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Generate impression based on findings. | Male; 54 years old. Reason: R lateral shoulder dermal thickening, evaluate for deep mass History: above In the area of the palpable abnormality overlying the right deltoid muscle is a 2.9 x 0.9 x 2.4 cm area of subcutaneous edema. No underlying mass is identified. There is no drainable collection. | Subcutaneous edema but no discrete mass or drainable collection in the area of the patient's reported abnormality. Correlate clinically for signs/symptoms of cellulitis. |
Generate impression based on findings. | 32-year-old female with focal pain and swelling left groin. In the left pudenda there is a hypoechoic region in the deep subcutaneous fat which appears mildly complex. During Valsalva,, this region elongates and there is an apparent, focal defect in the musculature of the pelvic wall deep to this location. Findings are consistent with a small hernia, likely containing fat. There is no evidence for bowel herniation. | Findings consistent with small pelvic wall hernia, likely containing fat. |
Generate impression based on findings. | Right upper quadrant pain. LIVER: The liver measures 17.4 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 0.21 m/s.BILIARY TRACT: Cholelithiasis without associated gallbladder wall thickening or pericholecystic fluid. Technologist reported positive Murphy's sign. There is a shadowing stone measuring up to 1.1 cm in the intrapancreatic portion of the common bile duct with associated upstream dilation of the common bile duct up to 8 mm. No significant intrahepatic biliary ductal dilatation.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.4 cm in length. RIGHT KIDNEY: Kidney measures 11.8 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Choledocholithiasis including 1.1 cm common bile duct stone with associated extrahepatic biliary ductal dilatation.2.Cholelithiasis without associated gallbladder wall thickening or pericholecystic fluid.Preliminary findings of choledocholithiasis were discussed by radiology resident on call resident with Dr. Bokarius 4:07 a.m. on 12/13/2016. |
Generate impression based on findings. | Short-term follow-up for probably benign mass in the right breast. A targeted right ultrasound was performed . An oval hypoechoic lesion does not appear significantly changed in size, today measuring 5 x 4 mm. No vascularity is seen within the finding. This is favored to represent a complicated cyst or another benign etiology. A normal morphology lymph node is also seen posterior and superior to this mass. There is no suspicious solid or cystic mass identified. | No significant change in right breast mass. At this point, bilateral diagnostic mammogram with possible ultrasound is recommended in February 2016.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 68 year old female with abnormal alkaline phosphatase and lipase. History of cholecystectomy and lupus on steroids. The study was limited due to the patient's body habitus and bowel gas shadowing.LIVER: The liver parenchyma is coarse and mildly hyperechoic. The liver measures 13.9 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is also hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm. The patient is status post cholecystectomy.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is mostly obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.4 cm in length without hydronephrosis or shadowing calculus. OTHER: There is mild generalized body wall edema. Small amount of ascites and pleural effusions. | 1. Limited study as described above without biliary ductal dilatation.2. Heterogeneous and coarse liver parenchyma likely related to steatosis/diffuse parenchymal dysfunction.3. Trace ascites and bilateral pleural effusions. |
Generate impression based on findings. | Ms. Warren is a 64-year-old woman with known biopsy proven left breast cancer on hormonal therapy presents for follow-up. On physical exam, there is a palpable hard mass in the left breast centered at the 12:00 position, compatible with known cancer.A targeted left breast ultrasound was performed for the palpable area of concern. In the 12:00 position, 1 cm from nipple, there is a 4.3 x 1.6 x 3.6 cm hypoechoic to isoechoic mass consistent with the known malignancy, previously measuring 3.4 x 1.5 x 3.1 cm. There does not seem to be any significant change in size of this mass, accounting for differences in image acquisition (panoramic views) and technique. | No significant change in size of biopsy-proven cancer in the left breast. Continued surgical management is recommended. The results and recommendations were discussed with the patient.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Patient is a 55-year-old female who presents for for the evaluation of the focal asymmetry seen in bilateral breasts seen on the prior screening mammogram dated 8/26/2015. Bilateral MLO and spot compression of both breasts Were performed digitally and reviewed with the aid of R2 CAD, 8.3. The breast parenchyma composed of scattered fibroglandular elements, unchanged in pattern and distribution.A 7 mm focal asymmetry identified on the screening mammogram in the left breast upper-outer quadrant persist on the diagnostic spot compression. Asymmetry in the medial right breast disperses into normal breast tissue.With physical exam, no discrete mass was palpated. Focused ultrasound demonstrates a 8 x 4 x 7 mm heterogeneous oval mass with calcifications and a few cystic components in the left breast at 2:00 location, 1 cm from the nipple. This likely represents a clustered cyst. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended in 6 months to evaluate stability of a clustered cyst. 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. | Male 60 years old Reason: RUQ pain History: RUQ pain LIVER: Gallbladder is significantly distended with layering debris. Gallbladder wall is thickened. The fifth cholecystitis cannot be excluded. Small amount of ascites is noted. Bilateral small pleural effusion.No evidence of intra or extrahepatic biliary dilatation. | Distended gallbladder with layering sludge. Cholecystitis cannot be entirely excluded. |
Generate impression based on findings. | Female 41 years old Reason: 41 yo AAF - with proteinuria and CKD - getting a biopsy History: 41 yo AAF - with proteinuria and CKD - getting a biopsy Ultrasound provided for the nephrology service for a ultrasound-guided biopsy of the right kidney. | Ultrasound provided for the nephrology service for a ultrasound-guided biopsy of the right kidney. |
Generate impression based on findings. | Left renal mass noted on outside hospital CT. A cortically based exophytic mass is partially visualized arising from the superior pole of the left kidney. Due to limited visualization, after discussion with the patient, the decision was made to proceed with a CT-guided biopsy. No biopsy was performed as part of the ultrasound examination. | Limited images obtained of the left kidney as part of an aborted biopsy procedure. CT-guided biopsy will now be performed. |
Generate impression based on findings. | Hepatitis B LIVER: Coarse echogenic liver parenchyma again noted. 1.2 x 1 x 1.5 cm hypoechoic focus within the right lobe again noted and unchanged. Liver length 13.8 cmGALLBLADDER, BILIARY TRACT: Stable subcentimeter gallbladder polyp measuring 0.5 cm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.2 cm in length.OTHER: Left kidney 12.5 cm in length. Spleen 12 cm in length. No ascites | Stable coarse echogenic liver parenchyma noted consistent with chronic liver disease. Stable right lobe hypoechoic focus; correlation with prior studies and MR suggests a benign etiology. Stable gallbladder polyp. No ascites. |
Generate impression based on findings. | Cirrhosis of liver LIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 17.4 cm. Limited Doppler interrogation of main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.6 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.4 cm in lengthOTHER: Left kidney 10.1 cm in length. No ascites | Coarse echogenic liver echotexture again noted consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 52 year old female who was recalled from screening mammogram for new right breast mass. No family history of breast cancer. MAMMOGRAM: An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Within the anterior, upper outer right breast, there is redemonstration of a new, circumscribed mass which persists on spot compression imaging, measuring approximately 0.7 cm. Approximately 2 cm posterior to this new mass, there is an intramammary lymph node.RIGHT BREAST ULTRASOUND: On physical examination, no palpable lesion is identified.At the 11 o'clock position of the right breast, 3 cm from the nipple, there is a 0.5 x 0.2 x 0.6 cm cluster of cysts. No significant vascularity is associated with this lesion.At the 11 o'clock position of the right breast, 5 cm from the nipple, there is a 0.7 cm benign intramammary lymph node. | Clustered cysts at the 11 o'clock position of the right breast, corresponding to the finding on prior mammogram.No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male, 50 years old. S/p renal txp, ureteral stenosis, eval degree of hydronephrosis. LEFT ILIAC FOSSA TRANSPLANT KIDNEY: The transplant kidney in the left iliac fossa measures 12.5 cm in length, with normal cortical echotexture. Moderate to severe hydronephrosis. No shadowing stone is identified. No perinephric fluid collections.OTHER: The native kidneys are atrophic. The bladder is incompletely distended. | Moderate to severe hydronephrosis of the left iliac fossa transplant kidney. No perinephric fluid collection. |
Generate impression based on findings. | 49-year-old male with history of abdominal pain, fevers. Assess for pyelonephritis. Very limited examination due to patient cooperation and positioning.RIGHT KIDNEY: Measures 8.4 cm in length. Mildly increased renal echogenicity without hydronephrosis.LEFT KIDNEY: Not clearly visualized due to the limitations of the study.BLADDER: Collapsed with a Foley catheter in place.OTHER: No significant abnormalities noted. | 1. Very limited examination as detailed above with nondiagnostic examination of the left kidney. 2. Increased right renal echogenicity consistent with medical renal disease, without hydronephrosis. |
Generate impression based on findings. | Enlarged thyroid on exam RIGHT LOBE MEASUREMENTS: 3.6 x 1.8 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.3 x 2.2 x 2.5 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Diffusely heterogeneous gland. Predominantly solid lower pole nodule measuring 0.6 x 0.6 x 0.6 cm. Predominantly cystic subcentimeter nodule mid pole measuring 0.4 x 0.3 x 0.4 cm.LEFT LOBE: Diffusely heterogeneous gland. Predominantly solid lower pole nodule measuring 2.2 x 1.7 x 1.8 cm. Subcentimeter cystic focus also noted within the mid pole.ISTHMUS: Diffusely heterogeneous glandPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland. Predominantly solid left lower pole nodule; this lesion is amenable to ultrasound-guided biopsy. Additional subcentimeter nodules as described. No thyromegaly. No regional adenopathy. |
Generate impression based on findings. | History of Hashimoto's thyroiditis with nodules. RIGHT LOBE MEASUREMENTS: 4.6 x 1.5 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.5 x 1.8 x 1.9 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Diffusely heterogeneous parenchymal echotexture, appearance consistent with sequelae of Hashimoto's thyroiditis. Hyperechoic midpole nodule measuring 0.7 x 0.6 x 0.9 cm.LEFT LOBE: Diffusely heterogeneous parenchymal echotexture, appearance consistent with sequelae of Hashimoto's thyroiditis. Hyperechoic midpole nodule measuring 0.9 x 0.7 x 0.5 cm.ISTHMUS: Heterogeneous echotexture without discrete nodules.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 2 cervical lymph node measuring 1.8 x 0.5 x 1.1 cm with indeterminate appearance in terms of shape and echogenicity.OTHER: No significant abnormality noted. | 1.Thyroid appearance compatible with Hashimoto's thyroiditis including hyperechoic nodules.2.Left level 2 cervical lymph node which may be reactive but has indeterminate imaging features. Continued follow-up is recommended. |
Generate impression based on findings. | Acute kidney injury, not improving Examination is limited by inability to reposition the patient.RIGHT KIDNEY: Poorly visualized due to inability to reposition the patient. No gross hydronephrosis.LEFT KIDNEY: 9.9 cm in length. Increased renal parenchymal echogenicity. An 8 mm nonobstructing stone is noted in the inferior pole. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Poorly visualized due to inability to position the patient.OTHER: No significant abnormality noted. | Left nephrolithiasis, without hydronephrosis. |
Generate impression based on findings. | Female 36 years old Reason: enlarged thyroid on exam with fatigue, please evaluate RIGHT LOBE MEASUREMENTS: 5.7 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.5 x 1.6 cm.ISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: No nodules are present in the right thyroid lobe. Right thyroid lobe is mildly heterogeneous, with possible mild hypovascularity.LEFT LOBE: No nodules are present in the left thyroid lobe. Left thyroid lobes also mildly heterogeneous, with possible mild hypovascularity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mild heterogeneity and possible mild hypovascularity can be seen in mild thyroiditis. Recommend correlation with lab values. |
Generate impression based on findings. | 87-year-old male with acute on chronic kidney disease. RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. The renal cortex is thinned and echogenic.LEFT KIDNEY: The left kidney measures 9.9 cm in length without hydronephrosis or shadowing calculus. There is a 2.9 x 2.8 x 2.7 cm nearly anechoic, partially septated cystic lesion, likely a septated cyst. Color Doppler demonstrates hilar blood flow. The renal cortex is thinned and echogenic.URINARY BLADDER: The urinary bladder is normally distended with anechoic fluid. There may be mild wall thickening.OTHER: No significant abnormalities noted. | No hydronephrosis. Medical renal disease. Probable septated left renal cyst. |
Generate impression based on findings. | Pulmonary hypertension with abdominal distention LIVER: Mildly coarse echotexture without mass. Liver length 18 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Multiple renal cysts. Right kidney 11.3 cm in length.OTHER: Left kidney not well visualized due to overlying dressings. Spleen 14.9 cm in length. Trace ascites. Left pleural effusion. | Mildly coarse liver echotexture associated with mild hepatomegaly without mass or ductal dilatation. Trace ascites. Echogenic right kidney parenchyma raises the possibility of medical renal disease/parenchymal dysfunction without hydronephrosis. |
Generate impression based on findings. | Palpable soft tissue mass in the right lower axillary region, increased in size in the last 6 months. This is a known mass for the past 6 years. Patient will undergo egg retrieval process seen. A targeted right lower axillary ultrasound was performed for the patient’s area of concern. A 2 cm oval nontender soft mass is palpated in the right lower axillary region along the anterior clavicular line, best in the sitting position. Ultrasound demonstrates an oval parallel rounded hypoechoic mixed echogenic mass measuring 4.6 x 1.3 x 1.7 cm with peripheral blood flow. The mass appears encapsulated with an adjacent small 6 x 4 mm normal morphology lymph node in the vicinity. The mass could arise within the muscle fibers and the skin. No definite glandular tissue is identified in the vicinity. | Palpable abnormality in the right lower axillary region although has benign characteristics with an adjacent normal morphology lymph node, could represent an atypical lipoma or fibroadenolipoma if this appears to be an extension of the breast tissue. Further evaluation with an FNA/core biopsy or MRI is recommended. The findings were discussed with the patient in detail.BIRADS: 3 - Probably benign finding.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 77-year-old female with renal transplant, rule out hydronephrosis stones or masses. LOCATION: Right iliac fossa.RENAL TRANSPLANT: The transplanted kidney measures 12.2 cm. The cortex has normal echogenicity. There is no evidence of hydronephrosis or stones. In the upper pole, there is a round exophytic hyperechoic area that appears solid. This appears stable in size from prior CT. There is also a hypoechoic round cyst located in the lower pole measuring 1.7 cm x 1.2 cm x 1.8 cm. There is a corresponding hypodense lesion seen on prior CT.PERITRANSPLANT TISSUES: No significant abnormality notedURINARY BLADDER: No significant abnormality noted | 1. There is a hyperechoic lesion in the upper pole of the transplanted kidney corresponding to the intermediately attenuating lesion seen on prior CT. This appears stable in size. The lesion appears solid on ultrasound and malignancy must be considered. Recommend contrast enhanced cross-sectional imaging for further characterization of this upper pole lesion.2. Renal cyst noted in the lower pole of the transplanted kidney, corresponding to the inferior pole lesion seen on CT.3. No perinephric collection or hydronephrosis. |
Generate impression based on findings. | 30-year-old female with history of hepatitis B. Evaluate for cirrhosis. LIVER:Measures 13.5 cm. Increased, coarse echotexture of the liver. No focal mass, ascites, or intrahepatic dilation. Portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The lumen of the gallbladder is anechoic. The gallbladder wall measures 0.4 cm. No stones or sludge. No pericholecystic fluid. The common hepatic duct measures 0.4 cm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 8.3 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 11.0 cm. Left kidney measures 11.0 cm. The cortices have normal echogenicity. No shadowing calculus, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Increased, coarse echotexture of the liver consistent with chronic liver disease/parenchymal dysfunction. No focal mass. Liver does not have cirrhotic morphology. |
