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Generate impression based on findings. | Male; 52 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No suspicious mass in the right thyroid bed.LEFT LOBE: Redemonstrated 3 x 3 x 6 mm hyperechoic focus in the left thyroid bed (previously 4 x 3 x 5 cm), unchanged. A new 4 x 3 x 5 mm hypoechoic lesion with flow on color Doppler is seen in the left thyroid bed.ISTHMUS: No suspicious mass in the isthmus bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right: Level 6 lymph node measures 6 x 3 x 7 mm with increased vascularity.Left: A 3 x 3 x 4 mm level 4 and a subclavicular 5 x 3 x 4 mm lack a normal fatty hilum.OTHER: No significant abnormality noted. | Abnormal lymph nodes and a new lesion in the left thyroid bed suspicious for recurrence. The thyroid bed lesions are small and may not be amenable to biopsy. The lymph nodes are amenable to biopsy. |
Generate impression based on findings. | Generalized abdominal pain LIVER: Mild hepatomegaly. Heterogeneous echotexture without mass. Liver length 18.1 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.3 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 13.4 cm in lengthOTHER: Upper pole left renal cyst. Left kidney 11.3 cm in length. No ascites. | Mild hepatomegaly and heterogeneous liver echotexture suggestive for fatty infiltration without mass or ductal dilatation. Unremarkable gallbladder. No ascites. |
Generate impression based on findings. | 31 years old, Female, Reason: Needs U/S of Thyroid - Rule Out Thyromegaly vs. Other. History: Dysphagia. Sticking Sensation in Throat. RIGHT LOBE MEASUREMENTS: 3.7 x 1.1 x 1.7 cmLEFT LOBE MEASUREMENTS: 3.7 x 1.1 x 1.5 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted. Homogeneous echotexture of the thyroid lobe without evidence of nodules.LEFT LOBE: No significant abnormality noted. Homogeneous echotexture thyroid lobe without evidence of nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of thyromegaly or thyroid nodules. |
Generate impression based on findings. | 53-year-old male history of right inguinal hernia repair 2007 with persistent right groin pain Flow within the femoral artery and vein appears patent and in the appropriate direction. Several benign-appearing lymph nodes with a fatty hilum are identified. Images with and without Valsalva were taken and no evidence of hernia are present. | No evidence for a recurrent right inguinal hernia are seen sonographically. |
Generate impression based on findings. | Male, 28 years old. Groin pain, difficulty voiding, hematuria. RIGHT KIDNEY: The right kidney measures 11.5 cm in length, with normal cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.0 cm in length, with normal cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is distended, without significant wall thickening or debris. | Distended bladder. No hydronephrosis. |
Generate impression based on findings. | Female 76 years old Reason: r/o problem with the gallstones History: abd pain with nausea. CT in the past showed gallstones. her pain is mid abd LIVER: Questionable nodular contour of the liver, which may indicate hepatic disease. No focal hepatic mass. Liver measures 18.1 cm. Main portal vein is patent with normal directional flow and peak velocity of 16.5 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Gallstones are present within the gallbladder. No evidence of acute inflammation. Common bile duct measures 2 mm.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 10.2 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.3 cm. Left kidney measures 10.3 cm.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without evidence of acute cholecystitis. 2.Questionable nodular contour of the liver, which may indicate chronic hepatic disease. Recommend correlation with lab values. |
Generate impression based on findings. | 59-year-old female with history of left renal mass. Please evaluate change. RIGHT KIDNEY: Right kidney measures 10.6 cm in length. No evidence of hydronephrosis, renal mass, or shadowing renal stone.LEFT KIDNEY: Left kidney measures 11.2 cm in length. Left renal cyst is noted in the interpolar region of the left kidney. An exophytic protrusion of the interpolar region of the left kidney measures 1.0 x 0.7 x 1.0 cm. This may represent normal parenchyma, cyst, or underlying lesion.OTHER: Bladder is unremarkable. | Indeterminate left renal lesion; follow-up by CT rather than ultrasound is recommended. |
Generate impression based on findings. | Female; 63 years old. Reason: Rising creatinine, decreased urine output, hematuria 3 days ago History: Rising creatinine recent stem cell transplant on chemo. RIGHT KIDNEY: Right kidney measures 9.6 cm in length. Renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, suspicious mass.LEFT KIDNEY: The left kidney measures 12.4 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone or suspicious mass.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on findings. | Asymptomatic female 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. Bilateral simple cysts are identified. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | Simple cysts of both breasts. No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | HBV LIVER: Mildly heterogeneous liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 21 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 12.7 cm in lengthOTHER: Left kidney 12.6 cm in length. No ascites. | Heterogeneous liver echotexture with mild hepatomegaly again noted without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Male; 39 years old. Reason: s/p orchiectomy for relapsed ALL on 3/2/15 with persistent severe pain of unclear cause. Exclude hematoma or other History: pain RIGHT TESTIS: 3.6 by 2.6 x 2.7 cm. Normal vascularity. Within the right testicle at the level of the previously seen hypoechoic lesion is a 1.5 x 1.6 x 2.1 cm hyperechoic focus with an internal hypoechoic portion. LEFT TESTIS: 4.2 x 2.2 x 2.6 cm. Normal echotexture and vascularity. The previously seen hypoechoic lesion is no longer identified. Dystrophic appearing calcifications redemonstrated.RIGHT EPIDIDYMIS: 5.9 x 2.6 x 4.4 cm and hypervascular.LEFT EPIDIDYMIS: 2.9 x 0.7 x 1.3 cm, normal in appearance.OTHER: Edema in the soft tissues of the right groin and in the area of the incision but no drainable fluid collection.Orchiopexy clips noted on the right.Small right and minimal left hydrocele. | Findings compatible with acute epididymitis on the right.Postsurgical changes in the right groin and testicle. Heterogeneous 1.6 cm hyperechoic focus with hypoechoic component in the testicle, entity most likely reflects a hematoma given patient's history, correlation with patient's procedural history recommended to confirm interval removal of entirety of previously seen focal hypoechoic lesion in right testicle, abscess is considered less likely as there is no evidence of increased vascularity.Interval resolution of hypoechoic left testicle lesion.Findings discussed with Dr Artz by telephone at 4:50 pm. |
Generate impression based on findings. | Short term follow-up ultrasound for a probable area of fat necrosis. Per the patient, this area was easily palpable in the past and has now completely resolved to her. A targeted left ultrasound was performed at the site of the previously palpable abnormality. At the site of previous palpable concern, in the left breast 10:00 position, there is a mixed echogenicity circumscribed lesion with hyperechoic components measuring 5 x 4 mm compatible with resolving fat necrosis/oil cyst formation. Note that though the current measurements are slightly larger than the prior measurements reported, the prior measurements included only the central cystic component and not the surrounding hyperechoic fat necrosis. When the surrounding hyperechoic areas included on the old exam, the finding previously measured up to 9 mm. | Resolving fat necrosis/oil cyst formation. As long as the patient's physical examination remains normal and no palpable abnormality can be re-appreciated at this site, routine clinical follow-up is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 55-year-old female patient with neck pressure, difficulty swallowing, known left thyroid nodule with significant family history. Evaluate for thyroid nodule size and location, and abnormal lymph nodes. RIGHT LOBE MEASUREMENTS: 4.2 x 1.9 x 1.7 cm.LEFT LOBE MEASUREMENTS: 3.5 x 1.4 x 1.4 cm.ISTHMUS MEASUREMENTS: 0.2 cm RIGHT LOBE: The right thyroid lobe is normal in echogenicity without focal lesion.LEFT LOBE: The left thyroid lobe is normal in echogenicity without focal lesion.ISTHMUS: There is a circumscribed, ovoid, hypoechoic lesion within the left lateral aspect of the isthmus measuring approximately 0.8 x 0.5 x 0.9 cm. This lesion has internal vascularity.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are two subcentimeter right level three and level four lymph nodes. Subcentimeter left level three and level four lymph nodes are present.OTHER: No significant abnormality noted. | Solid left lateral isthmus thyroid nodule. |
Generate impression based on findings. | 69-year-old male with history of renal mass, evaluate for change in size. RIGHT KIDNEY: Measures 10.9 cm in length. Unchanged 2.1 cm right renal cyst without septation or suspicious nodular component. No hydronephrosis. Increased renal echogenicity.LEFT KIDNEY: Measures 11.1 cm in length. Solid left upper pole mass measures 1.9 x 1.8 x 1.7 cm on today's study, not significantly changed compared with the previous examination. A left lower pole renal cyst is also unchanged. Increased renal echogenicity.OTHER: No significant abnormalities noted. | No significant interval change in left upper pole renal mass, which remains suspicious for malignancy. |
Generate impression based on findings. | Patient complains of tender palpable areas of concern in each outer breast. Family history of breast cancer in her mother at age 37. A targeted bilateral ultrasound was performed for the patient’s identified areas of concern. There is no solid or cystic mass identified. Areas of dense breast tissue are seen, appearing similar to breast tissues in other portions of her breasts. | Sonographic appearance compatible with dense breast tissue, but no focal mass lesion at the patient's palpable tender areas of concern. Clinical correlation is recommended to ensure physical exam findings are concordant with this exam.Also recommended is referral to cancer risk clinic, given her family history. The patient may benefit from genetic testing and or additional imaging with MRI.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 71-year-old male with history of alcohol abuse. LVAD workup. Evaluate for cirrhosis. LIVER: Liver is enlarged measuring 21 cm in length and appears moderately echogenic which is non---- specific. There is no focal hepatic abnormality. There is relative enlargement of the left and caudate lobes suggestive cirrhosis. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid. Visualized portions of the biliary tract are normal in caliber.PANCREAS: Limited due to bowel gas.RIGHT KIDNEY: The right kidney measures 10.8 cm in length and is mildly echogenic consistent with parenchymal disease.OTHER: Left kidney is also echogenic consistent with parenchymal disease measuring approximately 10.5 cm in length with a 3 cm exophytic simple cyst. Splenic size is within normal limits. Small amount of ascites. | Cirrhotic-appearing liver with small amount of ascites.Echogenic kidneys. |
Generate impression based on findings. | Left thyroid nodule RIGHT LOBE MEASUREMENTS: 1.9 x 1.3 x 4.4 cmLEFT LOBE MEASUREMENTS: 1.7 x 1.4 x 4.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 1.2 x 0.8 x 1.5 cm mixed cystic and solid inferior left thyroid noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mixed cystic and solid inferior left thyroid nodule. This nodule will be biopsied today. |
Generate impression based on findings. | Male, 28 years old. Elevated LFTs, h/o Crohn's disease, on MTC. LIVER: The liver measures 13.2 cm, with mildly heterogeneous echotexture, and no focal lesion.The main portal vein is patent, with normal hepatopetal flow.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. The common bile duct measures 0.2 cm. Gallbladder wall thickness is normal. No stones.PANCREAS: The visualized portions of the pancreas are normal.RIGHT KIDNEY: 11.1 cm in length, with normal echotexture. No shadowing stones or hydronephrosis.LEFT KIDNEY: 10.8 cm in length, with normal echotexture. No shadowing stones or hydronephrosis.SPLEEN: 9.8 cm in length, without focal lesion.OTHER: No significant abnormalities noted. | Mildly heterogeneous liver echotexture, suggestive of fatty infiltration or parenchymal dysfunction. No masses, evidence of acute cholecystitis, or other acute abnormality. |
Generate impression based on findings. | 59-year-old female with question of thyroid nodule RIGHT LOBE MEASUREMENTS: 4.7 x 1.5 x 1.5 cmLEFT LOBE MEASUREMENTS: 5.0 x 1.4 x 1.3 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Tiny benign subcentimeter cystic nodules.LEFT LOBE: Tiny benign subcentimeter cystic nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Tiny benign subcentimeter cystic nodules. No suspicious lesions identified. |
Generate impression based on findings. | 50 year-old female with history of thyroid cancer status post thyroidectomy. Evaluate for growth of lesions or other adenopathy, or any suspicious lesions that would be amenable to FNA. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Hypoechoic nodule inferior to the right thyroidectomy bed is again seen measuring 5 mm x 5 mm x 4 mm, previously 4 mm 4 mm x 4 mm. Additional hypoechoic nodule inferior to the right thyroidectomy bed and posterior to the right carotid artery measures 8 mm x 5 mm x 5 mm, previously 9 mm x 5 mm x 6 mm.LEFT LOBE: No nodules in the thyroidectomy bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 5 benign appearing lymph node measures one 1.0 cm x 0.3 cm x 1.0 cm. No pathologic lymphadenopathy. OTHER: No significant abnormality noted. | Two hypoechoic nodules, one within and one adjacent to the right thyroidectomy bed are unchanged. |
Generate impression based on findings. | Left flank pain RIGHT KIDNEY: 9.3 cm in length. Mildly echogenic renal parenchyma. 19 mm benign-appearing cyst noted in the midpole. No renal stone identified. No suspicious lesions. No hydronephrosis.LEFT KIDNEY: 10.8 cm in length. Mildly echogenic renal parenchyma. 13 mm benign-appearing cyst noted in the inferior pole. No renal stone identified. No suspicious lesions. No hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormalities noted. | No specific findings to account for the patient's flank pain. |
Generate impression based on findings. | Right upper quadrant pain and tenderness. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No intrahepatic biliary ductal dilation. Subcentimeter gallstones identified. Mild dilation of the common bile duct up to 8 mm, previously 7 mm. No choledocholithiasis evident. No gallbladder wall thickening, pericholecystic fluid, or sonographic Murphy sign.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.5 cm in length. The left kidney is 11.3 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 11.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | 1. Cholelithiasis without evidence of cholecystitis.2. Mild dilation of the common bile duct, also seen on 10/12/2015 when patient presented with similar symptoms. Correlation for obstructive pattern of liver function tests and possibly MRCP may be considered. |
Generate impression based on findings. | 42 year-old female with Murphy's, questionable wall thickness, positive stone. Evaluate for cholecystitis. LIVER: Increased echogenicity of the liver measuring 13.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 5 mm in thickness. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 9.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 8.2 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 6.6 cm in length. | Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No sonographic evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 54-year-old female with history of thyroid nodules. Evaluate stability. RIGHT LOBE MEASUREMENTS: 1.1 x 1.2 x 4.3 cmLEFT LOBE MEASUREMENTS: 1.0 x 1.3 x 3.7 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: There again noted several hypoechoic nodules in the right thyroid. Previously noted nodule in the upper pole measures 0.4 x 0.6 x 0.8 cm without change. Other smaller nodules appear unchanged as well as. Lobe is heterogeneous in echotexture.LEFT LOBE: There again noted several hypoechoic nodules in the left lobe. Previously measured mildly complex nodule in the upper pole measures 0.3 x 0.4 cm x 0.8 cm, slightly increased in size.ISTHMUS: Right ovoid and mildly echogenic isthmus nodule measures 0.4 x 0.9 x 1.2 cm without change.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight increase in upper pole nodule on the left. Otherwise, stable thyroid nodules. |
Generate impression based on findings. | 23-year-old female patient with tenderness to palpation and right upper quadrant abdominal pain. Previous sludge ultrasound. LIVER: The liver measures 13.8 cm in length. 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 head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9.8 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.2 cm in length. No evidence of hydronephrosis.The spleen measures 10.7 cm in length. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 54-year-old male patient with frequent nausea, undergoing cardiac transplant evaluation. LIVER:The liver measures 16.0 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/s.GALLBLADDER, BILIARY TRACT: No gallstones, gallbladder wall thickening, or pericholecystic fluid is identified. There is no intra or extra hepatic biliary ductal dilatation. The common duct measures 4 mm in diameter.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 8.3 cm in length.KIDNEYS: The right kidney measures 10.0 cm in length and the left kidney measures 10.0 cm in length. No evidence of hydronephrosis. ABDOMINAL AORTA: The proximal aorta measures 2.6 x 3.0 cm in diameter, the mid aorta measures 2.3 x 2.0 cm, and the distal aorta measures 2.0 x 2.1 cm.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: The bladder is distended with fluid. | No acute sonographic findings to account for the patient's symptoms. |
Generate impression based on findings. | 46-year-old female with transaminitis. Evaluate for fatty liver. LIVER:Measures approximately 16.4 cm. Normal echotexture. Hyperechoic foci measuring approximately 0.7 x 1.0 x 0.6 cm in the right lobe of uncertain etiology. No ascites or intrahepatic biliary dilation.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. The wall measures 0.1 cm. No pericholecystic fluid, stones, or sludge. The common bile duct measures 0.2 cm.PANCREAS: Evaluation of the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 10.2 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 9.3 cm. Left kidney measures 11.6 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Hyperechoic foci in the right lobe of the liver as described above statistically favors a benign entity, such as a hemangioma, however it is incompletely characterized on this study. Given the patient's personal history of breast cancer, dedicated cross-sectional imaging may be helpful if further characterization is desired. |
Generate impression based on findings. | History of bladder stones RIGHT KIDNEY: No significant abnormalities noted. No evidence for mass, stone, or hydronephrosis. 11.7 cm in lengthLEFT KIDNEY: No significant abnormalities noted. No evidence for mass, stone, or hydronephrosis. 12 cm in lengthOTHER: Bladder nondistended. Multiple subcentimeter bladder stones again noted. Enlarged prostate again noted. | No change in multiple subcentimeter bladder stones. No evidence for renal mass, upper tract stone, or hydronephrosis. |
Generate impression based on findings. | Male, 77 years old. UTI. Evaluate for urinary obstruction. RIGHT KIDNEY: The right kidney measures 11.5 cm in length, with normal cortical echogenicity. An upper pole exophytic simple cystic structure measures 1.5 x 1.3 x 1.4 cm. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.7 cm in length. A mid pole cystic structure measures 1.6 x 1.4 x 1.7 cm, with suggestion of peripheral soft tissue nodularity. No shadowing stones or hydronephrosis.OTHER: The bladder is decompressed. | 1.No hydronephrosis.2.A 1-2 cm left renal cyst with suggestion of a peripheral soft tissue nodular component. Follow-up contrast enhanced CT is recommended for further evaluation. |
Generate impression based on findings. | Female 76 years old; Reason: eval for cirrhosis and splenomegaly History: low albumin, elevated INR LIVER: The liver measures 12.8 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.5 mm. No stones are seen. Pericholecystic fluid is seen. The common bile duct measures 2.6 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 6.2 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 9.7 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A right renal cyst is seen and is unchanged when compared to the prior study.LEFT KIDNEY: The left kidney measures 9.0 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: Small bilateral pleural effusions. | 1. Liver echotexture could be compatible with cirrhosis in the correct clinical context.2. Ascites3. Bilateral pleural effusions.4. Echogenic small kidneys without obstruction. |
Generate impression based on findings. | Elevated LFTs LIVER: Markedly coarse echogenic liver echotexture without obvious mass. Liver length 20.1 cm. Limited interrogation of the main portal vein by Doppler demonstrates a patent portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in lengthOTHER: Left kidney 11 cm in length. Spleen 12.4 cm in length. No ascites. | Markedly coarse echogenic liver echotexture consistent with fatty infiltration/parenchymal dysfunction associated with moderate hepatomegaly. While no obvious mass is appreciated, this degree of fatty infiltration diminishes the sensitivity of ultrasound to detect a subtle mass lesion.Gallbladder sludge without acute inflammation or ductal dilatation. No ascites. |
Generate impression based on findings. | Right upper quadrant pain. Nausea and vomiting. LIVER: The liver parenchyma is mildly coarse and echogenic. The liver measures 16.2 cm in craniocaudal dimension. In the left hepatic lobe there is a 4.8 x 4.0 x 4.5 cm hypoechoic lesion with enhanced through transmission and small septations likely representing a complex cyst. Additional 1.1 cm left hepatic lobe cyst. Right hepatic lobe 2.6 x 1.9 x 1.9 cm lobular septated cyst.Normal hepatopedal portal venous blood flow at 0.2 m/s.BILIARY TRACT: The common duct is normal in caliber measuring 3 mm.The gallbladder is normally distended without wall thickening pericholecystic fluid or focal tenderness. There are small mobile shadowing gallstones.PANCREAS: The partially visualized pancreatic head and neck is unremarkable. The main pancreatic duct is normal in caliber. The remainder the pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is normal in size measuring 8.7 cm without a discrete lesion.RIGHT KIDNEY: The right kidney measures 10.5 cm in length without hydronephrosis or shadowing nephrolithiasis. OTHER: The left kidney measures 12.1 cm in length without hydronephrosis or shadowing lithiasis. | 1. Coarse and echogenic liver parenchyma suggestive of steatosis.2. Several hepatic cysts some of which are minimally complex.3. Cholelithiasis without specific evidence of acute cholecystitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 82-year-old male with hematuria. RIGHT KIDNEY: Measures 9.8 cm. Mildly echogenic parenchyma. No shadowing calculi, hydronephrosis, or focal mass.LEFT KIDNEY: Measures 10.6 cm. Mildly echogenic parenchyma. No shadowing calculi, hydronephrosis, or focal mass.URINARY BLADDER: Bladder is nondistended.OTHER: Large prostate. | 1. Echogenic kidneys consistent with medical renal disease/parenchyma dysfunction. No hydronephrosis.2. Prostatomegaly. |
Generate impression based on findings. | History of proteinuria and hematuria, ultrasound guidance for renal biopsy. Ultrasound guidance was provided for percutaneous biopsy of left kidney. Three passes were performed. | Ultrasound guidance for percutaneous biopsy of left kidney. |
Generate impression based on findings. | Hepatitis B LIVER: Stable segment 2 hemangioma measuring 1.6 x 1.4 cm. Stable right lobe hepatic cyst. Mildly coarse liver echotexture. Liver length 11.8 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.8 cm in lengthOTHER: Left kidney 11.3 cm in length. Spleen 6.5 cm in length. No ascites | Mildly coarse liver echotexture suggestive for chronic liver disease without worrisome mass or ductal dilatation. No ascites. Stable left lobe hemangioma and right lobe hepatic cyst. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 51-year-old female patient with elevated INR, hyperammonemia, altered mental status, leukocytosis, sepsis. Evaluate hepatic vasculature, ducts for cause of synthetic liver failure. Study is limited secondary to patient body habitus. LIMITED ABDOMENLIVER: The liver measures 23.8 cm in length and demonstrates increased parenchymal echogenicity.BILIARY TRACT: The gallbladder is surgically absent. There is no definite intra or extrahepatic biliary ductal dilatation. The common duct measures 5 mm in diameter.PANCREAS: The pancreas is not visualized on this examination.SPLEEN: The spleen measures 8.6 cm in length. RIGHT KIDNEY: The right kidney measures 10 cm in length. No evidence of hydronephrosis.OTHER: The left kidney measures 10.9 cm in length. No definite evidence of hydronephrosis. | 1. Limited study though with hepatomegaly and increased hepatic parenchymal echogenicity which can be seen with hepatic parenchymal dysfunction/hepatic steatosis.2. Patent hepatic vasculature. |
Generate impression based on findings. | Abnormal gallbladder seen on recent CT BILIARY TRACT: Cholelithiasis with trace pericholecystic fluid and mild diffuse gallbladder wall thickening. Negative Murphy's sign. No ductal dilatation.OTHER: No significant abnormalities noted. | Cholelithiasis with trace pericholecystic fluid and mild diffuse gallbladder wall thickening. Negative Murphy's sign. Findings are suggestive for chronic gallbladder inflammation; equivocal evidence for acute inflammation. |
Generate impression based on findings. | Cholecystitis in the past. Declined operative intervention. Right upper quadrant pain. 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. 1-2 cm gallstones identified. No gallbladder wall thickening, pericholecystic fluid, or definite sonographic Murphy's sign.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.2 cm in length. The left kidney is 12.5 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 10.1 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid. | Cholelithiasis without specific evidence of cholecystitis. |
Generate impression based on findings. | Ms. Alexandridou submitted outside mammogram dated 06/12/2012 and two prior ultrasounds dated 06/12/2012 and 01/21/2013, from University of Illinois, Urbana. Submitted outside studies were compared to the current mammogram dated 10/14/2016. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Previously identified mass in the right medial breast, far posterior depth, is new when compared to the prior mammogram from 2012.Previously identified mass in the left central breast, mid depth, appears to have increased in size when compared to the prior mammogram. In addition, prior ultrasound examination from 2012 may show a corresponding partly cystic/partly solid mass, which needs to be further evaluated. | Bilateral partially obscured incompletely characterized masses. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Ms. Dolehide is a 29-year-old female patient with mass felt by primary care physician in the 10:00 position of the right breast. Patient cannot feel lump. Physical exam was performed and no palpable abnormality was felt. A targeted right ultrasound was performed in the area of concern. There is no solid or cystic mass identified. | Normal glandular tissue seen in the right upper outer breast. No sonographic evidence for malignancy. If there is continued clinical concern for a mass, the palpable area of concern can be marked on the skin and a repeat ultrasound can be performed. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. All results recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: Renal failure RIGHT KIDNEY: The right kidney measures 11.6 cm in length. Echogenic renal parenchyma. Multiple anechoic cysts are again seen, the largest right upper pole cyst measures 2.9 x 2.5 x 2.7 cm. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 10.4 cm in length. Echogenic renal parenchyma. Left lower pole cyst measures 5.9 x 5.7 x 4.9 cm, increased in size compared to prior exam. No hydronephrosis or shadowing stones.OTHER: The bladder is decompressed, limiting its evaluation. | 1. Echogenic renal parenchyma, consistent with medical renal disease.2. Multiple large simple bilateral renal cysts, stable to mildly increased in size. |
Generate impression based on findings. | 50-year-old female. Recall from screening for a small mass in the right lower inner quadrant. MAMMOGRAM: An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The circumscribed small round mass in the lower inner quadrant of the right breast persisted on spot compression views.RIGHT BREAST ULTRASOUND: Targeted ultrasound of the right lower inner quadrant showed an anechoic 3 x 3 mm focus without internal vascularity in the retroareolar region at 5:00 o'clock, most likely a cyst and corresponding to the mass seen on mammography. | Small mass in the right lower inner quadrant on mammography most likely corresponds to a cyst. Ultrasound guided aspiration is recommended to confirm that it is a cyst. The results and recommendations were discussed with the patient at the completion of the exam, and the patient elected to schedule the ultrasound-guided aspiration.BIRADS: 3 - Probably benign finding.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: gallbladder, cholelithiasis on CT, now pain in RUQ LIVER: The liver measures 15.2 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 0.29 m/s.BILIARY TRACT: Cholelithiasis including large gallstone without associated significant 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 within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 6.9 cm in length. RIGHT KIDNEY: Right pelvic kidney measures 9.9 cm in length. Increased cortical echogenicity. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis or biliary ductal dilatation. 2.Increased hepatic echogenicity raising the possibility of parenchymal dysfunction/fatty infiltration.3.Increased echogenicity of right pelvic kidney raising the possibility of medical renal disease. |
Generate impression based on findings. | 55-year-old male with a history of brain cancer in remission. Smoking. Presents with left neck palpable abnormality. Targeted ultrasound was performed of the patient's left neck palpable abnormality. The abnormality corresponds to an asymmetric prominence of the tubercle of the left greater cornu of the hyoid bone when compared to the right. There is no soft tissue abnormality or lymphadenopathy. | The palpable abnormality corresponds to an asymmetric prominence of the tubercle of the greater cornu of the hyoid bone; of no clinical significance. No soft tissue mass or lymphadenopathy. |
Generate impression based on findings. | Mobile subcutaneous palpable mass in the posterior aspect of the occipital scalp. Targeted grayscale and color Doppler ultrasound of the occipital scalp showed no discrete fluid collection or mass. Significant acoustic shadowing limits evaluation of the soft tissue. | No discrete fluid collection or mass. Study limited by significant acoustic shadowing. |
Generate impression based on findings. | 73-year-old female patient with abdominal pain. LIVER: The liver measures 12.3 cm in length. There is a subcentimeter cyst within the left hepatic lobe. The liver parenchyma is echogenic. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. No intra- or extrahepatic biliary ductal dilatation is identified. The common bile duct measures 6 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.9 cm in length. No evidence of hydronephrosis.The spleen measures 7.5 cm in length. | 1. Echogenic hepatic parenchyma which can be seen with hepatic steatosis. 2. Simple left hepatic cyst. |
Generate impression based on findings. | Persistent frequency and pressure following UTI. The prevoid bladder volume is approximately 200 mL. The post void bladder volume is approximately 12 mL. No significant abnormality is identified. | No significant postvoid residual identified. |
Generate impression based on findings. | 38-year-old male with history of hepatitis B. Evaluate for HCC. LIVER:Measures 14.5 cm. Parenchyma is coarse and echogenic. There is approximately 1.3 x 1.0 hyperechoic lesion seen in the right lobe that was not present on the prior study. It was only able to be imaged in one oblique plane. Otherwise, no ascites or intrahepatic biliary dilation. Portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: Gallbladder is nondistended. The wall measures 0.2 cm. No stones, sludge, or pericholecystic fluid. The common bile duct measures 0.2 cm.PANCREAS: Unable to fully evaluate due to overlying bowel gas.SPLEEN: Measures 11.0 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.1 cm. Kidney measures 10.8 cm. Kidneys are mildly echogenic. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Hyperechoic lesion seen in the right lobe of the liver that was not present on the prior study of uncertain etiology. Further characterization with MRI is recommended.2. Increased, coarse echotexture of liver consistent with chronic liver disease/parenchymal dysfunction.3. Increased echogenicity of the kidneys consistent with medical renal disease/parenchymal dysfunction. |
Generate impression based on findings. | Female, 48 years old. Fevers, recurrent UTIs. RIGHT KIDNEY: The right kidney measures 9.8 cm in length, with normal cortical echotexture. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 8.8 cm in length, with normal cortical echotexture. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. The liver is partially imaged and has increased echogenicity. | 1.Normal sonographic appearance of the kidneys. No hydronephrosis.2.Increased hepatic echogenicity, compatible with fatty infiltration or parenchymal dysfunction. |
Generate impression based on findings. | 65-year-old female presents with transaminitis. LIVER:Measures 12.4 cm. Normal echogenicity. No focal mass, intrahepatic biliary dilation, or ascites. Portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: Nondistended with an anechoic lumen. Wall measures 2.5 mm. No stones or sludge. No pericholecystic fluid. Common bile duct measures 6.8 mm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Spleen measures 7.5 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 9.2 cm. Left kidney measures 10.4 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, focal mass. OTHER: No significant abnormality noted. | 1. Normal ultrasound of the abdomen without sonographic explanation for patient's elevated liver enzymes. |
Generate impression based on findings. | 69-year-old female patient with elevated LFTs. Question of nonalcoholic fatty liver disease. LIVER: The liver measures 19.2 cm in length and demonstrates increased hepatic parenchymal echogenicity. A 1.4 x 1.0 x 1.5 cm anechoic lesion within the left hepatic lobe with posterior acoustic enhancement is compatible with a cyst. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones but no 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 12.8 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 13.4 cm in length. No evidence of hydronephrosis.The spleen measures 10.9 cm in length. | 1. Increased hepatic parenchymal echogenicity consistent with hepatic steatosis.2. Left hepatic cyst.3. Cholelithiasis without sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | Male; 69 years old. Reason: neutropenic fever abdominal pain please r/o infection LIVER: Liver is 18.3-cm in length. Normal parenchymal echotexture. Minimally complex, predominantly anechoic cystic lesion in the right hepatic lobe measures 3.4 x 2.2 x 2.8 cm with a similar but smaller cystic lesion in the left hepatic lobe, as seen on preceding CT and for which benign etiology is favored. No intrahepatic biliary ductal dilation. Main portal vein is patent with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder is filled with numerous shadowing calculi. No definite gallbladder wall thickening, though evaluation is limited due to the cholelithiasis. No pericholecystic fluid, gallbladder fossa hepatic parenchymal hyperemia, or sonographic Murphy's sign to suggest acute cholecystitis. Normal caliber of the common bile duct measuring 4 mm.PANCREAS: Limited images of the pancreatic head are within normal limits. The remainder of the pancreas obscured by overlying bowel gas.RIGHT KIDNEY: Stable appearance of both kidneys since prior renal ultrasound with the right kidney measuring up to 12.4-cm and a septated cyst seen in the upper pole as well as additional smaller cysts.OTHER: Spleen measures 12.8-cm in length. No focal splenic lesions. | 1. Cholelithiasis without evidence of acute cholecystitis.2. No findings to explain the patient's symptoms. |
Generate impression based on findings. | 61-year-old male with right flank pain and history of kidney stones. Evaluate for nephrolithiasis. RIGHT KIDNEY: The right kidney measures 12.6 cm in length. Arising from the upper pole is a 3 cm cyst which may be minimally complex and has been identified on prior exams. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 14.5 cm in length and likely has a duplex collecting system. Shadowing, non--- obstructive calculus in the lower pole. No hydronephrosis or mass.OTHER: Within the urinary bladder posterior, focal echogenic foci likely represent stones and there is a small amount of debris as well as. Splenomegaly with echogenic masses as previously noted. | Nonobstructive left nephrolithiasis and calculi with debris in the urinary bladder.Minimally complex right renal cyst.Splenomegaly with echogenic foci as previously described. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of benign left breast stereotactic biopsy in 2013 for fibrocystic changes. 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. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Right testicular pain and swelling RIGHT TESTIS: 3.0 x 2.9 x 2.9 cm. Normal parenchymal echotexture. A moderate sized right hydrocele is noted. Subcentimeter extratesticular calcification may represent prior microtrauma or prior torsion of the appendix of the testicle.LEFT TESTIS: 2.8 x 2.6 x 4.2 cm. Normal parenchymal echotexture.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Mobile soft tissue in the right hemiscrotum appears to be bowel, suggestive of an indirect hernia.DOPPLER | 1. No evidence of testicular torsion.2. Right hydrocele.3. Mobile soft tissue in the right hemiscrotum appears to be bowel, suggestive of an indirect hernia. |
Generate impression based on findings. | 63-year-old male with palpable soft tissue mass involving the lateral, anterior abdominal wall. Region of pelvic abnormality, there is some deep soft tissue asymmetry adjacent to or involving the deep musculature. This is not changed appreciably with Valsalva maneuver. Differential considerations would include hernia, hematoma or less likely soft tissue mass. MR may provide superior soft tissue differentiation. | Soft tissue asymmetry in the deep subcutaneous tissues of the right abdomen as noted above. MR may provide better characterization. |
Generate impression based on findings. | 16 year old with palpable lump in right breast. With physical exam, a mobile mass was palpated near the nipple in right breast. Whole breast ultrasound was performed for both breast, by patient's mother's request. In the right breast, there is a circumscribed mass, measuring 19 x 10 mm, at 3 o'clock position, 1 cm from nipple, at the site of palpable lump. Color Doppler study shows a peripheral blood flow. This mass is likely a fibroadenoma. Elsewhere, no solid or cystic mass is present in either breast. | A palpable lump in the right breast, likely a fibroadenoma. Clinical correlation is recommended. If imaging follow up is clinically indicated, follow up ultrasound in 6 months is recommended. Results and recommendations were discussed with the patient and her mother.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Hepatic steatosis. Renal stones. LIVER: Non-cirrhotic liver morphology. 23 cm in length. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladder.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: Evaluation of the kidneys is limited by poor acoustic penetration. The right kidney is 14.9 cm in length. Several echogenic foci may represent nonobstructing stones, measuring up to 9 mm. No suspicious renal lesions. No hydronephrosis.The left kidney is 14.3 cm in length. Several echogenic foci may represent nonobstructing stones, measuring up to 13 mm. No suspicious renal lesions. No hydronephrosis.BLADDER: No significant abnormality noted.SPLEEN: 9.1 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent and measuring up to 2.3 cm, without aneurysmal dilation.INFERIOR VENA CAVA: Patent.OTHER: No significant abnormality noted. No significant abdominal free fluid identified. | 1. Hepatomegaly with nonspecific mildly coarsened echogenicity, compatible with parenchymal dysfunction.2. Several echogenic foci in the kidneys bilaterally may represent nonobstructing renal stones, however evaluation of total renal stone burden is limited by ultrasound. |
Generate impression based on findings. | Female 79 years old Reason: AKI, history of hydronephrosis, eval for hydro History: see above RIGHT KIDNEY: The right kidney measures 14.3 cm in length and demonstrates increased cortical echogenicity compatible medical renal disease. There is persistent mild hydronephrosis. No nephrolithiasis or ureterolithiasis is evident.LEFT KIDNEY: The left kidney has been removed surgically.OTHER: No significant abnormalities noted. | 1.Persistent mild right hydronephrosis. 2.Increased cortical echogenicity of the right kidney compatible medical renal disease. |
Generate impression based on findings. | 62-year-old female patient with right upper quadrant pain. Evaluate for gallstones or biliary obstruction. LIVER: The liver measures 19.6 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.16 m/sec.GALLBLADDER, BILIARY TRACT: There is biliary sludge, but 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 head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 12.3 cm in length. There is mild to moderate hydronephrosis. Right hydroureter is partially visualized.OTHER: The left kidney measures 12.6 cm in length. There is mild hydronephrosis.The spleen measures 8.1 cm in length.There is trace ascites.The bladder is decompressed by a Foley catheter. | 1. Biliary sludge without sonographic evidence of acute cholecystitis.2. Mild to moderate right and mild left hydronephrosis.3. Trace ascites. |
Generate impression based on findings. | Ms. Wassenhove is a 87 year female with known left breast cancer undergoing neoadjuvant hormonal therapy. She presents today for follow-up ultrasound to evaluate treatment response. A targeted left breast ultrasound was performed at the site of known malignancy. In the left breast 2:00 location, approximately 4 cm from the nipple, the index malignancy now measures 2.1 x 1.3 x 1.9 cm, compared to 1.6 x 1.1 x 2.0 cm. There continues to be minimal associated vascularity. | Slight interval increase in known left breast cancer. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 53 year old female with history of hepatitis C and cirrhosis. LIVER: Subtle increased hepatic echotexture, suggestive of hepatic steatosis. No focal masses or other significant abnormality. The liver measures 16.3 cm.GALLBLADDER, BILIARY TRACT: No biliary dilatation or other significant abnormality. Postcholecystectomy.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 11.1 cm, and there is a small 0.5-cm right kidney simple cyst.OTHER: No significant abnormalities noted. Left kidney measures 11.7 cm, and is within normal limits. | Findings suggestive of hepatic steatosis, similar to prior. No focal mass or other significant abnormality. |
Generate impression based on findings. | Right thyroid enlargement RIGHT LOBE MEASUREMENTS: 4.9 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple predominantly cystic and spongiform nodules. The largest within the upper pole measures 0.6 x 0.4 x 0.4 cm.LEFT LOBE: Multiple spongiform nodules. The largest within the lower pole measures 1.1 x 0.5 x 0.8 cm.ISTHMUS: Spongiform nodule within the right isthmus measuring 1.9 x 1 x 1.7 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral and right isthmic cystic and spongiform nodules; a benign etiology is favored. No regional adenopathy. |
Generate impression based on findings. | 60-year-old male with renal transplant post biopsy. Evaluate for hematoma. RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: There is a small anterior fluid collection adjacent to the transplanted kidney measuring 1.5 x 1.3 x 3.7 cm. This does not extend to the region of the hilum.KIDNEY: Kidney measures approximately 9.6 cm in length. Echotexture is normal and there is no parenchymal abnormality.COLLECTING SYSTEM/URETER: There is no hydronephrosis.URINARY BLADDER: Not examined.OTHER: No significant abnormality noted | Small anterior fluid collection adjacent to the transplant kidney. |
Generate impression based on findings. | 33-year-old female with history of thyroidectomy. Evaluate for change in nodes. THYROID: Status post thyroidectomy with no findings to suggest residual or recurrent disease.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Previously noted left supraclavicular, right level 5 lymph nodes are not identified on this current examination.OTHER: No significant abnormality noted. | No lymph nodes are identified on this current examination. No change in the thyroidectomy bed. |
Generate impression based on findings. | Male 61 years old Reason: US-guided FNA to r/o thyroid cancer History: h/o thyroid cancer. also has CLL. now with increasing lesion in left thyroid bed Small mixed solid cystic lesion in the left thyroid bed was targeted.Written informed consent was obtained. Skin was prepped injected in sterile fashion and anesthetized with lidocaine. Cytology was present. Under ultrasound guidance eight 25-gauge fine-needle aspiration biopsy samples were obtained. Preliminary report was done diagnostic final report follow. | Although targeting of the lesion was successful with good visualization preliminary cytology nondiagnostic full report to follow.Less than 5 cc blood loss. No complications. Patient discharged to home in good condition. |
Generate impression based on findings. | 71-year-old with grade 2 endometrial cancer, SBO, now resolved with bacteremia LIVER: Liver measures 20.4 cm with increased echogenicity consistent with hepatic steatosis. No focal lesions noted within the liver. Mild intrahepatic biliary ductal dilatation.BILIARY TRACT: Gallbladder is well-distended without any gallstones. No evidence of gallbladder wall thickening. Persistent the dilated common bile duct noted today measuring up to 1 cm, mostly unchanged from the recent CT scan.PANCREAS: Limited evaluation of the head of the pancreas without any abnormality. Tail of the pancreas not visualized due to overlying bowel gas.SPLEEN: Spleen measures 11.3 cm without any focal lesions.RIGHT KIDNEY: Right kidney measures 10.8 cm and left kidney measures 14.4 cm. Both kidneys appear slightly echogenic. OTHER: No significant abnormalities noted. | Mild bilateral echogenic kidneys.Persistently dilated common bile duct measuring up to 1 cm mostly unchanged from recent CT scan, MRCP can be performed if clinically indicated. Mild intrahepatic blurred ductal dilatation noted. Gallbladder appears unremarkable without cholelithiasis.Hepatic steatosis. |
Generate impression based on findings. | 36-year-old female with protruding palpable mass in epigastric region. Sonographic images of the subcutaneous tissues underlying the epigastric region show no focal mass in the area of palpable concern. Specifically, no cystic or solid lesion is identified. There is prominent subcutaneous fat. Underlying tissues are within normal limits. No free fluid. | No specific findings to account for the patient's symptoms in the area of palpable concern. |
Generate impression based on findings. | Ms. David is a 40 year old female with a personal history of left breast lumpectomy in 2014 for IDC followed by adjuvant chemotherapy and radiation. She 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. Unfortunately, due to a technical error, the top half of the skin/breast anatomy is not included in the field-of-view on imaging. | Technical repeat necessary due to incomplete evaluation of both breasts. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: R - Technical Repeat Views. |
Generate impression based on findings. | Congestive heart failure. Elevated LFTs. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 19 cm in length. No focal hepatic lesions. Normal direction of portal venous blood flow, with pulsatility and distended hepatic veins compatible with right heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. No cholelithiasis. The gallbladder wall is thickened, which may be seen in the setting of ascites. PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 8.0 cm in length. The renal parenchyma is echogenic. No suspicious renal lesions are evident. No hydronephrosis is present.The left kidney is 8.8 cm in length. The renal parenchyma is echogenic. There is a 5.3 cm solid and cystic mass at the inferior pole. No hydronephrosis is present.SPLEEN: 14.9 cm in length, without focal lesions evident.OTHER: Mild ascites is noted. Right pleural effusion, partially imaged. | 1. Hepatomegaly with increased hepatic echogenicity compatible with parenchymal dysfunction. Multiple additional findings compatible with of congestive heart failure.2. 5.3 cm solid and cystic mass at the inferior pole of the left kidney, suspicious for neoplasm. Dedicated renal protocol CT or MRI is recommended for further evaluation.3. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 75 year-old female with hypertension, history of stenosis of right main renal artery. ULTRASOUND KIDNEYSRIGHT KIDNEY: Increased echogenicity of the right kidney measuring 8.7 cm in length. No hydronephrosis or shadowing calculi are noted. LEFT KIDNEY: Increased echogenicity of the left kidney measuring 9.0 cm in length. No hydronephrosis or shadowing calculi are noted. At the upper pole there is a hypoechoic lesion measuring 1.2 cm x 1.3 cm x 1.4 cm which does not have the classic appearance of a cyst.OTHER: No significant abnormalities noted. | 1. No Doppler evidence of renal artery stenosis.2. Bilateral increased renal echogenicity suggestive of parenchymal dysfunction. Hypoechoic lesion in the upper pole of the left kidney does not have the classic appearance of a cyst, recommend CT for further evaluation. |
Generate impression based on findings. | Female 86 years old Reason: Elevated LFTs History: none LIVER: Echotexture of the liver is slightly coarse. There is minimal increased nodularity of the liver. Liver measures 12.7 cm. There is a simple cyst in the left lobe of the liver measuring 0.9 cm.BILIARY TRACT: Gallbladder is not visualized. No evidence of intra or extra hepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 7.9 cm.RIGHT KIDNEY: Right kidney measures 8.8 cm. No evidence of focal lesions or hydronephrosis. Left kidney measures 10 cm. Mild calyectasis involving the left kidney.OTHER: No significant abnormalities noted. | Slightly coarse echotexture of the liver. Mild calyectasis involving the left kidney. |
Generate impression based on findings. | 60 year-old female. Microscopic hematuria. RIGHT KIDNEY: Normal echogenicity. 11.6 cm in length. Focal bulge of the cortex in the midpole may relate to a Dromedary hump. Multiple cysts, the largest in the lower pole, measures 7.8 x 5.9 x 8.1 cm. No shadowing stone.LEFT KIDNEY: Normal echogenicity. 10.5 cm in length. Mild pelvocaliectasis. No shadowing stone. OTHER: Partially collapsed bladder. | Right renal cysts. No solid mass or shadowing stone. |
Generate impression based on findings. | Female, 39 years old. Worsening transplant kidney function. The right iliac fossa transplant kidney measures 10.6 cm in length, with increased cortical echogenicity. A midpole simple cyst measures 1.5 x 1.0 x 1.1 cm. No shadowing stones or hydronephrosis. No perinephric collection.OTHER: The bladder is incompletely distended. | Increased renal cortical echogenicity, similar to prior, compatible with medical renal disease. No hydronephrosis or perinephric collection. |
Generate impression based on findings. | CKD, hyperkalemia, renal insufficiency RIGHT KIDNEY: AbsentLEFT KIDNEY: Left kidney measures 11.5 cm with mild increased echogenicity. Benign-appearing cyst is identified in the upper pole measuring 1.2 x 1.4 x 0.1 cm. Interval decrease in the degree of minimal lower pole hydronephrosis, now almost resolved. Previously described nonobstructing subcentimeter stone could not be reproduced in the lower pole. Hyperechoic focus measuring 0.5 x 0.3 x 0.4 cm most likely represents a vascular calcification.OTHER: Well-distended urinary bladder without any focal lesions. | Interval resolution of left renal hydronephrosis. There is a described left lower pole nonobstructing stone is not reproduced, probably patient passed the stone.Mild increased echogenicity of the left kidney consistent with chronic medical renal disease. |
Generate impression based on findings. | Male 64 years old Reason: lvad work up History: lvad workup LIVER:Liver is normal in appearance without evidence of focal hepatic mass. Liver measures 14.3 cm. Main portal vein is patent with normal directional flow and a peak velocity of 33 cm/s.GALLBLADDER, BILIARY TRACT: No intra or extrahepatic biliary duct dilatation. Common bile duct measures approximately 4 mm. Small amount of sludge is present within the gallbladder. No evidence of acute inflammation of the gallbladder.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 9.4 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or solid mass. Right kidney measures 11.6 cm. Left kidney measures approximately 10 cm. Superior pole of the left kidney there is a large simple appearing anechoic renal cyst measuring 6.0 x 6.3 cm.ABDOMINAL AORTA: The abdominal aorta is normal with a normal waveform.INFERIOR VENA CAVA: IVC is patent and has a normal waveform.OTHER: Bladder is decompressed around a Foley. | No sonographic abnormality of the visualized abdominal viscera. |
Generate impression based on findings. | The patient submitted outside mammograms dated 3/2/2012, 4/11/2012, 6/20/2013 and outside ultrasounds dated 3/22/2012 and 4/11/2012 from Metrosouth Medical Center. Submitted outside study was compared to the current mammogram dated 7/17/2015. A T-shaped clip is identified within the left breast at the 6:00 position which corresponds to a fibroadenoma on prior biopsy performed on 4/11/2012. All the masses in left breast are stable and most likely correspond to benign cysts or fibroadenomas corresponding to the ultrasound dated 3/22/2012. A lesion seen on ultrasound from 3/22/2012 in the right retroareolar region was not reproduced on ultrasound dated 4/11/2012 and therefore biopsy was not performed. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 46 year old female patient with history of known right breast cancer with metastases to the right axilla presents for follow up after 12 cycles of neoadjuvant chemotherapy. A right breast ultrasound was performed. The previously identified lesion in the right breast in the 10:00 o'clock position currently measures 1.6 x 1.1 x 1.1 cm, previously 3.6 x 2.6 x 2.6 cm. Previously biopsied right axillary lymph node with clip measures 0.9 x 0.6 x 0.3 cm, previously 1.7 x 0.9 x 1.1 cm. | Moderate response to chemotherapy of right breast cancer and axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Thyroid nodule RIGHT LOBE MEASUREMENTS: 4.1 x 1.4 x 1.4 cmLEFT LOBE MEASUREMENTS: 7.7 x 4.1 x 5.3 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Large predominately solid nodule occupying much of the left thyroid gland measuring 7.3 x 4.0 x 5.5 cm. Coarse internal calcification noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Large predominantly solid nodule occupying much of the left thyroid gland. This lesion is amenable to ultrasound-guided biopsy. No regional adenopathy. |
Generate impression based on findings. | Male 62 years old Reason: MTC; mapping ultrasound History: MTC; mapping ultrasound RIGHT LOBE MEASUREMENTS: 5.4 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.3 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.12 cmRIGHT LOBE: In the mid right thyroid lobe is a hypoechoic irregular nodule measuring 0.9 x 0.9 x 0.9 cm with questionable punctate calcifications. Adjacent and deep to this hypoechoic nodule is a more solid-appearing nodule measuring 1.2 x 0.8 x 0.9 cm.LEFT LOBE: Hypoechoic nodule in the left inferior thyroid lobe measures 0.6 x 0.6 x 1.0 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a very large heterogeneous right level 2 lymph node measuring 5.3 x 3.8 x 3.3 cm. There is a enlarged right level 3 lymph node measuring 2.0 x 1.0 x 2.3 cm. There is also an enlarged left level 3 lymph node measuring 1.1 x 0.5 x 1.0 cm.OTHER: No significant abnormality noted. | 1.Hypoechoic irregular nodule in the right thyroid lobe is concerning for malignancy, and may be the primary, given history of MTC. 2.Very large right neck lymph nodes are concerning for metastatic disease. Enlarged left neck lymph nodes are also concerning for metastatic disease. |
Generate impression based on findings. | 44-year-old male with history of thyroid cancer. Evaluate for adenopathy, recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 2 lymph node measures 1.5 x 0.9 x 0.3 cm., unchanged. Previously described right lymph node not clearly demonstrated.OTHER: No significant abnormality noted. | Stable exam. Left cervical lymph nodes with benign morphology. No evidence of recurrence. |
Generate impression based on findings. | Male 63 years old Reason: 63 yo with cirrhosis, RUQ pain R/o cholelithiasis and possible ascites History: RUQ pain LIVER: Increased echogenicity of liver without change. Liver measures 15.1 cm. No focal mass. Main portal vein is patent with normal directional flow velocity of 13 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 4 mm. The gallbladder is visualized and echogenic focus along the nondependent portion of the gallbladder wall, which may represent adenomyomatosis versus a small adherent stone. No evidence of acute inflammation of the gallbladder. No other gallstones are identified.PANCREAS: Visualized portions of the pancreas are normal.SPLEEN: Spleen is within normal limits measuring 10.5 cm.KIDNEYS: Normal cortical echogenicity bilaterally. No hydronephrosis. Subcentimeter nonobstructing stone in the inferior portion of the right kidney measures 0.6 x 0.3 x 0.4 cm, similar to the prior exam. Nonobstructing stone in the inferior left kidney measures 1.0 x 0.4 x 0.8 cm.OTHER: No ascites. | 1.No evidence of acute cholecystitis. Focal echogenic area in the gallbladder may represent adenomyomatosis versus a small adherent stone. No other shadowing gallstones are identified. 2.Nonobstructing bilateral renal stones measuring up to 1.0 cm.3.Unchanged morphology and echogenicity of the liver . No suspicious masses are identified. |
Generate impression based on findings. | 62-year-old female with HCV, cirrhosis. Evaluate for HCC. LIVER: Nodular hepatic contour and mildly coarsened hepatic echogenicity without discrete focal lesion.BILIARY TRACT: No significant abnormalities noted.PANCREAS: Portions of the pancreas not clearly visualized due to bowel gas. The visualized portions of the pancreas appear unremarkable.SPLEEN: Splenic granulomata. KIDNEY: No significant abnormalities noted. OTHER: 1.8 cm peripancreatic lymph node with benign morphologic features. | Nodular hepatic contour and increased echogenicity consistent with chronic liver disease, without discrete lesion identified. |
Generate impression based on findings. | 59-year-old female with right upper quadrant pain and question cholecystitis. LIVER: No significant abnormalities noted. No intrahepatic biliary ductal dilation.GALLBLADDER, BILIARY TRACT: Nondistended gallbladder with gallbladder wall measuring up to 1.2 cm. Pericholecystic fluid is also visualized. 2 echogenic foci are visualized within the gallbladder neck and likely represent stones.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY/TRANSPLANT KIDNEY: The right kidney appears atrophic and fibrotic. Transplant kidney appears similar in size prior exam, 14 cm without change in morphology.OTHER: Patient is post void and there is incomplete evaluation of the bladder. | In the appropriate clinical setting, findings are consistent with cholecystitis. |
Generate impression based on findings. | Screening for HCC, hepatitis B infection LIVER: Liver measures 17.9 cm with mild increased echogenicity consistent with hepatic steatosis. No focal lesions noted. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is mildly contracted. Murphy sign is negative. Common hepatic duct measures up to 3 mm within normal limits.PANCREAS: The tail of the pancreas is obscured by bowel gas, otherwise no significant abnormality noted.SPLEEN: Spleen measures 11 cm without an focal lesions.RIGHT KIDNEY: Right kidney measures 13.4 and left kidney measures 13.6 cm. No hydronephrosis or focal lesions. OTHER: No ascites | Hepatic steatosis without any focal hepatic lesion. |
Generate impression based on findings. | Ms. Marazas is a 58-year-old female with a personal history of left breast mastectomy in 2013 for DCIS papillary type and right silicone breast implant. She has no current breast-related complaints. Upon physical exam at the mammographic area of concern, no discrete mass is appreciated. Targeted ultrasound of the right inner breast demonstrates five masses correlating to the mammographic findings, four of which have benign morphologic features consistent with benign cysts, but the other of which is solid with internal flow and calcifications. The solid mass measures 5 x 4 x 3 mm (images time stamped 9:50:08 through 9:50:57, labeled right breast 3:00 4 cm from the nipple), with internal calcifications and vascularity. The additional benign appearing lesions are as follows: Right breast 3:00 5 cm from the nipple: simple cyst measuring 4 x 4 x 3 mm. Right breast 3:00 4 cm from the nipple: simple cyst measuring 4 x 3 x 2 mm.Right breast 2:00 2 cm from the nipple: simple cyst measuring 6 x 5 x 6 mm. Right breast 1:00 2 cm from the nipple: septated cyst without vascularity or internal solid component measuring 5 x 5 x 5 mm. | Several new masses in the right medial breast, one with indeterminate features as described above, for which ultrasound guided core biopsy with clip placement is recommended. The other lesions are consistent with simple benign cysts. These findings and recommendation were discussed with the patient at the time of the examination. The patient does not take blood thinning medications. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Epigastric pain LIVER: No significant abnormalities noted. Liver length 14.4 cmBILIARY TRACT: Cholelithiasis without acute inflammation or duct dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.5 cm in lengthRIGHT KIDNEY: Nonobstructing subcentimeter renal stone. Right kidney 8.2 cm in length OTHER: Nonobstructing subcentimeter left renal stone. Left renal cyst. Left kidney 8.9 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Bilateral nonobstructing subcentimeter renal stones. No ascites. |
Generate impression based on findings. | Ms. Grelck is a 69-year-old female presenting for short term 6 month follow-up ultrasound for multiple cysts of the right breast. She has a personal history of left breast lumpectomy for invasive ductal carcinoma in 2007. On physical examination, no palpable masses were identified.A targeted right ultrasound was performed for the mammographic area of concern. In the right breast 7:00 position, approximately 3 cm from the nipple, there is an anechoic round circumscribed lesion with posterior acoustic enhancement measuring 6 mm x 3 mm x 6 mm, unchanged. No internal flow is present on Doppler imaging. This is compatible with a cyst. In the right breast 8:00 position, approximately 3 cm from the nipple, there is a cluster of round anechoic lesions with posterior acoustic enhancement measuring 9 mm x 2 mm. No internal flow is present on Doppler imaging. These are also compatible with cysts and are unchanged.No solid masses were identified. | Stable benign cysts of the right breast. No sonographic evidence for malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months in order to ensure stability of these findings, due next in Jan 2017. Results and recommendation were discussed with the patient.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. | 54-year-old female with history of left breast asymmetries on recent mammogram. Occasional breast pain. Three standard views of the left breast with spot compression were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. Subcentimeter masses in the left inner breast persist with spot compression. ULTRASOUND | 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. | Ms. Moore is a 49 year old female who was recalled from screening for left breast focal asymmetry. An ML, exaggerated left CC, 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 heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Focal asymmetry in left outer breast at posterior depth does not disperse on compression views. The appearance suggests a benign etiology. ULTRASOUND | Circumscribed subcentimeter mass is present at the 1:00 position of the left breast, posterior depth, and may represent a complicated cyst versus solid mass. Ultrasound-guided cyst aspiration versus core biopsy is recommended for further evaluation.BIRADS: 4 - Suspicious Abnormality.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 68 years old Reason: has unexplained palpable nodule in epigastrium History: patient can show you- rule out fibroma vs hernia Focal circumscribed area of heterogeneous hyperechogenicity measures 2.4 x 1.2 x 1.1 cm. No abnormally increased vascular flow is present within the mass. No evidence of bowel containing hernia. | Findings representing nonspecific soft tissue mass, which may represent a lipoma or fibroma. No bowel containing hernia as clinically questioned. |
Generate impression based on findings. | 50 year-old male with abnormal liver function LIVER: The liver is normal in size and is moderately to markedly echogenic. Although not specific, this may be due to fatty infiltration. No focal hepatic abnormality. Limited spectral and color Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Echogenic liver. |
Generate impression based on findings. | Right lower quadrant pain. Evaluate for hernia. No hernia is present. The subcutaneous soft tissues in the patient's area of concern are unremarkable. | No hernia or subcutaneous findings to account for the patient's right lower quadrant pain. |
Generate impression based on findings. | Female 64 years old; Reason: previous history of nodules, please re-evaluate History: thyroid nodules RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 3.0 x 2.2 x 7.3 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 2.4 x 1.7 x 5.4 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.6 cm.RIGHT LOBE: The right lobe appears enlarged and heterogeneous. At the inferior portion of the right lobe there is a heterogeneous dominant nodule redemonstrated from prior ultrasound, measuring 4.1 cm x 2.6 cm x 3.6 cm. This previously measured 4.1 cm x 2.6 cm x 3.2 cm. No internal microcalcifications are seen and minimal internal vascularity.LEFT LOBE: The left lobe is enlarged and heterogeneous. At the inferior portion of the left lobe there is a heterogeneous iso to hyperechoic nodule measuring 2.4 cm x 1.9 cm x 1.3 cm. This previously measured 2.7 cm x 1.5 cm x 1.6 cm. There is coarse calcification redemonstrated from prior ultrasound.ISTHMUS: A mixed cystic and solid nodule is reidentified within the isthmus. This measures 2.4 cm x 1.2 cm x 2.4 cm and was previously measured 2.5 cm x 1.0 cm x 2.4 cm.LYMPH NODES: No suspicious adenopathy noted. | 1. Multinodular goiter, the dominant nodule in the inferior right lobe and isthmus that appears stable from prior ultrasound. No suspicious adenopathy is identified.2. The dominant nodule in the inferior left lobe has coarse calcification which was seen previously. This nodule is amenable to biopsy, however it does appear stable in size from prior ultrasound. |
Generate impression based on findings. | Abnormal bilirubin LIVER: Mildly heterogeneous and echogenic liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent portal vein with normal directional flow. Liver length 13.6 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma again noted without mass, stone, or hydronephrosis. Right kidney 16.4 cm in length.OTHER: Echogenic left renal parenchyma again noted without mass, stone, or hydronephrosis. Left kidney 13 cm in length. Spleen 11.2 cm in length. Bilateral pleural effusions. | Mildly coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Ms. Pritchett is a 41-year-old female with history of head and neck cancer as well as right breast IDC status post right lumpectomy in 2015 followed by chemotherapy and radiation therapy. Patient also has a history of left breast reconstruction. Patient presenting for short-term evaluation of a prominent left axillary lymph node identified on CT dated 9/2/2016. Ultrasound evaluation of the left axilla redemonstrates a normal morphology lymph node measuring 1.1 x 0.6 x 1.1 cm, with normal hilar vascular flow. This lymph node appears stable in appearance dating back to prior ultrasound study of 9/14/2016. | Normal-appearing left axillary lymph node stable in appearance dating back to 9/14/2016. No sonographic evidence for malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually, due May 2017. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | 31-year-old woman history of two right breast masses resembling fibroadenomas presents for diagnostic mammogram. Patient states that her physician palpated a third mass right breast 12:00 position which FNA showed results suggestive of fibroadenoma. DIAGNOSTIC MAMMOGRAM | Four right breast masses, largest at 12:00 position, with imaging characteristics suggestive of fibroadenomas. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Reason: patient with abnormal LFTs, elevated Alk phos, want to eval for pathology History: abnormal LFTs LIVER: The liver measures 15.2 cm in length. The hepatic parenchymal echotexture and echogenicity are unremarkable. The portal vein is patent with normal directional hepatopetal blood flow, peak velocity 38.7 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: Contracted gallbladder. No evidence of cholelithiasis or pericholecystic fluid. The gallbladder wall measures 0.2 cm and the common bile duct measures 0.2 cm. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.6 cm in length. Echogenic renal parenchyma. No shadowing stones were hydronephrosis.LEFT KIDNEY: The left kidney measures 9.9 cm in length. 1.1 cm lower pole shadowing renal calculus. No hydronephrosis, however the upper pole the left kidney is not visualized.OTHER: Fibroid uterus, similar to prior exam. No free pelvic fluid. | 1. No acute hepatobiliary abnormality.2. 1.1 cm left lower pole nonobstructing renal stone. No hydronephrosis, however the upper pole is not visualized.3. Echogenic kidneys, consistent with medical renal disease. |
Generate impression based on findings. | Status post thyroidectomy for papillary thyroid carcinoma 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: Two slightly enlarged left level 3/4 lymph nodes. The largest measures 0.7 x 0.4 x 0.4 cm. Internal morphology of these lymph nodes demonstrates effacement of normal fatty hilum.OTHER: No significant abnormality noted. | Status post thyroidectomy. 2 slightly enlarged left level 3/4 lymph nodes with effacement of normal fatty hilum. While these may represent reactive lymph nodes, would recommend follow-up ultrasound in 4-6 months to document stability. |