.Poorly defined, confluent hypoattenuation involving the cerebral periventricular white matter has minimally increased since the previous examination. This is most probably from microvascular ischemia. Gray-white matter differentiation is preserved. There is no intracranial hemorrhage, midline shift or mass effect. The ventricles on the other CSF-containing spaces are mildly enlarged, reflecting volume loss. Mastoid air cells and paranasal sinuses are clear. Orbits are unremarkable accounting for bilateral lens replacement. Artifact related to the shoulders partially obscures mid or lower thoracic spine. Spinal alignment is notable for reversal of the normal lordosis which may reflect patient positioning. Craniocervical and cervicothoracic articulations are anatomic. Vertebral body heights are preserved. There is no acute fracture. Facets are anatomic but show progressive degenerative change at multiple levels as described below. The prevertebral soft tissues are not thickened. Included cervical soft tissues show no gross abnormality. Included lung apices show minimal reticular opacification which may reflect scarring. While there is no definite narrowing of the spinal canal, it is difficult to evaluate the spinal canal in the lower cervical levels because of the artifact from the shoulders. Proliferative changes are present at the atlantodental articulation but without compression of the thecal sac. Left more than right facet hypertrophy associated with mild C2-C3 and moderate C3-C4 left neural foraminal narrowing. The right facet hypertrophy cause mild right neural foraminal narrowing. Left facet degenerative change causes mild left neural foraminal narrowing. There is mild right neural foraminal narrowing by uncovertebral hypertrophy. Bilateral facet hypertrophy results in moderate left and mild right neural foraminal narrowing. These findings are not significant changed since the previous examination in 2012.
clinical findings_fin: {'poorly defined, confluent hypoattenuation': {'clinical finding': 'poorly defined, confluent hypoattenuation', 'existence': 'pos_dx', 'descriptive_term': 'poorly defined confluent', 'observation': 'hypoattenuation'}}clinical findings_fin: {'microvascular ischemia': {'clinical finding': 'microvascular ischemia', 'cf_snomed': {'ischemia': 52674009}, 'existence': 'unc_dx', 'descriptive_term': 'microvascular', 'observation': 'ischemia'}}clinical findings_fin: {'gray-white matter differentiation': {'clinical finding': 'gray-white matter differentiation', 'existence': 'pos_dx', 'descriptive_term': 'gray-white matter', 'observation': 'differentiation'}}location descriptor_fin: ['midline']clinical findings_fin: {'intracranial hemorrhage': {'clinical finding': 'intracranial hemorrhage', 'cf_snomed': {'intracranial hemorrhage': 1386000}, 'existence': 'neg_dx', 'descriptive_term': 'intracranial', 'observation': 'hemorrhage'}, 'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}}clinical findings_fin: {'enlarged': {'clinical finding': 'enlarged', 'existence': 'pos_dx', 'observation': 'enlarged'}, 'volume loss': {'clinical finding': 'volume loss', 'existence': 'pos_dx', 'descriptive_term': 'volume', 'observation': 'loss'}}anatomical entity_fin: {'mastoid air cells': {}, 'paranasal sinuses': {}}clinical findings_fin: {'clear': {'clinical finding': 'clear', 'existence': 'neg_dx', 'observation': 'clear'}}anatomical entity_fin: {'orbits': {}, 'lens': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral']clinical findings_fin: {'unremarkable accounting for bilateral lens replacement': {'clinical finding': 'unremarkable accounting for bilateral lens replacement'}}anatomical entity_fin: {'shoulders': {}, 'spine': {}}location descriptor_fin: ['lower']clinical findings_fin: {'artifact': {'clinical finding': 'artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'observation': 'artifact'}}imaging observation_fin: ['reversal']clinical findings_fin: {'spinal alignment': {'clinical finding': 'spinal alignment', 'existence': 'pos_dx', 'descriptive_term': 'spinal', 'observation': 'alignment'}, 'normal lordosis': {'clinical finding': 'normal lordosis', 'existence': 'pos_dx', 'descriptive_term': 'normal', 'observation': 'lordosis', 'strength_term': 'normal'}, 'patient positioning': {'clinical finding': 'patient positioning', 'existence': 'unc_dx', 'descriptive_term': 'patient', 'observation': 'positioning'}}imaging observation_fin: ['cervicothoracic']clinical findings_fin: {'craniocervical and cervicothoracic articulations are anatomic': {'clinical finding': 'craniocervical and cervicothoracic articulations are anatomic'}}anatomical entity_fin: {'vertebral body': {}}clinical findings_fin: {'vertebral body heights are preserved': {'clinical finding': 'vertebral body heights are preserved', 'change_term': 'preserved'}}clinical findings_fin: {'acute fracture': {'clinical finding': 'acute fracture', 'cf_snomed': {'fracture': 72704001}, 'existence': 'neg_dx', 'descriptive_term': 'acute', 'observation': 'fracture', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'facets': {}}clinical findings_fin: {'progressive degenerative change': {'clinical finding': 'progressive degenerative change', 'existence': 'pos_dx', 'descriptive_term': 'progressive degenerative', 'observation': 'change'}}clinical findings_fin: {'thickened': {'clinical finding': 'thickened', 'existence': 'pos_dx', 'observation': 'thickened'}}clinical findings_fin: {'gross abnormality': {'clinical finding': 'gross abnormality', 'existence': 'neg_dx', 'descriptive_term': 'gross', 'observation': 'abnormality'}}anatomical entity_fin: {'lung': {}, 'apices': {}}clinical findings_fin: {'minimal reticular opacification': {'clinical finding': 'minimal reticular opacification', 'existence': 'pos_dx', 'descriptive_term': 'minimal reticular', 'observation': 'opacification', 'strength_term': 'minimal', 'quantity_term': 'minimal'}, 'scarring': {'clinical finding': 'scarring', 'existence': 'unc_dx', 'observation': 'scarr'}}anatomical entity_fin: {'spinal canal': {}, 'shoulders': {}}location descriptor_fin: ['lower']clinical findings_fin: {'definite narrowing': {'clinical finding': 'definite narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'neg_dx', 'descriptive_term': 'definite', 'observation': 'narrowing'}, 'artifact': {'clinical finding': 'artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'observation': 'artifact'}}clinical findings_fin: {'proliferative changes': {'clinical finding': 'proliferative changes', 'existence': 'pos_dx', 'descriptive_term': 'proliferative', 'observation': 'change'}, 'compression': {'clinical finding': 'compression', 'cf_snomed': {'compression': 71173004}, 'existence': 'neg_dx', 'observation': 'compression'}}anatomical entity_fin: {'facet': {'location descriptor': 'right'}}location descriptor_fin: ['left', 'right']clinical findings_fin: {'left more than right facet hypertrophy': {'clinical finding': 'left more than right facet hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'left more than right facet', 'observation': 'hypertrophy', 'quantity_term': 'more'}, 'moderate c3-c4 left neural foraminal narrowing': {'clinical finding': 'moderate c3-c4 left neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'moderate c3-c4 left neural foraminal', 'observation': 'narrowing', 'strength_term': 'moderate'}}anatomical entity_fin: {'facet': {'location descriptor': 'right'}}location descriptor_fin: ['right']clinical findings_fin: {'right facet hypertrophy': {'clinical finding': 'right facet hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'right facet', 'observation': 'hypertrophy'}, 'mild right neural foraminal narrowing': {'clinical finding': 'mild right neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild right neural foraminal', 'observation': 'narrowing', 'strength_term': 'mild'}}anatomical entity_fin: {'facet': {'location descriptor': 'left'}}location descriptor_fin: ['left']clinical findings_fin: {'left facet degenerative change': {'clinical finding': 'left facet degenerative change', 'existence': 'pos_dx', 'descriptive_term': 'left facet degenerative', 'observation': 'change'}, 'mild left neural foraminal narrowing': {'clinical finding': 'mild left neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild left neural foraminal', 'observation': 'narrowing', 'strength_term': 'mild'}}location descriptor_fin: ['right']clinical findings_fin: {'mild right neural foraminal narrowing': {'clinical finding': 'mild right neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild right neural foraminal', 'observation': 'narrowing', 'strength_term': 'mild'}, 'uncovertebral hypertrophy': {'clinical finding': 'uncovertebral hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'uncovertebral', 'observation': 'hypertrophy'}}anatomical entity_fin: {'facet': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral', 'left', 'right']clinical findings_fin: {'bilateral facet hypertrophy': {'clinical finding': 'bilateral facet hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'bilateral facet', 'observation': 'hypertrophy'}, 'moderate left and mild right neural foraminal narrowing': {'clinical finding': 'moderate left and mild right neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'moderate left and mild right neural foraminal', 'observation': 'narrowing', 'strength_term': 'moderate - mild'}}clinical findings_fin: {'not significant changed since the previous examination in 2012': {'clinical finding': 'not significant changed since the previous examination in 2012', 'change_term': 'changed'}}
<s>[INST] Write the finding section for a radiology report based on the following information: clinical findings_fin: {'poorly defined, confluent hypoattenuation': {'clinical finding': 'poorly defined, confluent hypoattenuation', 'existence': 'pos_dx', 'descriptive_term': 'poorly defined confluent', 'observation': 'hypoattenuation'}}clinical findings_fin: {'microvascular ischemia': {'clinical finding': 'microvascular ischemia', 'cf_snomed': {'ischemia': 52674009}, 'existence': 'unc_dx', 'descriptive_term': 'microvascular', 'observation': 'ischemia'}}clinical findings_fin: {'gray-white matter differentiation': {'clinical finding': 'gray-white matter differentiation', 'existence': 'pos_dx', 'descriptive_term': 'gray-white matter', 'observation': 'differentiation'}}location descriptor_fin: ['midline']clinical findings_fin: {'intracranial hemorrhage': {'clinical finding': 'intracranial hemorrhage', 'cf_snomed': {'intracranial hemorrhage': 1386000}, 'existence': 'neg_dx', 'descriptive_term': 'intracranial', 'observation': 'hemorrhage'}, 'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}}clinical findings_fin: {'enlarged': {'clinical finding': 'enlarged', 'existence': 'pos_dx', 'observation': 'enlarged'}, 'volume loss': {'clinical finding': 'volume loss', 'existence': 'pos_dx', 'descriptive_term': 'volume', 'observation': 'loss'}}anatomical entity_fin: {'mastoid air cells': {}, 'paranasal sinuses': {}}clinical findings_fin: {'clear': {'clinical finding': 'clear', 'existence': 'neg_dx', 'observation': 'clear'}}anatomical entity_fin: {'orbits': {}, 'lens': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral']clinical findings_fin: {'unremarkable accounting for bilateral lens replacement': {'clinical finding': 'unremarkable accounting for bilateral lens replacement'}}anatomical entity_fin: {'shoulders': {}, 'spine': {}}location descriptor_fin: ['lower']clinical findings_fin: {'artifact': {'clinical finding': 'artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'observation': 'artifact'}}imaging observation_fin: ['reversal']clinical findings_fin: {'spinal alignment': {'clinical finding': 'spinal alignment', 'existence': 'pos_dx', 'descriptive_term': 'spinal', 'observation': 'alignment'}, 'normal lordosis': {'clinical finding': 'normal lordosis', 'existence': 'pos_dx', 'descriptive_term': 'normal', 'observation': 'lordosis', 'strength_term': 'normal'}, 'patient positioning': {'clinical finding': 'patient positioning', 'existence': 'unc_dx', 'descriptive_term': 'patient', 'observation': 'positioning'}}imaging observation_fin: ['cervicothoracic']clinical findings_fin: {'craniocervical and cervicothoracic articulations are anatomic': {'clinical finding': 'craniocervical and cervicothoracic articulations are anatomic'}}anatomical entity_fin: {'vertebral body': {}}clinical findings_fin: {'vertebral body heights are preserved': {'clinical finding': 'vertebral body heights are preserved', 'change_term': 'preserved'}}clinical findings_fin: {'acute fracture': {'clinical finding': 'acute fracture', 'cf_snomed': {'fracture': 72704001}, 'existence': 'neg_dx', 'descriptive_term': 'acute', 'observation': 'fracture', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'facets': {}}clinical findings_fin: {'progressive degenerative change': {'clinical finding': 'progressive degenerative change', 'existence': 'pos_dx', 'descriptive_term': 'progressive degenerative', 'observation': 'change'}}clinical findings_fin: {'thickened': {'clinical finding': 'thickened', 'existence': 'pos_dx', 'observation': 'thickened'}}clinical findings_fin: {'gross abnormality': {'clinical finding': 'gross abnormality', 'existence': 'neg_dx', 'descriptive_term': 'gross', 'observation': 'abnormality'}}anatomical entity_fin: {'lung': {}, 'apices': {}}clinical findings_fin: {'minimal reticular opacification': {'clinical finding': 'minimal reticular opacification', 'existence': 'pos_dx', 'descriptive_term': 'minimal reticular', 'observation': 'opacification', 'strength_term': 'minimal', 'quantity_term': 'minimal'}, 'scarring': {'clinical finding': 'scarring', 'existence': 'unc_dx', 'observation': 'scarr'}}anatomical entity_fin: {'spinal canal': {}, 'shoulders': {}}location descriptor_fin: ['lower']clinical findings_fin: {'definite narrowing': {'clinical finding': 'definite narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'neg_dx', 'descriptive_term': 'definite', 'observation': 'narrowing'}, 'artifact': {'clinical finding': 'artifact', 'cf_snomed': {'artifact': 47973001}, 'existence': 'pos_dx', 'observation': 'artifact'}}clinical findings_fin: {'proliferative changes': {'clinical finding': 'proliferative changes', 'existence': 'pos_dx', 'descriptive_term': 'proliferative', 'observation': 'change'}, 'compression': {'clinical finding': 'compression', 'cf_snomed': {'compression': 71173004}, 'existence': 'neg_dx', 'observation': 'compression'}}anatomical entity_fin: {'facet': {'location descriptor': 'right'}}location descriptor_fin: ['left', 'right']clinical findings_fin: {'left more than right facet hypertrophy': {'clinical finding': 'left more than right facet hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'left more than right facet', 'observation': 'hypertrophy', 'quantity_term': 'more'}, 'moderate c3-c4 left neural foraminal narrowing': {'clinical finding': 'moderate c3-c4 left neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'moderate c3-c4 left neural foraminal', 'observation': 'narrowing', 'strength_term': 'moderate'}}anatomical entity_fin: {'facet': {'location descriptor': 'right'}}location descriptor_fin: ['right']clinical findings_fin: {'right facet hypertrophy': {'clinical finding': 'right facet hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'right facet', 'observation': 'hypertrophy'}, 'mild right neural foraminal narrowing': {'clinical finding': 'mild right neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild right neural foraminal', 'observation': 'narrowing', 'strength_term': 'mild'}}anatomical entity_fin: {'facet': {'location descriptor': 'left'}}location descriptor_fin: ['left']clinical findings_fin: {'left facet degenerative change': {'clinical finding': 'left facet degenerative change', 'existence': 'pos_dx', 'descriptive_term': 'left facet degenerative', 'observation': 'change'}, 'mild left neural foraminal narrowing': {'clinical finding': 'mild left neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild left neural foraminal', 'observation': 'narrowing', 'strength_term': 'mild'}}location descriptor_fin: ['right']clinical findings_fin: {'mild right neural foraminal narrowing': {'clinical finding': 'mild right neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild right neural foraminal', 'observation': 'narrowing', 'strength_term': 'mild'}, 'uncovertebral hypertrophy': {'clinical finding': 'uncovertebral hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'uncovertebral', 'observation': 'hypertrophy'}}anatomical entity_fin: {'facet': {'location descriptor': 'bilateral'}}location descriptor_fin: ['bilateral', 'left', 'right']clinical findings_fin: {'bilateral facet hypertrophy': {'clinical finding': 'bilateral facet hypertrophy', 'cf_snomed': {'hypertrophy': 56246009}, 'existence': 'pos_dx', 'descriptive_term': 'bilateral facet', 'observation': 'hypertrophy'}, 'moderate left and mild right neural foraminal narrowing': {'clinical finding': 'moderate left and mild right neural foraminal narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'moderate left and mild right neural foraminal', 'observation': 'narrowing', 'strength_term': 'moderate - mild'}}clinical findings_fin: {'not significant changed since the previous examination in 2012': {'clinical finding': 'not significant changed since the previous examination in 2012', 'change_term': 'changed'}} [/INST] .Poorly defined, confluent hypoattenuation involving the cerebral periventricular white matter has minimally increased since the previous examination. This is most probably from microvascular ischemia. Gray-white matter differentiation is preserved. There is no intracranial hemorrhage, midline shift or mass effect. The ventricles on the other CSF-containing spaces are mildly enlarged, reflecting volume loss. Mastoid air cells and paranasal sinuses are clear. Orbits are unremarkable accounting for bilateral lens replacement. Artifact related to the shoulders partially obscures mid or lower thoracic spine. Spinal alignment is notable for reversal of the normal lordosis which may reflect patient positioning. Craniocervical and cervicothoracic articulations are anatomic. Vertebral body heights are preserved. There is no acute fracture. Facets are anatomic but show progressive degenerative change at multiple levels as described below. The prevertebral soft tissues are not thickened. Included cervical soft tissues show no gross abnormality. Included lung apices show minimal reticular opacification which may reflect scarring. While there is no definite narrowing of the spinal canal, it is difficult to evaluate the spinal canal in the lower cervical levels because of the artifact from the shoulders. Proliferative changes are present at the atlantodental articulation but without compression of the thecal sac. Left more than right facet hypertrophy associated with mild C2-C3 and moderate C3-C4 left neural foraminal narrowing. The right facet hypertrophy cause mild right neural foraminal narrowing. Left facet degenerative change causes mild left neural foraminal narrowing. There is mild right neural foraminal narrowing by uncovertebral hypertrophy. Bilateral facet hypertrophy results in moderate left and mild right neural foraminal narrowing. These findings are not significant changed since the previous examination in 2012. </s>