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Generate impression based on findings. | Abdominal pain right upper quadrant, assess for cholecystitis or cholangitis LIVER: Liver measures 15 cm with increased echogenicity suspicious for hepatic steatosis. No intrahepatic biliary duct dilatation. Portal vein demonstrates normal flow directionality and patency measuring up to 0.2 m/s. No focal liver lesions noted. GALLBLADDER, BILIARY TRACT: Gallbladder is well distended with sludge noted within the bladder. No evidence of gallstones. Multiple small punctate hyperechoic areas within known artifacts noted in the fundus of the gallbladder most likely representing cholesterolosis/polyps. No evidence of pericholecystic fluid. Common hepatic duct measuring up to 3 mm within normal limits.PANCREAS: No significant abnormalities noted.KIDNEY: Right kidney measures 10.1 cm with normal echotexture. No hydronephrosisLimited evaluation of the left upper quadrant due to overlying bowel gas. Left kidney measures 9.5 cm.OTHER: Spleen measures 10.2 cm with normal echotexture.Mild Ascites noted.Bilateral pleural effusion noted | Hepatic steatosis without any focal liver lesion.Multiple gallbladder cholesterolosis/polyps and sludge. No evidence of gallstonesBilateral pleural effusion.Limited evaluation of the left upper quadrant due to overlying bowel gas. |
Generate impression based on findings. | Elevated LFTs LIVER: Mildly coarse echogenic liver echotexture without worrisome mass. 1.9 x 2.3 x 2.4 benign cystic focus right lobe of liver. Liver length 17.5 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in length.OTHER: Spleen 10.6 cm in length. No ascites. | Mildly coarse echogenic liver echotexture suggestive for fatty infiltration without worrisome mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 64-year-old female with question thyroid nodule. RIGHT LOBE MEASUREMENTS: 5.6 x 1 x 1.7 cmLEFT LOBE MEASUREMENTS: 6.7 x 2.2 x 1.5 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Homogeneous in echotexture. Arising from the lower pole is a predominantly solid, isoechoic mass with some internal cystic change in small punctate echogenic foci. This measures approximately 0.6 x 0.7 x 1.3 cm with a somewhat lobulated margin on transverse imaging.LEFT LOBE: Homogeneous in echotexture. Presumably arising from the lower pole of the left lobe is a very large, solid, well-defined and heterogeneous mass measuring 2.1 x 2.3 x 3.2 cm. Portions of this are hyperechoic.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid masses with an indeterminate appearance. |
Generate impression based on findings. | History bladder cancer status post cystectomy with acute renal insufficiency RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 9.9 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.4 cm in lengthOTHER: Bladder nondistended | Mildly echogenic renal parenchyma raises the possibility of medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | Recurrent abdominal pain status post MALS surgery LIVER: Normal parenchymal echogenicity without mass. Liver length 16.2 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.5 cm in lengthOTHER: Left kidney 10 cm in length. Spleen 12 cm in length. No ascites. | Negative right upper quadrant ultrasound. No evidence for hepatobiliary abnormality. |
Generate impression based on findings. | 35-year-old female with right upper quadrant pain. Evaluate for cholecystitis. LIVER: The liver is normal in morphology with slightly coarsened echotexture. It measures 21 cm in craniocaudal dimension. No focal hepatic lesion or intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.GALLBLADDER, BILIARY TRACT: Sludge and gallstone at the neck of a normally distended gallbladder. No wall thickening, pericholecystic fluid or focal tenderness. The common bile duct is mildly prominent up to 10 mm without obstructing stone or lesion identified.PANCREAS: Partially visualized pancreas is unremarkable.RIGHT KIDNEY: Dense calcification in the superior pole of the right kidney, unchanged. No hydronephrosis.OTHER: The left kidney measures 9.7 cm in length with mild upper pole pelviectasis. No shadowing nephrolithiasis is apparent. The spleen is normal in size, measuring 10.9 cm. | Gallbladder sludge, gallstones and mild extrahepatic biliary ductal dilatation. No common bile duct stone is evident. No evidence of acute gallbladder inflammation. |
Generate impression based on findings. | Hepatic cirrhosis with TIPS LIMITED ABDOMENLIVER: Cirrhotic morphology again noted without worrisome mass. 2.7 x 1.9 cm hypoechoic focus adjacent to gallbladder fossa stable; favor benign etiology. Liver length 16.1 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.6 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11.5 cm in length OTHER: Left kidney 12.7 cm in length. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. Patent TIPS catheter with patent hepatic vessels with expected directional flow. No ascites. |
Generate impression based on findings. | 70 years, Male. Reason: r/o obstruction History: nausea and vomiting There is patchy opacification of the ascending and transverse colon by contrast material from the patient's endoscopic ultrasound dated 11/25/2015. A dilated loop of small bowel in the left abdomen measures up to 3.8 cm in diameter and is felt to represent a focal ileus. There is no evidence of intraperitoneal free air. A left upper quadrant surgical drain and numerous surgical staples and suture material overlie the abdomen. | A dilated loop of small bowel in the left abdomen measures up to 3.8 cm in diameter and is felt to represent a focal ileus. |
Generate impression based on findings. | 76 year old male with metastatic thyroid cancer. Evaluate for lymph nodes. RIGHT LOBE MEASUREMENTS: 4.5 cm x 1.9 cm x 1.7 cmLEFT LOBE MEASUREMENTS: 10.0 cm x 4.8 cm x 2.5 cm.ISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Hypoechoic subcentimeter nodule at the mid to lower pole measuring to up 6 mm. LEFT LOBE: Diffusely heterogeneous in echotexture. ISTHMUS: No significant abnormality noted.ILYMPH NODES: No suspicious lymphadenopathy. Right neck level 2 lymph node with fatty hilum measuring 2.0 cm x 0.5 cm 1.2 cm. Left neck level 2 lymph node with fatty hilum measuring 1.6 cm x 0.6 cm x 0.8 cm. | 1. Diffusely heterogeneous left thyroid lobe likely reflecting patient's known primary thyroid malignancy. Additional hypoechoic subcentimeter nodule is seen in the right thyroid lobe. 2. Bilateral lymph nodes with fatty hila, may be reactive. |
Generate impression based on findings. | Reason: history of liver disease, ?cirrhosis History: abnormal liver function tests LIVER: The liver measures 15.8 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.31 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 7.9 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | 67-year-old female with forearm lump. There is thickening in the subcutaneous tissues with some increased echogenicity in small amount of edema which may be due to cellulitis. On several views there is a 4-5 mm complex fluid collection in this region. I cannot exclude small abscess. No larger collections are identified. | Findings presumably related to cellulitis. There is a very small associated fluid collection. |
Generate impression based on findings. | Ms. Jackson submitted outside mammograms dated 7/25/2011 and 7/2/2013 and outside ultrasounds dated 5/31/2012 and 7/2/2013 from Little Company of Mary Hospital. Submitted outside studies were compared to the current mammogram dated 9/8/2016. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Previously identified partially obscured masses in bilateral breasts are either stable to slightly decreased in size when compared to prior mammograms, compatible with benign involuting cysts.The mammographic findings correspond to the prior ultrasound examinations demonstrating multiple benign simple cysts. | Bilateral benign involuting cysts. No mammographic evidence of malignancy. Physical examination is of increased importance for a patient with dense breast. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due in September 2017. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Chronic renal disease RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.9 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.7 cm in length.OTHER: Bladder nondistended. | Mildly echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Male 65 years old; Reason: r/o liver lesion History: HCV LIVER: The liver measures 13.2 cm in length. There is a coarse echotexture of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 22.5 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.6 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 3.9 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.5 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | Nonspecific coarse echotexture of the liver, which is compatible with chronic liver dysfunction. No worrisome masses are seen. |
