarcated hematoma in the left thalamus measuring at 18 times 11-mm which is minutely larger than prior study. There is surrounding vasogenic edema and several regional mass-effect without deviation of midline or hydrocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and grade I right leg differentiation otherwise. | Stable to possibly minute interval increased size of a left thalamic acute hematoma. |
Generate impression based on findings. | Clinical question: Frontal CT head 6 hours after presentation. Signs and symptoms: Left knee preference, left upper extremity and lower extremity weakness. Nonenhanced head CT:No evidence of acute or new finding since prior exam. There is a focus of low attenuation in the right occipital lobe with subtle regional mass-effect and a well demarcated internal focus of high density. The focus of high density could represent hemorrhage however possibility of calcification cannot be entirely excluded. As was suggested on prior study follow-up with an MRI exam is recommended to exclude other underlying etiologies and including a mass.The region of low-attenuation primarily involves the white matter and results in very subtle regional mass-effect. Stable and unremarkable exam otherwise and with revisualization of mild age indeterminate small vessel ischemic strokes. | 1.No evidence of new finding since prior exam.2.Stable focus of low attenuation in the right occipital lobe containing an internal focus of the demarcated high density. The finding could represent a hemorrhagic stroke. Possibility of finding representing a mass with calcification however cannot be entirely excluded and follow-up with an MRI exam is recommended. |
Generate impression based on findings. | Acute shortness of breath. Female; 82 years old with a history of NSCLC. Evaluate for pulmonary embolism PULMONARY ARTERIES: No acute pulmonary embolism. As seen on the prior CT the left subclavian artery, left main pulmonary artery, and left upper lobe pulmonary artery are encased by the patient's known pulmonary masses. A trace amount of contrast is seen passing through the left upper lobe pulmonary artery.LUNGS AND PLEURA: The left upper lobe necrotic mass measures 11 x 6.7 cm (series 10/33), unchanged. This abuts the mediastinum and pleural surfaces with invasion of the anterior chest wall. There are lytic and sclerotic lesions involving the first rib. The mass abuts the aorta and encases the left subclavian artery, left main pulmonary artery, and left upper lobe branch of the pulmonary artery as above described above. There are multiple left chest wall collaterals and chronic occlusion of the left subclavian vein. Right upper lobe mass again measures 2 cm in short axis (series 10/57), unchanged. The right middle lobe mass measures 2.2 cm in short axis (series 10/77), unchanged. Innumerable smaller nodular opacities throughout both lung are again seen.There is trace left pleural effusion, decreased compared to prior.MEDIASTINUM AND HILA: Reference right high paratracheal lymph node measures 3.5 cm (series 7/35) and right low paratracheal lymph node measures 2.3 cm (series 7/75), both are not significantly changedThe heart size is normal, there is no pericardial effusion. There is severe coronary artery and aortic atherosclerotic calcification.CHEST WALL: Mild collapse of the superior endplate of the T2 vertebral body is again seen. Multilevel degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. There is contrast refluxing within the hepatic veins. Multiple punctate splenic calcifications are likely sequela of prior granulomatous disease. | 1.No acute pulmonary embolism.2.Encasement of the left main pulmonary artery and left upper lobe branch of the pulmonary artery. Chronic left subclavian vein obstruction with multiple chest wall collaterals.3.No significant change in size or appearance of left upper lobe and right middle lobe masses or lymphadenopathy.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Clinical question: ICH. Signs and symptoms: Fall on Coumadin. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are extensive periventricular and subcortical patchy foci of low attenuation suggestive of age indeterminate small vessel ischemic strokes.Cerebral cortex , cortical sulci and ventricular system remain unremarkable and stable since prior exam. Mild large vessel intracranial vascular calcification is noted.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process.2.Extensive age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | The ventricles and sulci are mildly prominent, consistent with 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 stable moderate chronic small vessel ischemic changes. There is no extraaxial fluid collection. There is moderate mucosal thickening of the left maxillary sinus and minimal mucosal thickening of the right maxillary sinus. The other visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is a right globe prosthesis/device for treatment of glaucoma. There are bilateral lens implants. | 1. No acute intracranial abnormality. 2. Stable moderate 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. |
Generate impression based on findings. | Feeding tube placementVIEW: Chest AP and abdomen AP Feeding tube tip at the duodenal bulb. Cardiothymic silhouette normal. There is mediastinal shift from left to right. Right upper lobe and right lower lobe atelectasis not significantly changed. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Feeding tube tip in the duodenal bulb. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal for patient stated age.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: CVA; hemorrhage. Signs and symptoms going CVA. Nonenhanced head CT:Examination demonstrate bilateral hemispheric large mixed density subdurals with significant mass-effect on the adjacent brain parenchyma and rightward midline shift of approximately 4 mm. The mixed density left sided subdural measures a maximum of about 21 mm in thickness and contains extensive areas of acute blood product. The largest component of subdural is in left frontal region. Mixed density right hemispheric subdural also demonstrate internal foci of high density consistent with acute blood. The largest component of subdural is in the right frontal region and measures approximately at 15-mm in thickness. Subdural on the right extends along the right side of falx and measures at approximately 5 mm thickness. The ventricular system remains compressed and there is deviation of midline to the right of approximately 4 mm. There is also mild crowding of the basal cistern.Images through posterior fossa demonstrates a large hematoma (29 x 28 mm) in the vermis with surrounding vasogenic edema and with result in significant effacement of the fourth ventricle and effacement of cerebellopontine angle cisterns and resultant subtle effacement of quadrigeminal plate cistern. There is no herniation at the level of foramen magnum. | 1.Mixed density large bilateral hemispheric subdural hematomas which are most prominent in bilateral frontal region. Hematomas at the left frontal measures measures 21-mm and at the right frontal 15-mm thickness. Findings results in mass effect on the lateral ventricle and 4-mm rightward midline shift.2.Acute hematoma of the vermis measuring 28 x 29-mm with resultant complete effacement the fourth ventricle and effacement of cerebellopontine angle cisterns as detailed. |
Generate impression based on findings. | CoughVIEWS: Soft tissue neck AP and lateral The patient is inconsolable during the examination. The lateral projection of the neck was obtained in the expiratory phase. There is apparent prevertebral soft tissue swelling. No radiopaque foreign body. Minimal narrowing at the subglottic region. | Within the limitation described above no radiopaque foreign body. The apparent prevertebral soft tissue swelling could be secondary to artifact or retropharyngeal abscess and repeat radiograph or CT could be obtained for further evaluation. This was communicated to the clinical referring service by the radiology resident on call when the study was performed. |
Generate impression based on findings. | Redmonstrated is hypoattenuation in the MCA distribution involving the left frontal, parietal and occipital lobes. There is encephalomalacia of the left parieto-occipital lobe with adjacent ex vacuo dilatation of the left occipital horn. An additional focus of hypoattenuation involves the pericallosal right parietal lobe.The ventricles and sulci are mildly prominent, greater than expected for age. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is no extraaxial fluid collection. There is minimal scattered opacification of the bilateral ethmoid air cells. The other visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is extensive subgaleal edema. | 1. Redemonstration of a large area of hypoattenuation in a left MCA distribution with areas of encephalomalacia in the left parieto-occipital lobes, which is likely chronic; however, a superimposed subacute or acute component cannot be entirely excluded. 2. Focal hypoattenuation in the right parietal lobe, likely represents chronic ischemia.3. No acute intracranial hemorrhage.4. Extensive subgaleal edema, new from prior study. |
Generate impression based on findings. | 14-year-old female patient with pleural effusion. LUNGS AND PLEURA: There is interval decrease in bilateral pleural effusions with a left pleural catheter in place. There is persistent dependent atelectasis and small bilateral pleural effusions.MEDIASTINUM AND HILA: A pericardial drain is noted a small pericardial effusion. Prominent soft tissue density mass in the anterior mediastinum measures 5.8 cm in craniocaudal dimension, unchanged. There is no evidence of a large hematoma. The left pulmonary artery is smaller than the right, similar compared to prior examination and possibly due to mass effect from the mediastinal mass. There is a filling defect in the left internal jugular vein near the confluence with the left subclavian vein.CHEST WALL: No axillary or retrocrural lymphadenopathy.UPPER ABDOMEN: No significant abnormalities. | 1.No large hematoma in the chest.2.Filling defect in the left internal jugular vein can be further characterized with ultrasound. |
Generate impression based on findings. | Female 44 years old; Reason: Please evaluate for active bleed, s/p pre-peritoneal incisional hernia repair with Mesh, now with dropping hgb History: decreasing hgb ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. Subcentimeter hypodense segment 6 is nonspecific and too small to characterize. The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There are small amounts of hematoma extending along the left psoas muscle and left adnexa.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the anterior abdominal wall from a left lower abdominal hernia repair. There is gas in the subcutaneous tissues and small foci of hematoma within the left rectus muscle.The left inferior epigastric artery is patent. There is mild spasm of the artery. The hematoma is located medial to the artery. The accompanying veins are absent in the pelvisThere is a left lower pelvic hematoma that measures 7.3 x 7.5 cm on image 127/series 10. No evidence of active extravasation.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: The bladder is displaced to the right by the large pelvic hematoma.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Please see aboveOTHER: There are small amounts of pelvic hematoma that layer around the vagina, rectum and bladder base | 1.Findings of a left pelvic hematoma without active extravasation.2.Postsurgical changes in the left abdominal wall.3.Left inferior epigastric artery is patent however, the accompanying veins are not identified which may have been sacrificed at surgery or possibly may be the source of bleed.4.Pelvic hematoma may be followed with noncontrast CT of the pelvis to evaluate for size change and resolution. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with 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 density in the periventricular and subcortical white matter, consistent with extensive age indeterminate small vessel ischemic changes. There is a chronic lacunar infarct in the right basal ganglia. There is no extraaxial fluid collection. There are intracranial vascular calcifications. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | 1. No acute intracranial hemorrhage. 2. Extensive age-indeterminate 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. |
Generate impression based on findings. | 82 year-old female with constipation for one month, no flatus in two weeks. Evaluate for bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hyperdense material within the gallbladder, likely sludge. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: Splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal non-obstructing nephrolithiasis measuring up to 4 mm (series 3, image 44).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Contrast is noted throughout the nondilated small bowel loops as well as the colon. No findings to suggest small bowel obstruction. Nonspecific distal sigmoid narrowing (series 3, image 103) without focal mass. No evidence of colitis.BONES, SOFT TISSUES: Innumerable diffuse subcentimeter sclerotic osseous lesions throughout the visualized skeleton raising concern for metastatic disease.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: As above.OTHER: No significant abnormality noted | 1.Findings highly suspicious for osseous metastatic disease, of unknown primary but statistically likely breast versus lung carcinoma.2.No findings to suggest small bowel obstruction as clinically questioned. 3.Nonspecific distal sigmoid narrowing without evidence of a mass. Further evaluation with colonoscopy may be considered clinically indicated.4.Non-obstructing left nephrolithiasis. |
Generate impression based on findings. | History of left maxillary nasofrontal carcinoma status post resection and chemoradiation with tenderness tracking from neck to face. Evaluate for abscess. Redemonstrated are extensive post-surgical changes related to left maxillary antrectomy and partial maxilla resection with free flap placement. There is interval placement of a left anterior maxillary surgical hardware. There is unchanged soft tissue adjacent to the multiple surgical clips in the region of prior maxilla resection, which may represent scar tissue. There is new soft tissue swelling and subcutaneous fat stranding of the left cheek, compatible with cellulitis. No drainable fluid collection is identified. Multiple surgical clips are also seen in the left submandibular region with resection of the left submandibular gland suggestive of selective left neck dissection. The left globe is slightly retracted secondary to post-surgical changes. The mucosal space is preserved. The parotid and thyroid glands are unremarkable. Direct comparison to prior maxillofacial CT is suboptimal, but several mildly prominent level I and level II lymph nodes are grossly unchanged in size. The airways are patent. The imaged intracranial structures are unremarkable. There is minimal scattered opacification of the left ethmoid air cells. The imaged portions of the lungs are clear. | 1. Redemonstration of post-surgical changes related to left maxilla resection, maxillary antrectomy, and selective neck dissection.2. Soft tissue swelling and subcutaneous fat stranding along the left cheek, compatible with cellulitis. No abscess. 3. Unchanged size of level I and II lymph nodes. |
Generate impression based on findings. | 15-year-old female patient with right lower quadrant pain. ABDOMEN:LUNG BASES: No focal air space opacity.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: There is diffuse clonic wall thickening, compatible with colitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is diffuse clonic wall thickening, compatible with pancolitis. Suture material is noted at the cecum. There is no free air or evidence of abscess formation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Findings compatible with pancolitis.Findings discussed via telephone with Dr. Bagrodia at 18:30 hours by Dr. Vasnani. |
Generate impression based on findings. | Female 49 years old; Reason: Met Colon Cancer: Restaging History: None CHEST:LUNGS AND PLEURA: Mild emphysematous changes. No focal pulmonary nodules. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Mild pericardial thickening.Reference mediastinal lymph node measures 2.3 x 1.8 cm (image 20/series 3) previously, 2.0 x 1.4 cm.CHEST WALL: Left central venous catheter terminates at the cavoatrial junction.There are clips in the right breast.ABDOMEN:LIVER, BILIARY TRACT: There are multiple hepatic metastases. Status post right hepatic resection. Residual hepatic and portal veins are patent.Left lateral segment lesion measures 1.1 x 1.1 cm (image 73/series 3) previously, 1.3 x 1.1 cm.Second reference left lateral segment lesion measures 1.8 x 1.5 cm (image 70/series 3) previously, 0.9 x 0.6 cm.Segment 4 lesion measures 2.4 x 2.2 cm (image 82/series 3) previously, 1.2 x 1.1 cm.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: Extensive upper abdominal lymphadenopathy. Reference portacaval lymph node measures 2.4 x 2.2 cm (image 89/series 3) previously, 2.4 x 2.4 cm.BOWEL, MESENTERY: Postsurgical changes in the ascending colon.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. | 1.Slight increase in the size of the liver lesions. |
Generate impression based on findings. | Male 41 years old; Reason: Assess Crohn's activity. Assess for SBO History: Recent admission elsewhere for vomiting. Has known Crohn's ileocolitis 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. The terminal ileum is unremarkable. The appendix is normal. The ascending and proximal transverse colon are normal. There is chronic inflammation involving the descending colon and rectum with submucosal fat deposition. There is slight mesenteric hyperemia indicating mild ongoing inflammation.Fatty changes in the mesentery with small mesenteric lymph nodes are unchanged.Jejunum is suboptimally distended limiting evaluation.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: Postsurgical changes in the left femur.OTHER: No significant abnormality noted. | 1.Chronic inflammation involving the descending colon, and rectosigmoid region with mild acute inflammation.2.No significant inflammation near the ileocecal valve. |
Generate impression based on findings. | Female; 52 years old. Reason: Evaluate for fracture. History: point tenderness to the posterior aspect of left hand radiating into the thumb. There is tingling in the fingertips. No acute fracture malalignment. No radiographic evidence to explain the patient's hand pain. | No acute fracture or malalignment. |
Generate impression based on findings. | Male; 29 years old. Reason: evaluate for retained glass History: punched glass; R hand lacerations along the index finger. There is soft tissue swelling and laceration along the thenar eminence. There is no retained radiopaque foreign body. No acute fracture or malalignment. | No retained radiopaque foreign body. |
Generate impression based on findings. | Fall. Evaluate for fracture. Vertebral body heights are maintained. No fracture is evident. There is grade 2 anterolisthesis of L4 on L5. Moderate to severe facet joint arthropathy affect the lower lumbar spine. | No acute fracture. Degenerative changes as above. |
Generate impression based on findings. | Pain and difficulty ambulating. Evaluate for effusion. There is a small joint effusion as well as anterior soft tissue swelling which have decreased when compared to the films from April 2014. Hardware components of a total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. No acute fracture or malalignment. | Small joint effusion has decreased compared to the prior study. |
Generate impression based on findings. | 75-year-old female with weight loss, persistent nausea and vomiting, inability to tolerate p.o. Evaluate for malignancy versus obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nonspecific hypoattenuating foci in segments 7 and 8 (series 3, images 15 and 17).SPLEEN: Heterogeneous attenuation of the spleen likely secondary from poor perfusion given severe stenosis at the origin of the celiac axis.PANCREAS: No significant abnormality notedADRENAL GLANDS: Indeterminate left adrenal nodule measuring 1.6 x 1.9 cm (series 3, image 30) and with attenuation measuring 66 Hounsfield units.KIDNEYS, URETERS: Atrophic right kidney. Subcentimeter hypoattenuating focus at the inferior pole of the right kidney is too small to characterize. The kidneys enhance symmetrically without evidence of obstruction. RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications affect the abdominal aorta and its branches with severe narrowing at the origin of the celiac axis. The proximal SMA is thrombosed with re-constitution of the distal SMA. Multiple subcentimeter retroperitoneal lymph nodes are nonspecific with left para-aortic lymph node measuring 0.9 x 0.9 cm (series 3, image 39).BOWEL, MESENTERY: Ascending colonic submucosal fat deposition most suggestive of chronic colitis. There is a 3.0 x 2.5 x 2.8 cm (series 3, image 76) pericecal collection with foci of air and surrounding inflammatory changes which most likely represents an abscess. No evidence of small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Hysterectomy. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine.OTHER: No significant abnormality noted | 1.Findings most suspicious for a pericecal abscess measuring up to 3 cm, which may be secondary to perforated cecum versus perforated appendix.2.Findings consistent with chronic colitis affecting the ascending colon.3.Severe stenosis at the origin of the celiac axis with heterogeneous spleen, likely secondary to poor perfusion.4.Thrombosed proximal SMA with reconstitution distally.5.Indeterminate left adrenal nodule.6.Atrophic right kidney without evidence of hydroureteronephrosis. |
Generate impression based on findings. | Clinical question: Hemorrhage. Signs and symptoms: As above. Nonenhanced head CT:Images through posterior fossa demonstrates interval increase in hemorrhage in the vermis. On the current exam it measures approximately at 37 x 26 mm compared to prior study measurement of 28 x 29.There is resulting disorder increased mass effect in the posterior fossa with herniation of cerebellar tonsils through the foramen magnum and third are distortion of the quadrigeminal plate cistern. There is evidence of extension of hemorrhage into the fourth ventricle and subsequently extension superiorly into the third and lateral ventricles which is a new finding also since prior study.Images through supratentorial space demonstrate interval increased size of ventricular system highly concerning for development of hydrocephalus.Large bilateral mixed density subdural demonstrate no convincing evidence of change however they appear slightly smaller likely secondary to 4 to mass effect by expanded ventricular system. | 1.Interval increased hemorrhage in the posterior fossa, increased mass effect in the posterior fossa,extension of hemorrhage into the ventricular system and supratentorial hydrocephalus as detailed.2.Large mixed density bilateral subdurals without evidence of any new hemorrhage however they demonstrates subtle decreased size in appearance likely secondary to interval expansion of lateral ventricles/hydrocephalus. |
