Reason: Patient with large right renal mass and concern for IVC extension possibly thoracic. Has new onset SOB and need MRI for surgical planning. History: As above. Limited exam without intravenous contrast.LUNGS AND PLEURA: Left lower lobe pulmonary nodule measures 1.0 x 1.0 cm (series 601 image 8). Patchy opacity in the left upper lobe. Moderate left and small right pleural effusions.MEDIASTINUM AND HILA: Filling defects in the lower pulmonary arteries bilaterally from the right segmental level and the left lobar level compatible with history of pulmonary emboli. CHEST WALL: Degenerative changes. Scattered synovial or perineural cysts. T2 hyperintense, T1 hypointense lesion in the left L1 vertebral body with extension into the left pedicle suspicious for metastasis. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. See separately dictated MRI abdomen.
1.Right lower segmental and left lower lobar pulmonary emboli. Malignant thrombi cannot be excluded.2.Left lower lobe pulmonary nodule suspicious for metastasis. See recent CT chest. 3.Left L1 metastasis. 4.Left upper lobe patchy opacity may represent infarction, atelectasis, or infection.5.Moderate left and small right pleural effusions.