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Generate impression based on findings. | Cirrhosis LIVER: Stable cirrhotic morphology without mass. Liver length 11.7 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent portal vein with normal directional flow but diminished velocity of approximately 11 cm/s.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.7 cm in lengthOTHER: Left kidney 12.4 cm in length. Spleen 12.7 cm in length. Mild ascites. | Stable cirrhotic morphology without mass or ductal dilatation. Limited Doppler interrogation of the main portal vein demonstrates a patent portal vein with normal directional flow but diminished velocity. Mild ascites. |
Generate impression based on findings. | Known right breast cancer. Right axillary fullness on clinical exam. Also, left breast focal asymmetry for which ultrasound is requested. A targeted bilateral ultrasound was performed. The known malignancy at the right breast 4:00 position measures 3.6 x 2.9 x 2.8 cm. In the right axilla, several small lymph nodes with retained fatty hila and predominantly hilar blood flow are seen. In the left breast 3:00 position no suspicious cystic or solid mass was seen. Additional scanning above and below the 3:00 position also did not reveal any abnormality. | 1. Known right breast malignancy with current measurements as above, which are similar to outside hospital measurements.2. No sonographically suspicious right axillary lymph nodes.3. No correlate for the focal asymmetry in the left breast. Six-month follow-up is recommended.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: elevated liver enzymes LIVER: Normal liver echogenicity and echotexture. The portal vein is patent. Normal hepatopedal portal venous blood flow, 34.7 cm/s. The liver measures 17.6 cm in length.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. Negative sonographic Murphy sign. The gallbladder wall measures 0.3 cm. The common hepatic duct measures 0.2 cm. No intrahepatic or extrahepatic biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. 5.5 x 4.8 x 4.5 anechoic right renal cyst. Additional complex 2.2 x 1.9 x 2.7 cyst with multiple septations. Echogenic renal cortex. No hydronephrosis.LEFT KIDNEY: The left kidney measures 13.9 cm in length. Echogenic renal cortex. No hydronephrosis.SPLEEN: The spleen is prominent, measuring 14.0 cm in length.OTHER: No significant abnormalities noted. | Echogenic kidneys may reflect medical renal disease/parenchymal dysfunction. |
Generate impression based on findings. | 27-year-old male presents with a history of pain in the left axillary region for approximately two months. No known trauma history. Family history of breast cancer. Targeted ultrasound of the left axillary region was performed in the area of the patient's pain. No abnormal findings were identified to account for his symptoms. | Normal examination. No sonographic abnormalities to account for the patient's pain.BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 55-year-old female with thyroid nodules. Evaluate for calcification. RIGHT LOBE MEASUREMENTS: 1.9 x 1.8 x 5.5 cmLEFT LOBE MEASUREMENTS: 1.9 x 1.6 x 5.5 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: There again noted multiple nodules which are predominantly cystic, many with evidence for colloid comet tail artifact which are unchanged from prior exam. Large, reference cystic nodule in the upper pole measures 1 x 1.3 x 1.6 cm.LEFT LOBE: There again noted multiple nodules which are predominantly cystic, many with evidence for colloid, tail artifact which are unchanged from the prior exam. Reference spongiform nodule in the mid inferior left lobe measures 0.4 x 0.6 x 0.7 cm, slightly smaller than on the prior exam. This also demonstrates comet tail artifact.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable appearance of the thyroid with multiple nodules, most characteristic of colloid nodules. Comet tail artifact may be seen with calcification, but in this patient findings are consistent with colloid. |
Generate impression based on findings. | Reason: assess for liver dysfunction. Examination somewhat limited by ventilator status and limitations positioning patient.LIVER: The liver measures 23.3 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. Blood flow within the main portal vein is apparently diminished measuring 15.6 cm/s and with possible intraluminal filling defects.BILIARY TRACT: Cholelithiasis as well as diffuse gallbladder wall thickening measuring up to 7 mm. The sonographic Murphy's sign was not elicited. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted.The spleen measures 8.8 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.8 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.OTHER: Moderate abdominal pelvic ascites. | 1.Hepatomegaly and coarse hepatic echotexture suggestive of parenchymal dysfunction. 2.Moderate abdominopelvic ascites.3.Cholelithiasis. Gallbladder wall thickening which is nonspecific in the setting of liver disease and ascites, though cholecystitis not entirely excluded.4.Diminished flow and possible filling defects within the main portal vein which could be artifactual or due to thrombus. Correlation with cross-sectional imaging may be considered as clinically warranted.5.Echogenic kidneys suggestive of parenchymal dysfunction.Discussed with LIGTENBERG, KATHERINE |
Generate impression based on findings. | 1 year status post islet cell transplant; evaluate portal venous flow LIVER: Normal parenchymal echogenicity. Well-circumscribed subcentimeter echogenic foci within the right lobe of the liver; favor benign etiology. Liver length 15.3 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Main portal vein velocity 20 cm/s.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Subcentimeter nonobstructing right renal stone. Right kidney 10.5 cm in lengthOTHER: Left kidney 9.4 cm in length. Spleen 9.6 cm in length. No ascites. | Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Well-circumscribed subcentimeter echogenic foci within the right lobe of the liver; favor benign etiology. No ascites.Subcentimeter nonobstructing right renal stone. |
Generate impression based on findings. | 62-year-old male with alcoholism. Evaluate for cirrhosis. LIVER: Liver parenchyma is homogeneous without focal abnormality. There is no gross morphologic change to suggest cirrhosis.BILIARY TRACT: Multiple shadowing gallstones within the gallbladder without wall thickening or pericholecystic fluid. The visualized biliary tract is normal in caliber.PANCREAS: Limited by bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Echogenic consistent with parenchymal disease. OTHER: Limited spleen due to high position. Right pleural effusion | Normal-appearing liver.Gallstones.Echogenic kidneysRight pleural effusion. |
Generate impression based on findings. | The patient submitted outside mammogram dated 8/7/12. Submitted outside study was compared to the current mammogram dated 12/18/15. Focal asymmetry in the right upper outer breast appears new and additional spot compression views and possibly ultrasound are recommended. | New focal asymmetry in the right upper outer breast, for which additional spot compression views and possibly ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 37 years old; Reason: enlarged nontender thyroid gland RIGHT LOBE MEASUREMENTS: 4.8 x 2.0 x 1.2 cmLEFT LOBE MEASUREMENTS: 5.1 x 1.8 x 0.1 cmISTHMUS MEASUREMENT: 0.4 cmRIGHT LOBE: Slight heterogeneity of the gland with no dominant nodule.LEFT LOBE: Slight heterogeneity of the gland no dominant nodule.ISTHMUS: No significant abnormality noted.LYMPH NODES: 1.1 centimeter right level 2 and 2.0 cm left level 2 lymph nodes have fatty hila and benign appearance. | 1.Slight heterogeneity of the thyroid gland which is nonspecific but can be seen as a sequela of thyroiditis.2.No dominant nodule. |
Generate impression based on findings. | 39-year-old female with renal transplant and acute kidney failure. RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Transplant kidney measures 12.9 cm in length. Echotexture is normal. No evidence for mass.COLLECTING SYSTEM/URETER: No hydronephrosis.URINARY BLADDER: Not visualized, likely due to decompression.OTHER: No significant abnormality noted | No hydronephrosis. |
Generate impression based on findings. | 41-year-old male patient with right upper quadrant abdominal pain, positive Murphy. Evaluate for fatty liver disease. LIVER: The liver measures 19.3 cm in length and has increased echogenicity. No focal hepatic lesion is identified. The main portal vein flow is hepatopetal and measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. There is no intra- or extrahepatic biliary ductal dilatation. The common hepatic duct measures 1 mm in diameter. Sonographic Murphy's sign is negative.PANCREAS: The head of the pancreas is normal in echogenicity. The tail is obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 11.4 cm in length. No evidence of hydronephrosis.OTHER: The left kidney measures 12.2 cm in length. No evidence of hydronephrosis. There is a 2.3 x 2.3 cm left lower pole simple renal cyst.The spleen measures 10.6 cm in length. | 1. Hepatic steatosis.2. No cholelithiasis or sonographic evidence of acute cholecystitis.3. Left renal cyst. |
Generate impression based on findings. | Reason: elevated LFTs in mixed picture, r/o biliary obstruction History: nausea, vomiting LIVER: The liver measures 18.1 cm in length, upper limits of normal. 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 0.32 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 2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 7.9 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | History of poorly differentiated invasive ductal carcinoma of the left breast. Patient received neoadjuvant chemotherapy. Palpable mass in the left breast has recently increased in size. Please evaluate. Note is made that the patient is on Lovenox with marked bruising of the abdomen. History of breast cancer in 3 maternal aunts and two maternal cousins. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views, an additional MLO view and 2 spot magnification 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. A triangular marker was placed on the skin at the site of palpable mass. Near the 6 o'clock position of the left breast, a 4.5 x 3.2 x 5.5 cm lobulated mass is present containing a percutaneous clip and malignant calcifications. On the most recent mammogram, the mass measured 2.4 x 2.1 x 2.9 cm. On the mammogram of 8/6/2014, the mass measured 4.3 x 4.0 x 4.7 cm. Arterial calcifications are present. The left axilla is obscured by a cardiac generator device.LEFT BREAST ULTRASOUND: On physical examination, the patient has a 4 cm palpable mass at the 6 o'clock position of the left breast. The skin overlying the mass is ecchymotic. A focused left breast ultrasound was performed. At the 6 o'clock position of the left breast, 4 cm from the nipple, a 3.2 x 2.2 x 3.8 cm lobulated hypoechoic mass is present containing in Hydromark clip. Previous measurements on 10/28/2014 were 2.4 x 1.9 x 2.6 cm. On 8/6/2014 the measurements were 4.2 x 3.7 x 2.9 cm. | Interval increase in the size of biopsy proven carcinoma at the 6 o'clock position of the left breast. Given the history of Lovenox and overlying bruising, a portion of the size increase may be due to internal hematoma. Results were discussed with the patient and her daughter.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 79-year-old male with chronic kidney disease RIGHT KIDNEY: Measures 11.9 cm in length. Three right renal cysts measuring up to 5 cm in diameter without septation or nodular component. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 12.3 cm in length. Two left renal cysts measuring up to 3.7 cm in diameter without septation or nodular component. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | 1. Increased renal echogenicity consistent with medical renal disease and bilateral simple cysts as detailed above. 2. No nephrolithiasis, hydronephrosis, or suspicious mass lesion. |
Generate impression based on findings. | Male 47 years old Reason: r/o hydronephrosis, pyelonephriits History: AKI, leukocytosis LIVER:Echogenic liver, compatible with fatty infiltration. Liver is enlarged measuring 18 cm. No focal liver lesions.GALLBLADDER, BILIARY TRACT: No significant abnormality noted. No evidence of intra or extrahepatic biliary dilatation. Gallbladder is contracted, therefore, cannot be optimally evaluated.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 7 cm.KIDNEYS: Bilateral slightly echogenic kidneys. Right kidney measures 11.1 cm. Left kidney measures 10.4 cm. No evidence of hydronephrosis or focal lesions. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Small right-sided pleural effusion.Doppler findings:Hepatic veins and IVC are patent. Main portal vein and its branches are patent with normal flow direction. Hepatic artery is patent. | Mild hepatomegaly and echogenic liver. Bilateral echogenic kidneys.Normal Doppler findings. |
Generate impression based on findings. | 78-year-old female with goiter. RIGHT LOBE MEASUREMENTS: Incompletely measured due to substernal component. 7.7 x 3.2 x 5.4 cmLEFT LOBE MEASUREMENTS: Incompletely measured due to substernal component. 7.1 x 2.6 x 3.6 cmISTHMUS MEASUREMENTS: 1.6 cmRIGHT LOBE: Diffusely heterogeneous. Small cystic colloid nodule measuring 0.5 x 1.1 x 0.5 cm. Solid, isoechoic nodule arising from the lower pole likely incompletely visualized, measuring 2.3 x 2.5 x 1.9 cm. Other less well-defined solid nodules are present. LEFT LOBE: Diffusely heterogeneous. Complex cystic nodule in the upper pole measuring 0.7 x 1 x 1.3 cm. Rounded, probably cystic nodule with small wall nodule in the midportion measuring 1.1 x 1.2 x 1.1 cm. Incompletely marginated, isoechoic but heterogeneous solid lower pole nodule measuring 3.5 x 4 by at least 3.5 cm. There are discrete, coarse calcifications in the left thyroid.ISTHMUS: Confluent heterogeneous and solid nodules with coarse calcification the most measurable approximating 1.6 x 1.6 x 1.6 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Large goiter with substernal thyroid. Multiple solid and cystic nodules. Coarse calcification in the left lobe and isthmus. |
Generate impression based on findings. | 64-year-old female with acute kidney injury, decreased oral intake. RIGHT KIDNEY: Measures 10.3 cm in length. Small bilateral echogenic foci in the kidneys without twinkling or posterior acoustic shadowing most likely represent renal sinus fat or small angiomyolipomas. No hydronephrosis.LEFT KIDNEY: Measures 10.3 cm in length. Small bilateral echogenic foci in the kidneys without twinkling or posterior acoustic shadowing most likely represent renal sinus fat or small angiomyolipomas. No hydronephrosis.URINARY BLADDER: Incompletely distended. OTHER: No significant abnormalities noted. | 1. Small echogenic renal foci bilaterally may represent renal sinus fat or small angiomyolipomas, and do not have typical sonographic features of calculi. 2. No hydronephrosis. |
Generate impression based on findings. | 67 year old female with physician palpated left breast area. Recent, unremarkable screening mammogram. On physical examination, a ridge of dense breast tissue is noted at the approximate 12 to one o'clock position of the left breast. No further palpable abnormality is identified.A targeted left ultrasound of the upper outer quadrant was performed for the palpable area of concern. There is no solid or cystic mass identified. A band of dense parenchymal tissue is noted at the approximate one o'clock position, 2 cm from the nipple. No abnormal vascularity is associated with this area. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: mixed cardiogenic/septic shock with rising LFTs and WBC, eval gall bladder for e/o cholecystitis, eval hepatic and portal vein for clot History: worsening shock Very limited examination due to patient positioning/body habitus.LIVER: The liver appears demonstrates increased echogenicity and coarse echotexture. No focal hepatic lesions. Hepatic length measures 14.5 cm. The main portal vein is patent with normal hepatopedal flow directed towards the liver with a velocity of 18.7 cm/s. GALLBLADDER/BILIARY TRACT: Gallbladder sludge noted, with the wall measuring 3 mm. No pericholecystic fluid collection. The common bile duct measures 2 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: Not visualized.KIDNEYS: The right kidney measures 13.7 cm and without evidence of hydronephrosis. The left kidney is not visualized.OTHER: Ascites is noted in the upper abdomen. | 1.Very limited examination as above, with patient's left portal vein, hepatic arteries, right hepatic vein, splenic vein and artery, left kidney, and spleen not visualized.2.Increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction. No hepatic mass or ductal dilatation identified.3.Gallbladder sludge without evidence of cholecystitis or cholelithiasis.4.Patent main portal vein. |
Generate impression based on findings. | 75-year-old female with right upper quadrant pain. Evaluate for biliary pathology. Of note, the exam is limited by patient's inability to hold breath during the exam and due to bowel gas.LIVER:The liver measures approximate 14.7 cm. There is coarse, increased, and heterogeneous echotexture of the parenchyma. No mass or ascites noted. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended and the wall measures 0.1cm. There is a negative Murphy's. No stones or sludge seen. No pericholecystic fluid. The common bile duct measures 3.3 mm.PANCREAS: Evaluation of the pancreas is limited due to overlying bowel gas.SPLEEN: The spleen measures 7.7 cm. No significant abnormality noted.KIDNEYS: The right kidney measures 10.4 cm. There is a round anechoic area with posterior acoustic enhancement measuring approximately 2.2 x 2.3 x 3.1 cm that is consistent with a simple cyst. No concerning mass or shadowing calculi. No hydronephrosis. The left kidney measures 9.4 cm. There is a round anechoic area with posterior acoustic enhancement measuring approximately 2.3 x 2.1 x 1.9 cm and is consistent with a simple cyst. No concerning mass or shadowing calculi. No hydronephrosis. The kidneys appear atrophic bilaterally. OTHER: No significant abnormality noted. | 1. Coarse and echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No ductal dilatation, mass, or ascites.2. Atrophic kidneys consistent with chronic medical renal disease/parenchymal dysfunction.3. No evidence of cholelithiasis or gallbladder disease. |
Generate impression based on findings. | Callback from screening for left breast calcifications and a right breast mass. Bilateral ML views, right spot compression views and left magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. The cluster of calcifications in the left upper outer breast has a typically benign coarse morphology on spot magnification. Additionally, a smaller but similar cluster of calcifications can be seen on the right, further suggesting a benign etiology. The round circumscribed mass in the right lower outer quadrant persists on spot compression. There is the suggestion of fat density within mass. Elsewhere, a few scattered benign calcifications are seen on the right. ULTRASOUND | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 52-year-old female with right upper quadrant pain. Evaluate gallbladder. LIVER: Increased echogenicity of the liver measuring 20.4 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity the gallbladder. No gallbladder wall thickening. No pericholecystic 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 12.5 cm in length. There is a shadowing stone at the mid to upper pole measuring 1.8 cm x 1.2 cm x 1.7 cm which likely corresponds to the stone seen on CT dated 4/22/2014. No hydronephrosis is noted.OTHER: Left kidney measures 12.1 cm in length. No hydronephrosis or shadowing calculi are noted. Normal echogenicity of the spleen measuring 12.0 cm in length. | 1. Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Non obstructing right nephrolithiasis appears similar to CT dated 4/22/2014. 3. No evidence of cholecystitis. |
Generate impression based on findings. | Septic shock. LIVER: Non-cirrhotic liver morphology. Increased hepatic echogenicity, compatible with parenchymal dysfunction. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Biliary sludge and subcentimeter gallstones noted, without evidence of cholecystitis.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.9 cm in length. The left kidney is 11.2 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is seen.BLADDER: Not well visualized, likely secondary to underdistention from Foley catheter drainage.SPLEEN: Not well visualized, secondary to inability to reposition the patient.ABDOMINAL AORTA: Patent, without significant abnormality noted. Normal arterial waveforms. No aortic aneurysm identified.INFERIOR VENA CAVA: Patent, without significant abnormality noted. IVC filter noted.OTHER: Small right pleural effusion. Small amount of ascites identified. | 1. Biliary sludge and subcentimeter gallstones, without cholecystitis.2. Echogenic liver, compatible with parenchymal dysfunction.3. Echogenic renal parenchyma, compatible with medical renal disease.4. Small amount of ascites and small right pleural effusion. |
Generate impression based on findings. | Angiomyolipoma RIGHT KIDNEY: 11.2 cm in length. The hyperechoic mass in the superior pole measures 5.3 x 3.7 x 5.3 cm. This mass was previously measured as 5.1 x 3.7 x 6.5 cm, however is likely unchanged when measured similarly and accounting for differences in technique. No hydronephrosis is present.LEFT KIDNEY: 11.5 cm in length. A 2 cm benign-appearing cyst is noted in the lower pole. No suspicious lesion is seen. No hydronephrosis is present.OTHER: No significant abnormalities noted. | Right renal angiomyolipoma, without significant interval change. This lesion meets size criteria for interventional radiology consultation and possible embolization. |
Generate impression based on findings. | 30 year old female patient with palpable left breast mass and prior ultrasound demonstrating a fibroadenoma. A targeted left ultrasound was performed in the area of palpable abnormality at the 2:00 position 3 cm from the nipple. Dense glandular tissue was seen without solid or cystic mass identified.Separate from the palpable lesion in the 2:00 position 1 cm from the nipple a circumscribed oval hypoechoic mass was seen that measures 8 x 4 x 8 mm, compatible with a fibroadenoma. No other solid or cystic mass was identified in the remaining left breast or on ultrasound of the whole right breast. | 1.Dense glandular tissue in the area of palpable abnormality without cyst or mass at this location.2.Findings compatible with a fibroadenoma in the left breast at the 2:00 position 1 cm from the nipple, separate from the site of palpable abnormality.3.No cyst or mass in the right breast.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | BPH RIGHT KIDNEY: Atrophic echogenic parenchyma without mass or stone. Associated with moderate to severe hydronephrosis and proximal hydroureter. Right kidney 11.9 cm in lengthLEFT KIDNEY: No significant abnormalities noted. Left kidney 12.4 cm in length. OTHER: Enlarged prostate. Distended bladder. The patient could not void; accordingly post void images and evaluation of right hydronephrosis post void could not be obtained. | Atrophic echogenic right renal parenchyma associated with moderate to severe hydronephrosis and proximal hydroureter. Enlarged prostate with a distended bladder. The patient could not void; accordingly post void images and evaluation of right hydronephrosis post void could not be obtained. |
Generate impression based on findings. | Reason: rule out thyroid nodules, history of XRT for Hodgkin's lymphoma, ? lymph node on right RIGHT LOBE MEASUREMENTS: 1.7 x 0.9 x 0.9 cm.LEFT LOBE MEASUREMENTS: 1.4 x 0.6 x 0.9 cm.ISTHMUS MEASUREMENTS: 0.1 cm.RIGHT LOBE: 0.7 x 0.5 x 0.6 cm solid hyperechoic right mid pole nodule demonstrates internal vascularity however there are no internal calcifications. No other suspicious nodules or masses. Otherwise atrophic gland.LEFT LOBE: Atrophic left thyroid without suspicious nodules or masses.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Several subcentimeter benign-appearing lymph nodes. Right cervical level 2 lymph node measures 0.7 x 0.8 x 0.3 cm and demonstrates a fatty hilum.OTHER: No significant abnormality noted. | Solid right thyroid nodule as described above is indeterminate, although echogenic nodules are highly likely benign. However, if biopsy is desired in this high risk patient, the nodule is amenable. |
Generate impression based on findings. | Cirrhosis with history of TIPS LIVER: Cirrhotic morphology again noted. No mass. Liver length 12.1 cm. Limited Doppler interrogation of the TIPS demonstrates a patent TIPS. Patent main portal vein with normal directional flow. Main portal vein velocity 48 cm/s. GALLBLADDER, BILIARY TRACT: Cholelithiasis again noted. Moderate bilobar and extrahepatic ductal dilatation again noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.8 cm in lengthOTHER: Left kidney 11.2 cm in length. Spleen 8.8 cm in length. No ascites. | Technically limited study. Patent main portal vein with normal directional flow. Patent TIPS. Cirrhotic morphology without obvious mass. Moderate bilobar and hepatic ductal dilatation again noted. No ascites. |
Generate impression based on findings. | 31 year old female with rising liver function tests, evaluate for mass. LIVER: Enlarged measuring 22.1 cm in length. Increased echogenicity consistent with diffuse fatty infiltration. Focal fatty sparing noted adjacent to the gallbladder fossa. No discrete hepatic lesions identified. BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Hepatomegaly and increased echogenicity consistent with hepatic steatosis. No discrete liver masses or biliary ductal dilation. |
Generate impression based on findings. | 37-year-old female, 13 weeks pregnant presents to the diagnostic clinic to evaluate left breast palpable mass. Family history of breast cancer in 2 maternal aunts. Recent mammogram in February 2015 was within normal limits. A targeted left axillary ultrasound was performed for the patient’s area of pain. Patient indicates area of pain in the left lower axillary region. No discrete mass was palpated on physical examination. There is no solid or cystic mass identified. Normal axillary lymph node is identified in this entity. | Area of pain in the left lower axillary region corresponds to normal glandular tissue. A Normal axillary lymph node is identified in the vicinity.Patient is due in April 2016. Annual screening mammogram is recommended after April 2016.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 77-year-old female with weight loss, Nash LIVER: Measures 18.3 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Cholelithiasis without 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. | 1. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. 2. Cholelithiasis. |
Generate impression based on findings. | 38-year-old male post thyroidectomy for cancer. Follow-up for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: There is again noted in the inferior right bed extending to midline a hypoechoic ovoid mass measuring 0.4 x 0.6 x 0.8 cm without significant change. Previously noted second mass more superiorly in the bed is no longer visualized.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. | Stable hypoechoic mass in the inferior right bed extending to midline.Second right bed abnormality no longer visualized. |
Generate impression based on findings. | 70 year-old female. Her quadrant tenderness, liver distention, low platelets. Ultrasound for hepatomegaly, biliary disease, cirrhosis? LIVER: Normal echogenicity and echotexture of the liver. No focal hepatic mass. The liver is 15.9 cm in length. Hepatopetal portal venous flow with undulation of the waveform and dilated hepatic veins, likely related to congestion from right heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 4 mm in diameter, within normal limits. Cholelithiasis without evidence of acute cholecystitis.PANCREAS: Visualized pancreatic head is normal in echogenicity. The rest of the pancreas is obscured by bowel gas.OTHER: Small amount of right upper quadrant ascites. | 1. Cholelithiasis without evidence of acute cholecystitis. No biliary ductal dilatation. Liver length is at the upper limits of normal. Small amount of perihepatic ascites.2. Findings consistent with right heart failure. |
Generate impression based on findings. | 66 year old male, evaluation for heart transplant. Baseline exam LIVER: Coarse echogenicity of the liver measuring 17.2 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well-visualized overlying bowel gas.SPLEEN: Normal echogenicity of the spleen measuring 11.6 cm in length.KIDNEYS: Right kidney measures 11.1 cm in length. Non obstructing nephrolithiasis is noted. Left kidney measures 11.3 cm in length. No hydronephrosis or shadowing calculi are noted.ABDOMINAL AORTA: Atherosclerotic abdominal aorta with measurements as follows: proximal aorta measures 2.8 cm x 2.4 cm, the mid abdominal aorta measures 2.0 cm x 2.3 cm and the distal abdominal aorta measures 1.9 cm x 2.1 cm.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: Small amount of ascites.Incompletely imaged bilateral pleural effusions. | 1. Hepatomegaly with coarse echotexture suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Non obstructing right nephrolithiasis.3. Small amount of ascites and incompletely imaged bilateral pleural effusions. |
Generate impression based on findings. | 26-year-old female patient with fullness in neck, increased unilateral blood vessel appearance on neck exam. Evaluate for thyromegaly. RIGHT LOBE MEASUREMENTS: 1.8 x 1.3 x 4.5 cm.LEFT LOBE MEASUREMENTS: 1.8 x 1.7 x 4.8 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity without focal thyroid lesion.LEFT LOBE: The left thyroid lobe is homogeneous echogenicity and contains a 0.6 x 0.4 x 0.3 cm ovoid, spongiform nodule within the midpole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: There is a 0.6 x 0.5 x 0.5 cm hypoechoic nodule inferior to the right thyroid lobe which may represent a parathyroid adenoma.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No dominant thyroid lesion identified.2. Possible parathyroid adenoma inferior to the right thyroid lobe; correlate with serum calcium levels. |
Generate impression based on findings. | Acute renal sufficiency RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. 13 cm in length.LEFT KIDNEY: Left kidney absent.OTHER: Bladder nondistended | Echogenic right renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. Left kidney absent. |
Generate impression based on findings. | Reason: Assess for Kidney stones. Patient with Primary HPT. RIGHT KIDNEY: The right kidney measures 9.3 cm in length. 0.6 x 0.4 x 0.5 cm hyperechoic parenchymal stone in the mid right kidney. No evidence of obstruction or hydronephrosis.LEFT KIDNEY: Left kidney measures 9.2 cm in length. No shadowing stones or hydronephrosis. 1.6 x 1.6 x 1.8 cm anechoic cyst.OTHER: The urinary bladder is poorly distended, limiting evaluation. | Focal right parenchymal calcification without evidence of obstruction or nephrolithiasis. |
Generate impression based on findings. | 20-year-old male with abnormal liver function. LIVER: The liver is normal in size but is moderately echogenic, progressive when compared to prior exams. Presumably this is related to fatty infiltration although other causes of parenchymal dysfunction cannot be excluded. No focal hepatic abnormality. Portal vein is patent with appropriate flow direction.BILIARY TRACT: No significant abnormalities noted.PANCREAS: Limited due to bowel gas. No gross abnormality.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Progressively echogenic liver. |
Generate impression based on findings. | History of thyroid cancer and ovarian cancer, rule out adenopathy or recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No abnormal soft tissue nodules identified within the thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. No abnormal soft tissue nodules identified within the thyroidectomy bed.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant lymphadenopathy noted.OTHER: No significant abnormality noted. | No evidence of local recurrence or suspicious lymphadenopathy. |
Generate impression based on findings. | Elevated creatinine RIGHT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 12 cm in lengthLEFT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 11.9 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound without evidence for mass, stone, or obstruction. |
Generate impression based on findings. | Acute renal failure RIGHT KIDNEY: Normal appearing parenchyma without worrisome mass, stone, or hydronephrosis. Benign-appearing cyst. Right kidney 10.7 cm in lengthLEFT KIDNEY: Normal appearing parenchyma without worrisome mass, stone, or hydronephrosis. Benign-appearing cyst. Left kidney 10.7 cm in length.OTHER: Bladder nondistended. Left pleural effusion | Normal parenchymal echogenicity without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | 69-year-old female undergoing renal biopsy. Ultrasound guidance was provided for a renal biopsy performed by nephrology service. | Ultrasound guidance was provided for renal biopsy performed by nephrology service. 3 passes were attempted. |
Generate impression based on findings. | Reason: 45 yo with PSC please evaluate gallbladder LIVER: The liver measures 15.9 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 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, though this was better assessed on prior MRCP. The common bile duct measures 2.2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 10.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 12.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Increased hepatic echogenicity raising the possibility of chronic liver disease. Normal sonographic appearance of the gallbladder. No sonographic evidence of biliary ductal dilatation. |
Generate impression based on findings. | Ms. Gee is an 18 year old female who reports a right breast lump. No family history of breast cancer. Focused right breast ultrasound showed normal breast tissue in the area of palpable concern in the right breast 4:00 position 3 cm from the nipple. There is no solid or cystic mass identified. | Normal breast tissue corresponding to the area of palpable concern in the right breast. No sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually starting at age 40. Results and recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Ms. Rich is a 20-year-old female with palpable masses in the left upper outer breast presenting for follow-up ultrasound evaluation. History of right breast fibroadenoma status post excision. Family history of breast cancer in maternal grandmother diagnosed at 62 years of age. On physical examination, two palpable firm mobile masses were identified in the left upper outer breast.A targeted left ultrasound was performed for the palpable area of concern. In the left breast 2:00 position 5 cm on the nipple there are 2 hypoechoic masses as seen on the prior study with measurements provided below:The larger mass is lobular in shape with circumscribed margins measuring 2.1 cm x 1.2 cm x 2.0 cm, previously 2.0 cm x 1.0 cm x 1.6 cm. There is internal flow on Doppler imaging.The smaller mass is lobular in shape with circumscribed margins measuring 0.9 cm x 0.5 cm x 1.0 cm, previously 0.9 cm x 0.5 cm x 1.0 cm. There is internal flow Doppler imaging. | Stable to minimal increase in size of two presumed fibroadenomas of the left breast. Recommend follow-up with breast surgery as clinically warranted. All results and recommendations were discussed with the patient. BIRADS: 3 - Probably benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Papillary thyroid carcinoma status post resection with palpable lymph nodes RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Stable benign-appearing cervical lymph nodes bilaterally. 0.6 x 0.4 x 1.2 cm hypoechoic lymph node within the subcutaneous tissues left level 5 periarticular region corresponding to the palpable lesion.OTHER: No significant abnormality noted. | Hypoechoic normal sized lymph node within the subcutaneous tissues left level 5 periarticular region corresponding to the clinically palpable focus. Its appearance favors a benign reactive etiology over metastatic focus. Would recommend special attention to this lymph node on future surveillance scans. Otherwise stable examination without evidence for metastatic focus. Benign-appearing regional lymph nodes again noted and unchanged. |
Generate impression based on findings. | No retroperitoneal neuroendocrine tumor with chronic renal disease RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.2 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Stable left renal cyst. Left kidney 8.7 cm in lengthOTHER: Bladder nondistended. Retroperitoneal mixed cystic and solid mass again noted | Mildly echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Retroperitoneal mixed cystic and solid mass again noted. |
Generate impression based on findings. | 38-year-old female presents for short-term follow-up of right breast fibroadenoma. A targeted right ultrasound was performed for the patient’s area of concern. At the 11 o'clock position of the right breast, 9 cm from the nipple, there is redemonstration of an oval, circumscribed, parallel oriented hypoechoic mass measuring 1.7 x 0.9 x 1.8 cm (previously 1.6 x 0.7 x 1.8 cm). Given differences in technique, this is unchanged from prior examination. | Stable benign morphology mass at 11 o'clock position of the right breast, compatible with benign fibroadenoma. The lungs the patient's physical examination remains normal, bilateral diagnostic mammogram and right unilateral ultrasound is recommended in 6 months to confirm stability of the fibroadenoma. Result 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. | History of microhematuria. RIGHT KIDNEY: The right kidney is normal in size measuring 11.5 cm in length. No hydronephrosis. Normal echogenicity. No shadowing nephrolithiasis. No suspicious lesion.LEFT KIDNEY: The left kidney is normal in size measuring 11.3 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. Normal echogenicity.URINARY BLADDER: Normally distended urinary bladder. Bilateral ureteral jets are visualized.OTHER: No significant abnormalities noted. | No hydronephrosis, shadowing nephrolithiasis or suspicious lesion. |
Generate impression based on findings. | Male 65 years old Reason: baseline exam as part of heart transplant evaluation LIVER:Liver measures 15.7 cm. Mildly echogenic liver appearance which is nonspecific. No focal mass. Main portal vein is patent with normal directional flow and velocity 15 cm/s.GALLBLADDER, BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. The gallbladder is normal in appearance. No gallstones.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are scattered by overlying bowel gas. SPLEEN: Spleen is difficult to visualize but likely measures 6.2 cm.KIDNEYS: Right kidney measures 9.0 cm. Left kidney measures 11.1 cm. Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. ABDOMINAL AORTA: Proximal aorta is obscured by overlying bowel gas. The mid aorta measures 1.8 cm in diameter. The distal aorta is also obscured by overlying bowel gas.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Bladder is nondistended. | Appearance of the abdominal viscera is within normal limits. |
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. | Enlarged thyroid RIGHT LOBE MEASUREMENTS: 6.5 x 2.5 x 2.6 cmLEFT LOBE MEASUREMENTS: 6.6 x 2.5 x 2.5 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: 0.5 x 0.8 x 0.6 cm spongiform nodule lower poleLEFT LOBE: 0.5 x 0.3 x 0.5 cm spongiform nodule lower poleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral subcentimeter benign-appearing spongiform nodules. No regional adenopathy. |
Generate impression based on findings. | 49-year-old female with spinal cord compression/neurogenic bladder and AKI. RIGHT KIDNEY: Increased echogenicity, consistent with prior examination.LEFT KIDNEY: Increased echogenicity, consistent with prior examination.OTHER: Foley catheter in place. | Increased renal echogenicity consistent with medical renal disease. Foley catheter in place. |
Generate impression based on findings. | 41-year-old female with right renal biopsy earlier in the day, now with dizziness and hematuria. RIGHT KIDNEY: The right kidney measures 8.1 cm in length. Cortex is echogenic. No hydronephrosis, shadowing calculus or mass. There is a trace of perinephric fluid. No significant hematoma identified.LEFT KIDNEY: The left kidney measures 10.4 cm in length and the cortex is mildly echogenic. No hydronephrosis, shadowing calculus or mass.OTHER: Urinary bladder appears unremarkable without significant internal debris. No free fluid. | Trace perirenal fluid on the right. No significant hematoma identified.Mildly echogenic kidneys with asymmetric size. |
Generate impression based on findings. | 55 year-old female with Hashimoto's, left lobe slightly more prominent. RIGHT LOBE MEASUREMENTS: 3.7 cm x 1.2 cm x 1.2 cm.LEFT LOBE MEASUREMENTS: 3.7 cm x 1.3 cm x 0.7 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: Minimally heterogeneous echotexture with no discrete nodule identified.LEFT LOBE: Minimally heterogeneous echotexture with no discrete nodule identified.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. | Unremarkable examination. |
Generate impression based on findings. | 62-year-old female with multiple known gallstones, now with persistent right upper quadrant pain for past week. Evaluate for cholecystitis LIVER: Multiple hepatic hypoechoic lesions are identified. The largest of these measures 1.8 x 1.9 x 2.1 cm with posterior acoustic enhancement and no internal vascularity. Additional hypoechoic hepatic lesions with questionable peripheral vascularity. Main portal vein is patent with peak systolic velocity of 0.3 m/s. GALLBLADDER, BILIARY TRACT: Cholelithiasis with gallbladder wall measuring 0.3 cm without evidence of pericholecystic fluid. Common hepatic duct measures 0.5 cm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The kidneys are normal in echotexture with the right kidney measuring 11.1 cm and left kidney measuring 11.4 cm in length.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without specific findings to suggest cholecystitis.2.Multiple indeterminate hepatic hypoechoic lesions. Further evaluation with dedicated liver protocol CT or MR examination is recommended. |
Generate impression based on findings. | 28-year-old female with history of acute cholecystitis treated with antibiotics, now with recurrent abdominal pain. LIVER: No significant abnormalities noted. Limited spectral and color Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder contains multiple dependent and shadowing calculi as well as a non--- mobile calculus in the region of the neck. There is layered sludge within the gallbladder. Gallbladder wall thickness is increased. There is no discrete pericholecystic fluid. The biliary tract appears normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Findings consistent with acute cholecystitis given history. |
Generate impression based on findings. | Cirrhosis; HCC screen LIVER: Stable cirrhotic morphology without mass. Liver length 13.1 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Gallbladder absent. No ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: 15 cm in lengthRIGHT KIDNEY: AbsentOTHER: Left kidney 12.2 cm in length. Left renal cyst. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. No ascites. Mild splenomegaly again noted. |
Generate impression based on findings. | Male 84 years old Reason: Liver pathology History: new transaminitis, history of non-hodgkin's lymphoma, rheumatoid arthritis LIVER: Coarse echotexture of the liver. No focal liver lesions. Liver measures 17.7 cm, slightly increased in size.GALLBLADDER, BILIARY TRACT: No evidence of cholelithiasis. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: The visualized pancreatic head and body are unremarkable.RIGHT KIDNEY: Right kidney measures 12.2 cm. Left kidney measures 11.5 cm. No evidence of hydronephrosis or focal lesions.OTHER: No significant abnormalities noted. | Coarse echotexture of the liver. Mild hepatomegaly. |
Generate impression based on findings. | 44-year-old male with right scrotal mass. RIGHT TESTIS: Normal in size, contour and echogenicity. Normal vascularity by color and spectral DopplerLEFT TESTIS: Left testicle is smaller than the right, and slightly hypoechoic and heterogeneous. There is a 2 mm focus of increased echogenicity in the left testicle without definite shadowing to suggest calcification. This could also represent an area of focal fibrosis. There is no associated mass identified.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: 5 mm cyst.OTHER: Superior to the right testicle in the region of palpable abnormality as described by the patientThere is a 1.5 cm ovoid, simple cyst consistent with spermatic cord cyst. Also is a small supratesticular varicocele. | Small and mildly hypoechoic left testicle. Patient provides history of nondistended testis. Focal internal echogenicity without appreciable mass effect could be related to calcification or scar.Cyst of the right spermatic cord with small varicocele. |
Generate impression based on findings. | 45 years old, Male, Reason: elevated liver enzymes LIVER: The liver is mildly enlarged measuring 17.5 cm in length. Increased echogenicity of the hepatic parenchyma is consistent with fatty infiltration. Questionable minimal contour irregularity raises the possibility of early cirrhosis. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.1 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 11.5 cm in length. RIGHT KIDNEY: Kidney measures 12.5 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture. No evidence of hydronephrosis. Nonobstructing nephrolithiasis with a stone measuring up to .7 cm.OTHER: No significant abnormalities noted. | 1.Questionable minimal contour irregularity raises the possibility of early cirrhosis.2.Diffusely increased echogenicity of the liver is consistent with fatty infiltration.3.Nonobstructing left nephrolithiasis. |
Generate impression based on findings. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5.1 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.4 x 1.2 x 1.6 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant change in multiple subcentimeter predominantly cystic nodules. The largest nodule is within the superior pole measuring 0.8 x 0.5 x 0.6 cm.LEFT LOBE: Relatively stable upper pole isoechoic nodule measuring 1 x 0.9 x 1 cm.ISTHMUS: Stable subcentimeter hypoechoic nodules.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. No convincing extrathyroidal focus identifiable as a parathyroid lesion. |
Generate impression based on findings. | Renal stones RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 9.8 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 9.7 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound. No evidence for mass, stone, or hydronephrosis. |
Generate impression based on findings. | 45-year-old female patient with epigastric pain, lipase greater than 3000. Evaluate for gallstones. LIVER: The liver measures 15.7 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There 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 demonstrates decreased echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.9 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 12.1 cm in length. No evidence of hydronephrosis.The spleen measures 8.2 cm in length. | 1. Hypoechoic pancreas which can be seen with inflammation/pancreatitis. 2. No evidence of cholelithiasis. |
Generate impression based on findings. | 59-year-old female with uptrending AST/ALT. Evaluate for hepatic abnormalities. LIVER: Coarse echogenicity of the liver measuring 25.6 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: Sludge within the gallbladder. Small amount of pericholecystic fluid. No gallbladder wall thickening. Sonographic Murphy's sign is negative. Common duct measures 2 mm in thickness. No intra-or extra hepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas is obscured by overlying bowel gas. The visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Measures 12.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 10.6 cm in length and is normal in echogenicity.Left kidney is not well assessed measuring 10.9 cm in length. No definite hydronephrosis or shadowing calculi are noted. | 1. Sludge within the gallbladder with small amount of pericholecystic fluid however no definite evidence of cholecystitis.2. Hepatomegaly with coarse echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | 74-year-old female with history of pancreatitis, gallstones. Concern for ductal obstruction. Limited examination due to patient body habitus and presence of bowel gas.LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Cholelithiasis with gallbladder wall measuring upper limits of normal. No pericholecystic fluid or sonographic Murphy sign. No biliary ductal dilation or evidence of choledocholithiasis.PANCREAS: The majority of the pancreas is not clearly visualized due to bowel gas.RIGHT KIDNEY: Increased renal echogenicity. Small left renal calculi and mild prominence of the left collecting system.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without specific evidence of acute cholecystitis.2.Increased hepatic echogenicity consistent with diffuse parenchymal disease or hepatic steatosis.3.Limited evaluation of the pancreas secondary to patient's bowel gas. Please see recent prior CT from 8/23/2015.4.Increased renal echogenicity consistent with medical renal disease. Nephrolithiasis and mild prominence of the left renal collecting system, but no frank hydronephrosis. |
Generate impression based on findings. | Female 32 years old; Reason: 32 y/o 7 weeks pregant with right breast Ca, need ultrasound of thyroid for further eval History: 32 y/o 7 weeks pregnant with right breast Ca, need ultrasound of thyroid for further eval RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.6 x 2.0 x 1.7 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.7 x 2.6 x 1.8 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.13 cm.RIGHT LOBE: There are 2 nodules in the right lobe of the thyroid.Nodule #1: There is a round hypoechoic nodule without microcalcifications or internal vascularity in the mid right thyroid that measures approximately 0.6cm in diameter.Nodule #2: There is a mixed solid and cystic but predominately cystic appearing hypoechoic round lesion measuring approximately 9mm in diameter.LEFT LOBE: There is one nodule in the left thyroid.Nodule #1: There is a heterogenous nodule with scattered cystic spaces, no significant internal vascularity or definite microcalcifications measuring approximately 1.7 cm x 1.5 cm.ISTHMUS: There is one nodule in the isthmus of the thyroid.Nodule #1: There is echogenic lesion with peripheral vascularity and no definite microcalcifications measuring approximately 8mm in diameterLYMPH NODES: No suspicious adenopathy noted. OTHER: The thyroid has a diffusely heterogeneous echotexture. | 1.Multinodular thyroid as above. Background heterogenicity could be due to thyroiditis. Please correlate with laboratory values. |
Generate impression based on findings. | Male 58 years old Reason: Evaluate for patency of previous TIPS procedure History: GI bleeding, bright red blood per rectum LIVER: Cirrhotic liver morphology. Unchanged simple appearing cyst measuring 1 x 0.9 x 0.8 cm. TIPS stent is patent. Main portal vein is patent with peak velocity of 52 cm/s. It is somewhat tortuous near the area of the TIPS. Hepatic arteries patent with normal flow. Intrahepatic portal vein is not well-visualized. Right portal vein is not well-visualized. The left portal vein has normal flow.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Common bile duct measures 4 mm.PANCREAS: Pancreas is not well seen.SPLEEN: Spleen is enlarged measuring 18.5 cm. Splenic vein is patent with a peak velocity of 24.6 cm/s.KIDNEYS: Right kidney is not well visualized. There is a right superior pole renal cyst measuring 6 x 5.3 x 6.6 cm. Right kidney measures 11.6 cm in length. Left kidney demonstrates normal cortical echogenicity. No hydronephrosis or shadowing calculus bilaterally. Left renal cyst measures 3 x 2.8 x 2.6 cm.OTHER: Trace perihepatic ascites | 1.Patent TIPS stent and a patent main portal vein. 2.Cirrhotic morphology of the liver and trace perihepatic ascites.3.Splenomegaly |
Generate impression based on findings. | 62-year-old male with fever, abdominal pain. Evaluate for up quadrant from gallbladder pathology. Limited exam as patient unable to lie in the decubitus position or check for Murphy's sign. Midline bandage partially obscures the left liver and pancreas.LIVER: Increased echogenicity of the liver measuring 21.4 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Multiple shadowing stones within the gallbladder. Trace pericholecystic fluid. Gallbladder wall measures up to 3 mm in thickness. Unable to check for sonographic Murphy sign. Common bile duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Normal echogenicity of the visualized pancreas.RIGHT KIDNEY: Increased echogenicity of the right kidney measuring 11.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 14.4 cm in length.Left kidney measures 12.0 cm in length and is increased in echogenicity. No hydronephrosis or shadowing calculi are noted. | 1. Cholelithiasis with trace pericholecystic fluid. Findings may represent early cholecystitis.2. Hepatomegaly with increased echogenicity of the liver compatible with fatty infiltration.3. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No hydronephrosis. |
Generate impression based on findings. | History oncocytoma and right renal lesion RIGHT KIDNEY: 3.1 x 2.3 x 3.3 cm solid mass arising from the lower pole the right kidney again noted and relatively unchanged from the recent CT. No stone or hydronephrosis. Right kidney 10.1 cm in lengthLEFT KIDNEY: 7.5 x 7.5 x 7.2 cm solid mass arising from the upper pole the left kidney again noted unchanged from the recent CT. No hydronephrosis. No stone. Left kidney 12.2 cm in length.OTHER: Bladder nondistended | No change in bilateral solid renal masses. No hydronephrosis or stone. |
Generate impression based on findings. | Male; 33 years old. Reason: eval for obstruction, reason for AKI History: AKI RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: Continued decrease in size of the complex fluid collection along the posterior portion of the transplanted kidney. This currently measures 1.8 x 1.9 x 0.8 cm (previously 2.3 x 1.4 x 1.3 cm).KIDNEY: The transplanted kidney measures 12.7 cm in length. The cortex is echogenic. There is no shadowing renal stone.COLLECTING SYSTEM/URETER: Persistent mild dilatation of the transplant collecting system appearing similar to the prior study.URINARY BLADDER: The bladder wall appears thickened however the bladder is not fully distended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels.The iliac artery and anastomoses are patent. The renal arteries are patent with velocities of 0.4-0.9 m/sec (resistive indices 0.63-0.80). The segmental arteries are patent with velocities of 0.3-0.5 m/sec (resistive indices 0.61-0.66).The arcuate arteries are patent with velocities of 0.2-0.4 m/sec (resistive index 0.62-0.68).The iliac vein and renal vein are patent. OTHER: No significant abnormality noted | 1.Mild hydronephrosis not significantly changed compared to the prior ultrasound.2.Patent transplant renal vasculature.3.Continued decrease in size of perinephric hematoma. |
Generate impression based on findings. | Elevated creatinine Ultrasound guidance was provided for biopsy of a transplant kidney in the right iliac fossa by the nephrology service. | Ultrasound guidance provided for transplant renal biopsy. |
Generate impression based on findings. | Nodular goiter RIGHT LOBE MEASUREMENTS: 7.1 x 4.4 x 9.3 cm. Large in size with heterogeneous background echotexture. Unremarkable vascularity.LEFT LOBE MEASUREMENTS: 4.7 x 3.8 x 8.8 cm. Large in size with heterogeneous background echotexture. Unremarkable vascularity.RIGHT LOBE: Diffusely heterogeneous background gland, without discrete measurable nodules.LEFT LOBE: Diffusely heterogeneous background gland, with a spongiform 4.0 cm nodule again seen.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Heterogeneous goiter with benign-appearing nodules. |
Generate impression based on findings. | Thyroid nodule seen on CT scan. RIGHT LOBE MEASUREMENTS: 5.1 x 2.0 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.4 x 1.4 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: The parenchyma is normal in echogenicity. In the inferior pole there is a 2.1 x 1.6 x 1.9 cm well-defined isoechoic solid nodule.LEFT LOBE: The parenchyma is normal in echogenicity. In the mid region there is a 9 x 8 x 8 predominately cystic nodule. More superiorly there is a 8 x 5 x 7 mm predominantly solid isoechoic nodule with small cystic components with possible comet tail artifact suggesting a colloid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules with the largest being a solid 2.1 cm on the right. No specific suspicious sonographic features, however it is amenable to FNA sampling as clinically indicated. |
Generate impression based on findings. | 32-year-old female with Papillary thyroid cancer. Assess lateral lymph nodes. RIGHT LOBE MEASUREMENTS: 5.5 cm x 1.6 cm x 2.2 cmLEFT LOBE MEASUREMENTS: 4.8 cm x 1.7 cm x 1.5 cmISTHMUS MEASUREMENTS: 7 mm in thicknessRIGHT LOBE: No discrete nodules identifiedLEFT LOBE: No discrete nodules identifiedISTHMUS: Conglomerate mass along the Isthmus is noted measuring 1.2 cm x 2.4 cm with lobular margins and internal echogenic foci likely microcalcifications as well as internal vascularity on Doppler exam.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small bilateral benign appearing lymph nodes in the neck.OTHER: No significant abnormality noted. | Dominant Isthmus mass as described above. No sonographic evidence of nodal metastases. |
Generate impression based on findings. | Patient with ischemic cardiomyopathy and acute kidney injury. Evaluate for obstruction. RIGHT KIDNEY: Right kidney measures 12.1 cm in length. A 3.7 cm septated cyst is redemonstrated and unchanged compared to prior. There is no evidence of hydronephrosis. Kidneys mildly echogenic.LEFT KIDNEY: Left kidney measures 11.2 cm in length. No hydronephrosis. Left kidney is mildly echogenic.URINARY BLADDER: Poorly distended and difficult to evaluateOTHER: No significant abnormalities noted. | No hydronephrosis of either kidney. Stable septated cyst in the right kidney. Medical renal disease. |
Generate impression based on findings. | History of cirrhosis. Evaluate for HCC. LIVER: The liver is shrunken and nodular compatible with cirrhosis. The parenchyma is coarse and moderately echogenic. No focal lesion is evident. It measures 13.7 cm in craniocaudal dimension.Normal hepatopedal portal venous blood flow at 0.2 m/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation with the common duct measuring 5 mm. PANCREAS: Limited evaluation of the pancreatic head/body is unremarkable.SPLEEN: The spleen measures 9.8 cm in length.RIGHT KIDNEY: The right kidney measures 8.1 cm in length without hydronephrosis or shadowing nephrolithiasis. It is mildly echogenic with cortical thinning.OTHER: The left kidney measures 8.3 cm in length without hydronephrosis or nephrolithiasis. It is mildly echogenic with cortical thinning.Moderate volume ascites. | Cirrhotic morphology without a suspicious focal lesion. Moderate volume ascites. |
Generate impression based on findings. | 58 year-old female with ascites and elevated lipase, evaluate for cholelithiasis or infection. LIVER: The liver measures 15.5 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 0.3 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 diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.4 cm in length. RIGHT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. Mild hydronephrosis. LEFT KIDNEY: Kidney measures 13.1 cm in length. Normal echotexture. Mild hydronephrosis. OTHER: Ascites. | 1.No evidence of cholelithiasis or cholecystitis.2.Abdominal ascites and bilateral pleural effusions. 3.Mild righter greater than left hydronephrosis. |
Generate impression based on findings. | 60-year-old female patient with elevated liver enzymes. LIVER: The liver measures 19.9 cm in length and demonstrates increased parenchymal echogenicity with focal hypoechogenicity near the gallbladder. 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 gallbladder wall thickening or pericholecystic fluid.. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.9 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.2 cm in length. No evidence of hydronephrosis.The spleen measures 7.8 cm in length. | 1. Increased hepatic echogenicity consistent with hepatic steatosis with focal areas of sparing.2. Cholelithiasis without sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | 65-year-old male with acute on chronic pancreatitis and abdominal pain. Evaluate for gallstones. LIVER: Mildly echogenic without focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder contains deep tendon sludge, but no shadowing gallstones or wall thickening. There is no pericholecystic fluid.PANCREAS: Pancreatic substance is poorly visualized. Multiple large complex cystic masses are identified in the abdomen consistent with pseudocystsRIGHT KIDNEY: No significant abnormalities noted.OTHER: Trace ascites | Gallbladder sludge without stones.Pseudocysts.Trace ascites. |
Generate impression based on findings. | Evaluate for pathology, renal disease, advanced heart failure workup LIVER:Liver measures 16.9 cm with mildly increased echotexture. No intrahepatic biliary ductal dilatation. No focal lesion noted. Portal vein demonstrates normal flow directionality and patency.GALLBLADDER, BILIARY TRACT: Mildly distended gallbladder with shadowing gallstones within it consistent with cholelithiasis. Gallbladder wall thickness is within normal limits. Trace ascites noted.PANCREAS: Not well visualized due to overlying bowel gasSPLEEN: Spleen measures 7.6 cm appears unremarkable.KIDNEYS: Right kidney is not visualized. Please correlate with history of nephrectomy or agenesis?Left kidney measures 11.5 cm with normal echo texture. Prominence of the left renal pelvis resolved on postvoid sonography.ABDOMINAL AORTA: Abdominal aorta appears unremarkable. No evidence of aneurysmal dilatation or atherosclerotic changes. Proximal aorta measures 2.5 x 2.4 cm, mid aorta measures 1.8 x 1.5 cm and distal aorta measures 1.5 x 1.5 cm.INFERIOR VENA CAVA: PatentOTHER: No significant abnormality noted. | No findings suggestive of acute cholecystitis.Trace ascites in the abdomenRight kidney could not be visualized in the abdomen, correlate with history of nephrectomy or concerned for agenesis. |
Generate impression based on findings. | 37-year-old male with acute kidney failure. Evaluate for hydronephrosis. Abnormal liver function. LIVER:There is hepatomegaly with the liver measuring at least 20 cm in length. The hepatic parenchyma is echogenic which is nonspecific. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: The head is normal. The body and tail are less well seen due to bowel gas.SPLEEN: Splenomegaly with the spleen measuring at least 15 cm in length.KIDNEYS: Right kidney measures 15.7 cm in length and is likely mildly echogenic consistent with parenchymal disease. No hydronephrosis, shadowing calculus or mass. Left kidney measures approximately 15.2 cm in length and is likely mildly echogenic consistent with parenchymal disease. No hydronephrosis, shadowing calculus or mass.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites. | Hepatosplenomegaly with echogenic liver.No evidence for hydronephrosis. Kidneys may be mildly echogenic. |
Generate impression based on findings. | Ms. Mukhopadhyay is a 24 year old female presenting with a palpable abnormality in the left breast for the past 6 months. She denies any tenderness or history of trauma. Upon physical exam at the patient's area of concern, no discrete mass is appreciated.A targeted left breast ultrasound was performed for the palpable area of concern. Dense fibroglandular tissue is identified at the area of concern along with a 6 mm cyst. No suspicious cystic or solid masses are identified. | Dense fibroglandular tissue without sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Cirrhosis with nausea and vomiting LIMITED ABDOMENLIVER: Cirrhotic morphology without mass. Liver length 17.5 cmBILIARY TRACT: Gallbladder absent. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: 14.4 cm in length. RIGHT KIDNEY: No significant abnormalities noted. 10.2 cm in length.OTHER: Left kidney 11.7 cm in length. No ascites | Cirrhotic liver without mass or ductal dilatation. Patent hepatic vessels with normal directional flow. No ascites. |
Generate impression based on findings. | Hepatitis B LIVER: Coarse echogenic liver echotexture without mass. Liver length 16.8 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.7 cm in lengthOTHER: Left kidney 11.6 cm in length. Spleen 11.4 cm in length. No ascites. | Coarse echogenic liver suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Male 65 years old with left inguinal area mass Well-circumscribed heterogeneously echogenic nodule measuring 5.6 x 4.9 x 2.0 cm. No abnormal vascularity. | Correlating the ultrasound findings with CT, this most likely represents a lipoma. |
Generate impression based on findings. | 63-year-old male with thyroid nodule on MR exam. RIGHT LOBE MEASUREMENTS: 4.9 x 1.8 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.2 by 2 x 1.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Homogeneous in echotexture. LEFT LOBE: Homogeneous in echotexture. In the mid portion of the left lobe there is a rounded, solid nodule measuring approximately 1 x 1 x 1 cm which is uniform and slightly hypoechoic compared to thyroid tissue.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Solitary 1 cm solid left thyroid nodule the appearance is nondescript by ultrasound and in this age range could be followed. |
Generate impression based on findings. | Elevated creatinine RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Lower pole cyst. Right kidney 9.8 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass or hydronephrosis. Possible subcentimeter nonobstructing renal stone. Left kidney 9.9 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass or obstruction. Possible nonobstructing left subcentimeter renal stone |
Generate impression based on findings. | Reduced urine output acute renal insufficiency RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. 11.7 cm in length.LEFT KIDNEY: Echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. Left hepatic cyst. 10.4 cm in length.OTHER: Bladder nondistended. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | 49 year-old asymptomatic female presents for whole breast ultrasound for dense breast screening. Patient has history of right breast invasive ductal carcinoma and DCIS status post mastectomy with reconstruction and implant in August 2013. 3-D whole breast ultrasound was performed for the left breast and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy in the left breast.BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | Male 77 years old; Reason: history of thyroid nodule, please evaluate for interval change History: left thyroid nodule Multiple nodules identified within the right and left lobes of the thyroid as noted previously without substantial change.RIGHT LOBE MEASUREMENTS: 5.3 x 2.5 x 2.3 cm, not substantially changedLEFT LOBE MEASUREMENTS: 4.6 x 2.2 x 2.1 cm, not substantially changedISTHMUS MEASUREMENT: 0.4 cm, not substantially changedRIGHT LOBE:The largest nodule on the right measures 0.6 x 0.6 x 0 .3 cm, stable in size, with the cystic component, as noted previously. This nodule is located within the superior pole and contains central calcifications. Small nodule also noted posterior to the right lobe of the thyroid which could represent a parathyroid gland.LEFT LOBE: The largest nodule on the left is predominantly solid. It is centrally iso/hyperechoic and peripherally hypoechoic and measures 1.2 x 1.2 x 1.0 cm, slightly smaller (this nodule was previously sampled). This is located within the inferior pole.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Atherosclerosis of the carotid arteries noted. | Multiple nodules are redemonstrated throughout the thyroid gland, not substantially changed compared to prior. |
Generate impression based on findings. | Multinodular goiter. RIGHT LOBE MEASUREMENTS: 4.8 x 2.1 x 2.5 cm, similar to prior. Normal background vascularity.LEFT LOBE MEASUREMENTS: 4.2 x 2.4 x 2.1 cm, similar to prior. Normal background vascularity.ISTHMUS MEASUREMENTS: 3 mm in AP dimension.RIGHT LOBE: Multiple predominantly solid nodules with minimal cystic elements are again noted. The largest of these measures 1.8 x 1.7 x 1.4 cm in the superior pole and is unchanged accounting for differences in measurement technique. Unchanged vascularity. No new suspicious features.LEFT LOBE: Mildly heterogeneous lobulated solid nodule is again noted, measuring 2.6 x 2.4 x 2.0 cm and is unchanged accounting for differences in measurement technique. Unchanged vascularity. No new suspicious features.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Multinodular goiter, without significant interval change. |
Generate impression based on findings. | Call back from screening mammogram for multiple focal asymmetric density in the right breast. DIAGNOSTIC MAMMOGRAM OF THE RIGHT BREAST: Three standard views with spot compression of right breast 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.The previously described 3 focal asymmetries seen in the upper outer right breast persist on the spot compression. In addition, another small asymmetry in the right middle breast is also confirmed on the CC view with spot compression. Incidental note is made of the low-lying right axillary lymph node.TARGETED ULTRASOUND OF THE RIGHT BREAST:On physical examination, no mass is appreciated in the upper-outer right breast and medial right breast. At the 9:00 location of the right breast, approximately 5 cm from the nipple, 2 adjacent oval, well-circumscribed hypoechoic masses are identified measuring up to 4 mm in maximum diameter. These two masses demonstrate fatty hila and central vascular flow, most compatible with intramammary lymph nodes and corresponding to the 2 adjacent well defined masses in the mid right breast upper outer quadrant on the diagnostic mammogram.There is no sonographic finding to correlate mammographic area of concern in the upper outer right breast, slightly posterior to the above intramammary lymph nodes.At 4:00 location of right breast, approximately 3 cm from the nipple, a 5 x 2 x 5 mm well-circumscribed hypoechoic mass is noted, which is parallel to the skin, most compatible with a small fibroadenoma.Incidental note is made of the 7 x 8 mm right axillary lymph node, corresponding to the mammographically incidental finding. | A small focal asymmetry in the upper outer posterior right breast without sonographic correlate or abnormal finding on physical exam, probably a benign process. Other benign findings as described above. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended in 6 months. 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. | 46-year-old male with cirrhosis and on autoimmune hepatitis. Evaluate for hepatocellular carcinoma. LIVER: Mildly and coarsely echogenic without focal abnormality. Overall size within normal limits. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Biliary tract is normal in caliber. Gallbladder appears unremarkable.PANCREAS: Head and body are normal. The tail was not well seen.SPLEEN: Upper normal in size.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Stable examination without hepatic mass. |
Generate impression based on findings. | 19-year-old female patient with history of right lumpectomy for fibroadenoma. Patient complains of new/increasing right breast mass immediately inferior to the nipple. A targeted right ultrasound was performed for the palpable area of concern. Physical examination demonstrated a small palpable lump in the inferior right breast just below the nipple. Targeted ultrasound of this area at the 6:00 position 1 cm from the nipple showed a 1.7 x 1.1 x 1.4 cm (previously 1.8 x 0.9 x 1.3) parallel circumscribed oval hypoechoic mass with internal vascularity. | No significant interval change in inferior right breast benign morphology mass, likely representing a fibroadenoma. Recommend continued surgical consultation follow-up.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Reason: evaluate right renal mass History: 25lb weight loss, stage IV Chronic renal disease, renal mass seen on non contrast CT RIGHT KIDNEY: Exophytic predominantly anechoic mass arising from the right kidney measuring 4.2 cm x 4.2 cm x 3.6 cm with internal septation and questionable solitary mural nodule seen dorsal to the area of septation on a few of the images. Increased echogenicity of the renal parenchyma suggestive of medical renal disease. No hydronephrosis.LEFT KIDNEY: Increased echogenicity of the renal parenchyma suggestive of medical renal disease. No hydronephrosis.OTHER: No significant abnormalities noted. | Exophytic predominantly cystic mass with internal septation and questionable mural nodule. Continued follow-up in 4 months is recommended to ensure no increase in size of the mural nodule. |
Generate impression based on findings. | 48 year old female with history of right upper quadrant pain. Evaluate for gallbladder pathology. LIVER: Hepatic steatosis, without focal abnormality.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Hepatic steatosis, without additional abnormality. |
Generate impression based on findings. | 67-year-old female patient with pain, tingling on right side. RIGHT LOBE MEASUREMENTS: 4.6 x 1.4 x 1.7 cm.LEFT LOBE MEASUREMENTS: 4.8 x 1.5 x 1.7 cm.ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity without dominant thyroid lesion.LEFT LOBE: The left thyroid lobe is homogeneous in echogenicity. There is a subcentimeter cystic nodule containing colloid.ISTHMUS: The isthmus is homogeneous in echogenicity. There is a subcentimeter echogenic nodule within the inferior aspect of the right isthmus. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No specific findings to account for the patient's symptoms.2. No dominant thyroid nodule. |
Generate impression based on findings. | Female; 47 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer, 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No residual thyroid tissue. No suspicious lesion.LEFT LOBE: No residual thyroid tissue. No suspicious lesion.ISTHMUS: No residual thyroid tissue. No suspicious lesion.LYMPH NODES: Two prominent level 4 lymph nodes on the left are seen. The largest measures 1.2 x 0.6 x 0.5 cm and has a fatty hilum. A left level 6 lymph node near the clavicle measures 0.7 x 0.3 x 1.1 cm and has a fatty hilum. | 1.No evidence of recurrence in the thyroid bed. 2.A few prominent bilateral lymph nodes have a normal appearing fatty hila and are likely benign reactive nodes. |