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Generate impression based on findings. | 75-year-old female with postprandial discomfort. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Cholelithiasis and mild gallbladder wall thickening. Trace pericholecystic fluid. No sonographic Murphy's sign was elicited during the examination. There is no biliary ductal dilation.PANCREAS: No significant abnormalities noted.KIDNEY: 0.8 cm hypoechoic structure in the left kidney favored to represent a benign cyst however is incompletely visualized on this examination.OTHER: No significant abnormalities noted. | 1. Cholelithiasis with associated findings described above are not specific for acute cholecystitis, however a chronic component of inflammation could account for this appearance. 2. 0.8 cm hypoechoic structure in the left kidney is favored to represent a benign cyst however is incompletely visualized on this examination. Continued attention to this region on subsequent studies is recommended. |
Generate impression based on findings. | Elevated lipase. Pancreatic cyst. Please note that this examination is limited by poor acoustic penetration.LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Cholelithiasis. No gallbladder wall thickening or sonographic Murphy sign.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. No cystic lesion is evident in this region. The body and tail are obscured by bowel gas. KIDNEYS: The right kidney is 9.3 cm in length. The renal parenchyma is echogenic. No suspicious renal lesions are evident. No hydronephrosis is present. The left kidney is not well visualized due to increased echogenicity and poor acoustic penetration.SPLEEN: Not well visualized.OTHER: No significant abnormalities noted. No ascites. | 1. Limited visualization of the pancreatic head and neck, without cystic lesion evident.2. Cholelithiasis without evidence of cholecystitis.3. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 34 year old female with history of hepatitis B. Evaluate for HCC. LIVER: The liver parenchyma is coarse, similar to prior. The liver is 14.3 cm in length. Punctate, 3-mm hyperechoic focus which is likely a benign granuloma, however this area may be given special attention on subsequent screening utrasound as occasional HCC may contain large amounts of fat and be similarly hyperechoic.BILIARY TRACT: The gallbladder appears normal, and there is no gallbladder wall thickening, pericholecystic fluid, or cholelithiasis. No intrahepatic or extrahepatic biliary duct dilation. The common bile duct measures 0.2 cm.PANCREAS: Pancreas is partially visualized, and is normal in appearance.KIDNEYS: The right kidney measures 10.5 cm in length, and has normal parenchymal echogenicity. No shadowing calculi are present.The left kidney measures 10 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present.SPLEEN: The spleen measures 9 cm. | Coarse hepatic parenchyma echotexture, similar to prior. Punctate, 3-mm hyperechoic focus which is likely a benign granuloma, however this area may be given special attention on subsequent screening utrasound -- see above discussion. |
Generate impression based on findings. | 51-year-old female patient with transaminitis, abdominal pain. Evaluate liver and common bile duct. LIVER: The liver measures 20.8 cm in length and demonstrates increased parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. No intrahepatic biliary ductal dilatation is identified. The common duct measures up to 11 mm in diameter, appearing similar to a recent CT. The distal common bile duct is not visualized.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 9.6 cm in length. No evidence of hydronephrosis. OTHER: The left kidney is not visualized on this examination.The spleen is not visualized on this examination. | 1. Hepatic steatosis. 2. Non-specific dilatation of the common bile duct, appearing similar to a recent CT; MRCP may be considered if there is clinical concern for choledocholithiasis. |
Generate impression based on findings. | sacral cellulitis concern for abscessVIEW: Ultrasound of the gluteal region Dedicated ultrasound of the gluteal region superior to the gluteal cleft was performed. There is a small hypoechoic area measuring 2.2 x 1 cm at this region. There is marked soft tissue edema. | Hypoechoic area superior to the gluteal cleft which may represent a phlegmon. There is no drainable fluid collection. |
Generate impression based on findings. | 58 years old, Female, Reason: RUQ US exam to evaluate biliary tree History: Abdominal distention in patient with HCV/EtOH cirrhosis, HIV LIVER: The liver measures 19 cm in length. The liver has a nodular contour with widened fissures. No definite focal liver lesion. The liver parenchyma is diffusely echogenic. Echogenic material consistent with a thrombus is again noted at the confluence of the splenic vein and SMV. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s. There is trace ascites present.BILIARY TRACT: The gallbladder is hydropic, there is increased distention of the gallbladder since the prior study, now measuring 5 cm. There is sludge within the gallbladder and small cholelithiasis. The gallbladder wall is mildly diffusely thickened measuring 5 mm, which is nonspecific in the setting of cirrhosis and ascites. Per the ultrasound technologist, the sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11 cm in length. RIGHT KIDNEY: Kidney measures 12 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13 cm in length. Normal echotexture. No hydronephrosis. | 1.Cirrhotic liver without definite focal hepatic lesion.2.Hydropic gallbladder with circumferential wall thickening as above, nonspecific in setting of chronic liver disease and ascites. Correlation with patient's clinical history/physical exam recommended and if there is continued clinical concern, a HIDA scan may be considered for further evaluation.3.Thrombus at the confluence of the splenic vein and SMV is similar in appearance to prior study. |
Generate impression based on findings. | HCC screen LIVER: Mildly coarse echogenic liver echotexture without mass. Liver length 16.4 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 8.9 cm in lengthOTHER: Left kidney 9.7 cm in length. Spleen 10.8 cm in length. No ascites. | Mildly coarse echogenic liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites |
Generate impression based on findings. | 42 years old, Female, Reason: hx of UTIs and hydroneprhosis History: utis RIGHT KIDNEY: Kidney measures 11.5 cm in length. Proximal hydroureter is present on the right just not extend the length of the entire ureter to the level of the bladder. Mild hydronephrosis on the right. Normal echotexture. No shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Proximal right hydroureter with mild right hydronephrosis. |
Generate impression based on findings. | 65 year old woman with history of Sjogren's, possible axillary lymph node enlargement and history of left axillary biopsy. A targeted bilateral axillary ultrasound was performed. Normal appearing lymph nodes are noted bilaterally measuring up to 1.3 cm in length and with normal morphology and normal hilar blood flow. Biopsied lymph node in the left axilla is noted with clip, normal in morphology. | Normal appearing lymph nodes in the bilateral axillae. The patient is seeing Dr. Jaskowiak today. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 34-year-old with history of left breast carcinoma and left axillary lymph node metastases. Patient additionally has right breast DCIS. Now with palpable right axillary lymph node. Ultrasound obtained for further characterization. A targeted right ultrasound was performed of the right axilla for the palpable area of concern. A total of 6 normal-appearing lymph nodes were identified within the right axilla. No abnormal lymph nodes are seen. | No abnormal lymph nodes in the right axilla.BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 50 year old female presents for a follow-up study of left breast cyst. 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 (BiRADS Density Category C), unchanged in pattern and distribution. Multiple benign appearing calcifications are essentially unchanged in both breasts. There is a developing mass at 9:00 position in the left breast, measuring 24 mm. Other multiple small masses and asymmetries are unchanged in both breasts.Focused ultrasound is performed for the left medial breast.There is a lobulated hypoechoic mass measuring 24 x 18 mm at 9:00 position, 8 cm from nipple in the left breast. This mass corresponds to the developing mass seen on the mammogram. There is a stable clustered cysts at 10:00 position in the left breast. | Developing mass at 9:00 position in the left breast, for which ultrasound-guided 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. | 67-year-old male patient with history of thyroid cancer status post surgery. Question of abnormal masses. RIGHT LOBE MEASUREMENTS: No residual thyroid tissue.LEFT LOBE MEASUREMENTS: No residual thyroid tissue.ISTHMUS MEASUREMENTS: No residual thyroid tissue.RIGHT LOBE: No residual thyroid tissue.LEFT LOBE: No residual thyroid tissue.ISTHMUS: No residual thyroid tissue.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a 1.8 x 0.6 x 0.9 cm left level 3 lymph node with punctate internal echogenic foci which may represent microcalcifications. An adjacent left level 3 subcentimeter lymph node is also noted.OTHER: No significant abnormality noted. | 1. No residual thyroid tissue is identified in the surgical bed.2. A left level 3 lymph node with possible microcalcifications is suspicious for disease recurrence; biopsy is suggested for further evaluation. |
Generate impression based on findings. | 55-year-old female patient with 6 cm right-sided nodule. RIGHT LOBE MEASUREMENTS: 8.6 x 3.6 x 4.8 cm.LEFT LOBE MEASUREMENTS: 6.9 x 1.6 x 2.5 cm.ISTHMUS MEASUREMENTS: 6 mm in thickness.RIGHT LOBE: The right thyroid lobe is predominantly replaced by a complex nodule measuring approximately 6.9 x 5.9 x 3.8 cm, previously 6.1 x 5.6 x 3.1 cm. A smaller solid peripherally calcified nodule within the right upper pole measures 0.7 x 0.6 x 1 cm, previously 0.8 x 0.7 x 0.7 cm.LEFT LOBE: No focal thyroid lesion is identified.ISTHMUS: A previously described isthmus nodule likely reflects extension of the dominant right thyroid nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Similar appearance of a dominant complex right thyroid nodule, which was previously biopsied. |
Generate impression based on findings. | Female 30 years old Reason: abnormal LFT History: abnormal LIVER: Liver has increased echogenicity suggestive of fatty infiltration measuring 15.2 cm. No focal mass. Main portal vein has normal directional flow and a peak velocity of 24 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures up to 3 mm. Negative sonographic Murphy's sign. No gallstones.PANCREAS: The visualized portions of the pancreas are normal in appearance.SPLEEN: Spleen is normal in appearance measuring 14.3 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.4 cm. 0.1 cm. OTHER: No significant abnormalities noted. | Increased echogenicity of the liver is consistent with fatty infiltration. Normal appearance of the gallbladder. |
Generate impression based on findings. | Weight loss and anorexia LIVER: Coarse echogenic liver echotexture without mass. Liver length 13.4 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.5 cm in lengthOTHER: Left kidney 10 cm in length. Spleen 9.7 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 58 year-old female with history of small thyroid nodules. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 4.5 cm x 1.5 cm x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 cm x 1.3 cm x 1.4 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: Heterogeneous echotexture. Small primarily cystic appearing nodule at the midpole measures 4 mm x 4 mm x 4 mm, unchanged.LEFT LOBE: Heterogeneous echotexture. Small primarily cystic appearing nodule at the midpole measures 3 mm x 3 mm x 3 mm unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 lymph node measures 1.1 cm x 0.8 cm x 0.4 cm. Left neck level 3 lymph node measures 0.8 cm x 0.5 cm x 0.4 cm.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with bilateral cystic appearing nodules unchanged. |
Generate impression based on findings. | 62-year-old male with mantle cell lymphoma with splenic involvement and splenomegaly. Prior splenic infarct with increasing pain. SPLEEN: There is marked splenomegaly with the spleen measuring at least 24 cm in length. There is no focal splenic abnormality identified on today's exam. There is no peri-splenic or intrasplenic fluid collection.OTHER: No significant abnormalities noted. | Marked splenomegaly without change. No focal splenic abnormality and no evidence for hematoma. |
Generate impression based on findings. | Female 83 years old; Reason: hx of thyroid nodules History: asymptomatic RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.6 x 1.8 x 1.6 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.7 x 2.0 x 1.5 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.3 cm.RIGHT LOBE: The right lobe appears mildly heterogeneous. In the mid/lower portion of the right lobe there is a nodule measuring 1.1 cm x 0.9 cm x 1.0 cm. This nodule is iso to hyperechoic compared to the thyroid with no internal vascularity. No microcalcifications are seen. LEFT LOBE: The left lobe appears mildly heterogeneous with no dominant nodules identified.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious adenopathy noted. | The thyroid appears mildly heterogeneous with slight increase in vascularity, correlate with thyroiditis. No suspicious adenopathy is seen. There is a nodule in the right lobe as described above, favored to be benign. |
Generate impression based on findings. | 62-year-old female patient with a 3 cm solid thyroid nodule at the level of the isthmus seen on CT. Patient is asymptomatic. RIGHT LOBE MEASUREMENTS: 7.1 x 2.6 x 2.0 cm.LEFT LOBE MEASUREMENTS: 6.5 x 2.8 x 2.0 cm.ISTHMUS MEASUREMENTS: 7 mm in thickness.RIGHT LOBE: The right thyroid lobe is mildly heterogeneous in echogenicity containing a few subcentimeter cysts.LEFT LOBE: The left thyroid lobe is mildly heterogeneous in echogenicity containing scattered subcentimeter cystic nodules along with a spongiform-appearing nodule within the lower pole measuring 1.4 x 1.4 x 0.7 cm.ISTHMUS: The isthmus is predominantly replaced by a heterogeneous solid nodule measuring 3.2 x 1.6 x 4.8 cm. No internal calcification is identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A benign morphology right level two lymph node is noted.OTHER: No significant abnormality noted. | 1. Dominant solid isthmic nodule, which is amenable to biopsy.2. Spongiform-appearing left lower pole thyroid nodule, which is favored to be benign in etiology. |
Generate impression based on findings. | 70 year-old with acute kidney failure RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Kidney measures 9.7 cm with normal echotexture. Mild prominent corticomedullary differentiation is noted compared to prior study. COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels No significant abnormality notedPeak systolic velocity of the iliac artery is .5 m/sec.Proximal 1. 2 m/secMid 0.7 m/secDistal 0.3 m/secThe intrarenal resistive indices measure between 0.71 and 0.82.Minimal tardus parvus.OTHER: No significant abnormality noted | No definite evidence of renal artery stenosis. |
Generate impression based on findings. | Asymptomatic female presents for baseline screening mammography. Family history of breast cancer in paternal and maternal grandmother diagnosed at unknown age. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Multiple clusters of pleomorphic calcifications in the right breast, the largest measuring 2 cm in the right upper outer breast for which spot magnification views are recommended. 2 partially obscured masses in the left upper outer breast best seen on the CC view the largest measuring 10 mm for which spot compression views and ultrasound are recommended. | Multiple clusters of pleomorphic calcifications in the right breast, the largest measuring 2 cm in the right upper outer breast for which spot magnification views are recommended. Two partially obscured masses in the left upper outer breast best seen on the CC view the largest measuring 10 mm for which spot compression views and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 79-year-old female with bilateral biopsy proven oncocytomas. Surveillance examination. RIGHT KIDNEY: Large solid right renal mass measures 7.8 x 7.3 x 6.8 cm, increased in size compared to prior studies. No hydronephrosis.LEFT KIDNEY: Large solid left renal mass measures 16.0 x 12.4 x 9.7 cm, also increased in size compared to prior studies. The left kidney is displaced medially by this lesion. No hydronephrosis.OTHER: The bladder is collapsed. | Interval increase in size of bilateral renal masses. |
Generate impression based on findings. | 58-year-old female with history of hepatitis B. LIVER: Coarse, diffusely increased echogenicity of the liver. No focal hepatic lesion or mass. The liver measures 13.1 cm in length. No dilatation or cystic changes are noted of the intrahepatic or extrahepatic biliary ducts.The main portal vein is patent with normal hepatopedal flow and velocity of 24.0 cm/s.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance. There is no pericholecystic fluid, gallbladder wall thickening or cholelithiasis. The common bile duct measures 0.2 cm in diameter. PANCREAS: The head and proximal body of the pancreas are normal. The tail is obscured by bowel gas.SPLEEN: The spleen is normal in echogenicity and measures 5.5 cm in length. RIGHT KIDNEY: The right kidney measures 10.1 cm in length and shows normal echotexture. There is mild hydronephrosis. No mass or shadowing calculi.LEFT KIDNEY: The left kidney measures 9.4 cm in length and shows normal echotexture. There is minimal hydronephrosis. No mass or shadowing calculi.URINARY BLADDER: The urinary bladder is normal in appearance.OTHER: There is no free or loculated fluid. | Fatty infiltration of the liver. Mild right and minimal left hydronephrosis. |
Generate impression based on findings. | Thyroid carcinoma status post partial left thyroidectomy RIGHT LOBE: Status post thyroidectomy and ablation therapy. No worrisome mass. Benign-appearing right thyroid bed lymph node again noted and unchanged.LEFT LOBE: Status post thyroidectomy and ablation therapy without worrisome massISTHMUS: Status post thyroidectomy and ablation therapy without worrisome massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy and ablation therapy without worrisome mass or regional adenopathy. |
Generate impression based on findings. | History of cholangiocarcinoma status post colostomy and bariatric surgery. Abdominal pain and nausea. LIVER: Coarse liver parenchyma. Large right hepatic lobe mass is better evaluated on recent CT. It measures approximately 8.9 x 9.1 cm. There is perihepatic ascites with septations and internal echogenicity. Multiple small vessels are noted in the region of the portal vein with hepatopedal portal venous blood flow.BILIARY TRACT: No extra hepatic biliary ductal dilatation with the common duct measuring 6 mm. Partially distended gallbladder with probable sludge. Nonspecific wall thickening in the setting of ascites. No shadowing gallstones.PANCREAS: The visualized pancreatic body and head is unremarkable.SPLEEN: The spleen measures 16.4 cm in length without a focal lesion. RIGHT KIDNEY: The right kidney measures 12.2 cm in length with a lobular contour. No hydronephrosis or shadowing nephrolithiasis. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11.8 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. | 1. Coarse liver parenchyma with large right hepatic lobe mass better evaluated on recent CT. Complex perihepatic ascites. Portal vein thrombosis with collateral vessel formation was better characterized on CT.2. Partially distended gallbladder with probable sludge and nonspecific wall thickening. Correlate clinically and with HIDA scan results for chronic cholecystitis. |
Generate impression based on findings. | 44-year-old with right breast cellulitis. Right breast ultrasound was performed. There is an irregularly-shaped hypoechoic lesion with increased vascularity, measuring 36 x 23 mm at two o'clock retroareolar region, consistent with abscess formation. Diffuse skin thickening and edema is seen in the right breast. | Abscess formation at two o'clock retroareolar region in the right breast. Diffuse skin thickening and edema in the right breast.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 66-year-old female with right upper quadrant pain, rule out Budd-Chiari syndrome, evaluate hepatic veins LIMITED ABDOMENLIVER: Cirrhotic morphology of the liver with perihepatic fluid. | Patent hepatic veins.Normal liver Doppler study.Cirrhotic morphology of liver with moderate ascites and right pleural effusion. |
Generate impression based on findings. | 54 years old, Male, Reason: 54yo M with significant etoh abuse and abnormal labs concerning for cirrhosis. History: etoh use, hepatomegaly LIVER: The liver size is within normal limits measuring 15.4 cm in length. Increased echogenicity of the liver is consistent with fatty infiltration. No significant nodularity of the liver. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s. No evidence of ascites.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 8.6 cm in length. RIGHT KIDNEY: Kidney measures 10.6 cm in length. No evidence of hydronephrosis. Echogenic focus in the right kidney with posterior shadowing likely represents a renal calculus.LEFT KIDNEY: Kidney measures 10.8 cm in length. No evidence of hydronephrosis. | 1.Increased echogenicity of the liver is consistent with fatty infiltration. No definite capsular nodularity of the liver or widening of the fissures to suggest cirrhosis.2.Echogenic focus in the right kidney with posterior shadowing is favored to represent a renal calculus. |
Generate impression based on findings. | Renal insufficiency RIGHT KIDNEY: 7.8 cm in length. The renal parenchyma is markedly echogenic. No focal lesions or hydronephrosis is present.LEFT KIDNEY: 8.6 cm in length. The renal parenchyma is markedly echogenic. A 2 cm simple appearing cyst is noted in the midpole. No suspicious lesion or hydronephrosis is present.BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Markedly echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | Recurrent persistent hematuria. Provide guidance for native kidney biopsy. Ultrasound guidance provided for Dr. Cunningham for native right kidney biopsy | Ultrasound guidance provided for Dr. Cunningham for native right kidney biopsy. |
Generate impression based on findings. | Reason: evaluate for perinephric abscess/pyelo History: URI, lactic acidosis RIGHT KIDNEY: The right kidney measures 9.7 cm in length. Echogenic renal parenchyma. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.8 cm in length. Echogenic renal parenchyma. Anechoic lower pole cyst measures 3.0 x 2.5 x 2.3 cm. No shadowing stones or hydronephrosis.OTHER: The urinary bladder is partially decompressed by a Foley catheter, with some residual fluid. The liver parenchyma is mildly heterogeneous. | 1. Echogenic renal parenchyma, consistent with medical renal disease or parenchymal dysfunction. No hydronephrosis.2. Heterogeneous hepatic parenchyma, consistent with hepatic steatosis or parenchymal dysfunction. |
Generate impression based on findings. | AKI, history of CHF, rule out obstruction RIGHT KIDNEY: Echogenic kidney measures 12.5 cm in length. No hydronephrosis or mass. LEFT KIDNEY: Echogenic kidney measures 12.0 cm in length. No hydronephrosis or mass.OTHER: The bladder is nondistended. | Medical renal disease. No hydronephrosis. |
Generate impression based on findings. | 57-year-old female patient with TIPS and hepatic encephalopathy. LIMITED ABDOMENLIVER: The liver measures 15.0 cm in length, demonstrates coarsened echotexture, and is nodular in contour. A septated cyst is noted within the right hepatic lobe measuring 5.8 x 4.8 x 6.3 cm, previously 5.4 x 5.6 x 5.3 cm.BILIARY TRACT: The gallbladder is absent. There is no intra or extrahepatic biliary ductal dilatation. The common duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 14.5 cm in length. RIGHT KIDNEY: The right kidney measures 10.4 cm in length. No evidence of hydronephrosis.OTHER: The left kidney measures 8.0 cm in length. No evidence of hydronephrosis.No ascites. | 1. Patent TIPS with elevated velocities near the portal venous anastomosis.2. Cirrhotic morphology of the liver with patent hepatic vasculature. No ascites.3. Right hepatic cyst. |
Generate impression based on findings. | Male, 76 years old. Nephrolithiasis, renal colic. RIGHT KIDNEY: The right kidney measures 10.9 cm in length, with normal cortical echotexture. A lower pole stone measures 1.3 x 1.1 x 0.4 cm, unchanged. No hydronephrosis.LEFT KIDNEY: The left kidney measures 11.3 cm in length, with normal cortical echotexture. No large shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. A left sided bladder diverticulum is noted. | 1.Unchanged nonobstructing right renal stone. No hydronephrosis.2.Left bladder diverticulum. |
Generate impression based on findings. | 68-year-old male with multiple myeloma and renal insufficiency. Ultrasound guidance. | Ultrasound guidance for left renal biopsy. |
Generate impression based on findings. | 46-year-old female with history of gallstones. Pre cholecystectomy. LIVER: The liver is normal in size and echotexture. No focal hepatic abnormality.BILIARY TRACT: Gallbladder contains dependent sludge and stones. No wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: The head and body are normal. The tail was not well seen due to bowel gas.SPLEEN: Limited but normal in size.RIGHT KIDNEY: 3.7 cm cyst in the upper pole of the right kidney. No hydronephrosis. OTHER: No hydronephrosis involving the left kidney. | Gallstones and sludge. |
Generate impression based on findings. | Call back from screening mammogram for asymmetry and calcifications in both breasts. An ML view and two spot magnification views of both breasts and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense. Compared to the images from 2012, multiple of clustered calcification are mildly increased in benign fashion in both breasts. No uniquely suspicious cluster of calcifications are not noted. A mass in the right retroareolar region seen on the recent screening mammogram partially disperses into normal glandular tissue. Whole breast ultrasound for both breasts is performed. There are no solid or cystic lesions in either breast. | High probability benign calcifications in both breasts. Short interval follow up for both breasts is recommended in 6 months. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 48 year-old female with a history of umbilical hernia with pain. Evaluate for umbilical hernia. Note is made of a small fat containing umbilical hernia which slightly increases in size with Valsalva maneuvers. There are no loops of bowel identified within the hernia sac with or without Valsalva maneuver. | Small fat-containing umbilical hernia. |
Generate impression based on findings. | Scrotal pain. RIGHT TESTIS: 3.8 x 2.5 x 3.1 cm. Few nonspecific coarse calcifications noted. Otherwise, normal parenchymal echotexture and vascularity. LEFT TESTIS: 3.4 x 2.0 x 3.3 cm. Normal parenchymal echotexture and vascularity.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: 5 mm epididymal cyst noted. No significant abnormalities identified.OTHER: No significant abnormalities noted. No evidence of hydrocele or varicocele.DOPPLER | No specific findings to account for the patient's pain. |
Generate impression based on findings. | Renal failure RIGHT KIDNEY: Echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. Benign-appearing right renal cyst. Right kidney 10.4 cm in length.LEFT KIDNEY: Echogenic renal parenchyma without worrisome mass or hydronephrosis. Subcentimeter nonobstructing left renal stone. Left renal cysts. Left kidney 10.9 cm in length.OTHER: Bladder nondistended | Echogenic parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass or hydronephrosis. Subcentimeter nonobstructing left renal stone. |
Generate impression based on findings. | Thyroid cancer, evaluate for adenopathy or recurrence RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No suspicious lesions in the right thyroid bed.LEFT LOBE: No suspicious lesions in the left thyroid bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No specific evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Reason: 52 yo M with abdominal pain, elevated lipase of unclear etiology LIVER: The liver measures 15.5 cm in length. Normal hepatic parenchymal echogenicity and echotexture. The portal vein is patent with normal hepatopedal directional flow, peak velocity 28.5 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. No cholelithiasis or gallbladder sludge. The common hepatic duct measures 0.2 cm. The gallbladder wall measures 0.1 cm. No significant biliary ductal dilatation. Negative sonographic Murphy's sign.PANCREAS: Hypoechoic, edematous appearing pancreas with a significantly dilated pancreatic duct measuring 0.3 mm, abruptly terminating proximally in the region of the pancreatic head.RIGHT KIDNEY: The right kidney measures 10.6 cm in length. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.2 cm in length. No shadowing stones or hydronephrosis.OTHER: The spleen measures 8.2 cm in length. No ascites. | Edematous pancreatic parenchyma consistent with acute pancreatitis. Significantly dilated pancreatic duct truncating abruptly in the region of the pancreatic head; cannot exclude obstructing mass lesion. Dedicated contrast-enhanced CT of the abdomen should be obtained for further evaluation. |
Generate impression based on findings. | Male 48 years old with scrotal mass. Please evaluate. RIGHT TESTIS: The right testicle measures 4.0 x 3.0 x 3.3 cm, it is normal in echogenicity and without focal lesion. External to the right testicle in the area of palpable abnormality is a 0.3 x 0.1 x 0.3 cm anechoic lesion with no vascularity consistent with the tunica albuginea cyst.LEFT TESTIS: The left testicle measures 4.5 x 2.7 x 3.5 cm, it is normal in echogenicity and without focal lesion.RIGHT EPIDIDYMIS: The right epididymis measures 1.6 x 1.3 x 1.1 cm with a normal sonographic appearance.LEFT EPIDIDYMIS: The left epididymis measures 0.8 x 1.6 x 1.8 cm and contains a 0.3 x 1.2 x 0.3 cm anechoic structure consistent with an epididymal cyst.OTHER: Small right varicocele and small bilateral hydroceles. Normal, symmetric testicular vascularity. | 1.0.3 x 0.1 x 0.3 cm right tunica albuginea cyst corresponds to the patient's palpable abnormality.2.Small right varicocele. |
Generate impression based on findings. | 37-year-old female patient with right thyroid lobe larger than left by exam. No palpable nodules. RIGHT LOBE MEASUREMENTS: 4.8 x 1.8 x 1.7 cm.LEFT LOBE MEASUREMENTS: 5.0 x 1.5 x 1.6 cm.ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity without focal thyroid lesion.LEFT LOBE: The left thyroid lobe is homogeneous in echogenicity without focal thyroid lesion.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology lymph node is noted on the left.OTHER: No significant abnormality noted. | No dominant thyroid lesion is identified. |
Generate impression based on findings. | 68-year-old male patient with decreased BP with low SVR. LIVER: The liver measures 19.7 cm in length. No focal hepatic lesion is identified. Main portal vein flow is pulsatile and hepatopetal measuring 0.3 m/sec. The hepatic veins and IVC are prominent.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 8.5 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. OTHER: The left kidney measures 11.2 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis.The spleen measures 12.4 cm in length.No ascites. | 1. Hepatomegaly with prominent hepatic veins/IVC and pulsatile portal venous flow, which is likely secondary to right-sided heart failure.2. Medical renal disease.3. No ascites. |
Generate impression based on findings. | Thyroid cancer status post resection RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy without mass or regional adenopathy. |
Generate impression based on findings. | Evaluate for HCC. History of hepatitis C. LIVER: The liver is mildly echogenic and measures 14.8 cm in length. No focal hepatic lesion. Normal hepatopedal portal venous blood flow at 24 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation with the common duct measuring 4 mm. Normally distended gallbladder without gallstones, wall thickening pericholecystic fluid or focal tenderness.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable.SPLEEN: The spleen measures 9.6 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 9.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Stable mild pelvocaliectasis.OTHER: The left kidney measures 10.6 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | 1. Mildly echogenic liver parenchyma suggestive of parenchymal dysfunction and/or fatty infiltration without a focal lesion.2. Stable minimal right pelvocaliectasis. |
Generate impression based on findings. | Reason: history of total thyroidectomy T3N1b thyroid cancer, now with recurrent disease. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy.LEFT LOBE: Status post thyroidectomy. Within the inferior thyroidectomy bed, there is an irregular shaped hypoechoic region measuring approximately 2.0 x 2.1 x 1.0 cm which is thought to correspond with the area of increased metabolic activity on recent outside PET scan.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level IV 1.1 x 0.4 x 0.9 cm and left level V 1.0 x 0.3 x 0.7 cm lymph nodes, favor benign morphology.OTHER: No significant abnormality noted. | Irregular soft tissue mass within left inferior thyroidectomy bed which appears to correspond to hypermetabolic activity on outside PET, suspicious for recurrent or residual disease and was subsequently biopsied. |
Generate impression based on findings. | Parathyroidectomy. Papillary thyroid carcinoma was also noted on pathology report. RIGHT LOBE MEASUREMENTS: 3.8 x 1.3 x 1.6 cm. Normal in size with normal background vascularity.LEFT LOBE MEASUREMENTS: 2.9 x 1.6 x 1.7 cm. Normal in size with normal background vascularity.ISTHMUS MEASUREMENTS: 3 mm in AP dimension.RIGHT LOBE: Two right-sided nodules identified. A cystic nodule in the lower pole measures 7 mm. A spongiform nodule in in the mid pole measures 4 mm. These nodules are similar to the prior outside ultrasound and do not demonstrate suspicious characteristics. LEFT LOBE: A spongiform nodule in the midpole measures 6 mm. This is similar to the prior outside ultrasound and does not demonstrate suspicious characteristics.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Stable subcentimeter thyroid nodules, without suspicious features. |
Generate impression based on findings. | Hepatitis B LIVER: Diffusely heterogeneous parenchyma. Multiple bilobar ill-defined hyperechoic foci somewhat more conspicuous on the current examination. A representative left lobe lesion measures 0.7 x 0.6 x 0.8 cm. Liver length 17.9 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.1 cm in lengthOTHER: Left kidney 12.5 cm in length. Spleen 12 cm in length. No ascites. | Diffusely heterogeneous liver parenchyma again noted consistent with chronic liver disease. Increased conspicuity of multiple bilobar ill-defined hyperechoic foci; given the interval change, would recommend correlation with dedicated CT or MR. No ductal dilatation or ascites. |
Generate impression based on findings. | Reason: follow-up on isthmus adenomatoid nodule History: history of nodule, no symptoms (1.4 x 1.1 x 0.6cm in 2013) RIGHT LOBE MEASUREMENTS: 6.1 x 1.5 x 1.4 cmLEFT LOBE MEASUREMENTS: 5.8 x 1.4 x 1.1 cmISTHMUS MEASUREMENTS: 0.2 cm in the AP dimensionRIGHT LOBE: Right mid pole nodule appears cystic with a hyperechoic focus and measures 0.3 x 0.2 x 0.3 cm. No internal calcifications or vascularity.LEFT LOBE: Homogenous, unremarkable left thyroid gland.ISTHMUS: Spongiform nodule measures 1.1 x 0.4 x 0.9 cm without microcalcifications or vascularity.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted. No cervical lymphadenopathy.OTHER: No significant abnormality noted. | Isthmus nodule as described above is decreased in size compared to reported prior measurement of 1.4 x 1.1 x 0.6 cm in 2013 and lacks definite suspicious features. |
Generate impression based on findings. | Epigastric pain with distended gallbladder and prominent biliary system on CT LIVER: No significant abnormalities noted. Liver length 15.1 cmGALLBLADDER, BILIARY TRACT: Diffusely thickened gallbladder wall with positive Murphy's sign. Mild prominence of extrahepatic bile duct with maximal diameter of 8 mm. No cholelithiasis.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.3 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 9 cm in length. No ascites. | Abnormally diffuse thickening of gallbladder wall with positive Murphy's sign worrisome for acute acalculus cholecystitis. Mild prominence of extrahepatic bile duct; distal aspect of bile duct obscured by gas. No ascites. |
Generate impression based on findings. | 48-year-old male with hepatitis B. LIVER:Cirrhotic liver morphology. A 1.2 x 1.1 x 0.9 cm hypoechoic nodule along the left liver capsule is new since the prior study. Patent portal vein.GALLBLADDER, BILIARY TRACT: 0.5 cm echogenic focus along the gallbladder wall may represent a small stone or polyp.PANCREAS: No significant abnormality noted.SPLEEN: Splenomegaly. The spleen measures 12.3 cm in length.KIDNEYS: No significant abnormality noted. OTHER: No significant abnormality noted. | New 1.2 cm hypoechoic hepatic nodule on a background of cirrhosis is suspicious for malignancy. Cross-sectional imaging is recommended for further evaluation. |
Generate impression based on findings. | Rule out hydroureteronephrosis History: incomplete bladder emptying and indwelling Foley catheter RIGHT KIDNEY: Mildly echogenic right kidney measures 9.6 cm. No evidence of hydronephrosis or hydroureter.LEFT KIDNEY: Mildly echogenic left kidney measures 9.55 cm. No evidence of hydronephrosis or hydroureter.OTHER: Well distended urinary bladder without any focal lesions. | Mildly echogenic kidneys without evidence of hydronephrosis or hydroureter. |
Generate impression based on findings. | 58-year-old female with worsening CKD. Evaluate Body habitus limits examination.RIGHT KIDNEY: The right kidney measures 7 cm in length and is increased in echogenicity.LEFT KIDNEY: Evaluation of the left kidney is limited. Again noted is mildly increased echogenicity at the upper pole of the left kidney.Bladder: No significant abnormalities noted. | Limited examination with bilaterally hyperechoic renal parenchyma consistent with renal disease. The left kidney is incompletely imaged. |
Generate impression based on findings. | Enlarged right thyroid gland RIGHT LOBE MEASUREMENTS: 6.8 x 2.5 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.2 x 1.2 x 1.2 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: Diffusely heterogeneous gland. Predominantly solid lower pole nodule measuring 4.3 x 2.5 x 3.5 cm.LEFT LOBE: Diffusely heterogeneous gland without massISTHMUS: Diffusely heterogeneous gland without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Predominately solid dominant lower pole right thyroid nodule; this nodule is amenable to percutaneous ultrasound-guided biopsy. Diffusely heterogeneous thyroid gland raises the possibility of chronic thyroiditis. No regional adenopathy. |
Generate impression based on findings. | History of appendicitis treated with antibiotics now with persistent right lower quadrant pain/dullness. Within the right lower quadrant abdomen, there is a tubular, predominantly hypoechoic structure measuring up to 12 mm in diameter which is noncompressible and contains shadowing reflectors compatible with appendicoliths. No adjacent fluid collections are identified to suggest abscess. | Findings compatible with appendicitis of indeterminate chronicity. Discussed with ordering provider, APN FLERICK, THERESA who advised to send patient to emergency department. |
Generate impression based on findings. | 82-year-old male with history of right upper back soft tissue swelling/mass which he first noticed approximately 3 weeks ago. No pain, no limited range of motion, no fevers, no redness or any other complaints. Physical exam reveals a fluctuant, nontender soft and relatively mobile approximately 6 to 8-cm wide area of masslike swelling in the right upper back just deep to the skin surface. No overlying redness or crepitus.Ultrasound shows a large, approximately 5-10 cm structure within the subcutaneous soft tissues between the skin and the chest wall. It appears separate from the underlying ribs and chest wall, and has a clearly defined interface with the adjacent soft tissues. The structure contains relatively homogeneously isoechoic material that causes dirty shadowing and partially obscures its posterior extent. Although the relatively high acoustic impedance of this structures internal contents limits evaluation, we favor a benign etiology such as epidermoid inclusion cyst. | Findings suggestive of benign etiology, such as a large epidermoid inclusion cyst. |
Generate impression based on findings. | 65-year-old female with abdominal distention, assess for ascites, progression of cirrhosis. LIVER: Nodular hepatic contour without discrete focal lesion.BILIARY TRACT: Status post cholecystectomy. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.KIDNEY: 4.1 x 3.9 x 3.8 cm right renal cyst without septation or solid component. Mildly increased renal echogenicity without hydronephrosis. OTHER: Minimal ascites. | 1. Cirrhotic liver morphology without discrete lesion. 2. Minimal ascites. 3. Increased renal echogenicity consistent with medical renal disease. |
Generate impression based on findings. | 27 year-old history of biopsy-proven right breast fibroadenoma presents for follow-up of the right breast mass and for evaluation of tenderness in left breast. On physical exam, there is a small palpable mass in the right breast upper outer quadrant there is a 10:00 position. No palpable or visible abnormality in the left breast.RIGHT BREAST ULTRASOUND: A targeted right ultrasound was performed for the palpable area of concern. In the right breast 10:00 3 cm from nipple at the site of palpable abnormality there is a lobulated hyperechoic mass with biopsy clip seen centrally measuring 5 x 3 x 7 mm (previously measured 5 x 3 x 8 mm) consistent with biopsy-proven fibroadenoma. Also in the 10:00 position 3 cm in 3 cm from nipple there is a 5 x 3 x 7 mm cyst. In the 9:00 position 5 cm from nipple there is an 8 x 3 mm benign intramammary lymph node. No suspicious masses.LEFT BREAST ULTRASOUND:Targeted left breast ultrasound was performed in the 3:00 position 3 cm from nipple at the site of patient's reported pain and tenderness. Unremarkable dense fibroglandular tissue is seen. No suspicious masses. | No change in size of biopsy-proven right breast fibroadenoma measuring 5 x 3 x 7 mm. Right breast cyst and benign intramammary lymph node.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Transaminitis LIVER: Coarse echogenic liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 19.2 cm.BILIARY TRACT: Gallbladder sludge and stones without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.6 cm in length RIGHT KIDNEY: No significant abnormalities noted. 12.5 cm in lengthOTHER: Left kidney 12.6 cm in length. Trace ascites. | Mild hepatomegaly associated with coarse echogenic liver echotexture raises the possibility of parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Trace ascites. Gallbladder sludge and stones without acute inflammation. |
Generate impression based on findings. | BPH. Evaluate for hydronephrosis RIGHT KIDNEY: 10.1 cm in length. Mildly increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 9.6 cm in length. Mildly increased renal parenchymal echogenicity. Renal cysts noted, the largest of which measures 18 mm. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Fluid-filled with foci of debris and air, making evaluation for underlying lesion suboptimal. The Foley catheter is seen extending to the level of the prostatic urethra, however is not identified within the bladder. Mild circumferential wall thickening noted, which may be seen in the setting of BPH.OTHER: Bilateral pleural effusions, partially imaged. Prostatomegaly. | 1. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease.2. Distended bladder, without Foley catheter identified within the bladder, portion of catheter seen at level of prostatic urethra. Clinical evaluation of Foley catheter is recommended. |
Generate impression based on findings. | 27-year-old female patient with fullness on thyroid exam. Evaluate for thyromegaly or nodule. RIGHT LOBE MEASUREMENTS: 1.8 x 1.4 x 5.3 cm.LEFT LOBE MEASUREMENTS: 1.7 x 1.3 x 3.8 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity and contains a 0.3 x 0.2 x 0.4 cm hypoechoic, solid nodule within the right mid to posterior pole. The nodule has minimal internal vascularity and no microcalcifications.LEFT LOBE: The left thyroid lobe is homogeneous in echogenicity without focal thyroid lesion.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Subcentimeter hypoechoic right thyroid nodule. |
Generate impression based on findings. | 61-year-old female with transaminitis, asymptomatic. History of hepatitis C, screening. Evaluate prior benign lesions. LIVER: Coarse echotexture of the liver measuring 16.0 cm in length. Again seen is a predominantly anechoic lesion in the left hepatic lobe measuring 2.8 cm x 3.3 cm x 4.8 cm with thin internal septation. The previously noted smaller hepatic cyst is no longer visualized. GALLBLADDER, BILIARY TRACT: There is a 3-mm gallbladder polyp. Gallbladder wall measures 2 mm in thickness. No pericholecystic fluid. Common bile duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Right kidney measures 9.3 cm in length and is normal in echogenicity with no evidence of hydronephrosis.OTHER: Left kidney measures 10.1 cm in length and is normal in echogenicity with no evidence of hydronephrosis. Spleen is normal in echogenicity measuring 7.9 cm in length. | 1. Minimally complex cystic lesion in the left hepatic lobe not significantly changed. No new lesions identified. 2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration.3. 3-mm gallbladder polyp. |
Generate impression based on findings. | Ms. LINDA COLLINS is a 46 years old female with a personal history of lumps in both her breasts since she was 20 years old. Prior exam demonstrated bilateral benign-appearing masses, with six-month follow-up recommended. The patient is currently menstruating. ULTRASOUND:On physical examination, palpable masses were noted at the 12:00 position approximately 1 cm from the nipple, in both breasts.A targeted bilateral ultrasound was performed for both breasts.Right breast: Again seen is a well-circumscribed hypoechoic mass at the 12:00 position, approximately 1 cm from the nipple, which now measures 14 x 25 mm, previously 14 x 28 mm. A clustered cyst is again noted 3 cm from the nipple at the 12:00 position, now measuring 12 x 6 mm, previous 5 x 9 mm.Left breast: A well-circumscribed hypoechoic lesion is again seen at the 12:00 position, 1 cm from the nipple, now measuring 32 x 22 mm, previously 23 x 15 mm. An additional well-circumscribed hypoechoic lesion is again seen at the 1:00 position, 10 cm from the nipple, which now measures 12 x 16 mm, previously 10 x 17 mm. | 1.Interval increase in size of the dominant left breast mass, with characteristics most suggestive of a fibroadenoma, with interval increase in size felt likely related to menstrual cycle timing. However, six-month follow-up is recommended. Stable other benign fibroadenoma in the left breast 1:00 position and right breast 12:00 position. Surgical consultation is also recommended given interval increase in size.2.Slight interval increase in size of the clustered cyst in the right breast. Six month follow-up is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (6 Months). |
Generate impression based on findings. | Reason: 61 yo F with CBD dilation noted on CT abdomen, ? CBD dilation or stone ? Evidence of acute cholangitis History: CBD dilation on CT. No nausea/vomiting/abdominal pain Examination somewhat limited by overlying bowel gas and limitations positioning patient.LIVER: The liver measures 21 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 0.26 m/s.BILIARY TRACT: Contracted gallbladder which somewhat limits evaluation. No gallbladder wall thickening. The sonographic Murphy's sign is negative. The common bile duct is dilated measuring up to 12 mm in diameter until the region of the pancreatic head where there is a shadowing focus compatible with a common bile duct stone. No significant intrahepatic biliary ductal dilatation is seen.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas. The visualized proximal pancreatic duct is nondilated.SPLEEN: No significant abnormalities noted. The spleen measures 11.5 cm in length. RIGHT KIDNEY: Kidney measures 11.9 cm in length. Increased renal echogenicity with multiple small cysts.LEFT KIDNEY: Kidney measures 11.1 cm in length. Increased renal echogenicity with multiple cysts.OTHER: No significant abnormalities noted. | 1.Choledocholithiasis with stone in the common bile duct as seen on prior CT with associated dilation of the common bile duct.2.Mild hepatomegaly.3.Echogenic kidneys with multiple cysts compatible with medical renal disease.Findings discussed with SWEI, ERIC at 3:30 PM on 12/12/2016 |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Strong family history of breast cancer in sister, maternal aunt, maternal cousin, paternal aunt, and two paternal cousins. 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 75 years old Reason: r/o hydronephrosis History: CT w/nephrolithiasis, UTI RIGHT KIDNEY: Right kidney measures 10.6 cm. The cortex is echogenic suggesting medical renal disease. There are multiple shadowing stones. A simple appearing anechoic cyst is present within the midpole of the right kidney measuring 2.2 x 1.8 x 1.7 cm. No hydronephrosis.LEFT KIDNEY: Left kidney measures 8.9 cm. The left kidney has mildly increased cortical echogenicity suggesting medical renal disease. No hydronephrosis.URINARY BLADDER: The bladder is collapsed.OTHER: No significant abnormalities noted. | Echogenic kidneys bilaterally suggesting medical renal disease. Multiple shadowing stones without hydronephrosis. |
Generate impression based on findings. | Reason: assess for cirrhosis and ascites History: jaundice LIVER: The liver measures 21.3 cm in length and is nodular in contour. The liver parenchymal echotexture is coarse with increased echogenicity. No focal hepatic lesions or masses are identified within the limitations of an echogenic liver. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.14 m/s.BILIARY TRACT: No cholelithiasis. Mild gallbladder wall thickening measuring up to 4 mm which is nonspecific in the setting of chronic liver disease and ascites. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: Not visualized due to overlying bowel gas.SPLEEN: The spleen is enlarged and measures 19.5 cm in length. RIGHT KIDNEY: Kidney measures 13.2 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13.3 cm in length. Normal echotexture. No hydronephrosis.OTHER: Mild ascites. Bilateral pleural effusions. | 1.Hepatomegaly and echogenic, nodular liver compatible with chronic liver disease/cirrhosis. Splenomegaly, ascites, and decreased flow velocity within the main portal vein compatible with sequelae of portal hypertension.2.Mild gallbladder wall thickening which is nonspecific but may be related to chronic liver disease without evidence of cholelithiasis.3.Bilateral pleural effusions. |
Generate impression based on findings. | Ms. Smith is a 25-year-old woman with history of bilateral breast reduction presenting for further evaluation of a growing lump in the lateral right breast. On physical exam, there is ridgelike breast tissue palpated in the lateral right breast at the site of patient's concern.A targeted right ultrasound was performed for the patient’s area of concern. In the lateral right breast 9:00 position, 5 cm from nipple, dense fibroglandular tissue interspersed with fat lobules is seen. No suspicious cystic or solid masses are identified in this area or in adjacent breast parenchyma. | No sonographic evidence for malignancy. Clinical follow-up is recommended for the area of palpable concern. As long as the physical exam is unchanged, screening mammogram is recommended beginning at age 40. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Follow-Up Needed. |
Generate impression based on findings. | Reason: Rule out adenopathy, recurrence History: History of thyroid cancer RIGHT LOBE: Status post thyroidectomy without new nodules or masses.LEFT LOBE: Status post thyroidectomy without new nodules or masses.ISTHMUS: Status post thyroidectomy without new nodules or masses.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted. No cervical lymphadenopathy.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of recurrence or lymphadenopathy. |
Generate impression based on findings. | Extensive skin burns. Evaluate for perinephric abscess or stones; sepsis RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. No perinephric collection. 10.7 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. No perinephric collection. 9.3 cm in length.OTHER: Bladder nondistended. Trace ascites | Negative renal ultrasound. Normal parenchymal echogenicity without mass, stone, or hydronephrosis. No perinephric collection. Trace ascites. |
Generate impression based on findings. | 62-year-old male with history of right upper quadrant pain and elevated white blood cell count. LIVER: No significant abnormalities noted. GALLBLADDER, BILIARY TRACT: Cholelithiasis, with a small amount of gallbladder wall thickening and subtle mural striation. No intrahepatic or extrahepatic biliary dilatation. Common bile duct measures approximately 8 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Positive Murphy sign. | Given the patient's acute tenderness, gallbladder wall thickening and mural striation, this is most consistent with acute on chronic cholecystitis. |
Generate impression based on findings. | Ms. GWENDOLYN COLEMAN is a 65 years old female with history of left mastectomy 12/2013 for invasive ductal carcinoma and DCIS. Patient received radiation and chemotherapy. Benign right breast biopsies. She presents today for pain in the right axilla. On physical examination, no discrete masses are palpated at the area of pain in the right axilla.A targeted right axilla ultrasound was performed for the patient’s area of pain. There is no masses or abnormal lymph node identified in the area over pain. A normal morphology lymph node is noted in the right axilla. | No sonographic evidence for malignancy or for patient's pain in the right axilla. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. Routine diagnostic right breast mammogram is recommended, due in July 2016. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | Bilateral renal lesions seen on recent CT RIGHT KIDNEY: The previously noted multiple right renal lesions with intrinsic high attenuation on CT can be seen to represent multiple minimally complex cysts. A representative mid pole cyst measures 1.2 x 1.1 cm. No worrisome mass, stone, or hydronephrosis. Right kidney 9.8 cm in length.LEFT KIDNEY: The previously noted multiple left renal lesions with intrinsic high attenuation CT can be seen to represent multiple mildly complex cysts. The largest mid pole cyst measures 2 x 2 x 2 cm and demonstrates moderate internal complexity. No worrisome mass, stone, or hydronephrosis. Left kidney 9 cm in length.OTHER: Bladder nondistended | The previously noted multiple bilateral renal lesions with intrinsic high attenuation seen on the chest CT can be seen to represent multiple minimally complex cysts. The largest left mid pole cyst demonstrates moderate internal complexity; continued surveillance by ultrasound of this cystic lesion is recommended. |
Generate impression based on findings. | Alcoholic liver disease LIVER: Coarse echogenic liver echotexture without mass. Liver length 14.1 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Cholelithiasis without ductal dilatation or acute inflammation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.4 cm in lengthOTHER: Left kidney 12.4 cm in length. Spleen not visualized. No ascites. | Coarse echogenic liver echotexture consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites. |
Generate impression based on findings. | 73 year old female who was recalled from screening mammogram for focal asymmetry in the left lower inner breast . Mammogram: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. 5 mm oval circumscribed mass persists on spot compression views.Ultrasound: Targeted left lower inner quadrant ultrasound was performed. A 6 x 2 mm simple cyst is identified in the left breast at 8:00 position. No suspicious solid mass noted. | Subcentimeter simple cyst in the left breast. 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. | 65-year-old male with history of thyroid cancer status post surgery and iodine 131 treatment RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No evidence of recurrence in the thyroid bed.LEFT LOBE: No evidence of recurrence in the thyroid bed.ISTHMUS: No evidence of recurrence in the thyroid bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a benign appearing right level 5 lymph node which measures 0.9 x 0.4 x 0.7 cm.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of recurrent disease. |
Generate impression based on findings. | Reason: CT scan findings or gallstones/need to evaluate History: abdominal pain LIVER:The hepatic parenchyma appears normal in echogenicity and echotexture. No focal lesions are identified.GALLBLADDER, BILIARY TRACT: The gallbladder is mildly distended. There is a small amount of layering sludge. No shadowing gallstones are identified. Common bile duct distally measures up to 7 mm in diameter, within normal limits given patient's age. There is no gallbladder wall thickening or pericholecystic fluid. The gallbladder wall measures 2 mm. Per ultrasound technologist, sonographic Murphy's sign was negative.PANCREAS: Obscured by bowel gas.SPLEEN: No significant abnormality noted.KIDNEYS: The left kidney measures 18.9 cm in length. The right kidney measures 11.4 cm in length. A simple anechoic cyst in the upper pole the right kidney measures 3.7 x 3.7 x 3.6 cm. A simple anechoic cyst in the lower pole of the left kidney measures 2.3 x 1.5 x 1.7 cm. Mildly increased renal cortical echogenicity. There is no hydronephrosis. No shadowing stones or masses.OTHER: No significant abnormality noted. | 1. Gallbladder sludge without acute inflammation. 2. Mildly increased renal cortical echogenicity, may reflect underlying medical renal disease. |
Generate impression based on findings. | 66-year-old female with history of proven papillary thyroid cancer. RIGHT LOBE MEASUREMENTS: 3.6 x 1.7 x 1.3 cmLEFT LOBE MEASUREMENTS: 3.1 x 1.1 x 1.0 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Solid mass near the isthmus measures 1.7 x 1.3 x 0.9 cm, consistent with the patient's known malignancy, with likely microcalcifications.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered cervical lymph nodes without suspicious morphologic features.OTHER: Incidental note of heavy calcification and stenosis of the bilateral carotid arteries, partially imaged. | 1. Solid lesion in the left lobe consistent with the patient's known malignancy.2. Incidental note of heavy atherosclerotic calcification and narrowing of the carotid arteries bilaterally. A dedicated duplex ultrasound examination of the carotid arteries is recommended if one has not previously been performed. |
Generate impression based on findings. | Status post cystectomy with ileal conduit RIGHT KIDNEY: Atrophic right kidney without mass or stone. Minimal hydronephrosis. 10.1 cm in lengthLEFT KIDNEY: Minimal to mild left hydronephrosis. No mass or stone. Left kidney 11.4 cm in length.OTHER: Ileal conduit not visualized.Incidental note is made of a large right lobe liver mass measuring 10.7 x 7.6 x 9.4 cm. | Atrophic right kidney with minimal hydronephrosis. Minimal to mild left hydronephrosis. No mass or stone.Incidental note is made of a large right lobe liver mass; a malignant etiology must be considered.Dr. Bales notified of findings 4/20/2016; 9:55am. |
Generate impression based on findings. | Ms. Li is a 22 year old female with a personal history of right breast lumpectomy in 2015 for a borderline phyllodes tumor/ADH/FEA. She now presents with an interval increase in size and tenderness of known left breast mass. Upon physical exam of the left upper outer breast, there is a superficially located mobile mass.A targeted left breast ultrasound was performed for the palpable area of concern. In the left breast 1:00 location, approximately 3 cm from the nipple, there is revisualization of a macrolobulated hypoechoic mass now measuring 1.6 x 0.9 x 1.5 cm, previously measuring 1.3 x 0.9 x 1.2 cm. There is minimal associated vascularity. | Interval increase in palpable mass of the left upper outer breast. A consultation with a breast surgeon is recommended for further evaluation. All results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 6-year-old female patient with history of PBC cirrhosis. HCC screen. LIVER: The liver measures 13.6 cm in length. No focal hepatic lesion is identified. The liver contour is nodular. There are multiple cystic spaces within the subcapsular region in the right hepatic lobe which may be overlying loculated ascitic fluid. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are multiple shadowing gallstones. A small amount of pericholecystic fluid appears similar to the prior study. 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 is atrophic and echogenic measuring 6.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 13.4 cm in length. No evidence of hydronephrosis.The spleen measures 10.7 cm in length. | 1. Cirrhotic morphology of the liver without focal hepatic lesion.2. Cholelithiasis with small amount of pericholecystic fluid, appearing similar to the prior study.3. Atrophic right kidney. |
Generate impression based on findings. | 18-year-old female with history of pancreatitis, pain. Evaluate for gallstones. LIVER: Measures 15.4 in length. Unremarkable hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No evidence of cholelithiasis. Common bile duct is dilated up to 1 cm in diameter. Portions of the distal common bile duct are not clearly visualized due to bowel gas. No gallbladder wall thickening or pericholecystic fluid.PANCREAS: The pancreas is incompletely imaged due to bowel gas. The pancreatic head is heterogeneously hypoechoic and enlarged with surrounding peripancreatic fluid. There is no evidence of pancreatic ductal dilation. No discrete pancreatic fluid collections are identified.SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: Moderate ascites. | 1. No evidence of cholelithiasis or acute cholecystitis. Dilation of the common bile duct to 1 cm without evidence of choledocholithiasis, though portions of the distal common bile duct cannot be clearly visualized on this study. 2. Enlarged heterogeneously hypoechoic pancreatic head consistent with acute pancreatitis. 3. Moderate abdominal ascites. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of right breast and right axilla (9/15/15) performed at Glen Ellyn Clinic. For comparison, ultrasound images of right breast and right axilla (3/6/13) are available. ULTRASOUND IMAGES OF RIGHT BREAST AND RIGHT AXILLA (9/15/15):There are no abnormal findings in the right breast. One normal appearing lymph node is present in the right axilla. | No sonographic evidence of malignancy. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Goiter RIGHT LOBE MEASUREMENTS: 5.8 x 1.6 x 2 cmLEFT LOBE MEASUREMENTS: 9 x 5.8 x 3.8 cm ISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Relatively stable subcentimeter hypoechoic right thyroid nodules. The largest within the lower pole measures 0.6 x 0.8 x 0.7 cmLEFT LOBE: Interval decrease in size of cystic nodule measuring 1.1 x 1.1 x 1.2 cm. Slight interval increase in size of solid dominant left thyroid nodules. The largest within the lower pole now measures 4.8 x 3.7 x 4.9 cm; this is in comparison to 4.5 x 3 cm on 8/25/2011.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval decrease in size of cystic left lobe nodule. Slight interval increase in size of solid dominant left thyroid nodules. No regional adenopathy. |
Generate impression based on findings. | 84-year-old male with history of renal mass. Evaluate RIGHT KIDNEY: The right kidney measures 10.2 cm in length. There is increased parenchymal echogenicity. Solid lower pole mass measures 3.3 x 2.7 x 3.8 cm with internal vascularity. Multiple right renal cysts are not significantly changed. No hydronephrosis.LEFT KIDNEY: Left kidney measures 11.7 cm in length. There is increased parenchymal echogenicity. left lower pole simple cyst measures 1.7 x 1.6 x 1.9 cm, not significantly changed. No hydronephrosis.Bladder: No significant abnormalities noted. | 1.Stable solid right lower pole renal mass suspicious for renal cell carcinoma. 2.Increased renal echogenicity compatible with medical renal disease. |
Generate impression based on findings. | 50 year old asymptomatic female recalled from screening mammogram 03/29/16 for segmentally distributed calcifications in the left lateral breast. An ML view and four spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Again seen are segmentally distributed calcifications in the left breast, spanning approximately 16 cm in AP dimension. There are additional focal asymmetries within this region of calcification in the left upper outer breast. Again seen are an enlarged intramammary lymph node in the left upper outer breast as well as slight prominence of lymph nodes in the left axilla.ULTRASOUND | Redemonstration of segmentally distributed calcifications in the left upper outer breast corresponding to multiple hypoechoic lesions on ultrasound with indistinct margins and increased vascularity, highly suspicious for malignancy. Enlarged intramammary lymph node with markedly increased vascularity at the 2:00 position. Borderline enlarged left axillary lymph nodes. Further workup with bilateral breast MRI and ultrasound guided biopsies of the suspicious left breast lesions and abnormal intramammary lymph node is recommended. Findings and recommendations were discussed with the patient.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: RUQ u/s History: CHF patient. LVAD workup Limited examination due to patient's body habitus.LIVER:Liver measures 14.2 cm in length and demonstrates increased echogenicity and coarse echotexture. Evaluation of the left lobe of the liver is limited to the patient's body habitus.GALLBLADDER, BILIARY TRACT: Gallbladder is distended and there is dilatation of common bile duct, measuring 1.1 cm in diameter. Gallbladder sludge is noted. No pericholecystic fluid is present.PANCREAS: Evaluation of the pancreas is limited due to overlying bowel gas.SPLEEN: There is mild enlargement of the spleen, measuring 12.8 cm in length.KIDNEYS: Multiple small cysts are again noted in the right kidney. The right kidney measures 7.8 cm in length. No evidence of hydronephrosis. The left kidney measures 12.5 cm in length. Both kidneys demonstrate increased echogenicity.ABDOMINAL AORTA: Calcifications are noted within the aorta with no evidence of aneurysmal dilatation. The mid aorta measures approximately 1.4 x 1.4 x 1.5 cm. Focal calcifications are noted in the right common iliac artery wall.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Fluid is seen within the chest bilaterally. | 1.Increased echogenicity and coarse echotexture of the liver, suggestive of fatty infiltration/hepatic parenchymal dysfunction.2.Dilatation of common bile duct, which may be secondary to chronic cholecystitis or distal obstructing process. MRCP is suggested if clinically indicated.3.Increased echogenicity of both kidneys, which is nonspecific but compatible with medical renal disease. No evidence of hydronephrosis. |