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Generate impression based on findings. | Male 52 years old Reason: lung transplant pre evaluation, eval for liver disease LIVER: Liver echogenicity is within normal limits. No focal hepatic mass. The liver measures 13.7 cm in length.BILIARY TRACT: Gallbladder is minimally contracted. No intra or extrahepatic biliary ductal dilatation. No gallstones are identified. PANCREAS: Pancreas is obscured by overlying bowel gas.SPLEEN: Spleen is normal in appearance.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 12.4 cm. Left kidney measures 12.5 cm.ABDOMINAL AORTA: Normal abdominal aortic waveforms. Distal aorta measures 1.8 cm. Right iliac measures 1.1 cm in diameter. Left iliac measures 1.2 cm in diameter.INFERIOR VENA CAVA: Not well visualized secondary to overlying bowel gas.Bladder: Bladder is normal in appearance. | Normal appearing sonogram the abdomen. No significant abnormality. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are standard diagnostic mammogram (2/15/2016), bilateral breast ultrasound (2/15/2016), bilateral ultrasound-guided breast biopsy images (2/24/2016), and bilateral post-procedure mammogram (2/24/2016). These studies were performed at St. Anthony Breast Care Center in Crown Point, Indiana. Final pathology was benign for both breasts (PASH) as per Donna Christian, NP. Bilateral Diagnostic Mammogram (2/15/2016): Right CC view has been submitted only. The breast parenchyma is heterogeneously dense, which limits the sensitivity of the mammogram. Limited examination, please submit the remaining views.Bilateral Breast Ultrasound (2/15/2016): Targeted left breast ultrasound demonstrates a hypoechoic parallel mass with scattered cystic areas and some internal vascularity at the 12:00 position, approximately 4 cm from the nipple. The mass measures 4.9 x 1.1 x 5.4 cm and likely represents a fibroadenoma with cystic changes. Normal morphology lymph node is present in the left axilla.Targeted right breast ultrasound demonstrates a hypoechoic solid mass with cystic component and some internal vascularity at the 11:00 position, approximately 3 cm from the nipple. This mass measures 3.8 x 2.6 x 1.3 cm. Normal morphology lymph nodes are noted in the right axilla.Bilateral Ultrasound-Guided Breast Biopsy (2/24/2016): Core needle biopsy of the hypoechoic mass in the left breast, 12:00 position, is demonstrated with good targeting using a 14-gauge needle. 5 core specimens were obtained and a bowtie biopsy clip was placed.Core needle biopsy of the hypoechoic mass in the right breast, 11:00 position, is demonstrated with good targeting using a 14-gauge needle. 5 core specimens were obtained and a bowtie biopsy clip was placed.Bilateral Post-Procedure Mammogram (2/24/2016): CC and ML views of both breasts demonstrate heterogeneously dense parenchyma, which limits the sensitivity of the mammogram. Bowtie biopsy clips are noted in the upper outer quadrants of both breasts. No definite hematoma is identified in either breast. | Successful ultrasound-guided core needle biopsies of bilateral breast masses and clip placement. Final pathology was benign and concordant (PASH). Limited evaluation by mammography. Although the patient has heterogeneously dense breast, submission of left CC and bilateral MLO views is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Thyroid thyroid carcinoma status post thyroidectomy RIGHT LOBE: Status post thyroidectomy. Vague hypoechoic focus within the right thyroid bed measuring 0.5 x 0.4 x 0.6 cm.LEFT LOBE: Status post thyroidectomy. No worrisome massISTHMUS: Status post thyroidectomy. No worrisome massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy. Vague subcentimeter hypoechoic focus within the right thyroid bed; favor benign postoperative etiology. However, would pay special attention to this focus on future surveillance scans. No regional adenopathy. |
Generate impression based on findings. | 65 years old, Male, Reason: evaluate for cirrhotic morphology History: HCV, prior HBV LIVER: The liver measures 14.1 cm in length. Echogenicity of the liver is within normal limits. No surface nodularity of the liver to suggest cirrhosis. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 8 cm in length. RIGHT KIDNEY: Kidney measures 8.6 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. No hydronephrosis shadowing calculus. Small cortical renal cyst measuring 0.7 x 0.5 x 0.5 cm. | No sonographic evidence of cirrhosis or focal hepatic lesion. |
Generate impression based on findings. | 63-year-old male with deceased donor renal transplant and decreased urine output, evaluate for flow and hematoma. RENAL TRANSPLANT:LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No peritransplant fluid collection is seen.KIDNEY: No evidence of nephrolithiasis. The renal cortex appears within normal limits.COLLECTING SYSTEM/URETER: No evidence of hydronephrosis.URINARY BLADDER: The bladder was not well visualized on today's examination.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels. Inflow and outflow vasculature appear intact with appropriate directional flow. The resistive index in a segmental artery ranges from 0.62-0.69. The resistive index in arcuate arteries range from 0.55-0.61.OTHER: No significant abnormality noted | No significant abnormality related to the right iliac fossa renal transplant. No evidence of nephrolithiasis or hydronephrosis. Inflow and outflow vasculature appear patent with appropriate directional flow. |
Generate impression based on findings. | History of hepatitis C. Evaluate for HCC. LIVER: The liver measures 14 cm in length. It is mildly coarse in echotexture. No focal lesion. No intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 0.2 cm/s.BILIARY TRACT: The gallbladder is normally distended. It contains an echogenic shadowing focus compatible with a small gallstone. The common duct measures 9 mm without choledocholithiasis.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable.SPLEEN: The spleen measures 9.9 cm in length.RIGHT KIDNEY: The right kidney measures 10.1 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 10.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | 1. Mildly coarse hepatic echotexture without a discrete lesion.2. Cholelithiasis without cholecystitis. Mild prominence of the common bile duct; correlate with LFTs. |
Generate impression based on findings. | Elevated creatinine Left iliac fossa renal transplant again demonstrates moderate hydronephrosis and proximal moderate hydroureter unchanged from the prior study. No ureteral stent could be identified within the left iliac fossa collecting system. No worrisome mass, stone, or perinephric collection appreciated. Neobladder collapsed. | No change in moderate left iliac fossa hydronephrosis and proximal moderate hydroureter. No ureteral stent could be identified. |
Generate impression based on findings. | 38-year-old female with right-sided thyroid nodule. RIGHT LOBE MEASUREMENTS: 6.2 x 2.5 x 2.2 cmLEFT LOBE MEASUREMENTS: 5.1 x 1.6 x 1.1 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Primarily solid nodule measures 4.7 x 4.0 x 1.7 cm, with inferior cystic component measuring 1.5 cm. This nodule is not significantly changed in size compared with the prior study from 2012, at which time it was biopsied.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. | Large right thyroid nodule without significant interval change. |
Generate impression based on findings. | Female 73 years old Reason: ?AKI on CKD, eval for hydro. Limited by body habitus.RIGHT KIDNEY: Mildly increased echogenicity. 9 cm length. No hydronephrosis or hydroureter. Normal vascularity and limited color Doppler ultrasound imaging.LEFT KIDNEY: 10.8 cm in length. No hydronephrosis or hydroureter.URINARY BLADDER:Collapsed with Foley catheter in place.OTHER: No significant abnormalities noted. | Mild increased echogenicity suggestive medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Female 54 years old Reason: pls study liver, spleen in pt w severe CHF and 1 month h/o abd 'bloating' History: no periph edema; no crackles in lungs, but increasing upper abd fullness x 1 mo in pt w severe CHF LIMITED ABDOMENLIVER: Liver is enlarged measuring 15 cm. Hepatic veins and IVC are dilated. These findings are secondary to patient's known congestive heart failure. No evidence of focal liver lesions. Liver echogenicity is unremarkable.BILIARY TRACT: Gallbladder wall is thickened likely secondary to heart failure. No evidence of cholelithiasis.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 12 cm. There is a hyperechoic area within the spleen measuring 7 mm likely representing a hemangioma. RIGHT KIDNEY: Right kidney measures 11.7 cm. Normal echogenicity. No focal lesions or hydronephrosis.OTHER: Left kidney measures 12 cm. | Hepatomegaly, dilated hepatic veins and IVC secondary to patient's known history of congestive heart failure. Mild splenomegaly. Likely a small hemangioma within the spleen. |
Generate impression based on findings. | 48-year-old female with abdominal pain and question calcification on an outside plain film. RIGHT KIDNEY: The right kidney measures 10.6 cm in length. Echotexture is normal. There is no hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 10.9 cm in length. There is a very small, septated cyst in the midportion of the left kidney. In the upper pole of the kidney extending to the periphery of the cortex there are shadowing calcifications. There is focal parenchymal loss adjacent to this. Findings are suggestive of chronic calyceal stones. No associated mass is identified.OTHER: Bladder is decompressed. | Calcifications left kidney associated with parenchymal cortical loss. Presumably, chronic stone disease. |
Generate impression based on findings. | 48-year-old male with history of cirrhosis, evaluate for HCC. LIVER: Measures 15.8 in length. Cirrhotic morphology and 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. Gallbladder polyps measuring up to 0.4 cm without acute interval change.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. 0.6 cm right renal cyst without significant change. 0.5 cm nonobstructive right renal calculus.OTHER: No significant abnormalities noted. | Cirrhotic hepatic morphology and increased echogenicity consistent with chronic liver disease, without evidence of discrete mass. |
Generate impression based on findings. | 44-year-old female with a history of follicular thyroid carcinoma status post thyroidectomy presents for follow-up of nodules noted on prior ultrasound. RIGHT LOBE, LEFT LOBE, ISTHMUS MEASUREMENTS: The thyroid is absent.RIGHT LOBE: The thyroid is absent.LEFT LOBE: The thyroid is absent.ISTHMUS: The thyroid is absent.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Several lymph nodes are seen on the study.The previously seen node in level 2 on the right neck is not visualized on this study.Right neck level 3: An approximately 0.8 x 0.4 by is 1.6 cm node is seen with benign morphology.Right neck level 5: An approximately 1.0 x 0.4 x 1.3 cm node is seen with benign morphologyLeft node level 2: Previously seen lymph node is not visualized on this study.Left neck level 4: A previously seen 0.9 x 0.5 x 0.8 cm lymph node appears stable but is without definite benign characteristics.Left neck level 1: An approximately 1.0 x 0.3 x 1.5 cm lymph node is seen with benign morphologyOTHER: No significant abnormality noted. | 1. Surgical changes of a thyroidectomy.2. Lymph nodes appears stable as described above. Specifically, left neck level IV lymph node is stable but without definite benign characteristics. Recommend continued follow up with ultrasound. |
Generate impression based on findings. | Male 61 years old Reason: rule out liver abscess History: sepsis LIMITED ABDOMENLIVER: The liver measures 18.1 cm. Heterogeneous hepatic parenchymal echotexture with multiple mixed echogenicity foci throughout the liver measuring up to 2 cm in the right hepatic lobe. The portal vein is patent with normal directional flow. Small volume perihepatic ascites.BILIARY TRACT: Moderate intrahepatic biliary ductal dilation. The extrahepatic biliary duct measures 4 mm. Status post cholecystectomy. No evidence of biliary ductal dilation.PANCREAS: No significant abnormality noted.KIDNEYS: The right kidney measures 10.6 cm. The left kidney measures 10.8 cm.SPLEEN: The spleen measures 17.8 cm. Perisplenic ascites. | 1.Multiple mixed echogenicity foci throughout the liver as described above most consistent with liver abscesses as seen on comparison CT. The dominant right hepatic lobe abscess has decreased in size.2.Moderate intrahepatic biliary ductal dilation. 3.Hepatosplenomegaly. |
Generate impression based on findings. | Female 78 years old; Reason: elevated LFTs, eval for hepatic lesions or abnormalities History: elevated LFT LIVER: The liver measures 17.1 cm in length. There is coarse increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 16.0 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.0 mm. No stones are seen. No pericholecystic fluid. Negative sonographic Murphy sign. The common bile duct measures 0.3 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 6.6 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.7 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A renal cyst is seen measuring 2.4 cm x 1.9 cm x 2.1 cm. | There is coarse increased echogenicity of the liver compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses are seen. |
Generate impression based on findings. | 52 year-old female with heart failure and ascites. LIVER: Liver echotexture coarsely echogenic and mildly heterogeneous fashion. Within the left lobe of the liver there is a mildly hyperechoic ovoid region measuring 1.3 x 2 . 5 x 2 cm which may have a central linear decrease echogenicity extending to the periphery. This would best be evaluated by dedicated liver CT. Overall hepatic size within normal limits. Venous distention consistent with congestive heart failure.GALLBLADDER, BILIARY TRACT: Dependent sludge within the gallbladder without shadowing gallstones. Gallbladder wall within normal limits.PANCREAS: Exclude a small cystic area in the pancreatic head although the associated pancreatic duct does not appear dilated. Again this could be evaluated by CT or preferably MRCP.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Marked ascites. | Ascites. Coarsened hepatic echotexture.Apparent hyperechoic mass within the liver although this could also represent focal fatty infiltration. Dedicated CT or MR of the liver recommended.Cystic area within the pancreas. M.R.C.P. recommended. |
Generate impression based on findings. | Left testicular pain. RIGHT TESTIS: Right testis measures 4.1 x 2.7 x 2 cm. no focal lesions. Normal vascularity. Testicular microlithiasis.LEFT TESTIS: Left testis measures 3.9 x 2.3 x 2 cm. normal vascularity. Testicular microlithiasis. No focal lesions.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: Subcentimeter epididymal cyst.OTHER: Small left varicocele. Mild scrotal wall thickening, nonspecific. | Left varicocele. Bilateral testicular microlithiasis. Follow-up testicular imaging in one year is recommended. Mild nonspecific scrotal wall thickening. |
Generate impression based on findings. | 87-year-old male patient with excessive fatigue and anemia, concern for MDS. Also with evidence of CKD. Evaluate the spleen and kidneys. LIVER: The liver measures 18.9 cm in length and demonstrates increased parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 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 10.3 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.9 cm in length. No evidence of hydronephrosis.The spleen measures 7.7 cm in length. | 1. Mild hepatomegaly with increased parenchymal echogenicity, likely secondary to hepatic steatosis.2. Spleen size within normal limits. |
Generate impression based on findings. | Reason: 66 y/o man with a right thyroid nodule. RIGHT LOBE MEASUREMENTS: 8.1 x 4.3 x 2.9 cm.LEFT LOBE MEASUREMENTS: 5.7 x 3.1 x 1.8 cm.ISTHMUS MEASUREMENTS: Up to 3 mm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echogenicity. Partially visualized heterogeneous predominantly hypoechoic solid nodule at the inferior pole measuring 4.5 x 4.0 x 4.0 cm which extends substernally. The nodule demonstrates some internal vascularity, and a single dystrophic appearing calcification is noted.LEFT LOBE: Mildly heterogeneous background parenchymal echogenicity. No discrete nodules identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Partially imaged dominant thyroid nodule in the right inferior pole extending substernally which is of intermediate suspicion for neoplasm. |
Generate impression based on findings. | Female 49 years old Reason: gall stones History: epigastric pain LIVER: Heterogeneous background echogenicity of the liver. No definite focal mass is identified. Main portal vein is patent with normal directional flow and a peak velocity of 13.4 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallbladder wall thickening or signs of acute inflammation. No gallstones are identified.PANCREAS: Pancreas is obscured by overlying bowel gasSPLEEN: Spleen is normal in appearance measuring 10.5 cm.RIGHT KIDNEY: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10 cm. Left kidney measures 10.3 cm.OTHER: No significant abnormalities noted. | Normal appearance of the gallbladder without evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | Right upper quadrant abdominal pain LIVER: Non-cirrhotic liver morphology. Enlarged, measuring 23 cm in length. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.1 cm in length, with a 9 mm nonobstructing stone noted in the lower pole. The left kidney is 10.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 8.8 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No free fluid is identified. | 1. Hepatomegaly with increased hepatic echogenicity compatible with steatosis.2. Nonobstructing right nephrolithiasis.3. No specific findings otherwise to account for the patient's symptoms. |
Generate impression based on findings. | 70-year-old female with cancer status post thyroidectomy and I-131. Evaluate for abnormal masses or nodes. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Hyperechoic nodule is seen in the right thyroidectomy bed measuring 8 mm x 6 mm x 3 mm. LEFT LOBE: Hypoechoic nodule in the left thyroidectomy bed measures 4 mm x 3 mm x 2 mm, unchanged accounting for differences in technique, previously measuring 3 mm x 3 mm x 2 mm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral benign appearing lymph nodes in the neck, the largest on the right measures 1.7 cm x 1.0 cm x 0.5 cm. No pathologic lymphadenopathy. OTHER: No significant abnormality noted. | 1. Hyperechoic subcentimeter nodule in the right thyroidectomy bed with appearance favoring a benign process. 2. Hypoechoic nodule in the left thyroidectomy bed is unchanged. |
Generate impression based on findings. | 59 year old female presents for hepatocellular carcinoma screening. Participant in a clinical trial. LIVER: Subtle heterogeneous echogenicity of the liver, with contour nodularity consistent with early cirrhosis. No identifiable masses. The liver measures 20.7 cm.BILIARY TRACT: No biliary dilatation. Small amount of gallbladder sludge/debris. No pericholecystic fluid or gallbladder wall thickening.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. The spleen measures 10.7 cm.RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 12.3 cm.OTHER: No significant abnormalities noted. The left kidney measures 10.2 cm, and has a small superior pole exophytic simple cyst measuring 2.5 x 2.1 x 2.6 cm. | Findings of early hepatic cirrhosis, with no identifiable liver masses. |
Generate impression based on findings. | Reason: RUQ History: r/o cholecystitis LIVER: The liver measures 14.8 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Status post cholecystectomy. The common bile duct measures up to 9 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 8.6 cm in length. KIDNEY: Native kidneys not visualized. Transplant kidney in the left iliac fossa measuring 12.9 cm in length without hydronephrosis.OTHER: No significant abnormalities noted. | Status post cholecystectomy without evidence of acute cholecystitis. |
Generate impression based on findings. | Reason: Assess for thyroid enlargement/nodules History: 10lb weight loss, low TSH, high free T4 RIGHT LOBE MEASUREMENTS: 3.5 x 4.0 x 1.5 cmLEFT LOBE MEASUREMENTS: 3.3 x 0.9 x 1.0 cmISTHMUS MEASUREMENTS: 0.3 cm in AP dimensionRIGHT LOBE: Right lower pole nodule measures 0.3 x 0.2 x 0.3 cm and likely represents a benign colloid nodule. Otherwise homogeneous gland with no suspicious nodules or masses.LEFT LOBE: Homogeneous gland with no suspicious nodules or masses.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted. No cervical lymphadenopathy.OTHER: No significant abnormality noted. | Subcentimeter thyroid nodule as described above. |
Generate impression based on findings. | 58 year-old female with anemia. Mildly prominent renal collecting systems on prior study. A targeted ultrasound was performed of the 4 quadrants of the abdomen and midline. There is a moderate volume of ascites. Small effusions. | Moderate volume ascites. Ultrasound is inadequate for evaluation of a retroperitoneal bleed; CT is recommended when feasible if there is continued clinical concern of a retroperitoneal bleed. |
Generate impression based on findings. | 79-year-old male with oliguria. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 10.9 cm in length. There is a 2.7 cm renal sinus cyst identified. No hydronephrosis, shadowing calculus or solid mass. Echotexture likely within normal limits.LEFT KIDNEY: The left kidney measures 10.6 cm in length. Echotexture is likely within normal limits. There is an exophytic 3 cm cyst arising from the left kidney which may be mildly complex. No hydronephrosis or shadowing calculus.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | No hydronephrosis. Echogenic kidneys with cysts. Left renal cyst may be mildly complex. |
Generate impression based on findings. | Right upper quadrant pain LIVER: No significant abnormalities noted. 17.4-cm in lengthGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.9 cm in lengthOTHER: Left kidney 11.2 cm in length. Spleen 10.2 cm in length. No ascites. | Negative for acute hepatobiliary abnormality. No ascites. |
Generate impression based on findings. | Flank pain; end-stage renal disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.4 cm in length LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 12.6 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | 72 year old female patient with two episodes of right upper quadrant pain. LIVER: The liver measures 13.1 cm in length and demonstrates coarsened parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones. No pericholecystic fluid or gallbladder wall thickening is noted. Sonographic Murphy's sign is negative. 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 8.8 cm in length. No evidence of hydronephrosis. There is a hypoechoic 1.5 cm lesion with low level internal echoes within the lower pole of the right kidney.OTHER: The left kidney measures 8.7 cm in length. No evidence of hydronephrosis.The spleen measures 5.9 cm in length. | 1. Cholelithiasis without sonographic evidence of acute cholecystitis.2. Minimally complex right lower pole renal cyst; follow up ultrasound is recommended in 12 months. |
Generate impression based on findings. | Male 52 years old Reason: decompensated cirrhosis, eval hepatic artery \T\ portosystemic shunts History: check liver doppler ABDOMENLIVER: Diffusely coarse and echogenic nodular appearance of the liver compatible with cirrhosis. No focal hepatic mass.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Gallbladder is distended with mild gallbladder wall thickening measuring up to 4.6 mm, which may be seen in the setting of cirrhosis. Layering sludge is present within the gallbladder. No shadowing gallstones.PANCREAS: Pancreas is obscured by overlying bowel gas.SPLEEN: Spleen is enlarged measuring 19.1 cm. Normal background echogenicity. KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Left kidney measures 11.5 cm. Right kidney measures 10.9 cm.OTHER: Right pleural effusion and mild to moderate ascites are present. | 1.Cirrhotic liver morphology, consistent with given history. Reversed flow (hepatofugal) in the main, left, and right portal veins.2.Splenomegaly.3.Right pleural effusion and mild to moderate ascites. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are screening mammogram dated 11/18/2015 and ultrasound-guided core biopsy right breast dated 12/16/2015 performed at Swedish dominant. For comparison,5/12/2014 are available. Screening mammogram dated 11/18/2015:2 standard views of both breasts and right exaggerated CC lateral view were obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. 12 mm focal asymmetry in the right breast 9:00 position posterior depth is new from prior study. A faint calcification is identified within the mass on the exaggerated CC lateral view.Spot compression views were not obtained. No suspicious abnormality identified in the left breast.Ultrasound guided biopsy was performed on 12/16/2015 that showed a suspicious hypoechoic mass measuring 13 x 9 x 11 mm without peripheral blood flow at 9:00 position of the left breast. Ultrasound-guided biopsy was performed, 3 cores were obtained. Targeting appears adequate. There is no demonstration of clip placement on the images. There is no mention of clip placement on the report. No postprocedure mammogram was obtained. Pathology results are not available. | Screen detected 12 mm focal asymmetry right breast 9:00 position, subsequently biopsied under ultrasound. Clip has not been placed within the mass. Pathology results to be reviewed at University of Chicago.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 54 year old female with bilateral thyroid nodules and anterior superior neck mass. RIGHT LOBE MEASUREMENTS: 6.0 cm x 2.2 cm x 2.1 cm. LEFT LOBE MEASUREMENTS: 6.0 cm x 1.7 cm x 1.5 cm. ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: A relatively isoechoic nodule is seen along the midpole of the right lobe measuring 0.9 cm x 0.8 cm x 0.8 cm and contains no internal vascularity or definite microcalcifications. There is inferior extension of the right thyroid lobe measuring 1.6 cm x 1.1 cm x 1.1 cm with no increased vascularity or definite microcalcifications. LEFT LOBE: Along the midpole of the left thyroid lobe there is a slightly hypoechoic heterogeneous nodule measuring 1.1 cm x 0.8 cm x 1.2 cm with no internal vascularity or definite microcalcifications. ISTHMUS: No significant abnormality noted. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small subcentimeter lymph node along the left lateral neck. OTHER: In the neck at level 6 superior to the isthmus there is a heterogeneous nodule measuring 1.4 cm x 0.7 cm x 1.6 cm with no internal vascularity or definite microcalcifications. This may be separate from the thyroid gland. | 1. Multiple thyroid nodules bilaterally that do not meet size criteria for biopsy. There is what apparently represents an inferior extension of the right thyroid lobe, further described above, however attention to this area is recommended on subsequent imaging. 2. Heterogeneous nodule in the neck at level 6 superior to the isthmus which was subsequently biopsied, pathology report pending. |
Generate impression based on findings. | 25-year-old female with cirrhosis evaluate blood flow and screening for HCC. LIVER:The transplanted liver measures 20.4 cm in length. The liver appears nodular with coarse echogenicity. No intrahepatic ductal dilation. No new worrisome masses are seen. No ascites.GALLBLADDER, BILIARY TRACT: The gallbladder surgically absent. The common bile duct measures 4.6 mm.PANCREAS: Pancreas is not well-visualized due to bowel gas. No significant abnormality noted.SPLEEN: The spleen measures 13.3 cm in length. No significant abnormalities are noted.RIGHT KIDNEY: Right kidney measures 10.3 cm in length. The right kidney was not well visualized but no significant abnormalities are noted.LEFT KIDNEY: The left kidney measures 10.3 cm in length. No significant abnormalities are noted.PORTAL Vein: the portal vein is patent with hepatopetal flow measuring 47.0 cm/s. The left portal vein is patent with hepatopetal flow measuring 23 cm/s. The right portal vein was not well visualized.HEPATIC VEIN: The common hepatic vein is patent with hepatofugal flow measuring 82.4 cm/s.HEPATIC ARTERY: The common hepatic artery is patent with hepatopetal flow and peak systolic velocity of 54 cm/s, and RI of 0.7. The left hepatic artery is patent with hepatopetal flow and peak systolic velocity of 50 cm/s and RI of 0.5. The right hepatic artery is not well-visualized.SPLENIC VEIN: The splenic vein is patent with hepatopetal flow measuring 21.7 cm/s.SPLENIC ARTERY: The splenic artery is patent with peak systolic velocity of 67 cm/s and RI of 0.5.ABDOMINAL AORTA: Not visualized on this study.INFERIOR VENA CAVA: The IVC is patent with hepatofugal flow measuring 104.2 cm/s. | The liver appears coarse and nodular which is concerning for developing cirrhotic morphology. No new worrisome masses are seen. Patent vasculature, as above, with normal directional flow. No ascites is seen. |
Generate impression based on findings. | 72 years old, Female, Reason: evaluation for parathyroid location and any abnormality History: secondary hyperparathyroidism RIGHT LOBE MEASUREMENTS: 4.8 x 1.8 x 1.1 cm.LEFT LOBE MEASUREMENTS: 4.1 x 1.8 x 1.1 cm.ISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Inferior to lower pole of the left thyroid lobe is a hypoechoic nodule with peripheral vascular flow measuring 1.8 x 1.4 x 1.6 cm, appearance consistent with parathyroid adenoma.LYMPH NODES: No significant abnormality noted. | Parathyroid adenoma adjacent to the left lower pole of the thyroid. Please refer to concomitant scintigraphic imaging from same day for additional findings. |
Generate impression based on findings. | 42-year-old female with gallbladder wall thickening on CT presents for further evaluation. LIVER:No significant abnormality noted.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. No stones or sludge. No pericholecystic fluid. The wall measures 0.3 cm. The common duct measures 0.3 cm.OTHER: No significant abnormality noted. | 1. Normal ultrasound of the gallbladder. |
Generate impression based on findings. | Cirrhosis. Gram-negative bacteremia. Acute kidney injury. Evaluate for renal obstruction or perinephric abscess. LIVER: Cirrhotic liver morphology with coarsened parenchymal echogenicity. The hepatic lesion seen on the prior MRI are not evident, likely due to heterogeneous background parenchymal echogenicity. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Cholelithiasis. Gallbladder distention, without wall thickening or sonographic Murphy's sign elicited.PANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney is 10.0 cm in length. The left kidney is 10.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present. No perinephric fluid collection.SPLEEN: 12.1 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent, without aneurysm.INFERIOR VENA CAVA: Patent.OTHER: Small amount of perihepatic ascites identified. No loculated fluid collection to suggest abscess identified. | 1. Cirrhosis with mild ascites.2. Cholelithiasis without evidence of cholecystitis.3. No hydronephrosis. |
Generate impression based on findings. | 50 year-old male with history of worsening liver failure. Evaluate hepatic vaso-occlusive disease. LIMITED ABDOMENLIVER: Mildly hyperechoic liver parenchyma, unchanged. No biliary dilatation is appreciated.BILIARY TRACT: Not well assessed on this nondedicated study.PANCREAS: Not well assessed on this nondedicated study.RIGHT KIDNEY: Not well assessed on this nondedicated study. | Patent hepatic vasculature as above. Redemonstration of echogenic liver parenchyma, with ascites and right pleural effusion incompletely imaged. |
Generate impression based on findings. | Possible mass on CT chest in the liver, probably in the dome LIVER: Liver measures 15.8 cm without any focal lesion. Especially in the dome of the liver no suspicious cystic or solid mass noted. Increased echogenicity of the liver suggestive of hepatic steatosis. Gallbladder is distended with a gallstone within it. Common bile duct measures up to 5 mm without any stones or sludge within it.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Gallbladder is distended with a gallstone within it.No pericholecystic fluid is notedPANCREAS: Head of the pancreas as visualized appears unremarkable. Body and tail of pancreas is not visualized.OTHER: No significant abnormalities noted. | No suspicious mass noted in the dome of the liver. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | 44-year-old male with acute kidney injury. Evaluate for hydronephrosis RIGHT KIDNEY: Right kidney is normal in echogenicity and measures 12.3 cm in length without evidence of hydronephrosis. LEFT KIDNEY: Left kidney is normal in echotexture and measures 13.5 cm in length without evidence of hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of hydronephrosis. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Mild hepatomegaly with coarse echogenic parenchyma without mass. Liver length 19.6 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.8 cm in lengthOTHER: Left kidney 10.5 cm in length. Spleen 11.3 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Mild hepatomegaly associated with coarse echogenic parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass. No ascites. |
Generate impression based on findings. | Kidney stones RIGHT KIDNEY: Extensive staghorn calculus occupying the right collecting system. No hydronephrosis. No worrisome mass. Right kidney 11.8 cm in length.LEFT KIDNEY: No significant abnormalities noted. 12.2 cm in length OTHER: Bladder nondistended | Extensive staghorn calculus occupying the right collecting system. No hydronephrosis. No worrisome mass. |
Generate impression based on findings. | Male, 40 years old. Worsening CKD. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.0 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.1 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. Bilateral ureteral jets are noted. | 1.No hydronephrosis.2.Increased renal cortical echogenicity, compatible with medical renal disease. |
Generate impression based on findings. | 58-year-old female with elevated LFTs. LIVER: Increased hepatic echogenicity without discrete focal lesion.BILIARY TRACT: No gallbladder wall thickening, cholelithiasis, or pericholecystic fluid. No ductal dilation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. No discrete lesions identified. |
Generate impression based on findings. | History of gallbladder wall thickening seen on recent chest CT. LIVER: The liver measures 15.5 cm in length. The liver parenchymal echotexture is normal. Multiple small hepatic cystic lesions likely represent biliary hamartomas. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.18 m/s.BILIARY TRACT: The anterior gallbladder wall is thickened, diffusely echogenic, generates dense shadowing, and generates twinkle artifact. The gallbladder lumen and posterior wall are obscured. This appearance is most likely related to cholesterolosis of the gallbladder wall, however, cholelithiasis cannot be excluded. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.0 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. No hydronephrosis. Small cyst.LEFT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. Mild hydronephrosis, not clearly evident on recent chest CT (although kidney only partially visualized on chest CT). Multiple cysts, the largest of which demonstrates minimal internal complexity.OTHER: No significant abnormalities noted. | 1.Findings suggestive of gallbladder cholesterolosis. Gallbladder lumen and posterior wall obscured, and cholelithiasis not excluded.2.Mild left hydronephrosis, possibly new.Findings discussed with Dr. Schwartz at 3:50 PM on 12/2/2016. |
Generate impression based on findings. | Gift of Hope liver workup LIVER: Unremarkable liver echogenicity without mass. Liver length 19.5 cm. Limited Doppler interrogation 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. 8.9 cm in lengthOTHER: Trace ascites | Mild hepatomegaly with unremarkable liver echogenicity without mass or ductal dilatation. Trace ascites. |
Generate impression based on findings. | Female 58 years old Reason: rule out obstruction History: acute kidney injury RIGHT KIDNEY: 10.5 cm in length. Mildly echogenic suggestive medical renal disease. No hydronephrosis or hydroureter.LEFT KIDNEY: 10.7 cm in length. No hydronephrosis or hydroureter.OTHER: Bladder collapsed with Foley catheter in place. | No evidence of hydronephrosis. Mildly echogenic kidneys. Collapsed urinary bladder. |
Generate impression based on findings. | History of multiple thyroid nodules. RIGHT LOBE MEASUREMENTS: 2.1 x 1.7 x 6 cmLEFT LOBE MEASUREMENTS: 1.6 x 1.6 x 6.4 cmISTHMUS MEASUREMENTS: 5 mmRIGHT LOBE: Two solid right thyroid lobe nodules. The larger nodule measures 1.6 x 1.3 x 2.3 cm in the inferior/mid pole. It is predominantly solid without specific suspicious sonographic features. Previously it measured approximately 1.9 x 1.5 x 1.8 cm.LEFT LOBE: Two solid left thyroid nodules are present. The larger nodule measures 1.2 x 1.0 x 1.5 cm in the superior pole. No specific suspicious sonographic features.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No pathologically enlarged or suspicious appearing cervical lymph nodes are identified.OTHER: No significant abnormality noted. | Bilateral thyroid lobe nodules with the largest being a 2.3 cm solid nodule in the inferior pole of the right thyroid lobe. This is minimally increased in size accounting for differences in measurement technique. |
Generate impression based on findings. | 59-year-old female patient with history of papillary cancer. RIGHT LOBE: Status post thyroidectomy. There is a new hypoechoic focus within the right thyroid bed measuring 0.2 x 0.2 x 0.4 cm.LEFT LOBE: Status post thyroidectomy without recurrent or residual tissue identified.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a non-descript right level III lymph node measuring 0.8 x 0.4 x 1.5 cm. A benign morphology left level III lymph node measures 0.7 x 0.3 x 1.2 cm. OTHER: No significant abnormality noted. | 1. New hypoechoic focus within the right thyroid bed.2. Non-descript prominent right level III lymph node; this is amenable to biopsy if clinically indicated. |
Generate impression based on findings. | 49-year-old female with right upper quadrant abdominal pain concerning for capsulitis versus issues with gallbladder. LIVER: The liver measures 17.3 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal measures approximately 0.2 m/s.GALLBLADDER, BILIARY TRACT: There are no gallstones, pericholecystic fluid, or gallbladder wall thickening. No intra or extrahepatic biliary ductal dilatation is identified. The common bile duct measures approximately 2 mm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. No evidence of hydronephrosis.OTHER: The left kidney measures 11.9 cm in length. No evidence of hydronephrosis. The spleen measures 9.3 cm in length. An accessory splenule is noted. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Screening findings in both breasts presents for further follow-up. Three standard views of both breasts left spot magnification and right spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses(BiRads Density Category C), unchanged in pattern and distribution. Multiple enlarged right axillary lymph nodes are again seen. The largest of these measures up to 17 mm, which is slightly enlarged compared to last year's mammograms. High probability benign calcifications in the left upper outer breast appear to layer on the ML view suggesting benign milk of calcium. There are bilateral benign calcifications elsewhere including arterial calcifications. Normal sized left intramammary lymph node in the upper outer quadrant.ULTRASOUND | Right axillary lymphadenopathy for which ultrasound-guided biopsy of the most suspicious lymph node is recommended. Left breast calcifications are most compatible with benign milk of calcium. If the right axillary lymph node biopsy is benign, then the next breast imaging for this patient could be a six-month follow-up for these calcifications.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: LVAD work up, rule out cirrhosis or kidney disease LIVER: The liver measures 16.0 cm in length. Increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.33 m/s.BILIARY TRACT: Sludge is present within the gallbladder without associated 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 within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.7 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.3 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass. Simple cyst. ABDOMINAL AORTA: The abdominal aorta measures 3.1 x 3.1 proximally. The mid and distal aorta are not well visualized.INFERIOR VENA CAVA: Not visualized.OTHER: Foley catheter. Moderate ascites. Right pleural effusion. | 1.Echogenic liver suggestive of fatty infiltration/parenchymal dysfunction without morphologic evidence of cirrhosis. 2.Ascites and right pleural effusion.3.Echogenic kidneys compatible with medical renal disease. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.8 x 2.1 x 2.4 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.9 x 1.6 cmISTHMUS MEASUREMENTS: 1 cmRIGHT LOBE: Stable benign-appearing right thyroid nodules. A representative lower pole spongiform nodule measures 0.7 x 0.6 x 0.5 cm.LEFT LOBE: Stable appearing left thyroid lobe without worrisome nodule.ISTHMUS: Stable isthmic nodules. The right isthmic nodule measures 1.3 x 0.9 x 1.5 cm. The left isthmic nodule measures 1.3 x 0.9 x 1.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable thyroid nodules. No regional adenopathy. |
Generate impression based on findings. | 76-year-old with a history of a multinodular thyroid presents for follow-up. RIGHT LOBE MEASUREMENTS: 4.1 x 1.9 x 2.1 cm.LEFT LOBE MEASUREMENTS: The left lobe is absent.ISTHMUS MEASUREMENTS: The isthmus is absent.RIGHT LOBE: There are several nodules in the right lobe. There is a dominant nodule measuring approximately 1.7 x 1.1 x 1.2 cm. It is mixed cystic-solid, predominantly cystic, well-defined with ring down artifact. This remains stable since the prior examination.LEFT LOBE: The left lobe is absent. There is a round hypoechoic area measuring 0.3 x 0.9 x 0.4 cm. It appears stable since the prior study.ISTHMUS: Isthmus is absent.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Multinodular thyroid as described above. There is has been an interval left thyroidectomy. The right thyroid appears stable. |
Generate impression based on findings. | Mass in tail of right carotid and Rathke's cyst or tumor pituitary. New fullness involving the anterior chest wall.IMAGE ACQUISITIONS: Enhanced CT performed of the head. Enhanced CT performed of the neck. See separate report for chest CT. Evaluation of the brain shows no evidence of abnormality of the ventricles or basal cisterns. There is an expansile cystic lesion in the sella turcica that correlates with the lesion noted on MR imaging. Allowing for differences in modality. This does not appear to have changed significantly from the prior study. There is 1 cm nodule within the tail of right parotid gland that is nonspecific, but may represent pleomorphic adenoma. Evaluation of the remainder of the neck soft tissues shows a normal appearance of the nasopharynx and parapharyngeal spaces. No other nodules are seen within the parotid glands. The submandibular glands show bilateral submandibular stones as well as a calcification in the right sublingual space that likely represents a stone as well. There are multiple low-attenuation nodules also seen in the thyroid gland with more pronounced nodularity identified on the left. The largest measures 1.3-cm. Correlation with ultrasound or biopsy may be helpful as warranted clinically. The larynx and hypopharynx are unremarkable. There is no evidence of significant lymphadenopathy identified involving the neck soft tissues. | Stable cystic mass involving sella turcica and extending into the skull base. Approximately 1 cm nodule right parotid gland. Bilateral submandibular and right sublingual stones. Multiple nodules identified in the thyroid gland, most pronounced involving left lobe. See separate report for chest CT. |
Generate impression based on findings. | 43-year-old female with concern for acute hyperthyroidism RIGHT LOBE MEASUREMENTS: The right lobe measures 6.9 cm x 2.7 cm x 2.2 cm.LEFT LOBE MEASUREMENTS: The left lobe measures 5.9 cm x 2.5 cm x 2.0 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.6 cm.RIGHT LOBE: The right lobe is enlarged and heterogeneous. There is increased vascularity. No dominant nodules are identified.LEFT LOBE: The left lobe is enlarged and diffusely heterogeneous. No dominant nodules are identified.ISTHMUS: The isthmus is enlarged and heterogeneous. No dominant nodules are identified.PARATHYROID GLANDS: None visualized.LYMPH NODES: Several small lymph nodes are seen on the right, the 2 largest were measured. On the right at level 1B this node measures 1.4 cm x 0.8 cm x 0.4 cm. On the right at level 3 this node measures 1.9 cm x 0.5 cm x 0.4 cm. Both of these nodes are slender with a fatty hilum. On the left, there is a level 1B lymph node that measures 1.6 cm x 0.9 cm x 0.4 cm. This node is slender with a fatty hilum. On the left inferior to the thyroid there is a lymph node that measures 1.1 cm x 0.8 cm x 0.8 cm. This is hypoechoic with a fatty hilum. | 1. Multinodular goiter with no dominant nodule seen. The thyroid gland is also hypervascular.2. Several benign-appearing lymph nodes are seen bilaterally, as above. |
Generate impression based on findings. | Male; 59 years old. Reason: ? nodules, nodes History: thyroid cancer s/p surgery, i131 RIGHT LOBE MEASUREMENTS: Surgically absent. No suspicious mass within the surgical bed.LEFT LOBE MEASUREMENTS: Surgically absent. No suspicious mass within the surgical bed.ISTHMUS MEASUREMENTS: Surgically absent. No suspicious mass within the surgical bed.RIGHT LOBE: As above.LEFT LOBE: As above.ISTHMUS: As above.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are prominent bilateral cervical chain lymph nodes, left greater than right. The largest on the right is in level 5 and measures 1.7 x 0.5 x 1.2 cm. The largest on the right is in level 5 and measures 1 x 0.9 x 1.1 cm. No pathologically enlarged lymph nodes by size criteria. No microcalcifications within the lymph nodes.OTHER: No significant abnormality noted. | Prominent lymph nodes, which are not pathologically enlarged by size criteria. No microcalcifications within the lymph nodes. However, given the prominence of the nodes, close attention at follow-up is recommended. |
Generate impression based on findings. | 66 years old, Male, Reason: renal failure History: AKI in post renal cell ca. RIGHT KIDNEY: Kidney measures 12.7 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The patient is status post left nephrectomy. No definite abnormality identified in the nephrectomy bed.BLADDER: The bladder is incompletely distended around a Foley catheter precluding complete evaluation. OTHER: No significant abnormalities noted. | 1.Normal echogenicity of the right kidney without evidence of hydronephrosis or shadowing calculus. |
Generate impression based on findings. | 35-year-old male patient with history of multinodular goiter and history of previous surgeries in 1990s. Evaluate for suspicious nodules. RIGHT LOBE MEASUREMENTS: 6.9 x 2.8 x 2.7 cm.LEFT LOBE MEASUREMENTS: 7.7 x 3.4 x 3.3 cmISTHMUS MEASUREMENTS: 1.3 cmRIGHT LOBE: Multiple predominantly solid nodules. Dominant nodule measures 2.1 x 1.7 x 1.6 cm, is heterogeneous and predominantly solid, not changed substantially but difficult to compare given the multiplicity of nodules.LEFT LOBE: Multiple heterogeneous nodules.Dominant nodule measures 2.1 x 1.8 x 1.7 cm, predominately solid with cystic components and a central, shadowing calcification. Again, not changed substantially but difficult to compare given multiplicity of nodules.ISTHMUS: Multiple predominantly solid nodules.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious pathologically enlarged lymph nodes.OTHER: No significant abnormality noted. | Multinodular goiter with no substantial interval change compared to prior. |
Generate impression based on findings. | Elevated T3 and T4 with cardiac anomalies RIGHT LOBE MEASUREMENTS: 4.9 x 1.5 x 2 cmLEFT LOBE MEASUREMENTS: 4.2 x 1.6 x 2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Diffusely heterogeneous gland with increased vascularity. No discrete mass.LEFT LOBE: Diffusely heterogeneous gland with increased vascularity. No discrete mass.ISTHMUS: Diffusely heterogeneous gland with increased vascularity. No discrete mass.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland with increased vascularity. No discrete mass. Findings suggestive for Graves' disease versus acute thyroiditis. |
Generate impression based on findings. | 7 day old male with encephalocele and meningomyelocele status post repair on 6/11; patient now has seizure like activity in the upper extremities. Patient needs head CT. There is no evidence of intracranial hemorrhage, mass or edema. Panventricular dilatation that is stable when compared to ultrasound obtained 6/13/2008.Wavy contour of the inner table of the calvarium consistent with Luckenschadel skull.Interdigitation of the interhemispheric fissure.Corpus callosum present.The visualized paranasal sinuses are normally pneumatized. | 1. Imaging features associated with Chiari malformation including Luckenschadel skull and interdigitation of the cerebral hemispheres.2. Stable panventricular dilatation compared to ultrasound obtained 6/13/2008. |
Generate impression based on findings. | 54 years old, Female, Reason: follow-up toxic mng History: increasing thyroid size RIGHT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.3 cmLEFT LOBE MEASUREMENTS: 8.1 x 2.4 x 1.7 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: The gland is diffusely heterogeneous. Subcentimeter hypoechoic focus in the right lower lobe is unchanged measuring 0.4 x 2.2 x 0.4 cm.LEFT LOBE: The gland is diffusely heterogeneous. Subcentimeter hypoechoic focus in the mid left thyroid lobe is unchanged in appearance. There is a dominant solid left lower thyroid lobe nodule is slightly smaller in size measuring 2.8 x 1.2 x 1.6 cm which is amenable to biopsy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Solid dominant left lower pole thyroid nodule measures slightly smaller in size and is amenable to biopsy. 2.Multiple other subcentimeter hypoechoic foci within the bilateral thyroid lobes appear unchanged. |
Generate impression based on findings. | Sarcoid with acute renal insufficiency RIGHT KIDNEY: Right pelvic kidney. Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.2 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 12.1 cm in lengthOTHER: Bladder nondistended | Mildly echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | History of hepatic adenoma status post excision now with epigastric abdominal pain. LIVER: The liver measures 12.8 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.29 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Sonographic Murphy's sign was negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.8 cm in length. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No focal hepatic lesions or forthcoming cause of patient's pain identified. |
Generate impression based on findings. | 65 year old male with abdominal distention, transaminitis, hyperbilirubinemia. Limited exam due to patient body habitus.LIVER: Coarse echotexture of the liver and nodular contour suggestive of underlying cirrhosis. Liver measures 20.9 cm in length. Portal vein is patent with appropriate directional flow. No focal hepatic lesion. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney measures 13.7 cm in length. No hydronephrosis.OTHER: Left kidney measures 13.8 cm in length. No hydronephrosis.Spleen measures 14.2 cm in length.Upper abdominal ascites. | 1. Hepatosplenomegaly. Coarse echotexture and nodular contour of the liver suggestive of underlying cirrhosis.2. Upper abdominal ascites. |
Generate impression based on findings. | Female 77 years old Reason: assess for lymphadenopathy History: L neck pain, swelling All lymph nodes in the neck are of normal size and morphology.Largest nodes are measured for baseline purposes as follows:On the right level 2, measuring 1 x 0.8 x 0.4 cm.On the left level 11.1 measuring x 0.7 x 3.1 cm.In the area of abnormal sensation on the left, the musculature appeared normal and symmetric comparing right and left sides.Formal thyroid ultrasound is not done but numerous bilateral thyroid nodules are identified with varying morphologies including solid, cystic and spongiform. These seem to be described on the ultrasound report of 10/20/2007. | No pathologic size nodes. No pathologic morphology nodes. Symmetric appearing neck muscles. Thyroid nodules. |
Generate impression based on findings. | 57-year-old female with history of thyroid cancer post thyroidectomy. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for recurrent disease. No interval change. |
Generate impression based on findings. | Abnormal LFTs; previously on statin LIVER: Mild improvement in degree of liver heterogeneity without mass. Liver length 15.2 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11 cm in lengthOTHER: Left kidney 12 cm in length. Spleen 16 cm in length. No ascites. | Mild improvement in degree of liver heterogeneity. No hepatic mass or ductal dilatation. No ascites. Stable mild splenomegaly |
Generate impression based on findings. | Thyroid nodule seen on CT RIGHT LOBE MEASUREMENTS: 4.7 x 1.9 x 2.5 cmLEFT LOBE MEASUREMENTS: 6.0 x 2.1 x 2.3 cmISTHMUS MEASUREMENTS: 3 mm in AP dimensionRIGHT LOBE: No significant abnormality noted.LEFT LOBE: A 12 mm solid nodule is identified in the left midpole. The nodule is homogeneous and well marginated, without suspicious calcifications or vascularity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | 12 mm left thyroid nodule identified, without suspicious features. |
Generate impression based on findings. | 59-year-old female with history of bilateral mastectomy in March 2016 and positive surgical margins in the right breast. Evaluate for abnormal right axillary lymph nodes. A targeted right axillary ultrasound was performed. Circumscribed nearly anechoic lesion with posterior through transmission is identified near the patient's site of recent surgery, compatible with an oil cyst. This cyst measures 0.4 x 0.5 x 0.5 cm. No abnormal lymph nodes or suspicious solid or cystic lesions are identified. | Right axillary oil cyst. No sonographic evidence of malignancy in the right axilla. Recommend surgical follow-up to direct any further management.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 21-year-old male with swelling over the lumbar spine area. Assess fluid collection. There is an approximately 3.2 x 0.4 x 0.9 cm uncomplicated fluid collection. There are some internal echoes. There is posterior acoustic shadowing. The fluid collection is very well-defined. Its depth is about 0.4 cm. It is approximately 0.2 cm from the skin surface. | 1. Nonspecific fluid collection in lower back as described above. |
Generate impression based on findings. | 16 year old female with recent laparoscopic cholecystectomy with recurrent biliary pain LIVER: The liver measures 14.9 cm. Normal liver echotexture without focal hepatic lesions. Limited interrogation of the main portal vein demonstrates blood flow towards the liver measuring 22.4 cm/sec.GALLBLADDER, BILIARY TRACT: Gallbladder has been removed. No intrahepatic or extrahepatic biliary ductal dilatation. The common bile duct measures up to 7 mm.PANCREAS: Pancreas body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 11.3 cm.KIDNEYS: The right kidney measures 10.5 cm. The left kidney measures 10.6 cm. No evidence of hydronephrosis.OTHER: No significant abnormalities noted. | Status post cholecystectomy with common bile duct measuring up to 7 mm. |
Generate impression based on findings. | Male; 60 years old. Reason: 60 y/o M with PMH of SVT with likely lipoma on upper back, please ultrasound and evaluate On the right upper back at the site of the palpable abnormality is a 6.2 x 1.6 x 4.5 cm intramuscular, ovoid structure which is isoechoic to the adjacent muscle with thin internal striations that are parallel to the long axis of the structure itself. Portions of the border of this lesion are not easily discernible from the adjacent muscle. There is no internal vascularity seen on color Doppler. | 6.2 x 1.6 x 4.5 cm intramuscular structure is most compatible with a lipoma. Other benign etiologies such as normal variant of the musculature are also considered. |
Generate impression based on findings. | 15-year-old history of right breast mass presents for follow-up. On physical exam, there is a soft mobile palpable mass in the right retroareolar region. A targeted grayscale and color Doppler right breast ultrasound was performed for the palpable area of concern. There is a 2.5 x 1.6 x 2.3 cm well-circumscribed oval hypoechoic mass with internal blood flow, previously measured 2.5 x 1.7 x 2.3 cm, and unchanged in size. Imaging features are highly suggestive of a fibroadenoma. | No change in size of 2.5 cm right retroareolar mass favoring fibroadenoma. Continual clinical follow-up is recommended as long as the patient's physical exam remains stable. Results and recommendations were discussed with the patient and her mother at the time of exam.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: Eval for signs of cirrhosis or portal hypertension History: Chronic HCV LIVER: The liver measures 13.8 cm in length. The liver is smooth in contour and is normal in echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.21 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameterPANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 14 cm in length and is top normal in size. RIGHT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture No hydronephrosis, shadowing calculus or mass.OTHER: No ascites | No focal liver lesions. No ascites. |
Generate impression based on findings. | 68-year-old female patient with multinodular goiter. RIGHT LOBE MEASUREMENTS: 6.9 x 3 x 2.3 cm, previously 6.7 x 2.8 x 3.3 cm. LEFT LOBE MEASUREMENTS: 4.2 x 1.5 x 1.6 cm, previously 4.1 x 1.3 x 1.5 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.7 cm.RIGHT LOBE: Two solid right lower pole nodules are again identified. The more superior nodule measures 2.7 x 1.7 x 1.6 cm, previously 2.3 x 1.4 x 1.8 cm. The inferior nodule measures 3.7 x 3 x 3.4 cm, previously 2.5 x 2.7 x 3.3 cmLEFT LOBE: No significant abnormality noted.ISTHMUS: A solid isthmic nodule measures 2.9 x 1.3 x 2.7 cm, previously 2.2 x 1.1 x 2.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mild increase in size of the thyroid lesions. |
Generate impression based on findings. | 51-year-old male undergoing preheart transplant evaluation. LIVER:Measures 14.6 cm. Increased, coarse echogenicity. No focal mass, ascites, or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: Gallbladder is nondistended with an anechoic lumen. Wall measures 0.3 cm. No pericholecystic fluid, stones, or sludge. Common bile duct measures 0.3 cm.PANCREAS: Evaluation of the pancreas limited due to overlying bowel gas.SPLEEN: Measures 9.8 cm. Multiple echogenic foci within the parenchyma of the spleen likely representing prior granulomatous disease.KIDNEYS: Right kidney measures 11.9 cm. Left kidney measures 11.7 cm. Unremarkable echogenicity. No shadowing calculi, hydronephrosis, or focal mass.ABDOMINAL AORTA: Unable to visualize the aorta due to body habitus and overlying bowel gas.INFERIOR VENA CAVA: Unable to visualize the IVC due to body habitus and overlying bowel gas.OTHER: The bladder is nondistended. | 1. Increased coarse echogenicity of liver consistent with fatty infiltration and chronic liver disease/parenchymal dysfunction. No focal mass or ascites.2. Multiple echogenic foci within the parenchyma of the spleen likely represents calcifications related to prior granulomatous disease.3. Unable to visualize aorta or IVC due to body habitus and overlying bowel gas. |
Generate impression based on findings. | 75 years old, Female, Reason: pt with cirrhosis, rule out hcc History: rule out hcc LIVER: The liver measures 14.6 cm in length. No significant nodularity or widening of the fissures to suggest cirrhosis. No focal hepatic lesions are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. No hydronephrosis. Subcentimeter right renal simple appearing cyst measuring up to 0.7 cm.LEFT KIDNEY: Kidney measures 10.6 cm in length. No hydronephrosis. Left renal cyst appearing similar to prior exam measuring up to 3.7 cm.OTHER: No significant ascites. | No sonographic evidence of cirrhosis. No focal hepatic mass. |
Generate impression based on findings. | Thyroid thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy without worrisome mass.LEFT LOBE: Status post thyroidectomy without worrisome massISTHMUS: Status post thyroidectomy without worrisome massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.7 x 0.8 x 2.2 cm enlarged lymph node left level 5 supraclavicular region with increased vascularity.OTHER: No significant abnormality noted. | Enlarged lymph node left level 5 supraclavicular region corresponding to palpable lesion. This lymph node is best considered indeterminate. Would recommend either short interval surveillance follow-up or ultrasound-guided percutaneous biopsy. |
Generate impression based on findings. | Female 29 years old Reason: rule out increased size in thyroid nodules History: dysphagia RIGHT LOBE MEASUREMENTS: 8.1 x 3.4 x 3.1 cmLEFT LOBE MEASUREMENTS: 7.9 x 4.0 x 2.9 cmISTHMUS MEASUREMENTS: 1.0 cmRIGHT LOBE: Unchanged heterogeneous large right thyroid nodule measures 5.0 x 3.2 x 3.0 cm, previously 6.1 x 2.9 x 2.5 cm. This nodule has been previously biopsied.LEFT LOBE: Unchanged mid left thyroid nodule, with a heterogeneous appearance, measuring 2.6 x 2.1 x 1.2 cm, previously 2.3 x 2.3 x 1.5 cm. Newly measured nodule, which is unchanged in size, measures 1.3 x 1.3 x 0.9 cm.ISTHMUS: Nodule in the isthmus which was previously present measures 2.2 x 1.5 x 2.3 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing right level 3 lymph node measures 0.8 x 0.4 x 1.2 cm.OTHER: No significant abnormality noted. | Multiple bilateral large thyroid nodules, which were previously biopsied, are not significantly changed in size. Newly measured nodules were present on the prior scans. |
Generate impression based on findings. | 74-year-old female patient with autoimmune hepatitis. Evaluate for cirrhosis and portal hypertension. LIVER: The liver measures 14.4 cm in length and demonstrates mildly increased echogenicity and coarsened hepatic echotexture. There are multiple bilobar hepatic cysts with the largest within the left hepatic lobe measuring 1.2 x 1.0 x 1.5 cm. 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 9.9 cm in length. No evidence of hydronephrosis. There is a 1.7 x 1.7 x 2.1 cm hypoechoic lesion within the inferior pole of right kidney with a septation.OTHER: The left kidney measures 8.5 cm in length. No evidence of hydronephrosis.The spleen measures 9.9 cm in length. | 1. Mildly increased hepatic echogenicity, likely representing chronic liver disease, without suspicious lesion. Bilobar hepatic cysts are identified.2. Minimally complex right lower pole renal cyst. |
Generate impression based on findings. | 48-year-old female patient with rising bilirubin. Concern for obstruction. LIVER: The liver measures 17.9 cm in length and mildly nodular in contour. Redemonstration of a hyperechoic region within segment IV of the liver which corresponded to fat on prior MRI. A right hepatic dome lesion is not seen on this examination. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is sludge within the gallbladder. The gallbladder wall is borderline thickened measuring approximately 4 mm in diameter, which is nonspecific in the setting of ascites. An echogenic focus in the gallbladder which likely reasons a polyp measures 0.5 x 0.4 x 0.5 cm. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 14.0 cm in length and demonstrate increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 14.1 cm in length and demonstrate increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 25.2 cm in length.There is mild ascites. | 1. Cirrhotic morphology of the liver with mild ascites and splenomegaly.2. Biliary sludge with non-specific gallbladder wall thickening in the setting of ascites.3. Subcentimeter gallbladder polyp.4. Medical renal disease. |
Generate impression based on findings. | 32-year-old female with premature hypertension. RIGHT KIDNEY: Right kidney measures 12.3 cm in length. There is no hydronephrosis, shadowing calculus or mass. Echotexture is normal.LEFT KIDNEY: The left kidney measures 12.4 cm in length. There is no hydronephrosis, shadowing calculus or mass. Echotexture is normal.OTHER: Bladder appears unremarkable. | Normal-appearing kidneys with symmetric size. |
Generate impression based on findings. | Chronic renal disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 13.5 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Benign appearing left renal cyst. Left kidney 12.7 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. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. She has a personal history of benign left axillary lymph node biopsy in 2013. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Scattered simple cysts are identified in both breasts. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 72-year-old male with history of cirrhosis, evaluate for hepatocellular carcinoma. LIVER: Measures 9.2 in length. Cirrhotic morphology and increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Cirrhosis and increased hepatic echogenicity consistent with chronic liver disease. No focal lesion identified. |
Generate impression based on findings. | 24-year-old male with VP shunt internalized to gallbladder. Right upper quadrant abdominal pain. LIVER: Normal echogenicity of the liver measuring 16.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures is 0.5 m/sec.GALLBLADDER, BILIARY TRACT: Partially visualized VP shunt with tip internalized within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Atrophic measuring 9.2 cm in length. Several shadowing stones are present at the inferior pole, largest of which measures 1.3 cm in length. No hydronephrosis is noted.OTHER: Normal echogenicity of the spleen measuring 10.2 cm in length.Left kidney is not visualized. Incompletely visualized right pleural effusion.Trace ascites. | 1. VP shunt internalized into the gallbladder with no surrounding inflammatory changes. 2. Atrophic right kidney with nephrolithiasis. No hydronephrosis. 3. Trace ascites and incompletely visualized right pleural effusion. |
Generate impression based on findings. | 51-year-old male with history of thyroid cancer. Evaluate for recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Hyperechoic nodular focus in the left thyroid bed unchanged measuring 0.6 x 0.5 x 0.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 3-4 lymph node measuring 1.1 x 1.0 x 0.4 cm without significant interval change. Left level 3 lymph node with benign morphologic features also unchanged.OTHER: No significant abnormality noted. | No significant interval change since the prior study. |
Generate impression based on findings. | 60-year-old male with history of alcohol abuse, smoking and cardiovascular risk factors. Patient has abdominal distention. Evaluate for cirrhosis, AAA, mass. LIVER:Hepatic size is upper normal. The liver is diffusely and markedly echogenic which is non--- specific. No focal hepatic abnormality is seen. The hepatic contour is not grossly cirrhotic.GALLBLADDER, BILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted.KIDNEYS: The right kidney measures 10.6 cm in length and the left 10.8 cm. Echotexture is normal. No hydronephrosis, shadowing calculus or mass. ABDOMINAL AORTA: Normal in caliber without evidence for aneurysm.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites. | Echogenic liver, otherwise normal exam. |
Generate impression based on findings. | Papillary thyroid carcinoma; assess for regional adenopathy RIGHT LOBE MEASUREMENTS: 4.9 x 1.5 x 1.3 cmLEFT LOBE MEASUREMENTS: 5.8 x 3.5 x 3.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 3.9 x 3.1 x 3.4 cm mixed cystic and solid nodule arising from the left thyroid gland. Solid component demonstrates probable internal microcalcifications and other worrisome complexity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.2 x 0.9 x 0.5 cm indeterminate left level 2/3 cervical lymph node. Other left level 2 and right level 2 lymph nodes are mildly enlarged but morphologically favor benign reactive lymph nodes.OTHER: No significant abnormality noted. | Mixed cystic and solid worrisome left thyroid nodule corresponding to known papillary thyroid carcinoma. A mildly enlarged left level 2/3 cervical lymph node is best considered indeterminant. This lymph node should be harvested when the thyroid lesion is resected. |
Generate impression based on findings. | Ms. Jacobsen is a 42-year-old female with right breast mastectomy in February 2014 for IDC/DCIS along with a prophylactic left breast mastectomy. She was treated with chemotherapy. She now presents with two palpable areas along the postsurgical scars in the right upper outer breast./right lower axillary region. Upon physical exam at the patient's palpable areas of concern, subtle nodularity is identified at the margin of the implant along the postsurgical scars.A targeted right breast ultrasound was performed for the palpable areas of concern. - in the right lower axillary region, no suspicious cystic or solid mass is identified. The edge of the implant is present at this location.- in the right upper outer breast, no suspicious cystic or solid masses identified. Again, the edge of the implant is present at this location. | No sonographic evidence for malignancy. Patient is scheduled to see Dr. Jaskowiak after this appointment. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 65-year-old male with lymphoma presents for thyroid ultrasound after having incidental thyroid nodules found on PET scan. RIGHT LOBE MEASUREMENTS: 4.6 x 1.2 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.5 x 1.4 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.07 cm.RIGHT LOBE: There is an approximately 1.7 x 1.3 x 0.8 cm mixed cystic-solid, predominantly solid, lesion in the midpole of the right thyroid. There are internal course calcifications.LEFT LOBE: There is an approximately 1.9 x 0.9 x 1.0 cm round mixed cystic-solid, predominantly solid, lesion in the midpole of the left thyroid. There are internal course calcifications.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral level 3 lymph nodes the largest of which measures approximately 2.0 x 1.0 x 0.4 cm.OTHER: No significant abnormality noted. | 1. Bilateral thyroid nodules as above both of which are amenable to biopsy. |
Generate impression based on findings. | Dense breast on mammogram, patient presents for whole breast ultrasound screening examination A bilateral whole breast ultrasound was performed using Sonocine. There is no solid or cystic mass identified. Normal dense glandular tissue identified.Study was double read by Dr. Kulkarni and Dr. Sheth. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: 1 year S/P islet cell transplant, please evaluate portal vein flow and doppler portal vein LIVER: The liver measures 16.7 cm in length. Heterogeneous coarse parenchymal echotexture. The portal vein is patent with normal hepatopedal directional blood flow. No focal masses.Peak portal venous velocities: Main portal vein: 29.1 cm/s, right portal vein: 22.47 cm/s, left portal vein: 25 cm/sGALLBLADDER, BILIARY TRACT: Shadowing surgical clips in the hilum. No biliary ductal dilatation. The gallbladder wall measures 0.2 cm and common bile duct measures 0.4 cm.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No hydronephrosis, masses, or shadowing renal calculi.LEFT KIDNEY: The left kidney measures 9.3 cm in length. No hydronephrosis, masses, or shadowing renal calculi.OTHER: No ascites. | 1. Coarse hepatic echotexture. Patent portal vein with peak velocities as documented above. |
Generate impression based on findings. | Left thigh mass Encapsulated hyperechoic soft tissue mass in the subcutaneous tissues nearly isoechoic to surrounding fat measures 5.0 x 2.4 x 3.3 cm. No significant internal vascularity. | Left thigh soft tissue mass with sonographic findings most consistent with a lipoma. |
Generate impression based on findings. | Evaluate for thyromegaly RIGHT LOBE MEASUREMENTS: 6. 2 x 2 x 2 cm, heterogenous echotextureLEFT LOBE MEASUREMENTS: 5.1 x 2.7 x 2.7 cm, heterogenousISTHMUS MEASUREMENTS: 1.1 cmRIGHT LOBE: 2 subcentimeter nodules identified in the right lobe mid pole, one which appears completely cystic and measures 6 x 4 x 5 mm and the other nodule that appears hypoechoic/solid that measures 7 x 5 x 3 mm.LEFT LOBE: Large heterogenous lobulated solid mass with microcalcifications involving the mid to inferior pole of the left lobe measures 1.6 x 2 x 1.9 cm. A second solid nodule has been measured in the midpole which appears to be contiguous with the larger inferior pole nodule. A cystic small nodule in the midpole measures 9 x 5 x 6 mm.ISTHMUS: Solid nodule involving the isthmus measures 3.1 x 1.3 x 0.8 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Multiple enlarged level 3 and 4 left neck lymph nodes with effaced hila, largest measuring 5.7 x 1.2 x 2.5 cmLevel 2 and level 3 right neck lymph nodes with normal morphology noted.OTHER: No significant abnormality noted. | Suspicious left inferior pole nodule with microcalcifications needs further evaluation with ultrasound-guided FNA. Multiple enlarged left level 3 and 4 neck nodes. |
Generate impression based on findings. | Reason: follow-up of multinodular goiter History: neck swelling RIGHT LOBE MEASUREMENTS: 5.1 x 1.8 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.5 x 2.7 x 2.0 cmISTHMUS MEASUREMENTS: 0.36 cmRIGHT LOBE: Reference nodules as noted below:Nodule #1:1.5 x 1.0 x 1.0 cm, predominantly hypoechoic spongiform nodule without significant vascularity or definite microcalcifications.Nodule #3:1.1 x 0.6 x 0.8 cm, part solid hypoechoic nodule without significant vascularity or definite microcalcifications.LEFT LOBE: Reference nodules as noted below:Nodule #1: 1.1 x 0.7 x 0.9 cm, predominantly solid nodule with hypoechoic rim and minimal vascularity without definite microcalcifications.Nodule #3: 0.8 x 0.7 x 0.8 cm, mixed solid and cystic nodule without significant vascularity or definite microcalcifications.ISTHMUS: Reference nodules as noted below:Nodule #1:1.0 x 0.8 x 0.8 cm, predominantly solid nodule with hypoechoic rim without significant vascularity or definite microcalcifications.Nodule #2: 0.9 x 0.6 x 0.7 cm, predominantly solid nodule with hypoechoic rim without significant vascularity or definite microcalcifications.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter as described above. |
Generate impression based on findings. | Ms. Towns is a 46-year-old female with a personal history of benign right lateral breast excisional biopsy 20 years previous. She was recalled from screening exam of 08/10/16 for architectural distortion in the right lateral breast. A targeted right ultrasound was performed for the mammographic area of concern. A linear, hypoechoic region is demonstrated on the ultrasound, correlating to the site of a scar from remote prior benign breast biopsy. No solid or cystic mass is identified. | Postsurgical scarring in the right lateral breast corresponding to the mammographically detected area of architectural distortion. No mammographic or sonographic evidence for 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. | Liver failure LIMITED ABDOMENLIVER: Markedly echogenic liver echotexture noted without obvious mass. Liver length 18.7 cm.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.4 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in lengthOTHER: Left kidney 10.9 cm in length. Trace ascites. | Markedly echogenic liver echotexture suggestive for severe fatty infiltration of the liver without mass. Cholelithiasis without acute inflammation or ductal dilatation. Trace ascites.Visualized hepatic vessels patent with normal directional flow. Left and right branches of the hepatic artery could not be visualized due to technical limitations of the exam including severe echogenicity of liver parenchyma. |
Generate impression based on findings. | 82-year-old male post left thyroidectomy and partial right thyroidectomy for thyroid cancer. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Right lobe measures 2.5 x 1.2 x 1.9 cmLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No massesISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No interval change. No evidence for recurrent disease. |