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Generate impression based on findings. | Male 51 years old Reason: Post Liver Transplant. Please evaluate all vessels for patency History: Liver Transplant LIMITED ABDOMENLIVER: Transplanted liver measures 22 cm, enlarged. No focal liver lesions.BILIARY TRACT: No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Mild splenomegaly. | Patent hepatic vasculature. Main portal vein is patent but not well visualized and a partial thrombus cannot be excluded. Increased velocity of the hepatic artery with decreased RI values. Clinical correlation and if necessary a follow-up Doppler study may be helpful for further evaluation. |
Generate impression based on findings. | 34-year-old male history of papillary carcinoma and prior surgeries. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomy ISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No abnormal lymph nodesOTHER: No significant abnormality noted. | No evidence for recurrent disease. |
Generate impression based on findings. | Flank pain, hematuria, evaluate renal stones RIGHT KIDNEY: Measures 12.5 cm. No hydronephrosis or nephrolithiasis.LEFT KIDNEY: Measures 12.1 cm. No hydronephrosis. Nonobstructive renal pelvis stone measures up to 0.9 cm. Multiple simple renal cysts measuring up to 2.3 cm.OTHER: The bladder is partially distended with dependent debris. | Nonobstructive left renal pelvis stone. No hydronephrosis. Debris in the bladder. |
Generate impression based on findings. | Female 51 years old; Reason: eval for cholelithiasis, biliary dilation, ascites History: AMS, hx of etoh cirrhosis, elevated bili and lipase LIVER: The liver measures 21.60 cm in length. There is coarse and heterogeneous echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow. GALLBLADDER/BILIARY TRACT: The gallbladder is surgically absent. The common bile duct measures 0.24 cm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 17.50 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 12.6 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 13.3 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. No sonographic signs of cholecystitis.2. Marked splenomegaly of uncertain etiology but perhaps could be sequelae of portal hypertension. |
Generate impression based on findings. | Female 29 years old Reason: HTN in a 29 year old female, please evaluate for renal artery stenosis History: HTN in a 29 year old female, please evaluate for renal artery stenosis ULTRASOUND KIDNEYSRIGHT KIDNEY: 8.9 cm in length. No hydronephrosis. Normal echogenicity.LEFT KIDNEY: 9.6 cm in length. No hydronephrosis. Normal echogenicity.Small echogenic focus near the pole measuring 0.6 x 0.7 x 0.9 cm possibly angiomyolipoma.OTHER:No significant abnormalities noted. | Small kidneys. No definite evidence of renal artery stenosis but the renal artery origins were not well seen.Small echogenic lesion left upper pole consistent with angiomyolipoma |
Generate impression based on findings. | 29-year-old male with history of thyroid cancer, evaluate for change in nodules, lymph nodes. RIGHT LOBE MEASUREMENTS: Surgically absentLEFT LOBE MEASUREMENTS: Surgically absentISTHMUS MEASUREMENTS: Surgical absenceRIGHT LOBE: 0.6 x 0.4 x 0.3 cm hypoechoic focus in the right thyroid bed is unchanged since the prior study. No new suspicious lesions are identified.LEFT LOBE: 0.7 x 0.4 x 0.4 hyper/hypoechoic focus in the left thyroid bed is unchanged since the prior study. No new suspicious lesions are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.4 cm left level II lymph node with overall benign morphologic features is not significantly changed. No new suspicious lymphadenopathy.OTHER: No significant abnormality noted. | No significant interval change since the prior study. No new suspicious nodules or lymphadenopathy. |
Generate impression based on findings. | 31-year-old female with right-sided abdominal pain. LIVER: Measures 13.7 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: 0.5 cm right lower pole renal stone without hydronephrosis.OTHER: No significant abnormalities noted. | 1. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. No evidence of cholelithiasis or cholecystitis. 2. Nonobstructive right nephrolithiasis. |
Generate impression based on findings. | Abdominal pain with nausea. LIVER: 13.1 cm in length. Non-cirrhotic liver morphology. Normal 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 10.1 cm in length, with a 2.2 cm benign-appearing cyst at the inferior pole.. The left kidney is 11.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 9.7 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | No acute intra-abdominal abnormality identified. |
Generate impression based on findings. | 51-year-old female post thyroidectomy with small nodule right thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the right thyroidectomy bed, there is again noted a somewhat high for occult area with surrounding hypoechoic rim, measuring 0.4 x 0.5 x 0.7 cm without significant change. A slightly more caudal, hypoechoic region measuring 0.3 x 0.3 by 0.4 cm is unchanged.LEFT LOBE: Slightly asymmetric hypoechoic region in the left bed measuring 0.4 x 0.4 x 0.5 cm is unchanged and could represent scarring.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically normal lymph nodes bilaterally OTHER: No significant abnormality noted. | Stable examination. Given stability and small size of the abnormality in the inferior right bed comment continued follow up warranted. |
Generate impression based on findings. | 59-year-old female with abdominal distention, ascites. Evaluate for portal vein thrombosis. History of metastatic breast cancer. LIVER: Measures 21.7 cm in length. Diffusely abnormal echotexture with several subtle lesions is consistent with diffuse hepatic metastases seen on prior studies.The portal vein is well visualized at the porta hepatis, and is patent in this location with antegrade flow measuring 0.1 m/s. The right and left portal vein branches are also patent. BILIARY TRACT: Collapsed gallbladder with secondary wall thickening. PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.KIDNEY: No significant abnormalities noted. OTHER: Mild ascites. | 1. Limited examination of the portal vein as detailed above demonstrates patency at the porta hepatis. Slow portal venous flow in this region may be secondary to widespread hepatic metastatic disease. 2. Hepatomegaly with diffusely abnormal hepatic echotexture consistent with hepatic metastases seen on prior studies. 3. Mild ascites. |
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. | Male 65 years old Reason: Hx esophageal cancer; study -related tissue biopsy right lower lobe liver. Kit provided; 4 cores needed 18-gauge; one in formalin; 3 snap-frozen Contact person: Sneha Solanki 2-1834/4564.IRB 15-0209. History: None Written informed consent was obtained. Patient was prepped and draped in sterile fashion. A lesion in the inferior aspect of the right lobe which measured about 4 cm amenable to subcostal approach biopsy was selected.Under ultrasound guidance 5 passes were obtained using 18-gauge core biopsy needle. Some passes yielded scant the tissue. One sample was placed in buffered formalin and 4 samples were placed in containers provided.Less than 5 cc blood loss.Patient was observed in nurse holding vital signs remained stable and the patient was discharged to home in good condition.Samples were picked up bySneha Solanki. | Successful ultrasound-guided biopsy of liver mass. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 20 cm in length. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Several subcentimeter gallstones noted. The gallbladder is collapsed, which limits evaluation for wall thickening. Trace pericholecystic fluid is nonspecific in the setting of liver dysfunction. Negative sonographic Murphy's sign reported.PANCREAS: 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 10.8 cm in length. The left kidney is 10.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 10.6 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. | 1. Cholelithiasis without specific evidence of cholecystitis. Trace pericholecystic fluid present, nonspecific in the setting of liver dysfunction. The gallbladder is collapsed, which limits evaluation. Negative sonographic Murphy's sign reported. If further clinical suspicion for cholecystitis persists, nuclear medicine HIDA scan may be helpful.2. Increased hepatic echogenicity, compatible with parenchymal dysfunction. |
Generate impression based on findings. | Hodgkin's lymphoma status post chemoradiation with thyroid nodules RIGHT LOBE MEASUREMENTS: 6 x 1.2 x 1.3 cmLEFT LOBE MEASUREMENTS: 5 x 1.2 x 1.6 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Diffusely heterogeneous gland. Multiple subcentimeter benign-appearing colloid cysts.LEFT LOBE: Diffusely heterogeneous gland. Multiple subcentimeter benign-appearing colloid cysts.ISTHMUS: Diffusely heterogeneous glandPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland with multiple bilateral subcentimeter benign-appearing colloid cysts. No worrisome mass lesion. No regional adenopathy. |
Generate impression based on findings. | 48-year-old female patient with history of goiter. Now with thyroid tenderness, possible subacute thyroiditis which did not respond to steroids. Question of masses or other lesions. RIGHT LOBE MEASUREMENTS: 2.3 x 2.7 x 6.7 cm, previously 2.2 x 1.9 x 6.17 cm.LEFT LOBE MEASUREMENTS: 2.2 x 3.1 x 8.3 cm, previously 3.0 x 3.0 x 7.7 cmISTHMUS MEASUREMENTS: 7 mm in thickness.RIGHT LOBE: A solid nodule with cystic spaces within the right midpole measures 1.6 x 1.2 x 1.0 cm, previously 1.3 x 1.0 x 1.5 cm. A spongiform-appearing nodule near the isthmus measures 1.0 x 0.4 x 1.1 cm, previously 1.2 x 0.5 x 1.0 cm.LEFT LOBE: A dominant left lower pole complex solid nodule is similar in appearance to the prior study measuring 3.7 x 2.4 x 2.8 cm, previously 3.6 x 2.4 x 2.8 cm. An additional hypoechoic nodule within the posterior medial aspect of the lower pole is similar in size measuring 0.9 x 0.8 x 0.4 cm, previously 0.8 x 1.1 x 0.5 cm. However, the appearance has changed now with a more defined cystic component and nodular solid component which could be related to hemorrhage.ISTHMUS: A predominately solid nodule with cystic spaces within the isthmus measures 1.0 x 0.6 x 1.1 cm, previously 1.2 x 1.0 x 1.3 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral neck lymph nodes are noted.OTHER: No significant abnormality noted. | Similar size and appearance of multiple bilateral thyroid nodules except for a hypoechoic left lower pole nodule which has more defined cystic and solid components. |
Generate impression based on findings. | 59-year-old female with history of papillocarcinoma post thyroidectomy and lymph node dissection x 2. RIGHT LOBE MEASUREMENTS: PostatherectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: In the left bed immediately adjacent to the carotid artery there is a hypoechoic region measuring 0.6 x 0.7 x 0.9 cm. I cannot exclude local recurrent disease although this could represent scarring from recent bed dissection. There is no associated calcification.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Asymmetric hypoechoic region in the left thyroidectomy bed. Scar versus recurrent tumor.No evidence for nodal recurrence. |
Generate impression based on findings. | Female 50 years old Reason: rule out thyroid nodules RIGHT LOBE MEASUREMENTS: 6.1 x 1.7 x 1.9 cmLEFT LOBE MEASUREMENTS: 5.7 x 2.0 x 1.9 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Mildly heterogeneous echotexture of the right thyroid lobe. No nodules are identified.LEFT LOBE: Mildly heterogeneous echotexture of the left thyroid lobe. No nodules are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small normal-appearing right level 3 lymph nodes are visualized.OTHER: No significant abnormality noted. | Mildly heterogeneous appearing thyroid which may be due to very small colloid nodules or minimal thyroiditis, recommend correlation with lab values. No discrete nodules are identified. |
Generate impression based on findings. | 43 year old female who was recalled from screening mammogram for a partially circumscribed oval mass in the right lower central breast. Mammogram: An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B). 24 mm oval circumscribed isodense mass persist in the right lower outer quadrant. No associated calcifications noted.Ultrasound: Targeted right lower outer quadrant ultrasound was performed that showed an oval circumscribed benign morphology hypoechoic mass with central hyperechogenicity that measures 1.8 x 0.6 x 1.2 cm corresponding to the mammographic abnormality. Mass is located at 7:00 position, 5 cm from the nipple. No definite blood flow is identified within the mass. This could either represent a benign intramammary lymph node or fibroadenolipoma. | Benign morphology mass in the right breast 7:00 position on mammogram and ultrasound.No mammographic evidence of malignancy. As long as patient's physical examination remains unchanged, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | The patient submitted outside mammogram dated 10/10/2013 and 7/30/2013, from Saint Anthony Hospital. Submitted outside study was compared to the current mammogram dated 8/18/2015. Focal asymmetry within the lower central left breast is new from prior studies and needs further evaluation with spot compression views with possible ultrasound. | Focal asymmetry within the lower central left breast is new from prior studies and needs further evaluation with spot compression views with possible ultrasound.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 19 year old with history of left breast mass, biopsy proven as fibroadenoma. A targeted left ultrasound was performed for the area of concern. At the left breast 4 o'clock position, the known mass is slightly increased in size, today measuring 3.6 x 1.8 x 2.6 cm. Previous measurements from August were 3.2 x 1.6 x 2.5 cm. | Continued interval increase in the left breast mass. Surgical consultation is recommended and the patient will see Dr. Chhablani today.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Male; 72 years old. Reason: assess for mass or cyst, suspect RCC History: increasing hemoglobin RIGHT KIDNEY: Right kidney measures 9.2 cm in length. The cortex is echogenic. There is no hydronephrosis or shadowing renal stone. No renal mass is identified on ultrasound.LEFT KIDNEY: Left kidney measures 10.0 cm in length. The cortex is echogenic. There is no hydronephrosis or shadowing renal stone. No renal mass is identified on ultrasound.OTHER: The bladder is decompressed. A right ureteral jet is visualized. | 1.Echogenic kidneys, compatible with medical renal disease.2.No renal mass is identified on ultrasound imaging. If there is continued concern for renal cell carcinoma, dedicated contrast enhanced cross-sectional imaging would be more sensitive and is recommended. |
Generate impression based on findings. | Sepsis, pyuria, urinary retention, evaluate for hydronephrosis RIGHT KIDNEY: Status post right nephrectomy many years ago as per the patient. Kidney is not visualized in the right renal bed.LEFT KIDNEY: Left kidney measures 14 cm with normal echotexture. No hydronephrosis noted. No focal lesions noted.OTHER: No significant abnormalities noted. | Status post right nephrectomy.No hydronephrosis in the left kidney. |
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. Multiple cysts are present in both breasts.There is no solid mass identified. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Reason: evidence of biliary dilation, stones; eval for liver echotexture History: rising bilirubin, possible cirrhosis LIVER: The liver measures 15.7 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 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 11.1 cm in length. RIGHT KIDNEY: Kidney measures 11.9 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 11.4 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or massOTHER: Right pleural effusion. Ascites. | 1.No evidence of acute cholecystitis or biliary ductal dilatation.2.Increased hepatic echogenicity suggestive of chronic hepatic disease. 3.Increased renal echogenicity suggestive of medical renal disease.4.Right pleural effusion. Ascites. |
Generate impression based on findings. | Papillary carcinoma status post resection now with local recurrence RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy. Multiple hypoechoic nodules within the left thyroid bed. A level 3 nodule measures 0.6 x 0.9 x 0.7 cm. Slightly more inferior level 3 nodule measures 0.8 x 0.2 x 1.3 cm. A level 4 nodule measures 1.7 x 1.7 x 1.3 cm. However, the inferior extent of this level 4 nodule extends into the thoracic inlet and its size is probably under estimated.ISTHMUS: Status post thyroidectomy without mass.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple hypoechoic nodules within the left thyroid bed spanning levels 3 and 4 consistent with suspected local recurrence. The inferior level 4 nodule extends into the thoracic inlet and is therefore not completely visualized. No regional cervical lymphadenopathy. |
Generate impression based on findings. | Right medial knee soft tissue mass, assess for growth, change versus September 20, 2015, patient has no pain Redemonstrated is a circumscribed large oval superficial hypoechoic mass, predominantly cystic with debris within it and few septations without peripheral blood flow, measures 8.8 x 4.7 x 6.8 cm, mostly unchanged from prior study when it measured 9.9 x 3.4 x 6.2 cm given difference in technique and operator dependence. The lesion is located in the right medial knee soft tissue and appears indeterminate, less likely to be a evolving hematoma given no definite change in morphology or size. | Indeterminate right medial knee predominantly cystic soft tissue mass, mostly unchanged in size with new septation and debris within it. This is less likely to be a hematoma given no definite change in size. FNA can be helpful for further evaluation. |
Generate impression based on findings. | Female 58 years old; Reason: hepatobiliary pathophysiology History: Rising Alk Phos and bile seen around G-tube in setting of prior cholestasis LIVER: The liver measures 18.2 cm in length. There is increased, coarse, and heterogenous echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow. No ascites.GALLBLADDER/BILIARY TRACT: There is diffuse gallbladder wall thickening measured at 3.8 mm. No stones are seen. There is dependent echogenic material in the lumen of the gallbladder consistent with sludge. No pericholecystic fluid. Sonographic Murphy's sign equivocal. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.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 13.2 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. Gallbladder sludge with abnormal diffuse wall thickening raising possibility of chronic inflammation. Equivocal Murphy's sign raises the possibility of acute on chronic inflammation. No ductal dilatation2. Coarse echotexture of the liver consistent with chronic liver disease / parenchymal dysfunction. No mass or ascites.3. Mild hepatomegaly. |
Generate impression based on findings. | History of RCC status post left nephrectomy RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.2 cm in length.LEFT KIDNEY: Status post nephrectomy.OTHER: Bladder nondistended | Echogenic right renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Male, 42 years old. Hematuria. RIGHT KIDNEY: The right kidney measures 10.3 cm in length, with normal cortical echotexture. A few scattered punctate nonshadowing echogenic foci are noted. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 12.3 cm in length with normal cortical echotexture. A few scattered punctate nonshadowing echogenic foci are noted. No shadowing stones are identified. No hydronephrosis.OTHER: The bladder is incompletely distended. | A few scattered punctate nonshadowing echogenic foci bilaterally correspond with punctate areas of calcification as seen on prior CT imaging. No hydronephrosis. |
Generate impression based on findings. | Female 36 years old; Reason: soft tissue US of epigastric History: unusual protuberance of the epigastric area with out any tenderness over the past few months. zero obv lipoma as such and does not have features of hernia. Please help evaluate this further. ? localizedPLEASE NOTE: THIS REPORT HAS BEEN ADDENDED FOR CHANGE IN ORDERED EXAMINATION. THE REPORT IS CORRECT AS DICTATED.Report Electronically Signed: 6/16/2015 6:20 PM Stephen Thomas, MDAddended on 6/16/2015 6:20:30 PM by Stephen Thomas, MD.US SOFT TISSUE CHEST WALL/UPPER BACK, 6/9/2015 10:45 AM Sonographic images of the subcutaneous tissues underlying the epigastric region show no focal mass in the area of palpable concern. Specifically, no cystic or solid lesion is identified. There is prominent subcutaneous fat. Underlying tissues are within normal limits. No free fluid. | No specific findings to account for the patient's symptoms in the area of palpable concern. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Personal history of bilateral cyst aspiration approximately 10-15 years ago. Family history of breast cancer in sister, diagnosed at the age of 52. 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. This examination was interpreted by both Dr. Sheth and Dr. Schacht. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 56 year old male with history of cirrhosis, evaluate for any concerning lesions. LIVER: Coarse liver echotexture, with subtle nodularity of the contour consistent with history of cirrhosis. No identifiable masses. Main portal vein is patent, with peak flow approximately 0.2 m/sec.GALLBLADDER, BILIARY TRACT: No significant biliary dilatation, with the common bile duct measuring approximately 0.4 cm. Gallbladder within normal limits.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures approximately 11 cm in length. No hydronephrosis or other significant abnormality.OTHER: Left kidney measures approximately 11.6 cm in length, without hydronephrosis or other significant abnormality. Spleen is slightly enlarged, at 16 cm, unchanged. | Cirrhotic liver morphology without identifiable mass, and unchanged splenomegaly. |
Generate impression based on findings. | Primary hyperparathyroidism RIGHT LOBE MEASUREMENTS: 3.6 x 0.9 x 1.2 cmLEFT LOBE MEASUREMENTS: 2.9 x 1 x 1 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Heterogeneous and atrophic right thyroid gland without noduleLEFT LOBE: Heterogeneous and atrophic thyroid gland. 0.4 x 0.6 x 1 cm hypoechoic lesion; it is unclear whether not this nodular focus arises from the posterior aspect of the mid atrophic right thyroid gland or is extrathyroidal.ISTHMUS: Heterogeneous and atrophic glandPARATHYROID GLANDS: 0.7 x 0.4 x 0.8 cm hypoechoic focus projecting inferior and posterior to the atrophic right thyroid gland.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hypoechoic focus projecting inferior and posterior to the atrophic right thyroid gland; while this may represent a parathyroid adenoma candidate, it is unclear whether this may represent a thyroid nodule arising from the atrophic gland. Similarly, there is a hypoechoic lesion arising from the posterior aspect of the mid atrophic right thyroid gland which may represent a thyroid nodule or parathyroid adenoma candidate. Correlation with nuclear medicine scan recommended. |
Generate impression based on findings. | Renal stone RIGHT KIDNEY: Mildly echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. Stable upper pole cyst. Right kidney 10.1 cm in length.LEFT KIDNEY: Mildly echogenic renal parenchyma with multifocal scarring and atrophy. Stable multiple cysts. No hydronephrosis. Subcentimeter lower pole calculus measuring 0.6 cm. In diameter again noted.OTHER: Bladder nondistended | Stable subcentimeter nonobstructing left lower pole calculus. No hydronephrosis. Mildly echogenic renal parenchyma bilaterally suggestive for medical renal disease/parenchymal dysfunction. |
Generate impression based on findings. | Male; 67 years old. Reason: eval for cirrhosis History: pt with GAVE vs portal hypertension on endoscopy in a LIVER: The liver measures 17.2 cm in length. The liver surface is smooth. Liver parenchyma demonstrates a mildly coarsened echotexture. No focal hepatic lesion is identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well evaluated due to overlying bowel gas.SPLEEN: The spleen measures 9.8 cm in length.KIDNEYS: The right kidney measures 9.0 cm in length, the left kidney measures 9.4 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. OTHER: No significant abnormalities noted. | Mildly coarsened hepatic echotexture but no definite evidence of cirrhosis. No focal hepatic lesion. |
Generate impression based on findings. | Acute renal failure; chronic renal disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 8.4 cm cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.3 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis |
Generate impression based on findings. | Elevated LFTs, presence of fatty liver or other liver pathology LIVER: Liver measures 16.1 cm with increased echogenicity consistent with hepatic steatosis. No focal lesions noted. No intrahepatic biliary ductal dilatation. Portal vein demonstrates normal flow directionality and patency.GALLBLADDER, BILIARY TRACT: Gallbladder is well distended with multiple gallstones that are mobile in nature. No evidence of gallbladder wall thickening or pericholecystic fluid. Common hepatic duct measures up to 2 mm without any stones within it.PANCREAS: No significant abnormalities noted.KIDNEY: Right kidney measures 11.1 cm and left measures 10.5 cm. No hydronephrosis. Normal echo texture. No focal lesions. OTHER: Spleen measures 8.8 cm without any focal lesions. | Cholelithiasis without evidence of cholecystitis.Mild Hepatic steatosis |
Generate impression based on findings. | 87-year-old female. Left breast cancer undergoing neoadjuvant hormonal therapy. Follow-up ultrasound to evaluate treatment response. A focused left breast ultrasound at the 2 o'clock location, approximately 4 to 5 cm from the nipple, showed a 1.6 x 1.1 cm hypoechoic irregular mass, previously 1.4 x 1.2 cm, not significantly changed allowing for differences in technique. | No significant interval change in the known left breast cancer.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: HCC surveillance History: HCV cirrhosis LIVER: The liver measures 14.2 cm in length. Coarse, echogenic hepatic parenchyma with a nodular contour, consistent with cirrhotic morphology. Round hypoechoic lesion with ill-defined borders in the anterior segment of the right hepatic lobe measures 2.3 x 2.5 x 2.5 cm. The main portal vein is patent with normal directional hepatopedal flow, peak velocity 21.5 cm/s.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The gallbladder wall measures 0.1 cm. The common hepatic duct measures 0.4 cm. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. Normal echogenicity. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 9.8 cm in length. Normal echogenicity. No hydronephrosis or shadowing stones.OTHER: No ascites. | New lesion in the right hepatic lobe is highly concerning for hepatocellular carcinoma and should be further evaluated with a dedicated contrast enhanced liver protocol CT or MRI.These findings were communicated to ordering physician Elizabeth Boyle at 10:00 on 2/24/16 |
Generate impression based on findings. | HCV LIVER: Multiple bilobar hepatic cysts again noted. No worrisome mass lesion. Liver length 13.4 cmGALLBLADDER, BILIARY TRACT: Gallbladder absent. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.4 cm in lengthOTHER: Left renal cyst. Left kidney 9.8 cm in length. Spleen 8 cm in length. No ascites. | Stable bilobar hepatic cysts. No worrisome hepatic mass. No ductal dilatation. No ascites. |
Generate impression based on findings. | Reason: patient with epigastric pain, r/o gallbladder disease History: abdominal pain, N/V LIVER: The liver measures 15.8 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.0 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis, biliary ductal dilatation, or other findings to account for the patient's symptoms. |
Generate impression based on findings. | 59-year-old female with history of thyroid carcinoma. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No mass in the bedLEFT LOBE: No mass in the bedISTHMUS: No mass in the bedPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for recurrent disease. |
Generate impression based on findings. | Male 55 years old Reason: RUQ pain History: RUQ pain This study is limited due to patient's bandages and scars across the abdomen.LIVER: Liver has slightly increased echogenicity, nonspecific. No focal liver lesions.BILIARY TRACT: There is sludge in the gallbladder. No evidence of gallbladder wall thickening or pericholecystic fluid. No evidence of intra or extrahepatic biliary dilatation. Sonographic Murphy sign could not be elicited.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 9.9 cm.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Slightly increased echogenicity of the liver. Sludge in the gallbladder. No sonographic evidence of acute cholecystitis or biliary dilatation. |
Generate impression based on findings. | Reason: kidney stone History: stone RIGHT KIDNEY: Right kidney measures 12.24 cm. There is severe right-sided hydronephrosis with parenchymal thinning. There are multiple renal stones throughout the right kidney, the largest in the right lower pole measuring 1.7 x 1.3 x 1.8 cm, previously 1.1 cm in greatest dimension on the prior CT. No suspicious renal lesions. There is been interval removal of right-sided nephrostomy tube and stent.LEFT KIDNEY: The left kidney measures 11.6 cm. There are no suspicious lesions or stones on the left.BLADDER: Bilateral jets are observed.OTHER: No significant abnormalities noted. | Severe right-sided hydronephrosis with multiple stones, the largest measuring up to 1.8 cm. |
Generate impression based on findings. | 53-year-old male patient with history of lymphoma, now with pancreatitis. Evaluate for stones or biliary dilation. Abdominal pain. LIVER: The liver measures 19.2 cm in length and demonstrates increased parenchymal echogenicity. There is a mildly complex right hepatic cyst measuring 1.5 x 1.6 x 1.6 cm. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones, but no gallbladder wall thickening, or pericholecystic fluid.. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate similar echogenicity compared to the prior study. The tail is not visualized secondary to overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.3 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 11.6 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 9.4 cm in length.Bilateral pleural effusions are noted. Free fluid is noted in the pelvis. | 1. Cholelithiasis without sonographic evidence of acute cholecystitis.2. Echogenic hepatic parenchyma which can be seen with hepatic parenchymal dysfunction/hepatic steatosis.3. Echogenic kidneys suggestive of medical renal disease.4. Bilateral pleural effusions and pelvic ascites. |
Generate impression based on findings. | 64 years old, Female, Reason: stones History: stones RIGHT KIDNEY: Kidney measures 9.3 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus. Simple appearing right renal cyst measures 0.9 x 0.8 x 1 cm.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.Bladder: No evidence of calculus within the bladder. | 1.No definite evidence of renal calculus.2.Simple appearing right renal cyst. |
Generate impression based on findings. | 21 years old, Male, Reason: Hx of stem cell transplant with new AKI of unknown cause RIGHT KIDNEY: Kidney measures 9.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. Subcentimeter hypoechoic focus in the inferior pole of left kidney is too small to accurately characterize on this examination but most likely represents a cyst. BLADDER: No significant abnormalities. OTHER: No significant abnormalities noted. | 1.No evidence of hydronephrosis or nephrolithiasis to account for the patient's symptoms. |
Generate impression based on findings. | 26-year-old female patient with right upper quadrant pain, apparent gallstones on bedside ultrasound, elevated transaminases. Evaluate for choledocholithiasis, cholelithiasis, cholecystitis. LIVER: The liver measures 20.7 cm in length. Hepatic parenchymal echogenicity is increased and coarsened in echotexture. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones without gallbladder wall thickening or pericholecystic fluid. No intrahepatic biliary ductal dilatation is seen. The visualized common duct measures 5-6 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas. A small peripancreatic lymph node is noted.RIGHT KIDNEY: The right kidney measures 10.5 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.5 cm in length. No evidence of hydronephrosis.The spleen measures 9.9 cm in length. | 1. Increased hepatic parenchymal echogenicity which can be seen with hepatic steatosis/hepatic parenchymal dysfunction.2. Cholelithiasis without sonographic evidence of acute cholecystitis. Mild prominence of the common bile duct, depending on the patient's last meal. |
Generate impression based on findings. | Elevated liver enzymes LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 13.7 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.3 cm in lengthRIGHT KIDNEY: Absent OTHER: Echogenic left renal parenchyma with multiple cysts. Left kidney 12.1 cm in length. No hydronephrosis. No ascites. | Mildly heterogeneous liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. No ascites. Echogenic left renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without evidence for obstruction. |
Generate impression based on findings. | Right upper quadrant abdominal pain. History of cholecystectomy, per patient. LIVER: Non-cirrhotic liver morphology. Mildly coarsened and increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Status post cholecystectomy.PANCREAS: 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 10.1 cm in length. The left kidney is 10.8 cm in length. No suspicious renal lesions are evident. Echogenic renal parenchyma bilaterally. No hydronephrosis is seen.SPLEEN: 7.7 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No significant abdominal free fluid is identified. | 1. Mildly increased hepatic echogenicity, compatible with parenchymal dysfunction. No specific findings otherwise to account for the patient's symptoms.2. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 87-year-old male with abnormal liver function. LIVER: The liver is normal in size and echotexture. There is no focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: No biliary tract dilatation. The gallbladder is somewhat collapsed with multiple large, shadowing calcarine and sludge. The wall, however, is not thickened and the patient was not tender over the gallbladder.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Nephrolithiasis without hydronephrosis. Large, simple lower pole cyst. Second highly complex cystic mass arising from the midpole with relatively thick internal septation and wall nodularity measuring 4.2 cm in diameter is unchanged from prior examinations.OTHER: Left kidney demonstrates nephrolithiasis without hydronephrosis.Splenic size upper normal.Small amount of ascites. | Liver appears unremarkable.Borderline splenomegaly.Multiple gallstones and sludge within the gallbladder without obvious complication.Bilateral nephrolithiasis without obstruction.Highly complex right renal cystic mass unchanged.Simple right renal cyst. |
Generate impression based on findings. | Stem cell transplant with increasing LFTs LIVER: Echogenic coarse liver parenchyma without mass or ductal dilatation. Liver length 15.6 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 13.1 cm in lengthOTHER: Left kidney 12.5 cm in length. Spleen 13.1 cm in length. No ascites. | Coarse echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Follow-up gallbladder polyp LIVER: Normal liver echogenicity without mass. 13.4 cm in lengthBILIARY TRACT: Stable subcentimeter gallbladder polyp measuring 0.3 x 0.3 x 0.3 cm. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.8 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Left kidney 9.2 cm in length. No ascites. | Stable subcentimeter gallbladder polyp. |
Generate impression based on findings. | Follow-up gallbladder polyp LIVER: Normal parenchymal echogenicity without mass. Liver length 16 cmBILIARY TRACT: Stable gallbladder polyp measuring 0.7 x 0.6 x 0.6 cm. Midportion of common bile duct obscured by gas. No evidence for intrahepatic ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.6 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.1 cm in lengthOTHER: Left kidney 10 cm in length. No ascites. | Stable gallbladder polyp. |
Generate impression based on findings. | Hepatitis C; Mantle cell lymphoma. LIVER: Coarse echogenic liver parenchyma without mass. Liver length 17.7 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.5 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 12.7 cm in length. No ascites. | Coarse echogenic liver parenchyma consistent with chronic liver disease without mass or duct dilatation. No ascites. |
Generate impression based on findings. | 53 y.o. male with SIRS but no source of infection. LIVER: Course, echogenic liver. No masses or intrahepatic ductal dilation. Small amount of ascites.GALLBLADDER, BILIARY TRACT: Gall bladder wall is within normal limits. Common bile duct measures 4.0 mm. No stones or sludge. Trace pericystic fluid is seen.PANCREAS: No significant abnormality noted.SPLEEN: Measures 14.3cm but not well visualized on this study. No abnormalities in the visualized portions of the spleen.KIDNEYS: Right kidney measures 12.2 cm. Normal echogenicity. No stones or hydronephrosis. Left kidney measures 12.7 cm. Normal echogenicity. No stones or hydronephrosis. ABDOMINAL AORTA: Measures between 2.0 and 2.4 cm in diameter. No abnormalities.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Coarse, echogenic liver consistent with diffuse parenchymal dysfunction / fatty infiltration.2. Trace pericholecystic fluid and edema.3. No sonographic signs of infection. |
Generate impression based on findings. | 32-year-old male with Burkitt's tumor or lymphoma and each IV. Palpable mass at level of left knee. In the posterior medial soft tissues at the level of the knee joint there is a complex cystic mass measuring 1.5 x 2.5 x 3.3 cm corresponding to the couple abnormality. There is no surrounding abnormality in the soft tissues and no obvious vascularity. | Baker's cyst left knee is the most likely consideration. Hematoma or abscess less likely possibilities. |
Generate impression based on findings. | Ms. Dupart is a 54 year old female with a personal history of ovarian cancer now status post total abdominal hysterectomy and bilateral salpingooophorectomy who presents for imaging evaluation of a palpable mass in the right breast. Three standard views of both breasts plus an additional left MLO view and spot compression right CC and ML views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty (BiRads Density Category A), unchanged in pattern and distribution. A triangular marker overlies upper inner quadrant of the right breast, indicating the site of the palpable abnormality. There are four contiguous focal asymmetries in the right medial breast, which are better appreciated on the ML spot compression view, which together occupy a region measuring up to 3.7 cm. Scattered benign calcifications are noted bilaterally. A benign intramammary lymph node present in the right upper outer quadrant. ULTRASOUND | 1 indeterminate structure within the right upper inner quadrant, for which ultrasound-guided biopsy is recommended to ensure benignity.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.Findings were discussed with the gynecology resident on call, Kathryn Hawley, on 9/15/2016 at approximately 2:15 PM. |
Generate impression based on findings. | Hepatitis C. Evaluate for cirrhosis and hepatocellular carcinoma. LIVER: Noncirrhotic liver morphology. No focal hepatic lesions evident. Normal portal venous blood flow.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladder.PANCREAS: Normal sonographic appearance of the visualized pancreatic head, neck, and proximal body. The distal body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.4 cm in length. The left kidney is 9.9 cm in length. No focal renal lesions are seen. No hydronephrosis.SPLEEN: 8.4 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites identified. | No sonographic evidence of cirrhosis or findings suspicious for hepatocellular carcinoma. |
Generate impression based on findings. | Abdominal pain and mild lipase elevation. LIVER: The liver is mildly coarse and echogenic without a focal abnormality. No intrahepatic biliary ductal dilatation. It measures 14.5 cm in length. Normal hepatopedal portal venous blood flow at 26.7 cm/s.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 4 mm. Normally distended gallbladder without gallstones wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: The visualized pancreatic body and head are unremarkable. The remainder of the pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 8.4 cm without a focal abnormality.RIGHT KIDNEY: The right kidney measures 10.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 10.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | Mildly coarse echogenic liver parenchyma may represent fatty infiltration and/or parenchymal dysfunction without a focal abnormality. The visualized pancreatic body and head are unremarkable. No gallstones or biliary ductal dilatation. |
Generate impression based on findings. | Male 55 years old Reason: incidental lesions in right kidney. Had ultrasound here in 2010, pleas compare RIGHT KIDNEY: Right kidney measures 9.7 cm. Renal cortical echogenicity is within normal limits. There are multiple cysts again seen in the right renal cortex. Within the lower pole of the right kidney there is a ill-defined, predominantly anechoic structure with an adjacent or peripheral calcification. Although this does not meet criteria for a simple renal cyst, it has not increased in size since the prior exam 6 years ago measuring 1.4 x 1.0 x 0.9 cm. A separate well-circumscribed anechoic right renal cyst near the superior pole measures 1.1 x 1.1 x 1.3 cm. No hydronephrosis.LEFT KIDNEY: Left kidney measures 10.5 cm. Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass.OTHER: No significant abnormalities noted. | 1.Cyst in the lower pole the right kidney has ill-defined borders with an adjacent or peripheral calcification. Although this does not meet criteria for a simple renal cyst, it has not increased in size since the prior exam 6 years ago2.No hydronephrosis. |
Generate impression based on findings. | 72-year-old female with bilateral lower extremity edema, heart failure, chronic kidney disease now with decompensated heart failure and acute kidney injury. Last ultrasound in 2/2016. RIGHT KIDNEY: The right kidney measures 11.7 cm in length. There is a right upper pole renal cyst measuring 2.8 x 2.8 x 2.8 cm. Multiple anechoic small cysts are again seen. No hydronephrosis. Echogenic renal parenchyma. There is a new shadowing echogenic focus in the right mid pole measuring 1.2 x 0.9 x 1 cm compatible with a stone.LEFT KIDNEY: The left kidney measures 11.7 cm in length. Echogenic renal parenchyma. The known left lower pole renal cyst measuring 7.3 x 6.4 x 6.2 cm has increased in size (prior 5.9 x 5.7 x 4.9 cm). No hydronephrosis or shadowing renal calculi.URINARY BLADDER: The urinary bladder is drained by a Foley catheter.OTHER: No significant abnormalities noted. | 1. Echogenic renal parenchyma compatible with medical renal disease.2. New nonobstructing stone of the right midpole.3. Bilateral renal cysts with the left lower pole cyst increasing in size. |
Generate impression based on findings. | Reason: 70-year-old man with hyperthyroidism. On anti-thyroid meds. Check thyroid anatomy. History: hyperthyroidism RIGHT LOBE MEASUREMENTS: 7.0 x 3.0 x 3.4 cm.LEFT LOBE MEASUREMENTS: 6.6 x 3.4 x 3.0 cm.ISTHMUS MEASUREMENTS: Up to 1.5 cm in thickness.RIGHT LOBE: Enlarged, heterogeneous gland containing multiple hyperechoic nodules. LEFT LOBE: Enlarged, heterogeneous gland containing multiple hyperechoic nodules. ISTHMUS: Enlarged, heterogeneous gland containing multiple hyperechoic nodules. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No regional lymphadenopathy.OTHER: No significant abnormality noted. | Enlarged, heterogeneous thyroid gland with multiple hyperechoic nodules compatible with thyroiditis. No suspicious nodules identified. |
Generate impression based on findings. | 66-year-old male with history of hepatitis C presents for evaluation of possible hepatocellular carcinoma. LIVER:Measures 16.3 cm. Increased echogenicity. No focal mass, intrahepatic biliary dilation, or ascites. Portal vein is patent with hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. The common bile duct measures 7.1 cm. The common hepatic duct measures 6.1 cm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 10.8 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.3 cm. Left kidney measures 11.1 cm. Echogenicity is unremarkable. No shadowing, hydronephrosis, or focal mass. OTHER: Known adrenal mass not well visualized on this study. | Echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No focal mass or ascites. |
Generate impression based on findings. | 59 year-old female with abnormal LFTs. LIVER: Normal echogenicity of the liver measuring 15.6 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No intra or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.5 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 10.2 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 8.7 cm in length. | Unremarkable examination. |
Generate impression based on findings. | Obesity and history of fatty liver LIVER: Coarse and echogenic liver parenchyma again noted without mass. Liver length 14.6 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.5 cm in lengthOTHER: Left kidney 11.7 cm in length spleen 10.9 cm in length. No ascites | Coarse and echogenic liver parenchyma again noted without change consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 56-year-old female with recent normal screening mammogram dated 9/24/2015 presents to the diagnostic clinic to evaluate left breast focal pain. Pain is predominantly in the left breast from 9 to 10:00 position On physical examination, no discrete palpable mass noted.A targeted right ultrasound was performed for the patient’s area of concern. Normal glandular tissue identified. There is no solid or cystic mass identified. | No sonographic evidence for malignancy corresponding to patient's area of pain in the left breast 9 to 10:00 position.Annual screening mammogram is recommended, due in September 2016.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: Recurrence of left hip abscess History: neutropenic septic shock, ESBL bacteremia, history of E.coli abscess There is extensive subcutaneous edema and inflammation in the soft tissues overlying the left hip. No loculated fluid collections. | Extensive subcutaneous edema and inflammation without loculated fluid collection or abscess. |
Generate impression based on findings. | 29 year-old female with recent elevated liver enzymes and epigastric abdominal pain. LIVER: Normal echogenicity of the liver measuring 13.8 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.1 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. Pericholecystic fluid. Common duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 10.5 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 8.9 cm in length. Cyst measures 7 mm x 7 mm x 7 mm.Left kidney measures 10.8 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted. | Splenic cyst. Otherwise unremarkable examination. |
Generate impression based on findings. | 67-year-old male patient with multinodular goiter. Evaluate nodule size, characteristics. RIGHT LOBE MEASUREMENTS: 3.2 x 1.5 x 1.8 cm.LEFT LOBE MEASUREMENTS: 3.5 x 1.3 x 1.6 cm.ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity. There is suggestion of a slightly hypoechoic, heterogeneous solid nodule within the lower pole measuring 0.9 x 0.9 x 1.3 cm. There is no significant increased vascularity over the background thyroid.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity without dominant lesion.ISTHMUS: The isthmus is heterogeneous in echogenicity. There is a 0.7 x 0.4 x 0.9 cm isoechoic solid nodule with cystic components within the left aspect of the isthmus.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are benign morphology lymph nodes within the left neck.OTHER: No significant abnormality noted. | 1. Heterogeneous thyroid gland compatible with chronic thyroiditis.2. Non-specific small bilateral thyroid nodules. |
Generate impression based on findings. | 48-year-old male with history of hepatitis C, evaluate for HCC and fibrosis. LIVER: Measures 19.9 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. 0.3 cm gallbladder polyp.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: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Hepatomegaly with increased echogenicity consistent with chronic liver disease, without discrete focal lesion. |
Generate impression based on findings. | History of cirrhosis LIVER: 15.1 cm with diffuse coarse echotexture, cirrhotic morphology. No focal lesion noted. No intrahepatic biliary ductal dilatation. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is well-distended without any gallbladder wall thickening. No evidence of gallstonesPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. Mildly increased size of the spleen measures 13.1 cm.RIGHT KIDNEY: Right kidney measures 13.1 cm and left kidney measures 14.7 cm. No hydronephrosis. Normal echotexture. OTHER: No ascites | Cirrhotic morphology of the liver without suspicious lesion.Mild splenomegaly. |
Generate impression based on findings. | History of multinodular goiter by biopsy, patient states slowly enlarging RIGHT LOBE MEASUREMENTS: 7 x 3 x 2.8 cm, enlarged and heterogenousLEFT LOBE MEASUREMENTS: 0.9 x 1.1 x 2.1 cmISTHMUS MEASUREMENTS: 11 mmRIGHT LOBE: Multiple heterogenous nodules throughout the right perihilar gland, mostly in the mid to inferior pole. The largest nodule with few cystic changes measures 5 x 3.1 x 5.3 cm.LEFT LOBE: A small hypoechoic nodule identified in the midpole of the left lobe that measures 1 x 0.6 x 0.8 cm.ISTHMUS: A heterogenous nodule noted within the isthmus and measures 2.4 x 1.2 x 1.3 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No abnormal lymph nodes identified in the neckOTHER: No significant abnormality noted. | Heterogenous multiple thyroid nodules predominantly in the right lobe and the isthmus most likely multinodular goiter. Comparison with prior ultrasound is recommended to confirm stability. |
Generate impression based on findings. | Post heart transplant 2 weeks ago. Now with acute kidney injury. Evaluation limited by patient body habitus.RIGHT KIDNEY: Right kidney measures 9.5 cm. No hydronephrosis or renal calculus identified.LEFT KIDNEY: Left kidney measures 10.0 cm. No hydronephrosis or renal calculus identified.URINARY BLADDER: No significant abnormalities noted. Right ureteral jet is observed.OTHER: No significant abnormalities noted. | Limited evaluation, with no evidence of acute renal abnormality. No renal calculus or hydronephrosis. |
Generate impression based on findings. | 59-year-old female with history of end-stage renal disease, multiple prior central venous access, and currently receiving dialysis via an upper arm graft on the left was recalled from her baseline screening mammogram for a small mass in the upper outer periareolar region of the right breast. No current breast related complaints. No prior breast biopsy seizure. No family history of breast cancer. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 8.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. The asymmetry persists and has the appearance of a small mass at the periareolar 10:00 position of the right breast. Note is made of extensive distended venous collaterals in the right breast as well as arterial calcifications.Ultrasound: Targeted ultrasound performed the area of mammographic concern. There is a fairly circumscribed 0.6 x 0.3 x 0.4 cm hypoechoic mass with partially smooth curved margins and partially irregular angulated margins located at the 10:00 periareolar position of the right breast at mid depth. This corresponds in size, shape, and location to the asymmetry that triggered this exam. There is questionable marginal blood flow on color Doppler imaging. | Indeterminate mass at the 10:00 periareolar position of the right breast. Both benign and malignant etiologies are possible. Ultrasound-guided core biopsy recommended. The results and recommendations were discussed with the patient at the completion of the exam, and the patient elected to undergo the biopsy. She was instructed that our Department will contact her to arrange an appointment for the biopsy.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneus Biopsy/Aspiration. |
Generate impression based on findings. | 48 year old female with abnormal liver function tests. LIVER: The liver measures 14.9 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. 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. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 9.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. Superior pole simple cyst measuring 1.8 x 1.5 x 1.9 cm. LEFT KIDNEY: Kidney measures 13.1 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | Abdominal pain and increasing LFTs.; pregnant with coagulopathy LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 20.6 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.2 cm in lengthOTHER: No ascites | Hepatomegaly with mildly heterogeneous liver echotexture suggestive for parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Reason: 51F with no known history of kidney disease, now with rising creatinine RIGHT KIDNEY: The right kidney measures 13.8 cm in length. Mildly echogenic renal parenchyma. No focal mass, hydronephrosis, or shadowing stones.LEFT KIDNEY: The left kidney measures 13.8 cm in length. Mildly echogenic renal parenchyma. No focal mass, hydronephrosis, or shadowing stones. There is a simple cyst in the superior pole of the left kidney measuring 4.8 x 3.3 cm.OTHER: No significant abnormalities noted. | Mildly echogenic renal parenchyma, possibly consistent with medical renal disease. No evidence of obstruction. |
Generate impression based on findings. | 26-year-old male. Elevated AST and ALT, elevated ACE level, lacrimal gland swelling. Evaluate liver for any changes suspicious for sarcoidosis. LIVER: Normal echogenicity of the liver, which measures 18 cm in length. No focal lesion. Hepatopetal portal venous flow.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 4 mm in diameter, with the normal limits. No cholelithiasis or gallbladder wall thickening.PANCREAS: Visualized portions of the pancreatic head and neck show normal echogenicity. The rest of the pancreas is obscured by bowel gas.RIGHT KIDNEY: Normal echogenicity without focal mass. 11.3 cm in length. No hydronephrosis.OTHER: The spleen is 11.3 cm in length. Left kidney is 11.9 cm in length without hydronephrosis. | Normal appearance of the liver with no focal lesions. |
Generate impression based on findings. | 50-year-old male with acute kidney injury, evaluate for obstruction. RIGHT KIDNEY: Measures 9.9 cm in length. No hydronephrosis, nephrolithiasis, or solid lesion. Normal echotexture.LEFT KIDNEY: Measures 9.8 cm in length. No hydronephrosis, nephrolithiasis, or solid lesion. Normal echotexture.URINARY BLADDER: Incompletely distended.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on findings. | 24-year-old male with cholecystostomy tube, abdominal pain. Evaluate for tube position. LIVER: Liver appears mildly coarsely echogenic without focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. Tracing is pulsatile which may be seen with congestive heart failure.GALLBLADDER, BILIARY TRACT: Gallbladder is nondistended. There is a portion of a drainage tube identified within the gallbladder. There are also moderately echogenic and non-shadowing foci which may be due to sludge or small amount of hemorrhage. No pericholecystic fluid.PANCREAS: Not visualized due to bowel gas.RIGHT KIDNEY: Atrophic with calcifications.OTHER: Ascites and right pleural effusion. | Echogenic liver.Drainage tube identified within the gallbladder.Ascites and right pleural effusion. |
Generate impression based on findings. | 73 year old female who was recalled from outside screening mammogram for left breast asymmetry. MAMMOGRAM: An ML view and two spot compression 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. Within the left breast, 12 o'clock position, the previously visualized asymmetry partially disperses on spot compression imaging, suggesting superimposition of fibroglandular tissues.Within the right breast, upper outer quadrant, there is a new 0.8-cm mass which persists on spot compression imaging.ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. A dense band of fibroglandular tissue is noted. There is no solid or cystic mass identified.A targeted right ultrasound was subsequently performed for the mammographic area of concern. At the 10 o'clock position of the right breast, 5 cm from the nipple, there is a well-circumscribed anechoic cyst mild posterior acoustic enhancement measuring 0.5 x 0.4 x 0.5 cm, likely corresponding to the finding on mammogram. | Dense fibroglandular tissue in the upper central left breast corresponding to the asymmetry on mammogram. Right simple breast cyst. 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. |
Generate impression based on findings. | Ultrasound guidance was provided for biopsy of transplant kidney in the left iliac fossa. Two passes were performed. | Ultrasound guidance for renal transplant biopsy. |
Generate impression based on findings. | Male; 60 years old. Reason: h/o hemangioma, assess for interval change LIVER: The liver has a nodular contour. Liver measures 18.0 cm in length. The parenchyma is normal in echotexture. There is no focal hepatic mass identified.The portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.25 m/sec.BILIARY TRACT: The gallbladder contains layering sludge. There is no cholelithiasis, wall thickening or pericholecystic fluid. Common duct measures 3 mm in diameter. 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 6.9 cm. The cortex is normal in echogenicity but thin. No shadowing calculi or hydronephrosis is present. 1.2 x 0.9 x 1.3 cm slightly hypoechoic structure is seen in the right kidney. There is no associated abnormally increased vascular flow. The left kidney measures 13.8 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 12.6 cm. in length. OTHER: Bilateral pleural effusions. | 1.Hepatomegaly.2.No hepatic hemangioma is identified and no prior imaging was available for comparison at the time of this dictation.3.Right kidney lesion likely represents a prominent column of Bortan but follow up with contrast-enhanced CT or MRI is recommended to exclude underlying neoplasm.4.Bilateral pleural effusions. |
Generate impression based on findings. | Reason: heart transplant w/u History: see above LIVER:Mild increased echogenicity may suggest a stenosis. No focal hepatic lesions. Portal vein is patent. Increased pulsatility of the main portal vein may suggest right-sided heart failure. Liver measures 19.2 cm in craniocaudal dimension.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy.PANCREAS: Pancreas is partially obscured.SPLEEN: Spleen measures 11.9 cm in length.KIDNEYS: Simple appearing right mid pole cyst measures 1.6 x 1.7 x 1.9 cm. Exophytic simple appearing right upper pole cyst measures 6.7 x 2.2 x 3.6 cm. Simple appearing left mid to lower pole cysts measures 5.7 x 4.9 x 5.1 cm ABDOMINAL AORTA: The proximal abdominal aorta measures 2.4 x 1.7 x 1.4 cm. The mid abdominal aorta measures 2.0 cm but is partially obscured by overlying bowel gas. The distal abdominal aorta and iliac arteries not visualized due to bowel gasINFERIOR VENA CAVA: IVC is patent.OTHER: Small bilateral effusions. | 1.Increased pulsatility of the main portal vein may suggest right-sided heart failure.2.Small bilateral effusions.3.Diffuse hepatic echogenicity suggestive of steatosis.4.Simple appearing bilateral renal cysts.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Multiple 1-2 cm gallstones identified. No gallbladder wall thickening or pericholecystic fluid. No sonographic Murphy's sign.PANCREAS: 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 8.9 cm in length. The left kidney is 10.3 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 9.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No significant free fluid identified. | Cholelithiasis without specific evidence of cholecystitis. |
Generate impression based on findings. | 64-year-old female with right upper quadrant pain. LIVER:Measures 15.2 cm. Increased, coarse echogenicity of the parenchyma. No ascites or intrahepatic biliary dilation. There is an approximately 2.6 x 2.3 x 2.8 cm well-defined hyperechoic lesion in the posterior right lobe.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. The wall measures 1.9 mm. No pericholecystic fluid, sludge, or stones. Common duct measures 4.1 mm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 10.7 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 12.8 cm. Left kidney measures 13.1 cm. Unremarkable echogenicity. No shadowing calculi, hydronephrosis, or focal mass.OTHER: No significant abnormality noted. | 1. Increased, coarse echogenicity of liver parenchyma consistent with chronic liver disease and fatty infiltration/parenchyma dysfunction. No ascites.2. Hyperechoic lesion as described above statistically most likely represents a benign etiology such as a hemangioma. If a malignancy is clinically suspected, then dedicated cross-sectional imaging may be indicated.3. No evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | Reason: assess parathyroids History: hyperparathyroidism RIGHT LOBE MEASUREMENTS: 4.0 x 1.8 x 1.9 cmLEFT LOBE MEASUREMENTS: 2.8 x 1.5 x 1.8 cmISTHMUS MEASUREMENTS: 0.5 cm in the AP dimensionRIGHT LOBE: Homogeneous gland with several subcentimeter benign-appearing cystic nodules.LEFT LOBE: Homogeneous gland. Small cystic upper pole nodule measures 0.3 x 0.3 x 0.4 cm without internal calcifications or vascularity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: None visualized.LYMPH NODES: No significant abnormality noted. No cervical lymphadenopathy.OTHER: No significant abnormality noted. | Normal appearing thyroid with several subcentimeter colloid nodules. No parathyroid candidate is identified. |
Generate impression based on findings. | Reason: Rule out cirrhosis; HCC History: HCV diagnosed 30 years ago LIVER: The liver measures 16.47 m in length. Coarse, echogenic hepatic parenchyma. Mildly nodular hepatic contour. The portal vein is patent with normal directional hepatopedal flow, peak velocity is 25.8 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. No cholelithiasis. The gallbladder wall measures 0.4 cm and the common bile duct measures 0.5 cm. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.6 cm in length. No hydronephrosis, shadowing renal calculi, or focal mass. Small anechoic mid pole cyst measures 1.2 x 1.0 cm in the longitudinal plane.LEFT KIDNEY: The left kidney measures 11.1 cm in length. No hydronephrosis, shadowing renal calculi, or focal mass.OTHER: The spleen measures 12.3 cm in length. No ascites. | Coarse, echogenic liver with a mildly nodular contour, consistent with parenchymal dysfunction or chronic liver disease. No focal mass identified. |
Generate impression based on findings. | 29-year-old female with nontoxic goiter. RIGHT LOBE MEASUREMENTS: 1.5 x 1.2 x 5.1 cmLEFT LOBE MEASUREMENTS: 1.3 x 1.5 x 5.2 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Homogeneous echotexture. Small cyst with comet tail artifact consistent with colloid.LEFT LOBE: Homogeneous echotexture. Very small cysts identified. In the lower pole there is a mildly hypoechoic nodule with a somewhat spongiform appearance measuring 0.5 x 0.6 x 0.7 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Small cystic nodules bilaterally. Slightly larger left nodule may be spongiform. |
Generate impression based on findings. | 66 year old female with hyperparathyroidism. Evaluate for abnormal parathyroid glands and thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.9 cm x 1.6 cm x 1.4 cm.LEFT LOBE MEASUREMENTS: 4.8 cm x 1.4 cm x 1.3 cm. ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: Heterogeneous echotexture. Several subcentimeter nodules are seen.LEFT LOBE: Heterogeneous echotexture. Several subcentimeter nodules are seen.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Hypoechoic nodular focus which appears separate from the left thyroid lobe inferiorly is seen measuring 4 mm x 4 mm x 3 mm.LYMPH NODES: Benign-appearing right neck level 5 lymph node measuring 1.1 cm x 0.4 cm x 0.6 cm.OTHER: No significant abnormality noted. | 1. Hypoechoic nodular focus inferior to the left thyroid lobe is nonspecific but given history of hyperparathyroidism may represent a parathyroid adenoma. Please refer to same day nuclear medicine scintigraphic study for additional findings. A small lymph node is another differential consideration.2. Subcentimeter thyroid nodules. |
Generate impression based on findings. | 49-year-old female presents with a history of clear intermittent left nipple discharge for approximately 12 months. Inverted left nipple for approximately two years. The patient states that she has always had "lumpy breasts". Three standard views of both breasts and spot compression views of the left retroareolar breast 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. There is asymmetric glandular density in the left retroareolar breast, which disperses with spot compression.ULTRASOUND | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 60-year-old female patient with known history of ADPKD and stage IV CKD. Evaluate for cysts in the liver. Evaluate size of kidneys. LIVER: The liver measures 20.1 cm in length. A 0.5 x 0.5 x 0.4 cm hyperechoic lesion is noted within the right hepatic lobe adjacent the gallbladder.. 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 4 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 18.7 cm in length, is echogenic, and contains multiple cysts, some of which are complex. The largest within the right upper pole measures 6.3 x 4.7 x 6.1 cm. No evidence of hydronephrosis. OTHER: The left kidney measures 18.4 cm in length, is echogenic, and contains multiple cysts, some of which are complex. The largest measures 12.7 x 7.0 x 10.7 cm. No evidence of hydronephrosis.The spleen measures 9.9 cm in length. | 1. No cysts identified in the liver. Subcentimeter hyperechoic right hepatic lobe lesion; this likely represents a hemangioma in the absence of chronic liver disease/abnormal liver morphology.2. Medical renal disease with bilateral renal cysts. |
Generate impression based on findings. | Primary biliary cirrhosis. Six-month screening per clinical trial. LIVER: Minimally nodular liver contours, compatible with chronic liver disease. 17.6 cm in length. Increased hepatic echogenicity, compatible with parenchymal dysfunction. 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. No pancreatic ductal dilation.KIDNEYS: The right kidney is 13.7 cm in length, with a 8 mm benign-appearing cyst. The left kidney is 12.1 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 10.0 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal ascites is identified. | Minimally nodular liver contours, compatible with cirrhosis. |
Generate impression based on findings. | 49-year-old male with acute kidney injury. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.3 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Normal renal echogenicity.LEFT KIDNEY: The left kidney measures 12 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Normal renal echogenicity.URINARY BLADDER: The urinary bladder is collapsed and not well evaluated.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on findings. | Colon carcinoma with bilateral hydronephrosis with ureteral stents with nausea vomiting and persistent diarrhea RIGHT KIDNEY: Echogenic renal parenchyma. Slight interval worsening of moderate right hydronephrosis. Right ureteral stent observed and in anatomic location. No worrisome renal mass or stone. Right kidney 12.6 in meters in length.LEFT KIDNEY: Echogenic renal parenchyma Stable mild left hydronephrosis. Ureteral stent in anatomic location. Stable left renal cyst. No worrisome mass or stone. Left kidney 12.1 cm in length.OTHER: Bladder nondistended. Questionable debris within the bladder noted. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction. Slight interval worsening of moderate right hydronephrosis. Stable left minimal hydronephrosis. Bilateral ureteral stents in anatomic location. Bladder not distended; questionable debris within the bladder. |
Generate impression based on findings. | 73-year-old female with cardiomyopathy and possibly cirrhosis. Preheart transplant. LIVER:Overall hepatic size is within normal limits. The liver is very mildly echogenic consistent with parenchymal disease. No focal hepatic mass is seen. Limited spectral and color Doppler demonstrates patency and appropriate flow direction in the main portal vein. GALLBLADDER, BILIARY TRACT: The gallbladder appears somewhat distended. However, the gallbladder is otherwise normal without cholelithiasis, wall thickening or pericholecystic fluid. The visualized portions of the biliary tract are normal in caliber.PANCREAS: No significant abnormality noted.SPLEEN: Normal in size.KIDNEYS: The right kidney measures 9.7 cm in length and appears unremarkable. No hydronephrosis, shadowing calculus or mass. Left kidney is in adequately visualized on this study due to bowel gas. There is however no gross hydronephrosis. ABDOMINAL AORTA: Normal in caliber without aneurysm.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No fluid collections are seen. | Mildly echogenic liver..Gallbladder distention without other abnormality. |
Generate impression based on findings. | 51-year-old with known left breast cancer and questionable left axillary lymphadenopathy on physician exam. A targeted left ultrasound was performed for the left axilla. Three lymph nodes as are seen in total. Two of these have completely normal morphology. The third node measuring 10 x 8 mm has a slightly eccentrically thickened cortex measuring only between two and 3 mm and preserved normal hilar blood flow. | Three axillary lymph nodes, two of normal morphology and the other of low suspicion. Findings were discussed with Dr. Jaskowiak. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 29-year-old female with biopsy proven fibroadenoma in the left breast presents for follow-up With focused ultrasound, there is a known hypoechoic mass, which is a biopsy proven fibroadenoma, with marker clip lateral to the mass at 12:00 position in the left breast. The lesion measures 0.9 x 0.5 x 1.1 cm (previously 0.9 x 0.5 x 1.2 cm). | No significant interval change in size of the biopsy-proven left fibroadenoma. No further imaging follow-up is needed.Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Right lower quadrant abdominal pain LIVER: Coarse echogenic liver echotexture without mass. Liver length 13.5 cmBILIARY TRACT: 0.3 x 0.3 x 0.2 cm subcentimeter gallbladder polyp. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 10.5 cm in lengthOTHER: Left kidney 9.5 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Subcentimeter gallbladder polyp. No ascites. |