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Generate impression based on findings. | Evaluate for possible acalculus cholecystitis in a patient with neutropenic fever, septic shock LIVER: Liver measures 23.6 cm, severely echogenic. No specific hepatic lesions noted. Smooth contour of the liver noted. Main portal vein demonstrates normal flow directionality and patency. No intrahepatic biliary ductal dilatation.BILIARY TRACT: Common bile duct measures up to 5 mm. Gallbladder is well-distended with multiple gallstones within it. Gallbladder wall is thickened and measures 6 mm. No evidence of pericholecystic fluid noted.PANCREAS: Cannot be visualized due to overlying bowel gas.SPLEEN: Spleen measures 13 cm, mildly increased in size, without any focal lesions.RIGHT KIDNEY: Right kidney measures 12.3 cm left kidney measures 13 cm. No renal stones or focal lesions or hydronephrosis noted. Normal echotexture noted. OTHER: No ascites | Distended gallbladder with gallstones within it and increased gallbladder wall thickening in comparison with prior examination suspicious for acute cholecystitis. No definite pericholecystic fluid noted.Mild splenomegaly.Mild hepatomegaly with fatty infiltration. |
Generate impression based on findings. | Female 6 months old Reason: Rule out mass due to torticollis History: neck mass, torticollisVIEWS: Chest AP/lateral (two views) 10/5/2015, 2142 Cardiomediastinal silhouette is normal. No focal airspace opacity, pleural effusion or pneumothorax. No neck mass is identified, however if there is ongoing concern ultrasound may be obtained for further evaluation. | No neck mass is identified, however if there is ongoing concern, neck ultrasound may be obtained for further evaluation. |
Generate impression based on findings. | Painful lump adjacent to the rib cage on the right. Limited ultrasound was performed at the site of the patient's palpable and painful lump. There is no evidence of a soft tissue mass in this region and it is possible that the palpable abnormality is within or extending from the rib cage (this area cannot be evaluated by ultrasound). Consider correlation with rib series as clinically indicated. | We could not visualize any soft tissue mass or fluid collection at the site of the lump. Consider rib series as clinically indicated. |
Generate impression based on findings. | Reason: RUQ; h/o HCV; abdominal pain. Per electronic medical record, also history of end-stage renal disease. LIVER: The liver measures 19.2 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 0.25 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 bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.4 cm in length. RIGHT KIDNEY: Kidney measures 12.5 cm in length. Most of the renal parenchyma is replaced by innumerable cysts, some with internal complexity.LEFT KIDNEY: Kidney measures 14.0 cm in length. Most of the renal parenchyma is replaced by innumerable cysts, some with internal complexity.OTHER: No significant abnormalities noted. | 1.Innumerable cysts in both kidneys compatible with acquired cystic renal disease in the setting of dialysis.2.No focal hepatic lesions identified. |
Generate impression based on findings. | 73-year-old female patient with history of multiple nodules. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 2.0 x 2.4 x 5.6 cmLEFT LOBE MEASUREMENTS: 1.8 x 2.4 x 4.7 cmISTHMUS MEASUREMENTS: 5 mm in thickness.RIGHT LOBE: Multiple heterogeneous nodules are again noted in the right thyroid lobe. The largest measures 1.2 x 0.9 x 0.9 cm in the superior pole, previously 1.0 x 0.9 x 0.8 cm. LEFT LOBE: Multiple heterogeneous nodules, some with cystic components are noted in the left thyroid lobe. The largest measures 1.8 x 1.1 x 1.3 cm in the superior pole, previously 1.9 x 1.1 x 1.2 cm.ISTHMUS: A hypoechoic nodule within the isthmus measures 0.4 x 0.3 x 0.5 cm, previously 0.6 x 0.5 x 0.3 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-morphology lymph nodes are noted in neck.OTHER: No significant abnormality noted. | Bilateral thyroid nodules without significant interval change. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma again noted without mass, stone, or hydronephrosis. 10.2 cm in lengthLEFT KIDNEY: Echogenic parenchyma again noted without mass, stone, or hydronephrosis. 9.3 cm in length.OTHER: Bladder nondistended. | Echogenic renal parenchyma again noted consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | Elevated creatinine RIGHT KIDNEY: 8.6 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 7.7 cm in length. The left kidney is not well visualized, due to poor acoustic penetration. Increased renal parenchymal echogenicity. No hydronephrosis.BLADDER: Collapsed.OTHER: No significant abnormality noted. | Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | Female 73 years old Reason: eval for cholecystitis History: s/p perc chole on 9/27 LIVER: Partially imaged liver is normal in appearance. Main portal vein is patent with normal directional flow and a peak velocity of 23.7 cm/s.BILIARY TRACT: Gallbladder has a drain within it. Patient is status post percutaneous cholecystostomy on 9/27/2016. The gallbladder is nondistended. There is no pericholecystic fluid or fluid collection. The partially visualized gallbladder wall measures 2 mm. No intrahepatic or extrahepatic biliary ductal dilatation. Common bile duct measures 3 mm.OTHER: No significant abnormalities noted. | Drain is present within the nondistended gallbladder. No evidence of complication. |
Generate impression based on findings. | Ms Minor is a 15-year-old female presenting with a history of bilateral clear nipple discharge over the last few months. Patient denies any palpable breast lump. However, her physician detected bilateral breast masses with bilateral nipple skin changes. On physical exam, bilateral areolar dryness and cracking are noted, left more than right.Bilateral whole breast ultrasound was performed. There is no cystic or solid mass in either breast. | No sonographic findings to explain patient's bilateral nipple discharge. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. Of note, patient has an appointment to be seen by Dr. Bao for further evaluation. All results and recommendations were discussed with the patient and her mother.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: concern for cholecystitis on CT scan History: epigastric abdominal pain BILIARY TRACT: The gallbladder is mildly distended and contains layering sludge. No shadowing gallstones are identified. No 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 3 mm in diameter. | Sludge in a mildly distended gallbladder without specific sonographic evidence of acute cholecystitis. If there is persistent clinical concern for acute cholecystitis, nuclear medicine HIDA scan may be considered as clinically warranted. |
Generate impression based on findings. | Reason: Liver ultrasound chronic hepatitis B carrier LIVER: The liver measures 13.5 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.53 m/s.BILIARY TRACT: Contracted gallbladder without evidence of cholecystitis. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 8.8 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Findings suggestive of chronic liver disease without focal lesions identified. |
Generate impression based on findings. | Nonalcoholic steatohepatitis. Hepatitis C. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 9.8 cm in length, with a subcentimeter benign-appearing cyst. The left kidney is 8.9 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 8.4 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites. | Increased hepatic echogenicity compatible with steatosis, without suspicious hepatic lesion identified. |
Generate impression based on findings. | 51 year-old female with right upper quadrant pain and chills. LIVER: Normal in size and echotexture.GALLBLADDER, BILIARY TRACT: Dependent gallstone in the gallbladder without wall thickening, distention or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Head and body are normal. Tail is not well seenRIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Dependent gallstone without complication. |
Generate impression based on findings. | 35-year-old pregnant female presents for right axillary ultrasound following physical examination where her physician noted a palpable area. A targeted right axillary ultrasound was performed for the patient’s area of concern. There is no suspicious solid or cystic mass identified. A normal appearing right axillary lymph node is present measuring 1.8 x 0.8 cmm, with normal hilar vascularity. | No sonographic evidence for malignancy. Normal morphology right axillary lymph node. Clinical follow up is recommended to ensure that this result is concordant with physical exam. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Hepatitis C LIVER: Mildly coarse liver echotexture without worrisome mass. Stable minimally complex benign-appearing left hepatic lobe cyst measuring 1.4 x 1.3 x 1.8 cm. Liver length 10.7 cm in lengthBILIARY TRACT: Stable cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.8 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11.3 cm in lengthOTHER: Left kidney 10.5 cm in length. No ascites | Mildly coarse liver echotexture suggestive for chronic liver disease without worrisome mass. Stable minimally complex benign-appearing left hepatic lobe cyst. Stable cholelithiasis without acute inflammation or ductal dilatation. No ascites. |
Generate impression based on findings. | Stated history of nontoxic multinodular goiter. RIGHT LOBE MEASUREMENTS: 0.9 x 0.6 x 4 cmLEFT LOBE MEASUREMENTS: 0.8 x 0.4 x 3.1 cmISTHMUS MEASUREMENTS: 1 mmRIGHT LOBE: Mildly atrophic right thyroid gland with mildly heterogeneous background parenchyma. 3 x 3 x 4 mm hypoechoic well marginated lesion in the superior portion of the right thyroid. Previously this measured 5 x 4 x 7 mm.In the inferior portion of the right thyroid lobe there is a 5 x 3 x 9 mm solid lesion with vascularity and probable small cystic components previously measuring 9 x 5 x 10 mm.LEFT LOBE: Atrophic left thyroid gland with mildly heterogeneous background parenchyma. 2 mm cystic nodule is noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Subcentimeter right thyroid nodules without specific suspicious sonographic features are relatively stable in size. |
Generate impression based on findings. | 69-year-old male patient with AMS. Concern for myxedema. Limited evaluation of the left thyroid lobe secondary to an IV obstructing probe placement. RIGHT LOBE MEASUREMENTS: 1.8 x 3.0 x 5.2 cm.LEFT LOBE MEASUREMENTS: 1.7 x 1.4 cm (measured in the trans).ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity and contains a few tiny cysts. Vascularity is within normal limits on color Doppler imaging.LEFT LOBE: Limited evaluation of the left thyroid lobe is without focal lesion. Vascularity is within normal limits on color Doppler imaging.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Limited evaluation of the thyroid though without definite abnormality. |
Generate impression based on findings. | 59 year-old male with right upper quadrant pain and nausea. LIVER: Coarsened liver architecture. Smooth liver contour. No focal mass lesions are identified. The portal vein flow is hepatopetal.GALLBLADDER, BILIARY TRACT: The gallbladder is incompletely distended. No gallstones are identified. No findings to suggest acute cholecystitis. No common duct stones are seen.PANCREAS: No significant abnormalities noted although partially of by overlying bowel gas.SPLEEN: Mild splenomegaly.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1. Coarsened liver echotexture may be seen in chronic liver disease.2. Mild splenomegaly. |
Generate impression based on findings. | Female 66 years old; Reason: Change in nodules History: Multinodular goiter, dominant right nodule with previous benign FNA RIGHT LOBE MEASUREMENTS: 7.9 x 5.0 x 3.8 cm (previously 8.0 x 6.1 x 5.4 cm)LEFT LOBE MEASUREMENTS: 3.3 x 1.0 x 1.3 cm (previously 4.6 x 1.0 x 1.3 cm)ISTHMUS MEASUREMENT: 0.3 cm (previously 0.2 cm)RIGHT LOBE: In the right inferior thyroid lobe is a predominantly solid nodule with an internal calcification which appears similar to the prior study. This measures 6.4 x 4.0 x 2.9 cm (previously 7.2 x 5.6 x 4.5 cm).LEFT LOBE: 0.5 x 0.7 x 0.4 cm solid nodule in the inferior pole previously measured 0.6 to 0.4 x 0.7 cm.ISTHMUS: No significant abnormality noted.OTHER: Scattered prominent cervical lymph nodes are seen with fatty hila and a benign appearance. | 1.Interval decrease in the size of the right lobe nodule. Stable left thyroid nodule.2.No suspicious lymphadenopathy. |
Generate impression based on findings. | Enlarging cystic lesion left side of neck with history of multinodular goiter RIGHT LOBE MEASUREMENTS: 3.4 x 3.3 x 5.8 cmLEFT LOBE MEASUREMENTS: 2.3 x 6 x 7 cm ISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Diffusely heterogeneous gland again noted with dominant mixed cystic and solid nodule measuring 4.2 x 3.8 x 3.2 cm. The cystic component of this nodule now demonstrates extensive internal debris.LEFT LOBE: Diffusely heterogeneous gland with relatively stable dominant mixed cystic and solid nodule measuring 3.9 x 3 x 2.6 cm.ISTHMUS: Diffusely heterogeneous glandPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change in bilateral dominant mixed cystic and solid nodules. Cystic component of right dominant thyroid nodule demonstrates significant internal debris. |
Generate impression based on findings. | Renal stone RIGHT KIDNEY: AbsentLEFT KIDNEY: Echogenic renal parenchyma without worrisome mass. Benign-appearing cyst. 0.3 x 0.3 cm echogenic focus within the lower pole consistent with nonobstructing subcentimeter stone. Interval decrease in degree of hydronephrosis which is now minimal. Left kidney 11.5 cm in length.OTHER: Bladder nondistended | Absent right kidney. Echogenic left renal parenchyma consistent with medical renal disease/chronic parenchymal dysfunction without worrisome mass. Interval decrease in degree of hydronephrosis which is now minimal. Subcentimeter nonobstructing lower pole left renal stone. |
Generate impression based on findings. | Reason: Is there an aneurysm? History: Reported history of AAA LIVER: The liver measures 18.9 cm in length. The hepatic parenchymal echotexture and echogenicity is coarse. There is a mildly nodular hepatic contour, concerning for a cirrhotic liver morphology. There are no focal masses. The main portal vein is patent with normal directional hepatopedal flow, maximum systolic velocity 19.4 cm/s.GALLBLADDER, BILIARY TRACT: The common hepatic duct measures 2 mm in diameter. The gallbladder is moderately distended. There is a small echogenic focus in the dependent portion of the gallbladder with posterior acoustic shadowing, consistent with a small stone. There is no pericholecystic fluid. The gallbladder wall measures 2 mm. There is no biliary ductal dilatation. Murphy's sign was negative.PANCREAS: Obscured by bowel gas.SPLEEN: The spleen measures 16.9 cm in length.KIDNEYS: The left kidney measures 11.8 cm in length. The right kidney measures 11.9 cm in length. No hydronephrosis. ABDOMINAL AORTA: The abdominal aorta is obscured by bowel gas distally. The abdominal aorta measures 3.2 cm proximally and 2.9 cm more distally in the AP diameter. The distal abdominal aorta was nonvisualized. The arterial waveform is pulsatile, consistent with reported history of intra-aortic balloon pump.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Left pleural effusion. No free intraperitoneal fluid. | 1. Echogenic coarse hepatic parenchyma with nodular contour, concerning for cirrhosis.2. Cholelithiasis without evidence of cholecystitis.3. Limited evaluation of the abdominal aorta without evidence of abdominal aortic aneurysm. |
Generate impression based on findings. | 67 year old female patient with a right thyroid nodule. Evaluate thyroid. RIGHT LOBE MEASUREMENTS: 5.0 x 2.5 x 2.3 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.9 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.3 cm in thickness. RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity. There is a dominant solid appearing, partially calcified nodule within the upper pole measuring 0.9 x 0.9 x 1.3 cm. An additional solid nodule near the isthmus measures 1.2 x 1.0 x 1.0 cm. Additional nodules have imaging features of colloid nodules.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity. There is a solid nodule within the left lower pole with a hypoechoic rim measuring 1.2 x 0.8 x 0.8 cm. Additional nodules have imaging features of colloid nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A left level III lymph node is present.OTHER: No significant abnormality noted. | Multinodular goiter as above. |
Generate impression based on findings. | 51-year-old female with a history of thyroid cancer status post right thyroid lobectomy presents for follow-up. RIGHT LOBE MEASUREMENTS: The right lobe is absent.LEFT LOBE MEASUREMENTS: 5.9 x 1.8 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.2 cm.RIGHT LOBE: The right lobe is absent.LEFT LOBE: Unremarkable echotexture. There are multiple nodules as below.Nodule 1: Measures approximately 1.1 x 0.6 x 1.3 cm in the mid left thyroid. Appears smaller and may have involuted since the prior study.Nodule 2: Measures approximately 1.4 x 0.8 x 1.7 cm in the mid left thyroid. Appears larger since the prior study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular thyroid. One reference nodule smaller, the other larger. |
Generate impression based on findings. | Rule out recurrence history of thyroid cancer 2 year follow-up RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No suspicious areas of recurrence or residual tumor noted.LEFT LOBE: No suspicious foci or residual tumor notedISTHMUS: No suspicious areas of recurrence or residual tumor notedPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology lymph nodes are again noted in the right level 1B and in the left neck level 3. Both these lymph nodes are stable from prior examOTHER: No significant abnormality noted. | Stable examination without evidence of residual/recurrent disease |
Generate impression based on findings. | Renal stones RIGHT KIDNEY: Normal echogenicity without mass. Lower pole nonobstructing stone measuring 1.4 x 1 x 1.2 cm. Minimal hydronephrosis. Right kidney 11.9 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. Left kidney 13.4 cm in length.OTHER: Bladder collapsed. Coarse echogenic liver parenchyma again noted consistent with known chronic liver disease. | Nonobstructing right lower pole renal stone. Minimal right hydronephrosis. |
Generate impression based on findings. | 20-year-old female with bilateral fibroadenomas, biopsy proven in the left breast 12:00 position and right breast 7:00 position. Follow-up examination. Mild intermittent pain, otherwise no new breast complaints. Ultrasound of both breasts was performed, redemonstrating five fibroadenomas, three in the right breast and two in the left breast, with measurements as follows.Right breast:7:00 position, 4 cm from the nipple: 2.7 x 1.4 x 2.0 cm, previously 3.1 x 2.5 x 1.8 cm.9:00 position, 3 cm from the nipple: 2.0 x 1.1 x 1.9 cm, previously 2.0 x 2.0 x 1.3 cm.Retroareolar region: 1.8 x 1.1 x 2.0 cm, previously 2.0 x 1.2 x 2.2 cm.Left breast:4:00 position, 2 cm from the nipple: 2.4 x 1.1 x 2.6 cm, previously 2.1 x 1.8 x 1.1 cm.12:00 position 1 cm from the nipple: 2.2 x 1.6 x 2.6 cm, previously 3.3 x 3.5 x 2.1 cm. | Bilateral solid masses consistent with fibroadenomas, which are overall stable or decreased in size compared with the prior studies dating back to 2013. No further ultrasound follow-up is necessary at this time. Additional imaging may be performed in the setting of new symptoms or as warranted clinically. BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 36-year-old male patient with recent acute pancreatitis. Evaluate for gallstones, CBD dilatation, peripancreatic fluid collection. LIVER: The liver measures 18 cm in length and demonstrates increased parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is a gallstone near the neck of the gallbladder which moves with dependent positioning. There is no significant gallbladder wall thickening or pericholecystic fluid. The common duct measures 9 mm in diameter, appearing larger in diameter compared to prior MRCP. The duct is not visualized distally.PANCREAS: Heterogeneous echogenic material is noted within the region of the pancreatic head consistent with inflammatory changes of pancreatitis. No discrete fluid collection is noted within this region.RIGHT KIDNEY: The right kidney measures 11.7 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 12.7 cm in length. No evidence of hydronephrosis.The spleen is not adequately visualized on this examination. Fluid is noted within the left upper quadrant. | 1. Echogenic material within the region of the pancreatic head consistent with history of pancreatitis. No discrete collection is seen in this region, however, CT is a better means of evaluation for complications of pancreatitis.2. Common bile duct dilatation, increased in size compared to prior studies; MRCP may be considered for further evaluation. 3. Cholelithiasis without sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | Reason: worsening kidney function RIGHT KIDNEY: The right kidney measures 8.5 cm in length. Echogenic renal parenchyma. Subcentimeter non-obstructing right upper pole shadowing renal calculus. No hydronephrosis or focal mass.LEFT KIDNEY: The left kidney measures 9.2 cm in length. Echogenic renal parenchyma. No shadowing renal calculi, hydronephrosis, or focal mass.OTHER: Unremarkable bladder. Ureteral tracts are visualized. | 1. Echogenic renal parenchyma, consistent with medical renal disease.2. Subcentimeter nonobstructive left renal stone. |
Generate impression based on findings. | Female 58 years old Reason: evaluate medial side of elbow for possible infection History: pain and swelling s/p surgery There is a small, ill-defined fluid collection measuring 1.3 x 0.5 x 1.4 cm abutting the left epicondyle.No other fluid collections are seen | Small ill-defined fluid collection.Dr. Meagan Meislin informed. |
Generate impression based on findings. | Reason: Rule out abscess formation at the site of prior abdominal chest tube sites. Drainage and purulence at the sites. Sonographic images of the anterior superficial abdominal wall demonstrate tracts related to prior drains/tubes without associated discrete, drainable fluid collections identified. | No drainable fluid collections identified. |
Generate impression based on findings. | Reason: enlarged thyroid gland on exam RIGHT LOBE MEASUREMENTS: 6.8 x 2.1 x 2.2 cm.LEFT LOBE MEASUREMENTS: 7.2 x 2.8 x 2.1 cm. ISTHMUS MEASUREMENTS: 0.5 cm.RIGHT LOBE: Markedly heterogeneous echotexture with increased internal vascularity, limiting evaluation for discrete nodules. Reference right mid pole nodule measures 1.5 x 1.4 x 0.5 cm.LEFT LOBE: Markedly heterogeneous echotexture with increased internal vascularity, limiting evaluation for discrete nodules. Subcentimeter dystrophic calcifications are noted in the left mid thyroid lobe.ISTHMUS: Markedly heterogeneous echotexture.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Thyromegaly and markedly heterogeneous thyroid echotexture. |
Generate impression based on findings. | 15-year-old with palpable right breast mass. On physical exam, there is a palpable mobile mass in the right breast 9:00 position.A targeted right ultrasound was performed for the palpable area of concern. In the right breast 9:00 position 2 cm from nipple there is a circumscribed hypoechoic mass with internal vascularity, measuring 2.7 x 1.2 x 2.6 cm. Sonographic features are highly suggestive of a fibroadenoma. Suggest FNA and/or percutaneous biopsy for tissue confirmation. | 2.7 x 1.2 x 2.6 cm circumscribed right breast mass, highly suggestive of a fibroadenoma. Surgical consultation for consideration of FNA or biopsy via palpable guidance is recommended. Findings are recommendations were discussed with the patient and her mother at time of exam.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 83 year old female status post right lumpectomy and complete axillary dissection in 2006 for IDC and DCIS, presents with palpable abnormality with the left axilla noted on physical examination. Patient received radiation, chemotherapy, and Arimidex. No current breast complaints. No family history of breast cancer. On physical examination, there is a 1.0 cm mobile circumscribed mass in the low left axilla. A targeted left axillary ultrasound was performed for the palpable area of concern. At the area of palpable abnormality, there are two adjacent lymph nodes. The first measures 0.7 x 0.7 x 0.7 cm, with cortical thickening measuring up to 0.5 cm, and effacement of the fatty hilum. No significant abnormal vascularity is identified within this node. The second measures 0.7 x 0.5 x 1.0 cm with complete effacement of the fatty hilum, and no appreciable vascularity on Doppler imaging. | Two indeterminant adjacent lymph nodes within the low left axilla, at the site of palpable abnormality. Ultrasound guided biopsy of these lymph nodes is recommended for definitive histologic diagnosis. These findings were discussed with the patient, and Joly Jose, APN, at the time of the examination.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: Evaluate RUQ, liver, gallbladder History: Nausea, vomiting, RUQ pain Examination mildly limited by overlying bowel gas.LIVER: The liver measures 20.5 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified, though sensitivity limited. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.8 mm in diameter.PANCREAS: The pancreas is not well-visualized.SPLEEN: No significant abnormalities noted. The spleen measures 15.0 cm in length. RIGHT KIDNEY: Kidney measures 11.9 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Enlarged, echogenic liver suggestive of hepatic steatosis/parenchymal dysfunction. 2.No evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Chronic kidney disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 9.3 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 8.5 cm in lengthOTHER: Bladder nondistended | Echogenic parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | Male; 25 years old. Reason: elevated ALT, evaluate for fatty liver History: elevated ALT LIVER: The liver measures 16.6 cm in length. The liver surface is smooth, the parenchyma is diffusely increased in echogenicity and coarsened in echotexture which limits sensitivity for detection of hepatic masses. Within this limitation, no worrisome mass identified. There are geographic areas of focal sparing, particularly along the gallbladder fossa. The portal vein is patent and demonstrates hepatopetal flow with peak velocity 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common duct measures 2 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.6 cm in length.KIDNEYS: The right kidney measures 11.5 cm in length. The left kidney measures 11.8 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone bilaterally. | Borderline hepatomegaly and coarse, echogenic liver compatible with hepatic steatosis/parenchymal dysfunction. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Mildly coarse liver echotexture without mass. Liver length 15.1 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 11.5 cm in length. Left renal cyst. Spleen 11 cm in length. No ascites. | Mildly coarse liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Unremarkable gallbladder. No ascites. |
Generate impression based on findings. | 81 years old, Male, Reason: evaluate L scrotal edema History: L scrotal edema. No testicular tenderness. RIGHT TESTIS: Heterogeneous right testis without focal lesions appearing similar to the prior exam. There is blood flow within the right testis. Right testicle measures 3.9 x 1.9 x 2.7 cm.LEFT TESTIS: Heterogeneous testis without any focal lesions appearing similar to the prior exam. Left testis measures 3.5 x 2 .0 by 2.7 cm.RIGHT EPIDIDYMIS: Small epididymal cyst. The right epididymis is within normal limits. No evidence of hydrocele. LEFT EPIDIDYMIS: The left epididymis appears smaller in size than on the prior study and is not significantly hyperemic.OTHER: No significant abnormalities noted. | 1. Testes are heterogeneous bilaterally appearing similar to the prior exam. 2. Left epididymis appears smaller than on the prior study is not significantly hyperemic. |
Generate impression based on findings. | 25-year-old female with right upper quadrant pain. LIVER: Liver is normal in size and is mildly to moderately echogenic. This may be due to fatty infiltration although not specific. There is a rounded, small and echogenic 6 mm mass arising from the posterior lateral segment of left lobe consistent with hemangioma. No other abnormality is limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal veinGALLBLADDER, BILIARY TRACT: Gallbladder is well-visualized and appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The intrahepatic biliary tract is normal in caliber and the common duct is normal the level of the porta hepatis. More distally, the common duct increases to 9 mm which is above normal range for this age although no obstructing mass or stone is seen.PANCREAS: Pancreas is normal in size but appears heterogeneous in echotexture.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1. Enlargement of distal common bile duct without intrahepatic dilatation of uncertain significance.2. Presumed fatty liver.3. Small hepatic hemangioma.4. Heterogeneous pancreatic parenchymaGiven the above findings, correlation with liver function enzymes would be useful. |
Generate impression based on findings. | 65 year-old female with known right breast IDC and metastatic right axillary lymph node. She presents for imaging evaluation to assess for response to hormonal therapy. A targeted right breast and axillary ultrasound was performed.In the right breast at the 9:00 position 6 cm from the nipple there is revisualization of an irregular hypoechoic mass with a centrally located biopsy marker clip. The mass measures 8 x 4 x 6 mm, decreased in size from prior 11 x 9 x 8 mm.In the right axilla there is revisualization of a lymph node with a centrally located biopsy marker clip. The lymph node measures 13 x 7 mm, decreased in size from prior 15 x 9 mm. | Interval decrease in size of right breast index malignancy and metastatic right axillary lymph node. Continued surgical consultation is recommended. Recommendations and results were discussed with the patient.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male 64 years old Reason: Cirrhosis, eval for HCC History: Cirrhosis LIVER: Echogenic and nodular appearance of liver is consistent with cirrhosis. No suspicious focal hepatic mass. Hypoechoic structure with posterior acoustic enhancement is compatible with a hepatic cyst in the left hepatic lobe measuring 1.0 x 0.8 x 0.8 cm. This is not significantly changed previously measuring 0.8 x 0.8 x 0.7 cm. Main portal vein is patent with normal direction of flow and a peak velocity of 13.4 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Gallbladder is normal in appearance. No gallstones.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 12.6 cm in length.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or solid mass. Right kidney measures 11.5 cm in length. Left kidney measures 11.4 cm in length. There is a small cystic-appearing structure in the superior pole the right kidney measuring 1.1 x 1.5 x 1.4 cm.OTHER: No significant abnormalities noted. | Cirrhotic liver morphology with an unchanged hepatic cyst. No suspicious hepatic lesions are identified. |
Generate impression based on findings. | 79 year old female with history of cirrhosis, HCV. Evaluate for hepatocellular carcinoma. LIVER: No focal masses or biliary dilatation. The liver measures 13.7 cm in length. Smooth liver contour. Diffuse increased echogenicity, similar to prior.BILIARY TRACT: No biliary dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. Spleen measures 7.4 cm.RIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 10.4 cm. Small right renal cyst measuring approximately 1 cm, similar to prior.OTHER: No significant abnormalities noted. Left kidney measures 9.7 cm, and has a small cysts measuring approximately 1.6 cm. The left kidney appearance is otherwise unchanged. | Slightly increased hepatic parenchyma echogenicity, similar to prior. No focal masses or biliary dilatation. |
Generate impression based on findings. | 43-year-old female patient with history of right breast cancer containing LCIS and DCIS. Evaluate for interval change status post holistic therapy. Patient feels that tumor is different in size. A targeted right breast ultrasound was performed. There is an ill-defined mass in the right upper outer quadrant with hyperechoic calcifications. A portion of this mass at the 10:30 position, 6 cm from the nipple, in the right breast measures 2.3 x 1.1 x 2.0 cm, previously 2.5 x 1.3 x 2.5 cm. A second portion of the mass towards the nipple at the 10:30 position measures 3.8 x 2.4 x 1.6, previously approximately 3.4 x 2.2 x 2.7 cm. The total extent of the mass measures 6.5 x 3.0 cm. | No significant interval change in size of known right breast malignancy compared to prior ultrasound given differences in technique.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Leukocytosis. Elevated lipase. Please evaluate for gallbladder or bile duct pathology or signs of pancreatitis. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: Minimal intrahepatic biliary ductal dilation. No extrahepatic biliary ductal dilation. Normal appearance of the gallbladder. No cholelithiasis.PANCREAS: No sonographic abnormality evident in the visualized pancreatic neck. The head, body, and tail are obscured by bowel gas.RIGHT KIDNEY: The right kidney is 11.6 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: Not well visualized, secondary to difficulty positioning the patient due to medical condition.OTHER: No significant abnormalities noted. No upper abdominal ascites identified. | No specific findings to account for the patient's clinical presentation. |
Generate impression based on findings. | Ms. Gayton is a 91-year-old female presenting with a palpable right breast mass, identified one month previous. History of benign left breast cyst. Three standard views of both breasts and two 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. A trying a marker is placed at the site of palpable abnormality in the right upper inner breast. Underlying this marker, is a dense, spiculated, poorly circumscribed mass. Multiple additional benign calcifications, including arterial calcifications, are present bilaterally. ULTRASOUND | (1) 2.5 cm suspicious mass in the right upper inner breast, corresponding to the patient's palpable area of concern. An ultrasound-guided biopsy with placement is recommended for further evaluation. (2) Abnormal right axillary lymph node. An ultrasound-guided biopsy with clip placement is recommended for further evaluation.The patient does take Xarelto and has been asked to hold this medication for 5 days prior to the biopsy. All results and recommendations were discussed with the patient and her caretaker at time of dictation. BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 30 years old Reason: RUE fluctuating mass, abscess vs lipoma vs hematoma? Site of heparin shot Lobulated hypoechoic fluid collection measuring 2.3 x 1.2 x 1.1 cm in the right upper extremity. This may represent hematoma or an abscess. No solid soft tissue mass. | Lobulated fluid collection the right upper extremity may represent a hematoma or an abscess. No soft tissue mass. |
Generate impression based on findings. | Female 64 years old Reason: r/o HCC History: cirrhosis, HCV LIMITED ABDOMENLIVER: The liver measures 20.1 cm in length. Echogenic parenchyma with nodular contour. No suspicious hepatic lesions. Left hepatic lobe lesion with mixed color flow compatible with intrahepatic portosystemic shunt. Liver cyst measures 1.1 cm The portal vein is patent with normal directional flow. BILIARY TRACT: No intrahepatic biliary ductal dilation. The common bile duct measures 5 mm in diameter. Status post cholecystectomy.PANCREAS: No significant abnormality noted.KIDNEYS: The right kidney measures 11.2 cm. The left kidney measures 12.2 cm. There is a 1.2 cm nonobstructive stone in the left kidney. No evidence of hydronephrosis or mass.SPLEEN: The spleen measures 11.8 cm in length. OTHER: No significant abnormalities noted. | 1.Cirrhosis without suspicious focal lesion to suggest HCC.2.Left hepatic lobe portosystemic shunt is unchanged.3.Nonobstructive left renal pelvis stone. |
Generate impression based on findings. | 26 year old with palpable left breast mass. On physical exam, there is a palpable mass in the inferior left breast.A targeted left ultrasound was performed for the palpable area of concern. In the left breast 6:00 location to-4 cm nipple, there is a 1.9 x 2.1 x 2.3 cm well-circumscribed hypoechoic mass with posterior acoustic enhancement and without significant internal vascularity, suggestive of fibroadenoma. This correlates with the possible abnormality. A surgical consultation and possible FNA of this mass is recommended. | Well-circumscribed mass in the left breast 6:00 measuring up to 2.3 cm, corresponding to the palpable abnormality. Sonographic features favor a fibroadenoma. A surgical consult is recommended. Findings and recommendations were discussed with the patient at the time of the exam.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 57-year-old male patient status post islet cell transplant. LIVER: The liver measures 16.2 cm in length and is mildly heterogeneous. An echogenic focus within the right hepatic lobe is unchanged and may correlate to embolization coils. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The pancreas is poorly visualized on this examination. RIGHT KIDNEY: The right kidney measures 11.7 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.1 cm in length. No evidence of hydronephrosis.The spleen measures 7. cm in length. | 1. Patent portal vein.2. Mildly heterogeneous liver parenchyma and stable echogenic focus in the right hepatic lobe which may represent embolization coils. |
Generate impression based on findings. | Viral hepatitis LIVER: Stable cirrhotic morphology without worrisome mass. Stable hepatic cyst. Liver length 15.2 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Moderate dilatation of extrahepatic bile duct again noted with maximal diameter of 1.2 cm.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.2 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 12.8 cm in length. No ascites. | Stable cirrhotic morphology without worrisome mass. Stable moderate dilatation of extra hepatic bile duct. No ascites. |
Generate impression based on findings. | 60-year-old female with acute kidney injury on chronic kidney disease. Please evaluate for hydronephrosis, sizes of the kidneys, and echogenicity. RIGHT KIDNEY: The right kidney measures 8.3 cm in length (prior 8.6 cm). Borderline hyperechoic renal parenchyma. No hydronephrosis, shadowing calculi, or worrisome masses.LEFT KIDNEY: The left kidney measures 9.2cm (prior 9.4 cm). Borderline hyperechoic renal parenchyma. No hydronephrosis, shadowing calculi, or suspicious masses.URINARY BLADDER: The urinary bladder is collapsed and not well evaluated.OTHER: No significant abnormalities noted. | 1. Borderline hyperechoic renal parenchyma consistent with medical renal disease. No hydronephrosis.2. Relatively small kidneys, but stable in size. |
Generate impression based on findings. | Reason: Evaluate for fatty liver disease History: Heavy ETOH use, abnormal liver function tests. LIVER: The liver measures 22.7 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.45 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 bile duct measures 2 mm in diameter.PANCREAS: The visualized head and body of the pancreas are mildly hypoechoic.SPLEEN: No significant abnormalities noted. The spleen measures 9.3 cm in length. RIGHT KIDNEY: Kidney measures 13.1 cm in length. Increased parenchymal echogenicity. No hydronephrosis. Lower pole simple cyst.LEFT KIDNEY: Kidney measures 12.3 cm in length. Increased parenchymal echogenicity. No hydronephrosis. Lower pole simple cyst.OTHER: No significant abnormalities noted. | 1.Hepatomegaly. Echogenic liver suggestive of parenchymal dysfunction/fatty infiltration.2.Echogenic kidneys suggestive of medical renal disease.3.Diffusely decreased echogenicity of the pancreas which is nonspecific but can be seen with infiltrative processes such as edema. |
Generate impression based on findings. | History of thyroiditis with small thyroid nodules RIGHT LOBE MEASUREMENTS: 4.7 x 1.3 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.9 x 1.2 x 1.2 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Heterogeneous echotexture. Spongiform nodule measures 0.8 x 0.8 x 0.6 cm, unchanged in size, although it appears more exophytic than previously.LEFT LOBE: Heterogeneous echotexture. Left midpole nodule with hypoechogenic rim measures 0.4 x 0.6 x 0.3 cm, previously 0.5 x 0.8 x 0.3 cm.ISTHMUS: Left isthmus hypoechoic nodule measures 0.4 x 0.6 x 0.3 cm, unchanged.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Essentially unchanged bilateral thyroid nodules. |
Generate impression based on findings. | Reason: Left deltoid nodule: lipoma History: firm nodule on L deltoid. Patient with painless lump and area for 6 years. Isoechoic soft tissue mass measuring 4.6 x 2.1 x 4.6 cm without vascularity is noted. | Isoechoic soft tissue mass, which is nonspecific. |
Generate impression based on findings. | 28 year old male patient with history of diabetes and hypertension with intermittent crampy abdominal pain after fatty food intake. Evaluate for gallstones. LIVER: The liver measures 18.1 cm in length demonstrates increased hepatic parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.4 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 pancreas is poorly visualized on this examination.RIGHT KIDNEY: The right kidney measures 12.3 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 13.4 cm in length. No evidence of hydronephrosis.The spleen measures 11.6 cm in length. | 1. Increased hepatic echogenicity likely secondary to hepatic steatosis/hepatic parenchymal dysfunction.2. Mild hepatomegaly.3. No cholelithiasis. |
Generate impression based on findings. | History of hypercalcemia. Evaluate for renal stones. RIGHT KIDNEY: The right kidney measures 9.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident. Color Doppler demonstrates hilar blood flow. Normal corticomedullary differentiation.LEFT KIDNEY: The left kidney measures 9.7 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident. Color Doppler demonstrates hilar blood flow. Normal corticomedullary differentiation.OTHER: Normally distended urinary bladder. A right ureteral jet was observed. | No hydronephrosis or shadowing nephrolithiasis as clinically questioned. |
Generate impression based on findings. | Reason: enlarged thyroid History: dysphagia RIGHT LOBE MEASUREMENTS: 3.7 x 1.3 x 1.9 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.5 x 2.9 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: Normal homogenous thyroid tissue without nodules or masses.LEFT LOBE: Normal homogenous thyroid tissue without nodules or masses.ISTHMUS: Normal homogenous thyroid tissue without nodules or masses.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted. No lymphadenopathy.OTHER: No significant abnormality noted. | Normal thyroid appearance and size without focal nodules or masses. |
Generate impression based on findings. | 30-year-old female with right axillary swelling. The patient states that the swelling increases during her menstrual cycle. With my physical examination, there is an area of thickness at right axilla. Focused ultrasound is performed for the right axilla. No solid masses or cystic masses are seen in this area. Normal fat the tissue with possible breast glandular tissue is present. | No sonographic evidence for malignancy. Accessory breast tissue in the right axilla is suspected.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 29 year-old male with a history of right suboccipital lymphadenopathy. Note is made of a 7 x 9 x 2 mm normal morphology lymph node with an apparent tiny fatty hilum, in the soft tissues along the posterior aspect of the head/neck. No suspicious mass or lymphadenopathy are identified. | No evidence of lymphadenopathy, as clinically questioned. |
Generate impression based on findings. | 77-year-old female patient with brain mass. Evaluate for tumor. LIVER: The liver measures 17.0 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 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 7.1 cm in length and demonstrates increased renal cortical echogenicity. No evidence of hydronephrosis. There is a subcentimeter right lower pole simple renal cyst.OTHER: The left kidney measures 10.7 cm in length and demonstrates increased renal cortical echogenicity. No evidence of hydronephrosis. There is a 1.9 x 2.3 x 1.9 cm left lower pole simple renal cyst.The spleen measures 8.1 cm in length. | 1. Atrophic right kidney.2. Medical renal disease and bilateral renal cysts. |
Generate impression based on findings. | Reason: 60 y/o female with thrombocytosis and INR 3.3 with large right knee effusion. Evaluate for bleeding/hematoma in right knee/thigh History: edema, immobility, pain in right leg Lateral to the right knee, extending a few centimeters above the right knee to a few centimeters below the right knee is a 10.8 x 2.1 cm heterogenous collection, about 2.5 cm deep to the skin on its most superficial aspect and 4.2 cm deep to the skin on its deepest aspect. A smaller simple collection is noted in the medial aspect of the left knee measuring 5 x 1.3 cm. | 1.Large heterogenous collection in the lateral aspect of the right knee, as above.2.Small collection in the medial aspect of the left knee, as above. |
