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Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 6.9 x 3.7 x 3.3 cmLEFT LOBE MEASUREMENTS: 5.8 x 1.4 x 2 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Interval increase in size of large spongiform nodule occupying much of the lower aspect of the right thyroid gland measuring 4.4 x 3 x 5.1 cm; this is in comparison to 2.2 x 2.7 x 1.5 cm in 2013.LEFT LOBE: No significant change in multiple benign-appearing left thyroid nodules the largest measuring 2.1 x 1 x 1.8 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in size of right spongiform nodule. Left thyroid nodule stable. No regional adenopathy. |
Generate impression based on findings. | Abnormal levels of other serum enzymes LIVER: The liver measures 13.4 cm in length. Normal hepatic parenchymal echogenicity and echotexture. Patent portal vein with normal directional hepatopetal blood flow, peak velocity 17.0 cm/s. Previously seen 2 cm segment II lesion on CT is homogeneously echogenic, consistent with hemangioma, measuring 2.4 cm in maximum diameter, without change.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. Status post cholecystectomy. The common hepatic duct measures 0.5 cm. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted. The pancreatic duct measures 0.4 cm.RIGHT KIDNEY: The right kidney measures 9.7 cm. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 10.5 cm in length. No hydronephrosis or shadowing stones.OTHER: The spleen measures 9.0 cm in length. No ascites. | No acute hepatobiliary findings.Stable hepatic hemangioma. |
Generate impression based on findings. | 10-year-old female, with history of enuresis and bladder dysfunction, evaluate. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Right ureteral jet observed. Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 8 cm Left: 7.7 cm Mean for age: 9 cm Range for age: 7.5 - 10.8 cmADDITIONAL OBSERVATIONS: No significant abnormalities. | Normal appearance of bilateral kidneys and the bladder.*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. | Female 70 years old; history of thyroid cancer at isthmus, evaluate for further nodules, and lymph nodes History: History of papillary thyroid cancer RIGHT LOBE MEASUREMENTS: 4.5 x 1.3 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.4 x 1.5 x 1.3 cmISTHMUS MEASUREMENT: 0.6 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Circumscribed hypoechoic lesion measuring 2.3 x 2.0 x 1.0 cm, previously 1.0 x 0.7 x 0.8 cm, slightly increased in size compared to prior exam.ISTHMUS: Primary solid hypovascular hypoechoic nodule measures 1.2 x 1.0 x 0.7 cm compared to 1.0 x 0.7 x 0.8 cm, not significantly changed compared to prior exam. This lesion was demonstrated to be a papillary thyroid cancer on biopsy.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Primary solid hypovascular hypoechoic nodule in the isthmus, not significantly changed in size as compared to prior exam. This nodule was found to be papillary thyroid cancer on biopsy.2.Circumscribed hypoechoic lesion in the left thyroid lobe, slightly increased in size as compared to prior exam. Given the history of known thyroid cancer, this may represent additional focus of thyroid cancer. |
Generate impression based on findings. | 66-year-old female. History of right inner breast mass that was biopsied on 10/7/2014 to be spindle cell proliferation and focal usual ductal hyperplasia. Patient presents for short interval follow-up mammogram of her right breast. Right breast diagnostic mammogram: Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The right breast mass containing a biopsy clip at the 3 o'clock position appears slightly larger; ultrasound was done for further evaluation. Right breast ultrasound: Targeted ultrasound for the right breast 3 o'clock position 2 cm from the nipple again showed a mixed echogenicity predominately hypoechoic mildly vascular mass that measures 2.3 x 1.2 x 1.8 cm, previously 1.5 x 1.1 x 1.3 cm. A few cystic components within this mass are again noted. The biopsy clip is at its inferior margin. | Mild increase in size of the right breast complex mass. Recommend surgical consultation regarding its management.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 72 years old, Female, Reason: R/o gallstones or Ulcer History: abdominal pain LIVER: The liver is slightly enlarged measuring 18 cm in length. The liver parenchyma is normal in appearance. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal appearing gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | Reason: Advanced CKD History: advanced CKD RIGHT KIDNEY: The right kidney measures 12.5 cm in length. Unremarkable renal parenchymal echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.7 cm in length. Unremarkable renal parenchymal echogenicity. No shadowing stones or hydronephrosis.OTHER: Renal jets visualized bilaterally. Unremarkable urinary bladder. | No acute renal abnormality. |
Generate impression based on findings. | Ms. Cowden is a 44-year-old female with recently diagnosed left breast cancer and prominent left axillary lymph nodes. She presents today for repeat ultrasound evaluation of these lymph nodes. A targeted left axillary ultrasound was performed. Two lymph nodes are identified in the left axilla. -The first lymph node measures approximately 1.5 x 0.6 cm with uniform cortical thickness measuring up to 0.3 cm and preserved fatty hilum. There is normal hilar vascular flow identified.-The second adjacent lymph node measures 0.9 x 0.6 cm with uniform cortical thickness measuring up to 0.3 cm and preserved fatty hilum. There is normal hilar vascular flow identified. | Two mildly prominent left axillary lymph nodes, which are not typically suspicious in appearance. These are likely reactive given the sonographic appearance and recent history of multiple biopsies. BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 60-year-old male with cirrhosis. Screen for HCC. Limited evaluation, particularly of the liver at the dome, due to technical factors including poor patient breath holding and bowel gas. Within this limitation, the following observations are made.LIVER: Cirrhotic liver morphology. No definite focal hepatic lesion. Liver measures 13 cm in length. Main portal vein is patent with normal directional flow. Patent TIPS visualized. No intrahepatic biliary ductal dilation.GALLBLADDER, BILIARY TRACT: Normal appearance of the gallbladder. Common bile duct measures 2 mm.PANCREAS: Poorly visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney is 9.9 cm in length. No hydronephrosis.OTHER: Left kidney is 11.7 cm in length. No hydronephrosis.Spleen is 15.3 cm in length. No focal splenic lesions.No ascites. | Limited examination without evidence of focal liver lesion. |
Generate impression based on findings. | Reason: s/p LVAD, drive line infection, please assess fluid collection around drive line site History: pain and drainage at site Within the superficial soft tissues of the right lower quadrant anterior abdominal wall, there is a 2.8 x 2.6 x 1.2 cm complex fluid collection medial to the LVAD drive line with increased vascularity in the surrounding soft tissues. | Findings concerning for superinfected fluid collection or abscess measuring up to 2.8 cm around and adjacent to the drive line.Findings were communicated to the emergency department staff via the stat consult system and acknowledged by Dr. Shah. |
Generate impression based on findings. | Abdominal pain LIVER: Coarse echogenic liver parenchyma. No mass lesion. Liver length 22 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11 cm in length.OTHER: Left kidney 11.7 cm in length. Spleen 10 cm in length. No ascites. | Hepatomegaly with coarse echogenic liver parenchyma suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 64-year-old female with history of goiter seen on chest x-ray. RIGHT LOBE MEASUREMENTS: 5.8 x 1.4 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.7 x 2.8 x 2.1 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Subcentimeter partially cystic nodule in the right lobe measures 0.5 x 0.5 x 0.5 cm. Mildly heterogeneous background gland. LEFT LOBE: Dominant left thyroid lobe nodule which is solid with a central cystic component measures 2.2 x 1.6 x 2.7 cm. A more posteriorly located smaller nodule with spongiform features measures 1.2 x 1.2 x 1.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered cervical lymph nodes with benign morphologic features.OTHER: Incidental note of calcification and atherosclerotic plaque with stenosis of both carotid arteries at the bifurcations. | 1. Thyroid nodules greater on the left as detailed above. 2. Incidental note of calcification and atherosclerotic plaque with stenosis of both carotid arteries at the bifurcations. Recommend a dedicated carotid vascular ultrasound examination for further evaluation. |
Generate impression based on findings. | Status post left breast lumpectomy followed by radiation now with increasing pain and swelling. No discrete mass noted. Patient presents for ultrasound. A targeted left ultrasound was performed for the patient’s area of pain. Patient indicates area of pain in the left breast 9:00, 8:00 10:00 and 4:00 position around the nipple. Breast edema with skin thickening noted consistent with post surgical change. Scar noted at 9 to 10:00 position periareolar. Scar tissue identified at that location with a small seroma cavity measuring 1.8 x 0.9 x 0.9 cm. No suspicious solid mass noted. | No sonographic evidence for malignancy corresponding to patient's area of pain at 9, 10, 8 and 4:00 position of the left breast.Postsurgical changes identified in the left breast.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 56-year-old female recalled for asymmetry in the lateral aspect of the right breast seen on screening mammogram One standard ML mammographic view of the right breast was performed followed by 2 right CC spot compression views and medial and lateral rolled CC views. Targeted grayscale and color Doppler ultrasound was subsequently performed and a BB was placed on the skin. Mammograms were then obtained with tangential and LMO views.The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The asymmetry in the lateral breast that triggered this exam was not evident on spot compression views. Medial rolled CC views demonstrated lateral displacement of the 5 mm asymmetry, which has the appearance of a circumscribed cyst as subsequently demonstrated by ultrasound.Targeted ultrasound of the right lower quadrant showed an anechoic, unilocular cyst with no internal flow measuring 3 x 3 x 3 mm located 8 cm from the nipple along the 8:00 radian. A BB was placed on the cyst. Tangential and LMO views of the right breast confirm that the cyst corresponds to the asymmetry that triggered this exam. | Asymmetry identified on the screening mammogram corresponds to a simple benign cyst. No further evaluation is necessary. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, annual bilateral screening mammography is recommended. The results and recommendations were discussed with the patient at the completion of the exam.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 48-year-old female patient with HCV infection. LIVER: The liver measures 17 cm in length. Mildly coarsened liver echotexture but no discrete lesion. Main portal vein flow is hepatopetal and measures 0.2 m/s.BILIARY TRACT: There is no intra or extrahepatic biliary ductal dilatation. The common bile duct measures 3 mm in diameter. The gallbladder has been surgically removed.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen is poorly visualized but measures approximately 7.4 cm in length.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. No evidence of hydronephrosis. OTHER: Left kidney measures 10.1 cm in length. No evidence of hydronephrosis. | Mildly coarsened liver echotexture but no discrete lesion. |
Generate impression based on findings. | 59-year-old male with worsening renal failure. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney is markedly echogenic and measures 8.9 cm in length. No evidence of hydronephrosis.LEFT KIDNEY: Nonvisualization of the left kidney.OTHER: No significant abnormalities noted. | 1.Markedly echogenic right kidney compatible with medical renal disease without evidence of hydronephrosis. 2.Nonvisualization of left kidney. |
Generate impression based on findings. | History of Hurthle cell cancer status post thyroidectomy. RIGHT LOBE: Status post thyroidectomy.Morphologically benign-appearing lymph noted in the inferior aspect of the inferior thyroidectomy bed measures 8 x 3 x 5 mm compared to 7 x 2 x 4 mm previously. The more superior homogeneously echogenic nodule measures 6 x 4 x 5 mm compared to 5 x 3 x 5 mm previously.LEFT LOBE: Status post thyroidectomy.Morphologically benign-appearing lymph nodes in the thyroidectomy bed are noted.The superior bed lymph node measures 7 x 3 x 6 mm compared to 7 x 2 x 4 mm.The mid/inferior bed lymph node measures 5 x 5 x 3 mm. It was not visible on the prior studies but is unchanged from 2012.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No new sites of disease. Stable bilateral thyroidectomy bed lymph nodes and stable nonspecific homogeneous echogenic nodule in the right inferior thyroidectomy bed. |
Generate impression based on findings. | Reason: nausea and vomiting, assess for gallstones LIVER: The liver measures 14.4 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.24 m/s.BILIARY TRACT: Cholelithiasis, shadowing from which obscures the posterior aspect of the gallbladder. No gallbladder wall thickening or pericholecystic fluid is visualized. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.0 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.4 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis or biliary ductal dilatation.2.Increased hepatic echogenicity raising the possibility of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | 84-year-old female with left neck mass Redemonstrated is a vascular tumor deep and medial to the left internal jugular vein inserting mass effect and measuring 3.8 x 2.8 x 4.3 cm. The tumor is isoechoic to muscle and mildly heterogeneous in echogenicity. No significant lymphadenopathy is present. | Left neck mass compatible with paraganglioma as described above. |
Generate impression based on findings. | Thyroid nodule suspicious for carcinoma. Assess cervical lymph nodes RIGHT LOBE MEASUREMENTS: 5.2 x 1.5 x 1.5 cmLEFT LOBE MEASUREMENTS: 5.2 x 1.5 x 1.5 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 1.3 x 0.8 x 1 cm hypoechoic nodule with worrisome internal echogenic foci within the upper pole. 0.4 x 0.4 x 0.4 cm hypoechoic midpole nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Worrisome hypoechoic nodule upper pole left thyroid gland with possible internal microcalcifications; this lesion is suspicious for a malignant focus.No regional adenopathy. |
Generate impression based on findings. | Male 67 years old with hepatitis C, evaluate for HCC History: HCV LIVER: Mild increase in hepatic parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions. Hepatic length measures up to 18.3 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation. The main portal vein is patent with normal hepatopedal flow directed towards the liver with a velocity of 26.5 cm/s. GALLBLADDER, BILIARY TRACT: The gallbladder is normal in echotexture with the wall measuring 4 mm. The common bile duct measures 5 mm in diameter. No choledocholithiasis. No extrahepatic biliary ductal dilatation.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.9 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. Thr right kidney measures 12.0 cm and has normal vascular flow. The left kidney measures 11.5 cm and has normal vascular flow. OTHER: No significant abnormality noted. | Mild increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction. No hepatic mass or ductal dilatation identified. |
Generate impression based on findings. | 56-year-old female with history of hepatitis C, evaluate for HCC. LIVER: Measures 21.3 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Hepatomegaly and increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. |
Generate impression based on findings. | 61-year-old female with palpable abnormality at mandibular angle Right submandibular gland is generally homogeneous in echotexture without diffuse slialectasis. There is a 1.3 cm lymph node within the substance of the gland. Cranial to this there is a complex cystic mass which is superficial within the gland and corresponds to the palpable abnormality. This measures 0.6 x 0.8 x 0.9 cm and contains multiple shadowing calcifications. On several images, it appears at this may communicate with a segment of duct. No definite thrombosed vasculature is identified.. | Complex cystic mass in the right submandibular gland with calcification. Differential considerations would include Sialic cyst/sialocele, there does not appear to be significant vascularity or soft tissue mass to suggest mucoepidermoid carcinoma or papillary carcinoma, and therefore this may be postinflammatory. |
Generate impression based on findings. | 60-year-old female with abdominal pain, right flank pain. Choledocholithiasis on CT, evaluate for acute cholecystitis. LIVER: Coarse echotexture of the liver measuring 19.7 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: Stones within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. No evidence of choledochal lithiasis within the visualized portions of the common bile duct.PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 11.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 10.2 cm in length.Left kidney measures 12.9-cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Cholelithiasis with no evidence of cholecystitis. No choledocholithiasis within the visualized common bile duct. 2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 88 year old female patient with right upper and lower quadrant abdominal pain. LIVER: The liver measures 14.2 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 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 8.6 cm in length. No evidence of hydronephrosis. There is a subcentimeter midpole renal sinus cyst.OTHER: The left kidney measures 8.6 cm in length. No evidence of hydronephrosis. There is a 1.6 x 2.1 x 1.4 cm superior pole renal cyst.The spleen measures 7.5 cm in length. | 1. No acute sonographic findings to account for the patient's symptoms.2. Left upper pole renal cyst. |
Generate impression based on findings. | Male 65 years old Reason: eval for lesions, assess hepatic vessel patency History: s/p OLT for HBV in October 2004, recurrent HBV LIVER: Liver measures 11.7 cm. Small liver cyst is present measuring 1.0 x 0.7 x 1.0 cm. No suspicious hepatic mass identified.BILIARY TRACT: Patient is status post cholecystectomy. No intra or extra hepatic biliary ductal dilatation. Common bile duct measures 0.7 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 normal in appearance measuring 12.5 cm.KIDNEYS: Cortical echogenicity is increased bilaterally which can be seen in the setting of medical renal disease. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 9.0 cm. Within the right kidney there is a small anechoic cyst measuring 1.3 x 1.3 x 1.1 cm. Left kidney measures 10.9 cm. Within the left kidney there is a small anechoic cyst measuring 2.7 x 2.6 x 3.6 cm.OTHER: No significant abnormalities noted. | 1.Echotexture of the liver within normal limits. Unchanged small hepatic cyst. Patent hepatic vessels with normal directional flow.2.Echogenic renal parenchyma is again noted, which can be seen in the setting of medical renal disease. |
Generate impression based on findings. | 38 year old female with right upper quadrant pain, history of breast cancer. Evaluate for cholelithiasis or other etiology of abdominal pain. LIVER: Increased echogenicity of the liver measuring 16.0 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common bile duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: Normal echogenicity of the visualized pancreas.RIGHT KIDNEY: Normal echogenicity measuring 10.3 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted. | Increased echogenicity of the liver compatible with fatty infiltration. No sonographic evidence of cholelithiasis. |
Generate impression based on findings. | History of pulsatile abdominal pain, evaluate for abdominal aortic aneurysm. ABDOMINAL AORTA: The abdominal aorta is normal in caliber without evidence of aneurysm. The proximal aorta measures 2.4 x 2.3 cm. The middle aorta measures 1.9 x 2.0 cm. The distal aorta measures 2.0 x 2.2 cm. OTHER: The right iliac artery measures approximately 1.5 x 1.6 cm. The left iliac artery measures approximately 1.5 x 1.6 cm. | No sonographic evidence of abdominal aortic aneurysm. |
Generate impression based on findings. | Prerenal transplant evaluation RIGHT KIDNEY: Atrophic echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Stable right renal cysts Right kidney 9.1 cm in length. LEFT KIDNEY: Atrophic echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left kidney 7.4 cm in length Complex fluid collection within the inferior left perinephric space measuring 5.2 x 4.1 x 7.7 cm consistent with evolution of previously noted hematoma.OTHER: Bladder nondistended. Moderate ascites with dialysis catheter noted. | Atrophic echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Interval decrease in size of loculated complex inferior left perinephric space cystic/fluid collection consistent with resolution of previously noted hematoma. |
Generate impression based on findings. | Male 74 years old; Reason: R/O HCC History: HCV, advanced liver fibrosis LIVER: The liver measures 13.8 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 12.1 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is hardly visualized due to shadowing from overlying bowel gas. The common bile duct measures 6.0 mm in diameter. PANCREAS: The majority of the pancreas is obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 6.3 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.2 cm in length. The cortex possibly has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 9.8 cm in length. The cortex possibly has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. The liver has coarse increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses or intrahepatic ductal dilation are seen.2. Bilaterally the kidneys may have increased echogenicity which would be compatible with medical renal disease. The exam is partially limited due to overlying bowel gas and the patient's breathing. |
Generate impression based on findings. | 32-year-old male with likely right varicocele RIGHT TESTIS: Measures 4.1 cm x 2.4 cm x 1.8 cm. Microcalcifications are again seen within the testicle. Arterial and venous flow are demonstrated in the right testis upon Doppler exam. LEFT TESTIS: Measures 3.6 cm x 3.0 cm x 1.7 cm. Microcalcifications are again seen within the testicle. Arterial and venous flow are demonstrated in the left testis upon Doppler exam. RIGHT EPIDIDYMIS: Measures 2.9 cm x 1.0 cm x 0.9 cm. Epididymal cyst is again noted measuring 4 mm x 3 mm x 4-mm.LEFT EPIDIDYMIS: Measures 3.2 cm x 1.6 cm x 0.8 cm. OTHER: Bilateral varicoceles, left greater than right however improved from prior study. Bilateral trace hydroceles. | 1. Bilateral varicoceles, left greater than right however improved from prior study. 2. Bilateral testicular microcalcifications are again noted. |
Generate impression based on findings. | Female, 64 years old. Elevated Cr RIGHT KIDNEY: The right kidney measures 9.8 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 8.3 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is decompressed. | Increased renal cortical echogenicity, compatible with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Male 55 years old Reason: assess for HCC History: Hx of HCV and cirrhosis LIVER: Cirrhotic appearance of liver, consistent with given history. No focal hepatic mass is identified. Main portal vein is patent with normal directional flow and uptake velocity of 13.8 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallstones. Unchanged gallbladder polyp measuring 0.3 x 0.3 x 0.4 cm. Negative Murphy's sign. Common bile duct is within normal limits measuring 4 mm.PANCREAS: Visualized portions of the pancreas are within normal limits.SPLEEN: Spleen is normal in appearance measuring 14.0 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 13.5 cm. Left kidney measures 14.1 cm. OTHER: No significant abnormalities noted. | 1.Cirrhotic liver morphology consistent with given history, without focal mass.2.Unchanged gallbladder polyp. Recommend continued attention to this polyp on regular follow-up exams. |
Generate impression based on findings. | 57-year-old female with history of cervical cancer, elevated alkaline phosphatase. Evaluate for liver pathology. Limited examination, particularly of the liver, due to pneumothorax, pulmonary opacities, and patient body habitus. LIVER: Increased hepatic echogenicity. Allowing for the limitations detailed above, no discrete hepatic lesions are identified. BILIARY TRACT: Very limited examination, however there is suggestion of dilation of the common bile duct and gallbladder distention. However, the gallbladder is not clearly visualized sonographically and incompletely characterized. PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.KIDNEY: Mild to moderate bilateral hydronephrosis. Increased renal echogenicity. OTHER: No significant abnormalities noted. | 1. Very limited examination as detailed above. Suggestion of common bile duct dilation and gallbladder distension, though neither can be clearly imaged or completely characterized on this limited exam. A short term follow up examination or a nuclear medicine hepatobiliary study may be considered for further evaluation as warranted clinically. 3. Mild to moderate bilateral hydronephrosis. Findings were discussed with Dr. Haman by phone at 1045 on 9/2/15. |
Generate impression based on findings. | 68-year-old female with acute kidney injury RIGHT KIDNEY: Measures 10.9 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 10.8 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: Bilateral renal stents in place. | 1.Increased renal echogenicity consistent with medical renal disease.2.Renal stents in place without hydronephrosis. |
Generate impression based on findings. | UTI; overactive bladder RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 9.7 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 9.3 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound. |
Generate impression based on findings. | 46-year-old female with 2 sites of fat necrosis/coil cyst in the left reconstructed breast presents for follow-up study. Focused ultrasound is performed for the palpable lumps at left 9:00 position and left axillary tail.At left 9:00 position, again seen is a hypoechoic lesion measuring 5 x 3 x 5 mm with an internal hyperechoic clip, consistent with fat necrosis. There is no significant change in size or shape of this lesion.At left axillary tail, there is a similar hypoechoic lesion measuring 5 x 3 x 7 mm with an internal hyperechoic clip, consistent with fat necrosis. Size of this lesion is somewhat smaller than the prior study. | Benign fat necrosis at 9:00 position and axillary tail in the left breast.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Shortness of breath and ascites Trace ascites within the left lower quadrant. | Trace ascites within the left lower quadrant. |
Generate impression based on findings. | Colicky epigastric pain LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. | Negative for acute hepatobiliary abnormality. Specifically, unremarkable gallbladder. No ductal dilatation. |
Generate impression based on findings. | History renal stones RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.6 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 11.3 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound. No evidence for worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | Question of cholestasis or gallstone, right upper quadrant pain LIVER: Liver measures 14.2 cm with normal echo texture. No focal lesions within the liver. No intrahepatic biliary ductal dilatation. Portal vein demonstrates normal flow directionality and patency.GALLBLADDER, BILIARY TRACT: Distended gallbladder with normal gallbladder wall thickness measuring up to 2 mm. Hyperechoic lesion within the gallbladder which is mobile, without definite shadowing that measures 6 x 5 x 9 mm most likely a gallstone bladder polyp.PANCREAS: Not well visualized due to overlying bowel gasKIDNEY: Right kidney measures 11.3 cm with a simple cyst in the upper pole measuring 1.5 x 1.7 x 1.7 cm. No hydronephrosis or other focal lesions. Normal echotexture noted.Left kidney measures 11 cm without any hydronephrosis or focal lesionOTHER: Spleen measures 7.3 cm with normal echotexture. | Gallbladder polyp measuring up to 9 mm noted. Follow-up ultrasound can be performed if clinically warranted to confirm stability of the polyp.Right simple renal cyst |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Family history of breast carcinoma in mother and ovarian carcinoma in sister 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious solid or cystic mass is identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Reason: r/o adenopathy, recurrence History: h/o thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Isoechoic nodule in the thyroid bed is unchanged in size measuring and 0.3 x 0.3 x 0.5 cm, previously 0.3 x 0.3 x 0.4 cm. LEFT LOBE: Status post thyroidectomy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination. |
Generate impression based on findings. | Female; 43 years old. Reason: elevated transaminases; +HepBsag LIVER: The liver measures 13.7 cm in length. The surface is smooth. The parenchyma is increased in echogenicity with a coarsened echotexture. The main portal vein is patent and demonstrates pedal flow with peak velocity of 0.2 m/sec. No worrisome masses identified. There is no ascites.BILIARY TRACT: The gallbladder is normal in appearance. There is no shadowing stone or gallbladder wall thickening. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 8.7 cm in length.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. The cortex is normal echogenicity. There is no shadowing stone, hydronephrosis, or worrisome mass identified. OTHER: The left kidney measures 10.3 cm in length and is partially visualized. | 1.Echogenic and coarse liver parenchyma suggestive of chronic liver disease/fatty infiltration. 2.No worrisome hepatic lesion. |
Generate impression based on findings. | Renal transplant with rising creatinine and hypertension RENAL TRANSPLANT: LOCATION: Left iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality noted. Multiple cysts again noted. 11.1 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 Interval development of slightly delayed systolic upstroke with slight increase in velocities of the mid distal renal artery.Interval development of 7 mm abnormal mixed arterial venous Doppler focus within the midportion of the kidney corresponding to the location of the 1/13/2015 biopsy site.OTHER: No significant abnormality noted | Interval development of slightly delayed systolic upstroke with slight increase in velocities of the mid distal renal artery; findings raise the possibility of mild inflow compromise/stenosis.Interval development of 7 mm abnormal mixed arterial venous Doppler focus within the midportion of the kidney corresponding to the location of the 1/13/2015 biopsy site. Findings consistent with AV fistula. |
Generate impression based on findings. | History of hepatitis C. Presents for HCC screening. LIVER: Diffusely coarse and mildly echogenic liver parenchymal echotexture compatible with chronic liver disease. The capsule is relatively smooth. The liver measures 13 cm in craniocaudal dimension.Noted again is a 7 mm mildly hyperechoic lesion adjacent to a hepatic vein, unchanged from prior ultrasound. Stable echogenic shadowing 4 mm probable calcified granuloma in the right lobe of the liver.Normal hepatopedal portal venous blood flow at 18 cm/second. BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid or focal tenderness. The common bile duct measures 5 mm.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 9.3 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 8.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. | 1. Stable examination from prior ultrasound including the stable 7 mm mildly hyperechoic lesion adjacent to the hepatic vein which was not visualized on intervening MRI. 2. Findings compatible with chronic liver disease. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Technical repeat study. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Female; 56 years old. Reason: History of multinodular goiter with tenderness to left palpable nodularity. RIGHT LOBE MEASUREMENTS: 5.1 x 1.7 x 1.4 cmLEFT LOBE MEASUREMENTS: 5.5 x 1.8 x 1.2 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: The right lobe is heterogeneous. In the lower pole is a mildly hypoechoic, heterogeneous solid nodule which measures 1.6 x 1.0 x 0.9 cm (previously 1.5 x 1.0 x 1.0 cm).LEFT LOBE: Multiple heterogeneous nodules are seen in the left lobe. A dominant nodule in the midpole heterogeneous with solid components and internal vascularity measures 1.6 x 1.2 x 0.7 cm (previously 1.6 x 1.1 x 0.8 cm). This is stable in appearance compared to the prior ultrasound.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.8 x 0.9 x 0.6 cm right level 2 and 1.7 x 0.9 x 0.8 cm left level 2 lymph nodes have a normal ultrasound appearance with a fatty hilum. | 1.Multinodular thyroid not significantly changed compared to the prior study.2.Bilateral prominent level 2 lymph nodes with a normal ultrasound appearance are likely reactive in etiology. |
Generate impression based on findings. | Patient w/ acute renal failure, eval for hydronephrosis RIGHT KIDNEY: Mildly echogenic renal parenchyma, suggestive of medical renal disease. Right kidney measures 10.5 cm. No hydronephrosis or hydroureter.LEFT KIDNEY: Mildly echogenic renal parenchyma, suggestive of medical renal disease. Left kidney measures 10.7 cm. No hydronephrosis or hydroureter.OTHER: Well-distended urinary bladder. | Mildly echogenic renal parenchyma, suggestive of medical renal disease. No hydronephrosis or hydroureter. |
Generate impression based on findings. | 22-year-old female presents with bilateral superior breast pain for few weeks. Patient does not palpate a lump. A targeted bilateral breast ultrasound was performed for the patient’s area of concern. Patient does not palpate a lump however, is tender in the superior bilateral breasts. Normal glandular tissue identified on ultrasound. There is no solid or cystic mass identified. | No sonographic evidence for malignancy corresponding to patient's area of concern in bilateral superior breast.Routine screening mammogram is recommended starting at the age of 40.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 41 year old female with right upper quadrant and epigastric pain. LIVER: The liver is minimally coarse in echogenicity. There is normal hepatopetal portal venous blood flow at 20 cm/sec. The common bile duct is normal in caliber at the porta hepatis, measuring 2.5 mm. The liver is normal in size, measuring 16.6 cm in the craniocaudal dimension.BILIARY TRACT: The common bile duct at the level of the pancreas is normal in caliber, measuring 3 mm. A normally distended gallbladder is present with no wall thickening, pericholecystic fluid, focal tenderness or cholelithiasis.PANCREAS: The partially visualized pancreatic head is unremarkable. The remaining pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The poorly visualized spleen measures 7.7 cm in length, within normal limits.RIGHT KIDNEY: The right kidney measures 9.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 9.9 cm in length without hydronephrosis or other discrete abnormality. | No specific findings to account for the patient's right upper quadrant pain. |
Generate impression based on findings. | Cirrhosis. Tongue cancer. LIVER: Mildly increased parenchymal echogenicity, suggestive of dysfunction. No focal hepatic lesions. The liver is large, measuring 23 cm in length.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. The gallbladder is contracted, 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 11.4 cm in length. The left kidney is 10.1 cm in length. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 11.4 cm in length, without focal lesions evident.OTHER: Small bilateral pleural effusions. No significant ascites identified.DOPPLER | 1. Hepatomegaly, without suspicious lesions. Patent hepatic vasculature.2. Echogenic renal parenchyma, compatible with medical renal disease.3. Small bilateral pleural effusions. |
Generate impression based on findings. | Male 65 years old Reason: Eval testicular fluid History: significant swelling extending into scrotum RIGHT TESTIS: Right testicle measures 4.8 x 3.5 x 2.7 cm. Echogenicity of the right testicle is normal.LEFT TESTIS: Left testicle measures 4.4 x 2.7 x 2.9 cm. Echogenicity of the left testicle is normal.RIGHT EPIDIDYMIS: Right epididymis measures 2.1 x 1.0 x 0.7 cm. There is a small right epididymal cyst measuring 0.4 x 0.2 x 0.4 cm. No evidence of epididymitis.LEFT EPIDIDYMIS: Left epididymis measures 2.4 x 1.2 x 1.6 cm. No evidence of epididymitis.OTHER: Small left hydrocele is present. Scrotal skin thickening consistent with soft tissue edema. | Small left hydrocele with simple appearing fluid. Scrotal soft tissue edema. |
Generate impression based on findings. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5.6 x 1.4 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.8 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Mildly heterogeneous gland without noduleLEFT LOBE: Mildly heterogeneous gland without noduleISTHMUS: Mildly heterogeneous gland without nodulePARATHYROID GLANDS: 1 x 0.6 x 0.9 cm hypoechoic extrathyroidal focus posterior and inferior to the right thyroid gland.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hypoechoic extrathyroidal focus posterior and inferior to the right thyroid gland consistent with clinically suspected parathyroid adenoma.Mildly heterogeneous thyroid gland without nodule. No regional adenopathy. |
Generate impression based on findings. | Ms. Thompson submitted outside study for review. Submitted for review is:-left breast ultrasound: 1/20/2016This examination was performed at MRI Lincoln imaging Center. Per outside documents, patient oresented to the outside hospital for a palpable concern in the left breast, 6:00 position. Static ultrasound images are submitted for interpretation.Multiple static images are taken of the whole left breast. In the left breast, labeled as 5 to 6:00 palpable area, there are multiple anechoic-hypoechoic lesions clustered together, measuring up to 5 cm in maximum dimension. In the left breast, labeled as 12:00, 1:00, 2:00, 3:00, 4:00, 5:00, 7:00, 8:00, 9:00, 10:00, 11:00 positions and around the nipple, no suspicious cystic or solid mass is identified. A normal lymph node is identified in the left axilla. | Cluster of cysts in the left inferior breast, corresponding to the palpable area of concern. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. As long as the patient's physical examination remains unchanged, a short term 6 month follow-up ultrasound examination is recommended to confirm stability of these findings. BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 43-year-old female with a probable benign fibroadenoma 2:00 position of the right breast presents for a six-month follow-up ultrasound examination. Strong family history of breast cancer. A targeted right ultrasound was performed. Redemonstrated is a benign morphology parallel oriented hypoechoic mass that measures 1.4 x 0.7 cm, unchanged from prior study most consistent with a benign fibroadenoma. | Stable benign fibroadenoma right breast.Annual screening mammogram with tomo synthesis is recommended.Whole breast ultrasound can also be performed at that time given the history of dense breasts.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 53-year-old female status post lung transplant now with liver failure, coagulopathy, elevated LFTs. Evaluate liver blood flow. LIMITED ABDOMENLIVER: Increased echogenicity of the liver measuring 17.8 cm in length. No focal hepatic lesions. BILIARY TRACT: Gallbladder is filled with sludge. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: Visualized pancreas is normal in echogenicity. SPLEEN: Not well visualized. RIGHT KIDNEY: Normal echogenicity measuring 9.6 cm in length. No hydronephrosis or shadowing calculi. OTHER: Normal echogenicity of the left kidney measuring 9.6 cm in length. No hydronephrosis or shadowing calculi. Perihepatic ascites. | 1. Partial thrombus in main portal vein. No flow is seen in the common hepatic artery, left hepatic artery, and left portal vein. 2. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Perihepatic ascites. 3. Gallbladder sludge. Findings were discussed with Dr. Todd Dodick by phone on 3/12/2015 at 3:25 PM. |
Generate impression based on findings. | 77 year-old female with right kidney cancer status post right partial nephrectomy. Evaluate for recurrent disease. RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 9.4 cm in length. No hydronephrosis or shadowing calculi are noted.LEFT KIDNEY: Normal echogenicity of the left kidney measuring 9.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Distended bladder. | No sonographic evidence of recurrent disease. |
Generate impression based on findings. | Bile duct carcinoma with fever LIVER: Coarse echogenic liver parenchyma without mass. Liver length 15.3 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Common bile duct stent unchanged. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11. 7 cm in length OTHER: Left kidney 10.4 cm in length. Spleen 13.5 cm in length. No ascites. | Coarse echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 62-year-old male with history of thyroid cancer status post thyroidectomy and radioactive iodine. RIGHT LOBE MEASUREMENTS: Surgically absentLEFT LOBE MEASUREMENTS: Surgically absentISTHMUS MEASUREMENTS: Surgically absentRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 0.3 x 0.2 cm cystic focus in the superior left thyroid bed is nonspecific and of uncertain clinical significance.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy. 0.3 cm cystic focus in the superior left thyroid bed is nonspecific and of uncertain clinical significance. Continued follow up is recommended. |
Generate impression based on findings. | 15-year-old female with tender palpable lump in the upper inner quadrant of the left breast for 5 months. Patient reports that the pain has been constant and the lump has been present all time. A targeted left ultrasound was performed for the palpable area of concern. On physical examination, vague focal thickening can be appreciated at the 10:00 position of the left breast at the site indicated by the patient. Placement of the transducer at this site elicited focal tenderness, which the patient indicated was her typical symptoms. The transducer was passed over this area multiple times in multiple different orientations. No solid masses or cysts are identified. Sonographically unremarkable appearing fibroglandular tissue is seen. | No sonographic evidence for malignancy. No sonographic abnormality to explain the patient's area of palpable concern and focal tenderness. Continued clinical management is recommended. Further evaluation of a clinically suspicious abnormality should not be delayed by negative imaging. Rather, negative imaging may serve to reinforce a negative or benign clinical impression. The results and recommendations were discussed with the patient and with her father at the completion of the examination.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 67 years old, Female, Reason: 67yo F with abnl LFTs, eval for stone or other abnl LIVER: The liver is mildly enlarged measuring 18.1 cm. No focal hepatic lesions. Increased echogenicity of the liver is consistent with fatty infiltration. Portal vein is patent with a patent flow measuring 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder sludge and stones are present without evidence of gallbladder wall thickening or peri-cholecystic fluid. The common hepatic duct measures 0.4 centimeters.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 9 cm. No significant abnormalities noted.KIDNEYS: The right kidney measures 12.8-cm. The left kidney measures 13 cm. Echogenicity of the kidneys is within normal limits. No evidence of hydronephrosis or shadowing calculus. ABDOMINAL AORTA: No significant dilatation of the abdominal aorta. The proximal aorta measures up to 2.5 cm in diameter. The mid aorta measures up to 1.7 cm in diameter. The distal aorta measures up to 1.4 cm in diameter.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: The bladder is collapsed around the Foley catheter precluding full characterization. | 1. Mild hepatomegaly.2. Increased echogenicity of the liver is consistent with fatty infiltration.3. Sludge and stones are noted within the gallbladder without evidence of cholecystitis.4. No evidence of abdominal aortic aneurysm. |
Generate impression based on findings. | Low GFR Study technically compromised secondary to patient body habitus.RIGHT KIDNEY: Mildly echogenic parenchyma without obvious mass, stone, or hydronephrosis. 14.5 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 11.9 cm in lengthOTHER: Bladder nondistended | Study technically compromised due to body habitus. Mildly echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | 18 years old, Male, Reason: of liver History: abnl lts LIVER: The liver measures 15.0 cm in length. The liver parenchymal echogenicity is normal in appearance. 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 two mm in diameter. There is a very small gallbladder polyp measuring up to 2 mm.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.5 cm in length. RIGHT KIDNEY: Kidney measures 10.4 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Very small polyp in the gallbladder without evidence of cholelithiasis or cholecystitis.2.The hepatic parenchyma is normal in echogenicity without evidence of focal hepatic lesion. |
Generate impression based on findings. | 25-year-old pregnant female with new palpable left breast lump, presenting for sonographic evaluation. Family history of postmenopausal breast cancer in paternal grandmother. No current breast complaints. Targeted ultrasound of the left upper breast, 12:00 5 cm from the nipple, in patient's area of palpable concern reveals no suspicious solid or cystic mass. | No sonographic evidence of malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | HCV cirrhosis LIVER: Coarse echogenic liver echotexture without mass. Liver length 13 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Stable left renal cyst. Left kidney 12.3 cm in length. Spleen 10.1 cm in length. No ascites. | Stable examination. Coarse echogenic liver echotexture again noted consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Elevated creatinine RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 10.9 cm in length.LEFT KIDNEY: Mildly echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left renal cyst. Left kidney 9.5 cm in length.OTHER: Bladder nondistended | Mildly echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction. |
Generate impression based on findings. | Cirrhosis and history of renal cysts LIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 13.4 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.5 cm in length.RIGHT KIDNEY: Stable lower pole benign-appearing renal cyst. Right kidney 13.1 cm in length OTHER: Left kidney 9.6 cm in length. No ascites. No obvious large collateral vessels/varices noted | Coarse echogenic liver again noted consistent with chronic liver disease without mass or ductal dilatation. No ascites. No obvious large collateral vessels/varices noted; however, ultrasound should not be considered as a comprehensive evaluation for varices/collateral vessels. Stable benign-appearing right renal cyst. |
Generate impression based on findings. | 61-year-old male with history of thyroid cancer. Evaluate for recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Circumscribed hypoechoic nodule relative to the surrounding fat in the right thyroid bed measures 1.1 x 0.9 x 0.5 cm, not significantly changed compared with prior examinations.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Incidental note of atherosclerotic calcification affecting the left carotid artery. | Unchanged nodule in the right thyroid bed. No new lesions or lymphadenopathy identified. |
Generate impression based on findings. | Follow-up thyroid nodule RIGHT LOBE MEASUREMENTS: 5.3 x 1.8 x 2.0 cmLEFT LOBE MEASUREMENTS: 5.3 x 1.7 x 1.8 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Stable mid/inferior hypoechoic nodule measuring 0.8 x 0.7 x 0.5 cm.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable subcentimeter right hypoechoic thyroid nodule. |
Generate impression based on findings. | 86-year-old female with history of breast cancer, presents for ultrasound guided biopsy of left axillary mass. Targeted ultrasound of the left axilla identified few surgical clips adjacent to the axillary vessels. No adjacent mass or lymph node was identified. | Unable to perform ultrasound guided left axillary biopsy, as target was not identified. Findings were discussed with the referring physician, Dr.James Godfrey at the time of dictation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 53 year old female with history of hepatitis C, evaluate for hepatoma. LIVER: The liver measures 16.7 cm, and has unchanged coarse echotexture. The main portal vein is patent. No focal liver lesion is identified.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted, and there is no biliary dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10 cm. No hydronephrosis.OTHER: Left kidney measures 11.5 cm, and there is no hydronephrosis. Spleen length is 10.6 cm. | Mildly coarse echogenicity of the liver, without focal mass or lesion. |
Generate impression based on findings. | Male 65 years old; Reason: concorn for gallstone pancreatitis vs biliary colic History: acute on chronic abd pain LIVER: The liver measures 16.2 cm in length. There is 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 36.8 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.5 mm. No stones are seen but there is a minimal amount of sludge. No pericholecystic fluid. There is thickening of the gallbladder fundus with a, tail artifact seen within. The common bile duct measures 2.1 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen was partially shadowed by rib and therefore was unable to be adequately measured. No significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.2 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A anechoic cyst is seen in the midpole measuring 3.3 cm x 3.7 cm x 3.0 cm.LEFT KIDNEY: The left kidney is surgically absent. | 1. Increased echogenicity of the liver parenchyma compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses are seen in the liver.2. There is some thickening of the gallbladder fundus that likely represents gallbladder adenomyomatosis. No cholelithiasis or evidence of acute cholecystitis is seen. |
Generate impression based on findings. | 63 year old female who was recalled from screening mammogram for 5 mm oval circumscribed mass in the right lower inner quadrant, mid depth, close to the skin, could represent a tortuous blood vessel or benign mass. 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 almost entirely fatty(BiRads Density Category A), unchanged in pattern and distribution. 5 mm round circumscribed mass located in the right lower inner quadrant persist on spot compression views. No associated calcifications.Ultrasound: Targeted right lower inner quadrant ultrasound was performed. 4 x 3 mm oval hypoechoic mass is identified at 4:00 position of the right breast. No peripheral blood flow is noted. | Indeterminate 5 mm hypoechoic mass in the right lower inner quadrant. Outside hospital mammograms cannot be obtained. 6 month follow-up versus ultrasound-guided possible cyst aspiration/core biopsy were discussed with the patient. Final plan of possible cyst aspiration/core biopsy was deferred by the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: assess renal cysts seen on MRI RIGHT KIDNEY: The right kidney measures 9.1 cm in length. Anechoic right renal cyst measures 0.9 x 1.2 x 1.0 cm. No hydronephrosis, masses, or stones.LEFT KIDNEY: The left kidney measures 11.2 cm in length. Multiple anechoic renal cysts noted. Minimally complex septated cyst measures 2.7 x 2.5 x 2.4 cm. No hydronephrosis, masses, or stones.OTHER: The urinary bladder is poorly distended, limiting evaluation. Neither ureteral jet is visualized. | Multiple bilateral simple cysts with a single minimally complex left renal cyst, favored to be benign. |
Generate impression based on findings. | 84-year-old female with known substernal goiter RIGHT LOBE MEASUREMENTS: 5.6 x 2.8 x 1.4 cm, previously 6.5 x 3.0 x 1.4 cm.LEFT LOBE MEASUREMENTS: 6.9 x 5.7 x 4.3 cm, previously 10 x 5.6 x 7.3 cm.ISTHMUS MEASUREMENTS: 4 mm, previously 4 mm.RIGHT LOBE: Multinodular goiter. Reference nodule measures 1.2 x 1.3 x 0.7 cm, previously 1.2 x 1.3 x 0.7 cm.LEFT LOBE: Dominant hyperechoic nodule replaces the left lobe.ISTHMUS: Nodule superior and left aspect of the isthmus measures 2.4 x 1.8 x 1.2 cm, previously 1.9 x 1.5 x 0.9 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Color Doppler demonstrates hypervascularity of bilateral thyroid lobes. | Multinodular goiter with measurements as detailed above. |
Generate impression based on findings. | History of familial adenomatous polyposis. Known subcentimeter nodules. RIGHT LOBE MEASUREMENTS: 5.5 x 2.1 x 2.5 cm.LEFT LOBE MEASUREMENTS: 4.5 x 2.1 x 1.9 cm.ISTHMUS MEASUREMENTS: 9 mm in AP dimension.RIGHT LOBE: The right thyroid lobe is diffusely heterogeneous and mildly enlarged with increased vascularity. The previously seen nodule is not discretely evident given this heterogeneity. A benign-appearing 8 mm nodule is noted at the superior pole.LEFT LOBE: The left thyroid lobe gland is diffusely heterogeneous and mildly enlarged with increased vascularity. No discrete suspicious nodule is identified.ISTHMUS: The isthmus is diffusely heterogeneous and mildly enlarged with increased vascularity. No discrete suspicious nodule is identified.PARATHYROID GLANDS: Not identified.LYMPH NODES: No significant abnormality noted. Benign-appearing cervical lymph nodes. | Enlarged diffusely heterogeneous thyroid gland with increased vascularity, suspicious for thyroiditis. Correlation with clinical symptoms and thyroid function tests is recommended. |
Generate impression based on findings. | 57-year-old female with a history of thyroidectomy many years prior for goiter, uncertain if partial or complete. Evaluate for residual thyroid tissue. RIGHT LOBE MEASUREMENTS: 2.2 x 2.7 x 5.6 cmLEFT LOBE MEASUREMENTS: Status post left thyroidectomy.ISTHMUS MEASUREMENTS: NoneRIGHT LOBE: The right thyroid lobe echotexture is mildly coarse with a 0.9 x 0.9 x 1.1 cm anechoic cystic nodule, most likely benign. LEFT LOBE: No residual left thyroid lobe tissue.ISTHMUS: No residual isthmus tissue.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post left thyroidectomy. The right thyroid lobe contains a 1.1-cm cystic nodule, most likely benign. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 15.1 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 8.6 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.6 cm in lengthOTHER: Left kidney 11.1 cm in length. No ascites | Mildly heterogeneous liver echotexture raises the possibility of fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Hepatitis B LIVER: Coarse echogenic liver echotexture without mass. Liver length 15.3 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in length.OTHER: Left kidney 11.6 cm in length. Spleen 9.8 cm in length. No ascites. | Coarse liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | US GUIDED FNA; 3/11/2016 9:58 AM RIGHT LOBE MEASUREMENTS: 1.4 x 1.6 x 4.5 cmLEFT LOBE MEASUREMENTS: 3.1 x 3.3 x 7.8 cm.ISTHMUS MEASUREMENTS: 1.5 cmRIGHT LOBE: There are several nodules in the right lobe which appears spongiform with comet tail artifact consistent with colloid nodules. For reference, a mid right lobe nodule measures 0.4 x 0.8 x 0.9 cm.LEFT LOBE: Within the posterior aspect of the left lobe there is a poorly defined, solid and heterogeneous mass. Margins are inconspicuous and the mass approximates 2.6 x 2.7 cm. There is some vague shadowing seen as well which may be due to calcification. Cannot exclude extrathyroidal extension.ISTHMUS: Large complex mass or adjacent masses in the isthmus are solid but heterogeneous, measuring 0.6 x 1.6 x 1.9 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are 2 large left cervical nodes identified. These are abnormal in morphology as well. Level 2-3 node measures 4.2 x 2.1 x 4.9 cm. Level 3-4 node measures 2.3 x 2.4 x 3.1 cm.OTHER: No significant abnormality noted. | Malignant--appearing left thyroid mass with possible extrathyroidal extension.Malignant--appearing adenopathy left neck.Indeterminant mass in the isthmus.Benign-appearing right thyroid masses. |
Generate impression based on findings. | Reason: mass vs surgical changes History: Asymmetric gland, history of thyroidectomy in 2013 RIGHT LOBE MEASUREMENTS: 10.0 x 6.9 x 4.4 cm.RIGHT LOBE: Marked enlargement of the right thyroid lobe with diffuse heterogeneity of the right thyroid lobe.Dominant right upper pole solid nodule with hypoechoic rim measures 2.7 x 1.8 cm x 1.8. Some internal internal vascularity. No microcalcifications.LEFT LOBE: Status post left hemithyroidectomy.ISTHMUS: No acute abnormality.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Several benign-appearing left cervical lymph nodes.OTHER: No significant abnormality noted. | Markedly enlarged, heterogeneous right thyroid lobe. Dominant nodule is amenable to percutaneous biopsy if indicated. |
Generate impression based on findings. | 20-year-old male with a history of undescended testes. There is clinical concern for testicular cancer. RIGHT TESTIS: The right testis measures 4.6 x 2.2 x 2.8 cm. There is normal echogenicity. Normal Doppler flow. No masses seen.LEFT TESTIS: The left testis measures 4.3 x 2.4 x 3.4 cm. There is normal echogenicity. Normal and symmetric Doppler flow. No masses seen. The testes are symmetric.RIGHT EPIDIDYMIS: Right epididymis measures 1.4 x 1.2 x 1.3 cm.LEFT EPIDIDYMIS: Left epididymis measures 1.5 x 0.7 x 0.7 cm. Measuring approximately 0.2 x 0.3 x 0.2 cm, consistent with a simple epididymal cyst or spermatocele.OTHER: Left-sided varicocele. | 1. Left-sided varicocele.2. No concerning masses.3. Epididymal cyst or spermatocele. |
Generate impression based on findings. | 41-year-old male with colicky abdominal pain. Evaluate for kidney stones. RIGHT KIDNEY: The right kidney measures 11.2 cm in length. Echotexture appears normal. There is no evidence for hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 11.9 cm in length. Echotexture appears normal. There is no evidence for hydronephrosis, shadowing calculus or mass.OTHER: Bladder poorly distended. | No evidence for nephrolithiasis or hydronephrosis. |
Generate impression based on findings. | Male 64 years old Reason: evaluate for toxic goiter History: see above RIGHT LOBE MEASUREMENTS: Right lobe of the thyroid measures 6.4 x 2.5 x 2.7 cm.LEFT LOBE MEASUREMENTS: Left lobe of the thyroid measures 6.6 x 3.4 x 1.9 cm.ISTHMUS MEASUREMENTS: 9 mm.RIGHT LOBE: Coarse echotexture of the thyroid.LEFT LOBE: Coarse echotexture of the thyroid. There is a 6 x 5 mm benign-appearing cystic nodule in the left lobe of the thyroid.ISTHMUS: There is a 6 x 5 mm cystic benign-appearing thyroid nodule in the right isthmus.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely enlarged thyroid with coarse echotexture suggestive of thyroiditis. Clinical correlation is recommended. Subcentimeter cystic nodules in the isthmus and left lobe, most likely benign. |
Generate impression based on findings. | 59 year-old male with a history of chronic kidney disease, Stage III. Hypertension. RIGHT KIDNEY: No significant abnormalities noted.LEFT KIDNEY: No significant abnormalities noted. There is a 1.9 x 1.9 x 1.8 cm simple cyst in the interpolar region of the left kidney. There is no internal vascularity.OTHER: The bladder is incompletely distended. | Unremarkable ultrasound examination of the kidneys. |
Generate impression based on findings. | 57 years Female with postoperative acute kidney injury, rule out obstruction. RIGHT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. A simple cyst is present in the mid/lower pole measuring 2.7 x 2.7 x 2.6 cm.LEFT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.BLADDER: Foley catheter is present within the collapsed bladder.. OTHER: The liver demonstrates increased echogenicity. | No hydronephrosis. Probable hepatic steatosis. |
Generate impression based on findings. | 17-year-old female presents to evaluate right breast lump that is increasing in size for one year. History of left breast excision in 2014 which is consistent with a fibroadenoma. A targeted right ultrasound was performed for the palpable area of concern. On physical examination, a 2 cm mobile lump is palpated in the right breast 3:00 position that has increased in size as per the patient. Ultrasound demonstrates a parallel oriented hypoechoic mass well encapsulated that measures 3.9 x 1.9 x 3.9 cm with minimal peripheral blood flow. | Palpable abnormality right breast 3:00 position corresponds to a benign fibroadenoma basin imaging. Surgical consultation and possible FNA is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Acute kidney injury RIGHT KIDNEY: 11.2 cm in length. Mildly increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 10.1 cm in length. Mildly increased renal parenchymal echogenicity. An 11 mm benign-appearing cyst is noted at the inferior pole No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormality noted. | Mildly echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 62-year-old male with history of thyroid cancer recurrence with surgery. Follow-up abnormalities on prior ultrasound. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: There is some soft tissue echogenicity adjacent to surgical clips, unchanged in the interim and poorly measurable.LEFT LOBE: There is again noted hypoechoic soft tissue echogenicity in the left fibroid that which is unchanged, measuring 0.2 x 0 . 5 x 0.7 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable exam. |
Generate impression based on findings. | Female 44 years old Reason: acute liver failure History: acetaminophen toxicity, LFTs uptrending LIVER: Liver measures 16.7 cm. No focal hepatic lesion. Mildly increased hepatic echogenicity.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallstones are present. No evidence of cholecystitis.PANCREAS: The visualized portions of the pancreas are within normal limits.SPLEEN: The spleen is normal in appearance measuring 11.2 cm. There is a small amount of ascites near the spleen.KIDNEYS: Left kidney is 11.5 cm. Right kidney is 11.2 cm. No shadowing calculus or hydronephrosis.OTHER: No significant abnormalities noted. | 1.Increased echogenicity of the liver which may be seen in the setting of diffuse hepatic parenchymal dysfunction.2.Hepatic vessels are patent. |
Generate impression based on findings. | Abnormal LFTs LIVER: Coarse echogenic liver parenchyma without mass. Liver length 15.3 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.5 cm in length OTHER: Left kidney 11.6 cm in length. Spleen 10.6 cm in length. No ascites. | Coarse echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Acute kidney injury RIGHT KIDNEY: 12.2 cm in length. The renal parenchymal echogenicity is increased. No shadowing nephrolithiasis. No hydronephrosis. LEFT KIDNEY: 11.1 cm in length. The renal parenchymal echogenicity is increased. A prominent column of Bertin is noted, a normal variant. No shadowing nephrolithiasis. No hydronephrosis.BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. No abdominal free fluid noted. | Increased renal parenchymal echogenicity without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 55 year old female patient with right upper quadrant pain and epigastric pain, known gallbladder sludge, and history of pancreatitis. Evaluate for gallbladder pathology, cholecystitis. LIVER: The liver measures 12.8 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. There is questionable minimal intrahepatic biliary ductal dilatation. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas. The pancreatic duct measures upper limits of normal in diameter.RIGHT KIDNEY: The right kidney measures 9.8 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 7.4 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. There is a 1.6 x 1.6 x 1.9 cm left lower pole renal cyst.The spleen measures 11.3 cm in length and contains multiple echogenic foci compatible with calcified granulomata. | 1. No evidence of cholelithiasis or acute cholecystitis.2. Questionable minimal intrahepatic biliary ductal dilatation.3. Medical renal disease and left renal cyst. |
Generate impression based on findings. | Ms. Alexandridou submitted outside mammogram dated 06/12/2012 and two prior ultrasounds dated 06/12/2012 and 01/21/2013, from University of Illinois, Urbana. Submitted outside studies were compared to the current mammogram dated 10/14/2016. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Previously identified mass in the right medial breast, far posterior depth, is new when compared to the prior mammogram from 2012.Previously identified mass in the left central breast, mid depth, appears to have increased in size when compared to the prior mammogram. In addition, prior ultrasound examination from 2012 may show a corresponding partly cystic/partly solid mass, which needs to be further evaluated. | Bilateral partially obscured incompletely characterized masses. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Painful right submandibular mass RIGHT LOBE MEASUREMENTS: 5.4 x 1.4 x 2.6 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.3 x 2.4 cmISTHMUS MEASUREMENTS: 0.4 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: Enlarged but morphologically normal appearing bilateral submandibular/level 1 lymph nodes bilaterally.OTHER: No significant abnormality noted. | Enlarged but morphologically normal appearing bilateral submandibular/level 1 lymph nodes bilaterally. Findings consistent with benign reactive adenopathy. No worrisome mass lesion or cyst. Normal thyroid gland. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Coarse echogenic liver parenchyma again noted without mass. Liver length 16.5 cm.GALLBLADDER, BILIARY TRACT: Gallbladder absent. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.1 cm in lengthOTHER: Left kidney 10.6 cm in length. Spleen 10.5 cm in length. No ascites. | Coarse echogenic liver parenchyma again noted consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 70 years old, Male, Reason: HCC screening History: ETOH cirrhosis LIVER: The liver measures 20 cm in length. Coarse echogenicity of the liver. No definite nodularity to suggest cirrhosis. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.4 m/s.BILIARY TRACT: Cholelithiasis without 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 11.5 cm in length. Normal echotexture. Nohydronephrosis. Anechoic focus in the midpole the right kidney measuring up to 1.2 cm is favored to represent a cyst.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal echotexture. Nohydronephrosis. Anechoic focus measuring up to 1.6 cm and the left kidney is favored to represent a cyst.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without evidence of cholecystitis.2.Coarsened echogenicity of the hepatic parenchyma without nodularity to suggest cirrhosis. |
Generate impression based on findings. | 33-year-old female presents with right upper quadrant pain and vomiting. Evaluate for hepatobiliary pathology. LIVER:The liver measures 16.9 cm. The liver parenchyma has a normal echotexture. No focal mass intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is contracted and the lumen is anechoic. There is no evidence of stone or sludge. The wall measures 2 mm. No pericholecystic fluid. The common bile duct measures 4 mm.PANCREAS: The head appears normal where as the body and tail are obscured by bowel gas.SPLEEN: The spleen measures 9.7 cm without sonographic abnormalities.KIDNEYS: The left kidney measures 10.8 cm. The cortex has normal echogenicity. No shadowing calculi, worrisome mass, or hydronephrosis. The right kidney measures 10.5 cm. The cortex has normal echogenicity. No shadowing calculi, worrisome mass, or hydronephrosis. OTHER: No significant abnormality noted. | 1. Normal ultrasound of the abdomen without gallbladder pathology. |