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Generate impression based on findings. | 45 year-old asymptomatic female presents for routine screening mammography. Family history of breast cancer in 2 maternal aunts. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Asymmetry in the right upper breast seen on the MLO view appears increased in size; this is questionably seen on the CC view. Round obscured mass in the right breast 12:00 position has decreased in size and was previously confirmed to be a cyst on ultrasound. Benign coarse calcifications in the left breast are stable. No suspicious masses or microcalcifications. | Asymmetry in the right upper breast on the MLO view for which further evaluation with spot compression views, and possibly ultrasound, is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 56-year-old female with history of goiter. RIGHT LOBE MEASUREMENTS: 5.1 x 2.4 x 2.2 cmLEFT LOBE MEASUREMENTS: 7.0 x 3.2 x 3.5 cmISTHMUS MEASUREMENTS: 1.6 cmRIGHT LOBE: Heterogeneous multinodular thyroid. Cystic and solid nodule in the right lower pole measures 1.6 x 1.1 x 1.2 cm.LEFT LOBE: Heterogeneous multinodular thyroid. Cystic and solid nodule in the left lower pole measures 2.0 x 1.5 x 1.4 cm.ISTHMUS: Cystic and solid nodule in the isthmus measures 2.0 x 1.9 x 1.6 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular thyroid as detailed above. |
Generate impression based on findings. | 51 year old who is called back from screening mammogram for developing calcifications. Family history of mother and sister with breast cancer. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. There are pleomorphic calcifications at posterior lower inner left breast, measuring 28 x 40 mm, distributing segmentally. No masses or distortions are associated with these calcifications.Focused ultrasound study was performed for the left breast lower inner quadrant. There are no solid or cystic masses. No increased blood flow is present. | Pleomorphic calcifications at lower inner quadrant in the left breast. Stereotactic core needle biopsy is recommended. Results and recommendations were discussed with the patient and her husband. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (1/14/2016), ultrasound images of left breast (1/14/2016), images from ultrasound guided biopsy of left breast with postprocedural left mammographic images (1/18/2016), images from ultrasound-guided wire localization of left breast and left digital mammographic images with specimen radiographs (1/22/2016) performed at Centegra Hospital. DIGITAL MAMMOGRAPHIC IMAGES (1/14/2016):Submitted images are low quality and cannot be used for diagnostic images.ULTRASOUND IMAGES OF LEFT BREAST (1/14/2016):There is an irregularly shaped hypoechoic mass measuring approximately 3.5 x 1.7 cm at 6:00 position in the left breast. There is an additional irregularly-shaped masses at 6:00 position, measuring 10 x 10 mm. Per outside radiology report, the smaller mass locates anteriorly to the larger mass.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF LEFT BREAST WITH POSTPROCEDURAL LEFT MAMMOGRAPHIC IMAGES (1/18/2016):Ultrasound guided biopsy was performed for the two 6:00 masses in the left breast and an additional irregularly shaped mass, measuring 15 x 7 mm, which is located at 5:00 position in the left breast. A biopsy needle appears to reach three masses.Per Epic note, those three biopsy results were all malignant.IMAGES FROM ULTRASOUND-GUIDED WIRE LOCALIZATION OF LEFT BREAST AND LEFT DIGITAL MAMMOGRAPHIC IMAGES WITH SPECIMEN RADIOGRAPHS (1/22/2016):Wire localization was performed under ultrasound guidance for the larger mass at 6 o'clock position in the left breast and mammographic guidance for other two masses in the left breast. Because of poor quality, post-procedural mammogram cannot be interpreted. Several radiographic images of specimen are also submitted, but they are also poor in quality.Per Epic note, surgical margins are free of tumor. | Status post wire localization and lumpectomy for left breast cancer. If available, good quality mammogram should be submitted. Alternatively, right unilateral mammogram is recommended for annual survey.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 66-year-old male with chronic kidney disease RIGHT KIDNEY: Measures 10.6 cm in length. Unremarkable echogenicity with preserved corticomedullary differentiation. No hydronephrosis or nephrolithiasis.LEFT KIDNEY: Measures 11.0 cm in length. Unremarkable echogenicity with preserved corticomedullary differentiation. No hydronephrosis or nephrolithiasis.OTHER: Increased hepatic echogenicity partially imaged. | 1. Unremarkable sonographic appearance of the kidneys without hydronephrosis or nephrolithiasis.2. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on findings. | Reason: history of papillary thyroid carcinoma, close monitoring of lymphadenopathy, please evaluate for interval changes History: none RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy.LEFT LOBE: Status post thyroidectomy. Redemonstration of nonspecific relatively echogenic soft tissue focus located between carotid artery and esophagus measuring 0.7 x 0.2 x 0.5 cm, not significantly changed in size.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Mildly prominent cervical lymph nodes appear similar to the prior exam. The lymph nodes demonstrate morphologic features suggestive of benignity, but continued follow-up is suggested.OTHER: No significant abnormality noted. | No significant change in subcentimeter echogenic focus in left thyroidectomy bed and mildly prominent cervical lymph nodes. |
Generate impression based on findings. | 83 year old male patient with history of right-sided renal mass. Evaluate for changes. RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No perinephric fluid collection is identified.KIDNEY: Renal cortical echogenicity is within normal limits.COLLECTING SYSTEM/URETER: No evidence of hydronephrosis.URINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color Doppler imaging of the transplant kidney is within normal limits.OTHER: There is a 2.1 x 1.9 cm hypoechoic mass within the superior pole of the right native kidney which appears to correlate with previously identified right renal mass. Given differences in modality/technique, the mass appears similar in size to the prior study. An additional subcentimeter hypoechoic lesion is noted. | 1. Similar size of a previously identified mass within the native right kidney given differences in modality/technique when compared to prior CT.2. Unremarkable transplant kidney. |
Generate impression based on findings. | 79-year-old male with elevated LFTs and history of alcohol abuse. Evaluate liver for portal hypertension and cirrhosis LIVER: The liver is normal in echotexture without evidence of nodular contour or other specific findings to suggest cirrhosis. Portal vein is patent with peak systolic velocity of 0.2 m/s.GALLBLADDER, BILIARY TRACT: Gallbladder wall measures 0.2 cm with the common bile duct measuring 0.2 cm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Kidneys are normal in echotexture with the right kidney measuring 9.4 cm and left kidney measuring 10.4 cm in length.OTHER: Small bilateral pleural effusions, right greater than left | 1.No sonographic evidence of cirrhosis or portal hypertension as clinically questioned.2.Small bilateral pleural effusions, right greater than left. |
Generate impression based on findings. | Status post thyroidectomy for thyroid carcinoma 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 worrisome mass or regional adenopathy. |
Generate impression based on findings. | 57-year-old female patient with intermediate sharp right upper quadrant abdominal pain. LIVER: The liver measures 16.2 cm in length. No focal hepatic lesion is identified. GALLBLADDER, BILIARY TRACT: The gallbladder is filled with shadowing stones. Sonographic Murphy's sign is negative. There is no significant 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 7.2 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A 0.9 cm anechoic lesion is noted within the right midpole.OTHER: The left kidney measures 6.2 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 7.0 cm in length. | 1. Cholelithiasis without sonographic evidence of acute cholecystitis.2. Right renal cyst. |
Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 1.7 x 1.5 x 4.5 cmLEFT LOBE MEASUREMENTS: 2.4 x 1.4 x 5.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant change in left thyroid nodules. Dominant mixed cystic and solid nodule measures 1.9 x 1 x 1.9 cm.ISTHMUS: No change in spongiform isthmic nodule measuring 1.4 x 0.7 x 1.6 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable left and isthmic thyroid nodules. No regional adenopathy. |
Generate impression based on findings. | Acute renal insufficiency and fever RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality noted. 14.6 cm in lengthCOLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedOTHER: No significant abnormality noted | Negative right iliac fossa renal transplant. No evidence for perinephric collection, abnormal echogenicity, mass, stone, or hydronephrosis. |