Generate impression based on findings. | 53-year-old female for follow-up thyroid nodules. RIGHT LOBE MEASUREMENTS: 6 x 2.2 x 2.8 cmLEFT LOBE MEASUREMENTS: 6.7 x 2.1 x 3 cmISTHMUS MEASUREMENTS: 1.1 cmRIGHT LOBE: In the right lobe, there is again noted and almost isoechoic mass with at least a partial hypoechoic rim measuring 0.7 x 0.6 x 0.7 cm without significant change.LEFT LOBE: Complex cystic nodule in the midportion of the left lobe anteriorly measures 1.5 x 1.7 x 1.8 cm, increased in size when compared to prior and also increase in complexity. Posterior hypoechoic and likely spongiform nodule measures 0.6 x 0.7 x 0.9 cm without change.ISTHMUS: Previously noted spongiform-appearing isthmus nodule has changed in appearance, now without obvious cystic component and with poorly defined borders measuring 0.8 x 1.4 x 1 cm, significantly decreased in size when compared to prior exam.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Increase in size of complex cystic left thyroid nodule.2. Stable right and posterior left thyroid nodules.3. Significant decrease in size of prior spongiform nodule, now with ill-defined margins and no obvious cystic component. Presumably, this is related to involution of a colloid nodule. |
Generate impression based on findings. | HIV; fevers LIVER: Heterogeneous and echogenic liver echotexture noted without mass. Liver length 19 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in length.OTHER: Left kidney 10.7 cm in length. Spleen 16.3 cm in length. No ascites. | Heterogeneous and echogenic liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Mild hepatomegaly.Mild splenomegaly without mass or associated loculated fluid collection. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.2 cm in length.OTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | 49-year-old female patient with pancreatitis. Evaluate for gallstones. LIVER: The liver measures 17.3 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 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 6.3 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. There is a 1.4 x 1.0 cm right midpole renal cyst. OTHER: The left kidney measures 7.2 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. There is a 0.9 x 0.8 x 1.0 cm renal sinus cyst.The spleen measures 10.4 cm in length. | 1. No cholelithiasis. 2. Medical renal disease with atrophic kidneys and bilateral renal cysts. |
Generate impression based on findings. | Female, 43 years old. Status post right nephrectomy for oncocytoma. RIGHT KIDNEY: The right kidney is surgically absent. A soft tissue focus in the right retroperitoneum measures approximately 1.5 x 2.2 x 2.7 cm, without internal vascularity.LEFT KIDNEY: The left kidney measures 11.7 cm with normal cortical echotexture. No focal lesion or hydronephrosis.OTHER: The bladder is incompletely distended. | 1.Status post right nephrectomy. No focal lesion in the left kidney.2.Nonspecific 2 cm soft tissue focus in the retroperitoneal soft tissues. |
Generate impression based on findings. | Evaluation for hydronephrosis RIGHT KIDNEY: 11.3 cm in length. No focal lesions or hydronephrosis. The renal parenchyma is mildly echogenic.LEFT KIDNEY: 10.9 cm in length. No focal lesions or hydronephrosis. The renal parenchyma is mildly echogenic.BLADDER: No significant abnormalities noted. Bilateral ureteral jets identified.OTHER: No significant abnormalities noted. | Findings compatible with medical renal disease, without hydronephrosis. |
Generate impression based on findings. | The patient submitted outside mammogram dated 5/11/11, 4/13/10, from 2525 S. Michigan Ave, Chicago 60616. Submitted outside study was compared to the current mammogram dated 3/18/15. Multiple masses in both breasts appear new from prior studies and ultrasound is recommended for further evaluation. Small cluster of calcifications in left upper outer quadrant is progressing in a benign fashion. The right axillary lymph node appears prominent but stable from prior exams. | Multiple masses in both breasts appear new from prior studies and ultrasound is recommended for further evaluation. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 64-year-old female with a history of alcoholism. Evaluate for liver lesions, vessel patency, cirrhosis. LIMITED ABDOMENLIVER: Measures 12.3 cm. Nodular contour. Increased, course, heterogenous echogenicity. No focal mass, ascites, or intrahepatic biliary dilation.BILIARY TRACT: Gallbladder is nondistended with an anechoic lumen. Gallbladder wall measures approximately 2.4 mm. No stones, sludge, or pericholecystic fluid. Common bile duct measures approximately 0.4 cm.PANCREAS: Evaluation of the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 14.8 cm. KIDNEYS: Right kidney measures 10.8 cm. Left kidney measures 11.6 cm. Normal echogenicity. No focal mass, hydronephrosis, or shadowing calculi.OTHER: No significant abnormalities noted. | 1. Portal vein thrombosis is suspected.2. No ascites which could be due to previously seen splenorenal shunt on a prior CT.3. Nodular contour of liver consistent with cirrhotic morphology. No focal mass. |
Generate impression based on findings. | Male, 74 years old. Hydronephrosis, follow-up. RIGHT KIDNEY: The right kidney measures 11.8 cm in length, with mildly increased cortical echogenicity. No focal lesions or hydronephrosis. LEFT KIDNEY: The left kidney measures 11.2 centimeters in length, with mildly increased cortical echogenicity. Mild hydronephrosis, unchanged. No focal lesions.OTHER: The bladder is distended, with bilateral ureteral jets noted. | 1.Mild left-sided hydronephrosis, unchanged.2.Mildly increased renal cortical echogenicity suggests medical renal disease. |
Generate impression based on findings. | Epigastric pain hepatitis C carrier LIVER: Coarse heterogeneous echotexture without mass. Liver length 16.5 cm.GALLBLADDER, BILIARY TRACT: Gallbladder absent. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Stable right renal cysts. Right kidney 10.4 cm in lengthOTHER: Left kidney 10.7 cm in length. Spleen 9.9 cm in length. No ascites. | Coarse heterogeneous liver echotexture suggestive for chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Reason: chronic itching in patient with chronically elevated Alk Phos LIVER: The liver measures 13.6 cm in length. Normal hepatic parenchymal echogenicity and echotexture. The portal vein is patent with normal hepatopedal portal flow, peak velocity 28 cm/s.GALLBLADDER, BILIARY TRACT: Equivocal to mildly dilated intrahepatic biliary ducts. No extrahepatic biliary ductal dilatation. The common bile duct measures 0.2 cm. Status post cholecystectomy.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 12.0 cm in length. No hydronephrosis or shadowing stones.OTHER: The spleen measures 10.2 cm in length. | Mild intrahepatic biliary ductal prominence, please correlate with bilirubin level. No extrahepatic biliary ductal dilatation. |
Generate impression based on findings. | Axillary painful soft tissue growth Hypoechoic focus in the subcutaneous soft tissues with surrounding ill-defined hyperechogenicity measures 0.3 x 0.2 x 0.3 cm. No significant vascularity within the hypoechoic focus. | Hypoechoic focus in the subcutaneous soft tissues of the right axilla with surrounding ill-defined hyperechogenicity as described above does not meet the criteria for a specific benign etiology. MRI or biopsy may be considered for further evaluation. |
Generate impression based on findings. | Renal failure. Ultrasound guidance provided for 3 right renal biopsy passes. No postprocedure hematoma is evident. | Ultrasound guidance provided for right renal biopsy. |
Generate impression based on findings. | Heart transplant workup LIVER:Coarse echogenic liver parenchyma without mass. Liver length 18 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. 10.7 cm in length KIDNEYS: Right renal minimally complex cyst. No hydronephrosis. Subcentimeter nonobstructing renal stone. Right kidney 12.1 cm in length; left kidney 12.2 cm in length ABDOMINAL AORTA: Distal aorta obscured by gasINFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites | Mild hepatomegaly with coarse echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites. Distal aorta are obscured by gas. Nonobstructing right nephrolithiasis. |
Generate impression based on findings. | Male 62 years old Reason: history of cirrhosis, HCC screening History: cirrhosis LIVER: The liver is enlarged measuring 19.4 cm. Nodular contour of liver is consistent with cirrhosis. No focal hepatic mass. Main portal vein is patent with normal directional flow and a peak velocity of 14.5 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. The gallbladder has been removed. Common bile duct measures 3 mm.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 15.0 cm.RIGHT KIDNEY: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 11.2 cm. Left kidney measures 11.6 cm. Left renal cyst measures 5.0 x 3.9 x 4.6 cm.OTHER: No ascites. | Cirrhotic liver morphology without focal mass. |
Generate impression based on findings. | Cirrhosis LIVER: Cirrhotic morphology again noted without mass. Liver length 14.5 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: No change in gallbladder wall thickening and trace pericholecystic fluid. Cholelithiasis unchanged. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9 cm in lengthRIGHT KIDNEY: Right kidney not visualized OTHER: Left kidney 13.5 cm in length. No ascites. | Stable cirrhotic morphology without worrisome mass or ductal dilatation. Stable cholelithiasis with chronic gallbladder wall thickening and trace pericholecystic fluid again noted and unchanged. No ascites |
Generate impression based on findings. | Female 64 years old; Reason: change in thyroid bed History: thyroid cancer s/p I131 sg RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENT: Status post thyroidectomy.RIGHT LOBE: No residual thyroid tissue identified.LEFT LOBE: No residual thyroid tissue identified.ISTHMUS: No residual thyroid tissue identified.LYMPH NODES: Single right level 2 lymph node with a normal smooth cortex and echogenic hilum measuring 1.1 x0.7 x 0.3 cm.OTHER: No significant abnormality noted. | No evidence of residual or recurrent disease. |
Generate impression based on findings. | 74-year-old male patient with history of thyroid cancer and large high-grade adenoma. Surgically resected. RIGHT LOBE: Status post thyroidectomy without evidence of disease recurrence. An echogenic focus within the right thyroid bed is unchanged.LEFT LOBE: Status post thyroidectomy without evidence of disease recurrence.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A lymph node in the left thyroid surgical bed is not significantly changed in size measuring 1.3 x 0.4 x 0.4 cm. A benign morphology right level three lymph node measures 1.4 x 0.4 x 0.9 cm, previously 1.5 x 0.4 x 0.9 cm. There is a benign morphology left level two lymph node measuring 1.5 x 0.8 x 0.3 cm.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of disease recurrence. |
Generate impression based on findings. | Rule out recurrent thyroid cancer RIGHT LOBE: Status post thyroidectomy. 0.8 x 0.3 x 0.5 cm hypoechoic focus within the right thyroid bed not clearly identified on the prior study. This lesion demonstrates a possible echogenic fatty hilum.LEFT LOBE: Status post thyroidectomy. Stable left thyroid bed hypoechoic focus measuring 0.6 x 0.3 x 0.4 cm.ISTHMUS: Status post thyroidectomyPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable subcentimeter left thyroid bed hypoechoic focus.Subcentimeter right thyroid bed hypoechoic focus with possible internal fatty hilum not clearly identified on prior studies. While this finding may represent a benign lymph node, would pay special attention to this lesion on future surveillance scans.No regional adenopathy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Bilateral call back for left breast mass and right breast calcifications. An ML view and two spot views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. Left upper outer quadrant mass persists with spot compression. Calcifications in the right lower outer breast appear to layer on the ML magnification view and appear smudgy on the CC magnification view, suggesting milk of calcium. Adjacent blood vessels are noted. ULTRASOUND | 1. Mass in the left upper outer quadrant for which ultrasound-guided biopsy is requested. Benign etiologies are favored, though malignancy is not entirely excluded.2. Probably benign calcifications in the right breast, suggestive of milk of calcium on mammography and clustered microcysts on ultrasound. Six-month follow-up right mammogram is recommended to ensure stability.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
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. In the right upper outer breast, 9:30 location, there is a superficially located round hypoechoic lesion identified measuring approximately 0.4 cm.In the left breast, no suspicious cystic or solid mass is identified. | Incompletely characterized hypoechoic lesion in the right upper outer breast. Additional imaging, including repeat diagnostic ultrasound with possible mammogram, is recommended for further evaluation. BIRADS: 0 - IncompleteRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male 66 years old Reason: CKD History: Nausea, dizziness RIGHT KIDNEY: Echogenic kidney. Right kidney measures 9.3 cm. No focal lesions or hydronephrosis.LEFT KIDNEY: Echogenic kidney. Left kidney measures 9.3 cm. No focal lesions or hydronephrosis. 1 states stone in the lower pole of the left kidney.OTHER: No significant abnormalities noted. | Echogenic bilateral kidneys. Left nephrolithiasis without hydronephrosis. |
Generate impression based on findings. | 75 year-old male with fever, abdominal pain, sepsis. Evaluate for cholecystitis. LIVER: Normal echogenicity of the liver measuring 18.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate direction of flow; the velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder unremarkable. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common hepatic duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas obscured by overlying bowel gas. The visualized portions are unremarkable.RIGHT KIDNEY: The right kidney measures 12.2 cm in length and is mildly increased in echogenicity. No hydronephrosis or shadowing calculi are noted. Cyst at the midpole measures 1.2 cm x 1.2 cm. OTHER: Left kidney measures 10.3 cm in length and is mildly increased in echogenicity. Hypoechoic focus not well assessed measuring approximately 2.3 cm x 1.9 cm x 1.5 cm.Spleen measures 12.7 cm in length. | 1. Mildly increased echogenicity of the kidneys suggestive of medical renal disease.2. Bilateral cystic renal lesions as described above. 3. No sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | Reason: cause of abdominal pain, suspect for choledocholithiasis History: episode of abdominal pain with elevated transaminases. LIVER: The liver measures 15.9 cm in length. Coarse echogenic hepatic parenchyma. The portal vein is patent with normal directional hepatopedal portal venous blood flow, peak velocity 22.1 cm/s. No focal masses.GALLBLADDER, BILIARY TRACT: Several mobile echogenic stones in the gallbladder lumen without evidence of pericholecystic inflammation. The gallbladder wall measures 0.2 cm, common hepatic duct 0.2 cm, common bile duct 0.3 cm. No biliary ductal dilatation. Negative sonographic Murphy's sign.PANCREAS: The pancreatic duct measures 0.3 cm.RIGHT KIDNEY: The right kidney measures 10.5 cm in length. No hydronephrosis, masses, or shadowing stones.LEFT KIDNEY: The left kidney measures 10.1 cm in length. No hydronephrosis, masses, or shadowing stones.OTHER: No ascites. | 1. Cholelithiasis without evidence of acute inflammation.2. Coarse echogenic hepatic parenchyma, consistent with hepatic steatosis or parenchymal dysfunction. |
Generate impression based on findings. | Female 58 years old; Reason: r/o adenopathy, recurrence History: thyroid cancer. 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomy. LEFT LOBE MEASUREMENTS: Status post thyroidectomy. ISTHMUS MEASUREMENT: Status post thyroidectomy. RIGHT LOBE: Status post thyroidectomy. Subcentimeter hypoechoic focus in the right thyroidectomy bed is unchanged from the prior examination, now measuring 0.4 x 0.3 x 0.2 cm.LEFT LOBE: Status post thyroidectomy.ISTHMUS: Status post thyroidectomy.LYMPH NODES: No suspicious cervical lymphadenopathy is identified.OTHER: No significant abnormality noted. | Stable examination, no evidence of locoregional disease recurrence. |
Generate impression based on findings. | Abnormal liver function tests. LIVER: Non-cirrhotic liver morphology. Mildly heterogeneous parenchymal echogenicity. 15 cm in length. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Contracted gallbladder, which limits visualization and evaluation. No sonographic Murphy's sign.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 10.4 cm in length. The left kidney is 10.3 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 8.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites. | Heterogeneous hepatic echogenicity, compatible with parenchymal dysfunction. |
Generate impression based on findings. | 57-year-old male presents with transaminitis. Evaluate for focal hepatic lesions. LIVER:The liver measures approximately 20.8 cm. There is increased, coarse, heterogeneous echotexture of the liver parenchyma. No masses or ascites. No intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended, the wall measures 0.17 cm. There is echogenic and dependent material within the gallbladder, likely representing sludge. No stones. Negative sonographic Murphy's sign. The common bile duct measures 0.14 cm.PANCREAS: Evaluation. There is limited due to overlying bowel gas.SPLEEN: The spleen measures 7.8 cm. No abnormalities noted.KIDNEYS: The right kidney measures 11.2 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. The left kidney measures 12.0 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. OTHER: No significant abnormality noted. | 1. Coarse echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No mass or ascites.2. Hepatomegaly. |
Generate impression based on findings. | 52 year old female with history of decompensated Nash cirrhosis and one of overload. LIMITED ABDOMENLIVER: Coarse hepatic echogenicity consistent with history of cirrhosis. No discrete masses are identified.BILIARY TRACT: No biliary dilatation. There is gallbladder wall thickening which is likely related to the patient's ascites.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. The spleen measures 13.3 cm. RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 9 cm.OTHER: Moderate amount of ascites. The left kidney measures 10.9 cm. | 1.Hepatic cirrhosis with moderate ascites.2. Probable cavernous transformation of main portal vein. |
Generate impression based on findings. | Elevated creatinine Interval decrease in size of perinephric hematoma, now measuring 5.1 x 2.9 cm. No stone or significant hydronephrosis. OTHER: Bladder nondistended. | Interval decrease in size of perinephric hematoma. No significant hydronephrosis. |
Generate impression based on findings. | Male, 84 years old. Palpable mass left upper quadrant. No discrete fluid collection or solid mass lesion is identified. No ascites. The region of reported palpable abnormality corresponds with bowel loops which appear normal.Limited images of the liver show increased hepatic echogenicity.The kidneys are only partially imaged. | 1.No mass, fluid collection, or other acute sonographic abnormality to account for the patient's symptoms.2.Increased liver echogenicity, compatible with hepatic steatosis or parenchymal dysfunction. |
Generate impression based on findings. | Decompensated cirrhosis LIVER: Diffuse coarse echotexture of the liver which measures 18.6 cm with nodular surface suggestive of cirrhotic morphology. Portal vein demonstrates reversal of flow (hepatofugal) within it. If clinically indicated, liver Doppler examination can be performed to evaluate the hepatic artery and portosystemic shunts.Minimal ascites noted.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Gallbladder is distended with mild gallbladder wall thickening measuring up to 4 mm which could be due to adjacent ascites. Gallbladder sludge noted. No definite evidence of gallstones. Sonographic Murphy sign is negative.PANCREAS: Not visualized due to overlying bowel gas.SPLEEN: Spleen measures 21 cm, increased in size without any focal lesions.RIGHT KIDNEY: Right kidney measures 13.2 cm and left kidney measures 12 cm with normal echotexture. No evidence of hydronephrosis. No renal stones. OTHER: Ascites noted. Right pleural effusion noted. | 1. Diffuse cirrhotic morphology of the liver without any focal lesions. Hepatofugal/reversal of flow in the portal vein noted. Distended gallbladder with sludge and gallbladder wall thickening most likely due to adjacent ascites rather than cholecystitis.2. Moderate splenomegaly with ascites.3. Right pleural effusion. |
Generate impression based on findings. | 68-year-old female with history thyroid cancer status post total thyroidectomy. 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: Single left level 2 benign-appearing lymph node measuring 1.8 x 0.3 x 0.7 cm. OTHER: No significant abnormality noted. | Status post thyroidectomy without mass in surgical bed. |
Generate impression based on findings. | Right upper quadrant pain. Status post cholecystectomy and splenectomy in 1987. LIVER: Non-cirrhotic liver morphology. Mildly coarse parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: Mildly prominent common bile duct, which may reflect prior cholecystectomy. Otherwise no biliary ductal dilation. PANCREAS: Limited evaluation of the pancreas due to partial obscuration by bowel gas. The visualized pancreatic head and neck appear prominent.KIDNEYS: The right kidney is 12.7 cm in length. The left kidney is 12.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: Status post splenectomy.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | 1. Limited evaluation of the pancreas. However, the visualized pancreatic head and neck appear prominent. If there is clinical and laboratory suspicion for pancreatitis, CT may be considered for further evaluation.2. Mildly coarse hepatic echogenicity, compatible with steatosis. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Stable complex benign cyst. Right kidney 11.3 cm in length.LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.4 cm in lengthOTHER: Bladder not visualized due to overlying bandages | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | 58-year-old male with a history of cirrhosis presents for HCC screening. LIVER: The liver is nodular in contour and coarse in echogenicity. The liver measures 14 cm in craniocaudal dimension. There is a new 2 cm hypoechoic well-defined mass in the left hepatic lobe. GALLBLADDER, BILIARY TRACT: Partially contracted gallbladder without wall thickening, pericholecystic fluid, gallstones or focal tenderness. No intrahepatic biliary ductal dilatation. No extra-hepatic biliary ductal dilatation with the common duct measuring 2 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.5 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident.OTHER: Splenomegaly, measuring 15.8 cm. The left kidney measures 11.3 cm without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. 1.3-cm simple appearing cyst. | New 2 cm hypoechoic mass is suspicious for HCC. Further characterization with a dedicated liver MRI is recommended. These findings were discussed with the ordering physician Dr. Shah at 1530 on 05/01/2015. |
Generate impression based on findings. | Bilateral axillary pain. A targeted bilateral ultrasound was performed for the patient's areas of pain. Slightly prominent lymph nodes that retain their normal fatty hila are seen in each axilla, none uniquely suspicious in appearance. No suspicious cystic or solid mass was apparent. | Symmetric mildly prominent axillary lymph nodes are probably reactive. This correlates to the findings from recent MRI.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 23-year-old male with acute kidney injury. Evaluate for hydronephrosis. History of sickle cell disease. RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No hydronephrosis, shadowing stones, or suspicious masses. Increased echogenicity of the renal parenchyma.LEFT KIDNEY: The left kidney measures 10.3 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Increased echogenicity of the renal parenchyma.URINARY BLADDER: No significant abnormality notedOTHER: No significant abnormalities noted. | 1. No hydronephrosis.2. Increased echogenicity of the renal parenchyma is nonspecific and suggestive of chronic medical renal disease. |
Generate impression based on findings. | 73 years old, Male, Reason: pt with +HepC Ab but negative RNA viral load. Looking for features of cirrhosis or splenomegaly History: none, just +Hepc Ab LIVER: The liver measures 17.3 cm cm in length. A coarse echogenic liver is consistent with fatty infiltration. No nodularity of the capsule to suggest cirrhosis. 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: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 8.9 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.2 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Coarse echogenic liver is consistent with fatty infiltration.2.No nodularity or widening of the fissures to suggest cirrhosis. |
Generate impression based on findings. | Hepatitis C LIVER: Mildly coarse liver echotexture noted without mass. Liver length 15.1 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 11 cm in length. No ascites | Mildly coarse liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 18-year-old female with waxing and waning palpable lump in the right axilla. The patient is able to identify the lump at this time, but indicates that it is much less conspicuous than it was last night or in the past. Family history of premenopausal breast cancer in the patient's mother. A targeted right axillary ultrasound was performed for the palpable area of concern. On physical examination, a focal area of thickening can be appreciated at the site indicated by the patient. There is no solid or cystic mass identified. There is some tissue in this area that has a questionable sonographic appearance of accessory breast tissue. The finding is not definite. No lymph nodes are identified in the area (normal, abnormal, or otherwise). | No sonographic evidence for malignancy. No definite finding to explain the patient's area of palpable concern. Continued clinical management is recommended for the patient's area of palpable concern. Further evaluation, including biopsy, should not be delayed by negative imaging. Rather, negative imaging may serve to reinforce a negative clinical impression. The results and recommendations were discussed with the patient at the completion of the exam.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 62-year-old with multiple cysts in both breasts complains of tenderness in both breasts. Ultrasound for both breasts are performed. The patient has a tender spot in the right 12 - 1 o'clock position. There is a simple cyst at one o'clock position in the right breast measuring 15 x 15 mm. Additionally, there are small simple cysts at one o'clock, 12 o'clock, 10 o'clock position and retroareolar region in the right breast. In the left breast, there is a simple cyst measuring 16 x 11 mm at 12 o'clock position, where the patient feels tenderness. There are more simple cysts in the left breast at upper outer quadrant. | Multiple simple cysts in both breasts. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | History of multinodular goiter. Previous bilateral fine-needle aspiration demonstrated benign thyroid nodules. RIGHT LOBE MEASUREMENTS: 5.3 x 2.2 x 1.5 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.4 x 1.2 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: 2 dominant right thyroid lobe nodules with the superior nodule measuring 2.7 x 1.5 x 1.7 cm, compared to approximately 2.3 x 1.5 x 1.2 cm previously. It is isoechoic well-defined and without significant vascularity.The mid nodule measures 1.6 x 0.6 x 1.4 cm, compared to 1.6 x 0.6 x 0.9 cm when remeasured using similar technique. This nodule has a more cystic colloid appearance.LEFT LOBE: 3 discrete nodules are noted in the left lobe with a stable mid nodule measuring 0.9 x 0.6 x 0.7 cm with coarse calcifications. The superior and inferior nodules measure 1.4 x 0.5 x 1.0 cm and 1.3 x 0.8 x 1.1 cm respectively and are predominantly isoechoic with cystic changes favoring colloid nodules, not significantly changed in size accounting for differences in measurement technique.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 are stable to minimally increased in size accounting for differences in measurement technique. Subcentimeter coarsely calcified mid left thyroid lobe nodule is unchanged. |
Generate impression based on findings. | Thyroid carcinoma status post thyroidectomy RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy without mass or regional adenopathy |
Generate impression based on findings. | Female, 58 years old. Flank pain RIGHT KIDNEY: The right kidney measures 9.7 cm in length, with normal cortical echotexture. No shadowing stones or hydronephrosis. No perinephric collection.LEFT KIDNEY: The left kidney measures 10.9 cm in length, with normal cortical echotexture. No shadowing stones or hydronephrosis. No perinephric collection.OTHER: The visualized portions of the bladder are unremarkable. | No hydronephrosis or urinary stones. |
Generate impression based on findings. | 74-year-old female, evaluate ascites. There is moderate four quadrant ascites noted. | Moderate four quadrant ascites. |
Generate impression based on findings. | Male 44 years old Reason: nodule vs thyroiditis History: hyperthyroidism RIGHT LOBE MEASUREMENTS: 5.2 x 2.1 x 2.3 cmLEFT LOBE MEASUREMENTS: 5.1 x 2.3 x 2.3 cm.ISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Diffusely hypervascular mildly heterogeneous thyroid without focal nodule or cystic structure. LEFT LOBE: Diffusely hypervascular mildly heterogeneous thyroid without focal nodule or cystic structure. ISTHMUS: Hypervascular and thickened isthmus.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 3 lymph node measures 1.5 x 0.5 x 0.9 cm and appears benign. Left level 3 lymph node measures 1.7 x 0.3 x 0.9 cm and appears benign.OTHER: No significant abnormality noted. | Findings consistent with hyperthyroidism. |
Generate impression based on findings. | Hepatitis C newly diagnosed myeloma LIVER: Unremarkable echogenicity without mass. Liver length 12.8 cmBILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.4 cm in lengthRIGHT KIDNEY: Renal cyst. 9.6 cm in length OTHER: Left renal cyst. Left kidney 8.6 cm in length. No ascites. | Unremarkable hepatic parenchyma without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites. |
Generate impression based on findings. | 31-year-old female with history of thyroid cancer status post thyroidectomy presents with palpable lymph nodes. Evaluate for lymphadenopathy. RIGHT LOBE, LEFT LOBE, ISTHMUS MEASUREMENTS: The thyroid has been surgically removed.RIGHT LOBE, LEFT LOBE, ISTHMUS: The thyroid has been surgically removed.LYMPH NODES: There are 2 suspicious cervical lymph nodes:There is a round, hypoechoic lesion with calcifications measuring approximately 0.8 x 0.5 x 1.0 cm in the right level II neck.There is a round, hypoechoic, 0.9 x 0.5 x 1.4 cm lesion with calcifications in the left level III neck.OTHER: No significant abnormality noted. | 1. Bilateral suspicious lymph nodes as described above. Recommend ultrasound-guided biopsy. |
Generate impression based on findings. | Hepatocellular carcinoma screening. Hepatitis C. LIVER: 13.9 cm in length. Non-cirrhotic liver morphology. Coarsened parenchymal echogenicity. Simple and complex-appearing cysts noted. No lesions suspicious for hepatocellular carcinoma are evident. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.3 cm in length. A 6.2 x 5.5 x 5.6 cm soft tissue mass is noted at the superior pole. An additional 4 mm simple appearing cyst is noted in the superior pole. No hydronephrosis is present.The left kidney is 9.0 cm in length. A 10 mm benign appearing cyst is noted in the midpole. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 7.3 cm in length, without focal lesions evident. | 1. Simple and complex-appearing hepatic cysts. No lesions suspicious for hepatocellular carcinoma evident. 2. 6.2 cm right renal mass, suspicious for renal cell carcinoma. Evaluation with renal-protocol CT or MRI is recommended for further evaluation. Findings were text paged to ordering physician Dr. Rao at 9:00 AM on 12/16/2015.px3wr |
Generate impression based on findings. | 51-year-old female post thyroidectomy with small nodule right thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the right thyroidectomy bed, there is again noted a small nodule, measuring 0.3 x 0.5 x 1.2 cm without significant change. Previously described slightly more caudal, hypoechoic region was not identified on today's examLEFT LOBE: Slightly asymmetric hypoechoic region in the left bed described previously was not identified on today's exam. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically normal lymph nodes bilaterallyOTHER: No significant abnormality noted. | No substantial interval change in right thyroid bed nodule. Several other nodules described previously are not identified on today's exam. |
Generate impression based on findings. | Elevated creatinine Limited examination due to body habitus.RIGHT KIDNEY: Pelvic in location and not well visualized, though without hydronephrosis.LEFT KIDNEY: 8.6 cm in length. Malrotated in configuration. Unremarkable parenchymal echogenicity. No suspicious lesions identified. No hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormalities noted. | No evidence of hydronephrosis. |
Generate impression based on findings. | Renal transplant with acute urine output dropped RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality noted. 10.4 cm in length COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels Patent renal vasculature without evidence for inflow or outflow compromise. Diastolic dampening observed.OTHER: No significant abnormality noted | Patent renal vasculature without evidence for inflow or outflow compromise. Diastolic dampening observed consistent with increased parenchymal resistance pattern. No hydronephrosis. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladder. No gallstones identified.PANCREAS: 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 11.2 cm in length. The left kidney is 11.5 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 9.6 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 43-year-old female with thyromegaly RIGHT LOBE MEASUREMENTS: 4.2 x 1.7 x 1.9 cm.LEFT LOBE MEASUREMENTS: 4.8 x 1.6 x 1.9 cm.ISTHMUS MEASUREMENTS: 5 mmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Hypoechoic, cystic nodule in the inferior pole of the left thyroid lobe measures 5 x 3 x 4 mm, previously 4 x 4 x 2 mm. Hypoechoic nodule in the posterior mid/inferior pole of the left thyroid lobe measures 8 x 4 x 7 mm, previously 6 x 6 x 3 mm. There is a left upper lobe hypoechoic thyroid nodule measuring 4 x 2 x 5 mm, not present on the study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Incidentally noted is mildly echogenic material in the left internal jugular vein with turbulent flow. | 1.No significant change in reference left thyroid lobe nodules. New left upper lobe thyroid nodule.2.Incidentally noted is mild echogenic material in the left internal jugular vein with turbulent flow that may represent nonocclusive thrombus. Formal evaluation is recommended.The findings were discussed with Dr. Nicole Leong at 1012 on 11/30/2016. |
Generate impression based on findings. | Status post LVAD with history of drive line infection. There is 1.9 x 2.3 cm hypoechoic fluid collection extending superficially from the drivelineto the skin surface, new from the prior study. This may follow the tract of previous instrumentation. There are no significant surrounding hyperemic changes. | Fluid tracking from the transplant to the skin surface. Superinfection of this fluid cannot be ruled out. The fluid may be filling a tract from prior instrumentation. |
Generate impression based on findings. | 48 years Female with elevated TSH and single thyroid nodule. RIGHT LOBE MEASUREMENTS: 5.8 x 2.1 x 1.3 cmLEFT LOBE MEASUREMENTS: 5.0 x 1.5 x 1.2 cmISTHMUS MEASUREMENTS: 0.2 cm in thickness. RIGHT LOBE: Heterogeneous echotexture with diffusely increased vascularity. Within the midpole of the right thyroid gland, there is an ill-defined hypoechoic area which is favored to represent parenchymal heterogeneity rather than a discrete nodule. No discrete nodules are identified.LEFT LOBE: Heterogeneous echotexture with diffusely increased vascularity. No discrete nodules.ISTHMUS: Heterogeneous echotexture with diffusely increased vascularity. PARATHYROID GLANDS: No significant abnormalities.LYMPH NODES: No significant abnormalities. OTHER: No significant abnormalities. | Findings suggestive of thyroiditis without discrete nodules. |
Generate impression based on findings. | 68 years old, Male, Reason: evaluate size of renal masses and characterize cysts RIGHT KIDNEY: Kidney measures 11.3 cm in length. Right renal cyst measures 2.3 x 2.8 x 2.1 cm. Previously noted mid kidney right renal mass is not well visualized on this exam. Right lower pole mass is not significantly changed in size measuring 4.7 x 5.2 x 4.4 cm, previously measuring 5.3 x 4.2 cm on most recent CT dated 7/17/14. Evidence of right-sided hydronephrosis.LEFT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. Nohydronephrosis. Left renal cysts.OTHER: Distal tips of nephroureteral stents are noted with urinary bladder. No significant abnormality within the bladder. | 1.Right lower pole renal mass not significantly changed in size since CT dated 7/17/14. Previously noted enhancing mass in the right mid kidney is not well visualized on this ultrasound examination.2.Right-sided hydronephrosis. |
Generate impression based on findings. | Male; 69 years old. Reason: evaluate for pancreatitis, also evaluate gallbladder for stones/gallstone pancreatitis History: elevated lipase, elevated WBC LIVER: The liver contour is smooth. The parenchyma is coarse and echogenic. The liver measures 18.3 cm in length.The main portal vein is patent and demonstrates a normal direction of flow with a peak velocity 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis. The gallbladder wall is normal thickness and there is no pericholecystic fluid. The common bile duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are normal in appearance. The pancreatic tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 5.6 cm in length.RIGHT KIDNEY: Right kidney measures 12.4 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis. OTHER: The left kidney measures 12.1 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis.Bilateral pleural effusions. | 1.Normal gallbladder, no cholelithiasis.2.No evidence of pancreatitis.3.Hepatomegaly and hepatic steatosis.4.Bilateral pleural effusions |
Generate impression based on findings. | Primary biliary cirrhosis LIVER: Coarse heterogeneous liver echotexture unchanged without mass. Liver length 16.4 cmBILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation. Stable subcentimeter gallbladder polyp measuring 0.5 x 0.4 x 0.4 cm.PANCREAS: No significant abnormalities noted.SPLEEN: Mild splenomegaly; spleen length 15.1 cmRIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 10.3 cm in length. No ascites. | Stable coarse heterogeneous liver echotexture without mass or ductal dilatation. Gallbladder sludge without acute inflammation. Stable subcentimeter gallbladder polyp. No ascites. |
Generate impression based on findings. | 59-year-old female patient with shortness of breath, abnormal LFTs. Evaluate liver and for portal vein thrombosis. LIVER: The liver measures 11.4 in length and is nodular in contour. A subcentimeter hypoechoic nodule is again noted in the right hepatic lobe. Main portal vein flow is poorly visualized on color Doppler imaging but appears hepatopetal measuring 0.1 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. The common bile duct is dilated measuring up to 12 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 13.7 cm in length and contains two cysts with the largest measuring up to 7.6 cm. No evidence of hydronephrosis. Renal cortical echogenicity is increased. OTHER: The left kidney measures 14 cm in length. No evidence of hydronephrosis. Multiple cysts are again noted, the largest measuring 5.2 x 4.2 cm. Renal cortical echogenicity is increased.The spleen measures 15.6 cm in length. There are splenic varices. A pleural effusion is present. | 1. Cirrhotic liver with limited evaluation of the portal vein which appears patent, but with sluggish flow. 2. Medical renal disease.3. Splenic varices. |
Generate impression based on findings. | 83-year-old male with acute kidney failure. Urinary retention. The exam is limited by patient's inability to cooperate.RIGHT KIDNEY: Right kidney is moderately to markedly echogenic consistent with parenchymal disease measuring approximately 9.4 cm in length. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney is moderately to markedly echogenic consistent with parenchymal disease. Length is difficult to assess, but likely approximate 10 cm. No hydronephrosis, shadowing calculus or mass.URINARY BLADDER: Small amount of debris. Not highly distended.OTHER: Dependent sludge within the gallbladder on limited views. | Echogenic kidneys without hydronephrosis. |
Generate impression based on findings. | 66-year-old female with known CLL in remission with concern for a left anterior cervical node. Two cervical lymph nodes were palpable by the patient's physician, and this study is limited to identifying those 2 lymph nodes. The cervical lymph node on the right was identified sonographically measuring 0.5 cm x 0.3 cm x 0.5 cm and has a fatty hilum. The other cervical lymph node is identified on the left measuring 0.5 cm x 0.3 cm x 0.7 cm. This also demonstrates a fatty hilum. No suspicious adenopathy is identified. | Right and left cervical lymph nodes, corresponding to the patient's palpable lymph nodes were visualized, and demonstrate benign morphology. No suspicious adenopathy is identified. |
Generate impression based on findings. | Abdominal pain worse with eating LIVER: Coarse echogenic liver parenchyma without mass. Liver length 14.9 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: Obscured by overlying gasRIGHT KIDNEY: No significant abnormalities noted. 10.6 cm in lengthOTHER: Left kidney 11.1 cm in length. Spleen 11.6 cm in length. No ascites. | Coarse echogenic liver parenchyma suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Unremarkable gallbladder. No ascites. |
Generate impression based on findings. | 48-year-old female with dysphagia, evaluate for dominant thyroid nodule. RIGHT LOBE MEASUREMENTS: 6.4 x 2.7 x 1.9 cmLEFT LOBE MEASUREMENTS: 6.5 x 2.5 x 1.6 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: 0.6 cm benign cystic right lobe nodule.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. | Small benign right thyroid pole cystic nodule. No dominant or suspicious solid nodule that would contribute to the patient's symptoms. |
Generate impression based on findings. | Female 46 years old; Reason: Diffuse goiter, check for nodules History: goiter RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 1.5 x 1.9 x 6.1 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 5.9 x 3.7 x 8.9 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.4 cm.RIGHT LOBE: Right lobe is heterogeneous with a predominantly solid nodule with cystic components measuring 2.4 cm x 1.3 cm x 1.7 cm in the mid/lower pole. There are punctate echogenic foci seen but no discrete calcifications.LEFT LOBE: The left lobe is predominantly a conglomerate of solid and highly complex cystic/spongiform nodules. The largest measures 3.3 cm x 2.4 cm x 3.6 cm and the cystic portion has complex internal echogenicity. There are several other smaller hyperechoic cyst in the left lobe.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious adenopathy noted. | 1.Multinodular goiter with no suspicious regional adenopathy identified.2.The left lobe is primarily a conglomerate of solid and highly complex cystic/spongiform nodules. A component of this may represent a hemorrhagic cyst.3.In the right lobe there is a predominantly solid nodule with cystic components which is amenable to percutaneous biopsy. |
Generate impression based on findings. | Evaluate for AAA ABDOMINAL AORTA: Proximal aorta measures 2.7 x 2.5 cm with ulcerated calcified plaque within it. Mid aorta measures 2.2 x 2 cm and distal aorta measures 2 x 1.9 cm. Normal flow directionality and patency noted. The flow velocity measures 81.9 cm/s. No evidence of aneurysmal dilatation noted.The right and left iliac artery measure 1.4 x 1.4 cm and 1.1 x 1.3 cm respectively. No evidence of aneurysmal dilatation with normal flow directionality and patency noted.INFERIOR VENA CAVA: PatentOTHER: No significant abnormality noted. | Mild calcified plaques noted in the proximal aorta. No evidence of aneurysmal dilatation of the abdominal aorta and iliac arteries. |
