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Generate impression based on findings. | Reason: Patient with bilious emesis and RUQ pain, assess liver and biliary system LIVER: The liver measures 16.9 cm in length. The hepatic parenchymal echotexture and echogenicity is normal. There are no focal masses. There is no biliary ductal dilatation. The main portal vein is patent with normal directional hepatopedal flow and waveform, peak velocity 29.3 cm/s.BILIARY TRACT: The gallbladder appears normal. There is no cholelithiasis. The common bile duct measures 5 mm. The common hepatic duct measures 3 mm. The gallbladder wall measures 2 mm.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 9.6 cm in length.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. No hydronephrosis, shadowing stones, or focal masses.LEFT KIDNEY: The left kidney measures 10.3 cm in length. No hydronephrosis, shadowing stones, or focal masses. OTHER: No significant abnormalities noted. | Negative exam. |
Generate impression based on findings. | Elevated LFTs. History stem cell transplant LIMITED ABDOMENLIVER: Coarse echogenic parenchyma again noted without mass. Liver length 18.9 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.1 cm in length RIGHT KIDNEY: No significant abnormalities noted. Right kidney 10.9 cm in lengthOTHER: Left kidney 11.9 cm in length. No ascites. | Echogenic coarse liver echotexture again noted consistent with fatty infiltration/parenchymal dysfunction. Mild hepatomegaly. No worrisome mass lesion or ductal dilatation. Hepatic vessels patent with normal directional flow. No ascites. |
Generate impression based on findings. | Primary hyperparathyroidism with high PTH and calcium RIGHT KIDNEY: Mildly echogenic parenchyma echogenicity without worrisome mass. Multifocal parenchymal based echogenic foci somewhat more conspicuous on the current study. Benign renal cyst. No hydronephrosis or renal stones. Right kidney 11.7 cm in lengthLEFT KIDNEY: Mildly echogenic parenchymal echogenicity without worrisome mass. Multifocal parenchymal base echogenic foci somewhat more conspicuous on the current study. No hydronephrosis or renal stones. Left kidney 11.1 cm in length.OTHER: Bladder nondistended | Interval appearance of mildly increased parenchymal echogenicity with more conspicuous multifocal parenchymal base echogenic foci. Findings raise the possibility of parenchymal dysfunction with nephrocalcinosis without nephrolithiasis or obstruction. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 5.8 x 3.7 x 3.0 cmLEFT LOBE MEASUREMENTS: 6.6 x 2.6 x 2.5 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Spongiform nodules again noted. Dominant nodule slightly increased in size measuring 3.5 x 2.7 x 3.6 cm.; this is in comparison to 3.2 x 2.9 x 2.1 cm on 3/19/2013.LEFT LOBE: Spongiform nodules again noted. Dominant left nodule measures 3.9 x 2.4 x 2.5 cm.; This is in comparison to 3.3 x 1.9 x 1.7 cm on 3/19/2013. This dominant left thyroid nodule now demonstrates a focus of coarse calcification.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval increase in size of bilateral dominant thyroid nodules. Although there has been slight interval increase in size of these nodules, the overall appearance of these nodules still favor colloid nodules. No regional adenopathy. |
Generate impression based on findings. | 81-year-old male with right upper quadrant pain, evaluate for liver or gallbladder pathology. LIVER: Increased hepatic echogenicity without discrete focal lesion.GALLBLADDER, BILIARY TRACT: Cholelithiasis and biliary sludge. No gallbladder wall thickening, pericholecystic fluid, or sonographic Murphy sign. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.KIDNEY: Increased renal echogenicity.OTHER: No significant abnormalities noted. | 1. Cholelithiasis without specific evidence of cholecystitis. 2. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. 3. Increased renal echogenicity consistent with medical renal disease. |
Generate impression based on findings. | Abnormal liver enzymes. History of renal cell carcinoma. Elevated creatinine. LIVER: Non-cirrhotic liver morphology. Coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. The gallbladder is distended with biliary sludge. There is mild gallbladder wall thickening and minimal pericholecystic fluid. No sonographic Murphy's sign is elicited.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 10.1 cm in length. The left kidney is 10.2 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 6.2 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent. 2.8 cm in maximal diameter, without aneurysm.INFERIOR VENA CAVA: Patent.OTHER: Prostatomegaly. Bilateral pleural effusions, partially imaged. | 1. Increased hepatic echogenicity compatible with parenchymal dysfunction, without biliary ductal dilation.2. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease.3. Gallbladder distention, biliary sludge, and mild wall thickening suggestive of cholecystitis in the appropriate clinical setting. |
Generate impression based on findings. | Male 66 years old Reason: eval for thyroid nodules, lymphadenopathy History: hyperthyroidism, L sided nodule on thyroid bed on exam RIGHT LOBE MEASUREMENTS: 8.1 x 3 x 4.8 cmLEFT LOBE MEASUREMENTS: 2 x 2.7 x 2.4 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: There are multiple subcentimeter nodules in the right lobe of the thyroid. Most of them looks sponges. Some of them have nonspecific ultrasound appearance. An index nodule in the upper lobe measures 9 x 6 x 10 mm. LEFT LOBE: There are multiple subcentimeter nodules in the right lobe of the thyroid. Most of them looks sponges. Some of them have nonspecific ultrasound appearance. An index nodule in the upper lobe measures 15 x 6 x 11 mmISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter. Most of the nodules are small and appear benign. |
Generate impression based on findings. | History of thyroid nodules, assess for changes. RIGHT LOBE MEASUREMENTS: 4.5 x 1.4 x 1.7 cm.LEFT LOBE MEASUREMENTS: 3.5 x 1.3 x 1.4 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Normal background parenchymal echotexture. Lower pole partially cystic partially solid nodule without internal vascularity or calcifications measures 1.9 x 1.5 x 1.6 cm, previously 2.1 x 1.7 x 1.7 cm and is of low suspicion for malignancy.LEFT LOBE: Normal background parenchymal echotexture. Upper pole partially cystic nodule without internal vascularity measures 0.6 x 0.3 x 0.4 cm, previously 0.4 x 0.4 x 0.2 cm and remains very low suspicion for malignancy.ISTHMUS: Benign cyst in the isthmus measures 0.9 x 0.8 x 0.9 cm, previously 0.6 x 0.9 x 0.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A few benign morphology lymph nodes are noted.OTHER: No significant abnormality noted. | Right lower pole partially cystic partially solid nodule, low suspicion for malignancy based on ATA guidelines, slightly decreased in size. |
Generate impression based on findings. | Female, 57 years old. Acute renal failure RIGHT KIDNEY: The right kidney measures 10.5 cm in length, with increased cortical echogenicity. An upper pole simple cyst measures 1.4 x 1.1 x 1.0 cm, unchanged. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.6 cm in length, with increased cortical echogenicity. An upper pole cyst measures 1.1 x 0.7 x 0.8 cm, unchanged. A lower pole nonobstructing stone measures 0.8 x 0.8 x 0.4 cm, unchanged. No hydronephrosis.OTHER: The bladder is incompletely distended. | 1.Increased renal cortical echogenicity, compatible with medical renal disease. No hydronephrosis.2.Nonobstructing 8 mm left renal stone. Small bilateral renal cysts, unchanged. |
Generate impression based on findings. | 56-year-old male presents with transaminitis. Evaluate for hepatic pathology. LIVER:Liver measures 15.9 cm. There is increased, coarse echogenicity. No focal mass, ascites, or intrahepatic biliary dilation. The portal vein is patent with hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. The common duct measures 0.5 cm.PANCREAS: Evaluation of the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 8.1 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 11.8 cm. Left kidney measures 12.5 cm. Unremarkable echogenicity. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Increased, coarse echogenicity of liver consistent with chronic liver disease/parenchymal dysfunction. No mass or ascites.2. Surgical changes of prior cholecystectomy. |
Generate impression based on findings. | 55-year-old female with history of thyroid cancer. Evaluate nodule seen in right thyroid bed on prior ultrasound. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Redemonstration of two hypoechoic nodules in the right thyroid bed, the larger measuring 0.6 x 0.4 x 0.2, and the smaller measuring 0.5 x 0.3 x 0.2 cm. These do not appear significantly changed compared to prior studies.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. | No significant interval change in subcentimeter nodules in the right thyroid bed. |
Generate impression based on findings. | 79-year-old male with history of lung cancer, concern for metastasis. Grayscale and color thyroid ultrasound of the left antecubital soft tissues again demonstrates a heterogeneous hypoechoic mass measuring 3.4 x 2.9 x 2.8 cm along the medial aspect, increased in size compared with the prior study. Additionally, there is an adjacent 1.2 x 1.2 x 1.4 cm hypoechoic nodule immediately inferiorly which has not been seen on prior studies. | Interval increase in size of left antecubital mass and development of a new adjacent smaller lesion. |
Generate impression based on findings. | Reason: graves disease History: high T4, tachycardia RIGHT LOBE MEASUREMENTS: 6.3 x 2.9 x 2.4 cm.LEFT LOBE MEASUREMENTS: 6.1 x 2.9 x 2.5 cm.ISTHMUS MEASUREMENTS: Up to 0.4 cm in thickness.RIGHT LOBE: Heterogeneous parenchymal echotexture and increased vascularity. No discrete nodules.LEFT LOBE: Heterogeneous parenchymal echotexture and increased vascularity. No discrete nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Few nonspecific mildly prominent right cervical lymph nodes, may be reactive.OTHER: No significant abnormality noted. | Heterogeneous, enlarged thyroid gland with increased vascularity suggestive of thyroiditis. |
Generate impression based on findings. | 69-year-old male with jaundice, abnormal overlying. Evaluate hepatic and portal vein. LIMITED ABDOMENLIVER: Increased echogenicity of the liver measuring 17.3 cm in length. No focal hepatic lesions.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized.SPLEEN: Enlarged measuring 16.4 cm in length and is normal echogenicity.RIGHT KIDNEY: Measures 11.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.8 cm in length. No hydronephrosis or shadowing calculi are noted. Moderate ascites. | 1. Hepatosplenomegaly with increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Patent hepatic inflow and outflow vasculature.2. Moderate ascites. |
Generate impression based on findings. | 69-year-old with personal history of breast cancer presenting with enlarged right supraclavicular lymph nodes. Ultrasound is requested. Targeted ultrasound is performed for the right supraclavicular region and right neck. There are numerous abnormal enlarged lymph nodes in this region. The largest and most superficial node measures 1.8 x 1.5 cm. Adjacent to the right jugular vein, at least two abnormal morphology are also seen, measuring about 9 mm each. | Multiple abnormal right supraclavicular and jugular lymph nodes. Surgical consultation is recommended, and the patient will be seeing Dr. Jaskowiak today.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 58-year-old male patient with tertiary hyperparathyroidism status post two parathyroidectomies with persistent HPT. Sestamibi scan shows left inferior uptake. Evaluate for thyroid nodule size and location and parathyroid adenomas. RIGHT LOBE MEASUREMENTS: 4.7 x 3.1 x 3.4 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.9 x 2.6 cm.ISTHMUS MEASUREMENTS: 7 mm in thickness.RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity and contains a 0.8 x 0.6 x 0.6 cm hypoechoic nodule within the left inferior pole.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity without dominant thyroid lesion.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: There is a 0.5 x 0.5 x 9 mm hypoechoic nodule inferior to the left inferior pole, which may correlate to a parathyroid adenoma.LYMPH NODES: A right level three lymph node measures 1.4 x 0.7 x 1.1 cm.OTHER: No significant abnormality noted. | 1. No dominant thyroid lesion identified.2. Possible parathyroid adenoma correlate inferior to the left thyroid lobe. |
Generate impression based on findings. | 2-year-old female patient with history of MEN2A presents for presurgery evaluation. Evaluate for suspicious nodules or lymph nodes. RIGHT LOBE MEASUREMENTS: 0.9 x 0.9 x 2.0 cm.LEFT LOBE MEASUREMENTS: 0.9 x 0.6 x 2.2 cm.ISTHMUS MEASUREMENTS: 0.1 cm.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No definitive parathyroid glands are observed.LYMPH NODES: Multiple enlarged lymph nodes are noted bilaterally. A right level III lymph node measures 0.8 x 0.3 x 1.1 cm. A left level II lymph node measures 0.9 x 0.9 x 1.8 cm.OTHER: No significant abnormality noted. | Normal-appearing thyroid gland with multiple enlarged bilateral lymph nodes in the neck. |
Generate impression based on findings. | Female 55 years old Reason: eval liver morphology, r/o thrombosis History: decompensated cirrhosis vs acute liver failure LIMITED ABDOMENLIVER: Nodular and cirrhotic contour of the liver. No focal masses identified. Liver measures 16.8 cm in length.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. No evidence of acute gallbladder inflammation. Bile duct is normal measuring 5 mm. Gallstone is present within the gallbladder measuring 2.8 x 2.8 x 2.9 cm.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 not well-visualized. KIDNEYS: Kidneys are not well-visualized secondary to body habitus and ascites. Left kidney measures 10.7 cm. Right kidney has normal echogenicity measuring 9.8 cm.OTHER: Mild to moderate ascites | 1.Cirrhotic liver morphology without mass. Portal vein is patent with hepatopetal flow, however the flow is sluggish and the caliber is small, which can be seen when a significant portosystemic shunt is present . Mild/moderate ascites2.Cholelithiasis. |
Generate impression based on findings. | Renal transplant with decreased urine output RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: Small perinephric fluid collectionKIDNEY: No worrisome mass or stone. 10.4 cm in lengthCOLLECTING 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 inflow or outflow compromise.OTHER: No significant abnormality noted | Unremarkable right iliac fossa renal transplant. Patent vasculature without inflow or outflow compromise. |
Generate impression based on findings. | Male 63 years old; Reason: Cirrhosis, eval for HCC History: Cirrhosis LIVER: The liver measures 15.3 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 20.8 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.5 mm. No stones are seen. Redemonstrated gallbladder polyp is visualized measuring 0.6 cm x 0.3 cm x 0.6 cm. No pericholecystic fluid. The common bile duct measures 4.7 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 7.8 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.8 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. Coarse echogenic liver compatible with history of cirrhosis. No new worrisome masses seen.2. Redemonstration of small gallbladder polyp, stable stable in appearance but slightly larger than prior exam. |
Generate impression based on findings. | 71-year-old male with known liver mass and abnormal liver function. LIVER: There is again noted a mildly heterogeneous, lobulated and echogenic mass or masses in the right hepatic lobe measuring approximately 7.6 x 10.8 x 10.4 cm, unchanged from prior exam. In the left hepatic lobe there is a similar-appearing 2.1 x 2.6 x 2.1 cm mass not definitely visualized on prior exams. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. However, main portal vein velocity is low at 9 cm/s which may be related to portal hypertension.GALLBLADDER, BILIARY TRACT: Gallbladder is adequately visualized and contains dependent sludge. There are several small echogenic foci within the sludge which may represent very small gallstones.The wall is mildly thickened but this is nonspecific in the face of ascites. No diffuse biliary tract dilatation. PANCREAS: Not visualized due to bowel gas.RIGHT KIDNEY: Limited without hydronephrosis.OTHER: Mild ascites not seen on prior exams. | Large right lobe hepatic masses again identified as well as a smaller left lobe mass.Dependent sludge in gallbladder with possible small stones. Gallbladder wall thickening is seen but nonspecific in face of ascites. |
Generate impression based on findings. | 29-year-old female with abdominal pain. Evaluate for gallstones. LIVER: Normal hepatic echogenicity and morphology. No focal lesions.BILIARY TRACT: No cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No sonographic Murphy sign. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | No cholelithiasis or other findings to account for the patient's symptoms. |
Generate impression based on findings. | 33-year-old male with erythema, pain in left groin. Evaluate for abscess. There is infiltrating fluid and edema of the subcutaneous soft tissues in the left groin compatible with cellulitis. There is a slightly more focal hypoechoic collection measuring 4 mm x 5 mm which could represent a small amount of complex fluid with apparent tract extending to the skin. | Left groin cellulitis with what may represent a small complex fluid collection with apparent tract extending to the skin. |
Generate impression based on findings. | Male; 52 years old. Reason: please evaluate for malignancy or worsening portal HTN (ascites) History: 52 yo M with Hereditary hemochromatosis associated cirrhosis LIVER: The liver measures 20.0 cm in length. The liver is nodular in contour, the parenchyma is echogenic and very coarsened in echotexture. Within this limitation, no focal lesion is identified.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.27 m/sec.BILIARY TRACT: Status post cholecystectomy. The common duct measures 8 mm in diameter. There is no intrahepatic biliary duct dilatation.PANCREAS: The the body of the pancreas are unremarkable. The pancreatic tail is not well-visualized due to overlying bowel gas.SPLEEN: The spleen measures 15.4 cm in length.KIDNEYS: Right kidney measures 13.2 cm in length. The left kidney measures 13.7 cm in length. A 2.5 x 1.5 x 2.2 cm simple cyst is seen in the upper pole of left kidney. There is no hydronephrosis, shadowing renal stone, or worrisome renal mass identified in either kidney. OTHER: A 3.5 x 3.8 x 5.3 cm lymph node is again seen in the region of the pancreatic head. | 1.Cirrhotic liver morphology. Within this limitation no focal lesion is identified.2.5.3-cm lymph node again seen near the pancreatic head, stable. |
Generate impression based on findings. | Nontoxic multinodular goiter. Colloid nodules noted on prior thyroid biopsy. RIGHT LOBE MEASUREMENTS: 4.4 x 1.6 x 1.4 cmLEFT LOBE MEASUREMENTS: 5.5 x 1.5 x 1.0 cmISTHMUS MEASUREMENTS: 0.3 cm in AP dimensionRIGHT LOBE: Unchanged spongiform nodule measuring 10 x 6 x 8 mm.LEFT LOBE: Unchanged heterogeneous nodule measuring 15 x 10 x 12 mm, without suspicious features.ISTHMUS: Unchanged nodule measuring 10 x 13 x 8 mm, without suspicious features.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign appearance of the identified cervical lymph nodes.OTHER: No significant abnormality noted. | Stable thyroid nodules and cervical lymph nodes. |
Generate impression based on findings. | Nontoxic multinodular goiter, history of Hashimoto's RIGHT LOBE MEASUREMENTS: 5.2 x 2 x 2.4 cm, mostly unchanged from prior study, heterogenousLEFT LOBE MEASUREMENTS: 5 x 1.8 x 2 cm, mostly unchanged from prior study, heterogenousISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Heterogenous right lobe nodule predominantly involving the mid portion measures 2.2 x 1.7 x 1.5 cm, unchanged from prior study when it measured 2 x 1.5 x 2.2 cm.LEFT LOBE: Heterogenous left thyroid gland with a small hypoechoic nodule which was not seen on prior study measuring 0.5 x 0.4 x 0.6 cm.ISTHMUS: Heterogenous nodule in the isthmus measures 1.2 x 0.4 x 1.2 cm, mostly unchanged from prior study when it measured 1.1 x 0.4 x 0.8 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Level 1 and level 3 lymph nodes identified in the right lateral aspect of the neck, largest measuring 1 x 0.5 x 1.7 cm, with normal morphology. In the left neck, level 3 lymph node measures 1.4 x 0.3 x 1.3 cm which demonstrates normal morphology.OTHER: No significant abnormality noted. | 1. Heterogenous echotexture of the thyroid gland consistent with known history of Hashimoto's thyroiditis2. Stable right thyroid nodule. A small new subcentimeter left thyroid nodule noted. Follow-up ultrasound can be performed to confirm stability.3. Normal morphology bilateral level 2 and 3 neck lymph nodes noted |
Generate impression based on findings. | Acute acute kidney injury. Limited evaluation due to poor penetration.RIGHT KIDNEY: Right kidney measures 9.8 cm. No suspicious lesion, hydronephrosis or renal calculus identified.LEFT KIDNEY: Left kidney measures 10.1 cm. No suspicious lesion, hydronephrosis or renal calculus identified.URINARY BLADDER: Incompletely distended.OTHER: No significant abnormalities noted. | Limited evaluation due to poor penetration. However, no worrisome hydronephrosis or renal calculi identified. |
Generate impression based on findings. | 66-year-old male with history of elevated creatinine. RIGHT KIDNEY: Measures 11 cm in length. Mild prominence of the right collecting system is not significantly changed compared with prior studies. Increased renal echogenicity without nephrolithiasis or frank hydronephrosis. LEFT KIDNEY: Measures 10.9 cm in length. Increased renal echogenicity without hydronephrosis or nephrolithiasis.OTHER: Mild ascites. | Increased renal echogenicity consistent with medical renal disease. |
Generate impression based on findings. | Hyperparathyroidism, please evaluate for thyroid nodules, size and location and any abnormal lymph nodesBilateral parathyroid nodules and right upper pole thyroid nodule which is previously not been biopsied needs FNA RIGHT LOBE MEASUREMENTS: 5.4 x 1.4 x 1.7 cm, normal echotextureLEFT LOBE MEASUREMENTS: 4.5 x 1 x 1.5 cm, normal echotextureISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: Within the right lobe upper pole there is a solid hypoechoic nodule with a halo around it that measures 1.2 x 0.7 x 0.7 cm with peripheral blood flow.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Small parathyroid nodules bilaterally, on the right measuring 0.7 x 0.3 x 0.3 cm and on the left measuring 1.4 x 0.3 x 0.4 cm.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 1.2 cm hypoechoic right upper lobe thyroid nodule which is previously not been FNA, is amenable to FNA.2. Bilateral parathyroid nodules left more than right |
Generate impression based on findings. | Thyroid nodule RIGHT LOBE MEASUREMENTS: 4 x 1.3 x 1.6 cmLEFT LOBE MEASUREMENTS: No significant abnormality noted.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT 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. | US THYROID, 4/6/2015 9:03 AMCLINICAL INFORMATION:Thyroid noduleCOMPARISON: 7/12/2013 TECHNIQUE: Thyroid ultrasoundFINDINGS:RIGHT LOBE MEASUREMENTS: 4 x 1.3 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.4 x 1.4 x 1.1 cmISTHMUS MEASUREMENTS: Zero .1 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Little significant change in the dominant solid left thyroid nodule now measuring 1.6 x 0.8 x 1 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. |
Generate impression based on findings. | Reason: please eval retroperitoneal and abdominal fluid History: decreasing hgb LIVER: Coarse hepatic parenchymal echotexture and echogenicity, consistent with hepatic steatosis. No biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.RIGHT KIDNEY: Mildly echogenic renal parenchyma. There is no hydronephrosis.OTHER: The left kidney is not visualized due to overlying bowel gas. The spleen appears unremarkable.Extremely limited exam due to suboptimal patient positioning and overlying material external to the patient. There is trace perihepatic ascites. Large left pleural effusion. | 1. Extremely limited exam. Trace ascites. No definite retroperitoneal hematoma.2. Large left pleural effusion.3. Echogenic hepatic parenchyma, consistent with hepatic steatosis.3. Echogenic right renal parenchyma, consistent with medical renal disease. |
Generate impression based on findings. | 90-year-old male with acute kidney failure and urinary tract infection. Evaluate for anatomic abnormalities, hydronephrosis, urinary retention. RIGHT KIDNEY: The right kidney measures approximately 9.5 cm in length. There is a complex cyst arising from the upper pole with a single thin to moderate septation. This was present on the prior study but is slightly larger, measuring 3.1 x 3.4 x 3.1 cm on today's exam. No obvious solid component. 2 other smaller cortical cysts are identified.Echotexture likely slightly increased. No hydronephrosis or shadowing calculus.LEFT KIDNEY: Left kidney is difficult to visualize due to positioning and a large lobulated cyst. The major component of this measures 7.3 x 9.8 x 9.9 cm, significantly increased in size when compared to the prior exam. This may also have a septation or adjacent smaller cyst. Limited visualization of the left kidney demonstrates no gross hydronephrosis.OTHER: Urinary bladder is collapsed with Foley catheter. | Limited exam with mild increase in renal echogenicity. Bilateral cysts with complex cyst upper pole right kidney and very large exophytic cyst arising from the left kidney. |
Generate impression based on findings. | Female 53 years old Reason: Post prandial epigastric pain, exclude pancreaticobiliary process History: Post prandial epigastric pain, exclude pancreaticobiliary process LIVER: The liver measures 16.7 cm in length. The liver is homogeneously mildly echogenic consistent with fatty infiltration. No focal hepatic masses. Main portal vein is patent and has a peak velocity of 26.1 cm/s.BILIARY TRACT: Patient status post cholecystectomy. No intra or extra hepatic biliary ductal dilatation. The common bile duct measures 4.9 mm, within normal limits.PANCREAS: The tail of the pancreas is obscured by overlying bowel gas. The head of the pancreas is normal in appearance.SPLEEN: The spleen measures 11.5 cm and is normal in echogenicity.RIGHT KIDNEY: The right kidney measures 12.5 cm and has normal echogenicity. No hydronephrosis. No shadowing calculi. No mass.LEFT KIDNEY: The left kidney measures 12.7 cm and has normal echogenicity. No hydronephrosis. No shadowing calculi. No mass.OTHER: No significant abnormalities noted. | 1.No intra or extrahepatic biliary ductal dilatation. Head of the pancreas is within normal limits.2.Fatty infiltration of the liver. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are:Right breast ultrasound with postprocedure mammogram dated 9/28/16 performed at Lynn Sage breast CenterBilateral screening mammogram dated 2/29/2016 with tomo synthesis is available for comparison. Also available are prior mammograms dated 3/11/2015 and 3/10/2014 and 2/18/2013. Right breast ultrasound with postprocedure mammogram dated 9/28/16: Patient presented with a new palpable mass in the right breast.Ultrasound evaluation demonstrated 2 adjacent contiguous masses in the right outer breast for which ultrasound-guided biopsy was recommended.8 mm mass and the adjacent lobulated 17 mm mass at the 9:30 o'clock position of the right breast were targeted under ultrasound. A twirl clip was deployed at the biopsy site. Postprocedure mammogram demonstrates the clip at the site of the mass in the right outer breast.Pathology report revealed right breast 18 mm mass 9:30 o'clock position 3 cm from the nipple, IDC grade 3, largest tumor fragment measures 0.7 cm, microcalcifications overlying blood vessels. This is concordant.As per the report right unilateral diagnostic mammogram with ultrasound was performed on 9/28/2016 before performing the biopsy which have not been submitted. | Biopsy-proven multifocal cancer in the right breast 9:30 o'clock position. Given the dense breast, breast MRI is recommended for staging.Right unilateral diagnostic mammogram and ultrasound performed before biopsy should be submitted for review.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Precardiac transplant LIVER:Mildly heterogeneous liver echotexture without mass. Liver length 14.4 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. 10.6 cm in lengthKIDNEYS: No significant abnormality noted. Right kidney 11.5 cm in length; left kidney 10.8 cm in lengthABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. No ascites | Mildly heterogeneous liver echotexture suggestive for chronic liver disease without mass or ductal dilatation. Gallbladder sludge without acute inflammation. No ascites. |
Generate impression based on findings. | Polycystic disease RIGHT KIDNEY: Numerous cysts of varying sizes. No worrisome complexity within a cyst appreciated. The largest cyst measures 7.6 x 9.8 x 6.8 cm. No worrisome mass, stone, or hydronephrosis. Right kidney 24.3 cm in lengthLEFT KIDNEY: Numerous cysts of varying sizes. No worrisome complexity within the cyst appreciated. The largest cyst measures 7.6 x 4.7 x 6.6 cm. No worrisome mass or hydronephrosis. Possible subcentimeter nonobstructing left renal calculi. Left kidney 24.1 cm in length.OTHER: Bladder nondistended. | Numerous bilateral renal cysts consistent with known polycystic disease. No worrisome cyst complexity or mass. Possible subcentimeter nonobstructing left renal calculi. No hydronephrosis. |
