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Generate impression based on findings. | 60-year-old male with abdominal distention but poor urine output. Evaluate for ascites. Is mild/moderate ascites in the right upper and lower quadrants with smaller amounts of ascites in the left abdomen. There are bilateral pleural effusions. | Mild/moderate ascites.Pleural effusions. |
Generate impression based on findings. | Clinical concern for primary sclerosing cholangitis. LIMITED ABDOMENLIVER: The liver measures 15.4 cm in length. There is course, increased, and heterogeneous echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation or ascites.BILIARY TRACT: The gallbladder wall measures 3.0 mm. No stones are seen. No pericholecystic fluidPANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearanceSPLEEN: The spleen measures 15.2 cm and no significant abnormalities are noted RIGHT KIDNEY: The right kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. There is a round 1.5 x 1.0 cm well-defined, hypoechoic lesion in the right kidney consistent with simple renal cyst.LEFT KIDNEY: The left kidney measures 10.9 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. Increased, course, and heterogenous echotexture of liver consistent with chronic liver disease / parenchymal dysfunction with probable early cirrhotic morphology. No mass.2. There is a previously noted portal vein thrombosis involving the entire portal venous system with cavernous transformation and collateral formation.3. Interval resolution of ascites when compared to the prior study.4. Splenomegaly. |
Generate impression based on findings. | 66-year-old female patient with elevated liver enzymes on immunosuppresion medication for lung transplant. LIVER: The liver measures 16.4 cm in length. Hepatic parenchymal echogenicity is increased and there is nodularity of the liver contour. Scattered hepatic cysts are noted, the largest within the right hepatic lobe measuring approximately 1.1 cm in the largest dimension. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is a subcentimeter gallbladder polyp near the fundus. No gallstones are identified. Gallbladder wall thickening is non-specific in the setting of ascites. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 6.7 cm in length. No evidence of hydronephrosis. The kidney is atrophic with increased cortical echogenicity. A 1.6 cm right lower pole simple cyst is noted.OTHER: The left kidney measures 6.4 cm in length. No evidence of hydronephrosis. The kidney is atrophic with increased cortical echogenicity. A subcentimeter lower pole simple renal cyst is noted.The spleen measures 9.2 cm in length.There is mild ascites. | 1. Increased hepatic echogenicity and nodular contour consistent with cirrhosis. Scattered hepatic cysts.2. Mild ascites. 3. Subcentimeter gallbladder polyp.4. Atrophic kidneys with bilateral simple renal cysts. |
Generate impression based on findings. | 86-year-old female with hyperparathyroidism. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5.7 x 2.1 x 2 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 7.1 x 2.6 x 3.5 cm.ISTHMUS MEASUREMENTS: The isthmus measures 2.1 cm in thickness.RIGHT LOBE: Multinodular appearance. Partially cystic nodule with eccentric solid component of the right lower pole measuring 1.7 x 1.1 x 1.2 cm, and the solid portion of this nodule measures 1 x 0.7 x 0.7 cm.LEFT LOBE: Multinodular appearance. Heterogeneity of the enlarged left thyroid lobe limits visualization for accurate measurement of discrete nodules.ISTHMUS: Heterogenous predominantly hyperechoic nodule of the thyroid isthmus measuring 2.1 x 3.2 x 2.3 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Multinodular thyroid goiter. The measured nodules of the thyroid isthmus and right lower pole demonstrate characteristics most compatible with "low suspicion" nodules per ATA criteria. These nodules are amenable to percutaneous biopsy as clinically recommended.2. No definite candidates for a parathyroid adenoma. Please refer to the same day nuclear medicine exam for more details. |
Generate impression based on findings. | 56-year-old female status post parathyroidectomy in October 20, 2015. Patient now with persistent primary hyperparathyroidism. Evaluate. RIGHT LOBE MEASUREMENTS: 1.3 x 1.0 x 3.2 cmLEFT LOBE MEASUREMENTS: 1.0 x 0.8 x 2.6 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: There is a hypoechoic nodule with foci of increased echogenicity in the inferior right thyroid gland measuring 0.4 x 0.2 x 0.4 cm consistent with a colloid noduleLEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No extrathyroid lesion identified.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No extrathyroid lesion is identified. |
Generate impression based on findings. | Abnormal thyroid function RIGHT LOBE MEASUREMENTS: 4.8 x 1.6 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.6 x 1.3 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Stable mildly heterogeneous gland. Stable hypoechoic upper pole nodule measuring 0.4 x 0.4 x 0.4 cm.LEFT LOBE: Stable mildly heterogeneous gland. Stable hypoechoic midpole nodule measuring 0.3 x 0.3 x 0.3 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination. Stable mildly heterogeneous gland and no change in benign-appearing bilateral subcentimeter hypoechoic nodules. No regional adenopathy. |
Generate impression based on findings. | Female 22 years old Reason: history of hypothyroidism, possible nodule on the right, please evaluate History: none RIGHT LOBE MEASUREMENTS: 5.1 x 1.4 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.3 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Coarse echotexture of the thyroid lobe without any focal nodules.LEFT LOBE: Coarse echotexture of the left lobe of the thyroid without any focal nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Coarse echotexture of the thyroid consistent with thyroiditis. |
Generate impression based on findings. | Elevated LFTs LIVER: Coarse echogenic liver echotexture without mass. Liver length 19.4 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 9.5 cm in lengthOTHER: Echogenic left renal parenchyma without worrisome mass, stone, or hydronephrosis. Left renal cyst. Left kidney 10.6 in meters in length. Spleen 16.3 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation.Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | Female 49 years old Reason: evaluate for ascites History: abdominal swelling, chronic ascites Moderately large volume ascites is seen distributed freely throughout the abdomen without evidence of loculation. The volume of ascites appears somewhat less than seen on the 8/25/2016 ultrasound. | Moderate generalized ascites. |
Generate impression based on findings. | Left thyroid nodule RIGHT LOBE MEASUREMENTS: 6 by 1.5 by 2 cmLEFT LOBE MEASUREMENTS: 5.1 x 1.4 x 1.6 centimetersISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: Diffusely heterogeneous gland. Stable inferior hypoechoic subcentimeter nodule measuring 0.4 x 0.3 x 0.4 cm.LEFT LOBE: Diffusely heterogeneous gland. Stable solid upper pole nodule measuring 0.8 x 0.7 x 0.6 cm. This nodule demonstrates coarse calcification. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable left superior thyroid solid subcentimeter nodule with coarse calcification. This lesion will be biopsied later today. No regional adenopathy. |
Generate impression based on findings. | Female 72 years old; Reason: r/o nodule, adenopathy History: small thyroid nodule. This is a 3 year follow up study RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5.1 x 1.4 x 1.7 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.6 x 1.8 x 1.4 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.5 cm.RIGHT LOBE: Several subcentimeter hypoechoic nodules are seen the largest is seen in the superior portion of the right thyroid lobe measuring 0.5 cm x 0.3 cm x 0.4 cm which is likely spongiform. Other smaller nodules were likely present and are unchanged. No internal vascularity or microcalcifications are seen.LEFT LOBE: At the inferior portion of the left lobe a hypoechoic and likely spongiform nodule is redemonstrated measuring 0.5 cm x 0.5 cm x 0.6 cm. This previously measured 0.6 cm x 0.4 cm x 0.6 cm. No internal vascular microcalcifications are seen.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious adenopathy noted. | 1. Stable subcentimeter nodule seen in the inferior left thyroid lobe. There is also a new subcentimeter nodule in the superior right lobe. Favor a benign etiology for both of these lesions.2. No suspicious regional adenopathy is identified. |
Generate impression based on findings. | 55 years old, Female, Reason: 55 yo female with AKI, rule out obstruction History: AKI RIGHT KIDNEY: Kidney measures 8.9 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus. Simple appearing cyst in the superior pole of the right kidney measures 0.7 x 0.9 x 0.8 cm.LEFT KIDNEY: The left kidney is difficult to visualize due to patient's body habitus. Kidney measures 8.9 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.BLADDER: The bladder is incompletely distended. OTHER: No significant abnormalities noted. | 1.Increased echogenicity of the kidneys consistent with medical renal disease without evidence of hydronephrosis. |
Generate impression based on findings. | 52-year-old female patient with thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.8 x 1.7 x 1.3 cm.LEFT LOBE MEASUREMENTS: 5.1 x 1.6 x 1.2 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe contains multiple nodules, many which have imaging characteristics of colloid nodules. A reference complex cystic and solid upper pole nodule measures 2.1 x 1.2 x 1.0 cm, previously 1.9 x 1.1 x 0.7 cm. Without significant change. Other nodules appear stable as well.LEFT LOBE: The left thyroid lobe contains multiple nodules, many which have imaging characteristics of colloid nodules. A reference lower pole nodule which appears spongiform with comet tail artifact measures 1.5 x 0.8 x 0.9 cm, previously 1.6 x 1.0 x 0.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology lymph nodes are noted within the bilateral neck.OTHER: No significant abnormality noted. | Stable thyroid nodulesI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Benign renal cyst. Right kidney 11.4 cm in length.LEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Benign renal cyst. Left kidney 11.1 cm in length OTHER: Bladder nondistended. Bilateral pleural effusions. Trace ascites | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Bilateral pleural effusions. Trace ascites. |
Generate impression based on findings. | 36-year-old male patient with multinodular gland. Evaluate change in nodules. RIGHT LOBE MEASUREMENTS: 2.0 x 0.8 x 1.1 cm.LEFT LOBE MEASUREMENTS: 5.6 x 3.2 x 2.9 cm.ISTHMUS MEASUREMENTS: 1 mm in thicknessRIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity.LEFT LOBE: There is a complex cystic nodule with spongiform components within the left lower pole measuring 2.7 x 2.7 x 3.1 cm, previously 2.8 x 2.8 x 2.7 cm. There is a more focal hypoechoic solid nodule within a cystic component along the upper part of the nodule, which may not have been as well demonstrated on the prior study. This nodule appears to be more confluent in nature compared to the prior study and no other discrete nodules are identified.ISTHMUS: A solid, hypoechoic nodule in the right aspect of the isthmus measures 0.7 x 0.7 x 0.6 cm, previously 0.7 x 0.5 x 0.6 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A right submandibular lymph node measures 1.8 x 0.8 x 2.1 cm and a left submandibular lymph node measures 2.2 x 0.6 x 3.3 cm. Additional benign morphology lymph nodes are noted bilaterally. OTHER: No significant abnormality noted. | 1. Heterogeneous right thyroid gland suggestive of prior thyroiditis.2. Slight interval increase in size of a complex cystic left thyroid nodule, which appears more confluent compared to the prior study.3. Unchanged solid right isthmic nodule. |
Generate impression based on findings. | 65 years old, Female, Reason: eval for obstruction, medical renal disease History: AKI (cr 2.1 up from baseline 1) RIGHT KIDNEY: Kidney measures 12.2 cm in length. Increased echogenicity kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 10.6 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.BLADDER: No significant abnormalities. A Foley is visualized in the bladder.OTHER: Bilateral pleural effusions are present. A mild amount of ascites is noted within the pelvis. | 1.Increased echogenicity of the kidneys consistent with medical renal disease without evidence of hydronephrosis or shadowing calculus.2.Bilateral pleural effusions and a mild amount of ascites is present. |
Generate impression based on findings. | Hepatitis C. Large amount of ascites in the past. Hernia repair. A mild-to-moderate amount of ascites is identified.Cirrhotic liver with nodular contours and coarsened parenchymal echogenicity noted. | Mild to moderate amount of ascites. |
Generate impression based on findings. | 87-year-old male with a history of a newly distended abdomen. Evaluate for ascites. Bilateral pleural effusions. Incidental 11.8 x 7.4 x 8.8 cm simple appearing left inferior renal pole cyst. Catheter in a collapsed urinary bladder. No significant ascites. | Bilateral pleural effusions without significant ascites. Large left renal cyst. |
Generate impression based on findings. | 65-year-old male with elevated creatinine. RIGHT KIDNEY: Measures 10.7 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. 2.0 cm upper pole cyst without septation or solid component.LEFT KIDNEY: Measures 10.5 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. 1.1 cm cyst without septation or nodular componentURINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | 1. Increased renal echogenicity consistent with medical renal disease. 2. No nephrolithiasis, hydronephrosis, or suspicious mass. |
Generate impression based on findings. | 78-year-old female with cardiogenic shock. Evaluate liver. LIVER:Measures 19.8 cm. Mildly increased and coarse echogenicity. No focal mass, ascites, or intra or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. The wall measures 0.2 cm. No stones, sludge, or pericholecystic fluid. Common bile duct measures 4.4 mm.PANCREAS: Evaluation limited by overlying bowel gas.SPLEEN: Measures 12.5 cm. No sonographic abnormalities.KIDNEYS: Right kidney measures 14.5 cm. Left kidney measures 12.2 cm. The cortex is mildly echogenic and thin. No hydronephrosis, shadowing calculi, or focal mass. OTHER: No significant abnormality noted. | 1. Mildly increased and coarse echogenicity of liver consistent with chronic liver disease and fatty infiltration/parenchymal dysfunction. No mass or ascites.2. Hepatomegaly.3. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction. No hydronephrosis. |
Generate impression based on findings. | Elevated LFTs LIVER: Diffusely heterogeneous parenchyma with new contour nodularity. While no discrete measurable lesion is clearly identified, the possibility of widespread mass lesions should be considered. Liver length 20 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or duct dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12 cm in lengthOTHER: Left kidney 9.9 cm in length. | Diffusely heterogeneous liver echotexture with new contour nodularity. While no discrete measurable lesion is clearly identifiable, the possibility of widespread mass lesions should be considered. Would recommend correlation with contrast cross sectional imaging. |
Generate impression based on findings. | Reason: of liver, cirrhosis, screen for hepatocellular carcinoma. Examination limited due to patient body habitus.LIVER: The liver measures 15.6 cm in length and nodular in contour. Increased parenchymal echogenicity. 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. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common hepatic 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 10.8 cm in length. RIGHT KIDNEY: Kidney measures 9.3 cm in length. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.7 cm in length. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Limited exam.2.Cirrhotic liver without gross focal lesions, however, sensitivity is significantly decreased due to poor penetration. Dedicated cross-sectional imaging is recommended for follow-up screening examinations. |
Generate impression based on findings. | Female 25 years old Reason: elevated lfts History: elevated lfts LIVER: Liver is minimally homogeneously echogenic which may be seen in setting of fatty infiltration. No focal hepatic lesions. Liver measures 17.3 cm in length. Main portal vein is patent with appropriate directional flow and a peak velocity of 27.1 cm/s.BILIARY TRACT: Patient is status post cholecystectomy. Common duct measures 5.5 mm. No intra or extrahepatic biliary ductal dilatation. PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. Remaining visualized portions are unremarkable. Small peripancreatic lymph node measures 1.5 x 0.8 x 2 cm.SPLEEN: Spleen measures 5.7 cm. Normal and homogeneous echogenicity.RIGHT KIDNEY: Right kidney measures 10.3 cm and demonstrates normal cortical medullary echogenicity. No shadowing calculi or hydronephrosis.LEFT KIDNEY: Left kidney measures 11.2 cm and is normal in cortical medullary echogenicity. No shadowing calculi or hydronephrosis.OTHER: No significant abnormalities noted. | No focal hepatic masses. Liver is minimally homogeneously echogenic which can be seen in the setting of fatty infiltration, similar to the prior exam. |
Generate impression based on findings. | 57-year-old male patient with right upper quadrant tenderness. Assess for hepatic etiology. LIVER: The liver measures 16.9 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and contains a large amount of layering echogenic material. There is no significant pericholecystic fluid or gallbladder wall thickening. No intra- or extrahepatic biliary ductal dilatation is identified. 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.RIGHT KIDNEY: The right kidney is poorly visualized but echogenic and contains at least one cyst.OTHER: The left kidney measures 11.4 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is increased and heterogeneous, correlating to numerous small cysts on prior CT, which are poorly visualized on this exam.The spleen measures 10.9 cm in length. | 1. Distended gallbladder filled with echogenic material though specific surrounding inflammatory changes; HIDA scan may be considered for further evaluation if clinically indicated. 2. Medical renal disease and numerous renal cysts, which are poorly evaluated on this study and seen better on prior CT. |
Generate impression based on findings. | Female 70 years old; Reason: 70 year old female with persistent epigastric abdominal pain and recent normal upper endoscopy. Please assess for cholelithiasis or pancreatic abnormalities. History: epigastric pain LIVER: The liver measures 16.9 cm in length. There is normal 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. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.0 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 1.5 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 9.4 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. Normal abdominal ultrasound without hepatobiliary pathology. |
Generate impression based on findings. | Left thyroid nodule RIGHT LOBE MEASUREMENTS: The right lobe measures 1.0 cm x 2.2 cm x 5.8 cm.LEFT LOBE MEASUREMENTS: The left lobe measures 5.3 cm x 1.9 cm x 2.8 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.2 cm.RIGHT LOBE: Right lobe is primarily homogenous. No dominant nodules are seenLEFT LOBE: Within the left lobe there is a 2.5 cm x 1.6 cm x 3.5 cm dominant nodule that is mixed cystic and solid. There is a spongiform appearance inferiorly within this nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: None visualizedLYMPH NODES: No suspicious adenopathy is noted. | 1. Within the left lobe, there is a dominant nodule that is mixed cystic and solid and measures 2.5 cm x 1.6 cm x 3.5 cm. No suspicious adenopathy is noted. |
Generate impression based on findings. | 58-year-old male screening for hepatocellular carcinoma LIVER:The liver measures 16.1 cm in length. The liver is heterogeneous in echotexture similar to prior ultrasound. No new worrisome masses are seen within the liver. The portal vein is patent with hepatopetal flow measuring 37.3 cm/s. GALLBLADDER, BILIARY TRACT: The gallbladder is visualized without stones or significant sludge. Gallbladder wall measures 3.5 mm. Common bile duct measures 4.2 mm, which is normal in caliber.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 10.9 cm in length. There is significant abnormalities are noted.KIDNEYS: The right kidney measures 11.8 cm in length. The cortex is normal in echotexture. There is no new masses, hydronephrosis, or stone seen in the right kidney. The left kidney measures 10.5 cm in length. The cortex has normal echogenicity, there are no stones visualized, no hydronephrosis, and no masses seen. | 1. No new worrisome masses are seen within the liver. Again demonstrated, the liver is heterogeneous in echotexture similar to prior ultrasound and consistent with parenchymal dysfunction/chronic liver disease. |
Generate impression based on findings. | 49-year-old female presents as a callback from screening mammography for an asymmetry in the left upper outer breast. No current breast complaints. Three standard views of the left breast with additional spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. There is a lobulated asymmetry in the left breast 2:00 position which persists with spot compression. Adjacent glandular tissue in the left upper outer breast disperses with spot compression.ULTRASOUND | Benign cyst in the left upper outer breast correlating with the mammographic asymmetry. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female 68 years old; Reason: Hx of HCC , check portal vein, hepatic vein and artery History: abnormal LFT LIVER: The patient is status post right hepatectomy. The left lobe is hypertrophied as seen on prior CT. There is normal echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. GALLBLADDER/BILIARY TRACT: The gallbladder is surgically absent. The common bile duct measures 3.4 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 9.6 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 11.3 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.Dopplers:INFERIOR VENA CAVA: The inferior vena cava is patent with hepatofugal flow.HEPATIC VEINS: The main hepatic vein is patent with hepatofugal flow.HEPATIC ARTERIES: The hepatic artery is patent with hepatopedal flow with peak systolic velocity ranging from 96.62 to108.1 cm/s and RI of 0.7.PORTAL VEIN: The main portal vein is patent with normal hepatopetal flow measured at 39.0 cm/s. SPLENIC VEIN: The splenic vein is patent with hepatopedal flow measuring 25.9 cm/s.SPLENIC ARTERY: The splenic artery is patent with antegrade flow into the spleen with peak systolic velocity measured at 56.3 cm/s and RI of 0.7. | 1. Patient is status post right hepatectomy with left liver hypertrophy. No new worrisome masses are seen. 2. The portal veins, splenic vein, inferior vena cava, and hepatic/splenic arteries are patent with appropriate flow. |
Generate impression based on findings. | 3o year old female with acute liver failure. Evaluate for portal vein thrombosis. LIVER: Liver is enlarged measuring 20.8 cm in length and is normal in echogenicity. The portal vein is patent with appropriate flow and no evidence of thrombus. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common bile duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation. PANCREAS: Normal echogenicity with no pancreatic ductal dilatation. KIDNEYS: Increased echogenicity of the renal parenchyma, right greater than left. There is mild fullness of the left renal collecting system. OTHER: Status post splenectomy. Foley in a decompressed bladder limits evaluation. | 1. Portal vein is patent with no evidence of thrombus. 2. Increased echogenicity of the renal parenchyma, right greater than left, nonspecific, suggestive of medical renal disease. 3. Mild fullness of the left renal collecting system. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Questionable mild increased parenchymal echogenicity without mass, stone, or hydronephrosis. 11.4 cm in lengthLEFT KIDNEY: Questionable mild increased parenchymal echogenicity without mass, stone, or hydronephrosis. 10.6 cm in length OTHER: Bladder nondistended | Questionable mild increased parenchymal echogenicity raises the possibility of medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Worsening liver function tests. LIVER: The left hepatic lobe is poorly visualized due to overlying bowel gas. Non-cirrhotic liver morphology. Mildly increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: The pancreas is obscured by bowel gas.KIDNEYS: The right kidney is 11.6 cm in length with new mild calyectasis. The left kidney is 12.6 cm in length with mild to moderate hydronephrosis. No suspicious renal lesions are evident. SPLEEN: 10.6 cm in length, without focal lesions evident.OTHER: Bilateral pleural effusions. No ascites identified. | 1. Increased hepatic echogenicity, compatible with parenchymal dysfunction.2. Mild right calyectasis and mild to moderate left hydronephrosis. 3. Bilateral pleural effusions. |
Generate impression based on findings. | Cirrhosis LIVER: Cirrhotic morphology without mass. Liver length is 13.8 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Nonobstructing subcentimeter renal stone. Right kidney 11.9 cm in length.OTHER: Left kidney 14.5 cm in length. Spleen 15.7 cm in length. No ascites. | Cirrhotic liver without mass or ductal dilatation. Mild splenomegaly. No ascites. Nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | 50 year-old female with a history of bilateral breast lumps and fibrocystic disease. She has a history of bilateral benign breast biopsies and cyst aspirations. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Bilateral waxing and waning masses are present. Scattered benign calcifications are unchanged in both breasts.Whole bilateral ultrasound was performed. Multiple simple and complicated cysts are present in both breasts. The largest cyst is a complicated cyst, measuring 18 x 14 mm at 12 o'clock position in the left breast. | No mammographic evidence of malignancy. Multiple simple and complicated cysts in both breasts. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Epigastric abdominal pain LIVER: Unremarkable echogenicity without mass. 16.2 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis again noted without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 13.1 cm in lengthOTHER: Left kidney 11.7 cm in length. Spleen 9 cm in length. No ascites | Stable cholelithiasis without acute inflammation or ductal dilatation. Ascites. |
Generate impression based on findings. | 59-year-old male with right upper quadrant pain LIVER: Measures 15.4 cm in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Gallbladder sludge without 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. | 1. Gallbladder sludge without evidence of cholecystitis or biliary obstruction. 2. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. |
Generate impression based on findings. | LVAD; assess for fluid collection around driveline; purulent drainage No significant loculated fluid collection associated with LVAD drive line. | No significant loculated fluid collection associated with LVAD drive line. |