Generate impression based on findings. | Female 73 years old Reason: determine if cirrhosis History: ELEVATED INR LIVER: 18.5 cm in length. Minimally coarse texture. No focal masses.Flow in the portal vein is hepatopedal peak velocity 40 cm/sGALLBLADDER, BILIARY TRACT: Sludge in gallbladder with no evidence of gallstones. No Wall thickening or pericholecystic fluid.No intrahepatic or extrahepatic biliary dilatation. Common bile duct 0.2 cm in diameter.PANCREAS: Poorly visualized.RIGHT KIDNEY: Small 8.4 cm in length. No hydronephrosis. Mildly echogenicOTHER: Left kidney 7.7 cm in length. No hydronephrosis.Spleen 9.8 cm in length.No evidence of ascites. | Small kidneys consistent with chronic medical renal disease. No definite evidence of cirrhotic morphology. Sludge in gallbladder without evidence of biliary dilatation. |
Generate impression based on findings. | History of renal transplant with rising creatinine. RIGHT ILIAC FOSSA TRANSPLANT KIDNEY: The right iliac fossa transplant kidney measures 11.1 cm in length with mild pelviectasis. Color Doppler demonstrates hilar blood flow. No shadowing nephrolithiasis. No definite peri-transplant fluid collection with adjacent probable bowel noted. OTHER: No significant abnormalities noted. | Mild pelviectasis without shadowing nephrolithiasis. Please note that spectral Doppler evaluation was not performed. |
Generate impression based on findings. | 63-year-old male with history of thyroid cancer status post thyroidectomy. Follow-up examination. RIGHT LOBE MEASUREMENTS: Surgically absentLEFT LOBE MEASUREMENTS: Surgically absentISTHMUS MEASUREMENTS: Surgically absentRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 2 mm cystic focus in the superior left thyroid bed is unchanged since the prior study. No new abnormalities are identified in the thyroid bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A mildly prominent 10 x 8 x 4 mm lymph node is identified in the left neck level five station. This lymph node demonstrates a normal fatty hilum but questionable abnormal cortical thickening and increased echogenicity.OTHER: No significant abnormality noted. | 1.Postsurgical changes of thyroidectomy with unchanged small cystic focus in the left thyroid bed.2.Questionably abnormal small lymph node in the left level five station was not previously identified. This lesion raises suspicion of a new nodal metastasis. |
Generate impression based on findings. | Mitral valve regurgitation with right upper quadrant pain LIVER: Prominent hepatic veins consistent with cardiac disease. No hepatic mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal normal directional flow. Liver length 16.6 cm.BILIARY TRACT: Diffusely thickened gallbladder wall without stones or ductal dilatation. Due to the patient's somnolent state, a Murphy's sign could not be elicited.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.6 cm in lengthRIGHT KIDNEY: Mildly echogenic kidneys without mass, stone, or hydronephrosis. 10.3 cm in length. OTHER: Mildly echogenic left kidney without worrisome mass, stone, or hydronephrosis. Left kidney 10.1 cm in length. Benign appearing left renal cyst. Mild ascites. Left pleural effusion. | Diffusely thickened gallbladder wall without stones or duct dilatation. Unfortunately, due to the patient's somnolent state, a Murphy's sign could not be elicited. While this diffuse gallbladder wall thickening is nonspecific in the context of cardiac disease and congestion, some element of inflammation involving the gallbladder cannot be excluded; a nuclear medicine scan would be helpful as clinically warranted.Mildly echogenic kidneys suggestive for medical renal disease/parenchymal dysfunction without mass or stone or hydronephrosis.Mild ascites, left pleural effusion. |
Generate impression based on findings. | Cirrhosis LIVER: Cirrhotic morphology again noted without mass. Liver length 14.1 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.1 cm in lengthOTHER: Left kidney 11.7 cm in length. Spleen 12.6 cm in length. No ascites | Stable cirrhotic morphology without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Male 64 years old Reason: at the site of port-a-cath, check for abscess/ hematoma History: swelling at the site of port-a-cath There is a complex fluid collection the port pocket. This may represent hematoma, however, an abscess cannot be excluded. The collection measures 3.4 x 1.9 cm. | Complex hematoma sepsis surrounding the port. |
Generate impression based on findings. | 17-year-old with left breast discharge, nonspontaneous, nonbloody. She has recently started a new birth control shot. A targeted left ultrasound was performed retroareolar region. There is no solid or cystic mass identified. Comparison images of the right retroareolar region demonstrate similar normal breast tissue. | No sonographic evidence for malignancy. The patient should follow-up with her birth control provider regarding her birth control method and potential side effects and to consider other systemic causes of discharge.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | The patient submitted outside mammogram dated 10/10/2013 and 7/30/2013, from Saint Anthony Hospital. Submitted outside study was compared to the current mammogram dated 8/18/2015. Focal asymmetry within the lower central left breast is new from prior studies and needs further evaluation with spot compression views with possible ultrasound. | Focal asymmetry within the lower central left breast is new from prior studies and needs further evaluation with spot compression views with possible ultrasound.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Reason: Rising bilirubin and jaundice 8 months status post stem cell transplant with Busulfan conditioning. Concern for cholecystitis, cholelithiasis, GVHD, or VOD LIVER: The liver measures 18.0 cm in length. Normal hepatic echogenicity and echotexture. The portal vein is patent with normal directional hepatopedal portal venous blood flow, peak velocity 23.3 cm/s. Peak velocity of the right portal vein is -16.1 cm/s and left portal vein is 10.4 cm/s. Normal hepatic arterial directional blood flow. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The gallbladder wall measures 0.1 cm. The common hepatic duct measures 0.3 cm. No biliary ductal dilatation.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 12.8 cm. Small subcentimeter nonobstructing renal stone in the mid portion of the right kidney. No hydronephrosis or masses.LEFT KIDNEY: The left kidney measures 13.3 cm. No hydronephrosis, masses, or stones.SPLEEN: The spleen measures 12.1 cm. Peak splenic vein velocity is 18.4 cm/s. Peak splenic artery velocity is 48.7 cm/s. Abnormal directional venous and arterial flow.OTHER: No ascites. | 1. Subcentimeter nonobstructing right renal stone.2. Unremarkable hepatobiliary system with normal hepatopedal directional portal venous and arterial flow. |
Generate impression based on findings. | 41 year old female who was recalled from screening mammogram for multiple focal asymmetries, some with calcifications, in both breast presents for additional workup. Mammogram: 2 ML view and 8 spot magnification views of both breasts 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. 2 cm partially circumscribed mass in the left retroareolar region with multiple pleomorphic calcifications need further evaluation with ultrasound. A subcentimeter partially circumscribed mass is also identified in the left central slightly lateral breast.Another partially circumscribed mass with few calcifications is noted in the right upper outer quadrant approximately measuring 18 mm. These calcifications have coarse morphology.Few other benign morphology masses identified within the right breast.Ultrasound:A parallel oriented hypoechoic mass measuring 1.6 x 1.1 cm with few calcifications within it is identified in the right breast 11:00 position 2 cm from the nipple. Located slightly superior to it is another solid hypoechoic mass that measures 0.8 x 0.5 cm. Both these masses most likely correspond to the masses seen on mammogram.In the left breast 12:00 position there is an oval hypoechoic mass with multiple hyperechoic areas consistent with calcifications that measures 2.2 x 1 x 2.1 cm. This lesion demonstrates peripheral and central blood flow and most likely corresponds to the largest mass with indeterminate calcifications as seen on mammogram. Another small most likely benign morphology mass is identified at 3:00 position that measures 1.3 x 0.6 cm. | The largest mass in the left breast 12:00 position with multiple pleomorphic calcifications needs further evaluation with ultrasound-guided core biopsy. Specimen radiograph should be obtained to confirm suspicious calcifications within them.Multiple other most likely benign morphology masses in both breast. If the above-mentioned biopsies benign, annual diagnostic mammogram is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |