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Generate impression based on findings. | Female 23 years old Reason: evaluate for appendicitis History: RLQ abdominal pain The appendix was not visualized. An intrauterine pregnancy was visualized on a single image. | 1.Appendix not visualized. |
Generate impression based on findings. | 27 year old female patient with SBP. Evaluate ascites status post aspiration. There is mild to moderate ascites, decreased in comparison to recent CT accounting for differences in modality. There is splenomegaly and an accessory splenule. | Decreased mild to moderate ascites. |
Generate impression based on findings. | 21 year old female with known bilateral fibroadenomas presents for follow up ultrasound of right breast. Ultrasound was performed for the known masses at two o'clock position and 6 o'clock position. At two o'clock position, fourth and technique judged from nipple, there is a oval hypoechoic mass measuring 19 x 6 x 16 mm (previous measurement: 17 x 5 x 17 mm). At 6 o'clock position, 2 cm from the nipple, there is a oval hypoechoic mass measuring 11 x 5 x 10 mm (previous measurement: 15 x 5 x 10 mm). There is no significant change in its appearance in both masses. | Benign masses at two o'clock position and 6 o'clock position in the right breast. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Nephrotic range proteinuria RIGHT KIDNEY: 13.1 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 14.0 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: No significant abnormality noted.OTHER: Left pleural effusion, partially imaged. | Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | Chronic kidney disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 8.7 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11 cm in lengthOTHER: Bladder nondistended | Echogenic parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | 59-year-old female for follow-up of thyroid nodules RIGHT LOBE MEASUREMENTS: 5.7 x 1.7 x 2 cmLEFT LOBE MEASUREMENTS: 5.7 x 1.7 x 2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Right lobe is diffusely heterogeneous. There is again noted a right mid thyroid nodule which is difficult to measure. This is hypoechoic and not well marginated. When attempting to measure as per prior exam this nodule measures 0.5 x 1.1 by 0.8 cm.LEFT LOBE: Left lobe is diffusely heterogeneous. A left mid thyroid nodule abutting the isthmus measures 2 x 1.5 x 0.7 cm without change. This nodule appears somewhat spongiform.Left lower lobe isoechoic nodule with a hypoechoic rim measures 1.1 x 0.7 x 0.8 cm without significant change.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable appearance the thyroid. No change in size of bilateral thyroid nodules. |
Generate impression based on findings. | Reason: increased FDG activity within the right thyroid lobe on PET/CT RIGHT LOBE MEASUREMENTS: 6.2 x 2.8 x 1.9 cm.LEFT LOBE MEASUREMENTS: 4.7 x 1.9 x 1.1 cm.ISTHMUS MEASUREMENTS: Up to 0.8 cm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echotexture. Midpole nodule measuring 2.7 x 1.4 x 1.9 cm which is predominantly solid, isoechoic to the thyroid gland, demonstrates mild internal vascularity, has a hypoechoic halo, and lacks suspicious microcalcifications. Overall, this nodule is of intermediate suspicion for neoplasm.LEFT LOBE: Mildly heterogeneous parenchymal echotexture including a couple subcentimeter hypoechoic nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Dominant nodule within the right thyroid gland corresponding to increased uptake on recent PET scan is of intermediate suspicion for neoplasm and would be amenable to fine-needle aspiration. |
Generate impression based on findings. | Reason: Evaluate for hydronephrosis History: acute kidney injury RIGHT KIDNEY: The right kidney measures 11.0 cm in length. Unremarkable renal parenchymal echogenicity. No shadowing renal calculi or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.3 cm in length. Unremarkable renal parenchymal echogenicity. Mild left hydronephrosis without evidence of obstructing lesion. No shadowing renal calculi. The proximal and distal portions of the nephroureteral stent are visualized in the left renal pelvis and bladder.OTHER: The bladder is poorly distended, limiting its evaluation. | Mild left hydronephrosis without evidence of obstructing lesion. |
Generate impression based on findings. | History melanoma with radiation exposure as a child. RIGHT LOBE MEASUREMENTS: 5.4 x 2.4 x 1.7 cmLEFT LOBE MEASUREMENTS: 7.2 x 4.2 x 3.2 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: 2.4 x 1.8 x 1.3 cm predominantly solid nodule with rim and possible internal calcifications and somewhat irregular borders.LEFT LOBE: 4.5 x 3.5 x 3.2 cm predominantly solid nodule occupying much of the left thyroid gland.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral dominant indeterminate thyroid nodules; both nodules are amenable to ultrasound-guided FNA biopsy. No regional adenopathy. |
Generate impression based on findings. | Right breast mass 12:00 position with interval enlargement, biopsy recommended on 4/19/2016, patient refused and ultrasound-guided biopsy, now presents for a 3 month follow-up examination. Targeted right breast ultrasound was performed. Previously documented hypoechoic mass has minimally increased in size and now measures 2.3 x 1.4 x 1.6 cm, previously measured 2 x 1.4 x 1.4 cm. | Indeterminate right breast mass with interval increase in size, further evaluation with ultrasound-guided core biopsy is recommended. Findings and recommendations were discussed with the patient in detail.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 56-year-old male with AKI. RIGHT KIDNEY: The right kidney measures 11.4 cm in length. Mild parenchymal hyperechogenicity. No evidence of renal stone, mass, or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.6 cm in length. Mild parenchymal hyperechogenicity. No evidence of renal stone, mass, or hydronephrosis.OTHER: Foley catheter in the bladder. Bladder is decompressed, limiting evaluation. Splenule. | Mild bilateral parenchymal hyperechogenicity suggestive of medical renal disease. No hydronephrosis. |
Generate impression based on findings. | 33 years old, Male, Reason: Vascularity to transplanted pancreas History: Hyperglycemia post op PANCREAS TRANSPLANT: Transplant pancreas is identified in the right lower quadrant of the abdomen. Pancreas demonstrates homogeneous echotexture. Vascular flow is evident within the parenchyma of the pancreas itself.PERITRANSPLANT TISSUES: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels. The SMA portion of the arterial graft demonstrates arterial waveforms with resistive index of 0.7 and a peak systolic velocity of 0.2 m/sec. Peak systolic velocity of the right internal iliac artery are 0.6 m/sec with a resistive index of 1.0. | Normal echotexture of the transplanted pancreas without evidence of vascular stenosis or thrombosis. |
Generate impression based on findings. | 86-year-old female with hematuria. RIGHT KIDNEY: The right kidney measures approximately 9.4 cm. There are several anechoic round areas with posterior acoustic enhancement, consistent with renal cyst. These measure approximately 1.6 x 1.8 x 2.1 cm in the midpole, 1.3 x 1.8 x 1.5 cm in the upper pole, and 1.5 x 1.3 x 1.4 cm in the midpole. There is increased echogenicity of the cortex and the kidney appears atrophic. No evidence of hydronephrosis, worrisome mass, or shadowing calculi.LEFT KIDNEY: The left kidney measures approximately 9.2 cm. The cortex has increased echogenicity and the kidney appears atrophic. No evidence of hydronephrosis, mass, or shadowing foci.URINARY BLADDER: The bladder is nondistended.OTHER: No significant abnormalities noted. | 1. Right-sided simple renal cysts as above. No worrisome mass, hydronephrosis, or stones.2. Echogenic and atrophic kidneys consistent with medical renal disease/parenchymal dysfunction. |
Generate impression based on findings. | Reason: evaluate right thyroid nodule History: right thyroid nodule, benign RIGHT LOBE MEASUREMENTS: 6.4 x 3.0 x 2.2 cm.LEFT LOBE MEASUREMENTS: 6.1 x 2.1 x 1.3 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture. Mixed cystic, predominantly solid nodule involving the mid to lower pole measures 4.4 x 1.9 x 2.9 cm, not significant changed in size. Mild internal blood flow. No suspicious microcalcifications.LEFT LOBE: Mildly heterogeneous background parenchymal echotexture. No dominant left thyroid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology left level 2 cervical lymph node.OTHER: No significant abnormality noted. | Dominant right thyroid nodule measuring up to 4.4 cm, not significantly changed in size. |
Generate impression based on findings. | 38-year-old female patient with history of thyroid nodules. RIGHT LOBE MEASUREMENTS: 5.4 x 1.4 x 1.5 cmLEFT LOBE MEASUREMENTS: 4.4 x 1.2 x 1.5 cmISTHMUS MEASUREMENTS: 6 mm in thicknessRIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity without dominant thyroid lesion. The gland is hypervascular on color Doppler imaging, unchanged.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity without dominant thyroid lesion. The gland is hypervascular on color Doppler imaging, unchanged. ISTHMUS: There is a ovoid, solid hypoechoic nodule within the right isthmus measuring 0.6 x 0.4 x 1.1 cm, previously 0.7 x 0.5 x 0.2 cm. An additional solid hypoechoic nodule within the left isthmus measures 0.4 x 0.2 x 0.2 cm, previously 0.6 x 0.5 x 0.3 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a 1.3 cm right level 3/4 lymph node. There is a 0.4 x 0.4 x 0.8 cm lymph node inferior to the left thyroid lobe and left level II lymph node.OTHER: No significant abnormality noted. | 1. Two solid hypoechoic nodules within the isthmus. 2. Hypervascular thyroid gland, which is unchanged; correlate with history of thyroiditis. |
Generate impression based on findings. | 55-year-old female patient with history of left thyroid cyst status post aspiration. RIGHT LOBE MEASUREMENTS: 1.7 x 1.3 x 5.2 cm.LEFT LOBE MEASUREMENTS: 2.2 x 1.9 x 5.6 cm.ISTHMUS MEASUREMENTS: 1 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity containing a spongiform-appearing nodule in the upper pole measuring 0.7 x 0.4 x 0.5 cm, previously 0.7 x 0.4 x 0.4 cm. Additional subcentimeter cystic nodules are again noted.LEFT LOBE: There is a 3.5 x 1.5 x 2.1 cm cystic nodule with a peripheral solid nodular component within the left lobe, which corresponds to a previously aspirated benign colloid nodule. Prior to near complete cyst aspiration, it measured approximately 3.7 x 2.0 x 2.6 cm. An additional smaller cystic nodule is also noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Reaccumulation of fluid within a previously aspirated benign cystic left thyroid nodule.2. Stable right upper pole thyroid nodule. |
Generate impression based on findings. | 59-year-old male with abnormal liver function. LIVER: Liver is enlarged, measuring at least 24 cm in length and demonstrates significant and mildly heterogeneous increased attenuation due to fatty infiltration. There are areas of focal sparing about the gallbladder fossa. There is no focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Small amount of dependent sludge in the gallbladder. No gallstones or wall thickening. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Left kidney and spleen appear unremarkable. | Irregular fatty infiltration of the liver with hepatomegaly. |
Generate impression based on findings. | 48 years old, Male, Reason: Right Testicular pain History: Right testicular pain. Concern for epidydimitis RIGHT TESTIS: Echotexture of the right testicle is within normal limits. Arterial and venous color Doppler are within normal limits.LEFT TESTIS: Echogenicity and vascular flow in the left testicle is within normal limits.RIGHT EPIDIDYMIS: Right epididymis is not enlarged or hyperemic.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: 1 cm benign appearing lymph node in the right inguinal area. | Normal ultrasound examination of the testicles. No specific finding to account for patient's pain. |
Generate impression based on findings. | 61-year-old male history of alcoholism presents with abdominal pain and hematemesis. LIVER:The liver measures 17.5 cm. There is increased, coarse, heterogeneous echotexture of the liver parenchyma. No masses, ascites, or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder wall measures 0.2 cm, negative sonographic Murphy sign, no pericholecystic fluid, no stones or sludge. The common bile duct was not well seen on the study.PANCREAS: Evaluation the pancreas is limited by overlying bowel gas.SPLEEN: The spleen measures 7.5 cm without sonographic abnormalities.KIDNEYS: The right kidney measures 10.6 cm. The cortex has normal echogenicity. No shadowing calculi, mass, or hydronephrosis. Left kidney measures proximal 0.4 cm. The cortex has normal echogenicity. No shadowing calculi, mass, or hydronephrosis. OTHER: No significant abnormality noted. | 1. Increased, coarse, and heterogeneous echotexture of the liver consistent with chronic liver disease/parenchymal dysfunction. No mass or ascites. |
Generate impression based on findings. | Male 52 years old Reason: r/o thrombus History: elevated SCr ULTRASOUND KIDNEYSRIGHT ILIAC FOSSA KIDNEY: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass.OTHER: Fluid collection on the subcutaneous tissues measures 11.1 x 1.9 x 4.1 cm the width mildly complex fluid and no vascular flow. | 1.Patent right iliac fossa renal transplant vasculature without evidence of inflow or outflow compromise.2.Fluid in the subcutaneous soft tissues, which may represent a postoperative seroma. |
Generate impression based on findings. | 55 year old female with multiple right breast masses and right axillary adenopathy who was recalled from interpretation of outside examination for left breast asymmetry. History of ovarian cancer in sister diagnosed at age 45. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: A ML view and 3 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, unchanged in pattern and distribution. There is redemonstration of a 1 cm mass in the the medial central left breast, which persists on compression imaging.LEFT BREAST ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. At the 9 o'clock position of the left breast, 3 cm from the nipple, there is a benign morphology intramammary lymph node measuring 0.7 cm, with normal color flow, corresponding to the finding on mammogram. At the 3 o'clock position of the left breast, 4 cm from the nipple, there is a 0.4 x 0.4 x 0.2 cm hypoechoic mass with ill-defined margins. | Ill-defined hypoechoic 0.4 cm mass at the 3 o'clock position of the left breast. While this may represent benign lesion, fine-needle aspiration with possible ultrasound guided core needle biopsy is recommended for definitive histologic diagnosis. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Female, 26 years old. Six months pregnant with twins. Back pain. RIGHT KIDNEY: The right kidney measures 12.6 cm in length, with normal cortical echotexture. Moderate hydronephrosis, without obstructing stone identified.LEFT KIDNEY: The left kidney measures 13.7 cm in length, with normal cortical echotexture. Moderate hydronephrosis, without obstructing stone identified.OTHER: Visualized portions of the urinary bladder unremarkable. | Moderate bilateral hydronephrosis, which may be physiologic. |
Generate impression based on findings. | 42-year-old female patient with medications, tremors. Evaluate for thyroid nodules or increased vascularity. RIGHT LOBE MEASUREMENTS: 7.1 x 2.6 x 1.9 cm.LEFT LOBE MEASUREMENTS: 6.6 x 2.4 x 1.5 cm.ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity and contains a complex cystic nodule within the right upper pole measuring 0.6 x 0.5 x 0.8 cm. Vascularity on color Doppler imaging is within normal limits.LEFT LOBE: The left thyroid lobe is homogeneous in echogenicity without dominant lesion. Vascularity on color Doppler imaging is within normal limits.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Thyromegaly without dominant thyroid nodule identified. |
Generate impression based on findings. | Weight loss nausea and abnormal LFTs and renal function LIVER: Coarse echogenic liver echotexture without mass. Liver length 15 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without mass, stone, hydronephrosis. 12.8 cm in length.OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 14.1 cm in length. Spleen 15.2 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Cholelithiasis without acute inflammation.Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | 64-year-old female with a history of cirrhosis. Evaluate for HCC. LIVER: Coarse echotexture and nodular morphology compatible with cirrhosis. The liver is mildly shrunken, measuring 13.8 cm in craniocaudal dimension. No focal hepatic lesion is identified. No intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 4 mm. Cholelithiasis within a normally distended gallbladder. Mild gallbladder wall thickening is nonspecific in the setting of ascites. No focal tenderness.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.RIGHT KIDNEY: The right kidney is normal in size, measuring 9.8 cm without hydronephrosis, shadowing nephrolithiasis, or discrete lesion. The cortex is echogenic.OTHER: The spleen is normal in size, measuring 11.4 cm.The left kidney measures 10 cm without hydronephrosis, shadowing nephrolithiasis, or discrete lesion. The cortex is echogenic.Small volume ascites. | 1. Cirrhosis without discrete hepatic lesion or biliary duct dilatation. Small volume ascites.2. Cholelithiasis without specific evidence of acute cholecystitis. 3. Medical renal disease. |
Generate impression based on findings. | History of Hashimoto's thyroiditis. Choking sensation. RIGHT LOBE MEASUREMENTS: 5.2 x 1.7 x 1.5 cm, mildly enlarged in size.LEFT LOBE MEASUREMENTS: 5.5 x 1.6 x 1.6 cm, mildly enlarged in size.ISTHMUS MEASUREMENTS: 3 mm in AP dimension.RIGHT LOBE: The thyroid gland is diffusely heterogeneous without discrete nodules.LEFT LOBE: The thyroid gland is diffusely heterogeneous without discrete nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Minimally enlarged heterogeneous thyroid gland compatible with prior Hashimoto's thyroiditis. |
Generate impression based on findings. | Reason: 41 y/o female with left calf pain for three weeks. Mild prominence. Left calf compared to Right. R/O Muscle Injury. Imaging through the soft tissues of the posterior lower leg demonstrates asymmetric prominence of the subcutaneous fat on the left compared with the right. However, no fluid collection or abnormality of the underlying muscle is evident. | Asymmetric prominence of the subcutaneous fat of the posterior left lower leg without fluid collection or evidence of underlying muscle abnormality. |
Generate impression based on findings. | 40-year-old female presents for evaluation of her parathyroid. RIGHT LOBE MEASUREMENTS: 4.7 x 1.4 x 1.3 cm.LEFT LOBE MEASUREMENTS: 5.1 x 1.5 x 1.17 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Homogenous parenchyma without nodule. Normal vascularity.LEFT LOBE : Homogenous parenchyma without nodule. Normal vascularity.ISTHMUS: Homogenous parenchyma without nodule. Normal vascularity.PARATHYROID GLANDS: Unable to identify parathyroid candidate.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Normal ultrasound of the thyroid without nodule. No definite parathyroid candidates. |
Generate impression based on findings. | Chronic kidney disease RIGHT KIDNEY: Echogenic parenchyma. Questionable 5.7 x 5.4 x 5.9 cm complex mass lesion arising from the lower pole of the right kidney. No stone. Minimal hydronephrosis. Right kidney 9.9 cm in length.LEFT KIDNEY: Echogenic parenchyma. Benign appearing cyst. No stone or hydronephrosis. Left kidney 9.3 cm in length.OTHER: Bladder nondistended. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without significant obstruction or stone.Questionable right lower pole complex mass lesion versus partial duplication. The degree of echogenicity of the right kidney makes it difficult to differentiate between a mass lesion or partial duplication; noncontrast CT may be helpful for further characterization. |
Generate impression based on findings. | 37-year-old male with hypercalcemia. Evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 6.3 cm x 2.1 cm x 2.7 cmLEFT LOBE MEASUREMENTS: 5.9 cm x 1.9 cm x 2.3 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Normal homogeneous echotexture with no discrete nodules or masses are identifiedLEFT LOBE: Normal homogeneous echotexture with no discrete nodules or masses are identifiedISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing left neck level 2 lymph node measures 1.1-cm x 0.4 cm x 2.0-cm. No pathological lymphadenopathy.OTHER: No significant abnormality noted. | Unremarkable examination. Specifically no sonographic evidence of parathyroid adenoma is noted. |
Generate impression based on findings. | 68-year-old male with hematuria. RIGHT KIDNEY: The right kidney measures 8.9 cm in length. Small to moderate hydronephrosis, unchanged. A simple cyst of the right upper renal pole is unchanged measuring 1.7 x 1.7 x 1.6 cm. Mildly echogenic renal parenchyma.LEFT KIDNEY: The left kidney measures 8.8 cm in length. No hydronephrosis. Multiple renal cysts are again seen. In the left lower renal pole, there is a complex cystic lesion with the cystic component measuring 4 x 3.8 x 4.4 cm and a mural nodule measuring 0.6 x 0.5 0.6 cm. The cystic component on the prior ultrasound measured 4 x 3.9 x 3.8 cm, however the mural nodule was not clearly identified. Mildly echogenic renal parenchyma.URINARY BLADDER: A Foley catheter and suprapubic catheter are in place. Intraluminal debris is noted within the bladder. OTHER: No significant abnormalities noted. | 1. Suprapubic catheter and Foley catheter are in place. The urinary bladder contains intraluminal debris.2. Complex cystic nodule of the left lower renal pole containing a subcentimeter mural nodule. The cystic component is unchanged in size compared to 12/5/2014 ultrasound exam, however the mural nodule was not clearly identified. Attention on follow-up imaging is recommended.3. Stable mild to moderate right-sided hydronephrosis. |
Generate impression based on findings. | 62-year-old male with increased LFTs, evaluate for steatosis, fibrosis, portal hypertension. LIVER: Measures 18.6 cm in length. Markedly increased hepatic echogenicity without discrete focal lesion. Note that the hepatic echotexture limits penetration and evaluation of deeper structures on this examination. Patent main portal vein with antegrade flow measures 0.2 m/s.BILIARY TRACT: No cholelithiasis or gallbladder wall thickening, pericholecystic fluid, or sonographic Murphy sign. No biliary ductal dilation.PANCREAS: The pancreas is obscured by bowel gas. The imaged portions of the pancreas appear unremarkable.SPLEEN: No significant abnormalities noted.KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Increased hepatic echogenicity consistent with steatosis or parenchymal disease. |
Generate impression based on findings. | Male 63 years old; Reason: eval for cause of hyperbilirubinemia, r/o clot with dopplers History: hyperbilirubinemia LIVER: The liver measures 16.6 cm in length. There is coarse increased echogenicity of the liver parenchyma. A vague a hyperechoic lesion is seen in the right lobe of the liver measuring 3.3 cm x 3.0 cm x 2.8 cm. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 26.1 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is contracted and the wall measures 3.9 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 4.2 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 16.1 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 15.4 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 14.7 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: Trace ascites is seen. | 1. There is increased coarse echogenicity of the liver parenchyma compatible with fatty infiltration/hepatocellular dysfunction.2. A vague hyperechoic lesion is seen in the right lobe of the liver. A discrete mass cannot be excluded and recommend contrast enhanced cross-sectional imaging for further characterization of this lesion.3. Splenomegaly and trace ascites are present. |
Generate impression based on findings. | 54-year-old male with history of abdominal distention. Evaluate for ascites. Limited abdominal ultrasound images demonstrate no abdominal ascites or discrete fluid collections. | No evidence of ascites. |
Generate impression based on findings. | 55-year-old female presents with abdominal pain. LIVER:Measures 15.8 cm. Normal echogenicity. No ascites, intrahepatic biliary dilation, or focal mass. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder wall measures 9.4 mm. There is echogenic material within the gallbladder is dependent and consistent with sludge. No stones. There is trace pericholecystic fluid. The common bile duct measures 7.1 mm. Positive sonographic Murphy's sign.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 9.8 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.2 cm. Left kidney measures 10.9 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, or focal masses. OTHER: No significant abnormality noted. | 1. Gallbladder wall thickening, trace pericholecystic fluid, and positive sonographic Murphy's sign are consistent with acute cholecystitis. |
Generate impression based on findings. | Elevated lipase LIVER: Coarse echogenic liver echotexture again noted without obvious mass. Liver length 19.9 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: Pancreas could not be visualized due to overlying gas and bandages.RIGHT KIDNEY: No significant abnormalities noted. 12.1 cm in length OTHER: Left kidney and spleen could not be visualized due to overlying gas and bandages. Mild ascites. | Coarse echogenic liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without obvious mass or ductal dilatation. Mild ascites. Pancreas could not be visualized due to overlying gas and bandages. |
Generate impression based on findings. | Elevated lipase and LFTs with gallbladder wall thickening seen on recent CT LIVER: Mild hepatomegaly. Liver length 19.2 cm.BILIARY TRACT: Gallbladder wall thickening with pericholecystic fluid associated with numerous gallstones. A Murphy's sign could not be elicited. Prominent extra hepatic duct without obvious distal obstructing lesion or intrahepatic ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 8.4 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 9.2 cm in length. OTHER: Left kidney 10.4 cm in length. | Gallbladder wall thickening with pericholecystic fluid associated with cholelithiasis. Although a Murphy's sign could not be elicited, the ultrasonographic findings are suggestive for acute cholecystitis. |
Generate impression based on findings. | 66-year-old woman history of left breast cancer status post mastectomy presents for further evaluation of an area in right breast that was incompletely characterized on recent whole breast ultrasound. On physical exam, there is a a rounded palpable mass in the right retroareolar region.A targeted right breast ultrasound was performed area of concern in the upper quadrant of the right breast. Ultrasound of the right upper inner quadrant demonstrates normal fibroglandular tissue. No discrete solid or cystic mass is identified.Corresponding to the palpable mass is a 1.3 x 1.2 x 1.6 cm hypoechoic well-circumscribed mass in the right retroareolar region near the 9:00 location 1 cm from the nipple, with imaging findings suggestive of fibroadenoma. This is stable from ultrasound dated back to 6/17/2009. | No sonographic evidence for malignancy. Stable 1.6 cm right retroareolar mass, with imaging findings suggestive of a fibroadenoma. Right unilateral diagnostic mammogram is due June 2016.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Ms. Jones is a 55 year old female presenting for a short-term follow-up for a high probability benign morphology mass in the right breast. A targeted right breast ultrasound was performed at the right breast, 12:30 position, approximately 2 cm from the nipple. There is reidentification of a oval, hypoechoic mass measuring 0.3 x 0.3 cm, compared to 0.4 x 0.2 cm. This mass appears very similar in appearance to the sonographic images of 12/18/2012 and 5/14/2014. There is no new solid or cystic mass identified. | Stable benign morphology mass in the right breast. No sonographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in April 2015.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Low-attenuation renal foci seen on prior CT RIGHT KIDNEY: Multiple benign appearing cysts corresponding to the low attenuation foci seen on the recent CT. A representative upper pole cyst measures 2.5 x 2.4 x 2 cm. No stone or hydronephrosis. Right kidney 9.5 cm in length.LEFT KIDNEY: Multiple benign appearing cysts corresponding to low-attenuation foci seen on the recent CT. A representative lower pole cyst measures 2.2 x 2.3 x 2.5 cm. No stone or hydronephrosis. Left kidney 10.1 cm in length.OTHER: Bladder nondistended | Multiple bilateral benign-appearing cysts corresponding to low-attenuation foci seen on the recent chest CT. No worrisome mass, stone, or obstruction. |
Generate impression based on findings. | Hyperbilirubinemia with elevated LFTs; patient with sickle cell disease status post stem cell transplant LIMITED ABDOMENLIVER: Moderate hepatomegaly. Liver length 21 cm. Normal parenchymal echogenicity without mass.BILIARY TRACT: Gallbladder not visualized. Mild prominence of extra hepatic duct without intrahepatic ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: Not visualized; presumably absent RIGHT KIDNEY: No significant abnormalities noted. 13.4 cm in length OTHER: Left kidney 12.9 cm in length. No ascites | Moderate hepatomegaly without mass or significant duct dilatation. No ascites. Patent hepatic vessels with normal directional flow. |
Generate impression based on findings. | Hepatitis B carrier LIVER: Heterogeneous coarse liver architecture again noted without mass. Liver length 13.3 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 11.1 cm in length.OTHER: Left kidney 10.8 cm in length. Spleen is 9.1 cm in length. No ascites. | Stable heterogeneous coarse liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 26 year old with palpable right breast masses. Per the patient, these do not feel different in size compared to the time of the prior outside ultrasound. A targeted right ultrasound was performed for the patient’s area of concern. Two solid masses and a cyst are seen. Near the right breast 12 o'clock position approximately 4 cm from the nipple, a 1.7 x 1.6 cm oval circumscribed mass is seen. Closer to the nipple and slightly more medially, a 1.4 x 1.0 cm mass with similar typically benign morphology is present. This is probably the mass labeled 12 o'clock on the prior outside ultrasound. Additionally, slightly lateral to the larger of the two solid masses is a 6-mm cyst. | Two likely benign masses in the right breast. The larger of the two solid masses is not seen on the images that were previously submitted. Surgical consultation is recommended. Palpably guided tissue sampling versus ultrasound guided biopsy can be considered to confirm a benign etiology, especially if there is a change detected on physical exam.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Follow-up thyroid cyst RIGHT LOBE MEASUREMENTS: 2.3 x 1.2 x 4.6 cmLEFT LOBE MEASUREMENTS: 1.7 x 1.4 x 5.3 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Stable 1.5 x 0.9 x 1.1 cm extrathyroidal cystic lesion projecting posterior inferior to the right thyroid lobe | Stable extrathyroidal cystic lesion projecting posterior and inferior to the right thyroid gland. No regional adenopathy. No thyroid nodules. |
Generate impression based on findings. | Left neck mass RIGHT LOBE MEASUREMENTS: 4 x 1.8 x 1.4 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.4 x 1 cmISTHMUS MEASUREMENTS: 0.25 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 0.8 x 0.5 x 0.7 cm well-circumscribed hypoechoic nodule upper pole ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Subcentimeter well-circumscribed hypoechoic upper pole left thyroid nodule. This lesion is amenable to ultrasound-guided percutaneous biopsy. No regional adenopathy. |
Generate impression based on findings. | 49 year old female patient with significant ascites status post paracentesis. Heart transplant evaluation. LIVER:The liver measures 16.6 cm in length. No focal hepatic lesion is identified. Main portal vein is patent with hepatopetal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. There is no intra or extrahepatic biliary ductal dilatation. The common bile 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.SPLEEN: The spleen is enlarged measuring approximately 15.2 cm in length.KIDNEYS: The right kidney measures 9.5 cm in length and left kidney measures 10.8 cm in length. No evidence of hydronephrosis. ABDOMINAL AORTA: The proximal aorta measures approximately 1.6 x 1.5 cm in diameter and the mid aorta measures approximately 1.6 x 1.9 cm in diameter. The distal abdominal aorta and iliac vasculature are not visualized secondary to overlying bowel gas.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: There are bilateral pleural effusions and moderate ascites. | 1. Moderate ascites and bilateral pleural effusions.2. Splenomegaly. |
Generate impression based on findings. | Reason: ? Gallstones History: pancreatitis LIVER: The liver measures 15.5 cm in length. Coarse, echogenic hepatic parenchyma. The portal vein is patent with normal directional hepatopedal blood flow, peak velocity 21.6 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: Numerous echogenic stones and sludge are seen within the gallbladder lumen and neck. The gallbladder wall measures 0.2 cm. The common bile duct measures 0.2 cm. No significant biliary ductal dilatation. No pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney measures 10.4 cm in length. The left kidney measures 10.3 cm in length. Normal renal echogenicity. No shadowing stones or hydronephrosis.OTHER: No ascites. | 1. Findings consistent with hepatic steatosis or hepatic parenchymal dysfunction.2. Cholelithiasis and gallbladder sludge without evidence of cholecystitis. |
Generate impression based on findings. | Thyroid nodule RIGHT LOBE MEASUREMENTS: 5.2 x 2.0 x 1.8 cm, normal in size with normal background echotexture and vascularity.LEFT LOBE MEASUREMENTS: 5.7 x 1.5 x 1.5 cm, normal in size with normal background echotexture and vascularityISTHMUS MEASUREMENTS: 1-2 mm in AP dimension.RIGHT LOBE: Two subcentimeter hypoechoic nodules are noted with internal features suggestive of colloid.LEFT LOBE: Two subcentimeter hypoechoic are noted, one which appears cystic and the other with internal features suggestive of colloid.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral subcentimeter thyroid nodules, without suspicious features evident. |
Generate impression based on findings. | 81 year old female with a history of thyroid nodules on CT scan at an outside institution. RIGHT LOBE MEASUREMENTS: 5.3 x 1.5 x 2.0 cm.LEFT LOBE MEASUREMENTS: 4.0 by 0.9 x 1.1 cm.ISTHMUS MEASUREMENTS: 5 mmThe thyroid gland is enlarged and diffusely heterogenous, which can be seen in thyroiditis.RIGHT LOBE: There is a 1.8 x 0.7 x 0.9 cm irregular lobulated heterogeneous, but predominantly hypoechoic nodule in the mid body of the right lobe of the thyroid gland. There is no internal vascularity or definite calcification. Indeterminant.LEFT LOBE: The mid portion of the left lobe of the thyroid gland is diffusely heterogenous with subcentimeter hypoechoic foci.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Cervical lymph node in the left lateral neck with nonspecific morphology, including a prominent cortex, measuring 1.2 x 0.6 x 1.4 cm. OTHER: No significant abnormality noted. | 1. 1.8 cm indeterminate nodule in the mid body of the thyroid gland for which further evaluation with FNA is recommended.2. Indeterminate left cervical lymph node which could also be further evaluated with FNA if clinically indicated. 3. Heterogenous thyroid echotexture, nonspecific and may be seen in setting of thyroiditis. |
Generate impression based on findings. | Look for iliac vein patency and iliac bifurcation, look for thrombus Limited examination due to overlying bowel gas. Left and right iliac veins are patent. No evidence of thrombus. | Patent iliac veins without thrombus. |
Generate impression based on findings. | 36-year-old female with right flank/upper quadrant pain. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Post cholecystectomy. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY:Known right staghorn calculus incompletely visualized. 2.2-cm cystic lesion in the upper pole of the right kidney. Complexity is difficult to evaluate.OTHER: No significant abnormalities noted. | No biliary tract abnormality.Shadowing staghorn calculus right kidney. Cystic lesion upper pole right kidney incompletely characterized. |
Generate impression based on findings. | HCC screening, hepatitis B LIVER: Liver measures 14.8 cm, mild heterogenous echotexture noted. No focal lesions. No evidence of cirrhosis no intrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Normal appearance of the gallbladder. Common bile duct measures less than 4 mm. No evidence of gallstonesPANCREAS: Head of the pancreas as visualized appears unremarkable. Body and tail is not visualized due to overlying bowel gas.KIDNEY: Right kidney measures 9.4 cm and left kidney measures 5.7 cm. Limited evaluation of the left kidney due to overlying bowel gas.Possible right upper pole caliectasis is noted. This appears more likely to be caliectasis than a simple cyst which was previously described on 7/20/2012.Limited evaluation of the left kidney however possible caliectasis noted.OTHER: No ascitesSpleen measures 7.5 cm without any focal lesions. | No evidence of cirrhosis or ascites.No focal lesions in the liver.Limited evaluation of the left kidney due to overlying bowel gas; Possible right upper pole and left renal caliectasis. |
Generate impression based on findings. | Call back from screening mammogram for calcifications for both breasts. Three standard views of both breasts and two spot magnification 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 elements, unchanged in pattern and distribution. There are several clusters of coarse benign calcifications in the right breast. In the left breast, there are multiple small masses at 6:00 position - lower inner quadrant, with coarse benign appearing calcifications. Ultrasound for left breast was performed. There are several cysts, some of which contain calcifications inside at 6:00 position and 8:00 position. No suspicious findings or solid lesions are present. | High probability benign calcifications in the left breast, for which left unilateral diagnostic mammogram in 6 months is recommended. No mammographic evidence for malignancy in the right breast. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Abdominal pain; acute pancreatitis LIVER: No significant abnormalities noted.BILIARY TRACT: Unremarkable gallbladder. No ductal dilatation. | Unremarkable gallbladder. No ductal dilatation. |
Generate impression based on findings. | Palpable right axillary lymph node and palpable left breast mass. The patient had left breast ultrasound-guided core biopsy several months ago which was benign and concordant. She feels the area in her left breast is somewhat increased since biopsy. A targeted bilateral ultrasound was performed for the patient’s areas of concern. In the right axillary region, including at the site of patient concern, several normal morphology axillary lymph nodes are seen. The finding at the site of concern is equivocal for a lymph node, but in any case benign. It measures 6 x 5 mm. In the left breast 9:00 position, a hypoechoic mass with adjacent biopsy clip is noted. The mass measures 8 x 6 mm. As a hydromark clip was placed and is close to the skin surface, it is possible that the biopsy clip is also palpable. | 1. Normal right axillary lymph nodes.2. Biopsy proven benign area in the left breast 9:00 position with adjacent biopsy clip. Given that the clip is close to the skin surface, it too may be palpable.The patient will follow-up with Dr. Jaskowiak today.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: Abdominal U/S to help rule out gallstones; Ongoing pelvic and abdominal pain. Recent abdominal xray suggestive of gallstones. LIVER: The liver measures 14.7 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 0.35 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 6.0 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of cholelithiasis, acute cholecystitis, or biliary ductal dilatation. |
Generate impression based on findings. | 71-year-old male with hepatitis C. Screen for HCC. LIVER: Diffuse increased echogenicity of the liver measuring 16.5 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow. GALLBLADDER, BILIARY TRACT: Comet tail artifact in the gallbladder consistent with adenomyomatosis of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common bile duct measures 4 mm in caliber. No intra or extrahepatic biliary ductal location.PANCREAS: The visualized portions of the pancreas are normal in echogenicity. No pancreatic ductal dilatation. RIGHT KIDNEY: Normal echogenicity of the right kidney measured 11.6 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 10.7 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 8.7 cm in length. | 1. Diffuse increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesion.2. Adenomyomatosis of the gallbladder. |
Generate impression based on findings. | 57-year-old male with renal transplant and acute renal insufficiency. History of hydronephrosis. RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Renal transplant measures 12.2 cm in length. There are multiple cortical and renal sinus cysts involving the transplanted kidney as previously noted. There is a mildly complex cyst in the mid upper pole with a single septation. There is no is for hydronephrosis, shadowing calculus or solid mass.COLLECTING SYSTEM/URETER: No hydronephrosis No significant abnormality notedURINARY BLADDER: Decompressed by Foley catheter.OTHER: No significant abnormality noted | No evidence for hydronephrosis. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 8.6 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 9.3 cm in length.OTHER: Bladder nondistended | Mildly echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Female, 18 years old. Recurrent pyelonephritis and CT with ?area of focal pyelo versus renal mass. RIGHT KIDNEY: The right kidney measures 10.7 cm in length, with normal cortical echogenicity. No focal lesions or perinephric collections. No hydronephrosis or urinary stones identified. Note is made of a duplicated collecting system.LEFT KIDNEY: The left kidney measures 12.5 cm in length, with normal cortical echogenicity. No focal lesions or perinephric collections. No hydronephrosis or urinary stones identified.OTHER: The urinary bladder is incompletely distended. | No focal renal mass lesion or hydronephrosis. |
Generate impression based on findings. | Evaluate for a left axillary lymph nodes. Known left breast cancer. A targeted left ultrasound was performed for the axillary region. Multiple lymph nodes with uniformly thickened cortices, retained hila and retained hilar blood flow are seen. There is no suspicious morphology lymph node or solid or cystic mass identified. | No suspicious morphology axillary lymph node. The patient will be seeing Dr. Chhablani again today.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Primary hyperparathyroidism RIGHT LOBE MEASUREMENTS: 4.7 x 1.6 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.5 x 1.2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No extrathyroidal focus consistent with a parathyroid adenoma candidate could be identified. No thyroid nodule. No regional adenopathy. |
Generate impression based on findings. | 73 years old, Female, Reason: r/o thyroid enlargement History: neck enlargement RIGHT LOBE MEASUREMENTS: 4.4 x 2.4 x 2 cm.LEFT LOBE MEASUREMENTS: 5.7 x 2.1 x 3 cm.ISTHMUS MEASUREMENTS: 1.1 cm.RIGHT LOBE: No evidence of thyroid nodules. The size of the thyroid is within normal limits. Echogenicity of the thyroid is homogeneous. No significant abnormality noted.LEFT LOBE: No evidence of thyroid nodules. The size of the thyroid is within normal limits. Homogeneous echogenicity of the thyroid. No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal ultrasound evaluation of the thyroid without evidence of enlargement or nodules. |
Generate impression based on findings. | 50 year-old female with hematuria. Ultrasound guidance was provided for biopsy of left kidney | Ultrasound guidance |
Generate impression based on findings. | 18-year-old-year-old female with 3 palpable lumps in the in the right breast. A targeted right ultrasound was performed in the palpable areas of concern. In the 11:00 location are again seen two adjacent round isoechoic masses with circumscribed margins. The more medial mass measures 1.5 x 1.2 x 1.7 cm, and the more lateral mass measures 1.5 x 1.3 x 1.7 cm. These are not significantly changed compared with the prior study. An additional isoechoic circumscribed mass is identified in the right breast 8:00 position which measures 1.4 x 1.2 cm. | No significant change in size and sonographic appearance of the two masses in the right upper outer breast, likely representing benign fibroadenomas. An additional palpable concern in the right lower outer breast also demonstrates imaging features most consistent with a benign fibroadenoma. Continued follow up at 6-12 months can be considered as warranted clinically. The patient will follow up in surgical clinic today. BIRADS: 3 - Probably benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | History of elevated alkaline phosphatase. Exam limited by positioning and patient body habitus. LIVER: The liver measures 15.5 cm in length. Numerous isoechoic hepatic lesions with hypoechoic halos are noted throughout the liver suspicious for metastases. An example lesion in the left lobe measures 3.4 x 4.8 x 3.3 cm. BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening. The sonographic Murphy's sign is negative. The common bile duct measures 5 mm in diameter.PANCREAS: The pancreatic duct is mildly prominent measuring 4 mm in diameter. SPLEEN: No significant abnormalities noted. The spleen measures 9.3 cm in length. RIGHT KIDNEY: Kidney measures 10.9 cm in length. Multiple right calyceal calculi the largest of which measures 9mm. Resolved hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length. Mild hydronephrosis with stent.OTHER: Ascites. | 1.Multiple bilobar hepatic lesions suspicious for metastases. Example lesion in left lobe measures 3.4 x 4.8 x 3.3 cm. 2.Cholelithiasis without evidence of cholecystitis.3.Multiple right calyceal calculi the largest of which measures 9mm. Resolved hydronephrosis on right. 4.Mild left hydronephrosis with stent.5.Ascites. Discussed findings with Dr. Akoegbe at 11:00 a.m. on 2/13/2015. |
Generate impression based on findings. | Reason: thyroid cancer s/p thyroidectomy and RAI History: thyroid cancer RIGHT LOBE: Status post resection. No residual soft tissue echogenicity.LEFT LOBE: Status post resection. No residual soft tissue echogenicity.ISTHMUS: Status post resection. No residual soft tissue echogenicity.PARATHYROID GLANDS: Not visualizedLYMPH NODES: No significant abnormality noted. No cervical lymphadenopathy.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of recurrence or lymphadenopathy. Stable exam. |
Generate impression based on findings. | 23-year-old with small palpable mobile mass in the right breast near the axillary region. Strong family history of breast cancer. A targeted right ultrasound was performed for the patient’s area of concern near the right axilla. There is an oval superficially located mass which is centrally echogenic and peripheral hypoechoic and very mild blood flow measuring 9 x 9 mm. | Benign morphology mass of the site of palpable concern is highly likely to be benign. Differential considerations include a small lymph node, lipoma or possibly fat necrosis. Given the highly likely benign appearance, a short term ultrasound follow-up in 3 to 6 months is recommended to ensure stability. However, if the area changes before then, intervention sooner would be warranted.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 47-year-old female with generalized abdominal pain. LIVER: Liver echotexture appears within normal limits. There is hepatomegaly with the liver measuring approximately 21 cm in length as seen on prior CT. No focal hepatic abnormality. Patient has had wedge resection in the left lobe of the liver.Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Gallbladder contains several, small dependent shadowing echogenic foci consistent with gallstones. No wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Small gallstones. Persistent hepatomegaly. |
Generate impression based on findings. | 46-year-old female undergoing renal biopsy. Ultrasound guidance was provided for a renal biopsy by the nephrology service. 5 passes were made. A heterogeneous collection suspicious for postbiopsy hematoma is seen measuring approximately 5.1 x 5.6 x 1.6 cm. | 1. Ultrasound guidance was provided for a renal biopsy by the nephrology service. Correlate with procedural report regarding possible hematoma. |
Generate impression based on findings. | 65-year-old female with history of hepatitis C virus cirrhosis. Evaluate for mass or ascites. LIVER: Liver is coarsely echogenic with a cirrhotic morphology. Focal, coarse calcifications again noted within the liver. Addition, complex cyst in the left lobe of the liver measures 1.6 x 2 x 2 cm. Right lobe hepatic cyst measures 2.6 x 3.9 x 4.1 cm. There is a less well-defined rounded, hypoechoic subcapsular nodule in the right lobe measuring 1 x 1 x 1.2 cm. This does have some evidence of cystic characteristics. This was not visualized with certainty on the prior exam. Previously noted vague nodular density not seen on today's study.BILIARY TRACT: Poorly tract is normal in caliber. The gallbladder may contain a small, nonshadowing polyp. In addition, there is some focal increased echogenicity in the region of the fundus. Given lack of stones or other fundal abnormality and prior studies, this may represent an adjacent hepatic calcification. There is not gross wall thickening or pericholecystic fluid.PANCREAS: The head and and body are normal. The tail was not well seen.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No ascites. | Cirrhotic liver with heterogeneous echotexture. No change in cysts within the liver or calcifications. Vague, subcapsular nodule may represent a complex cyst although difficult to assess in a liver that is this heterogeneous. Patient has had multiple cysts on prior MR exam as well as other noncystic nodules.Gallbladder polyp. See above. |
Generate impression based on findings. | 43-year-old male with renal insufficiency. Real-time ultrasound guidance was provided for right renal biopsy. Fluid adjacent to the kidney noted on post procedure imaging. | Ultrasound guidance. Postprocedural perirenal fluid. |
Generate impression based on findings. | 52-year-old female with kidney stone. RIGHT KIDNEY: The right kidney measures 10.4 cm in length. No hydronephrosis. In the right lower pole, there is a 0.5 x 0.2 x 0.5 cm shadowing calculus (prior 0.6 x 0.7 x 0.9 cm). No other stones are identified. Increased parenchymal echogenicity.LEFT KIDNEY: The left kidney measures 10.3 cm in length. No hydronephrosis. Increased parenchymal echogenicity.URINARY BLADDER: The urinary bladder is partially distended without acute abnormality.OTHER: No significant abnormalities noted. | 1. Slightly decreased size of the known nonobstructing subcentimeter stone of the right lower renal pole.2. Echogenic renal parenchyma suggestive of chronic medical renal disease. |
Generate impression based on findings. | 65-year-old male patient with elevated transaminases. Evaluate for hepatosplenomegaly. LIVER: The liver measures 17.4 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 are gallstones without significant pericholecystic fluid or gallbladder wall thickening. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The pancreas is poorly visualized on this examination.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney is not visualized.The spleen measures 9.7 cm in length.A left iliac fossa transplant kidney is without hydronephrosis. | Cholelithiasis without sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | Hepatitis C LIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 15.6 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. 9 cm in length.RIGHT KIDNEY: No significant abnormalities noted. 9.6 cm in length.OTHER: Left kidney 9 cm in length. No ascites. | Coarse echogenic liver echotexture again noted consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Right upper quadrant abdominal pain LIVER: No significant abnormalities noted. Liver length 17 cmBILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 17.2 cm in length RIGHT KIDNEY: No significant abnormalities noted. 12.3 cm in lengthOTHER: Left kidney 14.1 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Mild splenomegaly. No ascites. |
Generate impression based on findings. | Rising bilirubin and jaundice LIVER: Coarse echogenic liver parenchyma without mass. Liver length 25.6 cmGALLBLADDER, BILIARY TRACT: Gallbladder absent. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.1 cm in length.OTHER: Left kidney 11.8 cm in length. Spleen is 15.4 cm in length. No ascites. | Moderately severe hepatomegaly associated with coarse echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Mild splenomegaly. No ascites. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are bilateral diagnostic mammogram and left breast ultrasound dated 3/15/2016, left breast ultrasound-guided core biopsy with postprocedure mammogram dated 3/22/1960 performed at Porter regional Hospital Center for women's health, Valparaiso, Indiana. For comparison,none are available. Three standard views of both breasts were obtained. The breast parenchyma is heterogeneously dense, which limits the sensitivity of the mammogram . Triangular marker denoting palpable abnormality identified in the left upper-outer quadrant. Underneath the marker there is an irregular hyperdense focal asymmetry with few spiculations measuring 3 cm, with few associated faint calcifications. No dedicated spot compression or magnification views of this area obtained.A faint cluster of calcifications in the right breast 9:00 position measuring 12 mm needs further evaluation with spot magnification views. Few coarse benign morphology calcifications are seen elsewhere in the right breast. Benign right axillary lymph node is noted.Ultrasound demonstrates an irregular hypoechoic mass at 1:00 position approximately 5 cm from the nipple that measures 2.5 x 1.5 cm (on ultrasound dated 3/22/2016 which was on the day of the biopsy, this mass approximately measures 2.7 x 1.8 cm). In the left breast 1:00 position 2 cm from the nipple an oval benign morphology mixed echogenic mass is identified which could represent a benign intramammary lymph node although no definite blood flow is noted on ultrasound or definite focal asymmetry is noted on mammogram. It measures 5 x 7 x 3 mm and is located 1.5 cm anterior to the mass. Ultrasound-guided core biopsy of both these lesions was performed with clip placement. Good targeting noted of the larger of the 2 masses. 4 images have been submitted of the anterior smaller mass ultrasound-guided biopsy. Biopsy targeting appears suboptimal. Postprocedure mammogram demonstrated 2 clips in the left breast 1:00 position, distance between the clips is approximately 19 mm. Smaller of the 2 clips is within the center of the irregular spiculated mass. The longer of the 2 clips is within the anterior most likely benign morphology mass.Pathology results revealed left breast mass 1:00 2 cm from the nipple is fibrocystic change which appears concordant.Pathology results revealed left breast mass 1:00 position 5 cm from the nipple is IDC grade 2 which appears concordant. | Biopsy-proven IDC left breast 1:00 position posterior depth.12 mm cluster of indeterminate calcifications in the right breast need further evaluation with spot magnification views.4 images have been submitted of the ultrasound-guided core biopsy of the anterior smaller left breast mass. The results are benign and concordant however repeat ultrasound is recommended due to questionable targeting. Given the dense breast tissue, additional evaluation with breast MRI should be considered.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 86-year-old male with pain in cheek. Patient states left sided pain. Evaluate for submandibular gland or parotid gland stone. Right parotid gland appears unremarkable. Adjacent, prominent but morphologically normal lymph nodes identified.Left parotid gland with no sialectasis. In or immediately adjacent to the inferior aspect of the left parotid there is dense rim calcification measuring approximately 7 mm in transverse diameter. This obscures underlying tissue. | Rim calcified mass adjacent to inferior left parotid. The appearance is somewhat unusual but has been reported in pleomorphic adenoma. Other parotid masses typically produce only coarse calcifications.This could also be inflammatory or vascular in nature.This could represent a calcified lymph node. |
Generate impression based on findings. | Ms. Ada Louise Palmer is a 34 years old female with fibroadenoma in the left breast. Presents for questionable enlargement of the previously biopsied lump in the left breast. On physical examination, a mobile lobulated mass is palpated in the left subareolar region.A targeted left ultrasound was performed for the patient’s area of concern. The previously biopsied circumscribed, lobulated, hypoechoic mass in the left subareolar area measures 3.2 x 1.8 x 3.8 cm (previously 3.4 x 2 x 4 cm), stable in size and morphology. Biopsy clip with the results of fibroadenoma is noted in the center of this mass. | No sonographic evidence for malignancy. Stable biopsy-proven fibroadenoma in the left subareolar region. Results and recommendations were discussed with the patient. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Male 54 years old with history of lymphoma and new palpable bilateral axillary adenopathy. A bilateral breast ultrasound was performed for the palpable areas of concern. Multiple enlarged lymph nodes at varying depths are noted bilaterally.In the right lower axilla the largest lymph node measures 3.6 x 1.8 x 2.6 cm without increased vascularity.In the right upper axilla the largest lymph node in measures 5.1 x 2.6 x 2.4 cm without increased vascularity.In the left lower axilla the largest lymph node measures up to 3.7 cm without increased vascularity.In the left upper axilla the largest done measures 4.7 x 3.0 x 3.3 cm without increased vascularity. | Multiple enlarged axillary lymph nodes bilaterally (in the lower axillary tail and higher axillary tail). Palpable masses in the bilateral lower axillary regions are necrotic axillary lymph nodes. The patient is scheduled to follow-up with surgery for excisional biopsy. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 85-year-old male with known solid right renal mass for follow-up. RIGHT KIDNEY: Right kidney measures 9.3 cm in length. Cortex echotexture likely within normal limits. There is no hydronephrosis. There are multiple simple and complex cysts identified as seen on the prior exam, some of the cysts with septation and some with presumed internal debris. Arising from the upper pole of the right kidney is again noted an ovoid, exophytic solid mass. This measures 2.2 x 3.5 x 2.8 cm, unchanged from the prior study. Please note, measurements provided in prior report were incorrect and should be noted as 2.1 x 3.5 x 2.8 cm.LEFT KIDNEY: The left kidney measures 10.3 cm in length. Cortical echotexture likely within normal limits. There is no hydronephrosis. There are again noted multiple simple and mildly complex cysts. No solid mass is seen.OTHER: Prostate is markedly enlarged and protrudes and deforms the posterior bladder wall. Bladder is incompletely distended but appears somewhat thick-walled. | Stable examination. In particular, no significant change in the solid right renal mass. Please note replacement measurements for prior exam given above. |
Generate impression based on findings. | 57-year-old female status post thyroidectomy. Evaluate. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No evidence of residual or recurrent disease.LEFT LOBE: No evidence of residual or recurrent disease.ISTHMUS: No evidence of residual or recurrent disease.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small benign-appearing cervical lymph nodes are again noted. Benign-appearing right level 3 lymph node measures 1.9 x 1.3 x 0.4 cm, unchanged. OTHER: No significant abnormality noted. | No evidence of residual or recurrent disease. |
Generate impression based on findings. | Transplant kidney. Rising creatinine. The ultrasound guidance was provided for the nephrology service for biopsy of a transplant kidney in the left iliac fossa. | Ultrasound guidance for transplant renal biopsy. |
Generate impression based on findings. | History of ascites and abnormal liver architecture LIVER: Mildly coarse and heterogeneous liver echotexture without mass. Liver length 14.7 cm.GALLBLADDER, BILIARY TRACT: Gallbladder not visualized. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. 11.4 cm in lengthOTHER: Echogenic focus within spleen; favor benign etiology. Spleen length 10.8 cm. Echogenic left renal parenchyma without worrisome mass, stone, or hydronephrosis. Left renal cyst. Left kidney 10.1 cm in length. No ascites. | Mildly coarse and heterogeneous liver echotexture suggestive for chronic liver disease without mass or ductal dilatation. Gallbladder not visualized. No ascites.Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without hydronephrosis. |
Generate impression based on findings. | 65-year-old female. Callback from 5/6/2015 screening mammogram for adjacent masses in the lateral aspect of the right breast. RIGHT BREAST DIAGNOSTIC MAMMOGRAM: A standard ML view and three 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. Again seen are two adjacent masses in the right breast upper outer quadrant that persist on spot compression views. The larger of the two masses is on the 9:00 radian, measures 1.5 cm in diameter and has microlobulated margins. The second mass is anterior and inferior to the first. The second mass has partially smooth margins. An asymmetry at the superficial margin of the fibroglandular tissue that was superior to both masses on the MLO view dispersed into normal fibroglandular tissue on the spot compression views. RIGHT BREAST ULTRASOUND: Targeted ultrasound of the right breast upper outer quadrant demonstrated an irregular 1.5 x 1.2 x 1.7 cm hypoechoic mass at 9 o'clock 4 cm from the nipple, corresponding to the larger of the two masses seen on the mammogram. The mass has microlobulated margins, an echogenic halo, and mild internal flow on color Doppler imaging.A second mass is seen at the 8 o'clock periareolar position, approximately 1.5 cm anteroinferior to the first mass. The second mass is a parallel hypoechoic circumscribed mass measuring 0.8 x 0.4 x 1 cm, corresponding to the second mass visualized on mammography. There is no definite internal flow on color Doppler imaging. | 1. Right breast 9 o'clock mass with suspicious features. Ultrasound guided percutaneous biopsy is recommended. 2. Right breast 8 o'clock mass, approximately 1.5 cm away from the first mass, which has benign features, but which is non-specific. Ultrasound guided percutaneous biopsy is recommended. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Female 22 years old Reason: abnormal exam, please evalute for normal architecture History: none RIGHT LOBE MEASUREMENTS: 4.2 x 1.3 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.3 x 1.3 x 1.4 cmISTHMUS MEASUREMENTS: 0.2 cm.RIGHT LOBE: Right thyroid lobe is normal in appearance. No nodules.LEFT LOBE: Left thyroid lobe is normal in appearance. No nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small right benign-appearing level 2 lymph node measures 0.8 x 0.3 x 1.4 cm.OTHER: No significant abnormality noted. | Normal appearance of the thyroid. No nodules. |
Generate impression based on findings. | Acute renal failure RIGHT KIDNEY: Mildly echogenic renal parenchyma without mass, stone, or hydronephrosis. Ureteral stent present. Right kidney 10 cm in length.LEFT KIDNEY: Mildly echogenic renal parenchyma without mass, stone, or hydronephrosis. Ureteral stent present. Left kidney 12.6 cm in length.OTHER: Bladder nondistended. | Mildly echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. Bilateral ureteral stents. |
Generate impression based on findings. | Assess for hydronephrosis. Acute kidney injury RIGHT KIDNEY: Unremarkable echogenicity without mass or stone or hydronephrosis. 12.3 cm in lengthLEFT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 11.6 cm in lengthOTHER: Asymmetrical polypoid wall thickening involving the left bladder wall reported previously is difficult to evaluate secondary to a Foley catheter decompressing the bladder. | No hydronephrosis of either kidney. Foley catheter decompresses the bladder which is not well evaluated. |
Generate impression based on findings. | 84-year-old female with right upper quadrant pain. LIVER: In the left hepatic lobe (segment 5) is a circumscribed cystic structure with a peripheral hyperechoic rim and shadowing internal calcifications or possibly internal stones which appears intrahepatic and separate from the adjacent gallbladder. The portal vein is patent.GALLBLADDER, BILIARY TRACT: The gallbladder is somewhat patulous in morphology, but no discrete gallbladder stone is identified. The gallbladder wall is normal in thickness.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: A right kidney cyst with thin internal septations measures 2.1 x 1.9 x 1.8 cm. There is no hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cystic lesion in segment 5 as described above, for which differential considerations include a hepatic cyst with peripheral calcifications, focal intrahepatic biliary ductal dilation with stones, or less likely an accessory gallbladder.2.Otherwise, no evidence of cholelithiasis or acute cholecystitis. |
Generate impression based on findings. | Ms. Norfolk is a 65 year old female with known right breast IDC and metastatic right axillary lymph node. She presents for imaging evaluation to assess for response to hormonal therapy. Targeted grayscale and color ultrasound of the right breast and axilla.In the right breast 9:00 position, approximately 6 cm from the nipple, there is revisualization of an irregular hypoechoic mass with centrally located biopsy marker clip now measuring approximately 1.1 x 0.9 x 0.8 cm, previously 1.0 x 0.8 x 0.5 cm on outside examination. In the right axilla, previously biopsied axillary lymph node with centrally located clip now measures approximately 1.5 x 0.9 cm, previously 1.9 x 1.4 cm. | Known index malignancy in the right breast and metastatic right axillary lymph node are stable to slightly decreased when compared to prior imaging. Continued surgical consultation is recommended at this time. All results and recommendations were discussed with the patient.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of right breast and right axilla (2/5/15), images from ultrasound guided biopsy (2/9/15) performed at DuPage Medical Group. ULTRASOUND IMAGES OF RIGHT BREAST AND RIGHT AXILLA (2/5/15):Irregularly shaped, microlobulated mass, measuring 23 x 19 x 22 mm, with increased blood fow is visualized at 10 o'clock in the right breast. This mass is highly suggestive for malignancy. An abnormal lymph node with asymmetric cortical thickening is present in the right axilla. One normal appearing lymph node is also present in the right axilla.IMAGES FROM ULTRASOUND GUIDED BIOPSY (2/9/15):A needle biopsy was performed for the right breast mass at 10 o'clock position with an appropriate needle placement. The annotation on the image states that a "buckle clip" is placed within the mass.Per outside pathology report, the biopsy result was malignant, invasive carcinoma grade 3. | Biopsy proven right breast carcinoma, with an abnormal right axillary lymph node. If mammogram has not been performed, it should be performed.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 42 year old female with epigastric pain, history of gallbladder polyp. LIVER: Normal echogenicity of the liver measuring 13.6 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: Two subcentimeter polyps are noted along the nondependent portion of the gallbladder wall, one of which measures 3 mm x 2 mm x 3 mm and the second measures 5 mm x 4 mm x 5 mm. No gallbladder wall thickening. No cholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 10.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 9.7 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen measures 8.4 cm in length and is normal in echogenicity. | Two subcentimeter gallbladder polyps. |
Generate impression based on findings. | Female 29 years old Reason: Study-related tissue biopsy; see below; hx. Sarcoma kidney History: None Written informed consent was obtained. Subcostal approach to the right of midline was chosen for free hand biopsy of the lesion in the left lobe of the liver.Skin was prepped and draped sterilely. Skin and liver capsule were anesthetized with lidocaine.Under ultrasound guidance three 18-gauge core biopsies were obtained:The first specimen yielded a solid core with a few whitish specks and reddish tissue. This was placed in empty container provided.Second specimen yielded a focal white core of tissue which was cut in half. Half placed in formalin and have placed the second container provided. Third specimen yielded heterogeneous solid tissue which was placed in buffered formalin.Due to patient pain and nausea after the first biopsy pass and considering tissue obtained, a fourth core was not done.No signs of hematoma bleeding by ultrasound immediately post procedure.Specimens were given to the clinical research assistant.Less than 5 cc blood loss.Patient was observed in nurse holding vital signs remained stable. Pain was mild to moderate and stable. A dose of Zofran was ordered for nausea.The patient was discharged to home in good condition. | 3 core biopsies as described above. Complicated by mild to moderate pain and nausea. |
Generate impression based on findings. | Acute renal insufficiency with history of chronic renal disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.2 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left renal cyst. Left kidney 11.1 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction. |
Generate impression based on findings. | 44-year-old with right breast cellulitis. Right breast ultrasound was performed. There is an irregularly-shaped hypoechoic lesion with increased vascularity, measuring 36 x 23 mm at two o'clock retroareolar region, consistent with abscess formation. Diffuse skin thickening and edema is seen in the right breast. | Abscess formation at two o'clock retroareolar region in the right breast. Diffuse skin thickening and edema in the right breast.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Ms. Alexandridou submitted outside mammogram dated 06/12/2012 and two prior ultrasounds dated 06/12/2012 and 01/21/2013, from University of Illinois, Urbana. Submitted outside studies were compared to the current mammogram dated 10/14/2016. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Previously identified mass in the right medial breast, far posterior depth, is new when compared to the prior mammogram from 2012.Previously identified mass in the left central breast, mid depth, appears to have increased in size when compared to the prior mammogram. In addition, prior ultrasound examination from 2012 may show a corresponding partly cystic/partly solid mass, which needs to be further evaluated. | Bilateral partially obscured incompletely characterized masses. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Ms. Holly is a 22-year-old female with a biopsy-proven fibroadenoma in the left breast. She presents today for ultrasound evaluation to assess for possible growth of this fibroadenoma. Family history of breast cancer and maternal grandmother, three maternal cousins, and a maternal aunt. Upon physical exam at patient's area of concern, a soft mobile mass is appreciated.A targeted left breast ultrasound was performed for the palpable area of concern. In the left breast 6:00 location, approximately 2 cm from the nipple, there is reidentification of an oval hypoechoic mass measuring 2.4 x 1.3 x 2.9 cm, previously measuring 1.8 x 1.1 x 1.9 cm. | Interval increase in size of a biopsy-proven fibroadenoma in the left breast. Patient is scheduled to follow up with Joly Jose directly after the radiology appointment for further evaluation. All results and recommendations were relayed to the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Collected carcinoma with biliary stent with elevated bilirubin LIVER: Bilobar hepatic cysts unchanged.BILIARY TRACT: Interval improvement in degree of intrahepatic ductal dilatation. Biliary stents again noted.OTHER: Mild ascites again noted | Interval improvement in degree of intrahepatic ductal dilatation. Biliary stents again noted. Mild ascites again noted. |
Generate impression based on findings. | 39 years Female with history of bladder diverticulum, urinary tract infections, and hydronephrosis. RIGHT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.BLADDER: Bladder is incompletely distended but appears grossly unremarkable. No discrete bladder diverticuli are seen.OTHER: No significant abnormalities. | Unremarkable examination. |