Generate impression based on findings. | 39-year-old with right upper quadrant pain and nausea. LIVER: The liver measures 17.6 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.5 m/s.BILIARY TRACT: Numerous small mobile stones are present within the gallbladder. The gallbladder wall is mildly thickened measuring up to 4 mm. There is tenderness over the gallbladder. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.5 mm in diameterPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.The spleen measures 9.7 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.4 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Findings suspicious for early acute cholecystitis.2.Echogenic kidneys suggesting medical renal disease. Findings communicated with WYNNE, JOSEPH at 4:05 p.m. on 6/12/2015. |
Generate impression based on findings. | 73 years old, Male, Reason: evaluate firm extratesticular mass History: see above RIGHT TESTIS: No suspicious masses. No significant abnormalities noted.LEFT TESTIS: No significant abnormalities noted. No masses.RIGHT EPIDIDYMIS: Multiple right epididymal cysts the largest of which measures up to 1.2 cm.LEFT EPIDIDYMIS: Very large left epididymal cyst or spermatocele is near the midline and measures 3.5 x 3.4 x 7.4 cm. OTHER: Vascularity and waveforms of the testicles bilaterally are within normal limits. | 1.Very large left epididymal cyst or spermatocele is situated near the midline and measures up to 7.4 cm.2.No suspicious masses. |
Generate impression based on findings. | Hypovolemia with acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 8.5 cm in length.LEFT KIDNEY: Echogenic parenchyma without mass or hydronephrosis. Possible nonobstructing subcentimeter renal stones. Left kidney 8.7 cm in length.OTHER: No significant abnormalities noted. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass or hydronephrosis. Possible nonobstructing left renal stones. |
Generate impression based on findings. | 31-year-old male presents with right upper quadrant and epigastric pain. LIVER:Measures 15.6 cm. Mildly increased and coarse echotexture of the parenchyma. No focal masses or ascites. The common hepatic measures 0.7 cm. The portal vein is patent with normal hepatopedal flow.GALL BLADDER, BILIARY TRACT: The bladder is enlarged though nondistended. There is dependent echogenic mobile substance within the lumen, consistent with gallbladder sludge. No pericholecystic fluid or stones. Gallbladder wall measures 2.4 mm. The common bile duct measures 0.6 cm.PANCREAS: Increased echogenicity pancreas consistent with chronic pancreatitis.SPLEEN: The spleen measures 8.3 cm without sonographic abnormalities.KIDNEYS: The right kidney measures 9.6 cm. Left kidney measures 12.5 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Biliary prominence without signs of acute cholecystitis.2. Gallbladder sludge without signs of acute cholecystitis.3. Chronic pancreatitis. Recommend correlating with pancreatic enzymes to r/o acute pancreatitis. |
Generate impression based on findings. | Gallbladder polyp. LIVER: Non-cirrhotic liver morphology. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. A subcentimeter echogenic focus is noted in the gallbladder, likely representing a gallstone. The previously described polyp is not definitely seen. Otherwise unremarkable appearance of the gallbladder. No sonographic Murphy's sign.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.1 cm in length. The left kidney is 10.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 7.0 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. | Cholelithiasis without specific evidence of cholecystitis. The previously described gallbladder polyp is not visualized. |
Generate impression based on findings. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 1.5 x 1.7 x 5.1 cmLEFT LOBE MEASUREMENTS: 1.7 x 1.6 x 4.3 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: 2 mm benign colloid noduleLEFT LOBE: 2 mm benign colloid noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No parathyroid adenoma candidate could be identified within the neck. |
Generate impression based on findings. | Right upper quadrant colicky pain for 5 days. LIVER: The liver is normal in size measuring 14.7 cm in craniocaudal dimension. No focal lesion or biliary ductal dilatation. The parenchyma is normal in echogenicity. Normal hepatopedal portal venous blood flow at 0.3 cm/s.BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid or focal tenderness.No biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: The visualized portions of the pancreas are normal in appearance.SPLEEN: The spleen is normal in size and echogenicity measuring 12 cm in craniocaudal dimension.RIGHT KIDNEY: The right kidney is normal in size measuring 12 cm in length without hydronephrosis, shadowing nephrolithiasis or focal lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney is normal in size measuring 13.2 cm in length without hydronephrosis, shadowing nephrolithiasis or focal lesion. Color Doppler demonstrates hilar blood flow. | No specific findings to account for the patient's right upper quadrant pain. |
Generate impression based on findings. | Female 67 years old; nontoxic single thyroid nodule, evaluate. RIGHT LOBE MEASUREMENTS: 5.1 x 1.5 x 1.3 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.1 x 1.4 cmISTHMUS MEASUREMENT: 0.35 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Multiple left lobe cystic nodules, with the dominant nodule measuring 1.0 x 0.5 x 0.6 cm with peripheral comet tail artifact most suggestive of a colloid cyst.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Left thyroid lobe cystic nodules most suggestive of a colloid cysts. |
Generate impression based on findings. | 36-year-old female. Nodule. Evaluate for growth of right-sided thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.6 x 2.6 x 2.4 cm.LEFT LOBE MEASUREMENTS: 4.1 x 1.3 x 1.5 cm.ISTHMUS MEASUREMENTS: 0.3 cm in AP dimension.RIGHT LOBE: Dominant nodule is 3.4 x 1.5 x 2.9 cm. It is solid with no calcifications and demonstrates hypervascularity.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. | Dominant right thyroid nodule that is indeterminate and amenable to biopsy. |
Generate impression based on findings. | 26-year-old male with elevated bilirubin and alkaline phosphatase. LIVER: Nodular contour of the liver with coarse echotexture measuring 14.5 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measuring 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is not visualized. Mild prominence of the common bile duct measuring 6 mm in caliber. No intrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 23.1 cm in length.Normal echogenicity of the left kidney measures 12.5 cm in length.Bilateral pleural effusions. | 1. Cirrhotic liver morphology. Recommend CT for further evaluation. 2. Mild prominence of the common bile duct. No intrahepatic biliary ductal dilatation. No choledocholithiasis. 3. Splenomegaly. 4. Bilateral pleural effusions. |
Generate impression based on findings. | Female 62 years old; Reason: screen for HCC History: chronic hepatitis B LIVER: The liver measures 16.5 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. The main portal vein is patent with normal hepatopetal flow measured at 30.0 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.8 mm. Numerous echogenic shadowing foci are seen within the gallbladder. No sludge is seen. Negative sonographic Murphy sign. No pericholecystic fluid. The common bile duct measures 6.4 mm in diameter. No intrahepatic ductal dilation is seen.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 11.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 11.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. The liver has increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses are seen.2. Cholelithiasis without evidence of acute cholecystitis. |
Generate impression based on findings. | Call back from screening mammogram for a mass with calcifications in the left breast. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. 7 mm mass with internal calcifications is again seen at upper outer quadrant in the left breast.Ultrasound study was performed to correlate the lesion. However no sonographic correlation was obtained. | Indeterminate mass with calcifications at upper outer quadrant in the left breast, for which stereotactic core needle biopsy is recommended. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: evaluate mass over L upper extremity fistula History: mass over L upper extremity fistula, fistula functioning appropriately Immediately adjacent to the fistula is a large hypoechoic mass measuring 4.0 cm x 3.2 cm x 3.5 cm with internal vascularity in a swirling pattern demonstrating irregular waveforms with suggestion of arterial flow. This appears to be connected with the patient's known fistula. | Findings suspicious for pseudoaneurysm arising for the left upper extremity fistula as described above.Findings were discussed with Dr. Chandni Patel by phone on 9/24/2015 at 4:00 PM. |
Generate impression based on findings. | 56-year-old female patient with history of breast cancer. Evaluate thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.2 x 1.6 x 2.0 cm.LEFT LOBE MEASUREMENTS: 3.6 x 1.6 x 1.7 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe contains a 0.5 x 0.4 x 0.5 cm spongiform nodule within the right lower pole, unchanged in size.LEFT LOBE: The left thyroid lobe is without focal thyroid lesion.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are scattered nonspecific lymph nodes within the left level four lymph node station, with the largest measuring 0.6 x 0.3 x 1.8 cm. A right level 1B lymph node with a fatty hilum measures 1.8 x 0.7 x 2.9 cm.OTHER: No significant abnormality noted. | 1. Unchanged subcentimeter right thyroid nodule.2. Nondescript scattered left cervical lymph nodes. |
Generate impression based on findings. | 53-year-old woman with history of Graves' disease, now with new onset goiter. RIGHT LOBE MEASUREMENTS: 3.1 x 3.5 x 7 cm. The right thyroid lobe is enlarged with rounded contours.LEFT LOBE MEASUREMENTS: 2.1 x 2.6 x 6.9 cm. The left thyroid lobe is enlarged with round contours.ISTHMUS MEASUREMENTS: The isthmus measures 0.4 cm in AP diameter.RIGHT LOBE: There is heterogeneous echogenicity throughout the right thyroid lobe with a number of small, homogenously hyperechoic nodules scattered throughout the thyroid parenchyma. Additionally, there is diffusely increased vascularity. For reference, an echogenic nodule in the posterior, upper right lobe measures 0.8 x 0.9 x 1.3 cm.LEFT LOBE: There is heterogeneous echogenicity throughout the left thyroid lobe with a number of small, homogenously hyperechoic nodules scattered throughout the thyroid parenchyma. Additionally, there is diffusely increased vascularity. A 2.1 x 1.1 x 1.0 cm focus of slightly nodular tissue of similar echogenicity to the remaining thyroid gland is seen immediately posterior to the inferior pole of the thyroid lobe.ISTHMUS: Heterogeneous echogenicity. Ovoid iso to minimally hyperechoic nodule measuring 0.6 x 1.2 x 1.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Acute thyroiditis. Multiple echogenic nodules have been described in thyroiditis.2.Thyroid nodules as measured.3.Nodular region posterior to the inferior pole of the left thyroid lobe. This is most suggestive of exophytic thyroid nodule by echotexture, less likely to be a parathyroid adenoma or lymphadenopathy. |
Generate impression based on findings. | Reason: thyroid nodule on left side History: thyroid nodule RIGHT LOBE MEASUREMENTS: Measures 4.9 x 1.6 x 1.6 cm.LEFT LOBE MEASUREMENTS: Measures 4.6 x 1.7 x 1.9 cm.ISTHMUS MEASUREMENTS: Measures up to 0.4 cm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echotexture without discrete nodules. LEFT LOBE: Mildly heterogeneous background parenchymal echotexture. Left lower pole spongiform nodule measuring 0.7 x 0.5 x 0.6 cm, very low suspicion for neoplasm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mildly heterogeneous thyroid. Dominant subcentimeter spongiform nodule, low suspicion for neoplasm. |
Generate impression based on findings. | History hyper thyroidism RIGHT LOBE MEASUREMENTS: 6.4 x 3.3 x 2.3 cmLEFT LOBE MEASUREMENTS: 6.1 x 3.6 x 1.8 cmISTHMUS MEASUREMENTS: 1.1 cmRIGHT LOBE: Diffusely heterogeneous gland. Two midpole mixed cystic and solid nodules. A representative midpole nodule measures 1 x 0.7 x 0.9 cm.LEFT LOBE: Diffusely heterogeneous gland. Lower pole subcentimeter predominately solid nodule measuring 0.7 x 0.8 x 0.7 cm.ISTHMUS: Diffusely heterogeneous gland.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland. Multiple bilateral subcentimeter nodules as described.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 64-year-old female with a palpable right breast mass. She has a family history of breast cancer in a maternal aunt. A targeted right ultrasound was performed for the palpable area of concern in the lower inner breast. There is no solid or cystic mass identified. | No sonographic evidence for malignancy in the right lower inner breast in the area of palpable concern.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 52-year-old with autoimmune hepatitis LIVER: Liver measures 13.2 cm with diffuse coarse echotexture. No intrahepatic biliary ductal dilatation. No focal lesions noted. Liver surface appears slightly nodular. Status post cholecystectomyMain portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Status post cholecystectomy with common hepatic duct measuring up to 4 mm.No intrahepatic biliary ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen measures 8.3 cm without any focal lesions.KIDNEY: Right kidney measures 10.4 cm left kidney measures 12.1 cm. Normal echotexture noted. No hydronephrosis or focal lesions. OTHER: No ascites | Findings consistent with chronic liver disease without focal lesions. |
Generate impression based on findings. | 57-year-old female with biopsy-proven left papillary thyroid carcinoma. Evaluate for nodal disease. RIGHT LOBE MEASUREMENTS: 3.6 x 2.2 x 1 cmLEFT LOBE MEASUREMENTS: 3.9 x 1.8 x 1 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Within the right lobe there is a hypoechoic and at least partly cystic mass measuring 0.6 x 0.7 x 0.8 cm without change.LEFT LOBE: Within the left lobe, there is a hypoechoic and poorly marginated mass with internal calcification consistent with papillary thyroid cancer measuring 0.9 x 0.8 x 0.8 cm without change.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign appearing lymph nodes on the right.Benign appearing lymph node at level 2 on the left. At level for there is a rounded 0.6 x 0.8 x 0.9 cm lymph node with internal calcification and abnormal flow consistent with metastatic papillary thyroid carcinoma. A second level 4 lymph node is normal in morphology.OTHER: No significant abnormality noted. | Left papillary thyroid carcinoma with a metastatic level 4 lymph node on the left.Small cystic nodule right lobe. |
Generate impression based on findings. | 63 old female with abnormal liver function. Prior history demonstrates stem cell transplant. LIVER: Liver is again noted to be mildly echogenic. There is a complex, lobulated and partly septated cystic mass in the left lobe measuring 3.3 cm in greatest diameter which is stable.Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Post cholecystectomy. The intrahepatic delay tract is normal in caliber. The common duct is normal on today's exam.PANCREAS: The head and body are normal. The tail is incompletely visualized.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Stable examination. No biliary tract dilatation. |
Generate impression based on findings. | History of thyroid cancer. Previous left thyroid bed nodule biopsies were negative. RIGHT LOBE: Status post thyroidectomy. No specific evidence of recurrent disease in the right thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. Demonstrated again are lobulated soft tissue masses in the left thyroidectomy bed.The superior bed nodule measures 7 x 5 x 8 mm compared to 6 x 4 x 7 mm previously.The mid bed nodule measures 8 x 8 x 9 mm compared with 7 x 6 x 10 mm previously.The inferior bed nodule measures 6 x 3 x 6 mm compared to 6 x 2 x 14 mm previously.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal size cervical lymph nodes.OTHER: No significant abnormality noted. | Stable examination with several essentially stable nodules in the left thyroidectomy bed. |
Generate impression based on findings. | Sepsis RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10.4 cm in length. No perinephric collectionLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.3 cm in length. No perinephric collectionOTHER: Bladder nondistended | Echogenic parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. No perinephric collection. |
Generate impression based on findings. | 43-year-old female with history of right breast cancer status post mastectomy and chemotherapy as well as prophylactic left mastectomy presenting for unilateral left breast ultrasound for increasing left breast nodularity, specifically new nodularity inferior and medial to the nipple and near the left upper outer quadrant. Patient has bilateral breast implants. Family history of breast cancer in maternal grandmother diagnosed in her 40s. On physical examination, there is superficial small somewhat firm subcentimeter masses in the 7:00 and 8:00 position overlying the breast implant. On palpation of the left upper outer quadrant there is dense tissue with no discrete mass palpated. A targeted left ultrasound was performed for the palpable area of concern. The breast implant is visualized. In the left breast 7:00 position 2 cm from the nipple superificial to the implant is an oval circumscribed parallel hypoechoic mass with areas of internal hyperechogenicity measuring 0.5 cm x 0.2 cm x 0.3 cm with no internal vascularity on Doppler imaging. Adjacent to this mass in the left breast 8:00 position 2 cm from the nipple is a similar morphology mass measuring 0.5 cm x 0.1 cm x 0.4 cm with no internal vascularity on Doppler imaging. In the left breast 1:00 position 6 cm from the nipple there is dense breast tissue overlying the implant with no solid or cystic mass identified. | No sonographic evidence for malignancy. Two likely benign morphology masses in the left breast 7:00 and 8:00 position are most compatible with fat necrosis. Per discussion with patient, she would like to proceed with ultrasound-guided biopsy of one of these lesions to confirm benignity, and she declined short term follow up as a management option. BIRADS: 3 - Probably benign finding.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: assess for hydronephrosis/obstruction History: AKI RIGHT KIDNEY: The right kidney measures 9.3 cm in length. Anechoic lesion in the right upper pole represents a small cyst or scarring. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 9.47 m in length. No hydronephrosis or shadowing stones.OTHER: Subtle nodular contour of the liver and moderate to large volume ascites is consistent with cirrhosis. The renal jets are not visualized. | 1. No acute renal abnormality. No hydronephrosis.2. Moderate to large ascites and nodular liver contour, consistent with cirrhosis. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 5.3 x 2.5 x 2.1 cm. Unchanged in size with normal vascularity.LEFT LOBE MEASUREMENTS: 6.0 x 2.2 x 1.9 cm. Unchanged in size with normal vascularity.ISTHMUS MEASUREMENTS: 7 mm in AP dimension, unchanged.RIGHT LOBE: Multiple mixed solid and cystic nodules, some of which demonstrate slightly decreased cystic components. Otherwise no significant change is evident, accounting for differences in technique. The reference upper pole nodule measures 2.6 x 1.8 x 1.5 cm. The reference lower pole nodule measures 3.0 x 2.3 x 2.2 cm.LEFT LOBE: Multiple mixed solid and cystic nodules, without significant interval change. The reference midpole nodule is difficult to measure separately from an adjacent cystic nodule, measuring 3.7 x 1.9 x 2.1 cm in total.ISTHMUS: The reference nodule measures 2.1 x 1.9 x 1.0 cm, unchanged.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Bilateral thyroid nodules, which are stable to slightly decreased in size. No suspicious interval change. |
Generate impression based on findings. | Female, 87 years old. Acute on chronic CKD. RIGHT KIDNEY: The right kidney measures 8.2 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.2 cm in length, with increased cortical echogenicity. A mid-pole soft tissue prominence measures 1.3 x 1.3 x 1.4 cm, similar to the prior study dated 08/2012, and similar in configuration to the CT exam dated 03/2004.OTHER: The bladder is decompressed. | Increased renal cortical echogenicity compatible with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Ms. Becton is a 26 year old female presenting with a palpable mass in the left lateral breast for the past two months. Family history of breast cancer in mother, diagnosed at the age of 44. Upon physical exam of the left lateral breast, a soft mobile mass is appreciated. Targeted left breast ultrasound was performed for the patient's area of concern.In the left breast 3:00 location, approximately 1 cm from the nipple, there is an oval anechoic lesion measuring 1.9 x 1.0 x 2.0 cm, compatible with a simple cyst. | Simple cyst in the left breast. No additional imaging workup is necessary at this time. Patient should continue to follow up with her primary care physician for annual clinical breast exam.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Abdominal pain LIVER: No significant abnormalities noted. 14.7 cm in lengthBILIARY TRACT: No significant abnormalities noted. No evidence for acute inflammation or ductal dilatation. No evidence for gallstones.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Minimally complex left renal cyst. Nonobstructing lower pole left renal stone measuring 0.5 x 0.9 x 0.5 cm. Left kidney 10.8 cm in length. | No extrahepatic biliary abnormality. Specifically, no evidence for gallstones, acute inflammation, or ductal dilatation.Minimally complex left renal cyst. Nonobstructing left nephrolithiasis. |
Generate impression based on findings. | 52 year-old male with history of acute injury. Assess for stones or hydronephrosis. RIGHT KIDNEY: Mild cortical thinning, without hydronephrosis or nephrolithiasis. The right kidney measures 10.75 cm.LEFT KIDNEY: Mild cortical thinning, without hydronephrosis or nephrolithiasis. The left kidney measures 11.9 cm.OTHER: Bladder is relatively decompressed. | Mild bilateral cortical thinning, without hydronephrosis or nephrolithiasis, which may represent medical renal disease. |
Generate impression based on findings. | 90 year-old female with epigastric/upper abdominal pain. LIVER: Normal in size, contour and echogenicity. Small cysts identified.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted except a previously documented cyst.OTHER: Right pleural effusion. | No findings to account for patient's pain.Right pleural effusion.Right renal cyst. |
Generate impression based on findings. | Reason: assess for HCC History: Cystic fibrosis related cirrhosis LIVER: The liver measures 13.9 cm in length and is nodular in contour. 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 0.2 m/s.BILIARY TRACT: The gallbladder is not visualized. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: The pancreas is partially obscured.SPLEEN: The spleen is mildly enlarged and measures 14.6 cm in length.RIGHT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. No hydronephrosis. Several shadowing nonobstructive stones are noted, the largest of which measures 7 mm.LEFT KIDNEY: Kidney measures 13.1 cm in length. Normal echotexture. No hydronephrosis or shadowing stones. Simple cyst in the lower pole.OTHER: No ascites noted. | 1.Cirrhotic liver morphology without focal lesions. Splenomegaly. No ascites.2.Nonobstructing right nephrolithiasis. |
Generate impression based on findings. | 73 year old female with history of metastatic breast cancer abdominal pain, cholestasis. Evaluate for biliary obstruction. Limited exam as patient is laying in left lateral decubitus position and minimally responsive.LIVER: Coarse heterogeneous echotexture of the liver measuring 15.5 cm in length with numerous hypodense solid lesions seen diffusely throughout the liver most consistent with metastatic disease which has progressed from prior CT study dated 10/6/2014. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Multiple shadowing stones within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common duct measures 6 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 9.1 cm in length. No hydronephrosis or shadowing calculi noted.OTHER: Left kidney and spleen are not visualized due to patient positioning. | 1. Multiple solid lesions throughout the liver are most consistent with metastatic disease with interval progression compared to prior CT study dated 10/6/2014. Heterogeneous echotexture of the liver parenchyma suggestive of parenchymal dysfunction/fatty infiltration. No biliary obstruction.2. Cholelithiasis with no evidence of cholecystitis. Findings were discussed with Dr. Erica Mackenzie by phone on 3/23/2015 at 3:50 PM. |
Generate impression based on findings. | 59-year-old male with history of right thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.4 x 1.6 x 1.4 cmLEFT LOBE MEASUREMENTS: 3.7 x 1.3 x 1.1 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Solid and cystic circumscribed exophytic nodule in the right lower pole measures 2.5 x 1.5 x 2.1 cm.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered cervical lymph nodes with overall benign appearing morphologic features.OTHER: No significant abnormality noted. | Solid and cystic right inferior pole exophytic nodule which is amenable to biopsy. |
Generate impression based on findings. | 63-year-old female with thyromegaly and hoarseness. Evaluate for nodules. Goiter. RIGHT LOBE MEASUREMENTS: 2.4 x 2.5 x 5.6 cmLEFT LOBE MEASUREMENTS: 1.9 x 2.5 x 6 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Diffusely heterogeneous in echotexture. Multiple small cystic and complex cystic nodules, some with comet tail artifact. In the mid inferior right lobe is a complex cystic nodule measuring 0.9 x 1.4 x 1.1 cm with a large nodular component. Large cyst with a small amount of wall calcification inferomedially measures 1.4 x 2.5 x 2.1 cm. Similarly there is a. Early cystic nodule with small amount of wall calcification anteriorly in the upper pole extending into the isthmus measures 0.8 x 1.5 x 1.4 cm.LEFT LOBE: Diffusely heterogeneous in echotexture. Multiple small cystic and complex cystic nodules, some with comet tail artifact. Largest complex cystic nodule measures 0.5 x 0.6 x 0.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Thyromegaly with heterogeneous gland.Bilateral cystic and complex cystic nodules as described above. 2 cystic nodules on the right demonstrate a small amount of wall calcificationComplex cystic nodule on the right with eccentric, nodular soft tissue. |
Generate impression based on findings. | 56-year-old female with right flank pain. RIGHT KIDNEY: The right kidney measures 11 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Left kidney measures 10.4 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.OTHER: Bladder poorly distended without gross abnormality.Highly echogenic liver presumably related to fatty infiltration. | 1. Normal kidneys.2 fatty liver.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female; 63 years old. Reason: Sharp rise in LFTs, s/p stem cell transplant, concern for occlusive process History: Increase in LFTs LIVER: The liver measures 15.3 cm in length. The liver contour is smooth. The parenchyma is increased in echogenicity and coarse in echotexture. Within the left lobe of the liver is a 3.2 x 2.2 x 2.8 cm complex cyst which is not significant changed. No worrisome mass is identified.The main portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.46 m/sec.BILIARY TRACT: Status post cholecystectomy. The common duct measures 8 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas appear unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 12.6 cm in length.RIGHT KIDNEY: The right kidney measures in 12.3 length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass. OTHER: The left kidney measures 11.6 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass. | 1.Echogenic and coarse liver parenchyma consistent with chronic liver disease and/or hepatic steatosis. 2.Stable hepatic cyst. |
Generate impression based on findings. | Renal stones RIGHT KIDNEY: No significant change in multiple right renal stones. Mild right hydronephrosis also unchanged. Right kidney 12.7 cm in lengthLEFT KIDNEY: No significant change in nonobstructing left renal calculus. No hydronephrosis. Left kidney 12.9 cm in lengthOTHER: Bladder nondistended | No significant change in bilateral nephrolithiasis. Mild right hydronephrosis unchanged. |
Generate impression based on findings. | Cirrhosis. Evaluate for portal vein thrombosis. Acute kidney injury. Assess for hydronephrosis. LIVER: Cirrhotic liver morphology. Increased parenchymal echogenicity. No focal hepatic lesions evident. Limited evaluation of the portal vein demonstrates normal portal venous blood flow and direction, measuring 25 cm/s. A patent recanalized umbilical vein is noted, compatible with cirrhosis.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Thickened gallbladder wall, which is nonspecific in the setting of ascites. Cholelithiasis.PANCREAS: Not well visualized due to overlying bowel gas.KIDNEYS: The right kidney is 11.0 cm in length. The left kidney is 11.0 cm in length. The renal parenchyma is echogenic bilaterally. A 13 mm simple appearing cyst is noted in the left renal midpole. A subcentimeter echogenic focus in the left superior pole possibly represents a nonobstructing renal stone. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 12.2 cm in length, without focal lesions evident.OTHER: Large volume ascites present. | 1. Cirrhosis with recanalized umbilical vein and normal portal venous flow.2. Large volume ascites.3. Cholelithiasis.4. Left nonobstructing nephrolithiasis. |
Generate impression based on findings. | 85-year-old female with prior obstruction with suprapubic tube, elevated creatinine. Evaluate for hydronephrosis. RIGHT KIDNEY: Measures 7 cm in length. Increased echogenicity without evidence of hydronephrosis.LEFT KIDNEY: Measures 6.9 cm in length. Increased echogenicity without evidence of hydronephrosis.OTHER: Bladder decompressed with foley. | Very limited study without evidence of hydronephrosis. Increased renal echogenicity consistent with medical renal disease. |
Generate impression based on findings. | 53-year-old female patient with elevated LFTs, alkaline phosphatase. Evaluate for biliary, gallbladder, liver pathology. LIVER: The liver measures 14.8 cm in length. There is a 1.1 x 1.3 x 1.0 cm hyperechoic lesion within the inferior right hepatic lobe. An additional ill-defined area of hyperechogenicity is noted within the left hepatic lobe measuring approximately 1.5 cm. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 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 9.5 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.6 cm in length. No evidence of hydronephrosis. There is a 1.0 x 1.0 x 0.8 cm hypoechoic lesion within the left midpole.The spleen measures 8.7 cm in length. | 1. Right inferior hepatic lobe hyperechoic lesion and region of hyperechogenicity within the left lobe which are incompletely evaluated on this evaluation; given prior imaging findings and history of cancer, dedicated liver CT/MRI is recommended for further evaluation.2. Hypoechoic left midpole lesion is indeterminate. |
Generate impression based on findings. | Chronic renal disease with worsening function RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.6 cm in length.LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.3 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Left-sided mass. Pain. Fluid and bowel is seen tracking through the left inguinal soft tissues, likely representing an inguinal hernia with ascites. This was also present on the prior outside institution CT. The 2 cm inferior-most portion of this demonstrates some heterogeneity with loculation, favoring complex loculated ascites rather than necrotic bowel or lymph node | Left inguinal hernia containing ascites and bowel. |
Generate impression based on findings. | 36-year-old female with recurrent secondary hyperparathyroidism. Prior parathyroidectomy x4. RIGHT LOBE MEASUREMENTS: 4.9 x 2.4 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.7 x 1.4 cmISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: There is a rounded well-demarcated homogeneously hyperechoic nodule in the mid to upper pole of the right lobe measuring 1.6 x 1.7 x 1.6 cm with a complete hypoechoic rim. Very small cystic nodules are identified as well.LEFT LOBE: The inferior left lobe appears somewhat bulbous, but isoechoic with the remainder of the lobe without definable mass. . Smaller cystic areas are present as well.ISTHMUS: Small colloid cyst.PARATHYROID GLANDS: No extrathyroidal mass identified.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules. Largest nodule on the right is likely benign and was present although smaller on an exam from 11/18/2004. Small, predominately cystic areas throughout the thyroid consistent with colloid cysts.No extrathyroidal mass identified. |
Generate impression based on findings. | 58 years old, Female, Reason: rule out thyroid cancer History: none RIGHT LOBE: Patient is status post thyroidectomy. No evidence of recurrent mass.LEFT LOBE: Patient is status post thyroidectomy. No evidence of recurrent mass.ISTHMUS: Patient is status post thyroidectomy. No evidence of recurrent mass.LYMPH NODES: Several bilateral subcentimeter benign appearing lymph nodes are noted.OTHER: No significant abnormality noted. | No evidence of recurrent disease or lymphadenopathy. |
Generate impression based on findings. | 53-year-old male with abnormal liver function. History of alcohol abuse. LIVER: Liver is markedly echogenic consistent with fatty infiltration. There is diminished penetration of the ultrasound due to attenuation which may limit this exam. Morphology does not appear cirrhotic. There is no gross, focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: Gallbladder appears distended, but without obvious gallstones or wall thickening. Small amount of dependent sludge within the gallbladder.PANCREAS: Limited due to bowel gas.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Limited views of left kidney and spleen demonstrate no abnormality. | Severe fatty liver. |
Generate impression based on findings. | History of a left thyroid lobe nodule. FNA dated 3/6/2013 thyroid nodule demonstrated a colloid nodule. RIGHT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.2 cmLEFT LOBE MEASUREMENTS: 3.4 x 1.2 x 1.1 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: The right thyroid lobe is normal in echogenicity morphology and size without a discrete nodule.LEFT LOBE: The left thyroid lobe is of normal echogenicity morphology and size with an anterior interpolar mildly hypoechoic well-defined nodule measuring 7 x 5 x 6 mm, unchanged from prior. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable left thyroid lobe nodule. |
Generate impression based on findings. | Palpable right breast mass in the upper breast for the last 6 weeks. A targeted right ultrasound was performed for the patient’s area of concern. On targeted physical exam, a subcentimeter mass is appreciated.At the right breast 1:00 position, a 6 x 4 mm mass that is isoechoic to an adjacent 1.2 cm fat lobule is noted. Morphologically, this oval circumscribed mass is highly likely benign such as a fibroadenoma. | Probably benign mass in the right upper inner breast. Surgical consultation is recommended for this palpable mass. Palpably guided FNA can be considered. If no intervention is performed after correlation with surgeons physical exam, a 6 month sonographic follow up can be considered.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Hepatic failure with recent GI bleed LIMITED ABDOMENLIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 17.6 cmBILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Upper pole renal cyst. Right kidney 9.4 cm in length.OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. No ascites | Coarse liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Patent hepatic vessels with normal directional flow. Trace ascites.Echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. |
Generate impression based on findings. | HPV LIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 14.1 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.3 cm in length OTHER: Left kidney 10.4 cm in length. Spleen 10.2 cm in length. No ascites. | Coarse echogenic liver echotexture again noted consistent with chronic liver disease without mass or duct dilatation. No ascites. |
Generate impression based on findings. | Elevated LFTs LIVER: Coarse echogenic liver parenchyma without mass. Liver length 17.4 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.1 cm in lengthOTHER: Left kidney 12.2 cm in length. Spleen 12.3 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. | 55 year-old male with urinary retention. Ultrasound was provided as guidance for placement of suprapubic catheter performed by urology team. Again seen is echogenic material within the bladder. The bladder wall is thickened. Final imaging reveals portion of suprapubic catheter within the bladder. | Ultrasound was provided as guidance for placement of suprapubic catheter performed by urology team. Final imaging reveals portion of suprapubic catheter within the bladder. Echogenic material within the bladder with bladder wall thickening is again noted, clinical correlation is recommended. |
Generate impression based on findings. | 62-year-old male with chronic viral hepatitis C. Evaluate for cirrhosis and hepatocellular carcinoma. LIVER: Liver is normal in size and echotexture. No focal hepatic abnormality is identified except a single calcified granuloma. Hepatic morphology appears normal. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: Not visualized.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Limited views of left kidney demonstrate no abnormality | Normal-appearing liver without mass. |
Generate impression based on findings. | 33-year-old female patient with history of extrathyroidal nodule. Follow-up extrathyroidal lesion status post nondiagnostic FNA and lymph node. RIGHT LOBE MEASUREMENTS: 6.8 x 2 x 2.3 cm.LEFT LOBE MEASUREMENTS: 6.1 x 2.2 x 2.3 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity without dominant lesion.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity. A cystic nodule within the lower pole measures 0.8 x 0.5 x 0.5 cm, previous is 0.7 x 0.4 x 0.5 cm.ISTHMUS: The isthmus is heterogeneous in echogenicity.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: A hypoechoic nodule identified in the right neck superior to the medial aspect of the thyroid measures 0.8 x 0.6 cm, previously 0.7 x 0.5 cm. This lesion is similar in appearance to the prior exam in addition to an adjacent echogenic focus. | 1. Hypoechoic nodule in the medial aspect of the right neck is minimally larger in size, though unchanged in appearance. 2. Heterogeneous thyroid gland suggestive of prior thyroiditis. |
Generate impression based on findings. | Ms. Dalrymple is a 68 year old female with a personal history of benign right cyst aspiration in 2013. Family history of breast cancer in mother, diagnosed at the age of 48. She currently presents for ultrasound evaluation of a palpable mass was detected by Dr. Jaskowiak. Upon physical exam of the left breast, a site has been marked on the skin at the area of palpable concern. Targeted left breast ultrasound was performed. In the left breast 10:30 location, approximately 10 cm from the nipple, there is a oval hyperechoic mass measuring 1.1 x 0.5 x 0.8 cm. There is no associated vascularity. Sonographic findings are compatible with fat necrosis. | Benign fat necrosis of the left breast. No sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. All results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 41-year-old man with right upper quadrant pain. LIVER: Measures 21.3 cm in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | 1. No evidence of cholelithiasis or cholecystitis. 2. Hepatomegaly and increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. |
Generate impression based on findings. | Thyroid nodule seen on recent CT RIGHT LOBE MEASUREMENTS: 6.4 x 1.6 x 1.9 cmLEFT LOBE MEASUREMENTS: 5.3 x 1.4 x 1.5 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Punctate hypoechoic nodule right thyroid gland measuring 0.2 x 0.2 x 0.2 cmLEFT 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. | Punctate hypoechoic subcentimeter nodule right thyroid gland. No regional adenopathy. |
Generate impression based on findings. | New onset heart failure with mildly elevated LFTS, previously documented portal vein thrombosis on CT. Please evaluate. LIVER: Hyperechoic liver, suggestive of hepatic steatosis. Liver measures 12.2 cm. 4.5 x 2.7 cm peripheral right hepatic lesion is equivocal on ultrasound however consistent with cavernous hemangioma on CT. Findings consistent with known portal venous thrombosis and cavernous malformation.GALLBLADDER, BILIARY TRACT: Gallbladder nonvisualized. No intrahepatic or extrahepatic biliary ductal dilation. Common hepatic duct measures 1.45 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Right kidney measures 10.6 cm. Left kidney measures 11.8 cm. Mild right greater than left hydronephrosis.OTHER: No significant abnormalities noted. | 1. Mild right greater than left hydronephrosis.2. Findings consistent with known portal venous thrombosis and cavernous malformation.3. Equivocal hepatic lesion is consistent with cavernous hemangioma on CT.4. Hyperechoic liver, suggestive of hepatic steatosis. |
Generate impression based on findings. | 64-year-old female patient with abdominal pain, emesis. Question of cholecystitis. LIVER: The liver measures 16.0 cm in length and demonstrates increased, heterogeneous echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is cholelithiasis without significant gallbladder wall thickening. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The pancreas is not visualized on this examination.RIGHT KIDNEY: The right kidney measures 8.3 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A right upper pole renal cyst measures 3.5 x 2.9 x 3.4 cm.OTHER: The left kidney measures 8.1 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A left lower pole cyst measures 2.6 x 2.8 x 2.6 cm.The spleen measures 10.1 cm in length.There is mild ascites. | 1. Coarsened, increased hepatic echogenicity likely related to chronic liver disease without focal hepatic lesion identified.2. Cholelithiasis without sonographic evidence of acute cholecystitis.3. Mild ascites.4. Medical renal disease and bilateral renal cysts. |
Generate impression based on findings. | Thyroid cancer status post surgery and I-131 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: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: No suspicious lymph nodes identified.OTHER: No significant abnormality noted. | No evidence of residual or recurrent disease. |
Generate impression based on findings. | 64 years old, Male, Reason: eval for hydronephrosis History: AKI, elevated Cr RIGHT KIDNEY: Kidney measures 9.8 cm in length. Increased echogenicity of the kidney consistent with medical renal disease. No hydronephrosis or shadowing calculus. Simple appearing right renal cyst measures 3.5 x 2.4 x 2.4 cm.LEFT KIDNEY: Kidney measures 8.7 cm in length. Increased echogenicity of the kidney. No hydronephrosis, shadowing calculus or mass.Bladder: There is a Foley within the bladder. | 1.Increased echogenicity of the kidneys bilaterally is consistent with medical renal disease.2.Simple appearing right renal cyst. |
Generate impression based on findings. | Female 72 years old Reason: bilateral partial nephrectomies for RCC History: none RIGHT KIDNEY: Slightly echogenic kidney. Multiple small stones. Right kidney measures 10.6 cm. In the midportion of the right kidney there is a 1.9 x 1.9 x 2.1 cm, ill-defined predominantly hyperechoic lesion at the site of the patient's known resected cancer. This may represent postsurgical changes, however, either follow-up with ultrasound versus confirmation with dedicated contrast-enhanced CT or MR is recommended. No evidence of hydronephrosis.LEFT KIDNEY: Left kidney is also echogenic. Simple appearing cyst measuring 4.3 x 4 cm. Slightly echogenic kidney with punctate stones. No evidence of hydronephrosis.OTHER: No significant abnormalities noted. | Likely postsurgical changes in the right kidney. Follow-up with ultrasound for resolution versus further evaluation with dedicated renal mass protocol CT or MR is recommended to exclude any recurrent disease.Bilateral punctate stones.Simple appearing left renal cyst. |
Generate impression based on findings. | 35 year-old male with transaminitis. LIVER: Normal echogenicity of the liver measuring 13.5 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow.BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Not well assessed due to overlying bowel gas.SPLEEN: Normal echogenicity measuring 9.7 cm in length.RIGHT KIDNEY: Mild fullness of the collecting system. No nephrolithiasis delineated. OTHER: Left kidney measures 9.9 cm in length. No hydronephrosis. No shadowing intrarenal stone seen. | Mild fullness of the right renal collecting system which may be physiologic. |