Neck. There is approximately 50% stenosis and atherosclerotic calcification at the proximal right subclavian artery which is similar to the prior exam. Asymmetrically attenuated caliber of the right vertebral artery likely represents dissection, which is new since 2003 and unchanged since February 2012. Redemonstration of multiple consecutive smoothly narrowed foci of high grade stenosis within the midportion of the right vertebral artery at the level of C4-C6. There is no significant stenosis along the course of the left vertebral artery. The proximal internal carotid arteries are highly tortuous. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is redemonstration of weblike defects within the midportion of the left internal carotid artery associated with focal dilation to approximately 8 mm, which is unchanged The caliber of the left internal carotid artery distal to this is 5 mm. To a lesser degree there are some weblike defects along the distal right internal carotid arteryThe thyroid gland lobes are heterogeneous in appearance especially along the posterior aspects but unchanged from the 2/1/2012 study. Multilevel degenerative changes of the cervical spine are again seen and centered at C4-C5 with mild narrowing of the spinal canal and neuroforamina. Brain. There is a stable 3 x 2 mm aneurysm in the right pericallosal artery at the origin of the anterior internal frontal artery, unchanged from 2003. There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No intracranial stenosis is appreciated. The anterior communicating artery is a small and the posterior communicating arteries are tiny. The right vertebral artery is smaller than the left vertebral artery. No evidence of acute intracranial hemorrhage. Foci of encephalomalacia are again seen along the left precentral gyrus, left post central gyrus, right post central gyrus, right inferior parietal lobule and right occipital lobe. Encephalomalacia is also visualized the left middle frontal gyrus extending to the left inferior frontal gyrus. The ventricle sizes are stable. No intra or extra-axial fluid collection, midline shift or mass effect. The paranasal sinuses and mastoid air cells are clear.
anatomical entity_fin: {'right subclavian artery': {'location descriptor': 'proximal'}}location descriptor_fin: ['proximal']clinical findings_fin: {'approximately 50% stenosis': {'clinical finding': 'approximately 50% stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'pos_dx', 'descriptive_term': 'approximately 50 ', 'observation': 'stenosis'}, 'atherosclerotic calcification': {'clinical finding': 'atherosclerotic calcification', 'existence': 'pos_dx', 'descriptive_term': 'atherosclerotic', 'observation': 'calcification'}}anatomical entity_fin: {'right vertebral artery': {}}clinical findings_fin: {'dissection': {'clinical finding': 'dissection', 'existence': 'unc_dx', 'observation': 'dissection'}}anatomical entity_fin: {'right vertebral artery': {}}imaging observation_fin: ['foci']clinical findings_fin: {'high grade stenosis': {'clinical finding': 'high grade stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'pos_dx', 'descriptive_term': 'high grade', 'observation': 'stenosis'}}anatomical entity_fin: {'left vertebral artery': {}}clinical findings_fin: {'significant stenosis': {'clinical finding': 'significant stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'stenosis'}}anatomical entity_fin: {'internal carotid arteries': {'location descriptor': 'proximal'}}location descriptor_fin: ['proximal']clinical findings_fin: {'tortuous': {'clinical finding': 'tortuous', 'existence': 'pos_dx', 'observation': 'tortuous'}}clinical findings_fin: {'nascet': {'clinical finding': 'nascet', 'existence': 'unc_dx', 'observation': 'nascet'}, 'significant stenosis': {'clinical finding': 'significant stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'stenosis'}}size_fin: [{'size': '8 mm'}, {'size': '5 mm'}]anatomical entity_fin: {'internal carotid artery': {'location descriptor': 'left'}}location descriptor_fin: ['left', 'distal']clinical findings_fin: {'weblike defects': {'clinical finding': 'weblike defects', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'descriptive_term': 'weblike', 'observation': 'defect'}, 'focal dilation': {'clinical finding': 'focal dilation', 'existence': 'pos_dx', 'descriptive_term': 'focal', 'observation': 'dilation'}}anatomical entity_fin: {'thyroid gland': {}, 'lobes': {}}location descriptor_fin: ['distal', 'right', 'posterior']clinical findings_fin: {'some weblike defects': {'clinical finding': 'some weblike defects', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'descriptive_term': 'some weblike', 'observation': 'defect', 'quantity_term': 'some'}}anatomical entity_fin: {'cervical spine': {}, 'spinal canal': {}, 'neuroforamina': {}}clinical findings_fin: {'multilevel degenerative changes': {'clinical finding': 'multilevel degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'multilevel degenerative', 'observation': 'change'}, 'mild narrowing': {'clinical finding': 'mild narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild', 'observation': 'narrowing', 'strength_term': 'mild'}}size_fin: [{'size': '3 x 2 mm', 'size_descriptor': 'aneurysm'}]anatomical entity_fin: {'right pericallosal artery': {}, 'origin': {}, 'anterior internal frontal artery': {}}clinical findings_fin: {'stable 3 x 2 mm aneurysm': {'clinical finding': 'stable 3 x 2 mm aneurysm', 'cf_snomed': {'aneurysm': 432119003}, 'existence': 'pos_dx', 'descriptive_term': 'stable 3 x 2 mm', 'observation': 'aneurysm', 'strength_term': 'stable', 'change_term': 'stable'}}anatomical entity_fin: {'internal carotid arteries': {'location descriptor': 'distal'}, 'vertebral arteries': {'location descriptor': 'distal'}, 'middle': {'location descriptor': 'proximal anterior'}, 'posterior cerebral arteries': {}}location descriptor_fin: ['distal', 'proximal', 'anterior']clinical findings_fin: {'opacification': {'clinical finding': 'opacification', 'existence': 'pos_dx', 'observation': 'opacification'}}clinical findings_fin: {'intracranial stenosis': {'clinical finding': 'intracranial stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'intracranial', 'observation': 'stenosis'}}anatomical entity_fin: {'anterior communicating artery': {}, 'posterior communicating arteries': {}}clinical findings_fin: {'anterior communicating artery is a small and the posterior communicating arteries are tiny': {'clinical finding': 'anterior communicating artery is a small and the posterior communicating arteries are tiny'}}anatomical entity_fin: {'right vertebral artery': {}, 'left vertebral artery': {}}clinical findings_fin: {'smaller': {'clinical finding': 'smaller', 'existence': 'pos_dx', 'observation': 'small'}}clinical findings_fin: {'acute intracranial hemorrhage': {'clinical finding': 'acute intracranial hemorrhage', 'cf_snomed': {'intracranial hemorrhage': 1386000}, 'existence': 'neg_dx', 'descriptive_term': 'acute intracranial', 'observation': 'hemorrhage', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'left precentral gyrus': {}, 'right inferior parietal lobule': {}, 'right occipital lobe': {}}imaging observation_fin: ['foci']location descriptor_fin: ['left', 'central', 'right']clinical findings_fin: {'encephalomalacia': {'clinical finding': 'encephalomalacia', 'cf_snomed': {'encephalomalacia': 58762006}, 'existence': 'pos_dx', 'observation': 'encephalomalacia'}}anatomical entity_fin: {'left middle frontal gyrus': {}, 'left inferior frontal gyrus': {}}clinical findings_fin: {'encephalomalacia': {'clinical finding': 'encephalomalacia', 'cf_snomed': {'encephalomalacia': 58762006}, 'existence': 'pos_dx', 'observation': 'encephalomalacia'}}clinical findings_fin: {'ventricle sizes are stable': {'clinical finding': 'ventricle sizes are stable', 'change_term': 'stable'}}location descriptor_fin: ['midline']clinical findings_fin: {'intra or extra-axial fluid collection': {'clinical finding': 'intra or extra-axial fluid collection', 'existence': 'neg_dx', 'descriptive_term': 'intra or extra-axial fluid', 'observation': 'collection'}, 'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}}anatomical entity_fin: {'paranasal sinuses': {}, 'mastoid air cells': {}}clinical findings_fin: {'clear': {'clinical finding': 'clear', 'existence': 'pos_dx', 'observation': 'clear'}}
<s>[INST] Write the finding section for a radiology report based on the following information: anatomical entity_fin: {'right subclavian artery': {'location descriptor': 'proximal'}}location descriptor_fin: ['proximal']clinical findings_fin: {'approximately 50% stenosis': {'clinical finding': 'approximately 50% stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'pos_dx', 'descriptive_term': 'approximately 50 ', 'observation': 'stenosis'}, 'atherosclerotic calcification': {'clinical finding': 'atherosclerotic calcification', 'existence': 'pos_dx', 'descriptive_term': 'atherosclerotic', 'observation': 'calcification'}}anatomical entity_fin: {'right vertebral artery': {}}clinical findings_fin: {'dissection': {'clinical finding': 'dissection', 'existence': 'unc_dx', 'observation': 'dissection'}}anatomical entity_fin: {'right vertebral artery': {}}imaging observation_fin: ['foci']clinical findings_fin: {'high grade stenosis': {'clinical finding': 'high grade stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'pos_dx', 'descriptive_term': 'high grade', 'observation': 'stenosis'}}anatomical entity_fin: {'left vertebral artery': {}}clinical findings_fin: {'significant stenosis': {'clinical finding': 'significant stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'stenosis'}}anatomical entity_fin: {'internal carotid arteries': {'location descriptor': 'proximal'}}location descriptor_fin: ['proximal']clinical findings_fin: {'tortuous': {'clinical finding': 'tortuous', 'existence': 'pos_dx', 'observation': 'tortuous'}}clinical findings_fin: {'nascet': {'clinical finding': 'nascet', 'existence': 'unc_dx', 'observation': 'nascet'}, 'significant stenosis': {'clinical finding': 'significant stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'significant', 'observation': 'stenosis'}}size_fin: [{'size': '8 mm'}, {'size': '5 mm'}]anatomical entity_fin: {'internal carotid artery': {'location descriptor': 'left'}}location descriptor_fin: ['left', 'distal']clinical findings_fin: {'weblike defects': {'clinical finding': 'weblike defects', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'descriptive_term': 'weblike', 'observation': 'defect'}, 'focal dilation': {'clinical finding': 'focal dilation', 'existence': 'pos_dx', 'descriptive_term': 'focal', 'observation': 'dilation'}}anatomical entity_fin: {'thyroid gland': {}, 'lobes': {}}location descriptor_fin: ['distal', 'right', 'posterior']clinical findings_fin: {'some weblike defects': {'clinical finding': 'some weblike defects', 'cf_snomed': {'defect': 6920004}, 'existence': 'pos_dx', 'descriptive_term': 'some weblike', 'observation': 'defect', 'quantity_term': 'some'}}anatomical entity_fin: {'cervical spine': {}, 'spinal canal': {}, 'neuroforamina': {}}clinical findings_fin: {'multilevel degenerative changes': {'clinical finding': 'multilevel degenerative changes', 'existence': 'pos_dx', 'descriptive_term': 'multilevel degenerative', 'observation': 'change'}, 'mild narrowing': {'clinical finding': 'mild narrowing', 'cf_snomed': {'narrowing': 708528005}, 'existence': 'pos_dx', 'descriptive_term': 'mild', 'observation': 'narrowing', 'strength_term': 'mild'}}size_fin: [{'size': '3 x 2 mm', 'size_descriptor': 'aneurysm'}]anatomical entity_fin: {'right pericallosal artery': {}, 'origin': {}, 'anterior internal frontal artery': {}}clinical findings_fin: {'stable 3 x 2 mm aneurysm': {'clinical finding': 'stable 3 x 2 mm aneurysm', 'cf_snomed': {'aneurysm': 432119003}, 'existence': 'pos_dx', 'descriptive_term': 'stable 3 x 2 mm', 'observation': 'aneurysm', 'strength_term': 'stable', 'change_term': 'stable'}}anatomical entity_fin: {'internal carotid arteries': {'location descriptor': 'distal'}, 'vertebral arteries': {'location descriptor': 'distal'}, 'middle': {'location descriptor': 'proximal anterior'}, 'posterior cerebral arteries': {}}location descriptor_fin: ['distal', 'proximal', 'anterior']clinical findings_fin: {'opacification': {'clinical finding': 'opacification', 'existence': 'pos_dx', 'observation': 'opacification'}}clinical findings_fin: {'intracranial stenosis': {'clinical finding': 'intracranial stenosis', 'cf_snomed': {'stenosis': 415582006}, 'existence': 'neg_dx', 'descriptive_term': 'intracranial', 'observation': 'stenosis'}}anatomical entity_fin: {'anterior communicating artery': {}, 'posterior communicating arteries': {}}clinical findings_fin: {'anterior communicating artery is a small and the posterior communicating arteries are tiny': {'clinical finding': 'anterior communicating artery is a small and the posterior communicating arteries are tiny'}}anatomical entity_fin: {'right vertebral artery': {}, 'left vertebral artery': {}}clinical findings_fin: {'smaller': {'clinical finding': 'smaller', 'existence': 'pos_dx', 'observation': 'small'}}clinical findings_fin: {'acute intracranial hemorrhage': {'clinical finding': 'acute intracranial hemorrhage', 'cf_snomed': {'intracranial hemorrhage': 1386000}, 'existence': 'neg_dx', 'descriptive_term': 'acute intracranial', 'observation': 'hemorrhage', 'strength_term': 'acute', 'temporal_term': 'acute'}}anatomical entity_fin: {'left precentral gyrus': {}, 'right inferior parietal lobule': {}, 'right occipital lobe': {}}imaging observation_fin: ['foci']location descriptor_fin: ['left', 'central', 'right']clinical findings_fin: {'encephalomalacia': {'clinical finding': 'encephalomalacia', 'cf_snomed': {'encephalomalacia': 58762006}, 'existence': 'pos_dx', 'observation': 'encephalomalacia'}}anatomical entity_fin: {'left middle frontal gyrus': {}, 'left inferior frontal gyrus': {}}clinical findings_fin: {'encephalomalacia': {'clinical finding': 'encephalomalacia', 'cf_snomed': {'encephalomalacia': 58762006}, 'existence': 'pos_dx', 'observation': 'encephalomalacia'}}clinical findings_fin: {'ventricle sizes are stable': {'clinical finding': 'ventricle sizes are stable', 'change_term': 'stable'}}location descriptor_fin: ['midline']clinical findings_fin: {'intra or extra-axial fluid collection': {'clinical finding': 'intra or extra-axial fluid collection', 'existence': 'neg_dx', 'descriptive_term': 'intra or extra-axial fluid', 'observation': 'collection'}, 'mass': {'clinical finding': 'mass', 'existence': 'neg_dx', 'observation': 'mass'}}anatomical entity_fin: {'paranasal sinuses': {}, 'mastoid air cells': {}}clinical findings_fin: {'clear': {'clinical finding': 'clear', 'existence': 'pos_dx', 'observation': 'clear'}} [/INST] Neck. There is approximately 50% stenosis and atherosclerotic calcification at the proximal right subclavian artery which is similar to the prior exam. Asymmetrically attenuated caliber of the right vertebral artery likely represents dissection, which is new since 2003 and unchanged since February 2012. Redemonstration of multiple consecutive smoothly narrowed foci of high grade stenosis within the midportion of the right vertebral artery at the level of C4-C6. There is no significant stenosis along the course of the left vertebral artery. The proximal internal carotid arteries are highly tortuous. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is redemonstration of weblike defects within the midportion of the left internal carotid artery associated with focal dilation to approximately 8 mm, which is unchanged The caliber of the left internal carotid artery distal to this is 5 mm. To a lesser degree there are some weblike defects along the distal right internal carotid arteryThe thyroid gland lobes are heterogeneous in appearance especially along the posterior aspects but unchanged from the 2/1/2012 study. Multilevel degenerative changes of the cervical spine are again seen and centered at C4-C5 with mild narrowing of the spinal canal and neuroforamina. Brain. There is a stable 3 x 2 mm aneurysm in the right pericallosal artery at the origin of the anterior internal frontal artery, unchanged from 2003. There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No intracranial stenosis is appreciated. The anterior communicating artery is a small and the posterior communicating arteries are tiny. The right vertebral artery is smaller than the left vertebral artery. No evidence of acute intracranial hemorrhage. Foci of encephalomalacia are again seen along the left precentral gyrus, left post central gyrus, right post central gyrus, right inferior parietal lobule and right occipital lobe. Encephalomalacia is also visualized the left middle frontal gyrus extending to the left inferior frontal gyrus. The ventricle sizes are stable. No intra or extra-axial fluid collection, midline shift or mass effect. The paranasal sinuses and mastoid air cells are clear. </s>