Generate impression based on findings. | Left knee pain after fall two days ago. No acute fracture or malalignment. No joint effusion. Sharpening of the tibial spines and mild medial joint space narrowing indicate mild osteoarthritis with minimal progression since 2009. | No acute fracture or malalignment. Mild osteoarthritis. |
Generate impression based on findings. | Pain to the top of the foot radiating medially after a fall today. Evaluate for fracture. There is soft tissue swelling about the ankle, more prominent along the medial aspect. No underlying fracture or malalignment is evident. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | Finger crushed under heavy object today, pain at the lateral aspect of the finger tip. Evaluate for fracture. There is a nondisplaced tuft fracture of the right fifth finger. There is a soft tissue defect at the lateral aspect of the tip of the fifth finger with punctate radiopaque densities in the soft tissues which likely represent small foreign bodies. | Nondisplaced tuft fracture of the fifth finger. |
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. 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 middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm. | 1. No acute intracranial hemorrhage. 2. No evidence of flow-limiting stenosis or aneurysm. |
Generate impression based on findings. | Clinical question: Cerebellar lesion, ICH posterior circulation. Signs and symptoms: Vertigo, history of aneurysm. Nonenhanced head CT:Examination demonstrates post operative changes of a suboccipital craniotomy with underlying large focus of encephalomalacia of the right cerebellum and to a lesser degree of the vermis. The fourth ventricle is within normal size and the midline. Tiny focus of low-attenuation in the left cerebellum is suspected of a small chronic stroke.Images through the supratentorial space demonstrate no detectable acute intracranial process. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white differentiation for patient's stated age of 69.Calvarium demonstrate a right posterior temporal -- occipital burr hole and unremarkable otherwise.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.Neck CTA:The visualized aortic arch and the origins of major vessels are unremarkable.Grade 2 cephalic and bilateral subclavian arteries are unremarkable.Bilateral vertebral arteries are symmetrical in size and widely patent at their origins and through the cervical region as well as across the skull base.Bilateral common carotid arteries are patent at their origin and throughout their cervical course.Bilateral internal carotids as well as external carotid arteries are well visualized and unremarkable.Head CTA:Bilateral vertebral arteries are patent across the skull base and unremarkable.There is anatomical variation and the right pica branch arises from the vertebral artery at C1 level and extending superiorly and entering the subarachnoid space at the level of foramen magnum.The left pica branch arises from the subarachnoid component of left vertebral artery and is unremarkable.There is moderate vascular tortuosity of bilateral intracranial vertebral arteries without vascular lumen compromise.Mass or arteries of the visualized without evidence of vascular lumen compromise however with moderate vascular tortuosity.Bilateral superior cerebellar arteries and posterior cerebral artery visualized and unremarkable.Bilateral internal carotid arteries are patent and unremarkable across the skull base and in their supraclinoid segments. Internal carotids however demonstrate tortuosity through their course.Bilateral ophthalmic arteries are visualized and unremarkable on source images.Bilateral anterior and middle cerebral arteries are visualized and unremarkable.3-D reformatted images were not available at the time of interpretation. An addendum to this report will be submitted after 3-D images are acquired and provided for interpretation. | 1.Nonenhanced head CT demonstrates no acute intracranial process. Postoperative changes of suboccipital craniectomy and right cerebellar encephalomalacia is noted. Suspected a small focus of chronic left cerebellar stroke.2.Neck CTA is unremarkable.3.Head CTA is unremarkable. |
Generate impression based on findings. | Status post reduction of third metacarpal fracture. Interval placement of splint limits evaluation of fine bone detail. The comminuted fracture of the mid diaphysis of the third metacarpal demonstrates persistent posterior displacement, foreshortening, and volar angulation of the distal fracture fragment. This is not significantly changed compared to the prior study. | Interval splint placement. Redemonstration of comminuted fracture of the third metacarpal. |
Generate impression based on findings. | Hand smashed between door today, evaluate for fracture. There is a comminuted fracture of the mid diaphysis of the third metacarpal with foreshortening, posterior displacement, and volar angulation of the distal fracture fragment. There is deformity of the fifth metacarpal head from prior fracture. | Fracture of the third metacarpal as above. |
Generate impression based on findings. | Pain of the distal third digit off and on after bumping hand on the table 1 week ago. No acute fracture or malalignment. No radiographic evidence to explain the patient's pain. | No acute fracture or malalignment. |
Generate impression based on findings. | Fall today, unable to ambulate. Pelvis: No acute fracture or malalignment.Right hip: No acute fracture or malalignment.Right knee: No acute fracture or malalignment. No joint effusion. Growth arrest lines are seen in the distal femur and proximal tibia, likely of no current clinical significance.Left ankle: No acute fracture or malalignment. | No acute fracture or malalignment in the pelvis, right hip, right knee, and left ankle. |
Generate impression based on findings. | Fall today, generalized back pain. Minimal anterior wedging of the T8 vertebral body. This is on uncertain chronicity. No additional fracture or malalignment is identified. | Minimal anterior wedging of T8 vertebral body of uncertain chronicity. |
Generate impression based on findings. | Pain, swelling and numbness of the left hand. Mild soft tissue swelling at the fifth metacarpophalangeal joint but no underlying acute fracture or malalignment. | Soft tissue swelling but no acute fracture or malalignment. |
Generate impression based on findings. | Lower mid back pain after car accident today, evaluate for fracture. No acute fracture or malalignment. Vertebral heights and intravertebral disk spaces are maintained. | No acute fracture or malalignment. |
Generate impression based on findings. | Male; 19 years old. Reason: Evaluate for osteomyelitis History: L foot pain No erosion or periosteal reaction to suggest osteomyelitis. No acute fracture or malalignment. | No radiographic evidence of osteomyelitis. |
Generate impression based on findings. | Generalized pain in the lateral, medial scapular area for two days after punching a wall. Evaluate for fracture. No acute fracture or dislocation. No radiographic evidence to explain the patient's right shoulder pain. | No acute fracture or dislocation. |
Generate impression based on findings. | Generalized right hand and forearm pain. Evaluate for fracture. Right forearm: No acute fracture or malalignment.Right hand: No acute fracture or malalignment. | No acute fracture or malalignment. |
Generate impression based on findings. | Back and left knee pain after motor vehicle collision. Evaluate for fracture. Lumbar spine: Vertebral body heights and intervertebral disk spaces are maintained. No acute fracture or malalignment.Left knee: No acute fracture or dislocation. There is a small joint effusion. | No acute fracture, dislocation, or malalignment. |
Generate impression based on findings. | Female 83 years old; Reason: left adnexal mass or renal stone History: pressure left abdomen ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Nonspecific hypodense foci in the liver which cannot be further without intravenous contrast.Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Cystic mass in the pancreatic neck measures 3.0 x 2.1 cm (image 43/series 3) previously, 2.5 x 1.7 cm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable vascular calcification in the right renal hilum. No definite nephrolithiasis. No hydronephrosis or perinephric fluid collections.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: Bilateral adnexal lesions. Right adnexal mass measures 4.0 x 2.7 cm (image 118/series 3) previously, 4.3 x 4.2 cm.Left adnexal mass measures 6.2 x 4.5 cm (image 118/series 3) previously, 6.3 x 4.9 cm. it appears to have solid components within it.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. | 1.Bilateral adnexal lesions. Overall size is similar.2.Cystic pancreatic neck mass has increased in size ; further evaluation an M.R.C.P. is suggested. |
Generate impression based on findings. | Female 50 years old; Reason: 50y/o with cytopenias and night sweats. R/o adenopathy or other lesions History: cytopenias and night sweats CHEST:LUNGS AND PLEURA: Soft tissue attenuation 6-mm pulmonary nodule is located in the superior segment of the right lower lobe (image 39/series 4). Additional scattered subcentimeter pulmonary nodules.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Small mediastinal lymph nodes with the largest measuring 1.2 x 0.9 cm (image 23/series 3).CHEST WALL: Multiple bilateral axillary lymph nodes, abnormal by number.Large left thyroid nodule and smaller right thyroid nodule.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. There is mild intrahepatic ductal dilation. There is gallbladder sludge within a nondistended gallbladder.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: Small retroperitoneal lymph nodes. Reference left para-aortic lymph node measures 1.2 x 0.8 cm (image 111/series 3). BOWEL, MESENTERY: Postsurgical changes from a gastric bypass. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus is absent.BLADDER: No significant abnormality noted.LYMPH NODES: Multiple small pelvic lymph nodes. Right pelvic side wall lymph node measures 3.3 x 1.0 cm (image 160/series 5). BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Nonspecific small axillary retroperitoneal and pelvic lymph nodes. Given the symptoms, a low grade lymphoproliferative disorder is not excluded. 2.Right 6 mm pulmonary nodule, follow-up recommended.3.Thyroid nodules. |
Generate impression based on findings. | 48-year-old male with left flank pain. Evaluate. 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 nephrolithiasis or obstructing ureteral calculus. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No findings to suggest small bowel obstruction. No evidence of colitis.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: As aboveBONES, SOFT TISSUES: Moderate degenerative changes affect the L5/S1 with vacuum disk phenomena.OTHER: No significant abnormality noted | 1.No obstructing nephrolithiasis or ureteral calculus. 2.Moderate degenerative disease affects L5/S1. |
Generate impression based on findings. | 68-year-old female status post EVAR with known endoleak. Evaluate ANGIOGRAM: No significant interval change in the diffuse aneurysmal dilatation of the thoracic aorta beginning at the level of the proximal arch measuring approximately 4 cm in maximal diameter, extending inferiorly to the mid descending thoracic aorta. The great vessels of the aortic arch demonstrate conventional anatomy with stable dissection involving the right brachiocephalic artery. There is a focal ulcer involving the descending thoracic aorta, which is unchanged (series 15, image 58).Moderate atherosclerotic calcifications affect the abdominal aorta. Moderate atherosclerotic calcifications affect the origin of the celiac axis, which is patent without evidence of dissection or thrombus. Mild atherosclerotic calcifications affect the origin of the SMA which is patent. The renal arteries are patent bilaterally with mild to moderate atherosclerotic calcifications at the origin of the right renal artery.No evidence of aortic dissection. Postoperative changes of aortobiiliac stent graft without evidence of an endoleak within the limitation of streak artifact from the vascular coils posterior to the aneurysm at the level of the common iliac arteries (series 12, image 126), compatible with prior embolization. Previously noted Type 1A endoleak is no longer demonstrated. Aneurysmal dilatation of the suprarenal abdominal aorta measures 5.8 x 5.4 cm (series 15, image 136), not significantly changed. Aneurysmal dilatation of the abdominal aorta to the level of proximal origin of aortobiiliac stent measuring 5.2 x 4.9 cm at the level of the renal veins (series 12, image 98), previously measuring 5.2 x 4.8 cm. Additional more focal fusiform aneurysm of the infrarenal aorta measures 5.1 x 4.9 cm (series 12, image 123), previously measuring 4.9 x 4.8 cm.CHEST:LUNGS AND PLEURA: Severe upper lobe predominant centrilobular emphysema. Calcified right lower lobe pulmonary nodule consistent with prior granulomatous disease.No suspicious pulmonary nodules. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: There are postsurgical changes related to prior sternotomy and left internal mammary bypass graft to the left anterior descending coronary artery. No mediastinal or hilar lymphadenopathy.CT angiogram findings as above.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No arterially enhancing lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Angiogram findings as above.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Atrophic or surgically absent uterus.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.Multiple aortic aneurysms without significant interval change in size as above. 2.No evidence of an endoleak as clinically questioned.3.Previously noted Type 1A endoleak is no longer demonstrated. |
Generate impression based on findings. | Male 47 years old; Reason: pt with a history of testicular cancer, please assess for disease progression History: testicular cancer CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Nonspecific subcentimeter hypodensities in the liver. Hepatic and portal veins are patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right kidney is absent.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes in the right inguinal canal. Small bone island noted in the right ilium is unchanged.OTHER: No significant abnormality noted | 1.Stable exam without new sites of disease. |
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. If there is clinical concern for metastases and no contraindications, MRI of the brain with contrast may be considered. |
Generate impression based on findings. | Status post transoral robotic-assisted left base-of-tongue resection, left pharyngectomy and suture pharyngoplasty for T1 N1 squamous cell carcinoma at the junction of the left tonsil remnant and base-of-tongue on 1/22/2015. Post-surgical baseline study. Artifact from dental amalgam somewhat limits evaluation. There are post-surgical changes related to left base-of-tongue resection and left pharyngectomy. There is a defect at the left base of tongue with some peripheral enhancement of the surgical bed. There is mucosal irregularity and an infiltrative pattern of enhancement, which extends inferiorly into the left lateral pharyngeal wall, the left vallecula, hypopharynx and the left aryepiglottic fold which is slightly thickened. There is amorphous material in the left base of tongue surgical defect as well as along the left lateral pharyngeal wall and the left aspect of the vallecula, which could represent debris or packing material. Redemonstrated are multiple, enlarged, pathologic left level II and III lymph nodes, the largest of which is a left level IIa lymph node measuring 19 x 16 mm, previously 23 x 18 mm. At the left level Ib level, there is a nodule closely associated with the left submandibular gland which has a similar CT pattern as the submandibular gland, and which may represent an accessory salivary gland. However, a lymph node cannot be excluded. This is unchanged from prior CT neck and demonstrates no corresponding hypermetabolic activity on the prior PET-CT. The thyroid and major salivary glands are otherwise unremarkable. The major cervical vessels are patent. The osseous structures are unchanged. There is cervical spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs demonstrates a new ill defined opacity in the right apex. | 1. Surgical defect at the left base of tongue with some peripheral enhancement. Findings likely related to surgery. However, there is mucosal irregularity and an infiltrative pattern of enhancement extending inferiorly into the left lateral pharyngeal wall, vallecula, and hypopharynx with thickening of the left aryepiglottic fold. Again, this could reflect post-operative change if surgery was performed at these levels, but tumor cannot be excluded. Please correlate with operative findings and direct visualization. 2. Several pathologic left neck lymph nodes, the largest of which is decreased in size.3. New right apical lung opacity. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Female 61 years old; Reason: history of stage 4 cervical cancer now with worsening pain, evaluate for disease progression History: worsening pain CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Thyroid is enlarged.ABDOMEN: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: Left kidney is atrophic. Percutaneous nephrostomy catheter terminates within the left kidney collecting system.Right nephrostomy catheter tip is within the right renal pelvis. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes from a left lower ostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged uterus. Gas and fluid within the vagina with a thickened mucosa.BLADDER: Diffuse thickening of the bladder wall.LYMPH NODES: Reference left pelvic lymph node measures 1.3 x 1.2 cm (image 175/series 5) previously, 2.4 x 1.9 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lumbar spine degenerative changes.OTHER: Effacement of the soft tissues within the pelvis. | 1.Decrease in the size of the pelvic lymph nodes.2.Extensive thickening of the vaginal mucosa which now has fluid in the lumen and may represent infection or persistent fistulization to the bladder. |
Generate impression based on findings. | Female 55 years old; Reason: weight loss nausea History: as above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. No focal hepatic lesion. Hepatic and portal veins are patent. Gallbladder sludge layers within a nondistended gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst. No hydronephrosis in the right kidney. Left renal cyst. No hydronephrosis of the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus is absent or atrophic. Small foci of gas within the upper vagina.BLADDER: No significant abnormality noted.LYMPH NODES: Small nonspecific pelvic lymph nodes.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Degenerative changes affect the right hip.OTHER: No significant abnormality noted. | 1.Etiology of the patient's nausea/ vomiting is not evident on the current exam.2.Colonic diverticulosis. |
Generate impression based on findings. | Male 58 years old; Reason: 58 year old man with large B cell lymphoma post chemotherapy. COmpare to prior scans. History: none CHEST:LUNGS AND PLEURA: Reference soft tissue mass in the right upper lobe near the suture line has resolved. The right lower lobe pulmonary masses have also resolved. There is a new left lower lobe pulmonary nodule measuring 1.3 x 1.3 cm (image 61/series 4). The spiculated lesion extends to the pleural surface.The pleural spaces are clear.MEDIASTINUM AND HILA: Cardiac size is mildly enlarged. Left chest wall pacer has leads in the heart.Reference mediastinal lymph node measures 1.0 x 0.8 cm (image 31/series 3) previously, 1.1 x 0.7 cm.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathyBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathyBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Resolution of the right upper lobe and right lower lobe pulmonary nodules.2.New left lower lobe pulmonary nodule.3.No new lymphadenopathy. |
Generate impression based on findings. | Redemonstrated are multiple enhancing lesions in the bilateral cerebral hemispheres with associated T1 shortening and susceptibility artifact, consistent with hemorrhagic metastases. There is surrounding vasogenic edema of some of the lesions, left greater than right. There is regional mass effect. No midline shiftThere are enhancing dural based lesions at both sides of the falx cerebri at the posterior frontal region and at the posterior parietal falx. There is no meningeal enhancement.There is faint enhancement in the left pons (series 1501, image 11) seen on one sequence, without associated FLAIR/T2 abnormality. There is also subtle associated signal void on VEN BOLD sequence, suggestive of capillary telangiectasia or unusual presentation of hemangioma.The ventricles are unremarkable. The basal cisterns remain patent. No extra-axial fluid collection is identified. Calvarium and soft tissues of the scalp as well as orbits, and mastoid air cells are unremarkable. | 1. Multiple hemorrhagic intracranial metastatic lesions primarily in the supratentorial space as detailed above with regional mass effect. No midline shift or hydrocephalus. 2. At least two dural based metastases of the posterior frontal and posterior parietal falx. |
Generate impression based on findings. | Female 70 years old; Reason: 70F h/o cecal pneumatosis s/p ileocolectomy w/ EI and transverse colon mucous fistula, p/w elevated WBC, abdominal pain, tachycardia, cough History: abdominal pain, cough/congestion CHEST:LUNGS AND PLEURA: Pulmonary nodule adjacent to the left major fissure measures 1.0 x 0.5 cm (image 41/series 5). The pleural spaces are clear. There is mucous within the central airways.MEDIASTINUM AND HILA: Heart size is enlarged. Triple-vessel coronary vascular calcifications. Left subclavian artery is thrombosed. There is a stent graft partially imaged. Left carotid stent, partially imaged.Median sternotomy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuation of the liver suggests fatty infiltration. There is a lesion in the left lateral segment that measures 1.2 x 1.2 cm (image 88/series 3). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland nodule measures 2.0 cm (image 92/series 3)KIDNEYS, URETERS: Renal cortical cysts. No hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: Aortofemoral grafts. The superior mesenteric artery has been stented but is occluded. Severe calcific arteriosclerotic disease affects the celiac artery and branches of the SMA.BOWEL, MESENTERY: Postsurgical changes from a right lower abdominal ostomy. The bowel loops in the left upper abdomen are mildly dilated possibly from an ileus. Some of the ileal loops in the right lower abdomen have a thickened wall which may represent changes from recent manipulation versus ischemia.No drainable fluid collections.BONES, SOFT TISSUES: Postsurgical changes the midline abdomen with a right lower abdominal ostomy.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: Please see aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Postsurgical changes in the abdomen with mild dilatation of the left upper abdominal jejunal loops possibly representing an ileus.2.Thickening and mucosal hyperenhancement of the ileal loops in the right abdomen may be a sequela of recent surgery or possibly ischemia.3.Severe calcific arteriosclerotic disease of aorta with occlusion of the superior mesenteric artery.4.Left lower lobe pulmonary nodule.5.Small hepatic lesion. |
Generate impression based on findings. | CT HEAD: There is mild right posterior parietal scalp swelling. There is no intracranial hemorrhage. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There are minimal scattered areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with minimal age-indeterminate small vessel ischemic changes. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. CT CERVICAL SPINE: The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disc heights are well-maintained. There are mild degenerative cervical spondylosis without significant spinal canal or foraminal stenosis. | 1. Mild right posterior parietal scalp swelling. No acute intracranial hemorrhage or depressed calvarial fracture. 2. Minimal age-indeterminate small vessel ischemic changes.3. No acute fracture or subluxation of the cervical spine. 4. Mild cervical spondylosis without significant spinal canal or foraminal stenosis. |
Generate impression based on findings. | Female 61 years old; Reason: obstruction History: abd pain There is gas and stool within nondistended colon. On the upright view, there are a few scattered air-fluid levels. No free air is evident.Degenerative changes affect the lumbar spine and hips. | 1.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. SPINE | 1. No acute intracranial abnormality.2. Minimal spondylosis without significant spinal canal or foraminal stenosis. 3. Tiny round immediate left paramedian disc extrusion at T7-8 contributes to minimal flattening of the spinal cord. Additional tiny spurs at T6-7 and T8-9 contribute to minimal flattening of the spinal cord. No significant cord signal abnormality or cord displacement. |
Generate impression based on findings. | Male; 19 years old. Reason: infection History: L foot infection, evaluate for osteomyelitis. There is infiltration of the subcutaneous fat along the lateral aspect of the fifth metatarsophalangeal joint. No evidence of involvement of the joint. There is no evidence of bony erosion or periosteal reaction in this area. There is no drainable fluid collection. No additional areas of abnormal soft tissue attenuation are identified.No acute fracture or malalignment. | Cellulitis at the lateral aspect of the fifth metatarsophalangeal joint. No CT evidence of osteomyelitis. To exclude bone marrow changes MRI would be necessary. |
Generate impression based on findings. | History of vocal cord cancer and chemoradiation treatment. Compare to prior study. There is interval decrease in aryepiglottic fold thickening and enhancement. Mild distortion of the glottis and supraglottic tissues is similar to the prior examination. Erosive change of the anteromedial thyroid cartilage is stable. The left arytenoid cartilage is also slightly sclerotic similar to prior. An ill-defined enhancing region at the right tongue base is again identified and measures 11 x 11 mm (series 8456, image 60, previously 1.3 x 1.0 cm ).No definite pathologic enhancement is seen elsewhere throughout the aerodigestive tract. No pathologic adenopathy by CT size criteria. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent.No significant interval change in the well-defined round lucency within the left lateral mass of C1. No new or concerning focally destructive osseous lesions are present. The visualized lung apices demonstrate emphysematous changes. | 1. Interval decrease in thickening of the aryepiglottic folds. Distortion of the glottic and supraglottic space is unchanged.2. No evidence of pathologic adenopathy in the neck. |
Generate impression based on findings. | Male 68 years old; Reason: assess for intraabdominal free air History: assess for intraabdominal free air Persistent dilated loops of small bowel in the midabdomen measuring up to 4 cm. this likely due to an ongoing bowel obstruction. It appears similar to the CT dated 7/26/2014.Enteric tube terminates in the region of the gastric body.There are postsurgical changes with multiple clips in the right lower abdomen. | 1.Persistent dilated loops of small bowel likely related to a chronic bowel obstruction. |
Generate impression based on findings. | Female, 29 years old.Surgical Case Information | Procedure(s): Procedure(s) with comments: | KIDNEY-PANCREAS TRANSPLANT - Procedure: Kidney pancreas transplant | Operating Room: CDOR 15 CENTRAL | Surgeon(s) and Role: | * Yolanda Tai Becker, M.D. - Primary | * J Richard Thistlethwaite, M.D. - Assisting | Surgical drain and ureteral stent noted in the pelvis. External folded surgical towels extend vertically across the abdomen. Surgical clips are present in the right upper abdomen. Additional metallic wire-type device projects over the right hip. No unexpected radiopaque foreign body.The bowel gas pattern is nonobstructive. There is subcutaneous emphysema. | No unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Becker, the attending surgeon, on 2/7/2015 at 1815 by Raj Vasnani. |
Generate impression based on findings. | Male, 51 years old. Surgical Case Information | Procedure(s): Procedure(s): | ADULT LIVER TRANSPLANT | Operating Room: CDOR 17 CENTRAL | Surgeon(s) and Role: | * John F. Renz, M.D. - Primary | * Baddr Ahed Shakhsheer, M.D. - Resident - Assisting | * Piotr Witkowski, M.D. - Assisting | Multiple surgical clips, surgical drains, enteric tube, right femoral catheter, an IVC filter noted.No unexpected radiopaque foreign body.The bowel gas pattern is nonobstructive.Enteric tube terminates in the region of the gastric body. Right subhepatic and subdiaphragmatic drains are noted. | No unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Renz, the attending surgeon, on 2/8/2015 at 3 a.m.. By Dr. Raj Vasnani |
Generate impression based on findings. | Male 79 years old; Reason: s/p ileostomy, liquid stool, eval stool burden History: see above Mild gaseous distention of small bowel loops in the right upper abdomen measuring up to 4.4 cm. there is scattered amounts of gas within the rectum and descending colon. Less than average stool burden.No definite free intraperitoneal air.Degenerative changes affects the lumbar spine. | 1.Dilated small bowel loops in the right upper abdomen. |
Generate impression based on findings. | Large B-cell lymphoma status post chemotherapy. Compare to prior study. There is mild asymmetry of the tonsils without evidence of a mucosal-based enhancing mass. The left level 2a cystic lymph node is decreased in size measuring 26 x 18 mm, previously 30 x 23 mm. No other pathologic lymph nodes by size criteria are identified. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The visualized portions of the brain are unremarkable. There is mild cervical spondylosis. A left hemithoracic pacemaker/AICD device is present. There is interval decrease in size of the right upper lobe lung nodule measuring 9 x 9 mm, previously 18 x 13 mm. | 1. Prominent cystic left level 2a lymph node, which is decreased in size compared to the prior examination. No new cervical lymphadenopathy.2. Interval decrease in size of the right upper lobe nodule. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Male 61 years old; Reason: NGT placement History: NGT Improvement in the small bowel distention. There is scattered gas within the colon.Postsurgical changes with catheter type devices projecting over the abdomen and pelvis. Postsurgical staples in the pelvis.Enteric tube terminates in the region of the proximal gastric body. | 1.Improving ileus or obstruction. |
Generate impression based on findings. | Female 27 years old; Reason: eval for infection History: headache w precious vpleural shunt, fever, abd pain Bowel gas pattern is nonobstructive with scattered gas in the colon.Postsurgical clips are noted in the right upper abdomen. IVC filter projects over the L2-3 vertebral body. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | Female 48 years old; Reason: Evaluate for ileus History: No flatus, abdominal pain Bowel gas pattern is nonobstructive. IVC filter projects over the upper abdomen. Electronic device projects over the upper abdomen. Surgical clips in the pelvis. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | Recent dental extractions with concern for right buccal mass. There is evidence of bilateral mandibular and maxillary third molar extractions with soft tissue thickening partly filling the extraction sites, a non-specific finding. There is no discrete fluid collection. There is no evidence of any mass lesion or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. Soft thickening partly filling the bilateral mandibular and maxillary third molar extraction sites, which is non-specific, but likely represents inflammation and/or granulation tissue. 2. No evidence of mass or abscess. |
Generate impression based on findings. | Male 59 years old; Reason: Assess gastric bubble s/p decompression History: none Postsurgical changes of median sternotomy with multiple drains, lines and tubes projecting over the upper abdomen and chest. There is likely free air within the abdomen as the left hemidiaphragm is outlined.Enteric Dobbhoff tube terminates in the region of the gastric body. Nasogastric tube terminates in the region of the distal gastric body. Probable ileus. Stomach bubble is decompressed. | 1.No evidence of gastric distention.2.Postsurgical changes as detailed above with likely intraperitoneal free air. |
Generate impression based on findings. | Clinical question: None ICH, lesion. Signs and symptoms: And 8 and one bilateral upper extremities, exam limited by effort. Nonenhanced head CT:There is no evidence of an acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation remains unremarkable.Mild bilateral cavernous carotid and right vertebral artery vascular calcification is noted.Unremarkable images through the orbits and paranasal sinuses.There is near complete opacification of left mastoid air cells and partial opacification of the left middle ear cavity consistent with otitis media. The right mastoid air cells are also partially opacified however the middle ear cavity remains pneumatized. | 1.Unremarkable nonenhanced head CT.2.Left otitis media. Recommend further evaluation. There is extensive opacification of right mastoid air cells however with pneumatized right middle ear cavity. |
Generate impression based on findings. | Male 59 years old; Reason: Dobbhoff placement History: none Postsurgical changes from median sternotomy with multiple lines, drains and catheters projecting over the chest and upper abdomen.Dobbhoff tube terminates in the region of the gastric body.Nasogastric tube terminates in the region of the distal gastric body.The bowel gas pattern suggests an ileus with mildly dilated gas filled small bowel loops and mild gaseous distention of the transverse colon. | 1.Enteric tube terminates in the region of the gastric body. |
Generate impression based on findings. | Male 68 years old; Reason: g tube not flushing, assess placement History: as above Postsurgical changes in the midline abdomen with multiple skin suture staples. Postsurgical changes in the upper abdomen with multiple bowel suture lines. There is some gas within the colon.Percutaneous catheter terminates in the lower abdomen. | 1.Nonobstructive bowel gas pattern. If clinical concern for obstruction exists consider CT scan. |
Generate impression based on findings. | Male 65 years old; Reason: Dobbhoff placement History: above Cardiomegaly, postsurgical changes from median sternotomy and an LVAD device.The bowel gas pattern is nonobstructive. The Dobbhoff feeding tube terminates in the antropyloric region. | 1.Dobbhoff feeding tube terminates in the antropyloric region. |
Generate impression based on findings. | Female 63 years old; Reason: r/o free air History: abdominal pain Enteric tube terminates in the region of the gastric body. Bowel gas pattern is nonobstructive.Supine portable view is inadequate to evaluate for free air. | 1.Enteric tube tip is in the region of the gastric body |
Generate impression based on findings. | Female 86 years old; Reason: Dobbhoff History: Dobbhoff The bowel gas pattern is nonobstructive. Dobbhoff tube tip terminates in the region of the gastric body.Heart size is enlarged.Degenerative changes affect the lower lumbar spine and sacroiliac joints. | 1.Dobbhoff tube terminates in the gastric body. |
Generate impression based on findings. | Male 65 years old; Reason: OGT placement History: OGT placement Enteric tube terminates in the region of the gastric body. Catheters and lines project over the left upper abdomen and chest. | 1.Enteric tube terminates in the region of the gastric body |
Generate impression based on findings. | Male 55 years old; Reason: dry heaves History: dry heaves Catheter type device projects over the left lower pelvis. IVC filter projects over the L2-3 vertebral body.Extensive subcutaneous emphysema is noted in the right chest wall and body wall.There is a displaced right rib fracture.The bowel gas pattern is not obstructive. | 1.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 31 years old; Reason: eval ileus vs obstruction History: abdominal pain, postop hernia repair, absence of flatus Gaseous distention of the small bowel and colon without a discrete transition point. There is gas within the rectum. The overall imaging findings are most suggestive of an ileus. No definite free intraperitoneal air.Postsurgical changes in the femurs. | 1.Findings suggestive of ileus. |
Generate impression based on findings. | Male 83 years old; Reason: s/p G tube placement, now with abdominal pain after starting tube feeds History: same Catheter device projects over the left hemiabdomen.No significant small bowel dilatation. There is moderate stool burden.Degenerative changes affect the lumbar spine. | 1.No specific evidence of obstruction or ileus.2.Moderate stool burden. |
Generate impression based on findings. | Female 59 years old; Reason: abdominal pain History: as above Bowel gas pattern is nonobstructive with scattered gas and fecal matter within the colon up to the rectum.Postsurgical changes in the left hip. Degenerative changes affect the lumbar spine. | 1.Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 59 years old; Reason: is there signs of obstruction? History: nausea constipation Postsurgical changes in the chest with median sternotomy, pacer leads, pacer device and LVAD device.Bowel gas pattern is nonobstructive. Moderate amount of colonic fecal matter. | 1.Nonobstructive bowel gas pattern.2.Moderate colonic fecal burden.. |
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