Generate impression based on findings. | Coagulopathy and elevated ammonia LIVER: Mildly coarse liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 15.6 cm.BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.2 cm in length RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 9.1 cm in length OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 10.3 cm in length. Small bilateral pleural effusions | Mildly coarse liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Gallbladder sludge without acute inflammation. No ascites. Small bilateral pleural effusions.Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Male; 70 years old. Reason: tender mass in upper part of left testicle, s/p AUS 1 week ago, not sure if fluid filled, if reservoir from surgery or solid mass History: tender mass in upper part of left testicle, s/p AUS 1 week ago, not sure if fluid filled, if reservoir from surgery or solid mass RIGHT TESTIS: Right testicle measures 2.8 x 4.6 x 2.4 cm. No intratesticular mass. Normal arterial and venous flow.LEFT TESTIS: Left testicle measures 3 x 4.3 x 2.1 cm. No intratesticular mass. Normal arterial and venous flow. No hyperemia to suggest orchitis.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: Increased size and vascularity of the left epididymis, suggestive of left epididymitis.OTHER: Reservoir is seen in the subcutaneous soft tissues of the left lower quadrant with tubing seen extending down the left inguinal canal and lateral to the left testicle within the scrotal soft tissues. In the patient's area of palpable abnormality near an incision in the left groin, there is an ill-defined area of heterogeneous echotexture and increased vascularity measuring up to 3.6 x 5 x 3.2 cm, which may represent cellulitis and phlegmonous change. No well-formed, drainable abscess is evident.Small left hydrocele. | 1. Findings suggestive of left epididymitis without evidence of adjacent left orchitis.2. Findings suggestive of cellulitis and phlegmonous change in the patient's area of palpable concern near an incision in the left groin. No well-formed, drainable abscess is evident. Follow-up examination can be performed as clinically indicated.3. Left reservoir and tubing in expected location. |
Generate impression based on findings. | Recent pyelonephritis with ongoing back discomfort RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 9.9 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.1 cm in length.OTHER: Bladder nondistended. | Negative renal ultrasound without evidence for mass, stone, hydronephrosis, or acute inflammatory process. |
Generate impression based on findings. | Known right breast cancer with satellite lesion and axillary lymphadenopathy presents for right breast ultrasound to evaluate treatment response A targeted right breast and axillary ultrasound was performed. Index cancer in the right breast 9 to 10:00 position measures 2.9 x 1.7 x 3 cm, previously measured 3.2 x 1.5 x 3 cm, mostly stable to unchanged from prior study. A satellite lesion at 12:00 position measures 9 x 7 x 9 mm, previously measured 9 mm.Right axillary lymph node measures 3.4 x 2 x 3.6 cm, previously measured 2.4 x 1.1 cm, increased in size from prior study. | 1. Stable to minimal interval decrease in size of right breast index cancer.2. Stable satellite lesion right breast 12:00 position.3. Interval increase in right axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Chronic renal insufficiency RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 9 cm in lengthLEFT KIDNEY: Mildly echogenic renal parenchyma without mass or hydronephrosis. Possible subcentimeter nonobstructing lower pole stone. Left kidney 9.5 cm in lengthOTHER: Bladder collapsed | Mildly echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass or hydronephrosis. Possible nonobstructing subcentimeter lower pole left renal stone. |
Generate impression based on findings. | Ms. Reisetter is a 31-year-old female with strong family history of breast cancer (mother, maternal aunt) presenting for short-term follow-up for biopsy-proven fibroadenoma. Upon physical exam, a superficial soft mobile mass is appreciated in the left lower outer breast.- In the left breast 5:00 position, approximately 3 cm from the nipple, demonstrates a 2.1 x 1.3 x 2.0 cm circumscribed oval hypoechoic mass in parallel orientation with internal vascularity, previously measuring 1.9 x 1.4 x 1.6 cm. This is the biopsy proven fibroadenoma.- Again seen adjacent and inferior to this mass is a 0.6 x 0.4 cm well-circumscribed hypoechoic mass without internal vascularity, previously measuring 0.6 x 0.4 cm. - Superior to this mass is a 0.4 cm well-circumscribed hypoechoic mass without internal vascularity, previously measuring 0.5 cm. | Interval increase in size of biopsy proven fibroadenoma of the left breast. Additional two smaller masses are stable and presumed benign. Continued management with breast surgery is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. A simple cyst is identified in the left lower outer breast. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. Simple cyst of the left breast.BIRADS: 2 - Benign. RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 90 year-old female with transaminitis postop. Evaluate portal vein and liver and for obstructive nephropathy. LIVER: Increased in echogenicity measuring 14.2 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common hepatic duct measures 8 mm in caliber with diffuse prominence of the intrahepatic biliary ducts. No common duct dilatation. PANCREAS: Incompletely visualized. SPLEEN: Not well visualized.KIDNEYS: Right kidney measures 15.1 cm in length. Cyst at the upper pole measures 8.3 cm x 6.8 cm x 8.1 cm. No hydronephrosis or shadowing calculi are noted.Left kidney incompletely visualized containing multiple cysts, the largest of which measures approximately 7.2 cm x 5.3 cm x 6.0 cm. No definite hydronephrosis or shadowing calculi are noted.ABDOMINAL AORTA: Patent with appropriate direction of flow. The proximal aorta measures 2.6 cm x 2.3 cm x 1.9 cm. The mid aorta measures 1.9 cm x 1.9 cm x 1.6 cm.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: No significant abnormality noted. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. There is diffuse prominence of the intrahepatic biliary ducts with normal caliber of the common hepatic duct suggestive of hepatic hilar mass/masses or stricture. Recommend CT or MRI for further evaluation. 2. Bilateral renal cysts. |
Generate impression based on findings. | Female 66 years old Reason: R knee pain/fullness - evaluate for Baker's cyst History: pain Focused ultrasound performed over the right popliteal fossa at the site of patient's symptoms. No evidence of Baker's cyst. No significant fluid to suggest Baker's cyst rupture. | No evidence of Baker's cyst. |
Generate impression based on findings. | Acute liver failure LIMITED ABDOMENLIVER: Diffusely heterogeneous gland with innumerable bilobar mass lesions.BILIARY TRACT: No ductal dilatation. Gallbladder not identified.PANCREAS: Not visualized due to overlying gas.SPLEEN: Not visualized due to overlying gas OTHER: No significant abnormalities noted. | Diffusely heterogeneous liver with numerous bilobar hepatic lesions worrisome for metastatic disease. No ductal dilatation. Hepatic vessels patent with normal directional flow; however main portal vein velocity is diminished. |
Generate impression based on findings. | 70-year-old male with hyperparathyroidism, evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 5.5 x 2.5 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.8 x 2.2 x 1.8 cmISTHMUS MEASUREMENTS: 2.2 cmRIGHT LOBE: Normal in echogenicity without discrete noduleLEFT LOBE: Normal in echogenicity without discrete noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No discrete parathyroid lesions are identified.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No parathyroid adenoma identified. |
Generate impression based on findings. | Reason: Evaluate for suspicious cervical lymphadenopathy in the central and lateral neck in a patient s/p total thyroidectomy for papillary carcinoma with right modified neck dissection in 1997 with a new suspicious mass. Also history of primary hyperparathyroidism. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy. Within the right thyroidectomy bed, there is a heterogeneous, predominantly solid mass measuring 4.2 x 5.7 x 4.8 cm which demonstrates internal vascularity.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy. RIGHT LOBE: Status post thyroidectomy.LEFT LOBE: Status post thyroidectomy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See above. LYMPH NODES: Few benign morphology lymph nodes in the right level 3 and left level 2 and 3 stations.OTHER: No significant abnormality noted. | Solid mass within the right thyroidectomy bed measuring up to 5.7 cm which is nonspecific but could reflect recurrent neoplasm or parathyroid adenoma. The lesion would be amenable to fine-needle aspiration. |
Generate impression based on findings. | Reason: please assess for gallstones/cholecystitis, liver abnormalities, spleen abnormalities History: R-sided abdominal pain. LIVER: The liver measures 23.9 cm in length and mildly irregular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The hyperechoic lesion seen on the 1/20/2014 examination is not seen. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.42 m/s.BILIARY TRACT: There is no evidence of cholelithiasis or convincing gallbladder wall thickening. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common hepatic duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.7 cm in length. RIGHT KIDNEY: Kidney measures 12.6 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 14.8 cm in length. Normal cortical echotexture. No hydronephrosis. Previously described possible left hilar hypoechoic lesion is not seen.OTHER: No significant abnormalities noted. | 1.Hepatomegaly, increased hepatic echogenicity, and irregular hepatic contour compatible with chronic liver disease. No mass.2.No evidence of cholelithiasis or biliary ductal dilatation. |
Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 2.5 x 2.1 x 5.2 cmLEFT LOBE MEASUREMENTS: 2.9 x 2.9 x 6.3 cmISTHMUS MEASUREMENTS: 0.8 cmRIGHT LOBE: Multiple subcentimeter mixed cystic and solid as well as spongiform nodules. An upper pole nodule measures 0.9 x 0.7 x 1 cm; a mid pole nodule measures 0.7 x 0.7 x 0.9 cm; and inferior nodule measures 0.9 x 0.9 x 0.9 cm.LEFT LOBE: Ill-defined predominantly solid lower pole nodule measuring 3 x 3.2 x 1.9 cm. Additional solid mid pole nodule measuring 1 x 0.9 x 1.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Ill-defined predominantly solid lower pole left thyroid nodule. This lesion is amenable to ultrasound-guided FNA biopsy. Additional bilateral thyroid nodules; favor benign etiology. No regional adenopathy. |
Generate impression based on findings. | Elevated bilirubin sepsis and abdominal pain LIVER:Coarse echogenic liver echotexture without mass. Liver length 18.7 cm.GALLBLADDER, BILIARY TRACT: Mild gallbladder wall thickening with trace pericholecystic fluid. Negative Murphy's sign. No ductal dilatation. Multiple nonmobile subcentimeter gallbladder wall foci.PANCREAS: No significant abnormality noted.SPLEEN: Spleen length is 18 cmKIDNEYS: No significant abnormality noted. Right kidney 12.6 cm in length. Left kidney 12 cm in length.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites | Hepatosplenomegaly associated with coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascitesMildly thickened gallbladder wall with trace pericholecystic fluid. Although there is no Murphy's sign, some element of inflammation is suspected.Nonmobile stones or gallbladder polyps. |
Generate impression based on findings. | 84-year-old male with hyperbilirubinemia and lower extremity edema. Evaluate for cause of conjugated hyperbilirubinemia, concern for hepatic congestion secondary to heart failure. LIVER: Normal echogenicity of the liver measuring 13.3 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measuring 0.3 m/sec with a pulsatile waveform likely due to congestive heart failure.GALLBLADDER, BILIARY TRACT: Gallbladder is not well distended limiting evaluation for wall thickening. Shadowing gallstones within the gallbladder. Focal adenomyosis of the gallbladder. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common bile duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Mild increased echogenicity of the kidney measuring 9.2 centers in length. Cyst measures 3.8 cm x 3.9 cm x 3.6 cm. no hydronephrosis or shadowing calculi are noted.OTHER: Mild increased echogenicity of the left kidney measuring 10.4 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 11.1 cm in length. | 1. Cholelithiasis with the gallbladder not well distended limiting evaluation for wall thickening, however there is no sonographic evidence of cholecystitis. 2. Patent portal vein with pulsatile waveform likely related to congestive heart failure.2. Mild increased echogenicity of the kidneys suggestive of parenchymal dysfunction. |
Generate impression based on findings. | Gallstone pancreatitis LIVER: No significant abnormalities noted. 17.1 cm in length.GALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: Pancreas obscured by gasRIGHT KIDNEY: No significant abnormalities noted. 9.9 cm in lengthOTHER: Left kidney 11.5 cm in length. Spleen 8.8 cm in length. Large fibroid uterus again noted. | Cholelithiasis without acute inflammation or ductal dilatation. Pancreas obscured by gas. |
Generate impression based on findings. | Ms. Gill is a 31 year old female with a personal history of biopsy-proven fibroadenoma in the left breast diagnosed in February 05/20/2015. She presents today for short term ultrasound evaluation of this lesion. Upon physical exam at the patient's area of concern, there is a soft mobile superficial mass appreciated. Targeted ultrasound of the left breast demonstrates a 2.5 x 0.7 x 1.5 cm well-circumscribed mass, parallel to the skin, at 11:00 radian, 8 cm from nipple. There is minimal associated vascularity. This palpable mass is unchanged in morphology and size from the prior ultrasound study. | Stable size of biopsy-proven fibroadenoma of the left breast. Patient should continue to follow-up with her primary care team as clinically warranted. BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female; 82 years old. Reason: Please evaluate etiology of visible and palpable probable foreign body in left upper quadrant History: Patient states this is been present since her surgery approximately 45 years ago however, the patient's daughter and physician were not aware of it until a few weeks ago. Within the subcutaneous soft tissues left upper abdominal wall in the region of the palpable abnormality and just deep to a well healed surgical scar is a looped tubular structure. It is followed to its termination at only one end near the liver with no definite intraperitoneal penetration. | Looped tubular foreign body suspicious for tubing seen in the area of the patient's palpable abnormality. The termination is seen at only one end with no definite intraperitoneal penetration. |
Generate impression based on findings. | 58-year-old male with cardiogenic shock. Screening for LVAD work. LIVER: Increased echogenicity of the liver measuring 16.9 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common bile duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.SPLEEN: Spleen measures 9.6 cm in length.KIDNEYS: Increased echogenicity of the right kidney measuring 11.8 cm in length. No hydronephrosis or shadowing calculi are noted. Increased echogenicity of the left kidney measuring 11.6 cm in length. No hydronephrosis or shadowing calculi are noted. ABDOMINAL AORTA: The visualized abdominal aorta is normal in caliber with appropriate directional flow. The proximal aorta measures 1.9-cm x 1.8 cm x 1.8 cm.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: Foley within a decompressed bladder limiting evaluation. | 1. Increased echogenicity of the liver compatible with fatty infiltration2. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. |
Generate impression based on findings. | 45-year-old female complains of right knee pain. There is a clinical concern for a Baker's cyst. No fluid collection is seen in the posterior right knee suggestive of a Baker's cyst. | Normal ultrasound of the posterior right knee without evidence of Baker's cyst. |
Generate impression based on findings. | 66-year-old male with history of NASH cirrhosis evaluated for HCC. LIVER: Measures 20 cm in length. Cirrhotic hepatic morphology and increased echogenicity without discrete focal lesion.BILIARY TRACT: Mild biliary sludge but no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.SPLEEN: Enlarged spleen measures 17.6 cm in length without focal lesion.KIDNEY: Bilateral renal cysts without septation or suspicious nodular component. No hydronephrosis.OTHER: Trace ascites. | 1.Cirrhotic liver morphology and increased hepatic echogenicity consistent with chronic liver disease, without evidence of discrete lesion.2.Hepatosplenomegaly and trace ascites. |
Generate impression based on findings. | 83-year-old male with history of chronic kidney disease now with acute kidney injury. The exam is limited due to prominent bowel gas and limited mobility of the patient.RIGHT KIDNEY: The right kidney is atrophic measuring 8.4 cm in length. Increased parenchymal echogenicity. No hydronephrosis. No shadowing calculi.LEFT KIDNEY: Very limited visualization of the left kidney. The left kidney measures 12.4 cm in length. No hydronephrosis. The previously seen left lower pole renal cyst is not clearly evaluated on this exam.URINARY BLADDER: The urinary bladder is collapsed and incompletely evaluated.OTHER: No significant abnormalities noted. | 1. Echogenic renal parenchyma compatible with history of chronic kidney disease.2. No hydronephrosis. |
Generate impression based on findings. | Cirrhosis with history of TIPS LIVER: Cirrhotic morphology again noted. No mass. Liver length 12.1 cm. Limited Doppler interrogation of the TIPS demonstrates a patent TIPS. Patent main portal vein with normal directional flow. Main portal vein velocity 48 cm/s. GALLBLADDER, BILIARY TRACT: Cholelithiasis again noted. Moderate bilobar and extrahepatic ductal dilatation again noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.8 cm in lengthOTHER: Left kidney 11.2 cm in length. Spleen 8.8 cm in length. No ascites. | Technically limited study. Patent main portal vein with normal directional flow. Patent TIPS. Cirrhotic morphology without obvious mass. Moderate bilobar and hepatic ductal dilatation again noted. No ascites. |
Generate impression based on findings. | 69-year-old female with thyroid nodules. Rule out growth of nodules or suspicious features. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5 x 1.7 x 1 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 3.6 x 0.9 x 1.3 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.4 cm in thickness.RIGHT LOBE: There are 2 nodules again identified in the right thyroid lobe. In the right lower pole is a 0.9 x 0.6 x 0.6 cm hyperechoic solid nodule (prior 0.7 x 0.4 x 0.9 cm). In the right mid thyroid lobe, there is a 1.4 x 0.9 x 0.9 cm spongiform nodule (prior 1.2 x 1 x 0.8 cm). These nodules are unchanged in appearance.LEFT LOBE: Normal homogeneous appearance of the left thyroid lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable solid, hyperechoic and spongiform nodules of the right thyroid lobe. |
Generate impression based on findings. | 39-year-old female with history of microscopic papillary carcinoma status post lobectomy. Evaluate for nodules in the contralateral lobe. RIGHT LOBE MEASUREMENTS: The right lobe measures 5.7 x 1.9 x 1.5 cm.LEFT LOBE MEASUREMENTS: Status post left lobectomy.ISTHMUS MEASUREMENTS: Status post left lobectomy.RIGHT LOBE: The right lobe is homogeneous in echotexture without evidence of a focal nodule.LEFT LOBE: Surgically absent.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing bilateral level 3 lymph nodes.OTHER: No significant abnormality noted. | Postoperative changes of left lobectomy without evidence of a nodule in the right thyroid lobe. |
Generate impression based on findings. | Right flank pain, elevated bilirubin; metastatic colon cancer LIVER: Mildly coarse echogenic liver echotexture. Bilobar hepatic metastases again noted. Liver length 16.2 cmBILIARY TRACT: Gallbladder sludge without acute inflammation. Minimal intrahepatic ductal dilatation without significant extra hepatic ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.9 cm in length.RIGHT KIDNEY: No significant abnormalities noted. Renal cyst again noted. 10.3 cm in lengthOTHER: Left kidney 12.9 cm in length. Left renal cyst again noted. No ascites. | Bilobar hepatic metastases again noted. Mildly coarse echogenic liver echotexture suggestive for parenchymal dysfunction. Gallbladder sludge without acute inflammation. Minimal intrahepatic ductal dilatation without significant extrahepatic ductal dilatation. No ascites. |
Generate impression based on findings. | Right inguinal hernia, please evaluate the left side Normal peristalsis of the bowel loops noted. No evidence of inguinal hernia on the left side. | No evidence of left inguinal hernia. |
Generate impression based on findings. | 24-year-old female with elevated LFTs. Evaluate for liver/gallbladder abnormalities. LIVER: Normal echogenicity of the liver measuring 20.5 cm in length. No focal hepatic lesions. The main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 11.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.6 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen is not visualized.Several small peripancreatic lymph nodes are noted. | Hepatomegaly with no focal hepatic lesions. |
Generate impression based on findings. | 97-year-old with large suspicious left breast mass with skin nodules. Bilateral MLO, bilateral ML and 2 right CC views were performed digitally and reviewed with the aid of R2 CAD 9.3. Left CC views could not be performed due to patient discomfort. The breast parenchyma is composed of scattered fibroglandular density. The left breast is highly dense compatible with a large underlying mass. Left breast skin thickening is also noted throughout. Benign calcifications in the right breast are largely arterial in etiology. A presumed intramammary lymph node is noted in the right upper breast. ULTRASOUND | Findings compatible with diffuse left breast cancer with associated skin thickening and a suspicious left axillary lymph node. The patient is to be seen in breast surgery clinic immediately after this imaging.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Check right thyroid nodule. Assess stability. RIGHT LOBE MEASUREMENTS: 3.4 x 1.3 x 1.3 cm.LEFT LOBE MEASUREMENTS: 3.9 x 1.3 x 0.8 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: There is a 1.0 x 0.8 x 1.0 cm mildly hypoechoic, solid, interpolar nodule without increased vascularity or associated calcifications. The margins are well-defined. It appears stable. LEFT LOBE: The left thyroid lobe is mildly heterogeneous without a discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal sized bilateral cervical lymph nodes are present.OTHER: No significant abnormality noted. | Stable right 1 cm solid nodule. No additional significant interval change. |
Generate impression based on findings. | History kidney stone RIGHT KIDNEY: 1 x 0.8 x 0.9 cm echogenic focus with posterior shadowing consistent with nonobstructing stone. No hydronephrosis. No worrisome mass. Right kidney 12 cm in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended | 1 cm nonobstructing right renal stone. No hydronephrosis. No worrisome mass. |
Generate impression based on findings. | Soft tissue induration. Painful "cyst." There is a 2.2 x 1.2 x 2.0 cm heterogeneously hypoechoic collection 4 mm deep to the skin with peripheral vascularity compatible with an abscess given the clinical history. | 2.2 cm collection compatible with abscess identified. |
Generate impression based on findings. | Acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.6 cm. The cortex is normal in echogenicity. There is no evidence of hydronephrosis, shadowing calculi or mass.LEFT KIDNEY: The left kidney measures 10.0 cm. The cortex is normal in echogenicity. There is no evidence of hydronephrosis, shadowing calculi or mass.URINARY BLADDER: The bladder is distended with anechoic fluid. There are multiple bladder diverticuli.OTHER: Cholelithiasis incidentally noted. | 1.No evidence of hydronephrosis, renal calculi or mass.2.Cholelithiasis incidentally noted.3.Distended bladder with diverticuli again noted. |
Generate impression based on findings. | 60 year-old female with abnormal liver function. LIVER: Mildly echogenic. Main portal vein patent with appropriate flow direction.GALLBLADDER, BILIARY TRACT: Mild intrahepatic ductal dilatation with marked dilatation of the common duct as previously noted.PANCREAS: Limited with pancreatic ductal dilatation associate with patient's known pancreatic head mass.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Spleen not visualized. | Mildly echogenic liver with dilated biliary tract as previously noted. Pancreatic ductal dilatation as previously noted. |
Generate impression based on findings. | History of Non-Hodgkin's Lymphoma and Papillary Thyroid Cancer. RIGHT LOBE: Status post thyroidectomy with no evidence of residual or recurrent disease in the right thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. Within the inferior left thyroidectomy bed there is a poorly defined heterogeneously hypoechoic lesion measuring 1.3 x 1.2 x 2.2 cm compared to 1.3 x 1.4 x 1.3 cm previously.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Prominent right level 1B, level 2 and level 5 lymph nodes. Prominent left level 2/3 lymph nodes. These demonstrate a fatty hilum.The referenced right lymph node measures 1.7 x 1.3 x 0.7 cm on today's study compared to 1.5 x 0.7 x 2.1 cm previously.The referenced lymph node on the left measures 1.7 x 1.8 x 0.5 cm compared to 1.2 x 0.8 x 2.5 cm previously.OTHER: No significant abnormality noted. | 1. Persistent heterogeneous hypoechoic focus within the left thyroidectomy bed. This is amenable to percutaneous biopsy to exclude a thyroidectomy bed recurrence. 2. Prominent bilateral lymph nodes, similar to prior study. |
Generate impression based on findings. | 52 year old female with a history of hepatitis B. Presents for HCC screening LIVER: The liver is normal in size, morphology, and echotexture. It measures 15.5 cm in craniocaudal dimension. Stable simple appearing cyst in the left hepatic lobe measuring 1.1 cm. No suspicious focal hepatic lesion is identified. No intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.GALLBLADDER, BILIARY TRACT: A normally distended gallbladder is present without cholelithiasis, wall thickening or pericholecystic fluid. No extrahepatic biliary ductal dilatation with the common bile duct measuring 4 mm.PANCREAS: The visualized portions of the pancreas are normal.RIGHT KIDNEY: The right kidney measures 10.9 cm in length. No hydronephrosis, shadowing calculus or discrete lesion.OTHER: The spleen is normal in size, measuring 8 cm. The left kidney measures 9.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident.Incidental 2.4 x 1.7 x 3.1 cm anechoic, immobile simple cystic fluid collection at the left lung base, likely representing a loculated pleural effusion. | 1. No focal hepatic lesion or biliary ductal dilatation.2. Incidental small left loculated pleural effusion. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of benign left breast biopsy in 1980. She has a family history of breast cancer in her sister, diagnosed at age 57, and her daughter, diagnosed at age 31. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |