instruction
stringclasses 1
value | input
stringlengths 56
2.58k
| output
stringlengths 11
1.71k
|
|---|---|---|
Generate impression based on findings. | Female 40 years old Reason: Patient with left sided fluid collection - please evaluate as she had the fluid collection drained this week History: fluid collection Diffuse subcutaneous edema is present within the superficial soft tissues. Within the abdomen there is a simple appearing 10.0 x 1.2 x 5.2 cm. Superficial to this simple appearing fluid collection there is a much smaller round anechoic fluid collection measuring 0.9 x 0.9 x 0.6 cm. Adjacent to the midline in the left lower quadrant there is a heterogeneous appearing fluid collection measuring 4.2 x 4.6 x 2.7 cm with complex internal echogenicity. This collection is nonspecific. | 1.2 simple appearing fluid collections as above.2.Complex appearing fluid in the left lower quadrant is nonspecific. Interval follow-up imaging may be obtained if clinically warranted. |
Generate impression based on findings. | 72 year old female with history of thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.3 cmLEFT LOBE MEASUREMENTS: 5 x 1.9 x 1.7 cm ISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: There are several well-defined cystic and spongiform subcentimeter nodules. The largest measures 9 mm and is predominantly cystic. No specific suspicious sonographic features.LEFT LOBE: There are several well-defined cystic and spongiform nodules. The largest is a spongiform nodule with comet tail artifact reflecting colloid, measuring 1.3 cm.ISTHMUS: There is a 2.3 x 2.0 x 1.8 cm solid nodule extending from the inferior aspect of the isthmus without hypervascularity or microcalcifications. It is well defined and heterogeneous.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 2.3 cm indeterminate solid inferior isthmus nodule. Given its size and hypermetabolism on PET an FNA should be considered.2. Multiple additional bilateral cystic and spongiform nodules. |
Generate impression based on findings. | Ms. Hendrix is a 76 year old female with known left breast cancer undergoing neoadjuvant chemotherapy. She presents for ultrasound evaluation to assess response. On physical examination, no discrete mass is palpated in the left upper inner quadrant.A targeted left ultrasound was performed at the site of the biopsy-proven cancer. The biopsy-proven cancer in the left breast 11:00 position, approximately 7 cm nipple, now measures 1.3 x 0.9 x 1.3 cm , previously measuring 2.0 x 1.8 x 2.2 cm). Biopsy clip is noted centrally within this mass. | Interval decrease in size of known cancer in the left breast. Patient should follow-up with her breast surgeon for further management. Results and recommendations were discussed with the patient.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 26-year-old female with transaminitis. LIVER: Coarsely echogenic as previously noted but normal in size. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Gallbladder is collapsed without significant wall thickening. No cholelithiasis or pericholecystic fluid. Visualized biliary tract is normal in caliber.PANCREAS: Limited due to bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Both kidneys are within the pelvis. OTHER: No significant abnormalities noted. | No significant change. Echogenic liver. No biliary tract dilatation. |
Generate impression based on findings. | 45 year-old male with persistently mildly elevated LFTs. LIVER: The liver is coarse, echogenic with decreased through transmission, limiting evaluation for a focal lesion. Given this limitation, there is no focal lesion or intrahepatic biliary ductal dilatation. Liver measures 21.4 cm in craniocaudal dimension. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 2 mm.PANCREAS: The suboptimally visualized pancreatic body and head are grossly unremarkable.SPLEEN: The spleen is mildly enlarged, measuring 14.1 cm in length.RIGHT KIDNEY: The right kidney measures 13.7 cm in length without hydronephrosis. OTHER: The left kidney measures 13.3 cm in length without hydronephrosis. | 1. Hepatomegaly and findings compatible with severe diffuse fatty infiltration of the liver. 2. Mild splenomegaly. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Personal history of benign right breast biopsy with pathology of fibroadenoma. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. In the right upper outer breast, approximately 9:30 location, there is an oval hypoechoic lesion identified measuring 1.8 x 0.9 cm. This corresponds in size and location to the biopsy-proven fibroadenoma identified on the mammogram from 2013. No solid or cystic mass is identified. | Right breast fibroadenoma. No sonographic evidence for malignancy. Of note, the patient's last screening mammogram was performed in 2013. She is now due for a bilateral screening mammogram. BIRADS: 2 - Benign.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Female; 52 years old. Reason: evaluate for cirrhosis History: chronic HCV LIVER: The liver measures 14.5 cm in length. The liver surface is smooth and the liver parenchyma demonstrates a normal echotexture. No suspicious mass is identified. There is no ascites.The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 20 cm/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas appear normal. The pancreatic tail is obscured by overlying bowel gas.SPLEEN: 8.3 cm in length.RIGHT KIDNEY: Right kidney measures 10.8 cm in length. The renal parenchyma demonstrates normal echogenicity. There is no suspicious mass, hydronephrosis or shadowing stone. OTHER: The left kidney measures 9.8 cm in length. The renal parenchyma demonstrates normal echogenicity. There is no suspicious mass, hydronephrosis or shadowing stone. | No evidence of cirrhosis. No suspicious liver mass is identified. |
Generate impression based on findings. | 23-year-old with self palpated mass right breast 5 to 6 o'clock position for evaluation A targeted right ultrasound was performed for the palpable area of concern. On physical examination, normal dense glandular tissue noted. No discrete mass was palpated . Ultrasound demonstrated dense glandular tissue. There is no solid or cystic mass identified. | No sonographic evidence for malignancy, corresponding to patient's palpable area of concern right breast.Clinical correlation is recommended.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female 76 years old; Reason: follow up US history of thyroid nodule History: follow up US history of thyroid nodule 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: Multiple benign-appearing spongiform nodules all stable in size with the exception of one. There has been an interval increase in size of a mixed solid and cystic, predominantly cystic, lesion. It previously measured 5 cm x 5 cm and now measures 9 cm x 9 cm. There is peripheral vascularity but no definite microcalcifications.LEFT LOBE: Multiple benign-appearing nodules all stable in size in comparison to the prior study.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious adenopathy noted. OTHER: No significant abnormality noted. | 1.Multiple lesions throughout the thyroid all stable in size except slight increase of one right sided nodule as above.2.Overall increase of vascularity suggestive of possible underlying thyroiditis. Please correlate with laboratory values. |
Generate impression based on findings. | Nontoxic goiter RIGHT LOBE MEASUREMENTS: 5.6 x 3.3 x 2 cmLEFT LOBE MEASUREMENTS: 5.2 x 2.1 x 2.1 cmISTHMUS MEASUREMENTS: 1.2 cmRIGHT LOBE: Benign-appearing predominantly cystic subcentimeter nodule measuring 0.8 x 0.5 x 0.6 cm.LEFT LOBE: Hypoechoic subcentimeter nodule inferior pole left thyroid gland measuring 0.6 x 0.7 x 0.6 cm associated with old colloid and coarse calcification.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral subcentimeter nodules. No regional adenopathy. |
Generate impression based on findings. | Epigastric pain LIVER: Normal parenchymal echogenicity without mass. Liver length 16.1 cm. Limited Doppler interrogation the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. Spleen 7.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. 9.3 cm in lengthOTHER: Left kidney 9.3 cm in length. No ascites. Bilateral pleural effusions. | Cholelithiasis without acute inflammation or ductal dilatation. |
Generate impression based on findings. | Cysts RIGHT LOBE MEASUREMENTS: 5.5 x 2.2 x 2.0 cmLEFT LOBE MEASUREMENTS: 5.2 x 2.2 x 1.6 cmISTHMUS MEASUREMENTS: 5 mm in AP dimension.RIGHT LOBE: Few subcentimeter cystic and solid nodules identified. The largest cyst measures 11 mm. No suspicious features are identified. A spongiform soft tissue nodule measures 7 mm. LEFT LOBE: The left lobe is mildly heterogeneous with subcentimeter cysts, the largest of which measures 6 mm. No suspicious features are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Multiple cystic and spongiform thyroid nodules, without suspicious features. |
Generate impression based on findings. | 60-year-old female with multiple palpable nodules over the lower extremities. Right lower extremity:Note is made of multiple compressible superficial vessels, corresponding to the patient's palpable area of concern. No focal mass lesions are identified.Left lower extremity:Note is made of multiple compressible superficial vessels, corresponding to the patient's palpable area of concern. No focal mass lesions are identified. | No focal mass lesions to correspond to the patient's palpable areas of concern. There are multiple compressible superficial vessels in the adjacent area. If clinical concern for superficial thrombophlebitis or deep venous thrombosis, further evaluation with dedicated venographic sonography is recommended. |
Generate impression based on findings. | 49-year-old male patient evaluation for preheart transplant workup. Evaluate for intra-abdominal process. LIVER:The liver measures 17.0 cm in length and demonstrates increased, coarsened hepatic echotexture with prominent periportal echos. Scattered subcentimeter anechoic lesions with posterior acoustic enhancement within both hepatic lobes are consistent with cysts. GALLBLADDER, BILIARY TRACT: The gallbladder is not visualized on this examination. No intra or extrahepatic ductal dilatation is identified. The common duct measures 2 mm in diameter.PANCREAS: The pancreas is not visualized secondary to overlying bowel gas.SPLEEN: The spleen measures 9.9 cm in length.KIDNEYS: The right kidney measures 10.2 cm and the left kidney measures 11.7 cm in length. No evidence of hydronephrosis. ABDOMINAL AORTA: The abdominal aorta is normal in caliber. A catheter is noted within the aorta.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: The bladder is partially decompressed by a Foley catheter. | Coarsened hepatic echotexture with prominent periportal echoes; this appearance is nonspecific but has been described with hepatitis. Alternatively, prior CT demonstrates multiple cystic hepatic lesions likely representing biliary hematomas which might produce this appearance |
Generate impression based on findings. | 73 year old female with ascites and AKI. Evaluate liver, vasculature and kidneys. LIVER: Large portion of the liver is occupied by a heterogeneous predominantly solid lesion measuring 9.4 cm x 7.1 cm x 9.1 cm. The main portal vein is patent with appropriate directional flow. Peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Mild gallbladder wall thickening which is nonspecific in the setting of ascites. No pericholecystic fluid. Common duct measures 9 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Obscured by overlying bowel gas.SPLEEN: Normal echogenicity of the spleen measuring 11.2 cm in length.KIDNEYS: Right kidney measures 10.2 cm in length and is increased in echogenicity. Left kidney measures 10 .is an increase in length and is increased in echogenicity. No hydronephrosis or shadowing calculi are noted bilaterally.ABDOMINAL AORTA: Proximal aorta measures 2.4 cm x 2.4 cm. The mid aorta measures 1.8-cm x 1.4-cm.INFERIOR VENA CAVA: The visualized IVC is patent. OTHER: Moderate ascites. | 1. Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration. Large heterogeneous mass corresponds to the lesion noted on CT and does not appear significantly changed. Main portal vein is patent.2. Increased echogenicity of the kidneys suggestive of nonspecific medical renal disease. No obstruction. 3. Moderate ascites.4. Mild gallbladder wall thickening which is nonspecific in the setting of ascites. No sonographic evidence of cholecystitis. |
Generate impression based on findings. | Evaluate for change in thyroid nodules RIGHT LOBE MEASUREMENTS: 6.1 x 2.5 x 2.0 cm.LEFT LOBE MEASUREMENTS: 6.3 x 2.2 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.9 cm.RIGHT LOBE: Heterogeneous nodules measuring up to 0.7 to 0.7 x 0.6 cm in the midpole, grossly stable.LEFT LOBE: Heterogeneous nodules measuring up to 0.9 x 0.6 x 0.6 cm in the lower pole, grossly stable.ISTHMUS: Nodules measuring up to 1.5 x 1.0 x 1.2 cm, grossly stable.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable appearance of multinodular goiter. |
Generate impression based on findings. | 33-year-old male. Bilateral maxillofacial swelling, eyelid swelling. Evaluate for lymph node calcification or swelling? Neck masses? Edematous thickening of the subcutaneous tissues of the chin without a focal mass. Benign appearing normal-sized lymph node in the right upper neck. No lymphadenopathy. | Targeted area of site of swelling in the chin demonstrated subcutaneous edema without evidence of a focal mass or lymphadenopathy. |
Generate impression based on findings. | 56 years old, Female, Reason: HBV evalaute for HCC History: HBV LIVER: The liver measures 12.0 cm in length. Mildly coarse echogenicity of the liver. Unchanged small right liver cyst measuring 5 mm. No evidence of nodularity to the liver. 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. Patient's known 4-mm polyp is unchanged in size and appearance. 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 8.4 cm in length. RIGHT KIDNEY: Kidney measures 10.0 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 9.6 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | 1.No evidence of cirrhosis or hepatic mass. 2.Unchanged right hepatic 5-mm cyst.3.Subcentimeter gallbladder polyp is unchanged in size and appearance. |
Generate impression based on findings. | Male 65 years old Reason: assess for liver lesions History: HCV; advanced fibrosis LIVER: Coarse echotexture of the liver suggestive of chronic liver disease. No focal liver lesions.BILIARY TRACT: Cholelithiasis without sonographic evidence of cholecystitis or biliary dilatation.PANCREAS: Pancreas is not well seen due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 9.9 cm.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Coarse echotexture of the liver. Cholelithiasis. |
Generate impression based on findings. | Ms. Bruce submitted outside mammograms dated 1/8/2015 and 3/8/2016, from Mercy Hospital. Submitted outside studies were compared to the current mammogram/ultrasound dated 11/4/2016. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution. Previously identified mass in the right lateral breast (2:30 location) and left upper outer breast (1:00 location) are stable when compared to prior mammograms dating back to 2015.There is no significant change between these studies. | Bilateral stable benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in November 2017.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 76-year-old male. Abnormal LFTs. Evaluate for obstruction. LIVER: Normal echogenicity and echotexture the liver. The liver is 12 cm in length. No focal hepatic mass. Hepatoportal venous flow.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 3 mm, within normal limits. Gallbladder sludge. Trace pericholecystic fluid, nonspecific in presence of ascites. Patient is not tender over the gallbladder.PANCREAS: Visualized pancreatic head is normal in echogenicity. Remainder of the pancreas is obscured by bowel gas.RIGHT KIDNEY: Right kidney is than 20 cm in length and has a cyst. No hydronephrosis.OTHER: Large bilateral pleural effusions. Trace perisplenic fluid. | No biliary ductal dilatation. Gallbladder sludge with trace pericholecystic fluid, nonspecific in presence of ascites. Large bilateral pleural effusions. |
Generate impression based on findings. | 74-year-old female with history of cholecystectomy, outside ultrasound showing biliary dilation. LIVER: Mild intrahepatic biliary ductal dilation. No focal hepatic lesions identified.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Marked dilation of the common bile duct measuring up to 1.4 cm. No choledocholithiasis or discrete mass lesions are identified in the field of view of the examination. PANCREAS: The pancreatic body and tail are obscured by bowel gas. The visualized portions of the pancreas appear within normal limits. KIDNEY: No significant abnormalities noted.OTHER: 1.3 x 0.7 cm nonspecific peripancreatic lymph node. | Dilated common bile duct up to 1.4 cm and mild intrahepatic ductal dilation are somewhat greater than expected following cholecystectomy. Consider MRCP for further evaluation as warranted clinically. |
Generate impression based on findings. | Septic shock. Elevated alkaline phosphatase. LIVER: Non-cirrhotic liver morphology. Innumerable metastatic lesions are again noted. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Status post cholecystectomy.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: Status post right nephrectomy. The left kidney is 12.8 cm in length with simple appearing cysts, measuring up to 3.3 cm.. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 11 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. Bilateral pleural effusions. Small amount of ascites identified. | 1. No specific findings to account for the patient's septic shock. 2. Small amount of ascites and bilateral pleural effusions. |
Generate impression based on findings. | Reason: RUQ pain, rule out GB stone, pancreatitis LIVER: Coarse, heterogeneous liver echotexture, consistent with parenchymal dysfunction/hepatic steatosis. The liver measures 16.6 cm in length. The portal vein is patent with normal portal venous hepatopedal blood flow, maximum flow 31.6 cm/s. No nodules or masses.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The proximal common bile duct measures 0.2 cm. The gallbladder wall measures 0.2 cm. No biliary ductal dilatation. No stones within the gallbladder or evidence of cholecystitis.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.8 cm in length. No hydronephrosis.LEFT KIDNEY: The left kidney measures 10.7 cm in length. No hydronephrosis.SPLEEN: The spleen measures 12.0 centers in length.OTHER: No significant abnormalities noted. No ascites. | Findings consistent with hepatic parenchymal dysfunction or hepatic steatosis. No findings to support cholelithiasis or cholecystitis. |
Generate impression based on findings. | Reason: splenomegaly-evaluate liver, spleen and portal flow. LIVER: The liver measures 19.3 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: Gallbladder surgically absent. Mild prominence of the common bile duct measuring up to 10 mm, not unexpected status post cholecystectomy. No intrahepatic biliary ductal dilatation.PANCREAS: Obscured by bowel gas.SPLEEN: The spleen is enlarged measuring 16.3 cm in length.RIGHT KIDNEY: Kidney measures 12.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13.2 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | 1.Mild hepatomegaly. Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No ascites.2.Mild prominence of the common bile duct which is not unexpected status post cholecystectomy. |
Generate impression based on findings. | Status post liver transplant for hepatitis B with recurrent hepatitis B virus LIMITED ABDOMENLIVER: Status post liver transplant; no hepatic lesion. Liver length 15.5 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 13.1 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 10.2 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites. | Status post renal transplant without mass or ductal dilatation. No ascites. Patent hepatic vasculature with normal directional flow. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid mass or suspicious finding identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Male; 61 years old. Reason: History of hepatitis C. Please evaluate for hepatocellular CA. History: As above LIVER: The liver measures 16.5 cm in length. The liver contour is smooth. The parenchyma is diffusely increased in echogenicity with a coarsened echotexture. No worrisome mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.23 m/sec.BILIARY TRACT: The gallbladder is nondistended. Multiple shadowing stones are seen within the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 12.2 cm in length.RIGHT KIDNEY: The right kidney measures 11.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 10.8 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | 1.Coarse and echogenic liver compatible with parenchymal dysfunction. No worrisome hepatic lesion.2.Cholelithiasis without ultrasound evidence of cholecystitis. |
Generate impression based on findings. | Recurrent UTIs RIGHT KIDNEY: Echogenic renal parenchyma. No worrisome mass. Benign renal cyst. Multiple subcentimeter nonobstructing stones. Right kidney 9.1 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma without worrisome mass. Benign renal cyst. Multiple subcentimeter nonobstructing stones. Left kidney 8.7 cm in length.OTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass or hydronephrosis. Multiple bilateral subcentimeter nonobstructing renal calculi. |
Generate impression based on findings. | Male 57 years old Reason: 57 y/o M with pancreatitis eval for biliary stone History: belly pain LIVER: Liver is normal in appearance measuring 15.8 cm. No focal hepatic masses. No perihepatic fluid. Main portal vein is patent with normal directional flow and a peak velocity 23.5 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No evidence of acute inflammation of the gallbladder. Gallbladder wall measures 1 mm. No gallstones. There is a small gallbladder polyp which measures 0.3 x 0.2 x 0.4 cm. Common bile duct is nondilated measuring 4 mm. No evidence of choledocholithiasis.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 7.9 cmKIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.3 cm. Left kidney measures 10.4 cm. OTHER: No significant abnormalities noted. | 1.No evidence of choledocholithiasis as clinically questioned.2.Small, subcentimeter gallbladder polyp. |
Generate impression based on findings. | 62-year-old female with metastatic medullary thyroid carcinoma RIGHT LOBE MEASUREMENTS: 5.4 x 2.0 x 1.8 cmLEFT LOBE MEASUREMENTS: 6.0 x 2.8 x 2.6 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Heterogeneous hypoechoic mass with calcifications and ill-defined margins in the left thyroid lobe measures approximately 4.1 x 3.3 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Unilateral left cervical lymphadenopathy in stations II-IV. The largest lymph node in the level III station measures 2.5 x 2.8 x 1.8 cm and contains calcifications.OTHER: No significant abnormality noted. | Left thyroid mass and bulky left lymphadenopathy as described above is consistent with the patient's known malignancy. |
Generate impression based on findings. | 59-year-old female patient with multiple thyroid nodules. Assess thyroid nodules. RIGHT LOBE MEASUREMENTS: 5.1 x 1.7 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.4 x 1.4 cm.ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: There is a solid hypoechoic nodule measuring 0.9 x 0.5 x 0.7 cm within the inferior pole of the right thyroid lobe.LEFT LOBE: There is a well-circumscribed, hypoechoic solid nodule measuring 1.3 x 0.9 x 1.6 cm inferior to the left thyroid lobe which may be exophytic in nature or external to the gland.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See above.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Subcentimeter right thyroid nodule.2. Hypoechoic solid nodule inferior to the left thyroid lobe which could represent an exophytic nodule or possibly a parathyroid adenoma; correlate with calciums levels/nuclear medicine scan if clinically warranted. |
Generate impression based on findings. | Mass on the back with back pain Ultrasound shows an ill-defined hypoechoic area that measures 1.9 x 2.1 x 1.2 cm in the subcutaneous tissue involving the dermis without peripheral blood flow which could represent an infected sebaceous cyst or epidermal inclusion cyst. | Superficial hypoechoic subcutaneous lesion involving the dermis which could represent an infected sebaceous cyst or epidermal inclusion cyst. Clinical correlation is recommended. |
Generate impression based on findings. | Status post resection hepatic hemangioma with high drain output LIMITED ABDOMENLIVER: Status post resection right lobe hemangioma. Extensive overlying gas obscures much of remains of the right lobe of the liver. No focal parenchymal mass BILIARY TRACT: Status post cholecystectomy. No ductal dilatation RIGHT KIDNEY: No significant abnormalities noted.OTHER: No perihepatic fluid collection or hematoma. Trace ascites | Status post resection of hemangioma. No worrisome hepatic mass or perinephric fluid collection or hematoma. Trace ascites. Patent hepatic vessels with normal directional flow. |
Generate impression based on findings. | 72-year-old male with recurrent hyperparathyroidism after two prior parathyroid operations. Status post partial thyroidectomy. Please evaluate for adenoma. RIGHT LOBE MEASUREMENTS: Again seen are changes consistent with the patient's history of right lobe thyroidectomy. There is interval development of a focus of hypoechoic tissue in the right thyroid bed, measuring 1.5 x 0.9 x 1.1 cm. LEFT LOBE MEASUREMENTS: 2.9 x 1.4 x 1.6 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Again seen are changes consistent with the patient's history of right lobe thyroidectomy. There is interval development of a focus of heterogenous but predominately hypoechoic tissue with internal vascularity in the right thyroid bed, measuring 1.5 x 0.9 x 1.1 cm. Additionally, note is made of an round, hypoechoic focus along the inferior margin of the right thyroid bed, measuring 6 x 4 x 4 mm without internal vascularity.LEFT LOBE: The left lobe is again noted to be diffusely heterogeneous and lobulated, appearing slightly decreased in size when compared to the prior study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Note is made of an round, hypoechoic focus along the inferior margin of the right thyroid bed, measuring 6 x 4 x 4 mm without internal vascularity.LYMPH NODES: Normal appearing right level IV cervical lymph nodes are identified.OTHER: No significant abnormality noted. | Heterogenous left lobe of the thyroid with interval development of a 6 mm hypoechoic focus along the inferior margin of the surgical bed of the right lobe of the thyroid gland which may represent a parathyroid adenoma candidate. Further evaluation with a parathyroid nuclear medicine scintigraphic examination could be considered if clinically indicated. |
Generate impression based on findings. | History of right upper quadrant pain. No reported history of chronic liver disease. LIVER: The liver is normal in morphology, size and echogenicity, measuring 15 cm in length. The liver capsule is smooth. No intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 39 cm/s.Note is made of a 1.0 x 0.9 x 0.8 cm echogenic lesion without a surrounding halo, statistically likely a benign hemangioma in the absence of chronic liver disease.BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: The visualized pancreatic head and body is unremarkable. The remainder the pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 8.5 cm in length without a focal lesion.RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. The renal cortex is mildly echogenic. OTHER: The left kidney measures 10.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Note is made of prominent renal sinus fat and mild cortical echogenicity. Color Doppler demonstrates hilar blood flow. | No specific findings to account for the patient's right upper quadrant pain.1 cm right hepatic lobe echogenic lesion statistically likely represents a benign hemangioma in the absence of chronic liver disease.Findings suggestive of medical renal disease. |
