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Generate impression based on findings. | Mr. Cochran is a 63-year-old man presenting for ultrasound-guided biopsy of a previously identified right high axillary mass. A targeted right axillary ultrasound was performed for the previously identified axillary mass on ultrasound from 11/11/2015. After thorough examination of the high right axillary region, no such mass was able to be reproduced on today's examination. In addition, a second radiologist confirmed the absence of this axillary mass.At this point, a decision was made to abort the exam as no such mass could be reproduced on today's examination. | No sonographic evidence of malignancy in the high right axillary region. The patient should follow up with his primary care physician as clinically warranted. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma again noted without worrisome mass or hydronephrosis. Multiple echogenic foci consistent with subcentimeter nonobstructing stones. Right kidney 7.2 cm in length.LEFT KIDNEY: Echogenic parenchyma again noted without worrisome mass or hydronephrosis. Multiple echogenic foci consistent with subcentimeter nonobstructing stones. Left kidney 8.2 cm in length.OTHER: Debris within bladder noted. | Echogenic parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass or hydronephrosis. Bilateral nonobstructing subcentimeter nephrolithiasis. |
Generate impression based on findings. | 84 year old female with abdominal pain. Evaluate lesion seen on same day CT exam. The study is limited by the patient's reported contracted state.RIGHT KIDNEY: The right kidney is atrophic and echogenic, measuring 8.4 cm in length. There is a 2.0 x 1.8 x 2.2 cm inferior pole hypoechoic complex lesion corresponding to the lesion seen on the same day CT.LEFT KIDNEY: The left kidney is atrophic and echogenic, measuring 7.9 cm in length. Mild nonspecific heterogeneity of the superior pole of the left kidney is noted. There appears to be a 8 x 5 x 8 mm lower pole hypoechoic lesion which is difficult to characterize on ultrasound, uncertain whether correlates to interpolar region 8 mm lesion seen on the same day CT.OTHER: The urinary bladder is partially distended with anechoic urine. | Limited study as described above.1. 2.2-cm right inferior pole hypoechoic complex mass, again suspicious for a renal cell carcinoma. Additional left renal findings as above.2. Given the patient's contracted state, future follow up of the aforementioned lesions may be better achieved with dedicated CT imaging. |
Generate impression based on findings. | Female 64 years old; Reason: of liver screen for hcc. hbv History: same LIVER: The liver measures 15.2 cm in length. There is coarse increased echogenicity of the liver parenchyma. There is a nodular appearance of the liver No fluid worrisome masses. A simple appearing hepatic cyst is revisualized in the right lobe measuring 1.2 cm x 1.1 cm x 1.4 cm. This previously measured 1.7 cm x 0.8 cm x 1.4 cm. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 23.8 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder surgically absent. The common bile duct measures 2.8 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen is surgically absent.RIGHT KIDNEY: The right kidney measures 7.4 cm in length. The cortex has increased echogenicity and appears atrophic. No hydronephrosis, stones, or worrisome masses are seen.RENAL TRANSPLANT: The renal transplant is poorly visualized due to overlying bowel gas and is likely atrophic.LEFT KIDNEY: Not visualized due to overlying bowel gas, likely atrophic | 1. The liver has coarse increased echogenicity with a nodular appearance compatible with cirrhotic morphology. No new worrisome masses are seen.2. Right and left kidneys as well as the prior renal transplant are all not well visualized on this ultrasound and are likely atrophic. |
Generate impression based on findings. | History of right ureteral stone status post ureteroscopy. Evaluate for hydronephrosis or nephrolithiasis. RIGHT KIDNEY: 11.3 cm in length. The renal cortex is mildly thinned, likely within normal limits for age. Simple appearing cysts noted. No renal stones or suspicious lesions identified. No hydronephrosis is present.LEFT KIDNEY: 11.4 cm in length. The renal cortex is mildly thinned, likely within normal limits for age. Simple appearing cyst noted. No renal stones or suspicious lesions identified. No hydronephrosis present.BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | No nephrolithiasis or hydronephrosis. |
Generate impression based on findings. | Thyroid cancer status post surgery and I-131 RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: The previously seen hypoechoic focus measuring 5 x 6 x 2 mm is unchanged, accounting for differences in technique.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | No specific evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 52 year old female with lupus nephritis, needs ultrasound guidance for biopsy Ultrasound guidance was provided for right kidney biopsy performed by the renal service. | Ultrasound guidance was provided for right kidney biopsy performed by the renal service. |
Generate impression based on findings. | 45 year old female who was recalled from screening mammogram for focal asymmetry in the right upper outer breast. History of right breast second-degree burn at 12:00 position in may 2016. Mammogram: An ML , repeat MLO view and 3 spot compression views of the right breast 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. Focal asymmetry in the right upper-outer quadrant mid to posterior depth disperses into normal breast tissue. On repeat right MLO view it is not as conspicuous and most likely represents glandular tissue.Ultrasound: Targeted right upper-outer quadrant ultrasound was performed. No definite target identified on ultrasound. | Focal asymmetry in the right upper-outer quadrant which was seen on screening mammogram is not as conspicuous on diagnostic mammogram probably related to healing history of second degree burn involving the right breast. Right unilateral diagnostic mammogram is recommended in 6 months for confirmation.BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 21-year-old female with right upper quadrant pain. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: No cholelithiasis or biliary ductal dilation. No gallbladder wall thickening or pericholecystic fluid.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | No evidence of cholelithiasis or cholecystitis. No abnormalities identified to account for the patient's symptoms. |
Generate impression based on findings. | 58 year old female with history of right upper quadrant pain and prior elevated LFTs, evaluate liver, gallbladder and pancreas. LIVER: No significant abnormalities noted. Liver measures 17.9 cm.GALLBLADDER, BILIARY TRACT: Cholelithiasis, with gallbladder wall thickening up to 0.5 cm. A small amount of pericholecystic fluid is also seen. The common bile duct is dilated up to 0.7 cm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 11 cm.OTHER: No significant abnormalities noted. Left kidney is within normal limits, and measures 11.8 cm. | Findings of acute calculus cholecystitis. |
Generate impression based on findings. | Reason: evaluate for gallstones History: RUQ pain and bloating, worse after eating LIVER: Liver is normal in size, measuring 14 cm in length. Coarse hepatic echotexture is noted. No focal hepatic lesion is identified.GALLBLADDER, BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening, pericholecystic fluid. Sonographic Murphy sign is clinical.PANCREAS: Pancreatic head and tail is obscured by overlying bowel gas. Visualized pancreas is unremarkable.RIGHT KIDNEY: Right kidney measures 9.6 cm in length. No renal stones, mass, or hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis. Equivocal sonographic Murphy sign. No specific signs of cholecystitis.2.Coarse hepatic echotexture; correlate with liver function tests to exclude hepatic parenchymal dysfunction. |
Generate impression based on findings. | Renal failure. Oliguria. Please note that examination is significantly limited by the patient's body habitus.RIGHT KIDNEY: 8.2 cm in length. The renal parenchyma is echogenic. No hydronephrosis. No large focal lesions are evident.LEFT KIDNEY: 7.1 cm in length. The renal parenchyma is echogenic. No hydronephrosis. No large focal lesions are evident.BLADDER: Nondistended.OTHER: No significant abnormalities noted. | Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. She has a personal history of right breast cancer status post mastectomy in 06/2015 for IDC with disease positive nodes. Family history of breast cancer in paternal cousin, diagnosed at the age of 47. 3-D whole breast ultrasound was performed for the left breast and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy in the left breast.BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | Male 80 years old Reason: Primary HPT RIGHT LOBE MEASUREMENTS: 2.0 x 1.2 x 3.9 cmLEFT LOBE MEASUREMENTS: 4.1 x 1.7 x 1.6 cmISTHMUS MEASUREMENTS: 0.18 cmRIGHT LOBE: No significant abnormality. Right thyroid lobe has normal echogenicity.LEFT LOBE: No significant abnormality. Left thyroid lobe has normal echogenicity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Inferior to the right thyroid lobe there is a extrathyroidal rounded hypoechoic nodule consistent with a parathyroid adenoma measuring 1.2 x 0.9 x 0.9 cm.LYMPH NODES: Small benign appearing left level 3 lymph node measuring 0.6 x 0.3 x 1.4 cm.OTHER: No significant abnormality noted. | Hypoechoic nodule compatible with a parathyroid adenoma inferior to the right thyroid lobe. |
Generate impression based on findings. | Asymmetric enlargement of the right thyroid lobe. RIGHT LOBE MEASUREMENTS: 7.1 x 2.2 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.0 x 1.2 x 1.3 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: 3 discrete thyroid nodules are noted.The largest is in the inferior pole measuring 1.7 x 1.6 x 2.9 cm which is a complex predominantly solid nodule with well-defined margins and vascularity but no microcalcifications.An isoechoic more inferior 1.0 x 0.8 x 1.1 cm solid nodule is noted with poorly defined smooth margins.A mildly hypoechoic more superior 8 x 4 x 9 mm solid nodule is noted.LEFT LOBE: 3 subcentimeter left thyroid complex predominantly solid nodules with small cystic components are noted without specific suspicious sonographic features. The largest measures 1.0 x 0.9 x 0.9 cm in the mid inferior pole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral thyroid nodules the largest of which measures 2.9 cm on the right and demonstrates complex predominantly solid morphology. These are amenable to FNA sampling. |
Generate impression based on findings. | 72-year-old female for follow-up thyroid nodules. RIGHT LOBE MEASUREMENTS: 8.5 x 4 x 3.5 cmLEFT LOBE MEASUREMENTS: 9.1 x 4.4 x 3.9 cmISTHMUS MEASUREMENTS: 1.7 cmRIGHT LOBE: Mildly and heterogeneously echogenic with a suggestion of underlying hyperechoic nodules as is seen with thyroiditis. There is again noted in the midportion of the right lobe is a well circumscribed, solid nodule with cystic component that is mildly and heterogeneously echogenic. This measures 1.5 x by 2.1 x 2.4 cm. When remeasuring the prior study, this is unchanged, appearing better marginated on today's exam.LEFT LOBE: Mildly and heterogeneously echogenic with suggestion of underlying hyperechoic nodules. The appearance is overall unchanged in the interim.ISTHMUS: Within the isthmus, there is a heterogeneous, solid mass which is reasonably well demarcated measuring 0.7 x 0.8 x 0.8 cm without change.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable thyromegaly with stable nodules. |
Generate impression based on findings. | Ms. Krich is a 54 year old female with known IDC and suspicious-appearing right axillary lymph nodes on outside MRI examination. Targeted grayscale and color ultrasound examination of the right axilla.Multiple abnormal right axillary lymph nodes are visualized, some of which appear with internal calcifications. For reference, a right axillary node with mild internal calcifications measures1.2 x 0.9 x 1.1 cm. Another reference node with internal calcification measures 2.1 x 1.1 x 1.8 cm. Three additional abnormal lymph nodes without calcifications by ultrasound are adjacent to the reference nodes mentioned above. | Multiple suspicious-appearing lymph nodes within the right axilla as above. The patient was sent to breast surgery clinic upon completion of ultrasound examination and results were immediately relayed to the breast surgery clinic.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Male 62 years old Reason: s/p renal transplant History: elevated CR Ultrasound guidance and technical assistance was provided for a renal allograft in the right iliac fossa. 3 passes were made by Dr. Cunningham. The procedure was successfully completed. | Successful ultrasound guided biopsy of the renal allograft in the right iliac fossa. |
Generate impression based on findings. | 57-year-old female with right upper quadrant pain, fevers, nausea LIVER: Measures 15.4 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Cholelithiasis with gallbladder wall thickening and pericholecystic fluid. No significant 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: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Findings consistent with acute cholecystitis. |
Generate impression based on findings. | 58-year-old male with chronic kidney disease and worsening renal function. RIGHT KIDNEY: Right kidney measures 11.5 cm in length. Echotexture is difficult to judge due to overlying ascites, cortex is at least moderately echogenic. There is a small cyst in the upper pole of the kidney. No hydronephrosis, shadowing calculus or solid mass.LEFT KIDNEY: The left kidney measures 12.7 cm in length. Cortex is moderately echogenic. No hydronephrosis, shadowing calculus or mass.URINARY BLADDER: No significant abnormalities noted.OTHER: Moderate ascites. | Echogenic kidneys with small right cyst. Overall, the appearance of the kidneys is little changed from prior exams.Moderate ascites. |
Generate impression based on findings. | 39-year-old female patient with history of subacute thyroiditis with abnormal imaging, question of nodule. Previous painful, tender nodule on the right in April 2015, pain has resolved. Evaluate for nodules and other characteristics. RIGHT LOBE MEASUREMENTS: 1.2 x 1.2 x 4.4 cm, previously 2.3 x 2.5 x 4.3 cm.LEFT LOBE MEASUREMENTS: 0.9 x 1.1 x 3.9 cm, previously 1.4 x 1.0 x 4.3 cm.ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: The right thyroid lobe is slightly heterogeneous in echogenicity without focal lesion.LEFT LOBE: The left thyroid lobe is slightly heterogeneous echogenicity without focal lesion.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology lymph nodes are noted bilaterally laterally.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland which can be seen with a history of thyroiditis. No focal thyroid lesion is identified. |
Generate impression based on findings. | 51-year-old female called back from screening mammography for asymmetries in both breasts. No current breast complaints. Three standard views of both breasts and 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(BiRads Density Category B), unchanged in pattern and distribution. Several small circumscribed asymmetries in both breasts persist with spot compression. Additional ultrasound was performed. ULTRASOUND | Benign subcentimeter cysts in both breasts correlating with areas of mammographic asymmetry. 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. | 51 year old female who was recalled from screening mammogram for new mass in the left lower inner breast.. Mammogram: 2 ML views and two spot compression views of the left 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), unchanged in pattern and distribution. 14 mm circumscribed oval hyperdense mass in the left lower inner quadrant posterior depth persist on spot compression views. No associated calcifications. Multiple other benign morphology masses elsewhere are stable.Ultrasound: Targeted left lower inner quadrant ultrasound was performed. A small 5 x 4 mm simple cyst was identified in the left breast 8:00 position, 10 cm from the nipple. This probably is an incidental finding and might not correspond to the 14 mm circumscribed oval benign morphology mass in the left breast on the mammogram. | High probability benign morphology 14 mm circumscribed oval mass in the left breast lower inner quadrant without definite sonographic correlate needs further evaluation with left unilateral diagnostic mammogram in 6 months to confirm stability.Incidentally noted 5 mm simple cyst in the left breast on ultrasound.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 16 year old with recent biopsy right breast with benign results presents for right retroareolar ultrasound to evaluate right nipple discharge, one episode before the biopsy. A targeted right retroareolar ultrasound was performed. There is no solid or cystic mass identified. Normal glandular tissue noted. | No sonographic evidence for malignancy. Follow up in 6 months to confirm stability of the benign fibroadenoma and surgical consultation.BIRADS: 1 - Negative.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Hepatitis B LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 16.2 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. Right kidney 10.2 cm in lengthOTHER: Left kidney 9.7 cm in length. Spleen 8.1 cm in length. No ascites. | Mildly heterogeneous liver echotexture suggestive for chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Male 51 years old Reason: eval transplant kidney History: transplant RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Transplant kidney measures 11.3 cm. No evidence of hydronephrosis. Slightly echogenic kidney. Simple appearing cyst in the upper pole measuring 2 cm.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 No significant abnormality noted. Peak systolic velocity at the level of the anastomosis 110 cm/s. RI values range between 0.6 and 0.7. Transplant vein is patent.OTHER: No significant abnormality noted | Slightly echogenic renal transplant right iliac fossa. Normal Doppler study. |
Generate impression based on findings. | 59 year-old female with abdominal pain. Evaluate for ascites. Four abdominal quadrants were evaluated for the presence of ascites. No evidence of ascites is noted.Partially imaged liver is increased in echogenicity. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. 2. No ascites. |
Generate impression based on findings. | Altered mental status, heart failure, concern for congestive hepatopathy versus infectious process LIMITED ABDOMENLIVER: Liver measures 17 cm with normal with normal echotexture. Portal vein demonstrates normal flow directionality and patency.No focal lesions noted.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Gallbladder is well-distended with normal gallbladder wall thickness without any focal lesions or stones.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. RIGHT KIDNEY: Right kidney measures 10.2 cm and left kidney measures 10 cm with mildly increased echogenicity consistent with chronic medical renal disease. No hydronephrosis or focal lesions.OTHER: No ascites | 1. Bilateral echogenic kidneys consistent with chronic medical renal disease.2. Liver vasculature is patent. |
Generate impression based on findings. | Reason: Hashimoto's, history of subcentimeter thyroid nodules, assess need for FNA RIGHT LOBE MEASUREMENTS: 4.5 x 1.3 x 1.5 cm.LEFT LOBE MEASUREMENTS: 3.8 x 1.0 x 1.6 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echotexture. Multiple nodules. Superior pole heterogeneous but predominantly hyperechoic nodule measuring 0.9 x 0.7 x 1.1 cm. Midpole hypoechoic nodule with internal coarse calcification measuring 0.7 x 0.5 x 0.8 cm. Inferior pole hyperechoic nodule with hypoechoic halo measuring 0.8 x 0.7 x 0.8 cm. LEFT LOBE: Mildly heterogeneous background parenchymal echotexture. Multiple nodules. Midpole hyperechoic nodule measuring 1.2 x 0.8 x 1.1 cm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Single benign morphology right level 2 cervical lymph node.OTHER: No significant abnormality noted. | 1.Heterogeneous thyroid gland with multiple hyperechoic nodules compatible with clinical history of Hashimoto's thyroiditis.2.Subcentimeter hypoechoic nodule with coarse calcification in right midpole. Continued attention is recommended on subsequent follow-up examinations. |
Generate impression based on findings. | 35-year-old male with chronic kidney disease. RIGHT KIDNEY: The right kidney measures approximately 7.6 cm in length. The kidney is moderately to markedly echogenic consistent with parenchymal disease, and this has progressed in the interim. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures approximately 8.5 cm in length. The kidney is moderately to markedly echogenic consistent with parenchymal disease, and this has progressed in the interim. No hydronephrosis or shadowing calculus. The previously noted hypoechoic, lobulated region in the lower pole of the left kidney is not visualized on today's exam.OTHER: No significant abnormalities noted. | Progressive increased echogenicity of both kidneys which are atrophic.Previously noted questionable mass on the left is not visualized. |
Generate impression based on findings. | Acute kidney injury. Urinary retention. Please note that examination is limited due to poor acoustic penetration and inability to reposition the patient.RIGHT KIDNEY: 9.4 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: Evaluation of the left kidney is limited by inability to reposition the patient. No gross hydronephrosis is evident. BLADDER: Distended.OTHER: Numerous metastatic lesions identified in the liver, partially imaged. | No hydronephrosis. Distended bladder. |
Generate impression based on findings. | 31-year-old male with pancreatitis, elevated bilirubin. LIVER: Measures 21.1 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: Enlarged hypoechoic pancreas consistent with the clinical history of pancreatitis. Portions of the pancreatic tail are not well visualized due to bowel gas. No peripancreatic fluid collections are identified.SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | 1.Hypoechoic enlarged pancreas consistent with the clinical history of pancreatitis.2.No cholelithiasis or evidence of cholecystitis.3.Hepatomegaly and increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on findings. | 60-year-old female RUQ pain, tender, recent ERCP w/ stent placement & stone removal. Evaluate for cholecystitis, obstruction. LIVER: Normal echogenicity of the liver measuring 15.8 cm in length. No focal hepatic lesions.GALLBLADDER, BILIARY TRACT: Sludge noted within the gallbladder. No cholelithiasis. Gallbladder wall is mildly thickened measuring up to 4 mm in thickness. There is minimal surrounding pericholecystic fluid. Sonographic Murphy's sign is positive. Common bile duct is normal in caliber measuring 3 mm. No intra or extra hepatic biliary ductal dilatation. Possible common bile duct stent noted.PANCREAS: The distal pancreatic body and tail are obscured by overlying bowel gas. The remaining visualized pancreas is normal in echogenicity. No pancreatic ductal dilatation.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.6 cm in length. No nephrolithiasis or hydronephrosis. OTHER: The left kidney is normal in echogenicity measuring 10.6 cm in length. No nephrolithiasis or hydronephrosis. The spleen is normal in echogenicity measuring 7.3 cm in length. | Findings are suspicious for acute cholecystitis as described above.Findings were conveyed to Dr. Shah at pager 1597 at 4:04 PM. |
Generate impression based on findings. | Female 30 years old Reason: h/o goiter, 2 nodules detected on scan in NY 12/2015 RIGHT LOBE MEASUREMENTS: 5.9 x 2.4 x 1.7 centimetersLEFT LOBE MEASUREMENTS: 5.7 x 2.1 x 1.3 cmISTHMUS MEASUREMENTS: 0.2 centimetersRIGHT LOBE: Heterogeneous background echogenicity of the right thyroid lobe. No discrete nodules are identified.LEFT LOBE: Heterogeneous background echogenicity of the left thyroid lobe. Small, well-circumscribed, mildly hypoechoic, spongiform appearance and nodule in the inferior left thyroid with mild increased vascularity, without microcalcifications, measuring 0.7 x 0.8 x 0.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous echogenicity of the thyroid which could be due to tiny nodules or thyroiditis. Small spongiform nodule in the inferior left thyroid lobe without definite microcalcifications. |
Generate impression based on findings. | 64-year-old male with outside hospital Sestamibi scan showing a right inferior gland. Primary hyperparathyroidism. Assess for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 4.4 cm x 1.7 cm x 1.2 cmLEFT LOBE MEASUREMENTS: 3.2 cm x 1.1 cm x 1.0 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: No discrete nodules or masses are notedLEFT LOBE: No discrete nodules or masses are notedISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Hypoechoic extrathyroidal nodule posterior and inferior to the right thyroid lobe measures 9 mm x 6 mm x 4 mm. This corresponds to the uptake seen on outside hospital nuclear medicine Sestamibi scan and is consistent with suspected parathyroid adenoma. LYMPH NODES: Right neck benign appearing lymph node measures 8 mm x 8 mm x 4 mm. Left neck benign appearing lymph nodes are noted, largest measures 1.0 cm x 0.9 cm x 0.3 cm. OTHER: No significant abnormality noted. | Findings are consistent with suspected right parathyroid adenoma as described above. |
Generate impression based on findings. | 23-year-old male with dilated veins in left testicle. Rule out varicocele. The testicles are symmetric and normal in size, the right measuring 3 x 4.1 x 2 cm and the left measuring 2.9 x 3.7 x 2 cm. Testicular parenchyma is of normal homogeneous echogenicity bilaterally. Doppler exam shows unremarkable intratesticular arterial flow bilaterally. The epididymal heads are normal in size, maximal diameter measuring 0.9 cm on the right and 1 cm on the left. Small bilateral epididymal head cysts are noted. Prominent veins are seen posterior to the left testicle measuring up to 0.4 cm in diameter that do not significantly increase with the Valsalva maneuver. | 1. No acute testicular abnormality.2. Mild left varicocele. |
Generate impression based on findings. | 5-year-old female with right labial vascular lesion. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Within the subcutaneous soft tissues of the right labia, there is a 2.7 x 1.8 cm T1 hypointense, T2 hyperintense mass. The mass demonstrates avid fairly homogeneous arterial enhancement. Possible internal septations. It is supplied by mildly hypertrophied branches of the right pudendal artery. No early or enlarged draining vein is seen. OTHER: No significant abnormality noted. | Vascular mass within the right labia. Given the rapidity of filling in of the lesion on postcontrast imaging and the degree of vascularity demonstrated, a hemangioma is considered less likely as the appearance would be atypical. Among the differential considerations is a high flow AVM. While the mass appears to contain septations and otherwise appear fairly homogeneous on the current study, the sonographic appearance on the prior 5/26/15 ultrasound was much more heterogeneous. This raises concern for the possibility of a more rare, vascular tumor such as an angiomyxoma. Presurgical embolization is recommended prior to any future surgical intervention. |
Generate impression based on findings. | Ms. Los is a 70 year old female with a personal history of bilateral breast cysts. She complains today of focal right breast pain for the past 10 months. A targeted right breast ultrasound was performed for the patient’s area of concern. In the right breast 10:00 location, approximately 4 cm from the nipple, a round anechoic lesion with layering echogenic material is identified measuring approximately 0.5 x 0.5 cm. Sonographic findings are compatible with a simple cyst with layering calcification. | Bilateral benign calcifications and benign cysts. 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: 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. | Male 69 years old; Reason: Nodule size and characteristics History: thyroid nodules on CT RIGHT LOBE MEASUREMENTS: 4.6 x 2.0 x 1.5 cm.LEFT LOBE MEASUREMENTS: 3.7 x 0.9 x 1.2 cm.ISTHMUS MEASUREMENT: 0.5 cm.RIGHT LOBE: There is round solid complex nodule measuring 2.0 x 1.5 cm in the inferior aspect of the right lobe with foci of increased echogenicity. No other nodules are seen in the right thyroid.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.LYMPH NODES: No adenopathy noted. OTHER: No significant abnormality noted. | Complex nodule in right lobe of thyroid; recommend correlation with ultrasound-guided biopsy. |
Generate impression based on findings. | 76-year-old female with ovarian cancer, increased left flank pain. RIGHT KIDNEY: Measures 10.4 cm in length with increased renal echogenicity. Right renal stent in place without hydronephrosis.LEFT KIDNEY: Measures 9.9 cm with increased renal echogenicity. No nephrolithiasis or hydronephrosis.OTHER: Partially collapsed. | 1. Increased renal echogenicity consistent with medical renal disease. 2. No left hydronephrosis or nephrolithiasis. 3. Right ureteral stent in place without hydronephrosis. |
Generate impression based on findings. | Reason: LUE wound with induration c/f abscess History: as above Limited ultrasound along the dorsal aspect of the left forearm was performed. There is a tubular structure within the subcutaneous tissues without flow which likely represents a thrombosed vein. The adjacent subcutaneous tissues are mildly echogenic which may reflect inflammatory change. No focal fluid collection is identified. | 1.Superficial thrombophlebitis along the dorsal aspect of the left forearm.2.No underlying focal fluid collections. |
Generate impression based on findings. | Thyroid cancer status post surgery RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT 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 regional lymphadenopathy. | Post surgical changes without regional lymphadenopathy. |
Generate impression based on findings. | Right upper quadrant pain for several months LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 12.5 cm in length. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladder. No cholelithiasis.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 9.8 cm in length. The left kidney is 10.3 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 7.6 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites. | Increased hepatic echogenicity compatible with parenchymal dysfunction and/or steatosis, without biliary ductal dilation. |
Generate impression based on findings. | Female 77 years old; Reason: 77 yo with advanced fibrosis and GB polyps History: none LIVER: The liver measures 18.5 cm in length. There is coarse increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. A hepatic cyst is seen within the right lobe of the liver measuring 1.3 cm x 1.3 cm x 1.7 cm. The main portal vein is patent with normal hepatopetal flow measured at 14.9 cm/s. No ascites is seen.GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.6 mm. No stones are seen. No pericholecystic fluid. Negative sonographic Murphy sign. Several small gallbladder polyps are revisualized the largest measuring 0.5 cm x 0.3 cm x 0.4 cm. The common bile duct measures xx mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.7 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 9.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.1 cm in length. The cortex has normal echogenicity. Minimal hydronephrosis is present. No stones or worrisome masses are seen. | 1. The liver has coarse increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No ascites is seen. No worrisome hepatic lesions visualized.2. Several gallbladder polyps are revisualized. No evidence of cholelithiasis or acute cholecystitis are seen.3. Minimal hydronephrosis is present on the left. |
Generate impression based on findings. | 56-year-old female with HBV, HCC screening. LIVER: Coarse echotexture of the liver measuring 14.1 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 2 mm in thickness. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring .8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 9.6 cm in length. No hydronephrosis or shadowing foci are noted.Normal echogenicity of the spleen measuring 6.7 cm in length. | Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | Reason: r/o growth, adenopathy History: bilateral thyroid nodules. 1 year follow up study RIGHT LOBE MEASUREMENTS: 5.0 x 1.9 x 1.5 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.3 x 1.8 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Mid pole partially solid, partially cystic nodule measuring 1.5 x 1.6 x 1.4 cm, not significantly changed.LEFT LOBE: Upper pole predominantly solid, hyperechoic nodule measuring 1.5 x 0.6 x 1.0 cm, previously 1.3 x 0.9 x 0.8 cm, not significantly changed in size allowing for differences in technique. Overall, nodule is of low suspicion for neoplasm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology left cervical lymph node.OTHER: No significant abnormality noted. | No significant change in bilateral thyroid nodules as described above. |
Generate impression based on findings. | Male, 58 years old. Reason: Low urine output, rising creatinine. History of aortic dissection with ? limited blood flow to right kidney History: rising creatinine, oliguria RIGHT KIDNEY: The right kidney measures 10.5 cm, with mildly increased cortical echogenicity. No shadowing calculi or hydronephrosis.LEFT KIDNEY: The left kidney measures 13.6 cm, with mildly increased cortical echogenicity. No shadowing calculi or hydronephrosis.URINARY BLADDER: The bladder is not visualized.OTHER: No significant abnormalities noted. | Increased renal cortical echogenicity compatible with medical renal disease. Asymmetry in renal size with relatively small right kidney which may be related to a limited blood flow from chronic dissection. No hydronephrosis. |
Generate impression based on findings. | Male 51 years old Reason: patient w/ severe right upper quadrant pain, lactic acidosis, eval for acute cholecystitis History: abd pain LIVER: Gallbladder is distended with multiple stones. There is gallbladder wall thickening and pericholecystic fluid. These findings are consistent with acute cholecystitis. Echogenic kidney compatible with fatty infiltration. No evidence of intra or extrahepatic biliary dilatation. | Sonographic findings consistent with cholelithiasis and acute cholecystitis. |
Generate impression based on findings. | 61-year-old male with history of microhematuria and 1.4-cm echogenic renal mass ABDOMEN:LUNG BASES: Subcentimeter nonspecific nodule in image number 5, series number 7 in the left lower lobe. Subsegmental atelectasis in the left lower lobe.Small right sided pleural effusion.LIVER, BILIARY TRACT: Multiple cysts throughout the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple stones within the left kidney, predominantly in the lower pole largest measuring 1.1-cm. No hydronephrosis. No stones in the right kidney. No evidence of ureteral stones.1.3-cm enhancing mass in the lower pole of the right kidney. This mass measures 53 HU on the noncontrast and measures 80 HU on the delayed phase images. This is suspicious for a renal cell carcinoma such as papillary variant. Subcentimeter lesion in the midpole of the right kidney, on image number 48, series number 9 measures 8 mm and demonstrates possibly 30 this enhancement.2.2 x 1.2 cm hypodense lesion in the upper pole of the left kidney likely representing a simple cyst. There are multiple other small hypodense lesions which are too small to adequately characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Mildly enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Left nephrolithiasis.Right lower lobe enhancing lesion suspicious for renal cell carcinoma. Another subcentimeter lesion within the right kidney, too small to accurate characterize but likely demonstrates heterogeneous enhancement.Left renal cyst. Multiple other subcentimeter lesions in both kidneys which are too small to characterize.Multiple hepatic cysts. |
Generate impression based on findings. | 23-year-old female with abdominal wall mass. Patient relates mass occurred after C-section. In the region of palpable abnormality to the left of midline there is a defect in the peritoneum with protrusion of fat and possibly a small portion of bowel loop consistent with hernia. | Anterior abdominal wall hernia. |
Generate impression based on findings. | 55-year-old female patient with history of hyperparathyroidism. Evaluate thyroid nodule size, location, and any abnormal lymph nodes. RIGHT LOBE MEASUREMENTS: 7.2 x 3.1 x 2.2 cm.LEFT LOBE MEASUREMENTS: 4.7 x 1.6 x 1.4 cm.ISTHMUS MEASUREMENTS: 6 mm in thickness.RIGHT LOBE: The right thyroid lobe contains multiple nodules with the largest complex cystic nodule measuring 2.4 x 1.1 x 2.0 cm in the lower pole. Either within or extrathyroidal and posterior to the lower pole there is a 2.2 x 1.7 x 2.5 cm hypoechoic, solid nodule that demonstrates internal vascularity.LEFT LOBE: The left thyroid lobe contains scattered cystic nodules and a dominant 1.8 x 1.1 x 1.4 cm solid nodule with a central cyst.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Either within or extrathyroidal and posterior to the right lower pole there is a 2.2 x 1.7 x 2.5 cm hypoechoic, solid nodule that demonstrates internal vascularity. There is a solid, hypoechoic nodule measuring 0.9 x 1.0 x 1.7 cm medial to the inferior pole of the left thyroid lobe may represent a parathyroid adenoma.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Solid, hypoechoic nodule which is either extrathyroidal and posterior to the right lower pole or within in. If this is extrathyroidal, a parathyroid adenoma is favored; correlate with nuclear medicine scan. If this does not correlate to a parathyroid adenoma on nuclear medicine scan and/or is intrathyroidal in location, then biopsy is recommended for further evaluation.2. Extrathyroid hypoechoic nodule medial to the left lower pole may represent a parathyroid adenoma.3. Bilateral thyroid nodules as described above. |
Generate impression based on findings. | 25-year-old female with glomerular disease. Systemic lupus. Ultrasound guidance was performed for biopsy of right kidney. | Ultrasound guidance. |
Generate impression based on findings. | Reason: history of isthmus nodule, please evaluate for interval change. RIGHT LOBE MEASUREMENTS: 5.1 x 1.3 x 1.5 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.4 x 1.7 cm.ISTHMUS MEASUREMENTS: Up to 0.6 cm in thickness.RIGHT LOBE: Mildly heterogeneous parenchymal echotexture without focal nodules.LEFT LOBE: Mildly heterogeneous parenchymal echotexture without focal nodules.ISTHMUS: Previously biopsied nodule within the right aspect of the isthmus has decreased in size measuring 1.5 x 2.1 x 0.8 cm, previously 2.6 x 1.2 x 3.3 cm. The nodule is predominantly solid with interval decrease in size of the cystic component following the 12/24/2015 biopsy. The nodule demonstrates internal vascularity. No suspicious microcalcifications are identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval decrease in size of previously biopsied isthmic nodule. No new nodules. |
Generate impression based on findings. | Thyroid cancer 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: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy without worrisome mass or regional adenopathy. |
Generate impression based on findings. | RIGHT KIDNEY: Normal parenchymal echogenicity. No worrisome mass or hydronephrosis. Stable subcentimeter stone measuring subcentimeter stone measuring 0.8 x 0.9 x 0.5 cm. Right kidney 15.2 cm. in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended | Stable nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | Hepatitis B LIVER: Mildly coarse echogenic liver echotexture again noted without mass. Liver length 15.1 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 6.3 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10 cm in lengthOTHER: Left kidney 11.1 cm in length. No ascites | Mildly coarse echogenic liver parenchyma consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 69-year-old male with right upper quadrant pain. LIVER: Normal in size, contour and echogenicity. No focal hepatic abnormality.BILIARY TRACT: Biliary tract is normal in caliber. Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Lobulation involving the midportion left kidney without underlying mass. | Normal gallbladder and biliary tract. |
Generate impression based on findings. | Ms. MARY ZERVOS is a 50 years old female with biopsy proven left breast cancer, received neoadjuvant treatment, who presents today for ultrasound reevaluation of the treatment response. On physical examination, no discrete mass was palpated in the left upper inner quadrant. A targeted left ultrasound was performed at the site of biopsy proven cancer in left upper inner breast. The previously identified mass in the left breast at 10:00 location, 3 cm from the nipple has decreased in size and measures 10 x 2 x 4 mm versus 11 x 15 x 10 mm on the prior. This mass demonstrates more tubular and flat appearance with mild internal flow. | Interval decrease in size of the left breast biopsy-proven cancer. Continued follow-up with the surgical clinic for further evaluation is recommended. Results and recommendations were discussed with the patient. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female 56 years old Reason: r/o growth of nodules, adenopathy, or suspicious features. please compare with prior ultrasound History: multiple thyroid nodules. Family history of thyroid cancer. RIGHT LOBE MEASUREMENTS: 2.1 x 1.5 x 5.7 cmLEFT LOBE MEASUREMENTS: 1.9 x 1.5 x 5 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Again noted multiple nodules are predominantly cystic many with evidence for colon, tail artifact which are unchanged from previous exam. Index cystic nodule in the upper pole measures 2.2 x 1.1 x 1.7 cm, slightly enlarged compared to previous study. No evidence of solid component.LEFT LOBE: Again noted multiple nodules again predominantly cystic with possible correlate. Index spongiform nodule in the mid inferior left lobe measures 7 x 4 x 6 mm, not significantly changed compared to previous study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are unchanged.OTHER: No significant abnormality noted. | Stable appearance of the thyroid with multiple nodules, most characteristics of colloid nodules. |
Generate impression based on findings. | Viral hepatitis B LIVER: Mildly coarse liver echotexture. 1.5 x 1.4 x 1.7 cm hypoechoic focus within segment 2 of the left lobe of the liver not appreciated on the prior examination. Well-circumscribed echogenic foci consistent with hemangiomas again noted and unchanged. Liver length 14.1 cm. Limited Doppler interrogation the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Stable multiple gallbladder polyps. The largest again measuring 0.4 x 0.6 x 0.4 cm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.2 cm in lengthOTHER: Left kidney 11.1 cm in length. Spleen 8.6 cm in length. No ascites. | Mildly coarse liver echotexture again noted consistent with chronic liver disease. Segment 2 left lobe hypoechoic lesion not clearly identified on prior examinations. Would recommend dedicated contrast enhanced cross-sectional imaging for further characterization. Benign hemangiomas again noted and unchanged. Stable subcentimeter gallbladder polyps. No ascites. |
Generate impression based on findings. | 46 year old female patient with right upper abdominal discomfort. Evaluate for gallstones. LIVER: The liver measures 15.7 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There is a single gallstone at the gallbladder neck. There is no significant pericholecystic fluid or gallbladder wall thickening. No intra- or extrahepatic biliary ductal dilatation is identified. Sonographic Murphy's sign is negative. The common duct measures 2 mm in diameter.PANCREAS: The pancreas is not visualized secondary to overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.5 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.9 cm in length. No evidence of hydronephrosis.The spleen measures 9.6 cm in length. | Cholelithiasis without sonographic evidence of acute cholecystitis. If clinical concern for cholecystitis continues, a HIDA scan may be considered for further evaluation. |
Generate impression based on findings. | Testicular pain RIGHT TESTIS: 5.2 x 3.3 x 2.3 cm. No intratesticular mass.LEFT TESTIS: 4.4 x 3.6 x 2.5 cm. No intratesticular massRIGHT EPIDIDYMIS: Benign-appearing epididymal head cystLEFT EPIDIDYMIS: Enlarged left epididymis with slight increase in vascularity.OTHER: Moderate size left varicocele. Doppler interrogation demonstrates bilaterally symmetric testicular flow. | Enlarged left epididymis with slight increase in vascularity raises the possibility of epididymitis. No evidence of abscess or testicular involvement. Moderate-sized left varicocele. |
Generate impression based on findings. | 72-year-old male with cervical adenopathy with right anterior immobile mass. In the area of palpable abnormality in the right neck there are adjacent, dense calcifications which appear nodal. Although not grossly abnormal in shape, due to shadowing it is difficult to visualize margination of lymph nodes. These are similar rounded calcifications at level 2 and 3 as well as the right submandibular region.At level 2 on the left there is an area of densely shadowing calcification measuring 0.6 x 1.1 x 0.7 cm. This may represent calcified lymph node although underlying substance is obscured by shadowing calcification.Due to the calcification in lymph nodes, brief exam of the thyroid was performed. In the inferior right lobe there is a spongiform-appearing 0.7 x 0.7 x 0.8 cm nodule | Significant, bilateral neck calcifications likely nodal. Although portions of these regions are secured by shadowing from the calcification. An associated solid mass is not definitely visualized.CT May be preferable to evaluate the above findings. |
Generate impression based on findings. | Cholelithiasis transferred from outside hospital with worsening of right upper quadrant pain. LIVER: The liver is mildly echogenic without a focal lesion. It is normal in size measuring 16.5 cm in craniocaudal dimension.BILIARY TRACT: Cholelithiasis at the gallbladder neck within a distended gallbladder with wall thickening and pericholecystic fluid consistent with acute cholecystitis. Lack of focal tenderness is likely due to pain medication. No intra or extrahepatic biliary ductal dilatation with the common duct measuring 4 mm.PANCREAS: Limited evaluation of the pancreas demonstrates no gross abnormality.SPLEEN: The spleen measures 8.4 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 11.3 cm without hydronephrosis or shadowing nephrolithiasis. OTHER: The left kidney measures 12.5 cm without hydronephrosis or shadowing nephrolithiasis. | Compared to the prior study the gallbladder is now distended with wall thickening and pericholecystic fluid consistent with acute cholecystitis. Lack of focal tenderness is likely due to patient's receipt of pain medication.Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. No focal liver lesion. |
Generate impression based on findings. | 33-year-old male with history of recurrent thyroid cancer with increased thyroglobulin and stable masses in the thyroid beds RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the inferior right bed there is again noted a hypoechoic mass measuring approximately 0.6 x 0.8 x 0.7 cm without significant change from the prior study. Hypoechoic nodule in the more superior bed measures 0.3 x 0.4 x 0.4 cm without interval change. Third hypoechoic focus in the superior, medial right bed measures 0.4 x 0.4 x 0.3 cm without significant change.LEFT LOBE: In the left thyroid bed there is again noted a hypoechoic nodule, measuring 0.3 x 0.5 x 0.4 cm in the inferior bed which is unchanged. Second nodular density with a hyperechoic center consistent with lymph node in the left bed measures 0.4 x 0.6 x 0.9 cm, not definite seen on the prior exam. Third hypoechoic area in the superior bed measures 0.3 x 0.3 x 0.6 cm without change.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable hypoechoic nodules in the thyroid beds. New lymph node left bed which has normal morphology. |
Generate impression based on findings. | Islet transplant LIVER: Unremarkable parenchymal echogenicity without mass. Liver length 15.1 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Main portal vein velocity 23 cm/s.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.9 cm in lengthOTHER: Left kidney 12.5 cm in length. Spleen 13.8 cm in length. No ascites. | No hepatobiliary abnormality. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. No ascites. |
Generate impression based on findings. | Reason: patient w/ etoh history, elevated LFTs, INR, evaluate for cirrhosis History: elevated LFTs LIVER: The liver measures 18.0 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 0.15 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 hepatic duct measures 3 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 9.5 cm in length. RIGHT KIDNEY: Kidney measures 13.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 12.2 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Trace perihepatic ascites. | Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. Trace perihepatic ascites. |
Generate impression based on findings. | Fullness in the left axilla. FNA performed or earlier positive for malignancy in the left breast. A targeted left axillary ultrasound was performed. 3 lymph nodes are seen in the left axilla. The largest and most suspicious of these is located inferiorly and somewhat deep in the axilla and measures 1.5 x 1.8 cm. Normal hilar fat is not seen within this node. There is also an eccentrically thickened lymph node located more superiorly which measures up to 1.7 cm and has mild nonhilar blood flow, also somewhat suspicious. An additional normal morphology lymph node measuring 2.5 cm is seen further superiorly. | One highly suspicious and 1 moderately suspicious left axillary lymph node. The findings were discussed with the patient and Donna Christian. The surgical service will consider ultrasound-guided lymph node biopsy.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male; 65 years old. Reason: elevated LFT History: as above LIVER: The liver measured 13.1 cm in length. The liver contour is smooth, the parenchyma is coarse in echotexture and diffusely increased in echogenicity. No worrisome mass is identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: There is no cholelithiasis or gallbladder wall thickening. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.0 cm in length.RIGHT KIDNEY: Right kidney measures 10.0 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. No worrisome renal mass is identified. OTHER: The left kidney measures 11.1 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. No worrisome renal mass is identified. | Echogenic liver compatible with hepatic steatosis. |
Generate impression based on findings. | 45-year-old male with AML now with neutropenic fever, bacteremia, and elevated bilirubin. LIVER: The liver measures 18.5 cm in length. The parenchyma is moderately echogenic. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is contracted without evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. 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: The spleen measures 17 cm in length. RIGHT KIDNEY: Kidney measures 10.8 cm in length. The cortex is mildly echogenic. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.9 cm in length. The cortex is mildly echogenic. No hydronephrosis, shadowing calculus or mass. A simple cyst is present in the mid pole measuring 1.2 x 1.0 x 0.9 cm.OTHER: No significant abnormalities noted. | 1.Echogenic liver suggestive of fatty infiltration.2.Splenomegaly. |
Generate impression based on findings. | 52-year-old male with history of thrombocytopenia, hemolysis. Evaluate the spleen. Grayscale and color ultrasound demonstrates splenomegaly, with the spleen measuring up to 17.6 cm in diameter, without gross interval change compared with the recent study from 8/11/2015. Bilateral pleural effusions are also visualized. | Splenomegaly and bilateral pleural effusions. |
Generate impression based on findings. | Female 30 years old; Reason: r/o adenopathy, recurrence History: h//o thyroid cancer The patient is status post total thyroidectomy.POSTOPERATIVE BED: No suspicious lesions of recurrence are seen within the postoperative bed.LYMPH NODES: No suspicious adenopathy noted. OTHER: Parathyroids are not visualized. | Negative thyroid ultrasound status post total thyroidectomy. No areas suspicious for recurrence and no suspicious adenopathy. |
Generate impression based on findings. | Two palpable areas of concern in the right breast. Previous left mastectomy for malignant phyllodes tumor. A targeted right ultrasound was performed for the 2 areas marked by the clinical service. At the more superior area marked by the service, multiple cysts are seen. A larger septated cyst measures 6 x 5 mm. A smaller adjacent cyst measures 3 mm. No internal vascularity is seen within the cysts. At the area marked by the clinical service closer to the nipple, a 9 x 9 mm hypoechoic mass with mild internal vascularity is seen. This is more consistent with a solid mass rather than a complicated cyst. | 1. Right breast mass at the area closer to the nipple marked by the service measuring 9 mm is more consistent with a solid mass rather than a complicated cyst.2. Cysts are present at the more superior area marked by the clinical service.The patient is being seen today in surgery clinic, where palpably guided FNA will be considered. The solid mass would also be amenable to ultrasound-guided biopsy if clinically indicated.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 71-year-old female with history of edema, back pain. Evaluate for intrinsic kidney disease, cysts. RIGHT KIDNEY: Measures 12.0 cm in length. Unremarkable echogenicity without hydronephrosis, nephrolithiasis, or solid mass. 0.6 x 0.5 cm right superior pole cyst without septation or solid component.LEFT KIDNEY: Measures 9.7 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. Left inferior pole cyst measures 1.3 x 1.2 cm without septation or solid componentURINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | No nephrolithiasis, hydronephrosis, or suspicious mass. |
Generate impression based on findings. | Female 45 years old; Reason: r/o growth of nodules, adenopathy, worrisome characteristics History: multinodular goiter RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 3.4 x 3.0 x 6.9 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 2.7 x 3.1 x 7.2 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.7 cm.RIGHT LOBE: There are 3 nodules located within the right lobe which appear heterogeneous and iso to slightly hyperechoic with a hypoechoic rim. The first is located superiorly and measures 3.1 cm x 2.7 cm x 3.4 cm., Increased slightly in size. The second is located in the midportion of the right lobe and measures 2.6 cm x 2.5 cm x 2.2 cm., without changeThe third is located inferiorly and measures 2.2 cm x 1.9 cm x 2 cm., Without significant change.LEFT LOBE: There are 2 nodules located within the left lobe. The first is located superiorly and measures 2.4 cm x 1.9 cm 3.1 cm. ,without change.The second nodule is located superiorly and posteriorly, and measures 1.7 cm x 1.4 cm x 1.4 cm. Although not measured on the prior study, this was present and likely is unchanged.Additionally, a round poorly visualized hypoechoic mass is seen inferior to the left thyroid measuring 3.7 cm x 4.0 cm x 3.1 cm. This may extend below the clavicle, and although this wasn't seen on prior the study, it was visualized in the 2013 ultrasound.ISTHMUS: There is a heterogeneous nodule located within the isthmus and measures 2.2 cm x 1.9 cm x 2.1 cm.LYMPH NODES: No suspicious adenopathy noted. | 1.Multinodular goiter as seen on prior ultrasound. The majority of the nodules, as described above, appear to be relatively stable in size. No suspicious adenopathy is seen.2.There is a poorly visualized hypoechoic nodule seen inferior to left thyroid that may extend below the clavicles. Further cross-sectional imaging can be considered if indicated. This was also not well visualized on the prior study but was present on the prior 2013 ultrasound. |
Generate impression based on findings. | Right upper quadrant pain. Fever. LIVER: Non-cirrhotic liver morphology. 17 cm in length. Mildly increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladder. No gallstones identified. PANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney is 11.4 cm in length. The left kidney is 12.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 14.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | 1. Increased hepatic echogenicity, compatible with parenchymal dysfunction.2. Mild splenomegaly. |
Generate impression based on findings. | Right upper quadrant abdominal pain LIVER: No significant abnormalities noted. Liver length 12.6 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.2 cm in lengthOTHER: Left kidney 11 cm in length. Spleen 8.9 cm in length. No ascites. | Negative right upper quadrant ultrasound. No hepatobiliary abnormality. |
Generate impression based on findings. | Status post liver transplant with worsening liver enzymes LIMITED ABDOMENLIVER: Status post liver transplant. No intrahepatic mass. 10 x 6 x 8.4 cm heterogeneous perihepatic mass lesion posteriorly.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.OTHER: Trace ascites | Perihepatic mass consistent with hematoma. Patent hepatic vessels. Trace ascites. |
Generate impression based on findings. | 23-year-old female undergoing renal biopsy. Ultrasound guidance provided for biopsy of left kidney. | Ultrasound guidance for renal biopsy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Prior history of right ureteral stone RIGHT KIDNEY: Interval resolution of previously noted mild right hydronephrosis. No evidence for worrisome mass or stone. Right kidney 10.5 cm in lengthLEFT KIDNEY: No mass, stone, or hydronephrosis. 10.5 cm in lengthOTHER: Bladder nondistended | Interval resolution of previously noted mild right hydronephrosis. No evidence for worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | Female 64 years old Reason: assess for liver lesions History: HCV with SVR; cirrhosis LIVER: Hyperechoic coarse appearance of the liver is again seen. Nodularities consistent with cirrhosis. No focal hepatic lesion is seen. Main portal vein is patent with normal directional flow and a peak velocity of 22.9 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 4 mm. Gallbladder is normal in appearance. No gallstones.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are scattered by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 7.2 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. In the right kidney there is a anechoic cyst measuring 2.3 x 1.4 x 2.2 cm. Within the left kidney there is a small cyst measuring 1.4 x 1.1 x 1.4 cm.OTHER: No significant abnormalities noted. | Cirrhotic morphology of the liver without focal hepatic lesion. |
Generate impression based on findings. | 64 year-old female with abdominal pain. Evaluate for pancreatitis, cholelithiasis/common bile duct dilatation/obstruction. LIVER: Increased echogenicity of the liver measuring 13.3 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extra hepatic biliary ductal dilatation. Common bile measures 6 mm in caliber.PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Increased echogenicity of the right kidney measuring 10.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Increased echogenicity of the left kidney measuring 9.1 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 8.97 m in length. | 1. Increased echogenicity of the liver suggestive of fatty infiltration. 2. Increased echogenicity of the kidneys suggestive of cortical dysfunction.3. No evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 50-year-old female with multinodular goiter. Evaluate for stability. RIGHT LOBE MEASUREMENTS: 6.2 x 2.4 x 2.2 cmLEFT LOBE MEASUREMENTS: 6.2 x 2.9 x 2.1 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple nodules again identified. The majority of these nodules have a spongiform or cystic appearance consistent with colloid. Selected for measurement are a nodule in the midportion of the right lobe measuring 0.7 x 1.2 x 1.1 cm, unchanged from the prior study. On the prior exam this had a classic spongiform appearance and on today's study has some increased peripheral soft tissue which may be due to interval hemorrhage. Poorly defined, predominantly solid area of nodularity in the inferior right lobe is incompletely visualized due to substernal extension, but appears smaller, measuring approximately 1.3 x 1.6 x 2.3 cm. Other areas are unchangedLEFT LOBE: Colloid nodule in the upper pole is stable in size and appearance. Larger nodule in the mid upper pole measures 1.5 x 2.6 x 2.7 cm, slightly increased in the interim. This appears somewhat less spongiform than on the prior study with larger internal cystic components. Again, this may be due to interval hemorrhage. Predominantly solid nodule in the medial, midportion of the left lobe measures 1.4 x 1.5 x 2 cm, increased in size in the interim. Inferior, poorly defined nodule which is predominantly solid with a cystic component measures 1 x 1.3 x 1.6 cm without significant change. This is incompletely visualized, extending into a substernal location. Other areas are unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter there is been an increase in a predominant solid nodule in the medial, midportion of the left lobe. Other nodules are stable although with some change in appearance which may be due to interval hemorrhage. |
Generate impression based on findings. | Primary hyperparathyroidism; assess for nephrolithiasis RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 12.4 cm in length.LEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 12.2 cm in length.OTHER: Bladder nondistended. Incidental note made of echogenic liver parenchyma. | Negative renal ultrasound without evidence for mass, stone, or hydronephrosis. Incidental note made of echogenic liver parenchyma suggestive for hepatic fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | 60 year-old male with history of cardiomyopathy, requires baseline exam for heart transplant. LIVER: The liver measures approximately 15.3 cm in length. No focal liver lesions or intrahepatic biliary dilatation.GALLBLADDER, BILIARY TRACT: Cholelithiasis, without findings of cholecystitis.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted.KIDNEYS: Right kidney measures approximately 10 cm. Normal echogenicity, and there is no hydronephrosis. Left kidney measures approximately 10.5 cm. Simple left renal cyst measures approximately 3.7 x 2.7 cm, unchanged.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Limited visualization of the bladder is within normal limits. | Cholelithiasis, without cholecystitis. Otherwise, no significant abnormality. |
Generate impression based on findings. | Sepsis, elevated LFTs, and right upper quadrant pain. Acute renal failure LIVER:Mildly heterogeneous echotexture without mass. Liver length 18.2 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge and stones without obvious acute inflammation. No ductal dilatation.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. 12.8 cm in lengthKIDNEYS: Mild left hydronephrosis and hydroureter. The inferior most aspect of the left hydroureter cannot be determined due to overlying gas within the pelvis.Echogenic renal parenchyma bilaterally. Bilateral renal cysts. Right kidney 12.4 cm in length. Left kidney 12.3 cm in length. ABDOMINAL AORTA: Mild aneurysmal dilatation of distal abdominal aorta with maximal diameter of 2.2 cm. Mild bilateral common iliac aneurysmal dilatation of approximately 1.4 cm in diameter.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Trace ascites. Left pleural effusion Marked diffuse thickening of the bladder wall. Foley catheter within bladder. | Mild hepatomegaly associated with mildly heterogeneous echotexture suggestive for parenchymal dysfunction without hepatic mass or ductal dilatation. Gallbladder sludge and stones without acute inflammation. Trace ascites. Left pleural effusion.Marked diffuse thickening of the bladder wall suggestive for either chronic inflammation or outlet obstruction. Associated with mild left hydronephrosis and hydroureter. The distal most aspect of the left hydroureter cannot be determined due to overlying gas in the pelvis. Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunctionMild aneurysmal dilatation of the abdominal aorta and common iliac arteries. |
Generate impression based on findings. | Transaminitis with fibrosis noted at OSH, evaluate for liver disease. LIVER: The liver measures 12.1 cm in length and is nodular in contour. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating somewhat pulsatile hepatopetal flow with a velocity of 0.25 m/s.BILIARY TRACT: Cholelithiasis without significant 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 2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 8.5 cm in length. RIGHT KIDNEY: Kidney measures 9.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 9.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: Bilateral pleural effusions. | 1.Findings suggestive of chronic liver disease without focal lesions identified.2.Cholelithiasis without secondary evidence of acute cholecystitis.3.Bilateral pleural effusions. |
Generate impression based on findings. | 33-year-old female with abdominal pain. Unclear history of kidney stones. RIGHT KIDNEY: The right kidney measures 13.9 cm in length with no hydronephrosis, shadowing calculus or discrete lesion evident. Note is made of a prominent column of Bertin, symmetric bilaterally. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 13.4 cm in length with no hydronephrosis or shadowing calculus. There is a 1.4 x 1.2 x 0.8 cm hyperechoic, interpolar cortical lesion without significant associated shadowing.Note is made of a prominent column of Bertin, symmetric bilaterally. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is normally distended with anechoic urine.OTHER: No significant abnormalities noted. | 1. No hydronephrosis or shadowing nephrolithiasis. 2. Nonspecific 1.4-cm left interpolar hyperechoic lesion could represent an angiomyolipoma or fat. CT could help further characterize this lesion. |
Generate impression based on findings. | 7-year-old female with history of solitary right kidney and hydronephrosis BLADDER Wall Thickness: The bladder is incompletely distended, but appears upper limits of normal in thickness. Contents: Incompletely distended. Distal Ureter -- SFU Grade** Right: 0 Ureteral Jets Right: Not observed KIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Corticomedullary differentiation is normal in all but the posterolateral right lower pole Pelvicaliceal System -- SFU Grade* Right: 1 Length*** Right: 7.6 cm Mean for age: 8 cm Range for age: 7 - 9 cmADDITIONAL OBSERVATIONS: None | Solitary right kidney with grade 1 dilation. Persistent focal cystic dysplasia or segmental multicystic dysplasia in the lower pole.*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. | 68-year-old male with rising creatinine Technical assistance provided for ultrasound-guided renal biopsy by the nephrology service. Two passes were performed. | Technical assistance provided for renal biopsy. |
Generate impression based on findings. | 81-year-old female patient with pain in right flank. Evaluate for abdominal mass. LIVER: The liver measures 14.9 cm in length. There is a 1.3 x 1.5 x 1.1 cm hyperechoic lesion within the right hepatic lobe which likely represents a hemangioma, seen on prior CT study. Hepatic parenchymal echogenicity is increased. Main portal vein flow is hepatopetal and measures 0.3 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 3 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 10.4 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.8 cm in length. No evidence of hydronephrosis.The spleen measures 6.4 cm in length. | 1. Increased hepatic parenchymal echogenicity which can be seen with hepatic steatosis/hepatic parenchymal dysfunction.2. Right hepatic lobe hemangioma, seen on prior CT. |
Generate impression based on findings. | Post liver transplant, evaluate all vessels for patency LIVER: Increased parenchymal echogenicity suggested, nonspecific but may reflect underlying parenchymal dysfunction/steatosis. Hepatomegaly, liver measures up to 20 cm in craniocaudal dimension.GALLBLADDER, BILIARY TRACT: Not well assessed.PANCREAS: Not well seen.SPLEEN: Visualized splenic artery (artery not well seen due to patient's inability to sustain respiration) and vein patent.KIDNEYS: Not well seen.VASCULAR | Right portal and hepatic veins not well visualized. Power Doppler sonography needed to be utilized for evaluation of vasculature, may be related in part to slow flow. Visualized hepatic vasculature patent otherwise.Partially imaged right-sided pleural effusion and ovoid fluid collection related to left liver anteriorly.Additional findings as above. |
Generate impression based on findings. | 68-year-old male with hepatitis C presenting for hepatocellular carcinoma screening. LIVER: The hepatic parenchyma is mildly coarse and the liver capsule is nodular consistent with cirrhosis. No focal lesion is identified. The liver measures 15 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct measures 6 mm in caliber, within normal limits. Status post cholecystectomy.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 11.7 cm.RIGHT KIDNEY: The right kidney measures 13.9 cm in length without hydronephrosis or shadowing calculus. There is a 1.4-cm hypoechoic lower pole lesion, characterized as a simple cyst on the prior MRI. Color Doppler demonstrates hilar blood flow.OTHER: Status post left nephrectomy. | Cirrhotic liver morphology without a discrete hepatic lesion. |
Generate impression based on findings. | 34-year-old male with a history of hepatitis C. Screening for clinical trial. LIVER: Note is made of a coarse liver echotexture. No focal mass lesions identified. The liver contour is smooth. The portal vein flow is hepatopetal. The liver measures 15.1 cm in length.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Coarsened liver echotexture consistent with the known history of chronic liver disease. No focal masslesion identified. |
Generate impression based on findings. | On 56-year-old female with history of significant EtOH, hepatomegaly and abdominal pain, evaluate liver and for gallstones LIVER: Liver measures 14 cm with mild to moderate increased echogenicity consistent with hepatic steatosis. No focal lesions noted. No evidence of cirrhosis. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Common bile duct measures 3 mm within normal limits. Gallbladder is well-distended with normal gallbladder wall thickness. No focal lesions or stones noted. No pericholecystic fluid.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen measures 7.6 cm without any focal lesions.RIGHT KIDNEY: Right kidney measures 10.1 cm left kidney measures 10.3 cm. Normal echotexture noted. No focal lesions. No hydronephrosis. OTHER: No significant abnormalities noted. | Mild to moderate hepatic steatosis.No evidence of cholecystitis or cholelithiasis. |
Generate impression based on findings. | Evaluate for malignancy, worsening portal hypertension, 52-year-old male with hereditary hemachromatosis related cirrhosis LIVER: Liver measures 19.1 cm with nodular contour and increased coarse echogenicity consistent with cirrhotic morphology. Main portal vein is patent with normal flow directionality. No intra or extrahepatic ductal dilatation.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures up to 6 mm.PANCREAS: The liver parenchyma was not visualized due to overlying bowel gas. Body appears unremarkable. A lymph node in the ectatic head now measures 4.4 x 2.9 x 2.6 cm, previously measured 5.3 cm, reduced in size.Spleen and KIDNEY: Right kidney measures 12.6 cm and left kidney measures 13.3 cm. Normal echo texture. No focal lesions. A simple cyst noted in the left kidney that measures 0.9 x 0.9 x 1.4 cm.No hydronephrosisSpleen measures 16.7 cm, mildly centimeters without any focal lesion.OTHER: No ascites | Cervical morphology of the liver without any focal lesion. No ascites. Interval reduction in size of the lymph node seen in the pancreatic head, now measures 4.4 cmMild splenomegaly noted. |
Generate impression based on findings. | 42 year-old male with nephrotic range proteinuria. Ultrasound guided renal biopsy. Ultrasound guidance was provided to the clinical service. 5 passes were performed by the clinical service. On the final post procedural images, note is made of a small hematoma along the superior margin of the left kidney, measuring approximately 2.5 cm in diameter. Correlation with the procedural report is recommended. | Ultrasound guidance was provided to the clinical service for biopsy of the left kidney. Small postprocedural perinephric hematoma seen. |
Generate impression based on findings. | Hepatitis C LIVER: Coarse echogenic liver without mass. Liver length 14.9 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation. Mild bilobar intrahepatic as well as mild extrahepatic biliary dilatation. Maximal CBD diameter 0.9 cm. The distal bile duct cannot be assessed due to overlying gas.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. 9.6 cm in length.OTHER: Echogenic focus within the spleen; favor benign etiology such as hemangioma. Spleen length 10.2 cm. Left kidney 10.6 cm in length. Left renal cyst. No ascites. | Echogenic liver parenchyma consistent with chronic liver disease without mass lesion. Gallbladder sludge without acute inflammation. Mild bilobar intrahepatic and mild extra hepatic biliary dilatation. The distal bile duct cannot be assessed due to overlying gas and a distal obstructing lesion cannot be excluded on this study. Would recommend correlation with CT or M.R.C.P. No ascites. |
Generate impression based on findings. | 60 year old female who was recalled from screening mammogram for Right breast mass. Mammogram: Three full-field views 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, unchanged in pattern and distribution. 1 cm lobulated mass in question disperses into normal breast tissue in the right breast 12 o'clock position. On full-field views, the lesion in question could not be redemonstrated and could represent part of glandular tissue.Ultrasound: Targeted right breast ultrasound was performed. No suspicious cystic or solid mass was noted. | 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. | Reason: Evaluate biliary tree History: abdominal pain, nausea, h/o cholecystectomy BILIARY TRACT: Status post cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter. | Limited examination. No biliary ductal dilatation. |