Generate impression based on findings. | 65 year-old female with pancreatitis, evaluate for cholelithiasis. LIVER: Coarse echotexture of the liver measuring 14.0 cm in length. Portal vein is patent with appropriate directional flow. No focal hepatic lesion.GALLBLADDER, BILIARY TRACT: Shadowing calculus within the gallbladder without evidence of cholecystitis. No gallbladder wall thickening. No pericholecystic fluid. No intra or extra hepatic biliary ductal dilatation.PANCREAS: Hypoechoic pancreas.RIGHT KIDNEY: Measures 9.6 cm in length. No hydronephrosis.OTHER: Left kidney measures 10.1 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 7.0 cm in length. | 1. Cholelithiasis without evidence of acute cholecystitis.2. Coarse echotexture of the liver suggestive of parenchymal dysfunction. |
Generate impression based on findings. | Low back pain RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.3 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.8 cm in lengthOTHER: Bladder nondistended. Incidental note made of 1 x 1.1 x 1 cm well-circumscribed hyperechoic focus within the right lobe of the liver. | Normal renal parenchyma without mass, stone, or hydronephrosis. Incidental note made of well-circumscribed hyperechoic focus within the right lobe of the liver; statistically most probably represents a benign hemangioma. |
Generate impression based on findings. | Female 62 years old Reason: cirrhosis of liver? History: chronic hepatitis B, chronic hepatitis C LIMITED ABDOMENLIVER: . Liver measures 16 cm in length. The parenchyma is echogenic. No sonographically evident lesions.BILIARY TRACT: No biliary dilatation. Status post cholecystectomy.PANCREAS: Visualized portions are unremarkable. KIDNEYS: The right kidney measures 9 cm. The cortex is of normal echogenicity . No shadowing calculi or hydronephrosis is present. The left kidney measures 10 cm. The cortex is of normal echogenicity. No shadowing calculi or hydronephrosis is present. 2.7-cm renal hypocholic cystic lesion is difficult to visualize clearly, but likely a cyst.SPLEEN: The spleen measures 9 cm. in length. OTHER: No significant abnormalities noted. | 1.Echogenic liver is nonspecific, but can be seen in diffuse infiltrative disease or fatty liver. This limits evaluation for focal hepatic lesions. If indicated, MRI can be useful to further evaluate the liver.2.2.7-cm probable cyst in the left kidney as described above. This can also be definitively characterized on the MRI if indicated. |
Generate impression based on findings. | 64 year-old female with primary hyperparathyroidism, osteopenia. Evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 4.5 cm x 1.3 cm x 1.5 cmLEFT LOBE MEASUREMENTS: 4.7 cm x 1.1 cm x 1.4 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: Normal homogeneous echotexture. Cystic nodule at the lower pole measures 6 mm x 5 mm x 6 mm with no internal vascularity or definite microcalcifications.LEFT LOBE: Normal homogeneous echotexture.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Subcentimeter cyst in the right thyroid lobe. 2. No evidence of parathyroid adenoma. |
Generate impression based on findings. | Gallbladder polyp 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. The gallbladder polyp measures 7 x 7 x 6 mm, previously 8 x 5 x 4 mm. Although the measurements do not vary significantly, the polyp demonstrates a broader base and increasingly convex contours, suggestive of some interval growth. No significant internal flow seen on color Doppler evaluation. The gallbladder is otherwise unremarkable.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 10.2 cm in length. The left kidney is 10.4 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. | Slightly increased sized of the gallbladder polyp, which is nonspecific. Continued follow up is recommended. |
Generate impression based on findings. | 44-year-old male patient with epigastric pain. Evaluate for cholelithiasis. LIVER: The liver measures 16.8 cm in length. Hepatic parenchymal echogenicity is slightly coarsened. 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 11 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.4 cm in length. No evidence of hydronephrosis.The spleen measures 7.6 cm in length. | No cholelithiasis or sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | 51 year old female with elevated PTH and calcium. RIGHT LOBE MEASUREMENTS: 1.5 x 2.5 x 5.9 cmLEFT LOBE MEASUREMENTS: 1.2 x 2.5 x 5.4 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: The right thyroid lobe is normal in morphology, echogenicity and size without a discrete dominant nodule.LEFT LOBE: The left thyroid lobe background parenchyma is normal in echogenicity. There is a 1.4 x 0.9 x 0.6 cm superior pole solid hypoechoic nodule with well defined margins. No hypervascularity or associated calcifications. Additional, 8 x 5 x 7 mm inferior pole hypoechoic nodule with minimal vascularity and well-defined margins. No associated calcifications. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Immediately dorsal to the inferior pole of the left thyroid lobe is a 1.1 x 0.7 x 1.4 cm hypoechoic lesion without significant vascularity which may represent a parathyroid adenoma. LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 1.4 cm lesion immediately dorsal to the inferior pole of the left thyroid lobe may represent a parathyroid adenoma; correlate with nuclear medicine study.2. 1.4 cm left thyroid lobe solid indeterminate nodule. |
Generate impression based on findings. | Male 67 years old; Reason: assess for cholecystitis History: sepsis LIVER: The liver is incompletely visualized however numerous ill-defined lesion seen within the liver on prior CT are not visualized on this study.GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.9 mm but is difficult to define in this study. Several small shadowing echogenic foci are seen within the gallbladder. Negative sonographic Murphy sign. There is a trace amount of pericholecystic fluid which is likely compatible with patient's current ascites, seen better on prior CT. The common bile duct was unable to be visualized due to difficulty with technique and overlying bowel gas. | 1. Cholelithiasis without overt sonographic evidence of acute cholecystitis. There is a trace amount of pericholecystic fluid which is likely compatible with patient's ascites. This study is limited however and acute cholecystitis, although unlikely, cannot be entirely ruled out.2.The common bile duct was not able to be visualized due to difficulty in technique and overlying bowel gas.3. Multiple ill-defined lesions within the liver seen on CT are not well visualized on this ultrasound. |
Generate impression based on findings. | Reason: Patient with weakness and mild transaminitis History: Weakness LIVER: The liver measures 17.7 cm in length. Increased parenchymal echogenicity is compatible with fatty infiltration/parenchymal dysfunction. Hepatic cyst as seen on prior CT without additional focal hepatic lesions identified, though sensitivity limited. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Cholelithiasis including stones in the gallbladder neck without associated significant 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 within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.7 cm in length. RIGHT KIDNEY: Kidney measures 18.6 cm in length (including cyst). Normal echotexture. No frank hydronephrosis. Large upper pole cyst.LEFT KIDNEY: Kidney measures 13.0 cm in length. Normal echotexture. Mild hydroureteronephrosis appearing similar to recent CT.OTHER: No significant abnormalities noted. | 1.Echogenic liver compatible hepatic steatosis/parenchymal dysfunction. No suspicious focal hepatic lesions are identified, however, sensitivity is limited.2.Cholelithiasis without evidence of acute cholecystitis or biliary ductal dilatation.3.Mild left hydroureteronephrosis appearing similar to recent CT. |
Generate impression based on findings. | Abnormal LFTs LIVER: Coarse echogenic liver parenchyma without mass. Liver length 15.4 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10.4 cm in length.OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 9 cm in length. Trace ascites. | Coarse echogenic liver parenchyma consistent with fatty infiltration/parenchyma dysfunction without mass or ductal dilatation. Cholelithiasis without acute inflammation. Trace ascites. Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | 46 year old female with pain along right of umbilicus. Evaluate for hernia. In the region of the palpable area noted by the patient along the right periumbilical area is a benign appearing lymph node measuring 1.8-cm x 1.0 cm x 0.3 cm. No solid or cystic masses noted in this region. No evidence of hernia. | Benign appearing lymph node in the right periumbilical region corresponding to the palpable area noted by the patient. |
Generate impression based on findings. | Ms. Bracy is a 62-year-old female who was recalled from screening mammogram of 08/12/16 for a new partially obscured mass in the left upper outer breast. She has no family history of breast cancer. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Again seen is a partially obscured mass in the left outer breast at 3:00. A subsequent targeted ultrasound was performed.ULTRASOUND | There is a simple cyst in the left breast at the 3:00 position correlating to the partially obscured mass on the mammogram. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Globus sensation RIGHT LOBE MEASUREMENTS: 1.6 x 5 x 1.5 cm.LEFT LOBE MEASUREMENTS: 1.7 x 4.1 x 1.2 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Negative thyroid ultrasound. No evidence for acute, inflammatory, or neoplastic process. No regional adenopathy. |
Generate impression based on findings. | 64-year-old male with diffuse large B-cell lymphoma evolved from CLL and MUD stem cell transplant. Disseminated mycobacterial infection. Abnormal liver function. LIVER: Liver is mildly echogenic which is non--- specific. Liver is normal in size and there is no focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Multiple dependent, shadowing gallstones within the gallbladder without wall thickening or focal pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: Upper normal in size to mildly enlargedRIGHT KIDNEY: Highly echogenic consistent with parenchymal disease. No hydronephrosis. OTHER: Left kidney is highly echogenic consistent with parenchymal disease. No hydronephrosis. Mildly complex/septated 1.3 cm left renal cyst.Small amount of ascites.Pericardial effusion. | Mildly echogenic liver. Gallstones without complication.Small amount of ascites.Highly echogenic kidneys.Borderline splenomegaly. |
Generate impression based on findings. | History of renal stones RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Right kidney 10.1 cm in lengthLEFT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Left kidney 11.3 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound. Normal parenchymal echogenicity without mass, stone, or obstruction. |
Generate impression based on findings. | 57-year-old male for follow-up of right thyroid cystic mass. RIGHT LOBE MEASUREMENTS: 4.3 x 1.6 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.0 x 1.3 x 2.2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Homogeneous in echotexture. In the right lobe there is again noted a predominately cystic mass with slight eccentric nodularity and calcification. This is most likely benign, and measures 0.7 x 1 x 1 cm, unchanged from the prior exam.LEFT LOBE: Homogeneous in echotexture. In the most inferior left lobe of the thyroid and poorly visualized as a predominantly cystic mass with small eccentric echogenic focus measuring 0.4 x 0.6 x 0.7 cm, highly likely benign.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Stable complex cystic right thyroid mass likely benign.2. Smaller complex cystic left thyroid mass highly likely benign. Although not noted on the prior exam, the inferior left lobe is very difficult to visualize to this may have been present. |
Generate impression based on findings. | 73-year-old female with renal failure. RIGHT KIDNEY: The right kidney measures 9.9 cm in length, and is highly echogenic consistent with parenchymal disease. There is no hydronephrosis or shadowing calculus. There is a 1.9 cm cyst in the lower pole. There is diffuse and focal parenchymal loss. There is an echogenic focus in the midportion of the kidney and I cannot exclude a small nonobstructive stone. LEFT KIDNEY: The left kidney measures 12.6 cm in length. Cortex is thinned and highly echogenic consistent with parenchymal disease. There is no hydronephrosis, shadowing calculus or mass.URINARY BLADDER: Poorly distended without gross abnormality.OTHER: No significant abnormalities noted. | Echogenic kidneys bilaterally with parenchymal loss, progressive on the right.Right renal cyst. |
Generate impression based on findings. | 60-year-old female patient with history of CLL status post SCT. Anasarca and ascites. LIVER: The liver measures 19.2 cm in length. Hepatic parenchymal echogenicity is within normal limits. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There is cholelithiasis. The gallbladder wall is borderline thickened, which is nonspecific in the setting of ascites. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.2 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.4 cm in length. No evidence of hydronephrosis.The spleen is not visualized.There is mild ascites. | 1. Mild hepatomegaly and mild ascites.2. Cholelithiasis with borderline gallbladder wall thickening, which is non-specific in the setting of ascites. |
Generate impression based on findings. | Female 65 years old; Reason: c/f portal vein thrombosis in pt with advanced cirrhosis History: pt w/ cirrhosis c/f portal vein thrombosis 2/2 reversal of flow on previous u/s LIVER: The liver measures 10.1 cm in length. There is increased, coarse, heterogeneous echogenicity of the liver parenchyma with cirrhotic morphology. Multiple solid parenchymal lesions seen with "bull's-eye" appearance being an echogenic center surrounded by hypoechoic rim. The left-sided lesion measures approximate 1.7 x 1.7 x 1.6 cm which is increased from the prior study and the right-sided lesion measures proximal 2.1 x 2.4 x 2.0 cm. . No intrahepatic ductal dilation is seen. The main portal vein is patent with hepatofugal flow measured at 10.5 cm/s. There is no evidence of thrombus. GALLBLADDER/BILIARY TRACT: The gallbladder wall is circumferentially thickened. No stones are seen, however dependent hypoechoic material partially fills the gallbladder, consistent with sludge. No pericholecystic fluid. The common bile duct measures 1.9 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.1 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 8.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 8.6 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: There is marked ascites again noted. | 1. Hepatofugal flow of the portal vein as described above without evidence of thrombus.2. Cirrhotic morphology with lesions concerning for metastases which have slightly increased in size since the prior examination.3. Diffuse gallbladder wall thickening which is nonspecific in the setting of ascites. |
Generate impression based on findings. | 71 year old female with nontoxic multinodular goiter and dysphagia for follow-up. RIGHT LOBE MEASUREMENTS: 6.2 by 2.7 x 2.2 cmLEFT LOBE MEASUREMENTS: 7.4 x 3 x 2.7 cmISTHMUS MEASUREMENTS: 1.6 cmRIGHT LOBE: Complex nodule with cystic components in the inferior right lobe measures 1.6 x 2.4 by 3.6 cm without significant change. Multiple other nodules likely stable.LEFT LOBE: Nodules are less well-defined on today's study. Anterior upper pole nodule which is solid but demonstrates comet tail artifact suggestive of colloid measures 0.7 x 1.2 cm in transverse which is unchanged. Not adequately visualized in longitudinal dimension for measurement.Posterior left lobe solid nodule with cystic component measures are 0.6 x 0.6 cm in transverse which is unchanged. Not adequately visualized in longitudinal dimension for measurement. Other nodules appear slightly more confluent on today's exam.ISTHMUS: Spongiform during nodule measures 1.4 x 2.7 by 3 cm without significant change.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Although the thyroid measures slightly bigger than prior study and some nodules are less well-defined, reference nodules appear stable. |
Generate impression based on findings. | 99-year-old female with right-sided abdominal pain. RIGHT KIDNEY: Measures 9.3 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 9.0 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Distended bladder containing echogenic debris.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. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 4.2 x 1.4 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.6 x 1.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Upper pole spongiform nodule measuring 1 x 0.7 x 0.9 cmLEFT LOBE: Multiple spongiform nodules. A representative mid pole nodule measures 1 x 0.8 x 0.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: 1.7 x 1.2 x 0.9 cm hypoechoic extrathyroidal focus projecting posterior and inferior to the right thyroid gland. This hypoechoic focus demonstrates what appears to be a fatty hilum.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral spongiform thyroid nodules; favor benign etiology. Hypoechoic extrathyroidal focus projecting posterior and inferior to the right thyroid gland. While this lesion's morphology favors a lymph node, a parathyroid adenoma cannot be excluded. Would recommend correlation with radionuclide study. No regional adenopathy. |
Generate impression based on findings. | 30-year-old female with enlarged gland on exam. RIGHT LOBE MEASUREMENTS: 5.7 x 2.2 x 1.0 cm.LEFT LOBE MEASUREMENTS: 5.1 x 2.2 at 1.2 cm.ISTHMUS MEASUREMENTS: 0.5 cm.RIGHT LOBE: Right thyroid lobe echogenicity is homogeneous without dominant lesion.LEFT LOBE: Left thyroid lobe echogenicity is homogeneous without focal lesion.ISTHMUS: Isthmus demonstrates homogeneous echogenicity without focal lesion.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small perivascular lymph nodes are noted.OTHER: A subcentimeter nodule posterior and inferior to the right thyroid lobe may represent an exophytic thyroid nodule, parathyroid gland, or lymph node. | No dominant thyroid lesion is identified. |
Generate impression based on findings. | Ms. Chavez is a 39-year-old female with known left breast malignancy and biopsy-proven left axillary lymph node. She presents today for ultrasound reevaluation of left axillary lymph node. A targeted left axillary ultrasound was performed. A total of 3 lymph nodes are identified in the left axilla. The lymph node labeled #1 is the most superficial of the 3 and probably represents the previously biopsied lymph node based on depth of this node when compared to original ultrasound exam from 09/2015. Lymph node #1 measures approximately 1.1 x 0.5 x 0.9 cm. No biopsy clip is identified in this lymph node.Lymph node #2 measures 1.2 x 0.6 cm and is identified just inferiorly. Lymph node #3 measures 0.6 x 0.4 cm and is seen medially. | Total of three left axillary lymph nodes identified. The first one (labelled lymph node #1) is probably the previously biopsied lymph node. No biopsy clip is present in this node. Ultrasound-guided needle localization of this node could be considered if clinically indicated.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 88-year-old man with history of urinary tract infection. RIGHT KIDNEY: The right kidney measures 10.1 cm in length and shows normal echotexture. Right upper pole cyst contains no septations, debris or calcifications and measures 4.8 x 4.4 x 4.2 cm. No mass, stone or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.8 cm in length and shows normal echotexture. No mass, stone or hydronephrosis.URINARY BLADDER: The urinary bladder is normal in appearance.OTHER: There is no free or loculated fluid. Prostate appears enlarged. | Right upper pole simple renal cyst. Prostate appears enlarged. No hydronephrosis or focal bladder abnormality. |
Generate impression based on findings. | Melanoma with diarrhea fevers and elevated LFTs LIVER: No significant abnormalities noted. 17.1 cm in lengthGALLBLADDER, BILIARY TRACT: Probable interval increase in size of large mass arising from the gallbladder now measuring approximately 11.9 x 9.9 x 11.3 cm. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.4 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 11.2 cm in length. No ascites | Probable interval increase in size of large gallbladder/gallbladder fossa mass suggestive for melanoma metastasis. Unremarkable liver echotexture without intrahepatic mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Ms. Jadotte is a 55-year-old female presenting with bilateral breast tenderness and self palpated lumps. She has a personal history of bilateral cyst aspiration. Right breast: Upon physical exam at the patient's area of concern in the right breast, no discrete mass is appreciated. A right breast ultrasound is performed for the patient's area of concern. In the right breast 8 o'clock location, approximately 3 cm from the nipple, a normal 4-mm lymph node is identified. There is no suspicious cystic or solid mass seen.Left breast: Upon physical exam of the patient's area of concern in the left breast, no discrete mass is appreciated. A left breast ultrasound is performed for the patient's area of concern. In the left breast 3 o'clock location, approximately 3 cm from the nipple, a 4 mm simple breast cyst is identified. There is no suspicious cystic or solid mass seen. | Benign intramammary lymph node in the right breast. Simple breast cyst in the left breast. No sonographic evidence for malignancy. Patient should follow-up with her primary care physician for bilateral breast tenderness as clinically warranted. As long as the patient's physical examination remains normal, bilateral screening mammogram is next due in Sept 2015. All results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 91-year-old male with history of elevated liver enzymes. Evaluate for obstructive liver disease. Evaluation was limited by patient's poor acoustic window.LIVER: No biliary dilatation or other significant abnormality. The liver measured 15 cm.BILIARY TRACT: Cholelithiasis, without findings of cholecystitis. No biliary dilatation.PANCREAS: Pancreas is not clearly visualized.SPLEEN: No significant abnormalities noted. Spleen measures 8.5 cm.RIGHT KIDNEY: Hyperechoic renal parenchyma. Right kidney measures 10 cm. OTHER: Hyperechoic left kidney parenchyma. Left kidney measures 10 cm. | Limited exam, without significant abnormality to explain the patient's elevated liver enzymes. Incidentally noted cholelithiasis and other findings as above. |
Generate impression based on findings. | Right nodule suspicious for malignancy; assess cervical lymph nodes RIGHT LOBE MEASUREMENTS: 5.4 x 1.5 x 1.2 cmLEFT LOBE MEASUREMENTS: 5.6 x 1.7 x 1 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: 0.8 x 0.5 x 0.4 cm hypoechoic nodule within the right isthmus with possible internal microcalcifications.LEFT LOBE: 2 subcentimeter hypoechoic nodules within the left thyroid gland. Lower pole nodule measures 0.7 x 0.5 x 0.8 cm; the mid pole nodule measures 0.6 x 0.3 x 0.2 cm.ISTHMUS: Subcentimeter hypoechoic nodule within the right isthmus was possible internal microcalcifications as described.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Subcentimeter hypoechoic nodule within the right isthmus with possible internal microcalcifications. Additional subcentimeter hypoechoic nodules within the left thyroid gland. No regional adenopathy. |
Generate impression based on findings. | 76-year-old female presents for thyroid ultrasound. RIGHT LOBE MEASUREMENTS: 4.2 x 1.6 x 1.4 cm LEFT LOBE MEASUREMENTS: 4.5 x 1.8 x 1.3 cm ISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Heterogeneous parenchyma without discrete noduleLEFT LOBE: Heterogeneous parenchyma without discrete noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered cervical lymph nodes with benign morphologic features. OTHER: Incidental note of heavy atherosclerotic calcification of the left carotid artery. | 1. Heterogeneous thyroid parenchyma without discrete nodule. 2. Incidental note of heavy atherosclerotic calcification of the left carotid artery. A dedicated duplex Doppler ultrasound of the carotid arteries is recommended for further evaluation. |
Generate impression based on findings. | Reason: Patient with neutropenic fevers, pericholecystic fluid seen on CT. Assess for cholecystitis LIVER: The liver measures 20.5 cm in length, enlarged. The hepatic parenchymal echotexture and echogenicity is coarse and echogenic. There is no focal mass. No biliary ductal dilatation. The portal vein is patent with normal directional hepatopedal flow and waveform, peak velocity 39.5 cm/s.BILIARY TRACT: The gallbladder appears unremarkable. There is no pericholecystic fluid. There is no evidence of stones or sludge. The gallbladder wall measures 4 mm. The common bile duct measures 5 mm.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 13.7 cm.RIGHT KIDNEY: The right kidney measures 16.1 cm in length. There is no focal mass or hydronephrosis. LEFT KIDNEY: The left kidney measures 16.8 cm in length. There is no focal mass or hydronephrosis.OTHER: No significant abnormalities noted. | 1. Coarse, echogenic liver possibly representing hepatic parenchymal dysfunction or hepatic steatosis.2. Normal gallbladder. |
Generate impression based on findings. | 19 year-old female with history of urinary frequency, and feelings of incomplete voiding. Evaluate for urinary retention. Bladder:Pre-void bladder volume was 270 mL, and postvoid bladder volume was 3 mL. No significant retention. | No significant abnormal urinary retention. |
Generate impression based on findings. | Elevated LFTs LIMITED ABDOMENLIVER: Mildly coarse and echogenic liver echotexture without mass. Liver length 14.9 cm.BILIARY TRACT: Gallbladder absent. No ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 13.2 cm in length RIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 11.7 cm in length. No ascites. | Mildly coarse and echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Patent hepatic vessels with normal directional flow. No ascites. |
Generate impression based on findings. | Patient with benign morphology mass in the right breast 8:00 position for follow-up ultrasound A targeted right ultrasound was performed. Stable parallel oriented lobulated benign morphology mass in the right breast 8:00 position measures 11 x 6 x 13 millimeters, previously measured 10 x 7 x 11 mm, mostly unchanged from prior study. No suspicious masses noted.This mass appears to be slightly palpable on physical examination. | Stable benign morphology mass in the right breast 8:00 position most consistent with a benign fibroadenoma. Patient is scheduled for surgical follow-up today.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Benign renal cysts. Right kidney 12.1 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left kidney 9.1 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | 43-year-old female patient with a right thyroid nodule. Evaluate for nodular growth or lymphadenopathy. RIGHT LOBE MEASUREMENTS: 5.1 x 2.7 x 2.6 cm, previously 5.2 x 2.6 x 2.4 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.7 x 1.9 cm, previously 5.3 x 1.8 x 1.8 cm.ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity. A well defined, subcentimeter hyperechoic nodule is not significantly changed in size or appearance. LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity.ISTHMUS: The isthmus is heterogeneous in echogenicity. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-morphology lymph nodes are noted in the neck.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with unchanged subcentimeter right thyroid nodule. |
Generate impression based on findings. | 65 years old, Female, Reason: HCV cirrhosis, evaluate for HCC History: HCV cirrhosis LIVER: The liver measures 16.6 cm in length. Coarse nodular liver consistent with cirrhosis. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s. A nonoccluding thrombus of the main portal vein is identified.BILIARY TRACT: Cholelithiasis and sludge are present within the gallbladder without evidence of 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 10.1 cm in length. RIGHT KIDNEY: Kidney measures 11.8 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 11.0 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus. | 1.Coarse nodular liver consistent with cirrhosis without evidence of focal hepatic mass.2.Nonoccluding thrombus of the main portal vein.3.Increased echogenicity of the kidneys, may reflect medical renal disease in the correct clinical context.4.Cholelithiasis and sludge present within the gallbladder without evidence of acute cholecystitis. |
Generate impression based on findings. | Female, 39 years old. Recurrent UTI, r/o bladder obstruction. Recurrent suprapubic fullness RIGHT KIDNEY: The right kidney measures 9.3 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.8 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is distended, without significant wall thickening. | 1.No hydronephrosis.2.Increased renal cortical echogenicity, compatible with medical renal disease. |
Generate impression based on findings. | Ms. Rawles is a 46-year-old female recalled from screening mammogram for possible left breast cyst. She has a personal history of right breast cysts and benign left breast excisional biopsy. A targeted left breast ultrasound was performed for the mammographic area of concern. In the left breast 2:00 location, approximately 4 cm from the nipple, there is an oval anechoic lesion identified measuring approximately 2.1 x 1.5 x 2.3 cm, corresponding to the previously described mammographic finding. Sonographic findings are compatible with a simple cyst. | Simple cyst of the left breast. No sonographic evidence of malignancy in the left breast. As well as the patient's physical examination remains unchanged, an annual screening mammogram is recommended annually, due next in July 2017. All results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Benign renal cyst. Right kidney 12.2 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 13 cm in lengthOTHER: Bladder collapsed | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | 64 year old female called back from screening mammography for an asymmetry in the right breast. Three standard views of the right breast with additional spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. There is a persistent lobulated asymmetry at the 12:00 position. An adjacent circumscribed round asymmetry is also present. ULTRASOUND | Benign cyst in the right upper breast, but no definite sonographic correlate for the lobulated mammographic asymmetry in the right upper breast. The patient has filed for submission of prior mammograms. If these are obtained, they will be reviewed and an addendum will be issued. Otherwise, a right unilateral diagnostic mammogram is recommended in 6 months to confirm stability. 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. | Transaminitis LIVER: Unremarkable echogenicity without mass. Liver length 17.3 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.3 cm in lengthOTHER: Left kidney 10.8 cm in length. Spleen 11.3 cm in length. No ascites. Bilateral pleural effusions. | Gallbladder sludge without acute inflammation or ductal dilatation. Unremarkable liver parenchyma without mass or abnormal echogenicity. |
Generate impression based on findings. | 58-year-old male with HCV cirrhosis. Evaluate for HCC. LIVER: The liver contour is nodular and the parenchyma is moderately coarsened, consistent with cirrhosis. No discrete mass or intrahepatic biliary ductal dilatation evident. Normal hepatopetal portal venous blood flow is present at 20 cm/sec.BILIARY TRACT: The common bile duct at the level of the pancreatic head is normal in caliber, measuring 3 mm. A partially contracted gallbladder is noted with no wall thickening, pericholecystic fluid, focal tenderness or gallstones.PANCREAS: The visualized pancreatic head and body are unremarkable.SPLEEN: The spleen is mildly enlarged, measuring 13.7 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 13.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.There is mild ascites. | Cirrhotic liver morphology, mild splenomegaly, and small volume ascites. No discrete liver lesion or biliary ductal dilatation. |
Generate impression based on findings. | 45 year old male patient with cirrhosis. Screening HCC. LIVER: The liver measures 16.1 cm in length and demonstrates coarsened hepatic echotexture as noted previously. The liver contour is nodular. No focal hepatic lesion is identified although sensitivity is decreased given heterogeneity and contour nodularity. Main portal vein flow is patent with flow toward the liver.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas. Pancreatic duct measures 0.1 cmRIGHT KIDNEY: The right kidney measures 11.7 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 12.5 cm in length. No evidence of hydronephrosis.The spleen measures 12.4 cm in length. | No substantial interval change. Markedly heterogeneous nodular liver with no dominant lesions identified. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Focal hepatic parenchymal calcification again noted unchanged. No worrisome mass. Liver length 14.3 cm BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. 12.1 cm in lengthOTHER: Left kidney 10.3 cm in length. Left pleural effusion | Cholelithiasis without acute inflammation or ductal dilatation. Otherwise negative for acute hepatobiliary abnormality. Left pleural effusion. |
Generate impression based on findings. | History of left breast probable fat necrosis presents for follow-up. A targeted left ultrasound was performed for the known area of concern. At the left breast 2:00 position, a mixed echogenicity area measuring 1.0 x 1.1 cm is compatible with fat necrosis. These measurements represent interval decrease in size. | Imaging findings compatible with resolving benign fat necrosis. The patient is due for a bilateral diagnostic mammogram in December of this year.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 22-year-old female with right flank pain. Early pregnancy. RIGHT KIDNEY: Right kidney measures 10.2 cm in length. Echotexture is normal. There is no hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Left kidney measures 10.1 cm in length. Echotexture is normal. There is no hydronephrosis, shadowing calculus or mass.OTHER: Limited views of the bladder demonstrate no abnormality.Early intrauterine pregnancy noted. Complete OB study not performed.Mildly echogenic liver, likely due to fatty infiltration. | Normal kidneys.Mild fatty liver.Early IUP.US RENAL LTD, 11/18/2016 10:08 AMCLINICAL INFORMATION:22-year-old female with right flank pain. Early pregnancy.COMPARISON: Limited views from 11/26/2011 ultrasound TECHNIQUE: Real-time ultrasound images were obtainedFINDINGS:RIGHT KIDNEY: Right kidney measures 10.7 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Left kidney measures 10.1 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.OTHER: Mildly echogenic liver likely due to fatty infiltration.Early IUP noted but not evaluated. |
Generate impression based on findings. | 65-year-old female with history of thyroid cancer post thyroidectomy. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: ThyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for local recurrence or nodal disease. |
Generate impression based on findings. | 3-year-old female with left cutaneous ureterostomy takedown and reimplantation 10/04/16. History of cloacal reconstruction, left solitary kidney with obstructing megaureter with left pyeloplasty. Assess for possible improvement in dilation of bladder and left upper tracts. BLADDER Wall Thickness: Moderate wall thickening. Contents: There is slight decrease in the debris within the bladder, with the bladder appearing slightly more decompressed as compared to prior exam. Distal Ureter -- SFU Grade** Left: 0 , no significant ureter dilatation is observed on this exam. Ureteral Jets Left: Not observed LEFT KIDNEY Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Left: 3, small amount of debris is identified within the left renal pelvis. Dilatation of the renal pelvis measures 2.5 cm anteroposteriorly, as compared to 2.8 cm on the prior exam. Length*** Left: 8.4 cm Mean for age: 7.3 cm Range for age: 6.1 - 8.1 cmADDITIONAL OBSERVATIONS: No significant abnormalities noted | Persistent left hydronephrosis with debris in the renal pelvis and bladder. Ureteral dilatation is no longer visualized.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | Reason: Rule out hepatobiliary disease (cholelithiasis vs cholecystitis) History: RUQ pain LIVER: The liver measures 15.1 cm in length. Hepatic parenchymal echogenicity is suggestive of hepatic steatosis or parenchymal dysfunction. Normal hepatopedal portal venous blood flow, 25.4 cm/s.BILIARY TRACT: No significant abnormalities noted. No shadowing gallstones or sludge. Probable adenomyomatosis in the gallbladder fundus. The gallbladder wall measures 3 mm. The common bile duct measures 2 mm. No intrahepatic or extrahepatic biliary ductal dilatation. Negative sonographic Murphy sign.PANCREAS: Obscured due to overlying bowel gas.SPLEEN: The spleen measures 8.6 cm in length. Several scattered microcalcifications are noted.KIDNEYS: The right kidney measures 10 cm in length. The left kidney measures 11 cm in length. 2.4 x 2.2 x 1.9 cm anechoic left lower pole cyst.OTHER: No significant abnormalities noted. | Echogenic liver, which may reflect parenchymal dysfunction or hepatic steatosis. No cholelithiasis, evidence of cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Increasing LFTs LIVER: Mildly coarse heterogeneous echotexture without mass. Liver length 18 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge and stones without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 10.3 cm in length OTHER: Left kidney 10.7 cm in length. Spleen 12.8 cm in length. No ascites. | Mildly coarse heterogeneous echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Gallbladder sludge and stones without acute inflammation. No ascites. |
Generate impression based on findings. | Ms. Macklin is a 28 year old female with a known history of multicentric right breast cancer and metastatic right axillary lymph node. She is currently undergoing neoadjuvant chemotherapy and presents for ultrasound evaluation to assess for treatment response in the known metastatic right axillary lymph node. Targeted right axillary ultrasound was performed.The known metastatic right axillary lymph node with centrally located biopsy marker clip measures 1.4 x 0.4 x 1.3 cm, previously measuring 1.5 x 0.6 cm.In addition to the biopsied right axillary lymph node there are two additional abnormal morphology lymph nodes identified, the largest one of which measures approximately 1.7 x 0.8 x 1.6 cm. | No significant change in size of known metastatic right axillary lymph node with centrally located biopsy marker clip. Patient should continue to follow up with her breast surgeon as clinically warranted. All results and recommendations were discussed with the patient and her mother.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 41 year-old female with right upper quadrant pain with history of RYGB and lap band placement. Evaluate for cholelithiasis, cholecystitis. LIVER: Normal echogenicity of the liver measuring 18.3 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate direction of flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening or pericholecystic fluid. Sonographic Murphy's sign is negative. Common bile duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal in echogenicity.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 11.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 11.1 cm in length. No hydronephrosis or shadowing calculi noted.Normal echogenicity of the spleen measuring 10.6 cm. | No sonographic findings of cholelithiasis. |
Generate impression based on findings. | 72-year-old female patient with primary hyperparathyroidism. Assess for adenoma and thyroid nodule. RIGHT LOBE MEASUREMENTS: 5.7 x 1.8 x 1.7 cm.LEFT LOBE MEASUREMENTS: 5.8 x 1.1 x 1.8 cm.ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: There are three mostly solid, hypoechoic subcentimeter nodules within the right thyroid lobe. The largest within the medial inferior pole measures 0.9 x 0.8 x 0.5 cm.LEFT LOBE: The left thyroid lobe contains a complex cystic subcentimeter nodule within the superior pole measuring 0.5 x 0.4 x 0.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Subcentimeter bilateral thyroid nodules.2. No focus concerning for a parathyroid adenoma is identified. |
Generate impression based on findings. | 39-year-old female with nausea/vomiting/abdominal pain. LIVER: Increased hepatic echogenicity without discrete focal lesion.GALLBLADDER, BILIARY TRACT: Cholelithiasis without gallbladder wall thickening or pericholecystic fluid. No sonographic Murphy sign was elicited during the examination. There is no biliary ductal dilation.PANCREAS: No significant abnormalities noted.KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without evidence of acute cholecystitis.2.Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on findings. | Patient recalled for 2 circumscribed masses identified within the right breast on screening mammogram. Three standard views of the right breast and 2 spot magnification views of the right central breast posterior depth 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. There are 2 subcentimeter circumscribed masses within the right central breast posterior depth, the largest measuring up to 7 mm. ULTRASOUND | Follow-up demonstrated two benign-appearing lesions. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Hematuria RIGHT KIDNEY: 10.1 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 10.3 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormality noted. | No specific findings to account for the patient's hematuria. |
Generate impression based on findings. | 54-year-old male with hepatitis C cirrhosis. Evaluate for hepatocellular carcinoma. LIVER: Liver is enlarged measuring 22 cm in length and coarsely echogenic with cirrhotic morphology. No focal hepatic masses identified. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Gallbladder is poorly distended due to postprandial state and therefore wall cannot be well assessed. There is again noted a nondependent focal echogenic area in the gallbladder wall measuring 2 to 3 mm consistent with polyp. Biliary tract is normal in caliber.PANCREAS: Limited due to bowel gasSPLEEN: Upper normal mildly enlargedRIGHT KIDNEY: No significant abnormalities noted. . No mass identified.OTHER: Periportal lymph nodes which are nonspecific in face with cirrhosis. | Stable exam with cirrhotic liver |
Generate impression based on findings. | 34-year-old female with history of known right breast cancer who presents with a palpable right axillary lymph node from breast clinic for sonographic evaluation. A right axillary ultrasound was performed for the area of concern. There is a benign morphology right axillary lymph node measuring 4 x 8 mm. | No sonographic evidence for abnormal lymph node in the right axilla.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 63-year-old female with mediastinal mass, evaluate for lymphadenopathy. Enlarged rounded hypoechoic lymphadenopathy in the right level four station. Three abnormally enlarged lymph nodes are identified, measuring 1.3 x 1.3 cm, 0.9 x 1.1 cm, and 1.0 x 1.3 cm. No abnormal lymph nodes are identified on the left. | Right cervical lymphadenopathy as detailed above. |
Generate impression based on findings. | 54-year-old male patient with new ascites fluid. Question of portal vein thrombosis. LIMITED ABDOMENLIVER: The liver measures 14.3 cm in length, is coarsened in echotexture, and nodular in contour. BILIARY TRACT: There is a single shadowing gallstone. The gallbladder wall measures 9 mm in thickness which is nonspecific in the setting of ascites. The common duct measures 4 mm in diameter.PANCREAS: The pancreas is not visualized on this examination.SPLEEN: The spleen measures 12.8 cm in length. RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No evidence of hydronephrosis.OTHER: There is moderate to marked ascites. | 1. Questioned partial thrombosis of the main portal vein with poor visualization of the right and left portal veins.2. Patent hepatic arteries and veins.3. Cirrhotic morphology of the liver with moderate to marked ascites.Findings discussed with ordering service prior to dictation. |
Generate impression based on findings. | Male, 46 years old. Reason: 46M s/p L partial nephrectomy now with rising creatinine. RIGHT KIDNEY: The right kidney measures 11.6 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 12.1 cm in length, with increased cortical echogenicity. A mid to lower pole cystic lesion measures 4.1 x 3.3 x 3.8 cm. Corresponds with a simple cyst seen on prior CT imaging Additional previously identified solid left renal lesions are not seen on this exam, likely due to partial lumpectomy. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. | 1.Increased renal cortical echogenicity compatible with medical renal disease or parenchymal dysfunction. No hydronephrosis.2.Interval changes of left partial nephrectomy. Please note that based on the patient's body habitus, continued surveillance with CT imaging will be preferred over ultrasound. |
Generate impression based on findings. | Status post liver transplant with increasing abdominal girth and lower extremity edema LIMITED ABDOMENLIVER: No hepatic mass. Liver length 12.7 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: 11.7 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11.3 cm in length OTHER: Left kidney 10.1 cm in length. No ascites. | Status post liver transplant without evidence for mass or ductal dilatation. No ascites. Patent hepatic vessels with normal directional flow. |
Generate impression based on findings. | 64 year-old female with incidental finding of a thyroid nodule on CT of the neck. RIGHT LOBE MEASUREMENTS: 4.0 x 1.4 x 1.5 cm.LEFT LOBE MEASUREMENTS: 5.7 x 1.7 x 1.8 cm.ISTHMUS MEASUREMENTS: 0.5 cm.RIGHT LOBE: Note is made of a 3 x 4 x 2 mm anechoic collection with a punctate focus of increased echogenicity and associated comet tail artifact, without internal vascularity or microcalcification, consistent with a colloid cyst. LEFT LOBE: 9 x 8 x 9 mm spongiform nodule in the superior pole of the left lobe of the thyroid without internal vascularity or microcalcification.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral benign morphology thyroid nodules, as detailed above. |
Generate impression based on findings. | 53 years old, Male, Reason: cirrhosis? in 53M with AML and new diagnosis of hep C; bedside US if possible History: hep C active LIVER: The liver is mildly enlarged measuring 18.4 cm in length. The hepatic parenchyma is normal in echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s. No definite nodularity of the liver contours to suggest cirrhosis.BILIARY TRACT: There is gallbladder sludge without evidence of gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.6 cm in length. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No evidence of ascites. | 1.No nodularity of the liver to suggest cirrhosis. No focal hepatic lesions.2.Gallbladder sludge without evidence of cholecystitis. |
Generate impression based on findings. | Female 34 years old; Reason: Assess for evidence of HCC History: Chronic hepatitis B infection LIVER: The liver measures 14.4 cm in length. There is coarse increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 19.1 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.5 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 1.3 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.6 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A renal cyst is seen in the superior pole measuring 1.8 cm x 1.3 cm x 1.4 cm.LEFT KIDNEY: The left kidney measures 11.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | The liver has a coarse increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No focal hepatic masses are seen. |
Generate impression based on findings. | 71-year-old female with a history of left mastectomy 20 years ago and biopsy proven right breast cancer presents from surgery clinic with possible right axillary lymph node. A targeted right axillary ultrasound was performed for the palpable area of concern. There is an elongated lymph node in the right axilla measuring 4.1 x 1.2 x 2.8 cm within the eccentrically thickened cortex measuring 8 mm in thickness with eccentric vascularity. A second lymph node with benign morphology was also seen measuring 1.4 x 0.9 x 1.4 cm. | Right axillary lymph node with eccentrically thickened cortex. Ultrasound guided biopsy can be performed if desired.Please submit prior mammograms and ultrasound for comparison.BIRADS: 6 - Known cancer.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 60-year-old male with history of polycystic kidney disease. RIGHT KIDNEY: The right kidney measures 10.0 cm in length and shows normal echotexture. No cysts, worrisome mass, stone or hydronephrosis.LEFT KIDNEY: The left kidney measures 13.0 cm in length and shows normal echotexture. Numerous renal cysts are seen, with the largest in the left mid pole region measuring 5.3 x 4.8 x 5.2 cm. No mass, stone or hydronephrosis.URINARY BLADDER: The urinary bladder is normal in appearance.OTHER: There is no free or loculated fluid. | Multiple left renal cysts. No worrisome mass. |
Generate impression based on findings. | 40 year-old male with history of significant alcohol abuse, elevated transaminases. Evaluate for liver pathology. LIVER: Increased echogenicity of the liver measuring 19.2 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas obscured by overlying bowel gas. The visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Measures 10.1 cm in length. No hydronephrosis or shadowing calculi or noted.OTHER: Left kidney measures 10.8 cm in length. No hydronephrosis or shadowing calculi or noted.Normal echogenicity of the spleen measuring 8.3 cm in length. | Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | Elevated liver enzymes. Cardiac arrest. LIVER: Non-cirrhotic liver morphology. Mildly coarsened and increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.2 cm in length. The left kidney is 12.9 cm in length. The renal parenchymal echogenicity is increased bilaterally. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 9.0 cm in length, without focal lesions evident.AORTA: Patent, without aneurysmal dilation.OTHER: No significant abnormalities noted. No ascites identified. | 1. Mildly increased hepatic echogenicity, compatible with parenchymal dysfunction.2. Increased renal parenchymal echogenicity, compatible with medical renal disease. |
Generate impression based on findings. | 31 years old, Female, Reason: Abdominal pain, bloating gas, no emesis, no stool, possible association with greasy foods LIVER: The liver measures 15.5 cm in length. Echogenicity of the hepatic parenchyma is within normal limits. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.3 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. No evidence of hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture. No evidence of hydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | Male 68 years old Reason: Thyroid nodule. Assess stability. RIGHT LOBE MEASUREMENTS: 2.2 x 2.8 x 6.5 cmLEFT LOBE MEASUREMENTS: 3.8 x 3.3 x 7.1 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Right thyroid lobe is normal background echogenicity. No nodules.LEFT LOBE: Left thyroid lobe has a predominantly cystic nodule with internal septations likely representing a colloid nodule. This nodule is unchanged in size measuring 3.6 x 2.4 x 3.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No regional lymphadenopathy.OTHER: No significant abnormality noted. | Colloid appearing nodule in the left thyroid lobe is unchanged in size and appearance. |
Generate impression based on findings. | VHL status post right nephrectomy; evaluate left renal cysts RIGHT KIDNEY: Status post nephrectomyLEFT KIDNEY: No significant change in numerous left renal cysts. No evidence for worrisome cyst complexity or mass. Largest cyst within the mid pole measures 2.9 x 2.4 x 2.5 cm. No hydronephrosis. Left kidney 14.9 cm in length. OTHER: Bladder nondistended. | No significant change in numerous left renal cysts without evidence for worrisome cysts complexity or mass. No hydronephrosis. |
Generate impression based on findings. | Prostate cancer. Chronic cholecystitis. Chronic kidney disease. Fever. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. An ill-defined 3.4 cm cystic-appearing lesion is noted in the right hepatic lobe. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Pneumobilia is noted, similar to the prior CT. The gallbladder is contracted with gallstones and biliary sludge.PANCREAS: The pancreas is obscured by bowel gas.KIDNEYS: The right kidney is 12.3 cm in length, with a benign-appearing 4.4 cm cyst. The left kidney is 9.1 cm in length, with a benign-appearing 5.7 cm cyst. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is seen.BLADDER: No significant abnormality noted.SPLEEN: 9.1 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent, without significant abnormality noted.INFERIOR VENA CAVA: Patent, without significant abnormality noted.OTHER: No significant abnormality noted. No significant abdominal free fluid is identified. | 1. 3.4 cm cystic-appearing lesion in the right hepatic lobe. Further evaluation with CT is recommended.2. Echogenic renal parenchyma bilaterally, compatible with medical renal disease.Findings and recommendations discussed with the ordering physician by telephone at 3:00 PM on 12/16/2015. |
Generate impression based on findings. | 38-year-old female with nephrotic syndrome. Ultrasound guidance was provided for biopsy of the patient's right kidney. | Ultrasound guidance. |
Generate impression based on findings. | 60-year-old male with HCV and cirrhosis. Evaluate for hepatocellular carcinoma. LIVER: The liver is coarsely echogenic without underlying mass. Overall hepatic size is within normal limits. Morphology is cirrhotic. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: On today's study, no definite gallstones, polyp or significant wall thickening. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Renal cysts.OTHER: Left renal cysts. Splenic size normal. | Stable appearance the liver without mass. |
Generate impression based on findings. | Female 72 years old Reason: thyroid nodules, please assess for changes History: thyroid nodules RIGHT LOBE MEASUREMENTS: 6.8 x 3.6 x 2.0 cmLEFT LOBE MEASUREMENTS: 6.7 x 2.2 x 2.5 centimetersISTHMUS MEASUREMENTS: 1.4 cmRIGHT LOBE: Heterogeneous parenchymal echotexture with multiple cystic and subcentimeter solid nodules. Hypoechoic inferior pulmonary nodule is unchanged in size measuring 0.8 x 1.1 x 0.7 cmLEFT LOBE: Heterogeneous parenchymal echotexture with multiple cystic and septated nodules. Cystic and septated mid thyroid nodules unchanged in size measuring 1.9 x 1.8 x 2.0 cm.ISTHMUS: Cystic isthmus nodule with septations is unchanged in size measuring 2.3 x 3.4 x 1.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are identified.OTHER: No significant abnormality noted. | Enlarged thyroid with multiple cystic nodules with septations bilaterally, which are unchanged in size. No regional lymphadenopathy. |
Generate impression based on findings. | 53-year-old female presents for follow-up of hepatic lesions. LIVER:Measures 14.3 cm. Increased and coarse echogenicity of liver limits evaluation of the parenchyma. Several hypoechoic lesions are noted again on the current study, but definite evaluation of these cannot be performed due to increased echotexture and decreased penetration of ultrasound beam. GALLBLADDER, BILIARY TRACT: The lumen is anechoic. No stones or sludge. The wall measures 2.1 cm. The common hepatic duct is 6.1 cm. No pericholecystic fluid.PANCREAS: Pancreas has uniformly increased echogenicity, compatible with fatty infiltration.SPLEEN: Measures 9.3 cm. No sonographic abnormalities.KIDNEYS: Right kidney is 11.2 cm. Left kidney is 10.2 cm. Cortex disease have normal echogenicity. No shadowing I, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Coarse and increased echogenicity of liver consistent with chronic liver disease/parenchymal dysfunction.2. Several hypoechoic lesions as described above inadequately evaluated on this study. Could be better evaluated with multiphasic CT exam.3. Increased echogenicity of pancreas consistent with fatty infiltration. |
Generate impression based on findings. | Reason: s/p renal and pancreas transplant History: elevated Cr. Ultrasound guidance was provided to the clinical service for biopsy of transplant kidney in right iliac fossa. | Ultrasound guidance for transplant kidney biopsy. |
Generate impression based on findings. | 21-year-old male with right testicular pain to palpation. Evaluate for torsion. RIGHT TESTIS: Measures 5.7 cm x 2.3 cm x 3.6 cm. Normal homogeneous echotexture. No hydrocele. There is appropriate arterial and venous flow present on Doppler exam. LEFT TESTIS: Measures 5.6 cm x 2.6 cm x 3.6 cm. Normal homogeneous echotexture. No hydrocele. There is appropriate arterial and venous flow present on Doppler exam. RIGHT EPIDIDYMIS: Measures 3.9 cm x 1.0 cm x 1.0 cm. Normal echotexture with appropriate flow.LEFT EPIDIDYMIS: Measures 4.9 cm x 1.2 cm x 1.2 cm. Normal echotexture with appropriate flow.OTHER: No significant abnormalities noted. | Unremarkable examination. |
Generate impression based on findings. | 62-year-old male with history of bacteremia. LIVER: Mild amount of perihepatic ascites. The liver is enlarged, measuring 20.5 cm and has the appearance of steatosis. No biliary dilatation or focal masses. Posteroinferior to the liver is an area of increased echogenicity that is either complex fluid or soft tissue, but is incompletely evaluated given the depth of location. This may be further evaluated with CT if clinically indicated.GALLBLADDER, BILIARY TRACT: The gallbladder is decompressed. No biliary dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Increased renal echogenicity, without hydronephrosis or hydroureter. The right kidney measures 11.2 cm.OTHER: Subtle increased echogenicity of the left kidney. The left kidney measures 10.9 cm. No left kidney hydronephrosis. Redemonstration of splenic hypoattenuating foci, nonspecific. | Mild ascites, and hepatic steatosis. Nonspecific splenic lesions are again seen. An area of increased echogenicity posterior to the liver may represent complex fluid versus bowel that is incompletely evaluated due to the depth of this area. Consider contrast enhanced CT if clinically indicated. |
Generate impression based on findings. | Reason: 39 y.o. Male with PTC. Please evaluate RIGHT LOBE MEASUREMENTS: 6.1 x 2.6 x 2.1 cmLEFT LOBE MEASUREMENTS: 6.4 x 2.4 x 2.2 cmISTHMUS MEASUREMENTS: 0.2 cm in the AP dimensionRIGHT LOBE: No significant abnormality noted. No suspicious nodules identified.LEFT LOBE: Large solid nodule with a hypoechoic rim lacks significant vascularity or definite microcalcifications and measures 2.2 x 2.0 x 1.7 cm. No other suspicious nodules identified.ISTHMUS: No significant abnormality noted. No suspicious nodules identified.PARATHYROID GLANDS: None visualized.LYMPH NODES: There are several elongated, benign-appearing bilateral lymph nodes with fatty hila. No suspicious or enlarged cervical lymph nodes.Left level 3 node measures 2.9 x 0.7 x 0.5 cm.Right level 2 node measures 1.7 x 0.8 x 0.2 cm.OTHER: No significant abnormality noted. | Large solid left thyroid nodule highly suspicious for malignancy, consistent with history of biopsy-proven papillary carcinoma. No cervical lymphadenopathy or suspicious cervical lymph nodes. |
Generate impression based on findings. | Thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without worrisome mass. 0.4 x 0.3 x 0.5 cm benign-appearing lymph node within the left thyroidectomy bedISTHMUS: 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. | Renal stones RIGHT KIDNEY: Upper pole stone again noted measuring 0.7 x 0.9 x 0.9 cm. No worrisome mass. No hydronephrosis. Right kidney 11.7 cm in lengthLEFT KIDNEY: Stable nonobstructing left renal stone measuring 1 x 0.5 x 0.5 cm. No worrisome mass. No hydronephrosis. Left kidney 10.4 cm in length.OTHER: Bladder nondistended | Stable nonobstructing bilateral renal stones. |
Generate impression based on findings. | 54-year-old male, rule out HCC LIVER: Coarse echotexture of the liver measuring 15.8 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Focal hyperechoic focus with ring down artifact in the of the gallbladder fundus is again seen and likely representing focal adenomyomatosis. There is an echogenic nonmobile focus along the nondependent wall of the gallbladder likely a gallbladder polyp measuring 4 mm x 4 mm x 5 mm. Common duct measures 4 mm in caliber. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Not well seen due to overlying bowel gas.RIGHT KIDNEY: Measures 10.6 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 9.5 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen is not visualized. | 1. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions.2. Subcentimeter gallbladder polyp along the nondependent portion of the gallbladder wall. 3. Focal adenomyomatosis of the gallbladder is again seen. |
Generate impression based on findings. | Acute on chronic renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10.5 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10.4 cm in lengthOTHER: Bladder nondistended. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | 52-year-old female with right upper quadrant pain and tenderness, palpable cord in the right abdomen. LIVER: Normal echogenicity of the liver measuring 16.5 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickened. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 11.7 cm in length. Cyst at the upper pole measures 1.6 x 1.7-cm x 1.6 cm. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.7 cm in length. Cyst at the lower pole measures 1.4 cm x 1.0 cm x 1.1 cm. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 8.9 cm in length. | Bilateral renal cysts. Otherwise unremarkable examination. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 6.2 x 2.4 x 2.3 cmLEFT LOBE MEASUREMENTS: 6 x 2.3 x 2.6 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Stable right thyroid nodules. Reference inferior pole nodule measures 2.5 x 2.2 x 1.2 cm.LEFT LOBE: Stable spongiform nodules. Reference inferior pole nodule measures 1.7 x 1.2 x 0.8 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. |