Generate impression based on findings. | 54-year-old female presents with localized swelling of her neck. There is a clinical concern for goiter. RIGHT LOBE MEASUREMENTS: 2.3 x 1.8 x 4.0 cm.LEFT LOBE MEASUREMENTS: 1.8 x 1.3 x 4.5 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: There is an approximately 1.9 x 1.7 x 2.1 cm spongiform nodule; favor benign etiology. Otherwise, the parenchyma appears normal and homogenous.LEFT LOBE: There is approximately 0.9 x 0.8 x 1.1 cm spongiform nodule that appears similar to the nodule in the right lobe. Favor benign etiology. Otherwise, the parenchyma appears normal homogenous.ISTHMUS: Normal and homogenous appearing parenchyma.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are noted bilaterally.OTHER: No significant abnormality noted. | 1. Bilateral spongiform nodules as above; favor benign etiology. |
Generate impression based on findings. | 78-year-old male presents with abdominal pain. There is clinical concern for mesenteric ischemia. LIVER:Measures 15.0 cm. Coarse echotexture of liver. No 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. The wall measures 2.0 mm. No pericholecystic fluid, stones, or sludge. Common bile duct measures 2.9 mm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 9.6 cm without sonographic abnormalities.KIDNEYS: Right kidney is 11.7 cm. Left kidney is 12.1 cm. Kidneys are mildly echogenic bilaterally. No hydronephrosis, shadowing calculi, or focal mass. TECHNIQUE: Doppler flow images were obtained on abdominal vasculature.ABDOMINAL AORTA: Patent without aneurysm.OTHER: The celiac artery is patent with peak systolic velocity at 223.1 cm/s. The resistive index is 0.71.The superior mesenteric artery is patent with peak systolic value 172.0 cm/s. The resistive index is 0.83.The inferior mesenteric artery is shadowed out by bowel gas and not evaluated on this study. | 1. Coarse echotexture of liver consistent with chronic liver disease/parenchyma dysfunction. No mass or ascites.2. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction. No hydronephrosis.3. Aorta without evidence of aneurysm. Celiac artery and SMA are patent as above. IMA inadequately evaluated on this study. |
Generate impression based on findings. | Ms. Palmer is a 41-year-old female with history of high probability benign morphology mass in the right breast was originally recalled from screening of 01/20/16, presenting for her follow-up exam. Three standard views of the right breast and two additional 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, unchanged in pattern and distribution. Again seen is a circumscribed subcentimeter mass in the right retroareolar region, without associated calcifications. In addition, a triangular marker is placed at the site of palpable abnormality in the right lower outer breast. Underlying this marker are several partially obscured circumscribed masses, which appear similar to prior examinationsUltrasound was subsequently performed.ULTRASOUND | Benign cysts in the palpable area of concern in the right breast and a cluster of microcysts in the right breast in the mammographic area of concern. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months in order to ensure stability of these findings. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 44-year-old female with history of asymptomatic angiomyolipoma. RIGHT KIDNEY: Measures 12.4 cm in length. Increased renal echogenicity. Hyperechoic lesion in the superior pole of the right kidney measures 5.1 x 3.7 x 6.5 cm, previously 4.0 x 3.4 x 4.3 cm.LEFT KIDNEY: Measures 12.4 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | 1.Interval increase in size of right renal angiomyolipoma. The lesion meets size criteria for interventional radiology consultation and possible embolization.2.Increased renal echogenicity consistent with medical renal disease. |
Generate impression based on findings. | 61-year-old male presents with transaminitis. LIVER:The liver measures 20.2 cm. There is increased and coarse echogenicity of the liver. No masses or ascites. No intrahepatic biliary dilation. The portal vein is patent with hepatopedal flow measured with peak velocity at 16.6 cm/s.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended. An echogenic foci within the gallbladder is thought to represent a gallstone. Gallbladder wall measures 0.2 cm. Common bile duct measures 0.7 cm. No pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: Evaluation of pancreas is limited due to overlying bowel gas.SPLEEN: The spleen measures 8.5 cm. No abnormalities are noted.KIDNEYS: The right kidney measures 11.5 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. Left kidney measures approximately 11.1 cm. The cortex has normal echogenicity. No no shadowing calculi or hydronephrosis. OTHER: No significant abnormality noted. | 1. Coarse and echogenic liver consistent with chronic liver disease/parenchymal dysfunction.2. Hepatomegaly without masses or ascites.3. Cholelithiasis without signs of acute inflammation. |
Generate impression based on findings. | 48-year-old male presents for HCC surveillance with history of HBV. LIVER: The liver morphology is normal and the capsule is smooth. The liver parenchyma is echogenic. It is normal in size, measuring 16 cm in craniocaudal dimension. There is no focal hepatic lesion or biliary ductal dilatation. Normal hepatopetal portal venous blood flow is present at 40 cm/sec.GALLBLADDER, BILIARY TRACT: Normally distended gallbladder without evidence of inflammation. The common duct is normal in caliber, measuring 5 mm.PANCREAS: The visualized portions of the pancreas are normal in appearance.RIGHT KIDNEY: The right kidney is normal in size, measuring 10.5 cm without hydronephrosis. The left kidney is normal in size, measuring 12.1 cm without hydronephrosis.OTHER: The spleen is normal in size, measuring 10.4 cm. | Echogenic hepatic parenchyma, compatible with diffuse fatty infiltration. No focal hepatic lesion or stigmata of cirrhosis. |
Generate impression based on findings. | Nonspecific elevation of levels of transaminases and lactic acid dehydrogenase, screen for fatty liver LIVER: Liver measures 15.9 cm with mild to moderate hepatic steatosis. No focal liver lesions noted. No intrahepatic ductal dilatation. Portal vein demonstrates normal flow directionality and patency.GALLBLADDER, BILIARY TRACT: Gallbladder is well distended with normal gallbladder wall thickness. No evidence of gallstones.PANCREAS: No visualization of pancreas due to overlying bowel gas.RIGHT KIDNEY: Right kidney measures 11.8 cm and left kidney measures 12.3 cm. No hydronephrosis or hydroureter. Normal echotexture noted.OTHER: No ascitesSpleen measures 13.4 cm with normal echotexture. | Mild to moderate hepatic steatosis without any focal lesions.No ascitesLimited visualization of the pancreas due to overlying bowel gas. |
Generate impression based on findings. | 86-year-old female with abdominal pain after eating. Evaluate for gallstones. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Mild gallbladder sludge but no cholelithiasis or evidence of cholecystitis. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.KIDNEY: Atrophic echogenic kidneys consistent with chronic medical renal disease. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.No evidence of cholelithiasis or cholecystitis.2.Atrophic echogenic kidneys consistent with chronic medical renal disease. |
Generate impression based on findings. | Right middle and lower abdominal pain, assess for ventral hernia. Intact abdominal wall at the region of the sonographic evaluation in right mid/lower abdomen, with no evidence of fascial defect. | No fascial defect to suggest abdominal wall hernia. |
Generate impression based on findings. | 63-year-old female patient with right breast asymmetry on screening mammogram. History of two benign left breast biopsies in 2002 and 2003. Family history of breast cancer in paternal aunt diagnosed at unknown age. RIGHT DIAGNOSTIC MAMMOGRAM: An ML view and 3 spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. A 6-mm oval mass in the right lower inner breast persists on spot compression views.RIGHT BREAST ULTRASOUND: Targeted right breast ultrasound was performed. In the 5 o'clock position of the right breast 1 cm with from the nipple there is a septated cyst that measures 5 x 2 x 5 mm. | 5 mm benign morphology mass in the right breast possibly corresponding to a benign septated cyst on ultrasound. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 66-year-old male with bladder cancer and impaired renal function. RIGHT KIDNEY: The right kidney measures 11.5 cm in length without hydronephrosis or discrete lesion evident. There is an echogenic shadowing focus in the interpolar region without a recent CT correlate which may be a nonobstructing stone but is nonspecific. LEFT KIDNEY: The left kidney measures 11.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident.URINARY BLADDER: The urinary bladder is contracted around a Foley catheter. | No hydronephrosis. |
Generate impression based on findings. | 1-year-old female with thyromegaly and subclinical hyperthyroidism. RIGHT LOBE MEASUREMENTS: 5.5 x 1.8 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.7 x 2.1 x 1.6 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Diffusely heterogeneous in echotexture with small hypoechoic area in the upper pole measuring 0.4 x 0.5 x 0.6 cm which is not specific in appearance.LEFT LOBE: Diffusely heterogeneous in echotexture with ill-defined focal region in the mid left lobe which has a spongiform type appearance..ISTHMUS: Heterogeneous in echotexture.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are prominent but morphologically normal lymph nodes in the neck bilaterally. Patient complains of upper respiratory infection.OTHER: No significant abnormality noted. | Diffusely heterogeneous thyroid with small right nodule and ill-defined , spongiform appearing left nodule. |
Generate impression based on findings. | Palpable painful left breast mass. History of prior left breast benign biopsy. Physical examination in the patient's area of concern revealed a subcentimeter nodule in the left breast at the 11:00 position 3 cm in the nipple, with tenderness to palpation. No associated skin changes were noted.A targeted left ultrasound was performed in this area, demonstrating a round 4 x 3 x 4 mm hypoechoic lesion with well-defined margins and foci of internal vascularity. | Indeterminate 4 mm lesion with internal vascularity in the left breast. Ultrasound-guided biopsy is recommended. Findings and recommendation were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: assess for liver disease History: elevated AST and ALT LIVER: Mildly increased hepatic echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.24 m/s.BILIARY TRACT: Layering gallbladder sludge without shadowing gallstones. No associated gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.9 cm in length. RIGHT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Mildly increased hepatic echogenicity suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | Acute kidney injury. RIGHT KIDNEY: The right kidney measures 9.4 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. The renal cortex is echogenic. Perihepatic and perirenal ascites.LEFT KIDNEY: The left kidney measures 10.0 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. Note is made of a 5 cm simple appearing inferior pole cyst. The renal cortex is echogenic. Perirenal ascites.URINARY BLADDER: The urinary bladder is partially distended with diffuse smooth wall thickening.OTHER: At least moderate volume ascites. Heterogeneous/coarsened liver echotexture and splenomegaly suggested, partially imaged. | No hydronephrosis. Partially distended urinary bladder may account for the mild diffuse wall thickening.Echogenic kidneys compatible with medical renal disease.Moderate volume ascites.Heterogeneous/coarsened liver echotexture and splenomegaly suggested, partially imaged.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Elevated lipase and abdominal pain. Slightly limited by body habitus.LIVER: The liver is coarse and increased in echogenicity. It measures 11.9 cm in craniocaudal dimension. No focal lesion is evident. No intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 22 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation with the common duct measuring 4 mm.Partially contracted gallbladder containing sludge and small shadowing gallstones. No gallbladder wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 5 cm and is poorly visualized otherwise.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 10.8 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | 1. Cholelithiasis without evidence of acute cholecystitis.2. Coarse and increased liver echogenicity suggestive of diffuse fatty infiltration.3. No biliary ductal dilatation. The pancreas is obscured by overlying bowel gas. |
Generate impression based on findings. | 24-year-old female with personal history of right breast carcinoma with axillary lymph node involvement, status post right lumpectomy and sentinel lymph node biopsy in October 2014 for invasive ductal carcinoma, presents for right axillary ultrasound for physician palpated right axillary lymph node. Patient complains of right axillary tenderness. A targeted right axillary ultrasound was performed for the palpable area of concern. A single normal morphology right axillary lymph node is appreciated with normal hilar flow, measuring 0.6 x 0.4 x 0.5 cm. No abnormal solid or cystic mass is identified. | Single normal morphology right axillary lymph node. No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 63-year-old female with chronic kidney disease. Ultrasound guidance was provided for biopsy of the right kidney. | Ultrasound guidance. |
Generate impression based on findings. | Reason: further assessment of liver heterogeneity seen on CT imaging History: CT imaging findings LIVER: The liver measures 15.9 cm in length. The background liver parenchymal echotexture is normal. Corresponding to the area of hypoattenuation in hepatic segment 6 on the recent CT, there is a somewhat geographic area of increased echogenicity measuring 2.2 x 1.6 x 2.6 cm. No additional focal hepatic lesions are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 21.9 m/s.BILIARY TRACT: There is no evidence of cholelithiasis or pericholecystic fluid. Mild focal gallbladder wall thickening may reflect adenomyomatosis. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.The spleen measures 10.8 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | Nonspecific hyperechoic area within hepatic segment 6 corresponding to area of hypoattenuation on recent CT. Top differential considerations include focal fat deposition or hemangioma in the absence of known underlying malignancy. If further characterization is desired, MRI could be considered as clinically warranted. |
Generate impression based on findings. | 15-year-old male complains of swelling in the left pectoral region. Left nipple areolar complex is asymmetric in comparison to the right. No abnormal fluid collections. No mass. | Left nipple areolar complex asymmetry without mass or abnormal fluid collection. |
Generate impression based on findings. | 57-year-old male with prior thyroidectomy. Evaluate for recurrent neoplasm. 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: At the 1B level bilaterally there are prominent lymph nodes with fatty hila. Although one of the left nodes is somewhat lobulated, the appearance is suggestive of reactive/inflammatory adenopathy. Previously noted right level 2 node is not identified.] The right level 1B node appears similar. Other nodes were not demonstrated on prior exam.OTHER: No significant abnormality noted. | No evidence for local recurrence in the bed.Prominent 1B nodes bilaterally likely reactive. |
Generate impression based on findings. | Alcohol dependence with withdrawal; history fatty liver LIVER: Coarse echogenic liver echotexture without mass. Liver length 17.5 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. 12.6 cm in lengthOTHER: Left kidney 13.3 cm in length. Spleen 11 cm in length. No ascites. | Coarse echogenic liver consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 29 year old female with right upper quadrant pain. LIVER: Normal echogenicity of the liver measuring 16.1 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal echogenicity.SPLEEN: Normal echogenicity of the spleen measuring 11.9 cm in length.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 12.1 cm in length. No hydronephrosis or shadowing calculi are noted. OTHER: Normal echogenicity of the left kidney measuring 11.6 cm in length. No hydronephrosis or shadowing calculi are noted. | Unremarkable examination. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Known bilobar metastasis not well appreciated on the ultrasound. Liver length 13.1 cmGALLBLADDER, BILIARY TRACT: Diffuse abnormal gallbladder wall thickening and trace pericholecystic fluid associated with gallstones and positive Murphy sign. Mild bilobar intrahepatic ductal dilatation associated with extrahepatic ductal dilatation. Common bile duct diameter 1.1 cm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 10.9 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites. | Diffuse abnormal gallbladder wall thickening and trace pericholecystic fluid associated with gallstones and positive Murphy sign. Findings consistent with acute cholecystitis. Associated with mild bilobar intrahepatic ductal dilatation and moderate extrahepatic ductal dilatation. |
Generate impression based on findings. | 36-year-old female patient with bilateral thyroid nodules. RIGHT LOBE MEASUREMENTS: 8.6 x 4.2 x 3.5 cm.LEFT LOBE MEASUREMENTS: 10.2 x 3.5 x 3.4 cm.ISTHMUS MEASUREMENTS: 8 mm in thickness.RIGHT LOBE: The right thyroid lobe is enlarged and heterogeneous in echogenicity. There is a 3.0 x 2.6 x 3.1 cm complex, heterogeneous, mostly solid nodule with the right mid lobe.LEFT LOBE: The left thyroid lobe is enlarged and heterogeneous in echogenicity, predominantly within the lower pole. No discrete measurable nodule is identified within this large area of heterogeneity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter. |
Generate impression based on findings. | 29-year-old female presents for follow-up evaluation for neoadjuvant chemotherapy of the biopsy-proven cancer in the left breast. A left breast ultrasound was performed at the area of proven cancer at the 11:00 position, 3 cm from the nipple. The known cancer measures 11 x 7 x 12 mm (previously 14 x 10 x 12 mm). Increased blood flow within the mass is present. | Decrease in size of the proven left breast cancerBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Reason: Gallbladder activity on PET done for lymphoma staging-evaluate for inflammation vs solid mass. Asymptomatic. LIVER: The liver measures 15.7 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: No cholelithiasis. Gallbladder mildly contracted which somewhat limits evaluation, but no abnormal gallbladder wall thickening identified; visualized lumen unremarkable. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 7.1 cm in length. RIGHT KIDNEY: Limited visualization. Kidney measures 8.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis or abnormal gallbladder wall thickening. |
Generate impression based on findings. | 40 year-old male with renal failure and proteinuria. Ultrasound guidance was provided for biopsy of native right kidney. | Ultrasound guidance. |
Generate impression based on findings. | 49 year old female with history of right upper quadrant pain after meals. Please evaluate gallbladder. LIVER: No significant abnormalities noted. The liver measures 19 cm in length.BILIARY TRACT: Cholelithiasis, without gallbladder wall thickening or pericholecystic fluid to suggest cholecystitis. No biliary dilatation.PANCREAS: No significant abnormalities noted. There is an approximately 3 x 2 x 1 cm hypoechoic focus near the head of the pancreas, nonspecific and likely representing a lymph node.SPLEEN: No significant abnormalities noted. The spleen measures 8 cm in length.RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 11.7 cm.OTHER: No significant abnormalities noted. The left kidney measures 10 cm. | Cholelithiasis, without findings of cholecystitis. Small lymph node near the head of the pancreas, nonspecific. |
Generate impression based on findings. | Male, 72 years old. S/p cystectomy+ileal conduit now with acute renal failure. RIGHT KIDNEY: The right kidney measures 12.2 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.2 cm in length, with increased cortical echogenicity. Slight left renal pelvic fullness. No hydronephrosis or shadowing stones.OTHER: The urinary bladder is surgically absent. | Increased renal cortical echogenicity, compatible with medical renal disease or parenchymal dysfunction. No hydronephrosis. |
Generate impression based on findings. | 53-year-old female with thrombocytopenia. History of alcohol abuse LIVER: Liver is again noted to be coarsely echogenic, little change from prior exams. Liver is normal in size. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. GALLBLADDER, BILIARY TRACT: Previously identified small gallstone not visualized on today's exam. No wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Limited by bowel gasRIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Coarsely echogenic liver without change.Gallstone not identified on today's study. |
Generate impression based on findings. | Female; 23 years old. Reason: 23yoF T1DM with Cr 3.0, unclear if AKI on CKD or baseline CKD, p/w flank pain History: as above RIGHT KIDNEY: The right kidney measures 9.1 cm. The renal cortex is echogenic. There is no hydronephrosis, shadowing renal stone, or worrisome mass.LEFT KIDNEY: The left kidney measures 9.1 cm. The renal cortex is echogenic. There is a hydronephrosis, shadowing renal stone, or worrisome mass.URINARY BLADDER: The bladder is nondistended.OTHER: No significant abnormalities noted. | Echogenic kidneys compatible with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Reason: Assess for stability in size of nodules, unable to biopsy, as on Plavix History: see above RIGHT LOBE MEASUREMENTS: 4.7 x 1.5 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.9 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cm in the AP dimensionRIGHT LOBE: Hypoechoic spongiform nodule in the right mid pole measures 0.7 x 0.6 x 0.6 cm, previously 0.7 x 0.6 x 0.7 cm, stable in size and appearance.Mixed cystic and solid in the inferior pole measures 1.6 x 0.6 x 0.9 cm, previously 1.9 x 0.9 x 1 cm, stable in size and appearance.No new nodules or masses.LEFT LOBE: Previously described as two separate nodules, the mixed cystic and solid lesions with small calcified focus in the mid pole have not changed in size or appearance and measure as a whole 3.5 x 2.5 x 1.7 cm, previously measured at 2.0 x 0.6 x 1.5 cm and 2.1 x 2.1 1.9 cm.No new nodules or masses.ISTHMUS: No new nodules or masses.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Several benign appearing nonenlarged cervical lymph nodes.OTHER: No significant abnormality noted. | No significant interval change in size and morphology of bilateral thyroid nodules. |
Generate impression based on findings. | 86-year-old male with urinary retention presents for suprapubic bladder catheter placement. Ultrasound was provided during and for confirmation of suprapubic catheter placement. Preprocedural images demonstrate predominantly anechoic urine with small, echogenic foci representing debris in a normally distended bladder. After placement of the catheter the retention balloon is visualized within the lumen of the bladder. | Imaging was provided for successful suprapubic urinary bladder catheter placement. |
Generate impression based on findings. | 62-year-old female with a history of a renal neoplasm presents for follow-up. Evaluate for recurrence. RIGHT KIDNEY: The right kidney is absent. No evident mass in the renal fossa.LEFT KIDNEY: The left kidney measures 11.47 m. The cortex has normal echogenicity. No shadowing calculi, hydronephrosis, or focal mass.OTHER: The bladder appears nondistended. | 1. Left kidney without mass.2. Surgical changes of right-sided nephrectomy without evidence of recurrence. |
Generate impression based on findings. | 46 year old female who was recalled from screening mammogram for bilateral breast masses. No family history of breast cancer. MAMMOGRAM: An ML view and 3 spot compression views of the right breast, and An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. There is redemonstration of a subcentimeter mass within the upper central right breast, which persists on spot compression imaging. Additionally, there is redemonstration of a subcentimeter mass in the upper outer left breast, which partially disperses on spot compression imaging. ULTRASOUND: Targeted right ultrasound was performed for the mammographic area of concern. At the 12 o'clock position of the right breast, 14 cm from the nipple there is a circumscribed hypoechoic mass with parallel orientation measuring 0.6 x 0.1 x 0.1 cm. A second 0.1 x 0.2 x 0.4 cm is noted adjacent to this. These likely represent simple cysts and account for findings on mammogram.Targeted left ultrasound was performed of the mammographic area of concern. Within the upper outer quadrant of the left breast, no solid or cystic mass is identified. Findings on mammogram likely represent superimposed glandular tissue. | 1. High-probability benign right breast lesions most likely cysts, accounting for findings on mammogram. Six month follow-up right unilateral mammogram and possible ultrasound are recommended to assess stability.2. Partial dispersement of the left breast findings, with no sonographic correlate. The mammographic finding likely represents superimposition of normal glandular tissue. BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 76-year-old male with history of equivocal left renal lesion on CT. Hematuria. RIGHT KIDNEY: The right kidney is within normal limits.LEFT KIDNEY: Although the left kidney is normal in size, there are several small tiny cysts. Additionally, there is an approximately 1 cm hypoechoic focus with internal echoes in the upper pole that may represent a hemorrhagic/complex cyst. No definite internal vascularity.OTHER: No hydronephrosis, no hydroureter. Bilateral renal jets are seen. Prostate enlargement. | 1.Left renal upper pole complex cystic focus may represent a hemorrhagic/complex cyst, although this is nonspecific and should be followed up in 6 months with ultrasound.2.Prostate enlargement. |
Generate impression based on findings. | Papillary thyroid carcinoma status post thyroidectomy RIGHT LOBE: Status post thyroidectomy. Stable 0.5 x 0.3 x 0.5 cm hypoechoic focus within the right thyroid bed. The second more inferior right thyroid bed focus is not identified on the current examinationLEFT LOBE: Status post thyroidectomy. No worrisome mass or noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy. Stable hypoechoic focus within the right thyroid bed. No worrisome mass or regional adenopathy appreciated. |
Generate impression based on findings. | 37-year-old female with history of papillary thyroid cancer. RIGHT LOBE MEASUREMENTS: 4.9 x 1.8 x 1.0 cmLEFT LOBE MEASUREMENTS: 4.2 x 1.6 x 1.2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Two small primarily cystic nodules with peripheral echogenic foci measure 0.3 cm, most likely benign.LEFT LOBE: Solid heterogeneous hypoechoic mass in the left thyroid measures 2.2 x 1.6 x 1.5 cm with taller than wide ill-defined margins and microcalcifications, consistent with the patient's known malignancy. Cystic left inferior pole nodule with peripheral echogenic focus measures 0.6 cm, most likely benign.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A subcentimeter lymph node in the left level three station is indeterminate morphologically. Other scattered bilateral cervical lymph nodes have overall benign morphologic features.OTHER: No significant abnormality noted. | 1.Left thyroid lesion as described above consistent with the patient's known papillary neoplasm.2.Indeterminate left level three lymph node is amenable to either biopsy or intraoperative localization.3.Other cervical lymph nodes and subcentimeter thyroid nodules are without specific suspicious features. |
Generate impression based on findings. | 29-year-old female with history of multinodular goiter.Three dominant nodules. Please evaluate for interval changes. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5.7 x 1.8 x 2.3 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 6.4 x 3.7 x 4.8 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.4 cm in thickness.RIGHT LOBE: The right thyroid lobe has heterogenous echotexture. The dominant nodule of the right lower lobe measures 1.9 x 1 x 0.9 cm (prior 1.6 x 1 x 0.8).LEFT LOBE: Enlarged left thyroid lobe containing multiple solid/cystic nodules. The known dominant nodule of the left upper pole measures 4.9 x 2.7 x 3.8 cm (prior 4.6 x 3.5 x 2.4 cm).ISTHMUS: The heterogenous solid/cystic nodule of the isthmus measures 2.4 x 2.6 x 1.4 cm (prior 2.1 x 2 x 1.4 cm).PARATHYROID GLANDS: A hypoechoic focus posterior-inferior to the right thyroid lobe measures 1.3 x 0.8 x 0.7 cm.LYMPH NODES: No suspicious cervical lymphadenopathy.OTHER: No significant abnormality noted. | 1. Thyromegaly with multiple solid/cystic nodules. These nodules are similar in appearance and stable to slightly increased in size.2. A hypoechoic focus posterior-inferior to the right thyroid lobe is a candidate for parathyroid tissue. Correlation with nuclear medicine imaging is suggested. |
Generate impression based on findings. | Male; 29 years old. Reason: mild LFT abnormalities, evaluate for hepatic abnormalities History: LFT abnormalities LIVER: The liver measures 12.5 cm in length. Liver surface is smooth. The liver parenchyma is increased in echogenicity with a coarsened echotexture. No worrisome mass is identified. There is no ascites.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.3 cm in length.RIGHT KIDNEY: The right kidney measures 10.2 cm in length. The renal cortex is normal in echogenicity. There is no shadowing renal stone or hydronephrosis. No worrisome mass is identified. OTHER: The left kidney measures 9.2 cm in length. The renal cortex is normal in echogenicity. There is no shadowing renal stone or hydronephrosis. No worrisome mass is identified | Coarse, echogenic liver compatible with hepatic steatosis. |
Generate impression based on findings. | Antiphospholipid syndrome. Recurrent GI bleed. Evaluate for mesenteric thrombosis. Evaluation of portal vein only requested. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Patent portal vein with normal flow velocity 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 7.6 cm in length. The left kidney is 8.2 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 10.6 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites. | 1. Patent portal vein.2. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 38-year-old male with pancreatitis, mild transaminitis, abdominal pain. LIVER: Measures 21.7 cm in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Hepatomegaly and increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. |
Generate impression based on findings. | Reason: thyroid cancer s/p total thyroidectomy History: thyroid cancer RIGHT LOBE: Status post thyroidectomy. No focal lesion in the thyroid bed.LEFT LOBE: Status post thyroidectomy. No focal lesion in the thyroid bed.ISTHMUS: Status post thyroidectomy. No focal lesion in the thyroid bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are a few bilateral benign morphology cervical lymph nodes.OTHER: No significant abnormality noted. | Status post thyroidectomy. No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Enlarged thyroid RIGHT LOBE MEASUREMENTS: 5.9 x 1.8 x 1.7 cmLEFT LOBE MEASUREMENTS: 5 x 1.7 x 1.3 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Diffusely heterogeneous without discrete nodule. Normal vascularityLEFT LOBE: Diffusely heterogeneous without discrete nodule. Normal vascularityISTHMUS: Diffusely heterogeneous without discrete nodule. Normal vascularityPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland without increased vascularity raises the possibility of chronic thyroiditis. No discrete nodule. No regional adenopathy. |
Generate impression based on findings. | Thyroid nodule RIGHT LOBE MEASUREMENTS: 5.4 x 1.4 x 1.3 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.4 x 0.9 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: 0.4 x 0.3 x 0.3 hypoechoic nodule lower pole.LEFT LOBE: 1 x 0.8 x 0.5 spongiform nodule midportion left lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Spongiform nodule midportion left lobe thyroid gland. Subcentimeter hypoechoic right thyroid nodule. No regional adenopathy. |
Generate impression based on findings. | 59-year-old female with right upper quadrant pain and history of liver cysts. LIVER: Liver is normal in size and echotexture. There is a large, simple-appearing right lobe cyst measuring 5.4 x 7.2 x 6.3 cm. Compared to measurements obtained on prior study this has enlarged although is little changed from a CT from 2012. Smaller cyst is also identified measuring 1.3 x 1.6 x 1.7 cm in the inferior right lobe. 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: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Interval increase in size of larger hepatic cyst compared with most recent ultrasound although not significant change from remote CT. This remains simple in appearance without wall thickening or mass. Occasionally, a large biliary cystadenoma may have this unilocular appearance. |
Generate impression based on findings. | 49-year-old male with proteinuria and hematuria. Membranous glomerulo nephritis. Elevated creatinine. Ultrasound guidance, right kidney. | Ultrasound guidance as noted above. |
Generate impression based on findings. | Patient presents for evaluation of focal asymmetry in the left central posterior breast. DIGITAL LEFT BREAST DIAGNOSTIC MAMMOGRAM: One ML, CC and 3 spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry in the left central posterior breast as noted on the CC view partially persists on the spot compression views. This could not be reproduced on the repeat full field CC view and is most likely due to positioning. No suspicious microcalcifications are present. TARGETED LEFT BREAST ULTRASOUND: No evidence of a cystic or solid mass in the central left breast. | High probability benign left central breast focal asymmetry without a sonographic correlate. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 59-year-old female with acute kidney injury. RIGHT KIDNEY: Measures 12.7 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 12.7 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Collapsed with a Foley catheter in place.OTHER: No significant abnormalities noted. | 1. Increased renal echogenicity consistent with medical renal disease. 2. No nephrolithiasis, hydronephrosis, or suspicious mass. |
Generate impression based on findings. | Any evidence of a fluid collection or abnormality in transplant History: recent increase in creatinine and now odd pressure sensation over kidney KIDNEY: Transplanted kidney in the right iliac fossa measures 10.4 cm in length. There is a hypoechoic, heterogenous fluid collection along the posterior aspect of the kidney, with mild adjacent mass effect on the renal parenchyma. Mild pelvocaliectasis. Color doppler reveals patent vasculature. No shadowing stones are identified.OTHER: Nephroureteral stent is visualized in the bladder. Ureteral jets are not visualized. Additional small anechoic fluid collection in the pelvis lateral to the bladder measures approximately 5.3 x 2.5 x 3.2 cm and may represent the right ovary. | Perinephric hematoma posterior to the left iliac fossa transplanted kidney with mild pelvocaliectasis but no significant hydronephrosis. |
Generate impression based on findings. | 28-year-old female with history of thyroid carcinoma 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: Normal appearing lymph nodes bilaterallyOTHER: No significant abnormality noted. | No evidence recurrent disease. |
Generate impression based on findings. | Primary hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5.4 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.8 x 1.7 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Multiple subcentimeter spongiform nodules. A representative mid pole nodule measures 0.9 x 0.4 x 0.8 cm.LEFT LOBE: Multiple spongiform and solid thyroid nodules. The solid nodules demonstrate foci of comet tail artifact. A representative mid pole nodule measures 1.4 x 0.8 x 1.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral thyroid nodules; a benign etiology for these nodules is favored. No regional adenopathy. No convincing parathyroid adenoma candidate could be visualized. |
Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 4.9 x 1.2 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.3 x 1.4 x 2.1 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: No change in multiple benign-appearing mixed cystic and solid nodules. A representative lower pole nodule measures 0.5 x 0.5 x 0.3 cm.LEFT LOBE: No change in multiple benign-appearing mixed cystic and solid nodules. Representative upper pole nodule again measures 2.1 x 0.8 x 1 cm.ISTHMUS: Stable heterogeneous nodule within the isthmus measuring 0.8 x 0.4 x 0.8 cmPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral benign-appearing thyroid nodules. No regional adenopathy. |
Generate impression based on findings. | Hepatocellular carcinoma status post RFA LIVER: No significant change in size or appearance of right lobe ablation defect measuring 2.9 x 2.2 x 2.7 cm.GALLBLADDER, BILIARY TRACT: Stable cholelithiasis without acute inflammation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma again noted.. 7.9 cm in length.OTHER: Echogenic left renal parenchyma again noted. Left kidney 9.3 cm in length. Spleen 9.5 cm in length. No ascites. | No significant change in right lobe hepatic ablation defect lesion. No new hepatic lesions appreciated. No ascites. Echogenic renal parenchyma again suggestive for medical renal disease/parenchymal dysfunction without obstruction. |
Generate impression based on findings. | 70-year-old female with history of open cholecystectomy, gated by tissue infection with either edema, tenderness, warmth at the surgical site. Evaluate for abscess. Grayscale and color ultrasound of the anterior abdominal wall soft tissues demonstrate a small loculated subcutaneous collection at the right upper quadrant incision site associated with a surgical clip. Its largest component along the lateral margin measures 0.6 x 0.4 cm. There is associated overlying skin thickening. | Small loculated surgical site subcutaneous collection as described above is not drainable at this time. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (9/24/15), ultrasound images of both breasts (9/24/15), images from ultrasound guided biopsy of left breast with specimen radiograph and postprocedural left mammographic images, and images from ultrasound guided right breast aspiration (9/24/15) performed at Rush University Medical Center. For comparison, digital mammographic images (9/11/14, 9/11/13, 3/1/10), ultrasound images (9/11/14, 1/27/14, 9/11/13) are available. DIGITAL MAMMOGRAPHIC IMAGES (9/24/15):The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Multiple circumscribed masses are present in both breasts. Many of those masses are stable and benign. An oval mass at lower outer quadrant in the left breast shows interval increase in size. Multiple calcifications in both breast are unchanged. There are no suspicious findings in either breast on mammogram.ULTRASOUND IMAGES OF BOTH BREASTS (9/24/15):There are multiple simple cysts in the right breast. In the left breast, there is an irregularly shaped hypoechoic mass with angular margins at 6:30 position measuring 6 x 6 mm. A complicated cyst measuring 6 mm is seen at 4:00 position. In addition, there are multiple simple cysts in the left breast. A simple cyst at left 4:30 position likely corresponds to the developing circumscribed mass on left mammogram.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF LEFT BREAST WITH SPECIMEN RADIOGRAPH AND POSTPROCEDURAL LEFT MAMMOGRAPHIC IMAGES, AND IMAGES FROM ULTRASOUND GUIDED RIGHT BREAST ASPIRATION (9/24/15):An aspiration for the complicated cyst at 4:00 position in the right breast was performed. Complete resolution of the cyst was achieved. Core needle biopsy for the hypoechoic mass at 6:30 in the left breast was performed with appropriate needle placement. Radiograph of the specimen shows several pieces of solid tissue without calcifications. Postprocedural mammographic images show a marker clip located at lower inner quadrant in the left breast.Per outside pathology report, the result of the core biopsy of left breast was DCIS grade 3. | Biopsy proven DCIS in the left breast. The lesion was occult on mammogram and was detected on ultrasound. Given complicated appearance of mammogram and dense breast tissue, breast MRI would be helpful to rule out any other occult disease.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 49-year-old male with metastatic lung cancer, on Alectinib. CT showed mild diffuse gallbladder wall thickening suggestive of acute inflammation. LIVER: Measures 14.3 cm in length with multiple bilobar hepatic metastatic lesions similar to recent CT study. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/s.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Gallbladder wall thickening is noted measuring 8 mm in thickness. No pericholecystic fluid. Sonographic Murphy sign is negative. Common duct measures 3 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 9.4 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.2 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen measures 11.3 cm in length and is normal in echogenicity. | 1. Gallbladder wall thickening may represent chronic cholecystitis. No evidence of acute cholecystitis. 2. Multiple bilobar hepatic metastatic lesions similar to recent CT. |
Generate impression based on findings. | 27-year-old with personal history of biopsy-proven right breast papilloma and high probability benign fibroadenoma presents for follow-up. Targeted grayscale and color Doppler ultrasound was performed for the previously identified right breast masses.In the 9:00 position 4 cm from the nipple, the well-circumscribed mildly vascular hypoechoic mass likely representing a fibroadenoma is not significantly changed in size measuring 1.3 x 0.7 x 1.1 cm (previously measured 1.1 x 0.8 x 1.0 cm).In the 3:00 position 1 cm from the nipple, the isoechoic mass and marker clip representing the biopsy-proven papilloma is faintly visualized, measuring approximately 0.4 x 0.4 x 0.4 cm, unchanged in size. | No change in size of benign right breast masses. No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Hepatitis B. Evaluate for HCC. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. A 1.8 cm hypoechoic lesion is identified in the left hepatic lobe, not seen on the prior ultrasound or CT. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Several 1-2 cm gallstones noted. Otherwise unremarkable 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 12.0 cm in length, with a 1.7 cm exophytic cyst. The left kidney is 11.1 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 13.5 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites identified. | 1. Hypoechoic lesion measuring 1.8 cm in the left hepatic lobe, not seen on prior imaging. This lesion is indeterminate by sonographic appearance and further characterization with contrast-enhanced CT or MRI with liver protocol is recommended. 2. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Right upper quadrant and epigastric pain LIVER: Coarse echogenic liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 13.4 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 6.5 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 10.2 cm in length.OTHER: Multiple left renal cysts. Left kidney 9.1 cm in length. No ascites | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or duct dilatation. Unremarkable gallbladder without acute inflammation or gallstones. No ascites. |
Generate impression based on findings. | 30 yo female with loosely clustered calcifications in the right breast 3:00 position. Family history of breast cancer diagnosed in sister at age 27. A targeted right ultrasound was performed for the mammographic area of concern. There is no solid or cystic mass identified. Fibrocystic change with multiple calcifications are identified in the mammographic area of concern, which will be targeted for biopsy under ultrasound guidance. BIOPSY | Successful ultrasound-guided core biopsy of the right breast calcifications and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Abdominal pain and elevated LFTs LIMITED ABDOMENLIVER: Coarse echogenic liver echotexture without mass. Liver length 15 cm.BILIARY TRACT: Gallbladder absent. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.6 cm in length RIGHT KIDNEY: Mildly echogenic renal parenchyma again noted without mass, stone, or hydronephrosis. 8.7 cm in lengthOTHER: Mildly echogenic left renal parenchyma again noted without mass, stone, or hydronephrosis. 8.4 cm in length. No ascites. | Coarse echogenic liver consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. Patent hepatic vessels with normal directional flow.Mildly echogenic renal parenchyma again noted suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Right upper quadrant and right flank pain LIVER: Unremarkable echogenicity without mass. Liver length 14.8 cmGALLBLADDER, BILIARY TRACT: Probable gallbladder polyp measuring 0.3 x 0.3 x 0.3 cm. No acute inflammation. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in lengthOTHER: Left kidney 11.1 cm in length. Spleen 9.9 cm in length. No ascites. | Probable subcentimeter gallbladder polyp. Otherwise unremarkable examination. |