Generate impression based on findings. | Female, 77 years old. Left renal mass seen on CT RIGHT KIDNEY: The right kidney measures 8.4 cm in length, with increased cortical echogenicity. A mid to upper pole simple cyst measures 1.0 x 1.2 x 1.2 cm. No hydronephrosis.LEFT KIDNEY: The left kidney measures 12.1 cm in length, with normal echotexture. A 2.2 x 2.3 x 1.9 cm lower pole hypoechoic structure appear cystic. No hydronephrosis.OTHER: No significant abnormalities noted. | 1. The structure seen in the left lower renal pole on recent CT imaging corresponds with a simple cyst.2. Increased renal cortical echogenicity suggests medical renal disease. No hydronephrosis. |
Generate impression based on findings. | 65-year-old female with history of ulcerative colitis, new onset pruritis, elevated alkaline phosphatase. LIVER: The liver measures 16 cm in length. Patchy increased hepatic echogenicity without discrete focal lesion or intrahepatic biliary ductal dilation.BILIARY TRACT: No cholelithiasis or evidence of cholecystitis. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | 1. Patchy increased hepatic echogenicity consistent with hepatic steatosis.2. No superimposed focal hepatic lesion or biliary ductal dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 57-year-old male with primary hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 5.6 x 2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Homogeneous without evidence for mass.LEFT LOBE: Homogeneous without evidence for mass.ISTHMUS: Homogeneous without evidence for mass.PARATHYROID GLANDS: No extrathyroidal masses are identified.LYMPH NODES: No abnormal lymph nodes are identified.OTHER: No significant abnormality noted. | Normal exam without evidence for parathyroid adenoma. |
Generate impression based on findings. | 68-year-old male patient with advanced heart failure secondary to ICM, thrombocytopenia. Also with history of ulcerative colitis. Evaluation for heart transplant and exploration of thrombocytopenia. LIVER:The liver measures 17.6 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/s.GALLBLADDER, BILIARY TRACT: No gallstones, gallbladder wall thickening, or pericholecystic fluid is identified. The common duct measures 4 mm in diameter.PANCREAS: The pancreas is poorly visualized examination.SPLEEN: The spleen measures 12.3 cm in length.KIDNEYS: The right kidney measures 9.9 cm and the left kidney measures 10.7 cm in length. No evidence of hydronephrosis. ABDOMINAL AORTA: The proximal abdominal aorta measures 1.8 x 1.7 cm and the distal aorta measures 1.7 x 1.5 cm. The midportion of the abdominal aorta is obscured by overlying bowel gas.INFERIOR VENA CAVA: The IVC is patent.OTHER: No significant abnormality noted. | 1. No acute sonographic abnormality within the abdomen.2. Poor visualization of the mid-abdominal aorta. |
Generate impression based on findings. | Female 33 years old follow-up right renal mass (1.3 cm), stable on MRI. RIGHT KIDNEY: The right kidney measures 10.5 cm in length. There is a 1.6 x 1.6 x 1.4 cm hypoechoic lesion in the midpole of the right kidney with low-level internal echoes and no vascularity. The superior pole of the right kidney appears heterogeneous which may be due to a prominent medullary pyramid. No lesion was present at this location on the prior MRI. No shadowing renal stone hydronephrosis.LEFT KIDNEY: The left kidney measures 11.4 cm in length. There is no suspicious renal mass, shadowing renal stone or hydronephrosis.OTHER: The bladder was mildly distended and unremarkable in appearance.A 2.4 x 1.5 x 1.9 cm well marginated hyperechoic subcapsular hepatic segment 7 lesion which correlates with a hemangioma seen on the previous MRI. | 1. Right midpole renal lesion is likely unchanged in size from the prior MRI after allowing for differences in technique.2. The superior pole of the right kidney appears heterogeneous which is nonspecific and may be due to a prominent medullary pyramid. No lesion was present at this location on the prior MRI. |
Generate impression based on findings. | 60-year-old male with history of renal transplant presents with AKI. RENAL TRANSPLANT: Measures approximately 11.9 cm. There is a heterogenous echotexture of the parenchyma with poor corticomedullary differentiation.LOCATION: Left iliac fossa.PERITRANSPLANT TISSUES: Small amount of perinephric fluid measuring approximately 5.8 x 1.4 x 1.9 cm.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: The bladder is nondistended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels The left renal artery anastomosis area has a peak systolic flow of 93.2 cm/s and resistive index of 0.84.The mid renal artery had a peak systolic flow 102 cm/s and a resistive index of 0.88.The hilum had a peak systolic flow of 65 cm/s with a resistive index of 0.94.The mid segmental artery had a peak systolic flow 110 cm/s the resistive index of 1.0The mid arcuate artery has a peak systolic flow 35 cm/s resistive index of 1.0.The renal vein is patent without evidence of thrombus.OTHER: No significant abnormality noted | 1. Heterogenous echotexture parenchyma and increased resistive indices of the arcuate and segmental arteries most consistent with parenchymal dysfunction. Consider acute tubular necrosis or rejection. Renal vein thrombosis less likely given the renal vein is patent.Findings were discussed with Dr. Wright @ 2250 on 08/21/16 by the on call radiology resident. |
Generate impression based on findings. | 49-year-old female post resection of mediastinal thyroid and left lobe, with papillary thyroid microcarcinoma. RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.7 cm. No change in 5 mm cyst.LEFT LOBE MEASUREMENTS: Post thyroidectomy. ISTHMUS MEASUREMENTS: Not measurable on today's examRIGHT LOBE: No change in 5 mm cyst.LEFT LOBE: No massesISTHMUS: Not visible on today's study.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is again noted an enlarged subclavicular lymph node on the left measuring 1 x 1.4 by 2 cm, not significantly changed.OTHER: No significant abnormality noted. | Stable examination with resolution of thickened isthmus. Stable left subclavicular lymph node. |
Generate impression based on findings. | Pulsatile nodule in the right thyroid, needs follow-up RIGHT LOBE MEASUREMENTS: 3.7 x 1.2 x 1.5 cm heterogenous echotexture, atrophicLEFT LOBE MEASUREMENTS: 4.3 x 1.2 x 1.1 cm, heterogenous echotexture, atrophicISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Right mid pole there is a heterogenous hypoechoic nodule that measures 0.6 x 0.3 x 0.5 cm, unchanged from prior examination.LEFT LOBE: Heterogenous and atrophic glandISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Stable right mid thyroid lobe subcentimeter nodule2. Atrophic and heterogenous thyroid gland seen in the setting of thyroiditis. |
Generate impression based on findings. | 42-year-old female with history of follicular thyroid cancer post thyroidectomy. RIGHT LOBE MEASUREMENTS: AppendectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: Previously noted nodular density in the right bed no longer identified.LEFT LOBE: Small hypoechoic nodular density in the left bed is again identified measuring 0.2 x 0.3 x 0.5 cm, unchanged in size. This may contain a single calcification. Cranial to this there is a 0.3 x 0.4 x 0.5 cm hypoechoic nodule with dense calcification. There is a suggestion that this was present on the prior exam although incompletely visualized.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes on the right. There is again noted at level 3 on the left a 0.4 x 0.7 x 0.5 cm node with dense calcification which is unchanged in size and appearance when compared to prior exam.OTHER: No significant abnormality noted. | 1. No change in small hypoechoic left bed nodule. Right bed nodule not identified.2. Left bed nodule with calcification, which may have been present on prior exam.3. Stable left neck lymph node with calcification. |
Generate impression based on findings. | Viral hepatitis C and right renal cyst LIVER: Mildly coarse liver echotexture without worrisome mass. Liver length 14.9 cm. Benign-appearing right lobe hepatic cyst unchanged.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Stable minimally complex right renal cyst measuring 2.6 x 3 x 2.7 cm. Right kidney 12.8 cm in length.OTHER: Left kidney 11.7 cm in length. Spleen 8.7 cm in length. No ascites. | Mildly coarse liver echotexture suggestive for chronic liver disease without worrisome mass or ductal dilatation. No ascites. Stable minimally complex right renal cyst. |
Generate impression based on findings. | Reason: Evaluate for biliary pathology History: epigastric pain LIVER: Mild hepatomegaly with coarse echotexture. The liver measures 19 cm in length. The portal vein is patent. Normal hepatopedal portal venous blood flow, 21.6 cm/s.GALLBLADDER, BILIARY TRACT: Layering intraluminal sludge in the dependent portion of the gallbladder. No pericholecystic fluid, stones, or biliary ductal dilation. The gallbladder wall measures 2 mm. The common hepatic duct measures 4 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 12.0 cm.LEFT KIDNEY: The left kidney measures 11.2 cm. 3.0 x 3.9 cm x 3.7 anechoic cyst in the inferior pole of the left kidney.SPLEEN: The spleen measures 9.0 cm.OTHER: Small left pleural effusion. | Mild hepatomegaly and gallbladder sludge without other acute biliary pathology. |
Generate impression based on findings. | Pyelonephritis. UTI. RIGHT KIDNEY: 9.4 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis. No perinephric fluid collections.LEFT KIDNEY: 10.5 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis. No perinephric fluid collections.BLADDER: Debris is noted within the bladderOTHER: No significant abnormality noted. | No sonographic evidence of pyelonephritis or renal abscess. Nonspecific debris or clot noted within the bladder, correlation with patient's clinical history/urinalysis recommended. |
Generate impression based on findings. | 33-year-old female with history of left breast DCIS status post lumpectomy, followed by radiation and tamoxifen presents for six-month follow-up of probably benign right breast mass. A targeted right ultrasound was performed for the previously described area of concern.In the right breast, 5:00, 8 cm from the nipple, there is a 1.1 x 0.5 x 1.1 cm oval circumscribed hypoechoic mass, previously 1 x 0.5 x 1 cm. This mass demonstrates no internal vascularity. | No significant interval change in a right breast mass at the 5:00 position, which is probably benign given morphology and stability over time. Six-month follow-up right breast ultrasound is recommended to evaluate for stability. Patient will be due for bilateral mammogram at that time.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 67 years old, Female, Reason: Eval for cirrhotic morphology of liver History: Low VItamin K LIVER: The liver measures 14.4 cm in length. The liver is echogenic consistent with a fatty infiltration. Multiple focal hepatic lesions are indeterminate on this ultrasound exam. Largest hypoechoic lesion in the right hepatic lobe measures 1.2 x 1.1 x 0.9cm. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is nondistended. 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: The spleen is not well-visualized on this exam.RIGHT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. No hydronephrosis. Shadowing catheter was present within the right kidney.LEFT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1. The liver is echogenic consistent with fatty infiltration.2. No nodularity to suggest cirrhosis.3. Multiple hypoechoic lesions within the liver which are indeterminate on this exam. Dedicated liver follow-up imaging is recommended.Findings discussed with Dr. Minic at time of dictation. |
Generate impression based on findings. | Obstruction of bile duct, malignant neoplasm of the pancreas. Evaluate for jaundice On call after hours exam performed.LIVER: The liver measures 16.1 cm in length. No focal liver lesions. Presumed pneumobilia is noted making evaluation of the intrahepatic bile ducts somewhat limited. These appear to be mildly dilated. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Gallbladder sludge and wall thickening. Patient did not have a sonographic Murphy sign. The common duct measured 5 mm in diameter; metal stent noted.PANCREAS: There is a mass in head of the pancreas measuring approximately 3.8 cm in diameter. Pancreatic duct appears dilated Correlation with cross-sectional imaging is advised.RIGHT KIDNEY: No hydronephrosis of either kidney.OTHER: Right pleural effusion. | Pancreatic mass with mild intrahepatic and pancreatic ductal dilatation. Correlation with CT or MRI is advised. Right pleural effusion. Gallbladder sludge. |
Generate impression based on findings. | 32 year-old female with hyperthyroidism. RIGHT LOBE MEASUREMENTS: 3.2-cm x 6.4 cm x 2.5 cmLEFT LOBE MEASUREMENTS: 2.9 cm x 5.8 cm x 2.5 cmISTHMUS MEASUREMENTS: 1.0-cm in thickness.RIGHT LOBE: Markedly heterogeneous in echotexture and hypervascular. No discrete nodules are identified. LEFT LOBE: Markedly heterogeneous in echotexture and hypervascular. No discrete nodules are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Multiple bilateral benign-appearing lymph nodes likely reactive.OTHER: No significant abnormality noted. | Enlarged, heterogeneous and hypervascular thyroid gland, appearance consistent with thyroiditis. Multiple likely reactive lymph nodes in the neck. |
Generate impression based on findings. | 71-year-old male with a history of scrotal pain. RIGHT TESTIS: The right testis is normal in morphology, echogenicity, and size, measuring 3.2 x 2.4 x 4.6 cm. Spectral Doppler evaluation demonstrates arterial blood flow. There is a small 2 mm cyst.LEFT TESTIS: The left testis is normal in morphology, echogenicity and size measuring 3.2 x 2.0 x 4.8 cm. Spectral Doppler demonstrates arterial blood flow.RIGHT EPIDIDYMIS: Normal in size and appearance and contains a 2.2-cm head cyst. 4-mm epididymal body cyst. 1.5-cm epididymal tail cyst. Coarse calcification adjacent to the epididymal tail.LEFT EPIDIDYMIS: Normal in morphology, echogenicity, and size without hypervascularity.OTHER: Bilateral varicoceles and small hydroceles. | Bilateral varicoceles and small hydroceles. No acute epididymal or testicular abnormality. |
Generate impression based on findings. | Neck discomfort RIGHT LOBE MEASUREMENTS: 6.1 x 2.3 x 3.4 cmLEFT LOBE MEASUREMENTS: 5 x 2.3 x 2.5 cmISTHMUS MEASUREMENTS: 1.7 cmRIGHT LOBE: Diffusely heterogeneous and enlarged right thyroid gland with increased vascularity. No convincing discrete nodule could be appreciated.LEFT LOBE: Diffusely heterogeneous enlarged left thyroid gland with increased vascularity. No convincing discrete nodule could be appreciatedISTHMUS: Diffusely heterogeneous enlarged isthmus with increased vascularity without convincing discrete nodulePARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous enlarged thyroid gland with increased vascularity. Findings suggestive for thyroiditis or Graves. No convincing discrete nodule. No regional adenopathy. |
Generate impression based on findings. | The patient submitted outside mammogram dated 12/18/12, 12/14/11. Submitted outside study was compared to the current mammogram dated 2/16/15. A 1.0 cm mass in the left upper outer breast is new when compared to the prior studies. Recommend ultrasound guided needle biopsy for this mass. | A 1.0 cm mass in the left upper outer breast is new when compared to the prior studies. Recommend ultrasound guided needle biopsy for this mass.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 30 years Female with left flank pain and dysuria, evaluate for pyelonephritis. RIGHT KIDNEY: Kidney measures 13.4 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 14 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.BLADDER: No significant abnormalities. OTHER: No significant abnormalities. | Normal examination. |
Generate impression based on findings. | 44-year-old female with thyroid enlargement. RIGHT LOBE MEASUREMENTS: 5.9 x 1.6 x 2.1 cmLEFT LOBE MEASUREMENTS: 5.4 x 1.6 x 2 cmISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: In the inferior right lobe of the thyroid there is a complex nodule with small cystic spaces measuring 1.3 x 0.7 x 0.9 cm most suggestive of colloid nodule.LEFT LOBE: In the inferior left lobe of the thyroid there is a complex nodule with small cystic spaces measuring 0.6 x 0.4 x 0.7 cm most suggestive of colloid noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Small, bilateral thyroid nodules likely colloid nodules. |
Generate impression based on findings. | Abdominal pain with history of chronic viral hepatitis and hepatocellular carcinoma LIVER: Coarse echogenic liver echotexture again noted. Known hepatic mass lesion not well demonstrated on ultrasound. Porta hepatis infiltrative tumor and adenopathy again noted. Thrombosed undivided left portal vein again noted. Liver length 18.8 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.4 cm in lengthOTHER: Left kidney 11.6 cm in length. Spleen 14 cm in length. No ascites | Coarse echogenic liver parenchyma again noted consistent with chronic liver disease. Known hepatic mass lesion is not well appreciated on today's ultrasound. Porta hepatis infiltrative tumor and adenopathy unchanged. Thrombosed undivided left portal vein again noted. No ascites. |
Generate impression based on findings. | Female 64 years old; Reason: history of thyroid nodules, please evaluate for interval changes History: none RIGHT LOBE MEASUREMENTS: 5.0 x 1.7 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.6 x 1.2 x 1.4 cm.ISTHMUS MEASUREMENT: 0.5 cm.RIGHT LOBE: Again seen is a hypoechoic nodule in the right lobe of the thyroid measuring approximately 0.9 x 0.4 x 0.4 and it appears unchanged from the prior study. No significant vascularity or microcalcifications. Additionally, there is a 0.5 cm cyst that appears similar to the prior study.LEFT LOBE: Mildly heterogenous without discrete nodule.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious adenopathy noted. OTHER: No significant abnormality noted. | 1.Grossly stable right thyroid nodule and cyst. |
Generate impression based on findings. | Targeted ultrasound of the right upper breast at 1:00 and 11:00 is requested by the clinical service. Personal history of known right breast cancer. A targeted right ultrasound was performed for the areas requested at 1:00 and 11:00. Multiple masses are seen in the right upper breast. Two adjacent masses in the right breast near the 1:00 position measure 9 x 7 and 9 x 8 mm. Overall extent of these 2 masses near 1:00 is 2.4 cm, a slightly larger extent than can be measured on the prior study. An additional possible superficially located mass near the right 1:00 scar measures 7 mm. Additionally, an area of hypodensity and shadowing near the right breast 11:00 scarring is nonspecific, though similar to the prior study. | Multiple right upper breast masses as described above compatible with known malignancy. Treatment recommendations have been made by the breast surgery team.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female 54 years old Reason: evaluate for left buttock abscess History: left buttock pain, lesion, swelling There is diffuse edema of the subcutaneous fat and thickening of the skin in the region of the left buttock lesion where it's tender. No evidence of abscess. | Ultrasound findings compatible with cellulitis without evidence of abscess. |
Generate impression based on findings. | 43-year-old male with HBV, NASH, evaluate for HCC. LIVER: Measures 16.2 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. |
Generate impression based on findings. | Male, 79 years old. Elevated creatinine RIGHT KIDNEY: The right kidney measures 11.7 cm in length, with increased cortical echogenicity. An upper pole exophytic simple cyst measures 2.1 x 1.9 x 1.9 cm. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 12.8 cm in length, with increased cortical echogenicity. An exophytic lower pole simple cyst measures 3.4 x 2.6 x 3.4 cm. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. | 1.Increased renal cortical echogenicity compatible with medical renal disease.2.Bilateral renal cysts. |
Generate impression based on findings. | 71-year-old male with biopsy demonstrating "suspicious for follicular neoplasm" in the right lobe of the thyroid. Evaluate thyroid preoperatively. RIGHT LOBE MEASUREMENTS: 2.3 x 2.5 x 4.7 cmLEFT LOBE MEASUREMENTS: 1.5 x 1.8 x 5.5 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Within the right lobe of the thyroid posteriorly there is an unusually shaped and well-demarcated heterogeneous but hypoechoic mass with several small bright reflectors which could represent calcification. It is difficult to determine whether this is predominantly intra or extra thyroidal, and the mass corresponds to the outside biopsy.LEFT LOBE: No significant abnormality noted.ISTHMUS: In the left isthmus there is dense, shadowing calcification. No obvious mass although a mass posterior to the shadowing can't be excluded.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mass involving the right lobe of the thyroid although this could be arising from an extrathyroidal location.Dense calcification without obvious mass involving the left isthmus.No mass identified within the left lobe and no adenopathy. |
Generate impression based on findings. | 38-year-old female with right breast cancer. Evaluate right axilla. A targeted right ultrasound was performed of the right axilla. Few short axis subcentimeter lymph nodes are present, with normal morphology. No suspicious lymph node or mass identified. | No abnormal lymph node or mass identified within the right axilla. Known right breast cancer not evaluated. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 70 year-old male with acute kidney injury and possible urinary tract infection. RIGHT KIDNEY: The right kidney measures 12.6 cm in length. There is moderate hydronephrosis and moderate proximal hydroureter. The middle and distal ureter is not visualized. No shadowing calculus or focal renal lesion is evident. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 11.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is partially distended with anechoic urine. Ureteral jetsOTHER: No significant abnormalities noted. | Moderate right hydroureteronephrosis of uncertain chronicity and etiology.Findings were relayed to primary service (Anderson @ pager 6918) at 1415 on 01/07/2015. |
Generate impression based on findings. | 58-year-old male patient with right upper quadrant pain, hepatic dysfunction, and hepatitis C. Altered mental status, LFT abnormalities. LIVER: The liver measures 20.5 cm in length and demonstrates increased hepatic parenchymal echogenicity. There are regions of relatively well-demarcated hypoechogenicity within the right hepatic lobe. The largest measures approximately 5.7 x 3.7 cm. Additional smaller ill-defined areas are noted. Main portal vein flow is hepatopetal and measures 0.6 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder wall is diffusely thickened with obliteration of the lumen. No shadowing gallstone is identified. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 8 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.7 cm in length. No evidence of hydronephrosis.The spleen measures 11.6 cm in length.There is mild ascites. | 1. Increased hepatic parenchymal echogenicity consistent with hepatic steatosis with regions of hypoechogenicity which may represent focal fatty sparing, however, are incompletely evaluated on this examination. MRI is recommended for further evaluation.2. Diffusely thickened gallbladder wall of uncertain etiology; MRI is recommended for further evaluation. 3. Mild ascites. |
Generate impression based on findings. | 51-year-old female complains of recurrent abdominal pain. Evaluate biliary system. LIVER:The liver measures 15.3 cm. Mildly increased echogenicity of the parenchyma. No focal masses, intrahepatic biliary dilation, or ascites. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. The common bile duct measures 6.7 mm.PANCREAS: Evaluation the pancreas limited due to overlying bowel gas.SPLEEN: Measures 9.3 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.7 cm. Left kidney measures 11.4 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, or focal masses. OTHER: No significant abnormality noted. | 1. Mildly increased echotexture of liver consistent with chronic liver disease/parenchymal dysfunction.2. Surgical changes of a prior cholecystectomy. |
Generate impression based on findings. | 45 years old, Female, Reason: eval for medical renal disease History: rising Cr, hematuria, protenuria RIGHT KIDNEY: Kidney measures 12.1 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. Mild pelvicaliectasis is present.LEFT KIDNEY: Kidney measures 11.2 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis, shadowing calculus or mass.BLADDER: The bladder is incompletely distended. OTHER: Note is made of a mildly increased echogenicity to the liver which is consistent with fatty infiltration. | 1.Increased echogenicity of the kidneys consistent with medical renal disease. 2.Mild pelvicaliectasis on the right.3.Increased echogenicity of the liver is consistent with fatty infiltration. |
Generate impression based on findings. | 49 year-old male with transaminase elevation and history of alcohol abuse. Evaluate for biliary distention or liver abnormality. LIVER: Increased echogenicity of the liver, suggestive of hepatic steatosis. The portal vein flow is hepatopetal. The liver contour is smooth.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The common duct measures 4 mm in diameter. No gallstones or common duct stones are seen.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Increased echogenicity of the liver, suggestive of hepatic steatosis/parenchymal dysfunction. Otherwise, unremarkable ultrasound examination of the right upper quadrant. |
Generate impression based on findings. | 57 year-old female with a history of gradual increase in abdominal appearance. Rule out ascites. LIVER: Mild hepatomegaly. Increased echogenicity if the liver is nonspecific but can be seen in hepatic steatosis. The liver measures 17.4 cm in length. The liver contour is smooth. Portal vein flow is hepatopetal.BILIARY TRACT: Note is made of a 1.4 cm dependent gallstone in the body of the gallbladder without evidence of acute cholecystitis.PANCREAS: The pancreas is partially obscured by overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Note is made of a 4.9 x 4.8 x 4.2 cm cyst in the superior pole of the left kidney, with associated septation and peripheral nodularity. There is no internal vascularity.OTHER: No significant abnormalities noted. | 1. No evidence of ascites, as clinically questioned.2. Complex cyst in the left kidney with peripheral nodularity and septation. Further evaluation with a dedicated renal CT protocol is recommended.3. Mild hepatomegaly. Increased echogenicity if the liver is nonspecific but can be seen in hepatic steatosis. 4. Gallstones without evidence of acute cholecystitis. |
Generate impression based on findings. | Female 50 years old Reason: eval for causes of abdominal pain including pancreatitis History: lipase elev, abd pain LIVER: Intrahepatic biliary ductal dilatation is present. The liver has normal echogenicity. There is a large simple appearing central cyst measuring 3.7 x 3.7 x 3.5 cm, not significant changed in size. Liver measures 19.3 cm. Main portal vein is patent with a peak velocity of 19.1 cm/s.BILIARY TRACT: Patient is status post cholecystectomy. The common bile duct is 4 mm. Intrahepatic biliary ductal dilatation. No choledocholithiasis is identified.PANCREAS: Small cyst in the head of the pancreas measuring 0.7 x 0.9 x 0.8 cm is not significant changed. There is a new cyst is identified in the tail the pancreas measuring 1.7 x 2.6 x 1.7 cm.SPLEEN: The spleen measures 9.9 cm and is normal in echogenicity.KIDNEYS: Right kidney measures 10.9 cm. Small hyperechoic lesion measuring 0.5 x 0.5 x 0.5 cm likely representing an angiomyolipoma in the right kidney. Right exophytic renal cyst is not significant change in size measuring 1.2 x 1.0 x 1.1 cm. No hydronephrosis or shadowing calculi bilaterally.Left kidney measures 10.6 cm. No hydronephrosis, shadowing calculi, or mass.OTHER: Trace ascites. | 1.Unchanged liver cysts and intrahepatic biliary duct dilatation.2.Multiple cysts in the pancreas, one of which is new from the prior study. Recommend CT which would further characterize the cysts in the pancreas as well as more likely characterize the renal lesions.3.Renal cysts. |
Generate impression based on findings. | Reason: On CT of neck/chest, 1.9cm lesion just inferior to midline of thyroid History: Above RIGHT LOBE MEASUREMENTS: 4.1 x 1.3 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.0 x 1.4 cm.ISTHMUS MEASUREMENTS: 0.5 cm.RIGHT LOBE: Heterogeneous thyroid echotexture without discrete nodules or masses.LEFT LOBE: Heterogeneous thyroid echotexture without discrete nodules or masses.ISTHMUS: Heterogeneous thyroid echotexture without discrete nodules or masses.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No cervical adenopathy.OTHER: 1.9 cm lesion inferior to the thyroid seen on CT is not visualized on this ultrasound examination. | Heterogeneous thyroid echotexture. 1.9 cm lesion inferior to the thyroid seen on CT is not visualized on this ultrasound examination. |
Generate impression based on findings. | 44-year-old who presents for stability assessment of the left breast cyst. A targeted left ultrasound was performed for the area of concern. The previously identified cysts in the left breast 12:00 position are again seen. The smaller of these is located 3 cm from the nipple and measures 3 x 3 mm. The larger of these is located 2 cm from the nipple and measures 9 x 8 mm. There is no solid mass identified. | No sonographic evidence for malignancy. Left breast cysts. Based on the patient's mammographic density, she would qualify for automated whole breast ultrasound if clinically desired. Annual screening mammography is due in March 2016. BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Left breast mass consistent with fibroadenoma on ultrasound December 2015. Follow-up. A targeted left ultrasound was performed for the patient’s area of concern. A circumscribed, hypoechoic, oval mass is identified within the left breast at 6:00 location, 2 cm from the nipple, and measures 2.4 x 1.8 x 1.8 cm, not significantly changed. There is no internal vascularity or posterior shadowing. | No significant change in the circumscribed mass in the left breast, which is probably a fibroadenoma. The patient will see Dr. Jaskowiak for clinical follow up today.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Elevated INR, evaluate for cirrhosis. LIVER: The liver is enlarged and measures 20.2 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameterPANCREAS: Poorly visualized due to overlying bowel gas.SPLEEN: The spleen measures 14.6 cm in length and is heterogeneous in echotexture. Peripheral areas of low attenuation on the 11/17/2015 CT are nonspecific but raise the possibility of splenic infarcts.RIGHT KIDNEY: Kidney measures 13.8 cm in length. Normal echotexture. No hydronephrosis or mass. Two simple cysts are present in the right kidney the largest of which measures up to 3.9 cm.LEFT KIDNEY: Kidney measures 14.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: Bilateral pleural effusions. | 1.Hepatomegaly and coarsened hepatic echotexture suggesting liver disease without specific morphologic features of cirrhosis.2.Heterogeneous splenic echotexture nonspecific but raising possibility of splenic infarcts.3.Bilateral pleural effusions. |
Generate impression based on findings. | Suprapubic pain for one year ABDOMINAL WALL: No significant abnormalities are noted. No hernia is seen. No intra-abdominal fluid is seen.BLADDER: The bladder is visualized without abnormality. The prostate appears enlarged. | Negative bladder and suprapubic ultrasound. |
Generate impression based on findings. | 64-year-old male with history of right upper quadrant pain. LIVER: Increased hepatic echogenicity without discrete focal lesion.GALLBLADDER, BILIARY TRACT: Cholelithiasis without gallbladder wall thickening, pericholecystic fluid, or sonographic Murphy sign. No biliary ductal dilation.PANCREAS: Pancreas is obscured by bowel gas and not clearly visualized.KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without specific evidence of acute cholecystitis.2.Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal dysfunction. |
Generate impression based on findings. | 71 year old female with a personal history of right breast DCIS/IDC status post mastectomy in 2005 with adjuvant Arimidex therapy. She had a recent US-guided biopsy of right axillary mass on 5/28/2015 complicated by hematoma formation. Evaluate for axillary lymph nodes and hematoma. Upon physical exam, the right axillary region appeared normal without discoloration or swelling. Targeted ultrasound of the right axilla demonstrated near interval resolution of previously demonstrated hematoma now measuring 0.4 x 0.4 cm, previously 3.6 x 2.3 x 1.5 cm. There is no overlying skin thickening or parenchymal edema. There is no appreciable lymph nodes. Note that no biopsy clip was placed at the time of axillary biopsy. | Near interval resolution of right axillary hematoma without evidence of lymph nodes. |
Generate impression based on findings. | 76 are old female with ovarian carcinoma and abnormal liver function. LIVER: Liver is normal in size. There is marked parenchymal heterogeneity in the right lobe, with superficial complex cystic masses consistent with implants, as well as poorly defined, hyperechoic parenchymal lesions in the right lobe . Findings are consistent with progressive metastatic disease to liver.GALLBLADDER, BILIARY TRACT: Gall bladder contains sludge without gross wall thickening or pericholecystic fluid. Mild, focal biliary tract dilatation associated with mass. Biliary tract otherwise normal in caliberPANCREAS: Limited due to bowel gas.RIGHT KIDNEY: Parapelvic cysts and mild calyectasis without change.OTHER: Left kidney with parapelvic cysts and mild calyectasis without change. | Progressive surface and parenchymal disease involving the liver.Gallbladder sludge without complication segmental biliary tract dilatation associated with hepatic metastatic disease. |
Generate impression based on findings. | 40 year-old female complains of ongoing soft lesion in her left lower back. Evaluated with ultrasound. There is an approximately 4.8 x 0.9 x 3.0 cm is elongated isoechoic mass in the subcutaneous tissue of the left lower back was not present on the contralateral side. No calcifications. No internal vascularity. | 1. Soft tissue mass is described above. |
Generate impression based on findings. | History of thyroid cancer status post surgery RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No significant abnormality noted. LEFT LOBE: The hypoechoic focus in the left thyroid bed measures 9 x 4 x 4 mm, previously 8 x 4 x 4 mm when measured similarly and accounting for differences in technique.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign appearing cervical lymph nodes bilaterally.OTHER: No significant abnormality noted. | Unchanged nonspecific subcentimeter hypoechoic focus in left thyroid bed. No specific evidence of disease recurrence. |
Generate impression based on findings. | History papillary thyroid carcinoma RIGHT LOBE MEASUREMENTS: 4 x 1.4 x 1.9 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.4 x 1.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: 1.6 x 0.6 x 1.4 cm intermediate echogenicity solid nodule mid pole right thyroid glandLEFT LOBE: 1.2 x 0.9 x 0.6 cm predominantly hypoechoic nodule within the mid pole of the left thyroid gland with internal echogenic foci worrisome for coarse calcifications. 1.4 x 0.8 x 0.9 cm intermediate echogenicity solid nodule lower pole left thyroid gland.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules. A mid pole left thyroid gland nodule demonstrates hypoechogenicity with internal possible calcifications; this nodule may represent the clinically known papillary thyroid carcinoma focus.No regional adenopathy. |
Generate impression based on findings. | Flank pain. RIGHT KIDNEY: No significant abnormalities noted.LEFT KIDNEY: There is hydronephrosis of left kidney without visualized obstruction. There is prominence of the renal pyramids.OTHER: Mild ascites and a left pleural effusion are noted. There is sludge in the gallbladder. The bladder is partially distended. | 1. Mild left-sided hydronephrosis without evidence of obstruction. |
Generate impression based on findings. | RUQ pain. LIVER: Non-cirrhotic liver morphology. 17.6 cm in length. Mildly heterogeneous hepatic echogenicity. Unchanged hepatic cyst. No suspicious hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Biliary sludge and subcentimeter gallstones, without specific evidence of cholecystitis.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 12.1 cm in length. The left kidney is 11.6 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 9.7 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. | 1. Cholelithiasis without cholecystitis.2. Hepatomegaly with echogenicity suggestive of steatosis. |
Generate impression based on findings. | 82-year-old male with unexplained weight loss and transaminitis. LIVER:The liver measures approximately 13.5 cm. Increased echogenicity of the parenchyma. No intrahepatic biliary dilation. Mild ascites is noted. Portal vein is patent with pulsatile hepatopedal flow. There is prominence of the intrahepatic veins and inferior vena cava.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. There is an approximately 1.9 x 1.7 cm well-defined hyperechoic lesion within the lumen of the gallbladder that cast a shadow, consistent with choledocholithiasis or a sludge ball. Does not appear to be impacted. The gallbladder wall measures 1.3 cm. No pericholecystic fluid. Common duct measures 0.3 centimeters.PANCREAS: Unable to evaluate the pancreas due to overlying bowel gas.SPLEEN: Measures 9.5 cm. No sonographic abnormalities.KIDNEYS: Right kidney measures 10.0 cm. Left kidney measures 12.3 cm. Unremarkable and echogenicity. No shadowing calculi or hydronephrosis.There are three large simple renal cysts around the left kidney, the largest measuring 4.9 x 4.4 x 3.5 cm. OTHER: No significant abnormality noted. | 1. Increased echogenicity of the liver parenchyma consistent with fatty infiltration and chronic liver disease/parenchymal dysfunction.2. Mild ascites. 3. Gallbladder wall thickening which is nonspecific in the context of ascites. No other secondary signs of acute cholecystitis.4. Pulsatile portal vein and prominence of intrahepatic veins and inferior vena cava consistent with a congestive heart failure.5. Multiple left-sided simple renal cyst as described above. |
Generate impression based on findings. | 57 year old female who was recalled from screening mammogram for right breast mass. No family history of breast cancer. Right Breast Diagnostic 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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Within the medial slightly upper right breast, there is redemonstration of a circumscribed mass measuring approximately 0.4 cm which persists on spot compression imaging.Right Breast Ultrasound: On physical examination, no palpable abnormality is identified.A targeted right ultrasound was performed for the mammographic area of concern. At the two o'clock radian of the right breast, 4 cm from the nipple, there is a clustered cyst measuring 0.5 x 0.4 x 0.9 cm, corresponding to the mass visualized on mammogram. | Clustered cyst at the two o'clock position in the right breast, corresponding to the mass visualized on prior mammogram. Left unilateral diagnostic mammogram and ultrasound is recommended in 6 months to assess stability. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 25-year-old female with left upper quadrant fullness and pain. LIVER: Measures 13.2 in length. Unremarkable hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. 0.3 cm gallbladder polyp.PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity, measures 10.5 cm in length. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | No findings to account for the patient's left upper quadrant pain. |
Generate impression based on findings. | 80-year-old female with history of NASH. Evaluate for hepatocellular carcinoma. LIVER:Liver measures 12.5 cm. There is coarse and increased echogenicity of the parenchyma. No concerning mass or ascites. Again seen is a round anechoic 1.0 x 0.8 x 0.9 cm lesion with posterior acoustic enhancement consistent with a simple cyst. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended. The gallbladder wall measures 2.0 mm. No stones, sludge, or pericholecystic fluid.PANCREAS: Examination the pancreas is limited by overlying bowel gas. The visualized portions appear normal.SPLEEN: The spleen was unable to visualized.KIDNEYS: The right kidney measures 10.4 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. The left kidney measures 9.2 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 concerning mass or ascites. |
Generate impression based on findings. | Female 66 years old; Reason: r/o adenopathy, increased size of nodules, concerning features. Are nodes concerning and should be biopsied? History: h/o thyroid nodules, s/p lobectomy. Has nodes that are felt to be indeterminate. This is 9 month follow up study; please compare to prior ultrasounds. LEFT LOBE MEASUREMENTS: 5.1 x 2.3 x 1.9 cmISTHMUS MEASUREMENT: 0.4 cmRIGHT LOBE: Patient is status post right thyroidectomy.LEFT LOBE: There are multiple hyperechoic nodules, the largest of which measures 0.9 x 0.9 x 0.8 cm and the inferior pole and is stable.ISTHMUS: Nodule measuring 0.7 x 0.5 x 0.3 cm is stable.LYMPH NODES: Normal lymph nodes seen.OTHER: No significant abnormality noted. | No significant change in thyroid nodules and lymph nodes without suspicious features. |
Generate impression based on findings. | Thyroid nodule RIGHT LOBE MEASUREMENTS: 5.5 x 2.2 x 1.1 cm. Normal in size with unchanged mildly heterogeneous background architecture.LEFT LOBE MEASUREMENTS: 4.1 x 1.5 x 1.1 cm. Normal in size with unchanged mildly heterogeneous background echotexture.ISTHMUS MEASUREMENTS: 4 mm in AP dimension.RIGHT LOBE: The upper pole hypoechoic nodule is unchanged in appearance, measuring 7 mm, previously 6 mm. The lower pole hypoechoic nodule is unchanged in appearance, measuring 3 mm, previously 5 mm.LEFT LOBE: The mid pole hypoechoic nodule is unchanged in appearance and size at 4 mm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | 1. Stable subcentimeter thyroid nodules.2. Unchanged heterogeneous background thyroid gland, which may be seen with chronic thyroiditis. |
Generate impression based on findings. | 56-year-old female. Follow-up of colloid nodule. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5 x 1.4 x 1.5 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.7 x 1.4 x 1.3 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.1 cm in thickness.RIGHT LOBE: Heterogenous echotexture of the right thyroid lobe. In the right lower pole, there is a stable spongiform nodule measuring 0.7 x 0.5 x 0.6 cm (prior 0.6 x 0.5 x 0.5 cm). Mild increased vascularity of the right thyroid lobe.LEFT LOBE: In the left upper/mid pole, there is a spongiform nodule measuring 0.7 x 0.7 x 0.7 cm that has decreased in size (prior 1.1 x 1 x 0.6 cm). Mild increased vascularity of the left thyroid lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Decreased size of the spongiform nodule of the left upper/mid pole.2. Stable subcentimeter spongiform nodule of the right lower pole.3. Nonspecific increased vascularity of the thyroid parenchyma, which may be seen in the setting of thyroiditis; clinical correlation suggested. |
Generate impression based on findings. | Papillary thyroid cancer. Assess for abnormal lymph nodes. RIGHT LOBE MEASUREMENTS: 5.1 x 1.6 x 1.9 cm. Normal in size with normal background echotexture and vascularity.LEFT LOBE MEASUREMENTS: 5.2 x 0.8 x 1.2 cm. Normal in size with normal background echotexture and vascularity.ISTHMUS MEASUREMENTS: 2 mm in AP dimension.RIGHT LOBE: A heterogeneous 2.5 cm solid nodule with calcification is identified, compatible with the given history of thyroid cancer.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Right thyroid nodule compatible with the given history of thyroid cancer. Benign-appearing cervical lymph nodes identified. |
Generate impression based on findings. | 64-year-old female with history of thyroid cancer with nodules in right thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the inferior right bed there are again noted to hypoechoic nodular densities, measuring 0.4 x 0.4 x 0.6 cm and 0.4 x 0.6 x 0.4 cm. These measurements are unchanged from the prior study.LEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No morphologically normal lymph nodes.OTHER: No significant abnormality noted. | Stable soft tissue nodules right thyroid bed. |
Generate impression based on findings. | 38-year-old female patient status post resection of left thyroid lobe. Enlarging right-sided goiter. RIGHT LOBE MEASUREMENTS: 6.7 x 4.3 x 4.1 cm, previously 6.9 x 4.1 x 3.3 cm.LEFT LOBE MEASUREMENTS: Status post left lobectomy.ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: The right thyroid lobe is diffusely heterogeneous with mixed cystic and solid components, appearing similar to the prior study.LEFT LOBE: Status post left lobectomy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Diffusely enlarged, heterogeneous right thyroid lobe, appearing similar to the prior study.2. Status post left lobectomy. |
Generate impression based on findings. | 52-year-old male with renal transplant and liver lesions on prior CT. LIVER: Echotexture may be mildly coarsened. Within the lateral segment left lobe one of the nodules identified and CT represents a simple cyst measuring 8-9 mm in diameter. The dome lesions cannot be adequately visualized.GALLBLADDER, BILIARY TRACT: Very limited views the gallbladder demonstrate no gross abnormality. The visualized biliary tract is normal in caliber.PANCREAS: Not evaluatedRIGHT KIDNEY: Not evaluated.OTHER: Perihepatic ascites. | 1. Only one of the liver lesions noted on prior CT is identified and represents a simple cyst.2. Ascites. |
Generate impression based on findings. | Hepatitis C. Evaluate for hepatocellular carcinoma. LIVER: Cirrhotic liver morphology. Increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Minimally thickened gallbladder wall, which may be seen in the setting of ascites. Otherwise unremarkable appearance of the gallbladderPANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney is 10.1 cm in length. The renal parenchyma is echogenic. No suspicious renal lesions are evident. No hydronephrosis is present. The left kidney is not well visualized due to inability to reposition the patient. SPLEEN: 10.8 cm in length, without focal lesions evident.OTHER: Moderate amount of ascites present. | 1. Cirrhotic liver morphology without suspicious hepatic lesion identified.2. Moderate amount of ascites.3. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 54-year-old female with prior thyroidectomy for papillary carcinoma. Possible residual thyroid tissue on nuclear medicine exam from 10/2/2015. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massLEFT LOBE: No massISTHMUS: No massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No abnormal lymph nodesOTHER: No significant abnormality noted. | No ultrasound evidence for recurrent disease. |
Generate impression based on findings. | History renal cell carcinoma RIGHT KIDNEY: Echogenic renal parenchyma. Numerous renal cysts again noted. None of these cysts exhibit worrisome characteristics at this time. No stone or hydronephrosis. Right kidney 12.2 cm in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended | Echogenic right renal parenchyma consistent with medical renal disease/parenchymal dysfunction without obstruction. Stable numerous right renal cysts; none of the cysts exhibit worrisome characteristics at this time. |
Generate impression based on findings. | Female 62 years old; Reason: Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.1 x 1.3 x 1.6 cmISTHMUS MEASUREMENT: 0.24 cmRIGHT LOBE: Two small nodules are seen within the inferior aspect of the right thyroid lobe. The first is solid, heterogeneous but predominantly hyperechoic and measures 0.8 x 0.7 x 0.8 cm and has no increased vascularity. The second nodule is solid and hypoechoic and measures 0.9 x 0.6 x 0.8 cm.LEFT LOBE: The left lobe contains a poorly defined, heterogeneous, hypoechoic nodule with no increased vascularity which measures 3.2 x 1.1 x 1.4 cm.ISTHMUS: No significant abnormality noted.LYMPH NODES: Multiple prominent bilateral cervical nodes with fatty hila. | 1.Heterogeneous, ill defined 3.2-cm left thyroid nodule and reactive cervical lymphadenopathy may be seen with thyroiditis and correlation with clinical signs/labs is recommended. If clinically warranted, this nodule is amenable to ultrasound guided biopsy. |