Generate impression based on findings. | Male 63 years old Reason: possible MPGN, has low c3c4 , cryo levels pending History: anasarca Ultrasound guidance and technical assistance was provided for a negative right kidney. 3 passes using an 18-gauge needle were obtained at Dr. Cunningham The procedure was successfully completed. | Successful ultrasound guided biopsy of the right kidney. |
Generate impression based on findings. | 54-year-old female with chronic kidney disease, stage III. Biopsy guidance | Ultrasound guidance as noted above |
Generate impression based on findings. | Ms. Smith is a 59-year-old female with a personal history of right lumpectomy and sentinel lymph node biopsy in 2009 for IDC, grade 3, ER/PR positive. The patient currently reports breast tenderness and tightness on the right. On Arimidex. Upon physical exam at the mammographic area of concern, no discrete mass was appreciated.Targeted ultrasound of the right breast 6:00 position was performed, demonstrating a hypoechoic mass with irregular margins and internal calcifications 6 cm from the nipple measuring 0.7 x 0.6 x 0.8 cm, with mildly increased vascularity peripherally. | New suspicious mass in the right breast 6:00 position, for which ultrasound-guided biopsy is recommended. All results and recommendations were discussed with the patient. The patient is not on any blood thinning medications.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Rising LFTs status post gallbladder drain placement LIVER: Mildly coarse echogenic liver echotexture again noted without mass. Liver length 17.5 cmBILIARY TRACT: Gallbladder collapsed around percutaneous catheter. No pericholecystic fluid collection. No loculated fluid collection.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.7 cm in lengthRIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 12.6 cm in lengthOTHER: Left kidney 12.3 cm in length. Echogenic left renal parenchyma without mass, stone, or hydronephrosis No ascites. | Mildly coarse echogenic liver character echotexture again noted suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Gallbladder collapsed around percutaneous catheter without pericholecystic fluid collection or other loculated fluid collection.Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without hydronephrosis. |
Generate impression based on findings. | 27 years old, Female, Reason: AKI, assess for hydro, obstructing stone History: as above Technically difficult exam due to patient's body habitus.RIGHT KIDNEY: Kidney measures 14.3 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 13.2 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.BLADDER: Incompletely distended with no significant abnormalities. OTHER: No significant abnormalities noted. | 1.Normal echotexture of the kidneys bilaterally without evidence of hydronephrosis or shadowing calculus. |
Generate impression based on findings. | Reason: HCV, Hepatitis B carrier. Evaluate for HCC History: HBV carrier. LIVER: The liver is normal in size, echogenicity, and contour, measuring 11.3 cm in length. No focal hepatic lesion is identified.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallbladder wall thickening, cholelithiasis, or sonographic Murphy sign. Gallbladder sludge is noted.PANCREAS: Pancreatic tail is obscured by overlying bowel gas. Otherwise, no abnormality is identified.SPLEEN: The spleen is normal in size, measuring 8 cm in length.RIGHT KIDNEY: The right kidney measures 9.6 cm in length. No evidence of renal stone or hydronephrosis. OTHER: The left kidney measures 8.8 cm in length. No evidence of renal stone or hydronephrosis. | No focal hepatic lesion identified. |
Generate impression based on findings. | 52-year-old female with history of thyroid nodule. RIGHT LOBE MEASUREMENTS: 1.6 x 1.8 x 4.0 cmLEFT LOBE MEASUREMENTS: 0.9 x 1.5 x 3.7 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: 5-mm hypoechoic solid inter-polar nodule without specific suspicious sonographic features. Otherwise, the background thyroid gland is minimally coarse.LEFT LOBE: The left thyroid lobe is minimally coarse without a dominant nodule.ISTHMUS: Within the right aspect of the isthmus is a 1.5 x 1.0 x 1.9 cm complex solid and cystic lesion without associated microcalcifications, or vascularity. The contour is slightly lobulated. The appearance and size is relatively stable.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Relatively stable 1.9-cm right Isthmus complex solid and cystic lesion is amenable to FNA if clinically warranted. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 51-year-old male with history of cystic lesion seen on cervical spine MRI. RIGHT LOBE MEASUREMENTS: 5.0 x 2.7 x 1.2 cmLEFT LOBE MEASUREMENTS: 5.4 x 2.1 x 1.2 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: A 1.6 x 1.1 x 0.7 cm cystic lesion is noted posteriorly and inferiorly to the right thyroid lobe. There is a clear fat plane separating this structure from the thyroid. The lesion is completely cystic without internal solid components or significant internal vascularity. | Cystic lesion posterior and inferior to the right thyroid lobe without internal solid component or internal vascularity. Differential considerations include simple cyst vs cystic parathyroid adenoma. |
Generate impression based on findings. | Male 58 years old Reason: 58M s/p OLT 10/2 now with elevated LFTs s/p liver biopsy. History: Elevated LFTs LIVER: Background liver echogenicity is within normal limits. Stent or drain is partially visualized.BILIARY TRACT: Mildly prominent intrahepatic ducts without significant dilatation of the common bile duct which measures up to 6 mm.OTHER: No significant abnormalities noted. | Mildly prominent intrahepatic ducts without significant common bile duct dilatation, possibly related to cholestasis. |
Generate impression based on findings. | 52-year-old female with palpable abnormalities in the right breast for one week. Patient reports they feel linear. Limited physical examination of the right breast 11 and 8 o'clock positions in the patient's palpable area of concern was unremarkable. No mass was palpated.A targeted right ultrasound was performed for the patient’s palpable area of concern in the 11 and 8 o'clock positions, 5 cm from the nipple. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. The patient may be palpating the Cooper's ligaments. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female 83 years old; Reason: Parathyroid adenoma in the setting of hypercalcemia and high PTH levels History: Hypercalcemia RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.4 x 2.4 x 1.9 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.3 x 2.1 x 1.6 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.1 cm.RIGHT LOBE: The right thyroid lobe is heterogeneous. No dominant nodules are identified.LEFT LOBE: The left thyroid lobe is heterogeneous. No dominant nodules identified.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious adenopathy noted. There is a right level 3 lymph node visualized with a fatty hilum measuring 1.4 cm 1.5 cm x 0.4 cm. | 1.No evidence of a parathyroid adenoma visualized on this study. This ultrasound is partially limited due to patient's positioning/movement.2. Thyroid gland is heterogeneous but no dominant nodules are identified. No suspicious lymphadenopathy is seen. |
Generate impression based on findings. | Ms. ELAINE MCKENNEY is a 62 years old female with a personal history of right lumpectomy in June 2014 for IDC. She also has history of benign biopsy in March 2014 at outside hospital. She presents today with intermediate palpable concern in the left breast, same area as found one month ago. In the left breast upper inner quadrant, approximately 10:00 location, there is ink marker to indicate the palpable concern by the surgical clinic staff. Patient's palpable area of concern is slightly inferior to the ink marker at approximately 9:00 position.A targeted left ultrasound was performed at areas of palpable concern. Normal breast tissues are noted in both 10:00 and 9:00 location, 2 cm from the nipple. There is no solid or cystic mass to correspond to the palpable concerns. | No sonographic findings to account for patient's palpable concern. Routine annual diagnostic mammograms are recommended, due in March 2016. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | Female 67 years old; Reason: assess for progression in size of thyroid nodules History: none RIGHT LOBE MEASUREMENTS: 5 x 1.7 x 2.1 cmLEFT LOBE MEASUREMENTS: 7.5 x 3.9 x 2.4 cmISTHMUS MEASUREMENT: 1.2 cmRIGHT LOBE: There are two right thyroid nodules. The superior nodule measures 1.7 x 1.3 x 1.6 cm, previously, 2.3 x 1.2 x 1.2 cm.; This nodule is mostly solid.The inferiorly located nodule measures 2.0 x 1.2 x 1.6, previously, 9 x 9 x 7 mm previously.LEFT LOBE: There are at least two left thyroid nodules.The largest nodule is in the lower pole and measures 4.7 x 3.1 x 4.0 cm, previously, 4.2 x 3.9 x 3.5 cm. It is mostly solid with some cystic areas.ISTHMUS: Isthmus nodule measures 1.7 x 1.1 x 1.8 cm, previously, 2.5 x 1.2 x 2.2 cm previously. It is mostly solid.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable to slight increase in the size of the inferior right pole and inferior left thyroid pole nodules.2.The remainder of the nodules are stable in size. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Echogenic coarse parenchyma again noted without mass. Liver length is 16.6 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis again noted without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 9.6 cm in length.OTHER: Left kidney 12 cm in length. Spleen 7.9 cm in length. No ascites | Coarse echogenic liver parenchyma again noted consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation; this finding is unchanged. Cholelithiasis without acute inflammation again noted. No ascites. |
Generate impression based on findings. | 74-year-old female with bilateral thyroid nodules. RIGHT LOBE MEASUREMENTS: 6.4 x 3.4 x 2.8 cmLEFT LOBE MEASUREMENTS: 4.5 x 2.7 x 2.0 cmISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: Dominant solid right thyroid nodule measures 7.0 x 1.2 x 1.1 cm with peripheral hypervascularity. Two smaller hypoechoic nodules measure 4.2 x 2.4 x 3.0 cm and 1.1 x 1.1 x 0.7 cm.LEFT LOBE: Multiple thyroid nodules. An anterior hypoechoic nodule with peripheral calcification measures 1.0 x 0.6 x 0.5 cm. A more posteriorly located hyper-isoechoic nodule measures 1.5 x 1.5 x 0.9 cm. Two smaller adjacent colloid appearing nodules measure up to 1.5 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular thyroid as detailed above, which was subsequently biopsied. Please see separately dictated biopsy report for complete description of procedural findings. |
Generate impression based on findings. | Reason: Hx of sudden gross hematuria with AKI History: As above RIGHT KIDNEY: The right kidney measures 10.6 cm in length. Echogenic renal parenchyma. No shadowing renal calculi, hydronephrosis, or focal mass.LEFT KIDNEY: The left kidney measures 10.2 cm in length. Echogenic renal parenchyma. No shadowing renal calculi, hydronephrosis, or focal mass.OTHER: The bladder is decompressed by a Foley catheter, limiting its evaluation, however the bladder wall appears thickened and intraluminal mass cannot be excluded. | 1. Bladder wall thickening, similar to that seen on CT dated 2/22/2016; intraluminal mass cannot be excluded.2. Echogenic renal parenchyma, consistent with medical renal disease. |
Generate impression based on findings. | HCV LIVER: Cirrhotic morphology without mass. Liver length 17 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.5 cm in lengthOTHER: Left kidney 10.4 cm in length. Spleen 10.7 cm in length. No ascites. | Cirrhotic morphology without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 67 year-old female with a history of papillary thyroid cancer. Please evaluate. RIGHT LOBE MEASUREMENTS: 4.6 x 1.8 x 1.9 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.4 x 1.2 cmISTHMUS MEASUREMENTS: 2 mm.RIGHT LOBE: Note is made of multiple subcentimeter nodules, which are too small to accurately characterize. Nodule 1: Mid body of the right lobe of the thyroid gland. There is a 1.7 x 1.1 x 14 cm, oval, heterogeneous, and partially solid partially cystic well-circumscribed nodule with peripheral and internal vascularity, and probable microcalcification. Indeterminant with suspicious characteristics.Nodule 2: Mid body of the left lobe of the thyroid gland. There is a round, well-circumscribed isoechoic nodule with peripheral calcification, measuring 0.7 x 0.7 x 0.6 cm. There is no internal vascularity or microcalcification. Indeterminant.LEFT LOBE: Note is made of multiple subcentimeter nodules, which are too small to accurately characterize. Nodule 1: Mid body of the left lobe of the thyroid gland. There is a 0.7 x 0.9 x 0.8 cm, oval, well circumscribed, spongiform nodule with foci of apparent ring down artifact suggestive of a benign colloid nodule. There is internal vascularity. Probably benign.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Note is made of multiple nonspecific subcentimeter lymph nodes in the soft tissues of the right lateral neck.OTHER: No significant abnormality noted. | 1. Multiple indeterminate nodules in the right lobe of the thyroid gland, the largest of which measures 1.7 cm and demonstrates suspicious characteristics. Clinical correlation as well as submission of prior examinations is recommended, given the stated history of known thyroid carcinoma. If no priors are available, further evaluation with FNA of the dominant nodule could be considered.2. Nonspecific subcentimeter lymph nodes in the soft tissues of the right lateral neck. |
Generate impression based on findings. | 49-year-old female with tender nodule in the right upper quadrant, evaluate consistency and rule out abscess, liver/gallbladder pathology. LIVER: Measures 20.3 cm in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: Increased renal echogenicity without hydronephrosis. Lobulated contour of the left kidney without discrete mass. Cyst in the left mid polar region measures 1.2 cm, without septation or solid component.OTHER: Sonographic examination of the patient's superficial palpable nodule in the right upper quadrant demonstrates a hypoechoic lesion which appears contiguous with rib both medially and laterally, and may represent a chronic rib fracture with associated callus formation. The patient was not tender to palpation and denies known history of trauma to that location, however a neoplasm cannot be entirely excluded sonographically. | 1. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. No evidence of cholecystitis, biliary obstruction, or abscess.2. Increased renal echogenicity consistent with medical renal disease without hydronephrosis. Lobulated contour of the left kidney without discrete mass.3. Hypoechoic superficial lesion in the area of the patient's palpable nodule appears contiguous with rib both medially and laterally, and may represent a chronic rib fracture with associated callus formation. However, a neoplasm cannot be entirely excluded sonographically. If further imaging evaluation is warranted, dedicated rib series radiographs or CT may be considered. |
Generate impression based on findings. | Reason: eval for HCC lesions; eval for cirrhosis; eval for clot in portal vein or hepatic vein or IVC; hx Hep C multiple hypodensities seen on ct in left kidney LIMITED ABDOMENLIVER: The liver measures 14.1 cm in length. Mildly coarse, echogenic hepatic parenchyma. Questionable mild nodularity of the hepatic contour. No focal masses.BILIARY TRACT: No significant abnormalities noted. No biliary ductal dilatation. The gallbladder wall measures 0.2 cm. The common bile duct measures 0.4 cm.PANCREAS: Not visualized.SPLEEN: There is an anechoic lesion in the mid pole of the spleen representing a simple cyst. The spleen measures 7.5 cm in length. RIGHT KIDNEY: The right kidney measures 5.0 cm in length. Echogenic renal parenchyma. Several anechoic cystic lesions are noted in the upper and mid poles. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 7.3 cm in length. Echogenic renal parenchyma Large multicystic lesion in the mid pole of the left kidney with multiple thin septations measures approximately 3.1 x 2.3 x 2.4 cm. No hydronephrosis or shadowing stones.OTHER: No ascites. | 1. Mildly echogenic liver, consistent with hepatic parenchymal dysfunction or chronic liver disease.2. Patent hepatic vasculature with normal directional flow as described above.3. Echogenic renal parenchyma, consistent with advanced medical renal disease. |
Generate impression based on findings. | Ms. Hamlish is a 56-year-old female with a personal history of bilateral mastectomy in 2003 for multifocal IDC on the left. Presenting with palpable mass in the left upper chest wall. A targeted left breast ultrasound was performed for the palpable area of concern. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. All results and recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 20 years old, Male, Reason: s/p Right inguinal hernia repair, 1 day h/o right groin pain History: groin pain and bulgin reminiscent of inguinal hernia pain before repair No evidence of bowel or fat in an inguinal hernia. No evidence of other type of hernia in this area. Benign-appearing lymph nodes are noted within the inguinal area measuring up to 1.1 cm. Inguinal hernia was unable to be produced on standing and Valsalva. | No evidence of hernia sac despite valsalva and manipulation. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 75-year-old female patient with new ascites. Evaluate for cirrhosis. LIVER: The liver measures 16.0 cm in length. No focal hepatic lesion is identified and the liver contour is grossly normal. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is filled with stones. There is no significant gallbladder wall thickening. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The pancreas is poorly visualized secondary to overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.8 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is increased.The spleen measures 10.5 cm in length.There is moderate ascites. | 1. Moderate ascites. No focal hepatic lesion is identified.2. Medical renal disease. 3. Cholelithiasis. |
Generate impression based on findings. | The patient submitted outside mammogram dated 2/6/08. Submitted outside study was compared to the current mammogram dated 11/12/14. A circumscribed mass at 11 o'clock position in the left breast is stable when compared to the prior study. The other mass at retroareolar region in the left breast is not confirmed on the prior study; however, this mass appears a simple cyst on ultrasound study. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 63-year-old female; patient is bacteremic. There is a clinical concern for perinephric abscess. RIGHT KIDNEY: Right kidney measures 13.1 cm. The cortex has normal echogenicity. No shadowing calculi, hydronephrosis, or worrisome mass.LEFT KIDNEY: Left kidney measures 13.0 cm. The cortex is normal echogenicity. No shadowing calculi, hydronephrosis, or worrisome masses. There is an approximately 4.7 x 3.3 m hypoechoic well-defined lesion with posterior acoustic enhancement, compatible with benign renal cyst.BLADDER: Bladder is not distended and there is a Foley catheter in place.OTHER: No hypoechoic fluid collection suggestive of abscess seen in the perinephric space. | Normal limited ultrasound of the kidneys without perinephric abscess, stone, mass, or hydronephrosis. |
Generate impression based on findings. | Reason: Evaluate for etiology of transaminitis as well as rising Cr with known h/o hydronephrosis and hydroureter - 75 yo M with recently diagnosed bladder cancer and now with GNR bacteremia History: GNR bacteremia, transaminitis, AKI LIVER:Diffusely echogenic liver, suggestive of hepatic steatosis, measuring 18 cm. Normal portal venous blood flow.GALLBLADDER, BILIARY TRACT: No significant abnormality noted. Common bile duct measures 0.6 cm.PANCREAS: No significant abnormality noted.SPLEEN: Spleen measures 14.5 cm. Numerous calcified granulomata.KIDNEYS: Right kidney measures 14.4 cm. Persistent mild hydronephrosis and hydroureter despite right ureterovesicular stent placement. No left hydronephrosis or hydroureter.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Well-distended bladder with mild wall thickening and intraluminal debris. Ureterovesicular stent visualized in the bladder lumen. | Mild right hydronephrosis and hydroureter despite indwelling ureteral stent. No left sided hydronephrosis. |
Generate impression based on findings. | US GUIDED FNA; 3/11/2016 9:58 AM RIGHT LOBE MEASUREMENTS: 1.4 x 1.6 x 4.5 cmLEFT LOBE MEASUREMENTS: 3.1 x 3.3 x 7.8 cm.ISTHMUS MEASUREMENTS: 1.5 cmRIGHT LOBE: There are several nodules in the right lobe which appears spongiform with comet tail artifact consistent with colloid nodules. For reference, a mid right lobe nodule measures 0.4 x 0.8 x 0.9 cm.LEFT LOBE: Within the posterior aspect of the left lobe there is a poorly defined, solid and heterogeneous mass. Margins are inconspicuous and the mass approximates 2.6 x 2.7 cm. There is some vague shadowing seen as well which may be due to calcification. Cannot exclude extrathyroidal extension.ISTHMUS: Large complex mass or adjacent masses in the isthmus are solid but heterogeneous, measuring 0.6 x 1.6 x 1.9 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are 2 large left cervical nodes identified. These are abnormal in morphology as well. Level 2-3 node measures 4.2 x 2.1 x 4.9 cm. Level 3-4 node measures 2.3 x 2.4 x 3.1 cm.OTHER: No significant abnormality noted. | Malignant--appearing left thyroid mass with possible extrathyroidal extension.Malignant--appearing adenopathy left neck.Indeterminant mass in the isthmus.Benign-appearing right thyroid masses. |
Generate impression based on findings. | 62 years old, Female, Reason: 62 yo female with history of mucinous cervical versus ovarian cancer, s/p chemotherapy, with single liver cyst on 1/5/15 CT A/P, further characterize liver lesion History: single liver cyst on 1/5/15 CT LIVER: The liver measures 14.2 cm in length. Echogenicity of the liver is within normal limits. Hyperechoic lesion measuring 1.3 x 1.8 x 1.5 cm which correlates to the lesion seen on most recent CT scan and likely represents a hemangioma given imaging characteristics on both studies. A small hepatic cyst is identified in the right hepatic lobe. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Small gallbladder polyp is identified measuring up to 0.3 cm. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.2 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Lower pole the right kidney is not identified due to overlying bowel gas. Normal echotexture. No hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 11.8 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | 1.Hyperechoic lesion has imaging characteristics most compatible with a hemangioma.2.Very small gallbladder polyp. |
Generate impression based on findings. | Female; 26 years old. Reason: r/o goiter, nodules History: enlarge thyroid RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 3.9 x 1.4 x 1.0 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Heterogeneous thyroid with innumerable small hypoechoic nodules. There is no dominant nodule. The background gland is hypervascular.LEFT LOBE: Heterogeneous thyroid with innumerable small hypoechoic nodules. There is no dominant nodule. The background gland is hypervascular.ISTHMUS: Heterogeneous thyroid with innumerable small hypo echoic nodules. There is no dominant nodule. The background gland is hypervascular.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Prominent left level 3 lymph node measures 2.1 x 0.6 x 0.3 cm with a fatty hilum.OTHER: No significant abnormality noted. | 1.Hypervascular, heterogeneous thyroid gland with innumerable small hypoechoic nodules compatible with thyroiditis.2.Prominent left level 3 lymph node has a normal ultrasound appearance and is likely reactive in etiology. |
Generate impression based on findings. | 67-year-old male with history of appendectomy thyroid cancer and positive lymph nodes. Prior surgery and radioactive iodine therapy. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: Within the right thyroid bed there is a solid 0.7 x 1.1 x 2.3 cm mass. This contains several bright reflectors which could represent calcification.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mass in the right thyroid bed corresponding to the I-131 findings. |
Generate impression based on findings. | Right upper quadrant abdominal pain LIVER: Coarse echogenic liver echotexture without mass. Liver length 22 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in length OTHER: Left kidney 11.3 cm in length. Spleen 9.7 cm in length. No ascites. | Mild to moderate hepatomegaly with coarse echogenic parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Provided history of cirrhosis. Patient with sickle cell disease and schizophrenia. LIVER: The liver contour is lobular. The parenchyma is heterogeneously coarse compatible with stated history of chronic liver disease. No suspicious lesion is identified.Normal hepatopedal portal venous blood flow at 14 cm/s.BILIARY TRACT: The gallbladder is partially collapsed. The gallbladder wall measures 2 mm, within normal limits. No pericholecystic fluid or focal tenderness. Note is made of small gallstones. Adjacent to the gallbladder fundus is a 2.6 x 2.1 x 2.2 cm fluid collection which appears separate from the bowel and is of uncertain etiology. It may communicate with the gallbladder fundus.No intra or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreatic head and proximal body are unremarkable. Adjacent to the proximal body is a 2.5 x 1.4 x 2.5 cm hypoechoic lesion, previously measuring 1.8 x 1.7 cm.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. A small cyst is noted. OTHER: The left kidney measures 10.6 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. The spleen measures 6.5 cm in length. | 1. Findings compatible with stated history of chronic liver disease without a focal lesion evident.2. Cholelithiasis without evidence of acute cholecystitis. Nonspecific 2.6 cm fluid collection adjacent to the gallbladder fundus is of uncertain etiology. 3. Enlarging 2.5 cm peripancreatic lesion may represent a large lymph node. A MR or CT is recommended for further characterization of this lesion and the fluid collection described above. |
Generate impression based on findings. | 87 year old female with left breast invasive lobular carcinoma (two sites), on neoadjuvant Arimidex. Evaluate response to treatment. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is decreased asymmetry in the left upper outer breast, adjacent to the coil-shaped clip. There is redemonstration of a winged shaped clip within the left retroareolar region. There has been no significant mammographic change within the left retroareolar region.ULTRASOUND: A targeted left ultrasound was performed. At the 2:00 position of the left breast, 5 cm from the nipple, there is redemonstration of the irregular hypoechoic mass today measuring 0.6 x 0.6 x 0.9 cm (previously 1.3 x 0.8 x 1.2 cm), with adjacent Hydromark clip.Within the left retroareolar region, there is redemonstration of a heterogeneous, hypoechoic lobulated mass today measuring 2.7 x 1.2 x 2.2 cm (previously 4.3 x 2.0 x 3.4 cm). Increased peripheral vascularity is present surrounding this mass. | Interval decrease in size of biopsy proven breast carcinomas within the retroareolar and two o'clock positions of the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 66-year-old female with papillary thyroid carcinoma. RIGHT LOBE MEASUREMENTS: 2.2 x 2.3 x 5.3 cmLEFT LOBE MEASUREMENTS: 2.1 x 1.9 x 4.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Right lobe is diffusely heterogeneous in echotexture. In the midportion of the right lobe there is a poorly defined hypoechoic area with dense associated calcification measuring at least 0.4 x 0.8 x 1 cm. Posterior margin cannot be adequately visualized due to shadowing from calcification.LEFT LOBE: Left lobe is diffusely heterogeneous in echotexture without focal mass.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Ill-defined right lobe mass with calcification. No adenopathy. |
Generate impression based on findings. | 76-year-old male with hyperparathyroidism, history of thyroidectomy. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Echogenic material in the thyroid bed favored to represent post surgical scarring.LEFT LOBE: Echogenic material in the thyroid bed favored to represent post surgical scarring.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No discrete lesions to indicate parathyroid adenoma identified. LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Status post thyroidectomy. Echogenic material in the thyroid bed favored to represent post surgical scarring.2. No discrete parathyroid adenoma identified. Please refer to concurrently performed nuclear medicine examination for further characterization. |
Generate impression based on findings. | Chronic renal disease RIGHT KIDNEY: Echogenic parenchyma again noted without worrisome mass, stone, or hydronephrosis. Stable right renal cyst. Right kidney 8.5 cm in length.LEFT KIDNEY: Echogenic parenchyma again noted without mass, stone, or hydronephrosis. Left kidney 8.7 cm in length.OTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction again noted without worrisome mass, stone, or obstruction. |
Generate impression based on findings. | 40-year-old female with history of incompletely characterized subcentimeter mass within the left central breast. Patient is asymptomatic. No family history of breast cancer. A left ML view in addition to a CC and 2 mL spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses(BiRads Density Category C), unchanged in pattern and distribution. 8 mm oval well-circumscribed mass is reidentified within the left central breast.Focal asymmetry within the left lower outer quadrant, disappears on spot compression views.ULTRASOUND:Targeted left breast ultrasound at 12:00 posterior to the nipple demonstrates a well circumscribed anechoic avascular mass with posterior enhancement measuring 7 x 5 x 6 mm, compatible with a simple cyst. This finding correlates with previously described well-circumscribed mass within the left central breast identified on mammography. | Simple cyst in central left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 73 year-old female with thyroid nodules. Evaluate for growth or lymphadenopathy. RIGHT LOBE MEASUREMENTS: 4.6 cm x 1.2 cm x 1.4 cm.LEFT LOBE MEASUREMENTS: 6.5 cm x 5.3 cm x 4.5 cmISTHMUS MEASUREMENTS: 5 mm in thicknessRIGHT LOBE: Solid nodule at the lower pole measures 1.2 cm x 0.9 cm x 0.7 cm, previously measured 0.9 cm x 0.6 cm x 0.7 cm.LEFT LOBE: Left lobe is replaced by two large solid nodules, one of which is located in upper pole measuring 4.9 cm x 3.4 cm x 4.7 cm, previously 4.8 cm x 4.7 cm x 4.2 cm. Second nodule in the lower pole measures 3.3 cm x 4.1 cm x 4.5 cm, previously measured 1.7 cm x 4.0 cm x 4.3 cm.ISTHMUS: Subcentimeter nodule measures 3 mm x 2 mm x 4 mm, previously measured 3 mm x 2 mm x 2 mm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral solid nodules slightly increased in size compared to prior study. Dominant nodules in the left lobe were previously biopsied with benign histology. |
Generate impression based on findings. | Right renal cell carcinoma. Partial nephrectomy. RIGHT KIDNEY: 8.7 cm in length. Postsurgical changes are noted at the superior pole. No definite suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 11.0 cm in length. Normal renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormality noted. | Postsurgical changes at the right renal superior pole, without definite mass seen. Evaluation for recurrence is limited by ultrasound, and CT or MRI follow-up is recommended. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. 10.1 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma without significant hydronephrosis. Left ureteral stent in anatomic location. No mass. No stone. Left kidney 10.8-cm in lengthOTHER: Bladder nondistended. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without significant obstruction, mass, or stone. Left ureteral stent in anatomic location. |
Generate impression based on findings. | 75-year-old female with pancreatic adenocarcinoma with known liver metastases, now with abdominal swelling, evaluate for ascites. There is large four quadrant abdominal ascites. Incompletely visualized bilateral pleural effusions.Coarse echotexture and nodular contour of the visualized liver consistent with cirrhotic liver morphology. | 1. Large four quadrant abdominal ascites and bilateral pleural effusions. 2. Cirrhotic liver morphology. |
Generate impression based on findings. | 55-year-old female with history of hepatitis C, screening for HCC and cirrhosis LIVER: Measures 17.8 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: Atrophic kidneys with markedly increased echogenicity. 1.6 cm right superior pole cyst without septation or nodular component. No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | 1. Increased hepatic echogenicity consistent with chronic liver disease, without discrete focal lesion. 2. Atrophic kidneys with markedly increased echogenicity consistent with medical renal disease. |
Generate impression based on findings. | History of a thyroid nodule. RIGHT LOBE MEASUREMENTS: 5.8 x 2.6 x 2.7 cmLEFT LOBE MEASUREMENTS: 3.3 x 1.1 x 1.1 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: Complex partially cystic predominately solid inferior nodule measuring 3.2 x 2.5 x 2.6 cm compared to 3.5 x 2.4 x 3.0 cm previously, not significantly in size accounting for differences in measurement technique. Associated possible calcifications and comet-tail artifact. No significant hyperemia. The remainder of the right thyroid lobe demonstrates normal echogenicity.LEFT LOBE: The left thyroid lobe is normal in size and echogenicity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Complex partially cystic predominant solid right thyroid lobe nodule with suggestion of coarse calcifications and comet-tail artifact is not significantly changed from 2005. |
Generate impression based on findings. | Hepatitis C. LIVER: Cirrhotic liver morphology. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.9 cm in length. The left kidney is 10.3 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 9.5 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites is identified. | 1. Cirrhotic liver morphology, without suspicious lesion identified.2. Echogenic renal parenchyma, compatible with medical renal disease. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 10.8 cm in length.LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Left kidney 11.9 cm in lengthOTHER: Distended bladder with left bladder diverticulum. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | 46-year-old female patient with HCV carrier on Gleevec with LAM for suppressive therapy. Evaluate for HCC. LIVER: The liver measures 14.5 cm in length. Hepatic parenchymal echogenicity is increased. There is a 1.7 x 1.6 x 1.5 cm left hepatic cyst, previously 2.0 x 1.8 x 1.5 cm. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.6 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.1 cm in length. No evidence of hydronephrosis.The spleen measures 8.9 cm in length. | Increase hepatic parenchymal echogenicity which can be seen with hepatic steatosis/hepatic parenchymal dysfunction. No suspicious hepatic lesion identified. |
Generate impression based on findings. | 68-year-old female with history of bilateral thyroid nodules. Nodules suspicious for malignancy. Preoperative lymph node mapping. RIGHT LOBE MEASUREMENTS: 1.7 x 1.7 x 5.1 cmLEFT LOBE MEASUREMENTS: 4.4 x 2.0 x 1.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: There is right thyroid gland nodule with irregular borders, increased vascularity, and calcifications measures 1.1 x 1.3 x 1.4 cm.LEFT LOBE: There is a bunch of form left thyroid lobe nodule which measures 1.8 x 1.3 x 1.1 cm most likely a colloid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 1 lymph node measures 1.2 x 0.9 x 0.4 cm.Right level 2 lymph node measures 1.6 x 0.5 x 0.3 cm.Left level 1 lymph node measures 1.3 x 1.7 x 0.6 cm.Left level 2 lymph node measures 1.3 x 0.5 x 0.3 cm.Left level 3 lymph node measures 0.9 x 0.4 x 0.4 cm.Left level 5 lymph node measures 0.8 x 0.5 x 0.2 cm.OTHER: No significant abnormality noted. | 1.Suspicious right thyroid lobe nodule.2.Benign-appearing left thyroid lobe nodule.3.Bilateral enlarged lymph nodes. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. History of right mastectomy for ILC in 2011. 3-D whole breast ultrasound was performed for left breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | 59-year-old male patient with new diagnosis of cirrhosis and transaminitis. Evaluate for cirrhosis and/or clots in the venous system. LIMITED ABDOMENLIVER: The liver measures 11.1 cm in length, demonstrates increased parenchymal echogenicity, and is nodular in contour. No focal hepatic lesion is identified.BILIARY TRACT: The gallbladder is contracted without definite shadowing gallstone. There is no intra or extrahepatic biliary ductal dilatation. The common duct measures 3 mm in diameter.PANCREAS: The head and proximal body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 15.0 cm in length. RIGHT KIDNEY: The right kidney measures 11.3 cm in length and demonstrates increased cortical echogenicity. There is minimal prominence of the right renal collecting system.OTHER: The left kidney measures 11.1 cm in length. No evidence of hydronephrosis.There is mild to moderate ascites. | 1. Cirrhotic morphology of the liver with patent hepatic vasculature.2. Mild to moderate ascites.3. Right medical renal disease and minimal pelvocaliectasis. |
Generate impression based on findings. | Left upper quadrant discomfort and popping sensation along the angle of the rib cage No abdominal wall defects, hernia, or soft tissue abnormalities are visualized in the area of the patient's described discomfort. | Negative examination, as above. |
Generate impression based on findings. | Ms. Edwards submitted outside mammogram/ultrasound examinations dated 7/3/2014, 8/15/2014, and 8/29/2014, from Northwestern Memorial Hospital. Submitted outside studies were compared to the current mammogram dated 11/4/2016. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution.Previously identified circumscribed mass in the right lower inner breast is stable when compared to prior examinations (mammograms + ultrasounds) dating back to 7/2014 and with a benign pathology result of UDH/fibroadenomatous change (per outside pathology report).Previously identified asymmetry in the left upper breast is also stable when compared to prior mammogram from 07/2014.There is no significant change between these studies. | Benign biopsy of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in November 2017.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female; 53 years old. Reason: Patient s/p paracentesis in RLQ with pain at paracentesis site; evaluate for hematoma Scanning was performed over the right lower quadrant in the area of the paracentesis site. Within the subcutaneous tissues is edema and small areas of fluid, measuring up to 4 mm. There is no drainable collection otherwise. | Small edema/fluid in the ventral subcutaneous tissues measuring up to 4 mm. There is no drainable collection otherwise. These findings are compatible with postprocedural sequela/small hematoma. Correlation with physical exam is recommended to exclude cellulitis. |
Generate impression based on findings. | Male 54 years old Reason: r/o recurrence History: h/o medullary thyroid cancer. Some subjective abnormality in left upper neck. MEASUREMENTS: Patient is status post thyroidectomy.RIGHT THYROIDECTOMY BED: No significant abnormality noted. No abnormal tissue or evidence of recurrence.LEFT THYROIDECTOMY BED: No significant abnormality noted. No abnormal tissue or evidence of recurrence.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination without evidence of disease recurrence. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution. Diffuse scattered calcifications in both breasts particularly in the upper outer quadrants are not changed. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Abdominal swelling. Evaluate for ascites. No ascites identified. | No ascites identified. |
Generate impression based on findings. | 41-year-old female status post right mastectomy for DCIS in 2011 presents with 2 palpated lumps in the right implant. ULTRASOUND | Two palpable lumps in the right reconstructed breast, with suspicious sonographic features. Results were discussed with Dr. Barrera.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Female 63 years old; Reason: please evaluate for malignancy, progression of cirrhosis, portal HTN History: 63 yo F with NAFLD and Hep C cirrhosis LIMITED ABDOMENLIVER: The liver measures 20.8 cm in length. The liver has a micronodular contour. The parenchyma is echogenic with coarsened echotexture which limits the evaluation for focal mass. Within this limitation, no suspicious mass is identified. Again seen within segment 2 of the liver is a portosystemic shunt, unchanged. There is no ascites. The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec. BILIARY TRACT: The gallbladder is absent. Common duct measures 0.3 cm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 9.8 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 9.7 cm. The cortex is normal in echogenicity. There is a 1.4-cm nonobstructing, shadowing stone in the inferior aspect of the kidney. There is no hydronephrosis. SPLEEN: The spleen measures 10.8 cm. in length. | 1.Hepatomegaly with micronodular contour and coarse, echogenic parenchyma compatible with cirrhosis. Within the limitations of the exam, no suspicious liver mass is identified.2.No change in segment two intrahepatic portosystemic shunt. 3.Nonobstructing left renal stone. |
Generate impression based on findings. | 50 year-old male with history of acute kidney failure. Evaluate for renal obstruction. RIGHT KIDNEY: No hydronephrosis or hydroureter. The right kidney measures approximately 11 cm in length.LEFT KIDNEY: No hydronephrosis or hydroureter. The left kidney measures approximately 11.4 cm in length.OTHER: Small amount of abdominal ascites. The bladder is within normal limits, and there is a Foley catheter in place. | No hydronephrosis or hydroureter, or other findings of urinary obstruction. |
Generate impression based on findings. | 63-year-old male with hepatitis C. Evaluate for hepatocellular carcinoma. LIVER: Liver is relatively small but normal in morphology. The parenchyma is mildly and coarsely echogenic. No focal hepatic mass is identified. No gross evidence for cirrhosis.BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Limited by bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Mildly and coarsely echogenic liver without mass or overt cirrhotic morphology. |
Generate impression based on findings. | Lymphadenopathy. Enlarged lymph nodes. 26-year-old medical student with periauricular nodule and level 5 lymph node The right level 5 lymph node measures 1.6 x 0.3 cm and has a fatty hilum suggesting a benign etiology. The periauricular nodule measures 1.7 x 0.3 cm and has a nonspecific appearance on ultrasound. | Right level 5 lymph node with a benign appearance. Nonspecific soft tissue periauricular nodule. |
Generate impression based on findings. | 62-year-old female with hyperparathyroidism. RIGHT LOBE MEASUREMENTS: The right lobe measures 5.3 x 1.8 x 1.7 cm. No dominant nodules.LEFT LOBE MEASUREMENTS: The left lobe measures 1.9 cm x 1.4 cm x 4.5 cm. ISTHMUS MEASUREMENTS: The isthmus measures 0.3 cm.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: There is a subcentimeter hypoechoic nodule measuring 0.5 cm x 0.5 cm x 0.6 cm in the left superior thyroid lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: There is an extrathyroidal hypoechoic nodule inferior and posterior to the left thyroid gland measuring 0.6 cm x 0.5 cm x 0.6 cm.LYMPH NODES: No concerning adenopathy is noted. | 1. There is an extrathyroidal inferior/posterior nodule inferior and posterior to the left thyroid gland consistent with clinically suspected parathyroid adenoma.2. There is a round subcentimeter hypoechoic nodule within the left superior thyroid lobe.3. No regional adenopathy |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of left cyst aspiration in 2006. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified in the breast. Bilateral simple and complex cysts are identified. Note is made of a prominent left axillary lymph node, measuring approximately 13 x 9 mm. | Prominent left axillary lymph node. A dedicated left axillary ultrasound is recommended for further evaluation.BIRADS: 0 - Incomplete.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 48-year-old female with asymmetry on screening mammogram. Three standard views of the left breast with exaggerated CC and spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. The previously seen asymmetry in the posterior outer breast on the cc view disperses somewhat with spot compression, and ultrasound was performed for further evaluation.ULTRASOUND | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 8-month-old female with hydronephrosis. BLADDER Wall Thickness: Normal Contents: Not adequately distended Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 1 Left: 0 Length*** Right: 4.9 cm Left: 4.7 cm Mean for age: 6 cm Range for age: 4.5 - 7.5 cmADDITIONAL OBSERVATIONS: None | Kidneys are lower limits of normal for size.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | 59-year-old male with central venous catheter, question of clot or thrombus at catheter site. Grayscale and color ultrasound of the right neck soft tissues surrounding the central venous catheter demonstrates trace adjacent fluid, but no discrete fluid collection or other significant abnormality surrounding the catheter along its subcutaneous course. | No significant soft tissue abnormalities or collections surrounding the catheter. If there is continued concern for catheter thrombosis, the catheter may be interrogated by interventional radiology as warranted clinically. |
Generate impression based on findings. | Female 25 years old Reason: history of right sided thyroid nodule History: neck pain RIGHT LOBE MEASUREMENTS: 2.4 x 1.5 x 5.6 cm.LEFT LOBE MEASUREMENTS: 1.9 x 1.5 x 5.5 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: Primarily anechoic nodule with with some internal echogenicity in the midportion of the right thyroid measures 0.7 x 0.4 x 0.8 cm. Echogenicity of the background thyroid is normal.LEFT LOBE: Small cyst in the mid left thyroid measures 0.3 x 0.2 x 0.47 m. Normal background thyroid.ISTHMUS: In the right portion of the isthmus there is a spongiform-appearing nodule with mildly echogenic internal septa measuring 0.8 x 0.4 x 0.9 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Spongiform-appearing nodules in the isthmus and right thyroid lobe. Likely small cyst in left thyroid lobe as detailed above. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma again noted without mass or stone. Minimal right hydronephrosis. Right kidney 8.1 cm in lengthLEFT KIDNEY: Echogenic parenchyma again noted without worrisome mass, stone, or hydronephrosis. Mid pole cyst. Left kidney 9.8 cm in length.OTHER: Bladder collapsed around Foley. | Echogenic renal parenchyma again noted consistent with medical renal disease/parenchymal dysfunction without worrisome mass or stone. Minimal right hydronephrosis. |
Generate impression based on findings. | 55 year old female with fever, elevated GGT, elevated alkaline phosphatase. Evaluate for liver/gallbladder pathology. LIVER: Coarse echotexture of the liver measuring 12.6 cm in length. No focal hepatic lesions. Main portal vein is patent the directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Mild gallbladder wall thickening. No evidence of cholelithiasis or sludge. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Increased echogenicity measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Increased echogenicity of the left kidney measuring 7.8 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Mild gallbladder wall thickening with no evidence of cholelithiasis or cholecystitis.2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | Reason: r/o recurrence History: h/o thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No evidence of recurrent/residual tumorLEFT LOBE: No evidence of recurrent/residual tumorISTHMUS: No evidence of recurrent/residual tumorPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 3 node seen on the prior exam is not identified. A normal-appearing right level 3/4 node measures 0.9 x 0.4 x 1.3 cm, previously 1.3 x 0.4 x 1.4 cmOTHER: No significant abnormality noted. | No evidence of residual/recurrent disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Renal transplant with elevated creatinine RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality noted. 10.3 cm in length. COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels Transplant renal vasculature appears patent without evidence for inflow or outflow compromise. Diastolic dampening again noted. Iliac vessels not well visualized due to overlying gas.OTHER: No significant abnormality noted | Stable examination. Specifically, patent right iliac fossa renal transplant vasculature without inflow or outflow compromise. Persistent diastolic dampening suggestive for increased parenchymal resistance pattern. |
Generate impression based on findings. | 74-year-old male with prior left thyroidectomy for microfollicular adenomatous nodule. RIGHT LOBE MEASUREMENTS: 3.8 x 2.4 x 1.3 cmLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No massISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No mass within the thyroidectomy bed or right lobe. No suspicious adenopathy. |
Generate impression based on findings. | 57-year-old female with history of right breast mass found in 1/15. Ultrasound findings suggested a cluster of cysts. This is a 6 month followup diagnostic mammogram. Three standard views of the right breast and 2 spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. At the 2:00 position approximately 4 cm from the nipple there is redemonstration of a 7 mm focal asymmetry which is stable to slightly smaller in size when compared to the original asymmetry that triggered this follow up on the prior study. | Stable to slightly smaller right breast asymmetry corresponding to a cluster of cysts previously demonstrated on ultrasound. Given the stability to slightly improved appearance, a benign etiology is favored. A diagnostic mammogram is recommended in 6 months to confirm stability. Patient's scheduled annual left breast mammogram can also be obtained at this time. Results and plan discussed with patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 63-year-old female with acute hepatitis. LIVER: Measures 19.2 cm in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Collapsed gallbladder. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Not well visualized due to bowel gas. KIDNEY: 1.0 cm right renal cyst without septation or solid component No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | 1. Mild hepatomegaly and increased echogenicity may represent hepatic steatosis or parenchymal disease. 2. Patent portal vein. |
Generate impression based on findings. | 26-year-old female with a history of papillary carcinoma thyroid status post resection RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal appearing lymph nodes are identified in the right neck, superior to the surgical bed, not significantly changed.OTHER: No significant abnormality noted. | Stable negative examination. No evidence for recurrence or regional adenopathy. |
Generate impression based on findings. | Renal carcinoma status post right nephrectomy RIGHT KIDNEY: Status post nephrectomyLEFT KIDNEY: Subcentimeter lower pole cyst. No worrisome mass, stone or hydronephrosis. Left kidney 11.1 cm in length.OTHER: Bladder nondistended. | Status post right nephrectomy. Unremarkable left kidney without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | HCV cirrhosis LIVER: Cirrhotic morphology again noted without mass. Liver length 15 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Left kidney 11.1 cm in length. Spleen 13.3 cm in length. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 26-year-old female with pericholecystic fluid on CT, abdominal pain, and fevers. LIVER: No significant abnormalities noted. Portal venous flow is hepatopetal. No intra- or extrahepatic biliary ductal dilation is visualized.GALLBLADDER, BILIARY TRACT: The gallbladder is contracted, thus limiting evaluation. Multiple stones are visualized within the gallbladder. There is no evidence of gallbladder wall thickening or pericholecystic fluid.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Contracted gallbladder with numerous stones. |
Generate impression based on findings. | 48-year-old female with right upper quadrant pain with food. Evaluate for gallstones. LIVER: Increased echogenicity of the liver measuring 19.6 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Small gallstones within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. The sonographic Murphy's sign is negative. Common bile duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Right partial nephrectomy. Kidney measures 11.7 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER:Normal echogenicity of the left kidney measuring 12.3 cm in length. No hydronephrosis or shadowing calculi are noted. Cyst at the upper pole measures 3.6 cm x 3.6 cm x 3.9 cm. Cyst at the lower pole measures 2.4 cm x 1.7 cm x 2.5 cm.Normal echogenicity of the spleen measuring 9.4 cm in length. | 1. Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration.2. Cholelithiasis without evidence of cholecystitis.3. Left renal cysts. |
Generate impression based on findings. | Ms. Plesniak is a 29-year-old with a personal history of bilateral breast reduction at age of 19. She presents today with palpable abnormality in the right breast lower outer quadrant. Family history of breast cancer in paternal grandmother. On physical exam, there is a palpable mass in the right breast 8:00 location corresponding to the site of clinical concern.A targeted right gray scale and color Doppler ultrasound was performed for the palpable area of concern. In the right breast 8:00 position 6 cm from nipple, there is a 1.4 x 0.8 x 1.0 cm hypoechoic mass with rim calcification and marked posterior acoustic shadowing. This corresponds to the palpable abnormality and is consistent with an oil cyst. No suspicious solid or cystic masses are seen elsewhere in the right lateral breast. | 1.4 cm benign oil cyst corresponding to the palpable abnormality in the right breast. No sonographic evidence for malignancy. As long as the patient's physical exam remains unchanged, annual screening mammogram is recommended, starting at the age of 40. The finding and recommendations were discussed with the patient at a time of the exam.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 7.5 x 3.3 x 1.7 cmLEFT LOBE MEASUREMENTS: 6.7 x 3 x 2.2 cmISTHMUS MEASUREMENTS: 1 cmRIGHT LOBE: Diffusely heterogeneous lobe unchanged. Stable multiple nodules. Reference midpole nodule measures 0.8 x 0.8 x 0.3 cm.LEFT LOBE: Diffusely heterogeneous lobe unchanged. Stable nodules. Reference low module measures 1.3 x 0.8 by 1.2 cm.ISTHMUS: Diffusely heterogeneous lobe unchangedPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change in heterogeneous thyroid gland with multiple thyroid nodules. |
Generate impression based on findings. | 60-year-old male patient with multinodular goiter. RIGHT LOBE MEASUREMENTS: Status post right thyroidectomy.LEFT LOBE MEASUREMENTS: 4.7 x 1.8 x 1.6 cm, previously 5.1 x 1.7 x 1.6 cm.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: A 1.4 cm focus of residual thyroid tissue within the right thyroidectomy bed is not significantly changed.LEFT LOBE: There is heterogeneity of the parenchyma. A previously noted biopsy-proven benign left midpole thyroid nodule has decreased in size and now measures less than 1 cm. No dominant thyroid nodule is identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Interval decrease in size of a now subcentimeter path-proven benign left midpole thyroid nodule.2. No dominant thyroid nodule is identified. |
Generate impression based on findings. | 80-year-old male with transaminitis. Evaluate liver. This exam is severely limited by technical factors.LIVER:Most of the liver is not able to be imaged on this study. There is increased echogenicity of the parenchyma. No ascites.GALLBLADDER, BILIARY TRACT: The gallbladder is partially visualized. It appears mildly distended without other secondary signs of cholecystitis.PANCREAS: Unable to visualized pancreas on this study.SPLEEN: Measures 11.4 cm without sonographic abnormality.KIDNEYS: Unable to accurately measure kidneys. Appear to have normal echogenicity. No gross hydronephrosis. | 1. Exam severely limited due to technical factors. Please refer to details as above. |
Generate impression based on findings. | Hyperthyroidism RIGHT LOBE MEASUREMENTS: 2.1 x 2.0 x 5.2 cm. LEFT LOBE MEASUREMENTS: 1.8 x 1.3 x 3.7 cm.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: Heterogeneous in echotexture. 7 mm densely peripherally calcified solid nodule identified, LEFT LOBE: Heterogeneous in echotexture, without definite discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Heterogenous thyroid gland echotexture, which is nonspecific though may be seen in the setting of thyroiditis. Correlation with clinical symptoms and thyroid function tests is recommended.2. 7 mm rim calcified right thyroid nodule. |
Generate impression based on findings. | Reason: HBV carrier, evaluate for hepatocellular carcinoma. LIVER: The liver measures 18.8 cm in length. The liver demonstrates increased parenchymal echogenicity and appears heterogeneous. Redemonstration of a cyst in the left lobe measuring 1.4 x 1.2 x 1.8 cm, similar to prior. No additional focal hepatic lesions are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Gallbladder surgically absent. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 10.1 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.7 cm in length. Normal cortical echotexture. No hydronephrosis. Superior pole cyst, similar to prior.OTHER: No significant abnormalities noted. | Coarse, echogenic liver with mild hepatomegaly suggestive of chronic liver disease without suspicious focal lesions identified. |
Generate impression based on findings. | Reason: HCV cirrhosis, HCC screening History: HCV cirrhosis LIVER: The liver measures 14 cm in length. Mildly coarse, echogenic hepatic parenchyma. No focal mass. The main portal vein is patent with normal directional hepatopetal portal venous blood flow, peak velocity 45.2 cm/s.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. No cholelithiasis or biliary ductal dilatation. The common bile duct measures 0.1 cm. The gallbladder wall measures 0.2 cm.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 11.0 cm in length. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 10.9 cm in length. No hydronephrosis or shadowing stones.OTHER: The spleen measures 13.4 cm in length, upper limit of normal in size to mildly enlarged. No ascites. Trace right pleural effusion. | 1. Mildly coarse echogenic hepatic parenchyma, consistent with hepatic parenchymal dysfunction. No focal mass or other evidence of cirrhosis.2. Splenic size mildly increased.3. Trace right pleural effusion. |
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