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Generate impression based on findings. | Reason: Pt with hx of tonsil Ca; s/p CRT 2 year 11 months . Please re-eval and compare to prior scans History: as above CHEST:LUNGS AND PLEURA: Small nodular ground glass opacities in the right lower lobe, suggestive of aspiration, new from previous.MEDIASTINUM AND HILA: Small right thyroid nodule unchanged and likely benign.No significant lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small unchanged hypodensities, likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cortical scarring unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Small lipoma in the right chest wall.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | 69-year-old male with fever and lymphadenopathy. No infectious source. History of lymphoma and thymoma, in remission. CHEST:LUNGS AND PLEURA: Note is made of paramediastinal fibrosis, which may represent posttherapy changes. Bibasilar scarring/atelectasis.MEDIASTINUM AND HILA: Vascular calcifications of the aorta and its branches. Mild coronary calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: 13-mm hypodensity in right lobe of liver is incompletely characterized (81;series 3).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodularity of the adrenal glands, unchanged.KIDNEYS, URETERS: Exophytic simple cyst along the interpolar region of the right kidney, unchanged. Subcentimeter hypodensities in the kidneys, and are too small to characterize, but likely represent simple cysts. Punctate nonobstructing renal calculus in the inferior pole of the kidney. Interval resolution of the previously described left-sided hydronephrosis.RETROPERITONEUM, LYMPH NODES: Slight interval increase in retroperitoneal lymphadenopathy with the largest measuring 12 x 10 mm, previously 10 x 10 mm (118;series 3). Vascular calcifications of the aorta and its branches.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: Slight interval increase in retroperitoneal lymphadenopathy with the largest measuring 12 x 10 mm, previously 10 x 10 mm (118;series 3).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. 13-mm nonspecific hypodensity in the right lobe liver. This lesion is suspicious for metastases. Further evaluation with a contrast-enhanced MRI is recommended.2. Slight interval increase in retroperitoneal lymphadenopathy. 3. Interval resolution of the previously described left-sided hydronephrosis. Punctate, nonobstructing left renal calculus. |
Generate impression based on findings. | Reason: PATIENT WITH HIV AND HX OF TUBERCULOSIS, POOR HX BY DAUGHTER, PATIENT NOT ON MEDICATIONS FOR TB History: PATIENT WITH HIV AND HX OF TUBERCULOSIS, POOR HX BY DAUGHTER, PATIENT NOT ON MEDICATIONS FOR TB LUNGS AND PLEURA: Moderate upper zone centrilobular emphysema.Mild basilar dependent atelectasis.No sign of TB or other infection.MEDIASTINUM AND HILA: No significant lymphadenopathy.Moderate coronary artery calcification.No pericardial effusion.CHEST WALL: Moderate dextroscoliosis.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Intrahepatic biliary dilation with moderate dilation of the common bile duct and pancreatic duct. The area of the ampulla is not visualized on the current scan however. | 1.Moderate emphysema. No sign of TB or other active pulmonary disease.2. Dilated biliary and pancreatic ducts of uncertain etiology. |
Generate impression based on findings. | 59 year old female with history of one week of progressive left lower quadrant pain, nausea vomiting and diarrhea with chills and history of diverticulitis. 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 small bowel obstruction or free air. Several loops of small bowel demonstrate equivocal thickening, although this is most likely attributed to under distention with contrast. The colon is not adequately distended with contrast, so evaluation of the colon is limited.BONES, SOFT TISSUES: Small umbilical fat containing hernia.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The colon is not well distended with contrast, however there is no evidence to suggest diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No small bowel obstruction, no free air and no radiographic evidence of diverticulitis. |
Generate impression based on findings. | hoarseness, left vocal cord weakness, right facial weakness, bilateral submandibular gland enlargement. Head: There is no evidence of intracranial mass or abnormal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Neck: The larynx appears unremarkable. The submandibular glands and parotid glands are mildly prominent, but without focal lesions. There is no evidence of sialolithiasis. The thyroid gland is unremarkable. There is no significant cervical lymphadenopathy. No mass lesions are identified. The major cervical vessels are intact. There is multilevel degenerative spondylosis, which is most prominent at C5-6. The osseous structures are otherwise unremarkable. There is mild right maxillary sinus retention cyst formation. The orbits are unremarkable. The airways are patent. The imaged portions of the lungs are clear. | The submandibular glands and parotid glands are mildly prominent, but without focal lesions. This may represent sialosis, perhaps related to alcohol. The larynx appears unremarkable, without discernable polyp or other mass lesions, although laryngoscopy is often more sensitive for small mucosal lesions. No significant cervical lymphadenopathy. However, a brain MRI may be useful for further evaluation of brainstem lesions that may account for the cranial nerve deficits reported on clinical examination. |
Generate impression based on findings. | Male 33 years old; Reason: cva History: cva. Note that the cerebral convexities were not included. Within these limitations, mean transit time, time to peak and, cerebral blood volume and cerebral blood flow maps do not identify any evidence for hypoperfused territory. | No CT evidence of perfusion abnormalities in the visualized brain. Note that the high convexities were not included which precludes analysis of this region. |
Generate impression based on findings. | Abdominal pain and vomiting and fever 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: There is mild right-sided hydronephrosis. Right ureter is also dilated throughout its course. There is right Terry ureteric. Fat stranding. No evidence of stones. Right ureter is compressed by enlarged leiomyomatous uterus.Left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Borderline enlarged retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Leiomyomatous uterus. The uterus extends above the level of the pelvis and measures 17 by 15 cm.. There is also a left adnexal complex cystic mass measuring 5.6 x 5 .5-cm image number 108, series number 3. This lesion is suspicious for a cystic ovarian neoplasm.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Significantly enlarged leiomyomatous uterus, causing compression of the right ureter and mild right hydronephrosis. Fat stranding around the right ureter and the kidney is suggestive of pyelonephritis. Correlation with urinalysis is recommended.Complexed left adnexal cystic mass, suspicious for cystic ovarian neoplasm. |
Generate impression based on findings. | 83-year-old male with relapsed follicular lymphoma status post 6 cycles of chemotherapy. CHEST:LUNGS AND PLEURA: There is interval resolution of the previously described focal airspace opacity in the left upper lobe. Scattered calcified, noncalcified, and ground glass small pulmonary nodules are stable from the prior examination. There is mild centrilobular emphysema and biapical scarring. No pleural effusion.MEDIASTINUM AND HILA: Reference prevascular adenopathy, measures 2.3 x 0.8 cm, previously 3.8 x 1.8 cm in diameter (38; series 3). Again seen are multiple subcentimeter mediastinal lymph nodes, unchanged. Right hilar calcified lymph nodes again seen. Marked coronary artery calcification. No pericardial effusion.CHEST WALL: No axillary adenopathy. Bilateral mild gynecomastia. There are degenerative changes of the spine and a stable sclerotic focus within the left lateral seventh rib.ABDOMEN: Evaluation of the solid organs is limited by lack of intravenous contrast.LIVER, BILIARY TRACT: A subcentimeter focus of decreased attenuation within the right lobe of the liver is too small to characterize but likely represents a simple cyst, unchanged. Multiple punctate gallstones without evidence of acute cholecystitis.SPLEEN: Calcified granulomata in the spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: A stable 5-mm calcification in the upper pole of the right kidney may represent a non-obstructing calculus versus vascular calcification. A 4-cm diameter cyst is again seen in the lower pole of the left kidney.RETROPERITONEUM, LYMPH NODES: There are no enlarged retroperitoneal lymph nodes by size criteria, however there has been slight interval increase in size of multiple small retroperitoneal lymph nodes. The previously referenced periaortic lymph node measures 6 x 8 mm, previously 6 x 9 mm (series 3, image 113).An abdominal aortic aneurysm is again seen which begins approximately at the level of the renal arteries and measures maximally 5.0 cm, previously 5.0 cm in diameter, appearing similar to the prior study, although incompletely evaluated on this noncontrast examination. There is diffuse atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Postsurgical changes with cystectomy and ileal conduit. Multiple pelvic surgical clips.LYMPH NODES: The referenced left inguinal lymph node measures 1.4 x 1 .2 cm, previously 1.6 x 1.3 cm in diameter (series 3, image 196), stable in size from the prior study. A soft tissue mass, which may represent left inguinal lymph nodes measures 5.1 x 1.4 cm, previously 6.0 x 2.7 cm in diameter (series 3, image 203). Additional prominent left inguinal and left femoral lymph nodes are again seen.BOWEL, MESENTERY: Colonic diverticulosis, primarily involving the sigmoid colon.BONES, SOFT TISSUES: Extensive iliac and femoral atherosclerosis. Degenerative changes of the spine and stable sclerotic focus within the right femoral neck.OTHER: No significant abnormality noted | 1. Slight interval decrease in size of reference prevascular, mediastinal, retroperitoneal, and left inguinal lymph nodes. 2. Persistent 5.0-cm abdominal aortic aneurysm. |
Generate impression based on findings. | History of hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Small cystic lesion at the pancreas, unchanged.ADRENAL GLANDS: Bilateral nodular adrenal glands, unchanged. Right adrenal adenoma, measuring 2.4 by 1.8-cm image number 46, series number 3, unchanged.KIDNEYS, URETERS: 1.3-cm high density cyst in the upper pole of the right kidney is unchanged. This cyst measures 37 Hounsfield units on precontrast images and 40 Hounsfield unit on postcontrast images. Other subcentimeter hypodense lesions in both kidneys are also unchanged and some are too small to characterize. Simple cyst in the left upper pole is unchanged.No evidence of renal stones.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.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: No significant abnormality notedOTHER: No significant abnormality noted | Bilateral renal cysts are unchanged. Some of these renal lesions are too small to characterize. No CT findings to explain patient's hematuria.Right adrenal adenoma, unchanged.Cystic pancreatic lesion is unchanged. |
Generate impression based on findings. | Female 55 years old; Reason: 55 year old female with relapsed lymphoma. On observation. Compare to prior scan. History: none CHEST:LUNGS AND PLEURA: Mild upper lobe dominant emphysematous changes. There are multiple new focal ground glass opacities in both lungs.There is near symmetric upper lobe and lower lobe distribution. No bronchiectasis. No pleural effusions. Subcentimeter pulmonology of in the right lobe (image 51/series 4) is new.MEDIASTINUM AND HILA: Mediastinal lymph nodes are near stable in size. Right paratracheal lymph node measures 1.7 x 1.6 cm (image 34/series 3) previously, 1.8 x 1.6 cm.Other mediastinal nodes are not significantly changed in size.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Spleen is top normal measuring 12 cm in AP dimension.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland nodule measures 1.4 x 1.0 cm (image 93/series 3) previously, 1.5 x 0.9 cm.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mesentery reference lymph node measures 2.5 x 1.0 cm (image 125/series 3) previously, 2.8 x 1.0 cm.Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Post operative changes from hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Small inguinal and pelvic lymph nodes remain.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.New bilateral multiple ground-glass nodules. Atypical infection would be the leading differential. Allergic drug reaction and hypersensitivity would also be considered.2.No change in the size of the target lesions. |
Generate impression based on findings. | 56-year-old male. Abnormal CXR. Evaluate lung fields. LUNGS AND PLEURA: Mild left pleural thickening. Calcified left lung granuloma. Left basilar subsegmental atelectasis/scarring. Mild lower lobe bronchial wall thickening.No focal airspace consolidation.MEDIASTINUM AND HILA: Left subclavian ICD leads terminate in the right ventricle. Cardiomegaly. Small pericardial effusion.Enlarged mediastinal lymph nodes, measuring up to 19 mm (series 3, image 30), probably an incidental finding. Some nodes are calcified.CHEST WALL: Mild degenerative changes of thoracic spine. Prominent axillary lymph nodes bilaterally. Compression deformity of mid-thoracic vertebral body.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. Calcified splenic granulomas. 3 endoscopy clips in the stomach. | 1. Mild lower lobe bronchial wall thickening. 2. Enlarged mediastinal lymph nodes, likely reactive. |
Generate impression based on findings. | left frontal meningioma - for intraop guidance/preop planning (cannot have MRI)Signs and Symptoms: tumor bleed; preop planning There is some 19 x 20 mm axial dimension extra-axial contrast enhancing mass which abuts the falx cerebra and the adjacent left superior frontal gyrus which is associated with vasogenic edema extending into the left paracentral lobule in the left superior frontal gyrus. The mass itself is hyperdenseThe patient is status post a posterior fossa surgery. There is some encephalomalacia present along the right cerebellar hemisphere including the right middle cerebellar peduncle appeared there is extra-axial fluid present at the craniectomy site measuring approximately 14 mm in thickness.There is a 13 x 10 mm axial dimension hyperdense focus present adjacent to the right temporal lobe just above the right transverse sinus which does not enhance following contrast administrationThe right to jugular vein is larger than the left jugular vein. The right jugular bulb is high riding.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is an extra-axial parafalcine mass present associated with the adjacent brain edema along the left frontal lobe and left paracentral lobule2.patient status post posterior fossa surgery. There is some encephalomalacia present in the cerebellum. There is an extra-axial fluid collection present in the posterior fossa. Please correlate with the patient's prior imaging studies which are not available at this time3.there is a small hyperdense lesion present adjacent to the right temporal lobe. Please correlate with prior imaging findings.4.Examination was performed for the purpose of stereotactic guidance. |
Generate impression based on findings. | 73-year-old female patient with right shoulder osteoarthritis. Preoperative planning. There is medial narrowing of the glenohumeral joint with bone on bone apposition, osteophyte formation and subchondral cysts indicating severe osteoarthritis. The glenohumeral joint alignment is within normal limits and there is no frank glenoid bone loss. There is a moderate-sized glenohumeral joint effusion with extension of fluid into the subscapular recess. There is a small focus of gas density seen in the recess which may be due to recent injection or perhaps related to the patient's osteoarthritis. The lack of surrounding soft tissue swelling argues against infection. There is mild atrophy of the supraspinatus muscle with the remaining musculature within normal limits for age. Mild osteoarthritis at the the acromioclavicular joint. Degenerative changes affect the visualized portion of the cervical spine. | Arthritic changes with joint effusion as described above. |
Generate impression based on findings. | Reason: nodular opacity ? breast on the CXR History: ams LUNGS AND PLEURA: Mild upper zone centrilobular emphysema.Clustered nodular ground glass and air space opacities in the left lower lobe, suggestive of aspiration.No other suspicious pulmonary nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Extensive and severe coronary artery calcification.Moderate size sliding hiatal hernia.CHEST WALL: Multiple calcified lesions in both breasts with a benign appearance.Focal lucency in the T8 vertebral body, possibly an hemangioma though a metastasis is also a possibility.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Extensive abnormalities compatible with ascites and carcinomatosis as previously described in detail on the recent abdominal CT scan. | Focal opacities in left lower lobe suggestive of aspiration. No specific evidence of primary or metastatic cancer in the lungs. |
Generate impression based on findings. | 60 year old male. Metastatic mesothelioma and positive sputum for mycobacterium. Evaluate for underlying infectious disease. CHEST:LUNGS AND PLEURA: New focal airspace opacity in the right upper lobe (series 5, image 60), consistent with infection. Surgical changes at right lung base with a mesh graft again noted. Right lower lobe atelectasis/consolidation, similar to prior exam. Diffuse nodular right hemithorax pleural thickening, increased from prior exam.Reference measurements are as follows:1. At the level of the right pulmonary artery at the 9 o'clock position, pleural thickening measures 11 mm (series 3, image 48), previously 7 mm.2. At the level of the heart base at the 4 o'clock position, right crural soft tissue nodule cannot be accurately measured due to obscuration by right lower lobe atelectasis/consolidation.3. Abutting the right ventricle at the 12 o'clock position, pericardial soft tissue nodule measures 21 mm in short axis (series 3, image 55), previously 19 mm. Long axis dimension cannot be accurately reproduced. Innumerable bilateral lung nodules, not significantly changed from immediate prior exam but markedly progressed from 2012. This is consistent with hematogenous dissemination of tumor. Reference left upper lobe nodule is 6 mm (series 5, image 43).MEDIASTINUM AND HILA: Left upper lobe paratracheal lymph node measures 20 mm in short axis (series 3, image 27), previously 15 mm. Reference right paratracheal lymph node measures 32 mm in short axis (series 3, image 40), previously 26 mm. Reference right lower paratracheal lymph node measures 22 mm in short axis (series 3, image 40), previously 24 mm. CHEST WALL: Right axillary lymphadenopathy, not significantly changed. Multiple confluent enhancing right lateral chest wall masses, similar to prior exam. Interval development of severe compression deformity of T7 vertebral body.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy, not significantly changed. Reference aortocaval lymph node measures 14 mm, unchanged (series 3, image 92). BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. New right upper lobe focal airspace opacity consistent with infection.2. Significant interval increase in right hemithorax pleural thickening and mediastinal lymphadenopathy.3. Numerous bilateral lung nodules consistent with hematogenous dissemination of tumor, not significantly changed from immediate prior CT but markedly progressed from 2012. |
Generate impression based on findings. | Male 67 years old; Reason: Stage IV Esophagogastric Adenocarcinoma please compare to previous scan and provide index lesion measurements per RECIST History: As Above CHEST:LUNGS AND PLEURA: Stable bronchiectasis and scarring in the left apical anterior segment and in the left posterior medial lung segments. No suspicious pulmonary lesions. Calcified granulomata in the right lung apex.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Right chest wall port terminates at the cavoatrial junction. Esophagus wall is thickened.CHEST WALL: The pedicle and transverse process of the right T5 vertebral body and rib show mixed sclerotic and lucent changes.OTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal gland mass as mostly resolved. Asymmetric portion of the gland measures approximately 2.4 x 0.7 cm (image 90/series 4) previously, 3.6 x 2.3 cm.KIDNEYS, URETERS: Left renal cyst with peripheral calcification and minimal internal septations some of which are calcified and is unchanged. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease. Small retroperitoneal lymph nodes.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: Mesenteric pelvic lymph node measuring 1.4 x 1.3 cm (image 156/series 4) previously, 1.5 x 1.2 cm.BOWEL, MESENTERY: Soft tissue mass adjacent to the rectum on the right measures 1.9 x 1.2 cm (image 171/series 4) previously, 2.0 x 1.6 cm.BONES, SOFT TISSUES: Mixed sclerotic changes involving the lower lumbar spine from L3 to L5 with compression fractures.Sclerotic lesion involving the right proximal femur (image 193/series 4).OTHER: No significant abnormality noted | 1.Multiple peritoneal and pelvic lymph nodes may represent peritoneal deposits versus metastatic disease and from a rectal primary.2.Sclerotic changes involving the transverse process of T5 and lumbar spine suspicious for metastatic disease, unchanged.3.Bosniak II F. left renal lesion is stable. |
Generate impression based on findings. | Male 55 years old; Reason: Prostate Cancer, evaluation of diease after 6 cycles of investigational therapy. History: Prostate Cancer ABDOMEN:LUNGS BASES: Non specific 4mm pleural based nodule in the right lung base.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: Few too small character of the lesions in the kidneys are noted. No hydronephrosis or mass lesion detected. No perinephric fluid collection seen.RETROPERITONEUM, LYMPH NODES: 7-mm periaortic node noted (series 3 image 71). BOWEL, MESENTERY: Sclerotic focus in the L3 vertebral body and T10 vertebral bodies are likely metastatic lesions from the previously known diagnosis of prostate cancer.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Prostatic beads are seen from prior radiation.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic focus in the L3 vertebral body and T10 vertebral bodies are likely metastatic lesions from the previously known diagnosis of prostate cancer.OTHER: No significant abnormality noted. | 1. Prostate cancer s/p radiation seed therapy with metastatic disease in the spine and non specific retroperitoneal adenopathy.2.Non specific 4 mm nodule in the right lung base. CT chest advised for full characterization. |
Generate impression based on findings. | 76-year-old male with high-grade urothelial cancer and liver lesion. Evaluate liver for lesions. ABDOMEN:LUNG BASES: Bilateral lower lobe dependent atelectasis and left lower lobe scarring. Pacemaker leads with tips in the right atrial appendage and right ventricular apex are unchanged. Small pericardial effusion/thickening.LIVER, BILIARY TRACT: 0.8-cm homogenously hyperenhancing lesion in the right hepatic lobe is isodense on delayed imaging, appearing similar to the prior study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate nonobstructing nephrolithiasis bilaterally. Right renal cysts are unchanged. No ureteral stones. No hydronephrosis. Postsurgical changes of left ureterectomy. On delayed imaging, the left ureter is opacified throughout its course without focal filling defects. Minimal left periureteral fat stranding is unchanged and is likely postsurgical. The right ureter is opacified proximally without filling defects.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic foci in the left seventh lateral rib is unchanged and may be related to old trauma.OTHER: 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: Interval resolution of the previously described small fluid collection in the anterior left hemipelvis. | 1.No significant interval change in a nonspecific subcentimeter homogenously hyperenhancing lesion in the right hepatic lobe, which may represent a flash filling hemangioma, however, follow up examination is recommended.2.No evidence of local recurrence. |
Generate impression based on findings. | Reason: Pt with BOT scc completed CRT in 2011. please re-eval for recurrent disease History: as above CHEST:LUNGS AND PLEURA: Mild upper lobe predominant paraseptal and centrilobular emphysema. Small cyst in the right middle lobe with slight wall thickening and adjacent interstitial opacity, unchanged since 2011. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Mild coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic hypodensities consistent with cysts, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Lucent lesions in the L3 and L4 vertebral bodies are unchanged and may represent benign hemangiomas.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Clinical question:? Hemorrhage left occipital. Signs and symptoms: AMS. Nonenhanced head CT:Examination demonstrate no convincing evidence of hemorrhage. Previously noted foci of increased density. in the left posterior temporal -- occipital region is significantly better visualized on the current study and clearly appears to represent calcification and not a hemorrhagic process. Considering this observation the associated parenchymal loculation likely are presenting a chronic ischemic stroke.Large right PCA territory chronic ischemic stroke demonstrate no change since prior study. Mild small vessel ischemic stroke of indeterminate age are again noted. | 1.No evidence of intracranial hemorrhage.2.Focus of increased density in the left posterior temporal -- occipital region on the current exam clearly appears to represent calcification and not hemorrhage.3.Stable exam since prior study and without detectable new acute findings. |
Generate impression based on findings. | Reason: ?interval change - pt has history of interferon induced pneumonitis/fibrosis History: hypoxia LUNGS AND PLEURA: Moderate basilar bronchiectasis unchanged.Minimal subpleural fibrotic changes in the mid and lower lung zones similar in appearance to the prior exam.No new pulmonary opacities noted.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Mild coronary artery calcifications.Borderline enlargement of the pulmonary artery.CHEST WALL: None. Stable mild interval wedging of several midthoracic vertebrae.Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. | Basilar predominant traction bronchiectasis and mild subpleural fibrosis, unchanged. No acute abnormalities. |
Generate impression based on findings. | Reason: right vocal cord paralysis unknown etiology History: right vocal cord paralysis unknown etiology LUNGS AND PLEURA: Stable 11 by 8mm left upper lobe nodule with features suggestive of a hamartoma or granuloma.Additional very small nodules and scarring, unchanged.Mild centrilobular emphysema.Surgical staples at the right apex.MEDIASTINUM AND HILA: Stable dilation of the descending aorta and mildly ectatic descending aorta.No significant lymphadenopathy.Mild coronary artery calcification.CHEST WALL: Mild thoracic scoliosis.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Very small nonspecific hepatic hypodensities, unchanged, likely cysts. | No significant change and no specific evidence of neoplasm in the chest. |
Generate impression based on findings. | Reason: Egus CA on treatment. Please re-eval. Thanks. History: Egus CA CHEST:LUNGS AND PLEURA: Stable centrilobular and paraseptal emphysema.Mild bronchial wall thickening. Scattered areas of scarring in the left upper lobe, and right lower lobe.No suspicious pulmonologist or masses.No pleural effusions.MEDIASTINUM AND HILA: Stable mediastinal lymphadenopathy with reference, subcarinal, and measuring 11 mm in its short axis previously measuring the same.Interval decrease in esophageal wall thickening of the distal esophagus.Right chest port with the catheter tip in the subclavian and.Cardiac size is normal without evidence of a pericardial effusionCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Interval decrease in size of multiple hepatic metastases are. Reference right hepatic lesion measures 4.4 cm x 6.7 cm, previously measuring 6.7 cm x 12 cm (image 98 series 3).Reference left hepatic lesion (image 93, series 3) now measures 2 cm x 2.6 cm, previously measuring 13 cm by 3.5 cm (image 93, series 3) on prior exam.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Soft tissue mass in the region of the GE junction now measures 5 cm x 3.1 cm, previously, measuring 5.9 cm x 3.7 cm (image 102, series 3).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval decrease in gastroesophageal mass and multiple hepatic metastases. No new sites of disease identified. |
Generate impression based on findings. | Reason: compare to image from 11/2013, s/p treatment for aspiration pnuemonia History: cough LUNGS AND PLEURA: Bilateral upper lobe scarring and mild emphysema.Diffuse reticular interstitial opacities in the subpleural regions and lung bases with bronchial thickening, likely chronic.Moderately large left pleural effusion with pleural thickening and probable loculation. Underlying areas of atelectasis and consolidation in the left lower lobe and lingula, not significantly changed, some of which has a morphology suggestive of rounded atelectasis (arrow).Pleural thickening and calcification posteriorly at the right base.MEDIASTINUM AND HILA: Calcified lymph nodes in the left AP window area and left hilum compatible with previous granulomatous infection.Moderately dilated and patulous esophagus.Severe coronary artery calcification.Calcification of the aortic valve.CHEST WALL: Extensive degenerative disease in the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Extensive calcifications in the spleen compatible with previous granulomatous infection. | Findings the left hemithorax consistent with pleural effusion, possibly loculated, with underlying rounded atelectasis, not significantly changed. |
Generate impression based on findings. | Clinical question: Polyp of the nasal cavity. Signs and symptoms: Nasal polyp. Medtronic fusion sinus CT:Frontal sinuses.Very minimal mucosal thickening in the very dependent portion of bilateral frontal sinuses are present.Ethmoid sinuses. Evidence of bilateral ethmoidectomies. Mild bilateral mucosal thickening is noted.Sphenoid sinus.Complete opacification of the larger left chamber of the splenic sinus and with occluded previously operated communication with the left ethmoid sinus. There is uniform bony thickening of the left chamber and straight sinus consistent with chronic long-standing sinus disease. Lesser degree of similar findings on the right is also noted..There is a loculated soft tissue density likely representing mucosal thickening/retention cyst in the anterior aspect of the right chamber of the sphenoid sinus which extends to the right sphenoethmoidal recess.Maxillary sinuses.On the right there is extensive patchy well-demarcated mucosal thickening and retention cysts. There is evidence of prior endoscopic functional sinus surgery with patent however compromised sinonasal window.On the left there is extensive mucosal thickening and small additional well-demarcated round appearing soft tissues suspect that the retention cyst. There is evidence of prior endoscopic functional sinus surgery at this level as well with a widely patent sinonasal window.Nasal cavity.There are patchy foci of mucosal thickening (right greater than left) consistent with mucosal thickening. Small polyps can also have similar appearance and difficult to differentiate on CT. There is mild nasal septum deviation to the left.All mastoid air cells and bilateral middle ear cavities are well pneumatized and unremarkable.Images through the orbits are unremarkable. | 1.Extensive chronic sinusitis and small retention cyst in paranasal sinuses with the exception of the frontal sinuses.2.Extensive postoperative changes of bilateral endoscopic functional sinus surgery and including partial bilateral ethmoidectomies.3.Occluded bilateral sphenoethmoidal recess, compromised however patent right-sided sinonasal window and patent left sinonasal window.4.Patchy mucosal thickening and possibly small polyps in the nasal passage.5.Well pneumatized bilateral mastoid air cells and middle ear cavities.6.Unremarkable images through the orbits. |
Generate impression based on findings. | 69 year old female. Reason: h/o met thyroid ca, compare to previous, measurements pls History: none. LUNGS AND PLEURA: No significant interval change in size or number of innumerable bilateral diffuse pulmonary metastases. A reference left upper lobe lesion measures 12 x 12 mm (image 21, series #4), previously 12 x 12 mm. A reference left lower lobe lesion measures 9 x 9 mm (image 63, series #4), previously 8 x 9 mm.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy is redemonstrated and grossly unchanged.Reference right hilar lymph node conglomeration is unchanged (image 42, series #3), measuring approximately 17 mm from 16 mm previously.Reference subcarinal lymph node is unchanged, measuring 8 mm in its short axis (image 42, series #3) from previously 10 mm.Asymmetry of the thyroid bed is redemonstrated with enlarged, heterogeneous, right thyroid mass.Normal heart size. No pericardial effusion. Mild coronary calcifications. Tracheostomy again noted.CHEST WALL: The metastatic lesion in the left posteriolateral fifth rib is increased in size, measuring 3.0 x 4.4 cm (image 32, series #3), from previously 2.8 x 4.0 cm.T12 laminectomy again noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the left hepatic lobe, consistent with metastasis, is unchanged.Stable intra-and extrahepatic biliary ductal dilatation.The pancreatic duct is also chronically dilated and unchanged. | 1.Interval increase in size of the metastatic lesion of the left fifth rib.2.No significant interval change in pulmonary metastases, mediastinal/hilar lymphadenopathy, and left hepatic lobe metastasis.3.Right thyroid bed mass. Refer to CT scan of the neck for complete characterization. |
Generate impression based on findings. | Female 70 years old; Reason: 69 F with locally recurrent colon cancer s/p resection with persistently elevated CEA. Please eval for residual/metastatic disease. History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Minimal dependent atelectasis.MEDIASTINUM AND HILA: Right chest port catheter tip is at the SVC/RA junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Round hypodense lesion in the right hepatic lobe measures 9 mm (series 4, image 66) unchanged. A second subcentimeter hypodense lesion in the inferior right hepatic lobe is also unchanged. Subtle segment 6 hemangioma (image 82; series 4). No definite metastases.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 mesenteric lymph nodes again noted.BOWEL, MESENTERY: The previously referenced metastatic implant adjacent to the right colon (image 112; series 4) is much smaller and now measures 1.4 x 1.3cm, previously 2.9 x 2.7 cm. Small hiatal hernia as described previously. Post-surgical changes of right hemicolectomy and terminal ileal resection.Previously described ventral hernia appears to have been repaired. BONES, SOFT TISSUES: 2.6 x 2.6 enhancing nodule in the right anterior subcutaneous tissue (series 4 image 150) is worrisome for a metastatic implant in the soft tissue. Another lesion more inferiorly within the surgical scar (series 4 image 159) is also worrisome for metastatic implant.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Stable small mesenteric lymph nodes. BOWEL, MESENTERY: Post-surgical changes of right hemicolectomy and distal terminal ileum resection.BONES, SOFT TISSUES: 2.6 x 2.6 enhancing nodule in the right anterior subcutaneous tissue (series 4 image 150) is worrisome for a metastatic implant in the soft tissue. Another lesion more inferiorly within the surgical scar (series 4 image 159) is also worrisome for metastatic implant.OTHER: No significant abnormality noted. | 1. Likely metastatic implants in the anterior subcutaneous soft tissues, new from previous exam.2. Decrease in size of the previously referenced metastatic implant adjacent to the right colon. 2. Stable hepatic lesions, likely all benign. |
Generate impression based on findings. | 85 years. Male. Reason: right vocal cord paralysis unknown etiology History: right vocal cord paralysis unknown etiology Soft tissue evaluation is limited by lack of intravenous contrast.Head: There is no mass effect, midline shift, or acute hemorrhage. There is mild diffuse parenchymal volume loss without evidence of hydrocephalus. There is mild to moderate scattered periventricular and subcortical white matter hypoattenuating foci, suggestive of small vessel ischemic disease. There are large vessel vascular calcifications. The osseous structures are unremarkable. There are bilateral lens implants and glaucoma shunts. The paranasal sinuses and mastoid air cells are clear.Neck: The right vocal cord is deviated toward midline with some fatty atrophy. No lymphadenopathy or mass is noted. There is no significant airway stenosis. The salivary and thyroid glands are unremarkable. There is degenerative spondylosis, most pronounced at C4-5 and C5-6. Views of the upper chest demonstrate paraseptal and centrilobular emphysema. There is partially imaged ectasia and calcifications in the aortic arch. A 11-mm lobulated lesion in the left apex, which contains calcification is not significantly changed from 10/24/12. There are surgical sutures in the right apex. There are advanced degenerative changes of the bilateral shoulders with joint effusions and calcified loose bodies within the joints. | 1. Evidence of right vocal cord paralysis without discrete mass or lymphadenopathy on this noncontrast exam. Surgical sutures in the right lung apex, in the expected vicinity of the expected course of the right recurrent laryngeal nerve. Please refer to the separate chest CT report as well. 2. No definite evidence of intracranial mass, although assessment is limited by lack of intravenous contrast. |
Generate impression based on findings. | Male 64 years old; Reason: metastatic prostate cancer, confirmatory scan to evaluate of progression History: metastatic prostate cancer, CHEST:LUNGS AND PLEURA: The previously referenced 1.2 x 1.1 cm right upper lobe nodule is now not measurable (series 5 image 37). Smaller scattered micronodules. Peripheral airspace opacity left lower lobe has resolved in the interim.MEDIASTINUM AND HILA: Mediastinal and right hilar adenopathy is stable to slightly decreased. The representative precarinal lymph node best seen on image 39 of series 3 measures 1.1 x 0.7cm previously 1.4 x 1.1 cm. Right hilar reference lesion best seen on image 46 of series 3 measures 1.2 x 1.6 cm, previously 1.3 x 2.2 cm.CHEST WALL: Sclerotic lesions involving multiple thoracic vertebral bodies are relatively stable.ABDOMEN:LIVER, BILIARY TRACT: Stable bilobar hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hydronephrosis has resolved.RETROPERITONEUM, LYMPH NODES: Previously described reference lymph nodes are still unmeasurable. Shotty retroperitoneal borderline lymph nodes are stable, measuring up to 8 mm in short axis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable bone sclerosis throughout the visualized osseous structures. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Interval regression of adenopathy.. Reference left internal/external iliac bifurcation lymph node measures 0.8 x 0.7cm previously 0.9 x 0.9 cm (image 179; series 4), markedly decreased in size.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Stable bone metastasis as aboveOTHER: No significant abnormality noted | Stable nodal and bone metastatic disease without new lesions detected. |
Generate impression based on findings. | 20 year-old female with history of rhabdomyosarcoma, off therapy, evaluate for progression CHEST:LUNGS AND PLEURA: Micronodule along the left major fissure likely represents an intrapulmonary lymph node. No suspicious nodules or masses. No focal consolidation or pleural effusion.MEDIASTINUM AND HILA: Large bilateral thyroid nodules with a right-sided dominant nodule appears similar to the prior exam. No mediastinal or hilar lymphadenopathy. Heart size is normal.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions or biliary ductal dilatation. Gallbladder appears normal.SPLEEN: Spleen is normal in appearance.PANCREAS: Pancreas is normal in appearance.ADRENAL GLANDS: Bilateral adrenals are normal.KIDNEYS, URETERS: No focal renal lesions or hydronephrosis.RETROPERITONEUM, LYMPH NODES: Impression peritoneal lymphadenopathy.BOWEL, MESENTERY: No bowel dilatation or thickening. Appendix is air-filled.BONES, SOFT TISSUES: Scattered bone islands are unchanged.OTHER: No ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No pelvic or inguinal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No evidence of recurrent or metastatic disease.2.Multinodular thyroid gland. |
Generate impression based on findings. | 62-year-old male with urothelial cancer status post radical cystectomy. Evaluate for recurrence. Lack of intravenous contrast limits evaluation of solid organs as well as the collecting system.CHEST:LUNGS AND PLEURA: Note is made of paraseptal emphysema with an upper lobe predominance. Small right Bochdalek hernia.MEDIASTINUM AND HILA: Pretracheal lymphadenopathy measures 2.3 x 1.5 cm (42; series 3). Note is made of prominent mediastinal lymph nodes. Marked coronary artery calcifications. Vascular calcifications of the aorta and its branches. Calcified mediastinal lymph nodes suggestive of prior granulomatous disease.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The right kidney is small and atrophic.RETROPERITONEUM, LYMPH NODES: Abdominal aortic aneurysm, measuring 3.3 cm its largest diameter. The abdominal aorta is ectatic. Left common iliac artery aneurysm measuring 2.0 cm in diameter. There is a right common iliac artery aneurysm measuring 2.1 cm in diameter.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Postoperative changes consistent with the stated history of radical cystectomy with neobladder.LYMPH NODES: Right inguinal lymphadenopathy measures 2.6 x 1.4 cm (two; surgery).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: There is a 4.3 x 2.2 cm low density collection along the left external iliac artery which may represent a lymphocele or seroma although necrotic lymphadenopathy is a consideration. | 1. Mediastinal and inguinal lymphadenopathy. Limited evaluation of the collecting systems, secondary to lack of intravenous contrast.2. 4.3-cm low density pelvic collection which may represent a lymphocele or seroma, although necrotic lymphadenopathy is a consideration. Further evaluation with a contrast enhanced MRI is recommended. 3. Abdominal aorta and bilateral common iliac artery aneurysms, as detailed above. |
Generate impression based on findings. | 78 year-old male with metastatic prostate cancer. Evaluate disease after 3 cycles of investigational therapy. CHEST:LUNGS AND PLEURA: Biapical scarring/atelectasis. Note is made of extensive centrilobular and paraseptal emphysema with an upper lobe predominance. There are scattered bilateral pulmonary micronodules. Note is made of a 7-mm right upper lobe nodule (37; series 5). Scattered pulmonary micronodules.MEDIASTINUM AND HILA: Marked coronary artery calcifications. No pericardial effusion. Note is made of calcifications of the aorta and its branches. No evidence of lymphadenopathy.CHEST WALL: Note is made of multiple sclerotic lesions affecting the sternum, as well as multiple thoracic vertebral bodies and ribs bilaterally.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific small hypodensity in the inferior right lobe is unchanged, but may represent a simple cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst is unchanged. Persistent left-sided hydronephrosis and dilated left ureter up to the point of the anastomosis between the ureter and the pouch, unchanged.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Right lower quadrant ileostomy.BONES, SOFT TISSUES: Again seen is diffuse left iliac bone sclerosis consistent with metastatic disease. Irregularity of the pubic bones adjacent to the symphysis pubis is unchanged. Interval increase in sclerosis of multiple lumbar and thoracic vertebral bodies consistent with metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy. Presacral soft tissue density changes appearing similar to the prior study.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Right lower quadrant ileostomy and left lower quadrant colostomy.BONES, SOFT TISSUES: Again seen is diffuse left iliac bone sclerosis consistent with metastatic disease. Irregularity of the pubic bones adjacent to the symphysis pubis is unchanged. Interval increase in sclerosis of multiple lumbar and thoracic vertebral bodies consistent with metastatic disease.OTHER: Persistent small air and fluid containing collection in the pelvis, measures 3.4 x 1 .7 cm, previously 2.5 by 2.1-cm image number 192, series number 3. | 1. Apparent interval increase in numerous sclerotic lesions affecting the axial and proximal appendicular skeleton consistent with the stated history of metastatic prostate cancer, however, further evaluation with a dedicated nuclear medicine bone scan is recommended.2. Persistent 3.4-cm pelvic fluid collection. 3. Persistent mild left-sided hydronephrosis and hydroureter.4. 7-mm right upper lobe nodule, for which follow-up examination is recommended. |
Generate impression based on findings. | Reason: Esophageal cancer on treatment, please re-eval. Thanks. History: Egus ca CHEST:LUNGS AND PLEURA: Posterior paramediastinal postradiation fibrotic changes , more prominent on the left , and left basilar atelectasis stable.Minimal focal increase in pleural fluid adjacent to the medial basilar area of atelectasis and bronchiectasis.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Left thyroid lobe hypodensity, unchanged.No hilar or mediastinal lymphadenopathy.Cardiac size is normal.Mild pericardial effusion redemonstrated.Right chest port with its catheter tip in the SVC.Wall thickening in the distal esophagus similar in appearance to the prior exam.CHEST WALL: Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Gastrohepatic lymph node (image 83, series 4) measures 9 mm, previously, measuring 10 mm.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Jejunostomy tube redemonstrated.BONES, SOFT TISSUES: Stable radiolucency in the L1 vertebraeOTHER: No significant abnormality noted. | 1.No interval change in distal esophageal wall thickening. No new sites of disease identified. |
Generate impression based on findings. | Reason: Lung ca - on treatment, please reevaluate. Thanks. History: Lung cancer CHEST:LUNGS AND PLEURA: Spiculated subpleural nodule posteriorly in the left upper lobe measuring 15 x 16 mm on axial sections and 21 mm on coronal images, slightly decreased from 26 mm previously.Interval resolution of a small left pleural effusion. High density material in the pleural space suggestive of previous pleurodesis.Decreased nodular pleural thickening in the left hemithorax consistent with metastatic disease.Small subpleural nodules and scars, unchanged.MEDIASTINUM AND HILA: No significant lymphadenopathy. The previously described lower left paraesophageal lymph node is not visualized.CHEST WALL: Lytic cortical lesion involving the anterior left seventh rib with adjacent healing rib fractures, unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Focal fatty infiltration adjacent to the falciform ligament.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Slightly decreased left upper lobe nodule, with decreased left pleural effusion.2. Decreased anterior and nodular pleural thickening in the left hemithorax consistent with metastatic disease. |
Generate impression based on findings. | Clinical question: Rule out chronic sinusitis. Medtronic fusion sinus CT:Frontal sinuses.The frontal sinuses are not developed. This is a normal anatomical variation.Ethmoid sinuses.Extensive bilateral ethmoid sinusitis (left greater than right).Sphenoid sinus.Small amount of frothy contents and the dorsal (dependent portion) of sphenoid sinus consistent with acute sinusitis.Maxillary sinuses.The also thickening and retention cyst within the right maxillary sinus and with occluded right ostiomeatal unit.Mild diffuse mucosal thickening of left maxillary sinus with occluded left ostiomeatal unit.Nasal passage.Mild leftward nasal septum deviation and unremarkable otherwise. Bilateral mastoid air cells and middle ear cavities are well pneumatized and unremarkable. | 1.Anatomical variation or non-pneumatized frontal sinuses.2.Acute sinusitis the sphenoid sinus evident by a small amount of frothy sinus contents.3.Extensive (right greater than left) chronic sinus disease of bilateral maxillary sinuses with resultant occluded bilateral ostiomeatal units.4.Extensive bilateral ethmoid sinus disease (left greater than right).5.Mild leftward nasal septum deviation is noted.6.Well pneumatized bilateral mastoid air cells and middle ear cavities. |
Generate impression based on findings. | 11 year old female with scaphoid fracture There is a fracture along the volar and and ulnar aspect of the distal radial metaphysis extending into the physes in near-anatomic alignment. No epiphyseal involvement is evident. A small amount of callus formation is seen. No additional fractures are evident, specifically no scaphoid fracture. Madelungs deformity is again noted. Soft tissue edema surrounding the fracture is noted. | 1.Healing Salter Harris 2 fracture of distal radius.2.No scaphoid fracture. |
Generate impression based on findings. | Reason: cough with abnormal CXR History: cough with abnormal CXR LUNGS AND PLEURA: Upper lobe predominant multifocal areas of subpleural scarring .Basilar subpleural areas of subsegmental atelectasis.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence for pericardial effusion.Moderate coronary artery calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple small hepatic hypodensities incompletely characterized, but most likely cysts. Renal cysts with bilateral hydronephrosis. | Upper lobe and apically predominant subpleural fibrotic changes compatible with a prior inflammatory process. No acute abnormalities identified. |
Generate impression based on findings. | 57 year-old male. DLCL lymphome with right PA and bronchus encasement with SOB. LUNGS AND PLEURA: Lower lobe bronchiectasis with decreased bronchial wall thickening. Basilar subpleural tree-in-bud opacities persist consistent with residual bronchiolitis. Interval resolution of right base consolidation and right upper lobe nodular opacities. Moderate centrilobular emphysema.MEDIASTINUM AND HILA: Increased size of bulky mediastinal lymphadenopathy. Reference right paratracheal node measures 47 mm, previously 41 mm (series 3, image 39). Right jugular catheter tip in the SVC.Interval stenting of bronchus intermedius with reexpansion of lumen. No significant change in encasement and attenuation of right upper lobe bronchus, right main pulmonary artery/branch vessels, as well as right superior and inferior pulmonary veins. Vessels remain patent.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Resolution of right base consolidation and decrease in right upper lobe nodular opacities and basilar bronchial wall thickening. No new pulmonary opacities.2. interval increase in bulky mediastinal lymphadenopathy.3. Interval stenting of right bronchus intermedius with reexpansion of lumen. |
Generate impression based on findings. | Altered mental status Tachycardia, unspecified The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical confluent white matter hypodensities of a moderate degree are present. Punctate calcifications are present in the globus pallidus bilaterally.Atherosclerotic calcifications are present along the distal internal carotid arteries.Atherosclerotic calcifications are present along the distal vertebral arteries.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of nonhemorrhagic CVA3.Periventricular and subcortical white matter signal changes are nonspecific. At this age they are most likely vascular related though they could be related to a neurodegenerative process such as nonspecific leukoencephalopathy of aging. |
Generate impression based on findings. | Fever, LAD, no infectious source, hx lymphoma and thymoma in remission. There is interval development of bilateral suprahyoid lymphadenopathy. For example, a left level 2A lymph node measures 22 x 19 mm and a right level 2A lymph node measures 24 x 18 mm. There is also new enlargement of the left lingual tonsil. There is no significant airway narrowing. The left submandibular gland is absent. There has been interval resolution of the cystic lesion in the left parotid gland. The thyroid gland is unremarkable. The major cervical vessels appear grossly patent. The osseous structures are unchanged, with multilevel degenerative spondylosis. There is partially imaged mild paranasal sinus opacification. The partially imaged intracranial structures are grossly unremarkable. There is biapical scarring and emphysema. There are partially imaged postoperative findings in the upper mediastinum, without apparent mass lesions. There is an unchanged nodular lesion in the left posterior lower neck subcutaneous tissues that measures up to 9 mm, which may represent a sebaceous cyst. | Interval development of bilateral suprahyoid lymphadenopathy and left lingual tonsil enlargement, which suggests recurrent lymphoma. |
Generate impression based on findings. | T1N2B BOT SCC p16+ s/p CRT and TFHX completed in 10/2011. There are stable post-treatment findings in the region of the hypopharynx and oropharynx with persistent mild mucosal edema. There is no evidence of tumor recurrence. There is no evidence of significant cervical lymphadenopathy by CT criteria. The aerodigestive tract is patent. There is unchanged atrophy and hyperemia of the bilateral submandibular glands, which is also likely treatment-related. There is unchanged fatty atrophy of the bilateral parotid glands with multiple punctate calcifications. The thyroid gland is unremarkable. The cervical vessels are intact. The imaged portions of the lungs are clear. There is unchanged degenerative spondylosis at multiple levels. The partially imaged intracranial structures are grossly unremarkable. | No evidence locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | Reason: metastatic tonsil ca to lung, s/p CRT, on therapy, eval for dz progression with bi-dimensional measurements, on study 13-0311 History: as above CHEST:LUNGS AND PLEURA: Interval resolution of the previously described 6-mm right upper lobe nodule, which may have been due to infection.Surgical staples in the right upper lobe.Stable micronodules. No suspicious nodules.MEDIASTINUM AND HILA: Interval increase in right supraclavicular and right paratracheal lymph node size.Right hilar lymph nodes, 12 mm in short axis, and 19 mm in long axis, not significantly changed.Subcarinal lymph node approximately 20 x 11 mm, not significantly changed.Left hilar lymphoid tissue measuring 18 x 12 mm, not significantly changed.Decreased left paraesophageal/inferior pulmonary ligament lymph node.Left jugular chest port tip in the right atrium. Coronary artery calcifications. No pericardial fluid.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Slight increase in supraclavicular and paratracheal mediastinal lymph nodes.2. Resolution of right upper lobe nodule. |
Generate impression based on findings. | 69 year-old female. Sarcoma. Evaluate for metastases. CHEST:LUNGS AND PLEURA: Persistent left hemidiaphragm elevation and overlying basilar atelectasis, suspected to be from phrenic nerve paralysis. Mild left apical radiation fibrotic changes.Calcified lung granulomas. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Interval increased size of small and mildly enlarged mediastinal lymph nodes. For reference, a prevascular lymph node measures 11 mm in short axis (series 3, image 32), previously 7 mm.CHEST WALL: Postsurgical changes of left mastectomy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Nonspecific mildly enlarged mediastinal lymph nodes, increased in size from prior exam. Otherwise no significant interval change. |
Generate impression based on findings. | Male 62 years old; Reason: met CRC History: met crc CHEST:LUNGS AND PLEURA: Left upper lobe mixed ground glass opacity with solid components measures 1.9 x 1 .7 cm, (image 12, series 6), previously 2.4 x 1.5 mm . This morphology is suspicious for an indolent primary adenocarcinoma. Left upper lobe pulmonary micronodule measures 4 mm (image 11, series 6) and is not significantly changed.Right upper lobe nodular density measures 5 mm (image 25, series 6). This is smaller in size in which it measured 12 mm. This morphology is also suspicious for a primary carcinoma. Large necrotic mass centered in the right middle lobe with extension across the major and minor fissures measures 7.3 x 8.4 cm (image 72, series 4), previously 8.9 x 7.3 cm. Moderate upper lobe predominant paraseptal and centrilobular emphysema.MEDIASTINUM AND HILA: Reference right hilar lymph node measures 5 mm (image 52, series 3), previously 6 mm.Calcific atherosclerotic changes of the thoracic aorta. CHEST WALL: Right chest wall port with venous catheter tip at the atriocaval junction.No axillary lymphadenopathy.ABDOMEN: LIVER, BILIARY TRACT: Reference segment one liver lesion measures 2.8 x 3.1cm (image 98, series 3), previously 2.7 x 3.5 cm. Additional segment IVb index lesion measures 3 x 3.2cm (image 112, series 3), previously 2.4 x 2.9 cm. Smaller hypodense foci in the right hepatic lobe is unchanged and too small to characterize. No new hepatic lesions. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe calcific atherosclerotic changes of the abdominal aorta and its branches. BOWEL, MESENTERY: Eccentric, enhancing wall thickening of the cecum compatible with patient's known malignancy. The appendix is mildly dilated.BONES, SOFT TISSUES: Indeterminate lytic lesion involving the L2 vertebral body, unchanged. OTHER: No significant abnormality noted. | 1. Interval decrease in size of large necrotic right middle lobe mass. Additional pulmonary nodules in the left and right upper lobes are also smaller to unchanged. 2. Decrease in size of hepatic metastases. 3. Cecal mass compatible with patient's history of colon cancer.4. No new sites of disease. |
Generate impression based on findings. | Abdominal pain ABDOMEN:LUNG BASES: UnremarkableLIVER, BILIARY TRACT: Gallbladder is distended. There is possible cholelithiasis. Fat stranding around the gallbladder. These findings are compatible with acute cholecystitis. Ultrasound may be helpful for further evaluation. No evidence of biliary dilatationSPLEEN: 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, 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 | Possible acute cholecystitis. Ultrasound may be helpful for further evaluation. |
Generate impression based on findings. | PTC treated with total thyroidectomy and resection left recurrent laryngeal nerve and Montgomery implant placed. The patient then developed an increasing mass in the right paratracheal region that caused intermittent VC weakness. The mass was resected, but there airway obstruction developed resulting in a tracheostomy. There are stable postoperative findings related to total thyroidectomy, tracheostomy, left vocal cord prosthesis insertion, as well as right vocal cord injection thyroplasty. There has been interval increase in size of the infiltrative, heterogeneously enhancing ill-defined mass within the right thyroidectomy bed, which now measures 29 AP x 37 RL x 38 mm, previously 25 AP x 34 RL x 33 SI mm. The mass encases the right common carotid artery with associated mild narrowing of the vessel. The mass also abuts and mildly narrows the right internal jugular vein. In addition, there is extension of the mass into the party wall with associated thickening of the esophageal wall. There is mild narrowing of the airway at the level of the tracheostomy. However, there has been interval decrase in size of a right level 4 lymph node, which now measures 8 x 7 mm, previously 10 x 8 mm. There are numerous lung metastases and upper mediastinal, which no significantly changed, although these are not completely characterized in this scan. There is also no significant interval change in an incompletely imaged size of a left fifth rib metastases. The previously intracranial metastases are not included in the field of view of this scan. The major salivary glands are unchanged. The imaged paranasal sinuses and mastoid air cells are clear. | 1. Continued slight interval increase in size of the infiltrative recurrent tumor that encases the right common carotid artery within the right thyroidectomy bed, which now measures up to 37 mm, previously up to 34 mm. 2. No significant interval change in size of numerous lung, upper mediastinal, and partially imaged left fifth rib metastases. Refer to the separate body CT report for additional details. |
Generate impression based on findings. | Female 49 years old; Reason: RLQ abd pain, r/o inguinal hernia, chr appendicitis, neoplasm etc. History: RLQ abd pain ABDOMEN:LUNGS 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: Borderline retroperitoneal adenopathy is noted with reference left periaortic lymph node measuring 8 mm in short axis.BOWEL, MESENTERY: The appendix is not visualized, however there is no inflammatory reaction in the right lower quadrant. No obstruction, free air or contrast extravasation is noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Small Fibroids in the uterus. The endometrial canal is distended, nonspecific. Correlate with ultrasound.BLADDER: No significant abnormality noted.LYMPH NODES: Bilateral obturator and external iliac lymphadenopathy is seen. For example, reference left obturator node measures 1.6 x 2.7 cm (series 3 image 91). This lymph node was measuring 2.8 by 1.6-cm on image number 175, series number 4 on CT dated 6/3/2008. Reference right obturator node measures 1.6 x 2.6 cm (series 3 image 90). This node was measuring 2.5 x 1.3 cm on image number 174, series number 4 on CT dated 6/2008.A right external iliac node measures 1.3 x 2.0 cm (series 3 image 96), and left measures 1.6 x 1.9 cm (series 3 image 25)these lymph nodes are also unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No inguinal hernia as clinically questioned. | 1.Pelvic lymphadenopathy, not significantly changed from CT dated 6/3/2008.. Etiology is unknown. 2. Dilated endometrial canal. Correlation with ultrasound I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Malignant neoplasm of upper lobe, bronchus or lungMalignant neoplasm of colon, unspecified site The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular and subcortical confluent hypodense white matter lesions present .No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.No evidence for brain metastases on this CT exam. Please note that MR is more sensitive in detecting metastases than CT. Specifically there is MRI from 3/11/13 which demonstrated a metastatic lesion which was not readily identified on the temporally related CT exams.3.periventricular white matter hypodensities are present which were previously present and appear to progress over time. Most likely these are treatment related |
Generate impression based on findings. | 57 year old female with a history intra-abdominal fluid collections. Evaluate fluid collections. ABDOMEN:LUNG BASES: Small bilateral pleural effusions with basilar consolidation/atelectasis.LIVER, BILIARY TRACT: Interval decrease in size of right sub-diaphragmatic abscess, which currently measures approximate 1.8 cm in the craniocaudal dimension, previously 4.2 cm in craniocaudal dimension (coronal series image 77). The percutaneous drain is in place located centrally within the collection.Diffuse, homogeneous decrease in attenuation of right lobe it is not significantly changed and due to a perfusion abnormality. Small amount of pneumobilia in the left lobe.SPLEEN: Status post splenectomy.PANCREAS: Inflammatory changes surrounding the pancreatic tail not significantly changed, likely due to post surgical changes in the left upper quadrant.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There is an apparent filling defect in the infrahepatic IVC immediately adjacent to the IVC filter, suspicious for thrombus formation. IVC filter in place. Multiple small retroperitoneal lymph nodes not significantly changed.BOWEL, MESENTERY: Extensive postsurgical changes are again seen in the left upper quadrant and stomach. Again seen is a gastric stent, which traverses fistulous defect along greater curvature. Percutaneous drain tip is in left upper quadrant collection, which measures approximately 4.7 x 4 .4 cm, previously 4.6 x 4.2 cm, (series 3, image 30). Again seen is a communication of this collection with the greater curvature of the stomach ( series 3, image 29).BONES, SOFT TISSUES: Multiple round soft tissue attenuation foci in the anterior abdominal wall, likely representing injection granulomas. Postsurgical changes in anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enhancing lesions in the uterus, most consistent with fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Severe degenerative changes affect the lower lumbar spine.OTHER: No significant abnormality noted | 1. Chronic appearing infrahepatic IVC thrombus. Persistent perfusion abnormality affecting the right lobe of the liver may also represent thrombosis of the right portal vein.2. Interval decrease in size of large right sub-diaphragmatic abscess. 3. Persistent left upper quadrant abdominal collection with fistulous communication to the stomach. Percutaneous drain tip is located in collection. 4. Gastric stent in place which traverses fistulous communication from greater curvature to left upper quadrant collection. 5. Small bilateral pleural effusions. |
Generate impression based on findings. | 58-year-old male. Reason: nasopharyngeal cancer compare to last CT \T\ measure 1) nasopharyngeal mass, 2) LLL nodule, 3) segment 8 liver lesion \T\ 4) left paraaortic node History: post 2 cycles of therapy. CHEST:LUNGS AND PLEURA: Interval increase in size of numerous pulmonary metastases with no definite new lesions identified. A reference lesion in the left lower lobe measures 2.8 x 2.0 cm (image 50, series #5), from previously 2.4 x 2.3 cm.Interval development of diffuse groundglass opacities in the bases, most prominent in the left lower lobe.Small left pleural effusion is unchanged.MEDIASTINUM AND HILA: Dramatic increase in pericardial effusion. Left-sided chest port catheter tip terminates at the cavoatrial junction. Tortuous aorta with mild atherosclerotic calcification. Lack of IV contrast limits sensitivity for detection of lymphadenopathy, however no enlarged mediastinal or hilar lymph nodes are identified. Unchanged calcified left hilar and periaortic lymph nodes, consistent with prior granulomatous disease.CHEST WALL: Destructive expansile lytic lesion in the T5 spinous process has increased in size, now demonstrating cortical erosion.Scattered sclerotic lesions of the ribs bilaterally and vertebral bodies of T5 and T9 are unchanged.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Numerous liver metastases are again seen, incompletely evaluated without IV contrast. The reference lesion in segment 8 measures 2.3 x 2.3 cm (image 79, series #3), previously measured 2.6 x 2.6 cm. However, several other lesions demonstrate interval increase in size, including a right lobe lesion measuring 3.6 x 2.5 cm (image 86, series #3), from previously 2.9 x 2.5 cm. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches without focal ectasia.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic lesions as described above.OTHER: No significant abnormality noted. | 1.Recommend future exams with IV contrast unless clinically contraindicated.2.Progression of metastatic disease with interval growth of numerous pulmonary and likely hepatic metastases, though incompletely evaluated. Recommend dedicated hepatic imaging for more complete characterization if clinically indicated.3.New groundglass opacities, most prominent in the left lower lobe, may represent edema or hemorrhage.4.An expansile, lytic lesion in the vertebral body T5 is also increased in size. Stable rib and vertebral body sclerotic lesions.5.Marked interval increase in pericardial effusion. |
Generate impression based on findings. | Clinical question: Hemorrhage. Signs and symptoms: Weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Examination demonstrates interval complete resolution of previously seen left cerebellar acute hemorrhage. There is evidence of left paramedian craniotomy as was seen on prior exam with interval improvement of postop changes. There is a focus of encephalomalacia at the site of previous left cerebellar hematoma.Images through supratentorial space demonstrate minimal findings of age indeterminant small vessel ischemic strokes which appear grossly similar to prior exam. The cortical sulci and ventricular system remain stable since prior exam. Calvarium demonstrates post op changes are unremarkable otherwise.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. | 1.There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Complete resolution of previously noted left cerebellar hemorrhage an with residual focus of encephalomalacia.3.Grossly stable age indeterminate mild small vessel ischemic strokes. |
Generate impression based on findings. | Metastatic breast cancer CHEST:LUNGS AND PLEURA: Bilateral small pleural effusions. Biapical fibrosis.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Fatty infiltration of the liver. No focal liver lesions.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Extensive bone metastases involving the bones of the chest, abdomen and pelvis.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: Extensive bone metastases.OTHER: No significant abnormality noted. | Diffuse bone metastases involving the entire skeleton. Fat infiltration of the liver.Bilateral small pleural effusions, more on the right compared to the left. |
Generate impression based on findings. | Ovarian cancer CHEST:LUNGS AND PLEURA: Elevated right hemidiaphragm.MEDIASTINUM AND HILA: Paracardiac borderline enlarged lymph node unchangedCHEST WALL: No significant abnormality noted.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: Small left renal angiomyolipoma, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval development of and nodular peritoneal soft tissue measuring 1.8 x 1.4 cm lateral to the cecum on image number 146, series number 3. Adjacent cecum is not well opacified. Therefore, although less likely, this nodular density may also represent nonopacified bowel.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Interval increase in the size of the large midline pelvic mass. This mass now measures 11.8 x 9.3 cm on image number 172, series number 3. Previously, it was, measuring 6 .9 x 6.3 cm.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. | Interval increase in the size of the large pelvic mass.Possible peritoneal nodule lateral to the cecum. |
Generate impression based on findings. | Female 61 years old; Reason: abdominal pain post ERCP, r/o perforation History: abdominal pain ABDOMEN:LUNGS BASES: Heart size is enlarged. Minimal basilar atelectasis.LIVER, BILIARY TRACT: Liver contour is smooth. Parenchyma is unremarkable for unenhanced technique.SPLEEN: No significant abnormality noted.PANCREAS: Multiple small pancreatic calcifications. A pancreatic stent terminates within the duodenum. Small amounts of gas within the body and tail of the pancreas presumably post procedural in nature. Minimal fat stranding around the pancreas possibly chronic in nature. No pseudocyst formation.There are small foci of gas adjacent to the colon/duodenum image 71/series 3 and image 75/series 3 suspicious for a small foci of free air.ADRENAL GLANDS: Adrenal glands are slightly nodular.KIDNEYS, URETERS: No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Small bowel is normal in caliber. There are scattered colonic diverticula. There is gaseous distention of the small bowel and colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Multiple perigastric varices most suggestive of splenic vein thrombosis.PELVIS:UTERUS, ADNEXA: Calcified uterine fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticula.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post placement of pancreas duct stent that terminates within the duodenum. Small foci of gas within the pancreatic parenchyma are likely postprocedural. Findings suspicious for small foci of free air adjacent to the colon near the hepatic flexure. There are multiple air containing colonic diverticula in the adjacent colon. |
Generate impression based on findings. | Fever, strep+, neck stiffness. There are prominent palantine tonsils and adenoids as well as enlarged bilateral suprahyoid lymph nodes. There is associated moderate narrowing of the oropharynx and nasopharynx. There is no swelling of the retropharyngeal soft tissues., There is no fluid collection to suggest abscess. There is partially imaged mild scattered paranasal sinus opacification. The mastoid air cells are clear. The thyroid gland and major salivary glands are unremarkable. The major cervical vessels appear to be intact. The osseous structures are unremarkable. The imaged portions of the lungs are clear. | Enlargement of the palantine tonsils and adenoids as well as enlarged bilateral suprahyoid lymph nodes, likely related to pharyngitis. No evidence of retropharyngeal abscess. |
Generate impression based on findings. | 73-year-old male with metastatic pancreatic cancer on chemotherapy. Presents with bloating. ABDOMEN:LUNG BASES: Right chest port tip terminates at the cavoatrial junction.LIVER, BILIARY TRACT: Multiple hypoattenuating lesions in the liver are suspicious for metastatic disease appearing similar to the prior study. For reference, and lesion in the right lobe the latter measures 1.9 x 1 .4 cm, previously 2.4 x 2.1 cm (80; series 4).SPLEEN: No significant abnormality notedPANCREAS: Note is made of a 4.6 x 3.4 cm mass in the body of the pancreas, previously 4.5 x 3.4 cm, consistent with stated history of pancreatic carcinoma. There is associated thrombosis/occlusion of the splenic vein.ADRENAL 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: There is interval increase in size and number of innumerable sclerotic lesions throughout the axial and proximal appendicular skeleton consistent with stated history of metastatic pancreatic carcinoma.OTHER: 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: There is interval increase in size and number of innumerable sclerotic lesions throughout the axial and proximal appendicular skeleton consistent with stated history of metastatic pancreatic carcinoma.OTHER: No significant abnormality noted | Interval increase in size and number of numerous sclerotic bony lesions throughout the axial and proximal appendicular skeleton with interval decrease in size of the numerous hepatic metastatic lesions. No significant interval change in size of the pancreatic mass with associated splenic vein thrombosis/occlusion. |
Generate impression based on findings. | 81 year-old female with recurrent low grade ovarian cancer CHEST:LUNGS AND PLEURA: Scattered micronodules unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Index left para-aortic lymph node measures 1.5 x 1.6 cm on image number 102, series number 3, not significantly changed from previous study. Other retroperitoneal small lymph nodes are also unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: Index left obturator lymph node now measures 2.8 by 2 cm, image number 156, series number 3, not significantly changed from previous study. Other ill-defined, predominantly left-sided soft tissue masses invading the pelvic side wall are also unchanged.One of the left-sided pelvic lymph nodes is increased in size and now measures 1.9 x 1.5 cm on image number 152, series number 3. Previously, it was measuring 1 x 1.2 cm on image number 155, series numberBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the left inguinal canal. There is likely enhancing soft tissue in the left inguinal region suspicious for tumor.OTHER: No significant abnormality noted. | Retroperitoneal adenopathy and most of the pelvic adenopathy and postsurgical changes in the left inguinal region are unchanged. One of the Left pelvic lymph nodes has increased in size within interval.Infiltrative soft tissue mass invading the left pelvic sidewall adjacent to the left acetabulum is unchanged. |
Generate impression based on findings. | SCC of the left tonsil s/p cis-RT with lung metastases, followed by chemotherapy with carbo/taxol/cetux. Head: There is no evidence of intracranial masses or abnormal enhancment. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The paranasal sinuses and mastoid air cells are clear. Neck: There are stable post-treatment findings with persistent mild asymmetry of the glossotonsillar sulci. However, there is no evidence of mass lesion in the left tonsillar fossa to suggest locoregional tumor recurrence. There has been slight interval increase in size of the right lower paratracheal lymphadenopathy, including a lymph node that measures 10 x 7 mm (image 176, series 4), previously 6 x 5 mm, while another paratracheal lymph node measures 8 x 6 mm (image 191, series 4), previously 8 x 6 mm. There is no significant suprahyoid lymphadenopathy. There has also been interval increase in size of a right level 4 lymph node, which no measures 13 x 10 mm (image 173, series 4), previously 9 x 7 mm. There is a persistent air-filled right internal laryngocele that measures up to 5 mm. Otherwise, the larynx appears unremarkable. The submandibular glands are atrophic and hyperemic, likely secondary to treatment. The thyroid gland is unremarkable. There is a left internal jugular venous catheter. There is unchanged lack of opacification of the left internal jugular vein superior to the catheter with several small caliber collateral veins, suggesting chronic thrombosis of the internal jugular vein. The other major cervical vessels are intact. There is minimal scattered paranasal sinus mucosal thickening. The mastoid air cells are clear. There is multilevel degenerative spondylosis with 4 mm anterolisthesis of C4 upon C5. There is unchanged right apical scarring. | 1. Stable to slight continued interval increase in size of right lower cervical and paratracheal lymphadenoapthy. Otherwise, no evidence of locoregional tumor recurrence in the left tonsillar region or significant suprahyoid lymphadenopathy. Please refer to the separate chest CT report for additional findings.2. No evidence of intracranial metastases. |
Generate impression based on findings. | Reason: previous afib ablation- eval pulm vein History: fatigue The overall heart size is normal.Left Atrium: There are four distinct pulmonary veins which drain normally into the left atrium, two on the right and two on the left There is no evidence of left atrial appendage thrombus.RSPV: 17 X 20 mmRIPV: 16 X 17 mm. The right inferior pulmonary vein demonstrates 5 -vessel branching pattern, 3 of which are very diminutive in caliber. One small branch drains the superior segment of the right lower lobe and arises directly from the ostium. Two diminutive branches drain the basilar segments, arising approximately 3 mm from the ostium. LSPV: 18 X 24 mmLIPV: 15 X 17 mmNo early branching is noted on the left.Right atrium, vena cavae, and coronary sinus: The right atrium is normal in size. The superior and inferior vena cavae are unremarkable. The coronary sinus is normal in size. Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying 3 diagonal and septal branches. The proximal LAD is unremarkable. The mid LAD demonstrates multifocal calcified and mixed plaques with positive remodeling. The noncalcified component contributes up to 30 to 40% stenosis. The distal LAD demonstrates eccentric, noncalcified plaques also contributing to mild multifocal stenoses.The first diagonal branch is diminutive, demonstrating mild multifocal noncalcified plaques. The second diagonal branch is dominant and demonstrates a bifurcation pattern. The anterior branch demonstrates multifocal mixed plaques contributing to mild stenosis. The posterior branch demonstrates mild multifocal noncalcified plaques.The third diagonal branch is small. Eccentric, noncalcified plaques contribute to mild stenoses.LCx: The left circumflex coronary artery courses normally in the the left AV groove, demonstrating multifocal, eccentric calcified plaques. It gives rise to one dominant obtuse marginal branch. This branch contains one large calcified plaque at its mid segment. RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery which arises from the crux. The posterior descending artery courses along the inferior one third of the right ventricle where it joins the inferior interventricular septum and travels along the inferior interventricular groove. The PDA is unremarkable. A small posterior lateral branch supplies the basal inferior interventricular groove from the distal RCA. It is too small to characterize.Great vessels: The visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. The main pulmonary artery is 3.0 cm transverse. The branch pulmonary arteries are normal in caliber.Minimal aortic valvular calcification.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Lungs: Visualization of the lung parenchyma is limited by the field of view and length of scan which excludes a substantial amount of the lungs. No significant abnormality noted.Limited view of the thoracic spine demonstrates degenerative changes. | 1. Normal pulmonary vein anatomy, with branching patterns as above. 2. There is no evidence of left atrial appendage thrombus. 3. Diffuse but mild coronary artery disease, as described above |
Generate impression based on findings. | 52 year-old female status post liver transplant with abdominal pain. ABDOMEN:LUNG BASES: Interval resolution of previously described right basilar consolidation. No pleural effusion or pneumothorax. Prominent cardiophrenic lymph node, unchanged.LIVER, BILIARY TRACT: No evidence of ascites. Postoperative changes consistent with the stated history of liver transplant. Hypoattenuating lesion in segment 6 of the liver is incompletely characterized, but may represent a simple cyst or devitalized small region of liver parenchyma from surgery, unchanged. Additional subcentimeter hypodensity in the right lobe of the liver is too small to characterize, but may represent simple cyst. Hepatic vessels all appear to enhance appropriately. No biliary duct dilatation or other abnormalities. No pathologic enhancement is identified.SPLEEN: Moderate splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large nonobstructing right renal calculi, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Vascular calcifications of the aorta and its branches.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Postoperative changes consistent with stated history of liver transplant without evidence of hepatocellular carcinoma. |
Generate impression based on findings. | Female 69 years old; Reason: evaluate for progression. History: sarcoma. Again seen is extensive surgical change within the left supraclavicular fossa and left posterior neck, unchanged. This includes volume loss with resection of at least the trapezius and levator scapulae muscles. The defect is bridged with a fatty soft tissue flap. Scarlike thickening is evident along the lateral margin of the flap, similar to the prior examination. No new soft tissue lesion or pathologic enhancement is seen to suggest disease recurrence.Elsewhere in the neck, no soft tissue masses or pathologic adenopathy is identified. The aerodigestive tract is within normal limits. The salivary glands and thyroid are free of focal lesions. The cervical vessels are patent. Lung apices are unremarkable. No new or concerning bony lesions are seen. | No evidence of recurrent disease. |
Generate impression based on findings. | 36 year old female with a history of recurrent UTIs and nephrolithiasis. Evaluate for nephrolithiasis. Lack of intravenous contrast limits evaluation of solid organs. Lack of enteric contrast with evaluation of bowel.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: Note is made of numerous bilateral nonobstructing renal calculus with the largest measuring 5 mm in the inferior pole of the left kidney. There is no evidence of hydronephrosis, hydroureter, or perinephric fat stranding.RETROPERITONEUM, 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: 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 calculi. |
Generate impression based on findings. | Nasopharyngeal cancer with lung, liver mets and retroperitoneal lymph nodes on IRB 12-0169. The examination is limited by lack of intravenous contrast administration. Within these limitations, there has been marked interval decrease in size of the right nasopharyngeal mass, without measurable residual disease. The skull base appears to be intact and the intracranial structures appear grossly unremarkable. There is no definite evidence of significant cervical lymphadenopathy. There is a "sail sign" appearance of the left vocal cord, which is suggestive of vocal cord paralysis. There are partially imaged multiple bilateral infiltrative upper lung and mediastinal nodules and masses. There is a left internal jugular venous catheter in position. There is mild degenerative cervical spondylosis without lytic or blastic lesions. There is persistent opacification of the right sphenoid sinus. The mastoid air cells are clear. There is chronic deformity of the left frontal process of the maxilla, likely related to remote trauma. | 1. The examination is limited by lack of intravenous contrast administration. Within these limitations there has been marked decrease in size of the right nasopharyngeal carcinoma, without evidence of measurable residual tumor. No definite evidence of significant cervical lymphadenopathy. 2. Numerous partially imaged multiple bilateral infiltrative upper lung and mediastinal metastases. Refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Reason: evaluate for resolution of pneumonia History: dyspnea LUNGS AND PLEURA: Interval resolution of the extensive air space and groundglass opacities in both lungs. A minimal residual pleural and parenchymal scarring at the bases.Small right pleural effusion is present.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Cardiac size is normal without evidence of a pericardial effusion.Mildly prominent mediastinal lymph nodes in the right cardiophrenic and subcarinal regions.CHEST WALL: Median sternotomy with evidence of a previous heart transplant.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Bilateral atrophic kidneys. | 1.Significant interval clearing and resolution of extensive airspace groundglass opacities bilaterally.2.Small right pleural effusion.3.No significant acute cardiopulmonary abnormalities. |
Generate impression based on findings. | Reason: h/o HNC, CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Mild coronary calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.G-tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No interval change without evidence of metastatic disease. |
Generate impression based on findings. | 48 years old Male. Reason: h/o HNC, CRT, compare to previous, measurements pls Postsurgical changes of a right nodal dissection are similar to prior. Soft tissue stranding and pharyngeal mucosal edema are consistent with postradiation changes, slightly decreased in extent. No new masses. No lymphadenopathy.Limited view of the intracranial structures are unremarkable. The orbits are unremarkable. Mucosal thickening in the maxillary sinuses is again noted. The parotid and submandibular glands are unremarkable. The thyroid gland is unremarkable.The carotid arteries and jugular veins are patent. Osseous alignment and vertebral body heights are within normal limits. Deformity of the right clavicular head is likely degenerative in etiology.Limited views of the chest are unremarkable. | Stable postsurgical and post radiation changes without evidence of new lymphadenopathy or masses. |
Generate impression based on findings. | 51-year-old female. Status post right lower lobectomy. LUNGS AND PLEURA: Post-surgical changes right lower lobectomy. Scattered micronodules. 5 mm right basilar nodule (series 4, image 48).Moderate centrilobular emphysema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. 1 x 1.2 cm left adrenal nodule is incompletely characterized on this single phase CT. | Moderate emphysema. Right lung base 5 mm nodule. Left adrenal nodule is incompletely characterized. Retrieval of prior CTs requested for comparison. |
Generate impression based on findings. | Female 69 years old; Reason: pt with metastatic breast cancer on treatment please assess disease response and compare to previous imaging History: MBC CHEST:LUNGS AND PLEURA: Small calcified micronodules consistent with previous granulomatous infection. No suspicious nodules.Mild chronic reticular and ground-glass interstitial opacity at the lung bases, possiblyrelated to rheumatoid lung disease, unchanged.MEDIASTINUM AND HILA: Multi- Nodular calcified thyroid. Atheromatous calcifications of the aorta are noted.CHEST WALL: Left port-a-cath with its tip in the cavoatrial junction. Heterogeneous attenuation of the right breast with nodules noted, compatible with previous diagnosis of breast cancer.No significant axillary adenopathy.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Non obstructing calculi and multiple bilateral cysts, all essentially unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: Stable sclerotic focus in the L4 vertebral body.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Patient status post hysterectomyBLADDER: No significant abnormality noted.LYMPH NODES: Stable inguinal adenopathy with reference right inguinal lymph node measuring 3 x 2.1 cm (series 601 image 183). BOWEL, MESENTERY: Suggestion of a rectocele noted.BONES, SOFT TISSUES: Linear enhancements in the left gluteal muscle of unclear etiology.OTHER: No significant abnormality noted. | 1.Stable nodularity in the right breast with stable inguinal nodal involvement. 2.Linear enhancement of the left gluteus muscle of unclear etiology. |
Generate impression based on findings. | 35-year-old female with fibrolamellar carcinoma with liver treated with resection and RFA. History of thoracic and pelvic disease either resected or embolized. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Reference paracaval lymphadenopathy measures 7.2 cm in the short axis, previously 2.4 cm (52; series 16). There is underlying atelectasis/consolidation. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: There is a 8.6 x 6.4 cm mass in the right lobe of the liver (83; series 16). The portal vein is attenuated and may be occluded. Again seen is thrombosis within the infrahepatic IVC.SPLEEN: Note is made of a 2.9 x 3.0 cm peri splenic mass compatible with lymphadenopathy and similar to the findings seen on recent MRI performed on the same day. Splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference retrocrural, periaortic lymphadenopathy measures 4.0 cm in the short axis, previously 2.0 cm on prior CT dated 8/3/13 (67; series 16).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Prominent collateral vessels are identified along the anterior abdominal wall.OTHER: Note is made of a small to moderate amount of abdominopelvic ascites.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: Note is made of a small to moderate amount of abdominopelvic ascites. | Large hepatic mass and associated abdominopelvic lymphadenopathy consistent with the stated history of metastatic fibrolamellar carcinoma. There is associated thrombosis of the portal vein and infrahepatic IVC as seen on a recent MRI. |
Generate impression based on findings. | Nasal congestion, chronic sinusitis. There are postoperative findings related to bilateral uncinectomy, internal ethmoidectomy, and middle turbinectomy. There is mild mucosal thickening within the left maxillary sinus. The left neoinfundibulum is patent. There is moderate opacification of the right maxillary sinus and partial opacification of the right neoinfundibulum. There is extensive thickening and sclerosis of the maxillary sinus walls. There is partial opacification of the remaining ethmoid sinuses as well as a evidence of neo-osteogenesis. The right left sphenoid sinus is clear, which the right sphenoid sinus is completely opacified. The underpneumatized left frontal sinus is clear. There is partial opacification of the underpneumatized right frontal sinus. There is mild nasal septal deviation to the right. The nasal cavity is clear. There are multiple areas where the ethmoid roof is thinned. The ethmoid roofs are otherwise symmetric. The optic canals and carotid grooves are covered by bone. There is partial opacification of the left mastoid air cells. There is apparent mild cerebral white matter hypoattenuation, which likely represent small vessels ischemic disease. The partially imaged intracranial structures are otherwise grossly unremarkable. The orbits are unremarkable. | Findings of endoscopic sinus surgery with scattered paranasal sinus opacification amidst changes that are compatible with chronic sinusitis. |
Generate impression based on findings. | 73-year-old male with shortness of breath and opacity on recent chest radiograph. CHEST:LUNGS AND PLEURA: Note is made of small to moderate sized bilateral pleural effusions with underlying atelectasis/consolidation. There is pleural fluid tracking along the major fissure on the left. Multiple calcified granulomas are identified bilaterally.MEDIASTINUM AND HILA: Cardiomegaly. Vascular calcifications of the aorta and its branches. Moderate to severe coronary artery calcifications. Calcification of the mitral annulus. No pericardial effusion. Postoperative changes of prior CABG. Sternotomy wires in place.CHEST WALL: Multilevel degenerative changes affect the thoracolumbar spine.ABDOMEN:LIVER, BILIARY TRACT: Incidental note is made of colonic interposition. Mild hepatomegaly.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: Multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged.BLADDER: No significant abnormality notedLYMPH NODES: Prominent pelvic lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Bilateral pleural effusions, left greater than right, with underlying atelectasis/consolidation.2. Mild hepatomegaly. |
Generate impression based on findings. | 36 year-old female with melanoma -- status post 2 cycles of treatment -- assess response to therapy CHEST:LUNGS AND PLEURA: Enlarging nodules throughout both lungs. The prior reference left peri-fissural nodule (series 4 image 48) has increased in size and now measures 5.2 x 4.6 cm, previously 5.0 by 4.0 cm. No definite new nodules or masses are identified.MEDIASTINUM AND HILA: Referenced right paratracheal mass (series 3 image 27) measures 3.1 by 2.5 cm, previously 3.4 x 2 .7 cm. Again seen are multiple enlarged lymph nodes in the anterior mediastinum, subcarinal region, bilateral hilar regions. CHEST WALL: Left chest wall surgical changes again seen. No evidence of mass lesion. No skeletal metastatic lesionsABDOMEN:LIVER, BILIARY TRACT: Innumerable masses throughout the liver, consistent with metastatic disease. Reference segment 6 lesion (series 3; image 108) measures 3.8 x 3.2 cm, previously 3.9 x 3.6 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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in size of ill-defined mixed lytic/sclerotic lesion in the L5 vertebral body.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: Interval increase in size of ill-defined mixed lytic/sclerotic lesion in the L5 vertebral body.OTHER: No significant abnormality noted. | 1. Slight interval increase in size of reference pulmonary metastatic lesions with persistent mediastinal lymphadenopathy. 2. Slight interval decrease in size to stable diffuse liver metastatic lesions.3. Interval increase in size of ill-defined mixed lytic/sclerotic lesion in the L5 vertebral body consistent with metastatic disease. |
Generate impression based on findings. | 85 years old Female. Reason: rule out head bleed History: weakness The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. Subtle periventricular hypoattenuating foci may reflect mild small vessel ischemic changes, similar to prior. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | Negative for acute abnormality. |
Generate impression based on findings. | Female 92 years old; Reason: stroke History: aphasia, R sided weakness. Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the right and left subclavian arteries, right and left common carotid arteries, or left vertebral artery. However, there is significant stenosis at the origin of the nondominant right vertebral artery due to a small calcified plaque. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. There is significant atherosclerotic calcification of the cavernous and supra-clinoid internal carotid arteries. The right Pcomm is small but this is a normal variant. The intracranial left vertebral artery is small but this is a normal variant. No aneurysms or intracranial stenosis is appreciated. Common origin of the left vertebral artery and left PICA off the basilar artery which is a normal variant.CT head:There is no intracranial hemorrhage. However, the effacement of the sulci in the left MCA territory has increased and the hypoattenuation within the MCA distribution with cortical and subcortical regions has increased indicating more severe edema from ischemic infarct. There is no significant effacement of the left lateral ventricle. Again seen are periventricular hypodensities which are nonspecific but consistent with small vessel ischemic disease of indeterminate age. There are no extra-axial fluid collections or subdural hematomas. There are no masses or midline shift. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | 1.No evidence for acute intracranial hemorrhage.2.Increased sulcal effacement and edema within the MCA territory consistent with large acute ischemic infarct.3.Significant atherosclerotic calcification of the cavernous and supra-clinoid internal carotid arteries but no discrete evidence for intracranial cerebrovascular occlusive disease.4.Within the neck, the proximal left vertebral artery demonstrates significant stenosis secondary to a calcific plaque. |
Generate impression based on findings. | 73 years old Male. Reason: esophageal foreign body, infection? History: prevertebral soft tissue swelling, dysphagia, candidiasis Limited imaging through the skull base is unremarkable. Patient is edentulous.An enhancing soft tissue mass obliterates the piriform sinuses, right greater than left, and results in severe narrowing of the hypopharyngeal airway to 5mm. This mass measures approximately 4.2 x 2.0 cm in greatest axial dimensions. The posterior margins of the cricoid cartilage may be somewhat indistinct, with extension of abnormal enhancing soft tissue thickening posteriorly to abut the vertebrae. This lesion also partially extends along the superior paraglottic space bilaterally. Of note, the superior cornua of the right thyroid is inwardly deviated, likely developmental. A centrally hypoattenuating left level IIA node (series 5, image 22) measuring 1.9 x 1.5 cm displaces the submandibular gland anteriorly. No other pathologic cervical lymphadenopathy is noted. Subcentimeter superior mediastinal lymph nodes are not enlarged based on CT size criteria. A 5mm hypoattenuating focus in the left thyroid is indeterminate based on CT characteristics. The carotid arteries and jugular veins are patent. Bulky bridging anterior osteophytes are present at C4 through C7. Limited views of the chest demonstrates centrilobular emphysema. Calcified granulomas are noted. | 1. Narrowing of the hypopharyngeal airway by an enhancing soft tissue mass. This, and the presence of a necrotic left jugulodigastric lymph node, is highly suspicious for neoplasm with extension along the superior paraglottic space bilaterally. Infection is considered much less likely. 2. 5mm hypoattenuating lesion in the left lobe. Thyroid ultrasound is recommended for further characterization.Findings relayed to Dr. Demeter via telephone by Dr. Ben Meyer at 5pm on 12/30/2013. |
Generate impression based on findings. | 53 year old female with history of internal hernia and recent abdominal surgery. ABDOMEN:LUNG BASES: Bibasilar dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Free air is noted within the abdomen. There is a small amount of abdominal ascites, including one small area of slightly loculated fluid anterior to the site of anastomosis against the anterior abdominal wall.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis. | Findings of free air with a small amount of ascites and an area of slight loculation anterior to the anastomosis is suggestive of an anastomotic leak.These findings were discussed with the surgery resident Dr. Stern at the 4:00 p.m. |
Generate impression based on findings. | Swelling, mass, or lump in head and neck Enlargement of lymph nodes Serial CT images obtained during the biopsy procedure demonstrate the needle placement within the left neck mass. post procedural images demonstrate some air bubbles within the parotid lesion. | A total of 6 samples (two aspirates and 4 touch preps) were obtained and given for cytopathologic analysis. The cytopathologist suggested this most likely represents lymphoid tissue. Please refer to their report for further comments. Four biopsy samples were delivered to surgical pathology in one formalin jar for analysis. |
Generate impression based on findings. | 15-year-old female with connective tissue disorder, end-stage renal disease and small vessel vasculitis with chest pain and anemia LUNGS AND PLEURA: There is patchy upper lobe predominant ground glass and tree in bud opacities. No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal with a trace pericardial effusion. CHEST WALL: No axillary lymphadenopathy. Osseous structures are normal.UPPER ABDOMEN: No abnormalities within the visualized upper abdomen. | 1.Upper lobe predominant scattered ground glass and tree in bud opacities is nonspecific. Differential includes pulmonary vasculitis, pneumonitis, viral infection, drug reaction and edema.2.Trace pericardial effusion. |
Generate impression based on findings. | 67-year-old male with a history of of pancreatitis, complicated by pseudocyst formation. Evaluate for necrosis. ABDOMEN:LUNG BASES: Large right-sided pleural effusion and bilateral dependent atelectasis. Interval development of a small left pleural effusion with underlying atelectasis/consolidation.LIVER, BILIARY TRACT: Numerous hypodense lesions in the liver, appearing similar to prior study. Some of the more to small to accurately characterize, but larger ones, most likely represent cysts, unchanged. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: Enhancing pancreatic tissue is noted in the pancreatic neck and tail. Pancreatic head and most of the body are replaced by large pseudocysts. The pseudocyst in the body of the pancreas measures 4.6 x 5 .4 cm, previously 9.5 x 7.6 cm (53; series 3). The pseudocyst in the head and uncinate process of the pancreas measures 6.6 cm, previously 10 cm (66; series 3). Enhancing pancreas demonstrates mild pancreatic ductal dilatation. Splenic vein is chronically thrombosed and collateral vessels are present.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: Small amount of ascites. NG tube tip terminates in the proximal jejunum. 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 | 1. Interval decrease in size of the previously described pancreatic pseudocysts consistent with the stated history of pancreatitis. Chronic occlusion of the splenic vein is again seen.2. No significant interval change in multiple small hypodense lesions in the liver, some of which are too small to accurately characterize, but likely represent cysts.3. Large right-sided pleural effusion with interval development of a small left pleural effusion. |
Generate impression based on findings. | 78-year-old female with lymphadenopathy and fungal infection. Concern for occult fungal infection. Lack of intravenous contrast limits evaluation of solid organs.CHEST:LUNGS AND PLEURA: Note is made of small bilateral pleural effusions with overlying atelectasis/consolidation.Scattered bilateral pulmonary micronodules.MEDIASTINUM AND HILA: Vascular calcifications of the aorta as branches. Marked coronary artery calcifications. No evidence of cardiomegaly. Trace pericardial effusion/thickening.CHEST WALL: There is endplate destruction affecting the inferior endplate of T8 and superior endplate of T9, most consistent with diskitis/osteomyelitis. Post-surgical changes, consistent with the stated history of epidural abscess status post laminectomy along T7 to T10. Epidural drain in place.ABDOMEN:LIVER, BILIARY TRACT: Gallstones, without evidence of acute cholecystitis.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: No dilated loops of bowel suggest obstruction.BONES, SOFT TISSUES: Anasarca.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: Note is made of a lipoma along the right iliopsoas muscle.OTHER: No significant abnormality noted. | 1. Findings consistent with diskitis/osteomyelitis at the level of the T8/T9 vertebral bodies. Postsurgical changes at the level of T7 to T10, consistent with the stated history of epidural abscess status post laminectomy. Epidural drain in place.2. Small bilateral pleural effusions.3. Scattered bilateral pulmonary micronodules.4. Gallstones without evidence of acute cholecystitis. |
Generate impression based on findings. | Female 55 years old; Reason: ? appy History: RLQ pain after peri-umbilical pain ABDOMEN:LUNGS BASES: Right hilar lymphadenopathy, partially imaged.LIVER, BILIARY TRACT: Reference right hepatic lobe lesion measures 4.3 x 3. 2 cm (image 77/series 3) previously, 4.8 x 3.3 cm.There is new perihepatic fat stranding suggestive of mesenteric involvement by the tumor across the hepatic capsule.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland lesion measures 2.1 x 1.9 cm (image 49/series 3) previously, 2.2 x 1.8 cm.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix is normal in caliber and course. No surrounding inflammation. No bowel obstruction. No evident bowel perforation.The tumor or inflammation extends to the ascending colon serosal surface.BONES, SOFT TISSUES: Extensive osseous metastatic disease.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: Extensive sclerotic metastatic disease to the pelvis.OTHER: No significant abnormality noted. | 1.New infiltration of the fat adjacent to the right hepatic lobe suggestive of extension of tumor across the hepatic capsule possibly the cause of the patient's right lower abdominal pain. The inflammation or tumor extends to the ascending colon. |
Generate impression based on findings. | Clinical question : Evaluate for possible subdural hematoma. Signs and symptoms going left-sided headache after fall. Nonenhanced head CT:No detectable acute posttraumatic intracranial, calvarial or soft tissue of the scalp.Unremarkable cerebral cortex, cortical sulci, ventricular system CSF spaces and gray white matter differentiation for patient of stated age of 86.Unremarkable paranasal sinuses, mastoid air cells and orbits. | Negative nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Rule out CVA. Signs and symptoms: Altered mental status. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.There are extensive periventricular and subcortical low attenuation of white matter which are highly concerning for age indeterminant small vessel ischemic strokes. Cerebral cortex, cortical sulci and ventricular system remain within normal for patient stated age.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits.Unremarkable paranasal sinuses and mastoid air cells. | 1.No acute intracranial process.2.Age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Large submental swelling, concern for abscess. The images are degraded by patient motion. There is a soft tissue attenuation (40 to 50 HU) focus in the midline of the submental space that measures approximately 25 AP x 30 RL x 15 SI mm. There is associated subcutaneous fat stranding and overlying skin thickening. However, there is no rim-enhancing fluid collection to suggest abscess. The airways are patent. There are mildly prominent bilateral suprahyoid lymph nodes, which are likely reactive. The major salivary glands and thyroid gland are unremarkable. The major cervical vessels are patent. The imaged paranasal sinuses and mastoid air cells are clear. The osseous structures are unremarkable. The imaged lungs are clear. There is a tubular hyperattenuating structure in the medial right external auditory canal that measures 4 mm in diameter. The imaged intracranial structures are unremarkable. | 1. Soft attenuation within the midline submental space that measures up to 30 mm with associated fat stranding likely represents a phlegmon, without rim enhancing fluid collections to suggest abscess.2. A tubular hyperattenuating structure in the medial right external auditory canal likely represents a foreign body. |
Generate impression based on findings. | Clinical question: Right facial droop, nystagmus, fever for two weeks there signs and symptoms: Evaluate mass. 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 gray differentiation is within normal for patient stated age.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells are | Negative nonenhanced head CT. |
Generate impression based on findings. | eval for pathology. Metastatic renal cell carcinoma The patient is status post L2 vertebrectomy with instrumentation. The patient is status post posterior fusion with metallic rods and pedicle screws and pedicles screws are present at L4, L3, L1 and T12. Vertebral body cage is present at L2. The general alignment of the lumbar spine appears appropriate.Inferior vena cava filter is in place.At the L2 vertebral body level there is effacement of the fat planes in the perivertebral space surrounding spinal canal and at the expected location of posterior elements.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a minor disk bulge at this level as well as left-sided facet hypertrophy.At L4-5 there is loss of disk space height as well as diffuse disk bulge associated with bilateral facet hypertrophy resulting in some effacement of the fat at the lateral recess and laterally and narrowing of the neural foramina bilaterally.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a minor disk bulge at this levelAt L2-3 there is a significant amount of artifact present associated with effacement of fat planes within the spinal canal precluding adequate evaluationAt L1-2 there is no significant compromise to spinal canal or neural foramina.Incidental note is made of gallstones and others chronic calcifications are present in the aorta and many of its branches. The patient is status post right sided nephrectomyNote is made that the pleural effusions more on the left side than the right side. | 1.The patient is status post vertebrectomy and fusion at L2. It is not clear based on this exam whether there is local recurrence or encroachment on the thecal sac or spinal canal due to artifacts from metallic instrumentation. There is effacement of fat planes due to soft tissue infiltration surrounding the spinal canal at this level and in the paravertebral space. The possibility of local tumor recurrence, infection, CSF leak or compromise the spinal canal cannot be excluded at the L2 level.2.There multilevel degenerative changes in the lumbar spine worse at L4-5 are there's a moderate degree of spinal stenosis3.gallstones4.pleural effusions left more than right |
Generate impression based on findings. | Female 59 years old; Reason: sbo History: abd distention ABDOMEN:LUNGS BASES: Nonspecific left lingular and lower lobe pulmonary nodules.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: Stomach and small bowel loops are dilated measuring up to 3.8-cm. Ileum is normal in caliber. No discrete transition point is evident. Haziness of the mesentery in the left upper abdomen persists.No upper abdominal fluid collections.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: See aboveBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No pelvic ascites. | 1.Asymmetric distention of proximal small bowel loops (jejunum) and normal caliber ileum with mesenteric edema. Differential considerations include ongoing bowel obstruction, vasculitis, infection, inflammation. Consider follow up examination with enterography.2.Pulmonary nodules partially imaged. |
Generate impression based on findings. | 65 year old female. History of lung cancer. Tachycardia, dyspnea. Evaluate for PE. PULMONARY ARTERIES: No convincing evidence of acute pulmonary emboli.LUNGS AND PLEURA: Small pleural effusions bilaterally, partially loculated anteriorly on the right. Postsurgical changes of right middle lobectomy. Right mid lung consolidation and perihilar cavity, unchanged. Persistent right paramediastinal scarring and bronchiectasis consistent with radiation change. Severe diffuse centrilobular emphysema.MEDIASTINUM AND HILA: Mild coronary calcifications. Atherosclerotic calcification of the aortic arch. No mediastinal or hilar lymphadenopathy.CHEST WALL: Right lateral chest wall fluid collection is again seen, likely related to thoracotomy. Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. 2.6 x 2.7 cm mildly hyperdense lesion near the hepatic dome with peripheral calcification (series 8, image 178), unchanged from 2012, of unclear etiology but most likely benign. Again seen is enlargement of the pancreatic tail with mild peripancreatic fat stranding suggestive of pancreatitis, not significantly changed. | 1. no specific evidence of acute pulmonary emboli.2. No significant interval change in right lung areas of consolidation, suspicious for infection superimposed on underlying radiation changes.3. Pancreatic tail enlargement, not significantly changed. |
Generate impression based on findings. | 30-year-old male with a history of ulcerative colitis, status post ileostomy takedown with abdominal pain, fever. Rule out obstruction versus infection. 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: Left lower pole stone without evidence of hydronephrosis, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ileostomy. Postsurgical changes consistent with the stated history ileostomy takedown in the abdomen are again seen. No evidence of bowel obstruction. 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 | Postsurgical changes in the abdomen. No evidence of obstruction or intra-abdominal infection, as clinically questioned. |
Generate impression based on findings. | SLE and vasculitis, evaluate for mesenteric thrombus in the setting of nausea, vomiting, and diffuse abdominal pain ABDOMEN:LUNG BASES: Minimal dependent atelectasis.LIVER, BILIARY TRACT: Wedge-shaped hypodensity in the medial segment of the left hepatic lobe suggests focal fat, unchanged. Status post cholecystectomy.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: Several of small bowel appear adhesed to the anterior abdominal wall are suggestive of nonobstructive adhesions, unchanged. No evidence of bowel wall thickening, bowel obstruction, free air, or free fluid. BONES, SOFT TISSUES: No significant abnormality noted.VASCULATURE: No evidence of arterial narrowing or wall thickening to suggest vasculitis. No arterial dissection, thrombus, or aneurysmal dilatation.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered colonic diverticula.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No specific evidence of mesenteric ischemia or other acute intraabdominal abnormality.2.Small bowel adhesive disease. |
Generate impression based on findings. | 51-year-old male. Reason: r/o PE History: shortness of breath, hx of DVT and off coumadin. PULMONARY ARTERIES: Technically adequate exam. No evidence of pulmonary embolism.LUNGS AND PLEURA: Severe bullous emphysema redemonstrated. Interval increase in moderate right-sided effusion and compressive atelectasis. Right middle lobe atelectasis is unchanged.Diffuse groundglass opacity favoring the lung bases is slightly increased and likely reflects edema.MEDIASTINUM AND HILA: Asymmetric left-sided thyroid enlargement.Flattening of the interventricular septum raises the question of right heart strain. Heart size upper limits of normal. No pericardial effusion. Right IJ catheter tip at the cavoatrial junction.No mediastinal or hilar lymphadenopathy.CHEST WALL: Changes compatible with renal osteodystrophy.Left chest wall collaterals are suggestive of chronic central venous obstruction.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of a pulmonary embolism.2.Evidence of increased heart failure, including increased moderate right pleural effusion and slightly increased pulmonary edema.3.Severe bullous emphysema unchanged. |
Generate impression based on findings. | 31 year old female with abdominal pain and vomiting. Status post gastric sleeve with stent placement in December. Lack of intravenous contrast limits evaluation of solid organs.ABDOMEN:LUNG BASES: Right basilar scarring/atelectasis.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: The kidneys are small and atrophic. Again seen are bilateral nonobstructing renal calculi.RETROPERITONEUM, LYMPH NODES: Moderately prominent lymph nodes throughout the retroperitoneum, consistent with the patient's history of sarcoidosis, unchanged.BOWEL, MESENTERY: Interval placement of a gastric stent. No dilated loops of bowel suggest obstruction. No free intraperitoneal air, pneumatosis intestinalis, portal venous gas.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Peritoneal dialysis catheter in place with the tip terminating within the right hemipelvis. There is a small to moderate amount of free fluid within the abdomen and pelvis.PELVIS:UTERUS/ADNEXA: IUD in place, unchanged. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral sclerotic changes along the sacroiliac joints, most pronounced along the iliac aspect of the joint. These findings are most consistent with osteitis condensans ilii. | 1.No findings to account for patient's symptoms. Interval placement of a gastric stent, otherwise, no significant interval change.2.Bilateral punctate renal stones without evidence of obstruction. |
Generate impression based on findings. | pain, vomiting, rule out obstruction ABDOMEN:LUNG BASES: 1.6 x 1.5 cm pulmonary nodule at the left lung base (series 4, image 12) is new from the prior exam. Several pulmonary nodules are scattered throughout the lung bases. New right pleural effusion.Enlarged azygoesophageal lymph node (series 3, image 4) measures 2.9 x 2.7 cm, new from prior exam.LIVER, BILIARY TRACT: Innumerable hypodense hepatic lesions with central necrosis are compatible with metastases. A reference right hepatic lobe lesion measures 3.5 x 3.3 cm (series 3, image 18).SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral nephroureteral stents are unchanged in position. Multiple focal hypodense renal lesions are incompletely characterized but unchanged and compatible with simple cysts.RETROPERITONEUM, LYMPH NODES: Porta hepatis and retroperitoneal lymphadenopathy is new from the prior exam.BOWEL, MESENTERY: Prominent fluid filled loops of small bowel measuring up to 2.5 cm with a transition point in the right lower quadrant (series 3, image 80) are compatible with a small bowel obstruction. There is mural thickening distally within the ileum. Moderate ascites is new and raises the possibility of ischemia or carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. BLADDER: No significant abnormality noted.LYMPH NODES: Previously measured right pelvic lymph node is not seen with certainty on the current examination.BOWEL, MESENTERY: Persistent fluid collection in the right lower quadrant has decreased in size measuring 2.8 by 2.1 cm (series 3, image 74; previously 4.3 x 4.3 cm).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Small bowel obstruction with moderate ascites suggestive of ischemia or carcinomatosis.2.Increasing hepatic and pulmonary metastases.3.New and extensive lymphadenopathy in the chest and abdomen. |
Generate impression based on findings. | Male 79 years old; Reason: eval posterior circulation History: vertical nystagmus. Note that streak artifact from dental hardware limits evaluation.Neck CTA: Retroesophageal aberrant right subclavian artery is noted and there is a common origin of the carotid arteries from the aortic arch.There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations although there is mild to moderate calcification within the carotid bulbs bilaterally and mild scattered non-calcified plaque along the common carotid arteries. A focal eccentric plaque is noted just distal to the left carotid bulb. There is no significant stenosis along the course of the vertebral arteries. There is a dominant left vertebral artery.Multilevel degenerative changes are noted of the cervical spine. At least moderate spinal canal stenosis is noted at C5-6 secondary to a posterior disk osteophyte complex. Multilevel neuroforaminal narrowing is also noted. Diffuse heterogeneity and scattered lucency of the visualized osseous structures along the upper chest. Incidental note is made of a displaced left proximal 1/3 clavicular vertical fracture with inferior apex angulation of the fracture fragments. There is evidence of callous reaction at the fracture site indicating a non-acute stage to the fracture.Within the apices of the lungs, paraseptal emphysema is seen.Brain CTA: There is opacification of the distal internal carotid arteries, the distal left vertebral artery and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated. The right A1 segment is hypoplastic. The right vertebral artery developmentally terminates in the right PICA. CT head:There is prominence of the subarachnoid spaces at the convexities and anterior interhemispheric region. No mass effect, midline shift or herniation. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. There is no pathological enhancement. Age indeterminate periventricular and subcortical white matter hypoattenuation likely from the sequela of small vessel ischemic disease. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Periodontal and periradicular lucencies are seen about the ADA tooth #2. | 1.No acute intracranial abnormality.2.Incidental aberrant right subclavian artery and common origin of the common carotid arteries which is a normal variant.3.Diffuse lucency of the visualized osseous structures along the upper chest, correlate for possible underlying systemic disease such as myeloma or metastases.4.Left clavicle fracture with nonunion and callous formation at the fracture site.5.Findings indicative of possible periodontal/endodontal disease. Correlate with dental exam. Findings discuss with Dr. Saint-Hilar in the ED by Dr. Michael Veronesi of the Radiology department at the time of this dictation at 1139 hours on Dec 31, 2013. |
Generate impression based on findings. | Reason: PE History: hypoxia PULMONARY ARTERIES: The quality of this examination is excellent. No pulmonary embolus to the subsegmental level.LUNGS AND PLEURA: Large right pleural effusion with compressive atelectasis of the right lower lobe.Subsegmental atelectasis involves the left lower lobe. Pulmonary nodule within the left lower lobe measures 10 x 10 mm (series 9 image 98). Additional posterior pleural based patchy consolidation. These findings may be inflammatory and can be followed on subsequent CT following resolution of right pleural effusion. A MEDIASTINUM AND HILA: Partially calcified right intrathoracic goiter that extends to the level of the innominate artery, at the inferior manubrial level. Associated mild leftward tracheal deviation without significant extrinsic compression.Several mildly enlarged mediastinal lymph node. A representative AP window lymph node measures 12 mm in short axis (series 6 image 91).Cardiomegaly with right ventricular and biatrial chamber dilatation. There is some reflux into the hepatic veins which may be related to tricuspid insufficiency. Incidentally, there is apparent contrast at the inter atrial septum, possibly within the left atrium that would be suggestive of a right to left shunt, such is a PFO or a small ASD. Correlation to echocardiography is recommended. The heart is shifted to the left hemithorax secondary to left-sided subsegmental atelectasis and mass effect from the right effusion. No pericardial effusion.The pulmonary artery is mildly enlarged, 33 mm transverse.CHEST WALL: Anasarca..UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The kidneys are partially visualized, demonstrating atrophy. Small amount of ascites is noted in the upper abdomen. Cholelithiasis. Nodularity posterior to the stomach at the inferior field of view may represent a loop of small bowel but is indeterminate.. | No pulmonary embolus to the subsegmental level.Large right pleural effusion. 10 x 10 mm nodule left lower lobe with associated posterior pleural-based consolidation and subsegmental atelectasis. The findings may be post inflammatory. Follow-up with thoracic CT in 3 to 6 months following resolution of right pleural effusion is recommended.High-density contrast is noted within the left atrium in the presence of biatrial chamber dilatation. This may represent a patent foramen ovale or a small secundum ASD with a right to left shunt, which can be further interrogated with echocardiogram. |
Generate impression based on findings. | Unspecified intracranial hemorrhage There is redemonstration of a 35 x 63-mm hematoma centered in the right temporal lobe associated with surrounding edema. The dimensions of this hematoma are unchanged. There is associated mass effect with some compression of the trigone of the right lateral ventricle . The visualized portions of the paranasal sinuses demonstrate minor opacities with a mucous retention cyst in the left maxillary sinus and a small one in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is a right temporal lobe hematoma which is stable when compared to the prior exam. |
Generate impression based on findings. | 38 year-old female. Follow-up of ARDS and bilateral pulmonary opacities. LUNGS AND PLEURA: Interval resolution of previously seen multifocal groundglass opacities and right pleural effusion.Interval development of extensive interstitial opacities with associated traction bronchiectasis and architectural distortion, particularly prominent in the right upper and middle lobe. MEDIASTINUM AND HILA: Right jugular catheter tip terminates at the cavoatrial junction. No mediastinal or hilar lymphadenopathy.CHEST WALL: Renal osteodystrophy. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Peripheral wedge-shaped areas of hypodensity in the right hepatic lobe are unchanged and demonstrated to be focal fatty infiltration on prior MRCP. Large hypodense mass in the body of the pancreas consistent with a pseudocyst. | Interval development of acute fibrotic changes in both lungs, right greater than left. Resolution of groundglass opacities and right pleural effusion. |
Generate impression based on findings. | Unspecified intracranial hemorrhage Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.There are some endplate uncovertebral osteophytes are present at C4-5 and C3-4 with some narrowing of neural foramina at these levels facet hypertrophy is present at the C2-3, C3-4 and C4-5 bilaterally though worse on the left side at the C4-5 facet jointBrain CTA: There is a right temporal lobe arteriovenous malformation measuring approximately 18 x 25 mm in axial dimensions present which now appears to be supplied predominantly from right posterior cerebral artery branches (right posterior temporal artery) as well as the right middle cerebral artery (posterior temporal artery branch) This is associated with early opacification of the right basal vein of Rosenthal and the right tentorial veins and the right transverse sinus. There are pseudoaneurysms present associated with the patient's right temporal lobe hematoma resulting from posterior cerebral artery temporal lobe branches. The largest arterial aneurysm measures 10 x 8 mm axial dimensions another one is present which measures 6 x 5 mm axial dimensions. Additionally there are some dysplastic vessels associated with this hematoma.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right posterior communicating artery is fairly large almost as large as the right P1 segment. The left posterior communicating artery is small. The anterior communicating artery is very smallThere is a small basilar artery fenestration present at the vertebrobasilar junctionCT head:There is a 35 x 63-mm hematoma centered in the right temporal lobe associated with surrounding edema. There is associated mass effect with some compression of the trigone of the right lateral ventricle . The visualized portions of the paranasal sinuses demonstrate minor opacities with a mucous retention cyst in the left maxillary sinus and a small one in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.CTV brain:there is no evidence for dural venous sinus thrombosis | 1.Findings suggest an arteriovenous malformation associated with multiple pseudoaneurysm and dysplastic vessels located in the right temporal lobe which is the likely source of the patient's intracranial hemorrhage. Conventional angiography can help confirm this. The arteriovenous malformation may be compressed by the patient's adjacent hematoma. There appears to be deep venous drainage present and some superficial venous drainage . Arterial supply appear to be from the right posterior cerebral artery branches of the PCA and MCA.2.Right temporal lobe intraparenchymal hemorrhage. |
Generate impression based on findings. | Reason: ? pancreatitis History: abdominal pain in h/o cholangiocarcinoma ABDOMEN:LUNG BASES: Basilar scarring/atelectasis.LIVER, BILIARY TRACT: Ill-defined hypodensity along the hepatic fissure (series 3, image 43) suggests tumor involvement. Bilobar biliary stents are present. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No pancreatic ductal dilatation or parenchymal atrophy.ADRENAL GLANDS: Nodular thickening of the medial limb of the right adrenal gland is nonspecific.KIDNEYS, URETERS: Nonspecific hypodense foci in the right kidney are incompletely evaluated but compatible with renal cysts.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes. Extensive calcification of the abdominal aorta and its branches without aneurysmal dilatation.BOWEL, MESENTERY: Several mesenteric soft tissue nodules measuring up to 1.3 x 1.2 cm in the perigastric region (series 3, image 48).BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted. | 1.Mesenteric soft tissue nodularity compatible with carcinomatosis.2.Ill defined hepatic hypodensity suggests tumor involvement given the patient's history of cholangiocarcinoma. |
Generate impression based on findings. | Female; 15 years old. Reason: evaluate for spondylosis/spondylolisthesis nonunion History: lbp hx in 2007 of spondylolysis with cheerleading. There is 7 mm of anterolisthesis of L5 upon S1, previously 5 mm. There is persistent bilateral L5 spondylolysis with sclerotic margins. There is a 2 mm wide gap in the par interarticularis on the left and a wedged shaped gap in the pars interarticularis on the right that measures up to 15 mm. There is a new ossific fragment posterior to the left L5 superior facet that measures up to 9 mm, which may represent heterotopic bone formation. There is mild bilateral L5-S1 neural foramen stenosis. There is no significant spinal canal stenosis. The vertebral body heights are maintained. The paraspinal soft tissues are unremarkable. | Bilateral spondylolysis of L5 upon S1 with non-union and associated 7 mm of spondylolisthesis, mild bilateral neural foramen stenosis, and probable heterotopic bone formation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |