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Generate impression based on medical findings. | Shortness of breath Persistent marked COPD changes with minimal superimposed patchy streaky opacities and retrocardiac left lower lobe partial collapse. Small to moderate effusions are also unchanged.Right PICC line and right single jugular port terminating in the proximal SVC unchanged | Persistent patchy basilar changes suggesting atelectasis greater in the left lower lobe with effusions |
Generate impression based on medical findings. | Aortic mass removed Small residual right effusion with basilar atelectasis observed bilaterally. Improved aeration and decreased changes suggesting resolving edema.Cardiac and mediastinal contours are within limitsResuscitation wires project over right upper chest, removed | Improving aeration with small residual right effusion |
Generate impression based on medical findings. | Female, 68 years old.ETT. Tubes and lines similar in position. Dependent atelectasis with bronchial wall thickening suggestive of aspirated secretions, not significantly changed. No pneumothorax. No acute change | No acute change in findings suggestive of atelectasis and aspirated secretions. ETT 4.5 cm above carina. |
Generate impression based on medical findings. | Female 38 years old Reason: lung infiltrate History: cough x 1 week. Mild cardiomegaly, unchanged since prior examination. Low lung volumes. No focal opacity, pneumothorax, or pleural effusion is identified. | Low lung volumes with no acute cardiopulmonary abnormality. No specific evidence of infection. |
Generate impression based on medical findings. | Male 64 years old Reason: R/O HCC History: HCV, cirrhosis LIVER: The liver measures 16.0 cm in length with a mildly nodular contour. The parenchyma is mildly coarse and echogenic . No focal liver lesion is identified. The main portal vein is patent and demonstrates normal direction of flow with a velocity of 2.7 m/s. There is no ascites.BILIARY TRACT: The gallbladder is absent. The common duct measures 1.6 cm in diameter, it previously measured 2 cm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal with no evidence of mass. The body and tail are obscured by bowel gas. The pancreatic duct is mildly dilated but unchanged.KIDNEYS: The right kidney measures 8.7 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 8.6 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 8.8 cm. in length. OTHER: No significant abnormalities noted. | 1.Mildly coarse and echogenic liver compatible with chronic liver disease.2.No hepatic masses identified.3.Chronic, duct and pancreatic ductal dilatation is stable to slightly decreased. |
Generate impression based on medical findings. | Female, 30 years old.Reason: Cough x 8 weeks, evaluate cause. History: cough Cardiomediastinal silhouette is unremarkable. No focal airspace opacity, pleural effusion, or pneumothorax.Moderately severe pectus excavatum deformity. | No acute cardiopulmonary abnormalities. No evidence of infection. |
Generate impression based on medical findings. | Renal cell with brain mets, post resection and SRS 7/2014 & whole brain RT 12/2014. There are postoperative findings related to right frontal craniotomy with persistent confluent high T2 signal, but no evidence of abnormal enhancement in the region of the right superior frontal resection cavity. There is interval decrease in size of the enhancing component of the hemorrhagic right parietal lobe lesion and associated vasogenic edema, which now measures 10 mm, previously 17 mm. There is also interval decrease in size of the right occipital lobe hemorrhagic ring-enhancing lesion and associated vasogenic edema, which now measures up to 7 mm, previously 9 mm. In addition, there is interval decrease in size of the enhancing left occipital lobe lesion and associated vasogenic edema, which now measures up to 6 mm, previously 10 mm. Furthermore, there is interval decrease in size of the hemorrhagic enhancing lesion located more laterally in the left occipital lobe lesion and associated vasogenic edema, which now measures up to 5 mm, previously 7 mm. Likewise, the hemorrhagic enhancing lesion in the right precuneus has diminished in size, now measuring up to 2 mm, previously 6 mm. There is an unchanged focus of susceptibility effect in the right superior parietal lobule. There is no evidence of intracranial hemorrhage or acute infarct. There is diminished effacement of the left lateral ventricle posteriorly. There is no midline shift or herniation. The major cerebral flow voids are intact. There is nonspecific fluid signal within the bilateral mastoid air cells, which may represent effusions. There is a right maxillary sinus retention cyst. | Interval decrease in size of the brain metastases and associated vasogenic edema. |
Generate impression based on medical findings. | Thyroid dysfunction. Shortness of breath No cardiopulmonary abnormality | Normal |
Generate impression based on medical findings. | Male, 62 years old.Reason: r/o pneumothorax History: Chest tube removal Unchanged chest tubes with no significant pneumothorax.Stable subsegmental atelectasis with no new pulmonary findings.Moderate cardiomegaly. Prior right jugular Swan-Ganz catheter removed. | No significant pneumothorax. Unchanged subsegmental atelectasis. |
Generate impression based on medical findings. | Male, 52 years old.Reason: evaluate for cause of hypoxia in setting of known hemoptysis History: hypoxia, shortness of breath Extensive bullous fibrotic sarcoidosis is again noted in the mid and upper aspect of the lungs with severe lung volume loss. Superimposed consolidative abnormality, not substantially different compared to previous study but increased compared to 2006. Previously demonstrated mycetomas are also again noted but difficult to appreciate compared to recent CT. No pneumothorax. No large pleural effusion. No change in heart size. | No substantial change compared to previous study. |
Generate impression based on medical findings. | Possible arachnoid cyst and abnormal vessel: right side headache, abnormal CT. MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and brainstem appear unremarkable. There is focal prominence of cerebrospinal fluid spaces along the inferior aspect of the left cerebellar hemisphere, measuring 10 mm in width, 2 mm in height, and 10 mm anteroposteriorly. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA: The vertebrobasilar system is tortuous, but there is no evidence of significant steno-occlusive lesions or cerebral aneurysms. | 1. No evidence of arachnoid cyst in the premedullary space. However, a small areas of focal prominence of the cerebrospinal fluid spaces along the inferior aspect of the left cerebellar hemisphere may be attributable to an arachnoid cyst.2. No evidence of cerebral aneurysms. |
Generate impression based on medical findings. | 56-year-old male with brain lesion, evaluate for metastatic disease CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: 1.6-cm splenic cyst in its upper pole.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left UPJ obstruction causing moderate left-sided hydronephrosis. Left ureter is normal in caliber.. Bilateral small renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of primary or metastatic lesion the chest abdomen and pelvis.Left UPJ obstruction causing moderate left hydronephrosis. |
Generate impression based on medical findings. | Male, 53 years old.Reason: Infxn w/u History: fevers, chills Small left pleural effusion and possible basilar edema.Heart size upper normal status post mitral valve replacement.Unchanged mediastinal widening with numerous vascular stents. | Mild CHF without evidence of infection. |
Generate impression based on medical findings. | Clinical question: Evaluate for etiology of seizure. Signs and symptoms: Suspected seizures, as is right temporal and parietal hypodensities on CT. Pre-and post-enhanced brain MRI:Negative diffusion weighted images.Examination demonstrates a chronic healed depressed right parietal calvarial fracture as was noted on prior head CT. There is a small focus of underlying cortical and subcortical hemorrhagic encephalomalacia of the right parietal lobe. This finding measures approximately at 19 times 15-mm in largest transaxial dimensions.Additionally there is a larger focus of encephalomalacia in the inferior aspect of right anterior/mid temporal lobe confined primarily to the periventricular white matter of right temporal and extending inferiorly to the cortex. There is no evidence of hemorrhagic changes with this finding. It measures at least at 27 x 19 x 19-mm in size. There is mild ex vacuo dilatation of right temporal horn. This findings are best appreciated on coronal T2 and flair series 901 and 1001. The anatomical morphology of the brain is otherwise within normal and with normal signal intensity on all MRI sequences. The ventricular system and disuse of the spaces remain within normal and with maintained midline. The signal void of major intracranial arterial branches are identified and unremarkable.Post enhanced images demonstrate no detectable abnormal enhancement the brain parenchyma, leptomeninges or the calvarium.Unremarkable images through the orbits and including axial fat sat post enhanced series.Paranasal sinuses demonstrate a single retention cyst in the dependent portion of the left maxillary sinus and unremarkable otherwise. | 1.No acute intracranial process.2.Small focus of right parietal superficial hemorrhagic encephalomalacia under a chronic healed depressed skull fracture as detailed.3.Larger focus of nonhemorrhagic encephalomalacia along the inferior surface of right anterior/mid temporal lobe involving the white matter and the cortex. Finding results in mild expansion of right temporal horn. 4.Unremarkable pre-and post enhanced brain MRI otherwise. |
Generate impression based on medical findings. | 37 year-old female with metastatic rectal cancer. Please evaluate extent of disease status post chemo/radiation. CHEST:LUNGS AND PLEURA: No significant abnormality noted. No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.Anterior mediastinal soft tissue is again likely represents residual thymic tissue.CHEST WALL: Right chest port catheter with catheter tip near SVC/RA junction. ABDOMEN: LIVER, BILIARY TRACT: Hypoattenuating lesion in segment 7 (series 5, image 81) has decreased in size since prior study, currently measuring 0.9 x 0.9 cm; previously measuring 1.4 x 2 cm.Portal and hepatic vasculature are patent. No intra- or extrahepatic biliary ductal dilatation.New submucosal edema in the gallbladder with increased mucosal enhancement, possibly representing sequela chemotherapy. No pericholecystic fluid.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal thickening.KIDNEYS, URETERS: Right pelvic kidney.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Interval decrease in size of pelvic lymphadenopathy with reference right external iliac chain lymph node (series 5, image 168) measuring 1.1 x 1.3 cm; previously measuring 1.6 x 2 cm.Enlarged perirectal lymph node (series 5, image 164) measures 1.2 x 1.7 cm; previously measuring 1.7 x 2 cm.BOWEL, MESENTERY: Previously seen rectal wall thickening correlating with patient's known rectal cancer is no longer discretely visualized and therefore is not adequately measurable. Some mild residual rectal wall thickening seen on series 5, image 175 likely represents site of known cancer.BONES, SOFT TISSUES: Mild degenerative changes of the lumbar spine with chronic-appearing superior endplate depression at L4, unchanged. | 1. Previously seen rectal mass is no longer discretely visualized.2. Interval decrease in size of liver metastasis and pelvic lymphadenopathy.3. New submucosal edema in the gallbladder with increased mucosal enhancement, likely reflecting sequela of chemotherapy. |
Generate impression based on medical findings. | 62 yo male with history of MDS; pre-allo SCT evaluation. Normal cardiac silhouette. No focal airspace opacity, pleural effusion, or pneumothorax. No displaced rib fractures. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Cough, fever and SOB rule out pneumonia. Normal heart size. No visible lymphadenopathy. No pleural fluid or pneumothorax.No focal airspace opacities, visible nodules or masses. | No signs of pneumonia. No acute pulmonary abnormality. |
Generate impression based on medical findings. | Male, 33 years old.Reason: inubtated, resp failure History: intubated, resp failure NG tube tip 7 cm above carina. Venous catheters unchanged. ECMO cannula stable. Loculated left pneumothorax stable.Diffuse airspace and interstitial lung opacity is stable. | Diffuse airspace and interstitial lung opacity is stable. |
Generate impression based on medical findings. | Age: 75 yearsGender: MaleReason for Study: Reason: r/o infection History: leukocytosis The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions. | No acute cardiopulmonary abnormalities are identified. Specific evidence of infection. |
Generate impression based on medical findings. | Female, 85 years old.Reason: rule out chest metastasis History: hx of high grade urothelial carcinoma Extensive aortic arch calcification is unchanged. Cardiomediastinal silhouette is unchanged and within normal limits. Large lung volumes, bulla, and emphysema. Diffuse interstitial opacities opacities which are increased compared to chest radiograph 1915. | 1.No specific evidence metastasis background of chronic interstitial lung disease. If there is clinical concern for pulmonary metastatic disease, CT is recommended.2.Diffuse interstitial opacities have increased since chest radiograph 9/2/2015. ILD CT may be helpful for further evaluation. |
Generate impression based on medical findings. | Reason: Other History: CHF Cardiomegaly with moderately large pleural effusions and underlying atelectasis, similar to previous. Pacemaker leads and right jugular catheter unchanged. | Pleural effusions and atelectasis with no acute change. |
Generate impression based on medical findings. | Male, 59 years old.Reason: post op cardiac surgery History: post op cardiac surgery Multiple chest tubes with a persistent 17 mm right pneumothorax, slightly larger than before. Small lung volumes with moderate pulmonary fibrosis, unchanged.Heart size at least upper normal status post valve repair via median sternotomy. | Pulmonary fibrosis with slight enlargement of a right pneumothorax. |
Generate impression based on medical findings. | 41-year-old female status post BMT, worsening bilirubin, jaundice. Evaluate for VOD versus obstruction. LIMITED ABDOMENLIVER: Enlarged measuring 21.0 cm in length and is heterogeneous in echotexture. No focal hepatic lesions. BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The visualized portions are unremarkable. SPLEEN: Spleen is enlarged measuring 16.2 cm in length. RIGHT KIDNEY: Measures 12.1 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 12.6 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.Abdominal ascites.Incompletely visualized bilateral pleural effusions. | 1. Hepatosplenomegaly with heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/infiltration. Patent inflow and outflow hepatic vasculature.2. Abdominal ascites and bilateral pleural effusions. |
Generate impression based on medical findings. | Clinical question: Intraop ablation. Signs and symptoms: Intraop ablation. Pre- and postenhanced treatment planning MRI:Study is performed utilizing treatment planning protocol and is not a true diagnostic exam.Examination redemonstrates a tectal plate mass with a thick rim of enhancement and measuring approximately 21 x 21 mm in transaxial dimensions.The lesion demonstrates a defect within its posterior right lateral rim likely secondary to ablation. There is a large central necrosis which is new since prior exam from 4-29-50.The mass demonstrates slight interval increased size since prior study which could be treatment related. Severely dilated supratentorial ventricular system demonstrate no appreciable interval change.Small CSF signal intensity right hemispheric subdural collection demonstrate no appreciable change since prior exam. No detectable new foci of abnormal parenchymal or leptomeningeal enhancement. | 1.Interval significant central necrosis of a tectal plate tumor and a defect along its left posterior wall believed to be secondary to ablation.2.The tumor measures 21 x 21 mm in transaxial dimensions which is slightly larger than prior study and likely treatment related.3.Stable enlarged supratentorial ventricular system. |
Generate impression based on medical findings. | Male 51 years old Reason: ? SLAP tear, ? Rotator cuff tear History: pain ROTATOR CUFF: Rotator cuff is intact.SUPRASPINATUS OUTLET: There is a type I acromion. No significant abnormality.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is irregularity of the anterior superior labrum most consistent with degeneration. No discrete tear of the labrum. Bone island is situated within the glenoid anterior humeral head.BICEPS TENDON: The biceps tendon is situated in the bicipital groove. No significant abnormality. ADDITIONAL | Irregularity of the anterior superior labrum consistent with degeneration without discrete tear. |
Generate impression based on medical findings. | Elevated T3 and T4 with cardiac anomalies RIGHT LOBE MEASUREMENTS: 4.9 x 1.5 x 2 cmLEFT LOBE MEASUREMENTS: 4.2 x 1.6 x 2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Diffusely heterogeneous gland with increased vascularity. No discrete mass.LEFT LOBE: Diffusely heterogeneous gland with increased vascularity. No discrete mass.ISTHMUS: Diffusely heterogeneous gland with increased vascularity. No discrete mass.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland with increased vascularity. No discrete mass. Findings suggestive for Graves' disease versus acute thyroiditis. |
Generate impression based on medical findings. | Female, 31 years old.History of sickle cell disease. Stable mild enlargement of the cardiac silhouette. Limited assessment of the mediastinum.No abnormal focal lung parenchymal opacities. No pleural effusion or pneumothorax.Left IJ port port catheter with tip overlying the azygos vein, unchanged in position. | No radiographic findings to suggest pneumonia. |
Generate impression based on medical findings. | Male, 50 years old.Reason: check ETT adjustment History: previously cuff above cords, now replaced Slight increase in interstitial opacities suggestive of edema, with small pleural effusions.Heart size upper normal.ET tube tip approximately 3 cm above the carina. | Mild increase in edema. ET tube repositioned, the tip now 3 cm above the carina. |
Generate impression based on medical findings. | Reason: s/p tECAB History: na ET tube about 7 cm above the carina and right jugular catheter tip in the area the right jugular vein. Mild streaky lower lobe opacities suggestive of bronchial thickening and subsegmental atelectasis secondary to aspirated secretions.No sign of pneumonia or CHF. | ET tube in acceptable position. |
Generate impression based on medical findings. | Female 27 years old; Reason: cholecystitis, gallstones History: pancreatitis LIVER: The liver demonstrates normal echogenicity and echotexture. No focal hepatic lesions. Hepatic length measures 17.6 cm. The main portal vein is patent with normal hepatopetal flow with a velocity of 31.6 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is normal in echotexture with the wall measuring 2 mm. The common bile duct measures 2 mm in diameter. Sonographic Murphy's sign is negative. Trace pericholecystic fluid is present. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. The right kidney measures 10.1 cm and demonstrates increased echogenicity with no hydronephrosis. Anechoic focus in the midpole of the right kidney measuring 1.9 x 1.3 x 1.5 cm compatible with a renal sinus cyst. The left kidney measures 11.6 cm and demonstrates increased echogenicity with no hydronephrosis. OTHER: No significant abnormality noted. | 1.No sonographic evidence of cholelithiasis, choledocholithiasis, or acute cholecystitis.2.Increased cortical echogenicity of bilateral kidneys, compatible with medical renal disease, without evidence of hydronephrosis or shadowing calculi. |
Generate impression based on medical findings. | Female 59 years old Reason: History gallbladder malignancy, acute elevation in alk phos History: abnormal labs LIVER: Liver measures 15.4 cm in length. The parenchyma is increased in echogenicity and heterogeneous with multifocal and in some areas confluent hypoechoic masslesions seen, primarily involving the right hepatic lobe. Main portal vein patent with normal directional flow, increased velocity measuring 61 cm/sec. BILIARY TRACT: Status post cholecystectomy. Common bile duct stent present, echoes seen within stent. Intrahepatic biliary duct dilatation seen, more pronounced in left lobe and degree of dilatation increased from prior study (intrahepatic biliary duct dilatation measures up to 5 mm, previously measured 3 mm. Constellation of findings suspicious for obstructive stent.PANCREAS: Not well visualized in entirety due to overlying bowel gas. KIDNEYS: The right kidney measures 8.7 cm, mid to lower pole not well assessed but areas of heterogeneity suggested, appearance similar to earlier study. The left kidney measures 10.5 cm cm. Mildly increased renal cortical echogenicity, nonspecific.SPLEEN: The spleen measures 7.7 cm. in length. OTHER: Incompletely imaged small to moderate ascites. | 1. Mild interval worsening of intrahepatic biliary duct dilatation and intrastent echoes seen, constellation of findings suspicious for stent obstruction.2. Multifocal/confluent hepatic lesions again seen, metastatic disease/neoplasm among differential considerations, coalescing abscesses not entirely excluded, correlation with patient's clinical history and laboratory values recommended. Again recommended is further evaluation with dedicated contrast enhanced CT or MRI. Unchanged increased portal vein velocity.3. Incompletely imaged ascites.4. Mid to lower pole not well assessed but areas of heterogeneity suggested, appearance similar to earlier study, this, too, may be assessed with contrast enhanced crosssectional imaging. |
Generate impression based on medical findings. | Male, 55 years old.S/p BiVAD Iatrogenic devices are unchanged. No substantial change in diffuse pulmonary opacities given differences in inspiration. Unchanged cardiomegaly. No pneumothorax. Small pleural effusions. | No substantial change in diffuse pulmonary opacities given differences in inspiration. |
Generate impression based on medical findings. | Cough and shortness of breath. Low lung volumes with extensive chronic airspace opacities and consolidation bilaterally. Apparent interval worsening may reflect the interval decrease in lung volumes rather than disease progression. Superimposed pneumonia would be difficult or impossible to exclude on portable plain film technique. No evidence of pulmonary edema. | Extensive opacities previously described as advanced nummular pulmonary sarcoidosis; superimposed pneumonia would be difficult or impossible to exclude a portable plain film technique, especially given interval decrease in lung volumes. Consider reduced dose thoracic CT. |
Generate impression based on medical findings. | History of Crohn's disease and portal vein thrombosis. ABDOMEN:LIVER, BILIARY TRACT: The liver measures 15.7 cm in craniocaudal dimension. It is normal in contour and morphology.There are small cystic structures adjacent to the central biliary tree which appear to communicate with the biliary tree likely representing small peribiliary cysts. In addition there is mild irregularity and narrowing of the biliary tree centrally and of the proximal hepatic duct which raises the possibility of PSC. No suspicious focal lesion or dominant stricture.There is chronic thrombosis of the portal vein with cavernous transformation including large collateral periportal vessel formation.No suspicious liver lesion.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of the bowel are partially imaged. The colon is full of fluid. The presumed neoterminal ileum is collapsed and suboptimally evaluated.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Chronic portal vein thrombosis with cavernous transformation.2.Mild irregular narrowing of the biliary tree raises the possibility of PSC. No suspicious focal lesion or dominant stricture. |
Generate impression based on medical findings. | Female, 29 years old.Reason: eval for acute process History: fever/cough Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. No specific evidence of infection. |
Generate impression based on medical findings. | Female, 25 years old.MVA yesterday's there any evidence of rib fracture? Metallic BBs placed on sites of pain. Heart size appears upper normal for age, vascular redistribution is present and perihilar vascular unsharpness is suggestive of borderline edema. Please note that chest technique has a limited sensitivity for osseous pathology including fracture or dislocation. If clinically warranted, dedicated bone technique films of the are of interest would be recommended. Within this limitation, no conclusive displaced fractures of the visualized ribs are appreciated. The posterior spinal elements and right scapula near the markers are inadequately visualized for assessment. | 1. The cardiothoracic ratio appears prominent for the patient's age and the lungs also appear to show signs of mild hypervolemia. 2. Although no displaced rib fractures are identified, this does not exclude the presence of nondisplaced fracture which may not be visible by this technique. Dedicated bone-technique radiographs of the area of interest are suggested if there is continued clinical suspicion. |
Generate impression based on medical findings. | Age: 57 yearsGender: FemaleReason for Study: Reason: chronic cough in morbidly obese smoker (1/2 PPD) History: as above Decreased lung volumes with stable cardiomediastinal silhouette.The lungs are clear.No pleural effusions. | No acute cardiopulmonary abnormalities identified without interval change. |
Generate impression based on medical findings. | Macrocephaly, developmental delay. Sacral dimple. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The cerebral, cerebellar, and brainstem parenchyma appear unremarkable. There is a normal degree of myelination. The pituitary gland appears to be grossly intact. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Spine: The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The conus medullaris is positioned at the L1-2 level. There is no evidence of tumors or fibrofatty filum. The paravertebral soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage, mass, or ventriculomegaly.2. No gross spinal dysraphism or segmentation anomaly. |
Generate impression based on medical findings. | Multiple myeloma and ependymoma, evaluate interval change Five lumbar type vertebral bodies are presumed to be present. Again seen are multiple compression fractures including the T11, T12, L2, L3, and L4 vertebral bodies, not significantly changed since prior study from 2/19/2015. Relatively worse height loss is at T12 with approximately 70% loss of height. No bone marrow edema associated with the fractures to suggest recent loss of height.There is worsening of marrow signal abnormality including a rounded lesion involving the L3 vertebral body measuring approximately 2 cm in diameter, which is not definitively appreciated previously. There is also increased in diffuse mottled appearance of the bone marrow signal particularly from the L5 level through the pelvis. Multiple enhancing lesions are evident involving the sacrum and iliac bones bilaterally, which are new since 2/19/2015.Postoperative changes of laminectomy are seen at the L4-L5 and L5-S1 levels with small residual fluid collection in the posterior extradural soft tissues again noted.Multilevel degenerative changes are seen, as described below:L1-2: Mild disc bulge and unchanged small superimposed left paracentral disc extrusion with superior migration posterior to the L1 vertebra. No significant spinal canal stenosis. Minimal bilateral foraminal narrowing. L2-3: Mild facet and ligamentum flavum hypertrophy. Mild disc bulge. No significant spinal canal stenosis. Minimal right foraminal narrowing. L3-4: Mild facet and ligament flavum hypertrophy. Mild disc bulge. Unchanged prominent epidural fat contributes to mild narrowing of the spinal canal without significant stenosis. Mild bilateral foraminal narrowing. L4-5: Postsurgical change. Moderate facet and ligamentum flavum hypertrophy. Mild disc bulge. No significant spinal canal stenosis. Mild to moderate neural foraminal narrowing, left worse than right. L5-S1: Postsurgical change. Moderate facet and ligament flavum hypertrophy. Mild disc bulge with a small superimposed central protrusion. No significant spinal canal stenosis. Minimal to mild bilateral neural foramen stenosis.Abnormal areas of enhancement involving the sacral spinal canal at the S1 and S2 levels are not significantly changed and consistent with history of known ependymoma. No new or enlarging epidural tumor. | 1. Compared to 2/19/2015 there is diffuse worsening of bone marrow signal with development of multiple new enhancing osseous lesions which are most apparent in the pelvis. Findings would be consistent with interval progression of osseous metastases/myelomatous involvement.2. No significant change in multiple chronic compression fractures.3. No significant change in residual enhancing tumor within the sacral spinal canal at the S1 and S2 levels compatible with known myxopapillary ependymoma. |
Generate impression based on medical findings. | 37-year-old female, 13 weeks pregnant presents to the diagnostic clinic to evaluate left breast palpable mass. Family history of breast cancer in 2 maternal aunts. Recent mammogram in February 2015 was within normal limits. A targeted left axillary ultrasound was performed for the patient’s area of pain. Patient indicates area of pain in the left lower axillary region. No discrete mass was palpated on physical examination. There is no solid or cystic mass identified. Normal axillary lymph node is identified in this entity. | Area of pain in the left lower axillary region corresponds to normal glandular tissue. A Normal axillary lymph node is identified in the vicinity.Patient is due in April 2016. Annual screening mammogram is recommended after April 2016.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on medical findings. | Male, 82 years old.Reason: fu removal of chest tube History: na Interval removal of the right basilar chest tube.Accounting for change in position, there is no significant change in size of the right pleural effusion. No interval pneumothorax. Streaky left lower lobe opacities are consistent with subsegmental atelectasis. Diffuse subcutaneous emphysema extends from the base of the right neck to the infralateral chest wall. | No significant pneumothorax following chest tube removal. |
Generate impression based on medical findings. | 61 year-old female with recurrent stage IIIc fallopian tube cancer status post surgery and chemo. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Aortic arch atherosclerotic calcifications. No enlarged mediastinal or hilar lymphadenopathy. The heart size is normal. No pericardial effusion.CHEST WALL: Right chest port with tip in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Fissural prominence. No hepatic lesions. The gallbladder is normal.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small portocaval and peripancreatic lymph nodes, which are likely reactive, are unchanged. Abdominal aortic atherosclerotic calcifications.BOWEL, MESENTERY: Small hiatal hernia. No ascites. Bowel is normal in appearance. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. There is a 1.5 x 2.4 cm soft tissue nodule (series 3, image 179) posterior to the most superior aspect of the vaginal fornix, which is new from prior examination. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | New soft tissue nodule posterior to the most superior aspect of the vaginal fornix, which may represent a recurrence of tumor. |
Generate impression based on medical findings. | Male, 66 years old, history of cough and shortness of breath. Fibrosis on an outside CT. LUNGS AND PLEURA: Diffuse nodular and interstitial opacities, septal thickening and bronchiectasis are noted, predominantly peripheral and slightly more severe at the bases. Evidence of early honeycombing is seen. These findings have not significantly changed when compared to the outside examination dated 12/19/08.Interval postoperative change with a suture line is evident in the superior segment of the right lower lobe. A small pneumothorax is evident in the right lower lobe, likely postoperative in etiology.MEDIASTINUM AND HILA: Prominent superior mediastinal, prevascular, and pretracheal lymph nodes. A right paratracheal node referenced on the outside examination measures 1.9 x 1.4 cm (axial image 34/85, series 3) and demonstrates a fatty hilum indicating a benign morphology.Cardiomegaly. No significant pericardial effusion.CHEST WALL: Degenerative change affects the thoracic spine with mild compression deformities of several midthoracic vertebral bodies.UPPER ABDOMEN: No significant abnormality noted. | 1.Diffuse interstitial abnormality as described above. The pattern is most compatible with UIP (usual interstitial pneumonitis).2.Small pneumothorax on the right adjacent to postoperative change in the lower lobe. |
Generate impression based on medical findings. | Female, 75 years old.Altered mental status. Evaluate for infection. Interval removal of the central venous catheter. Right lower lobe and partially calcified right upper lobe nodules are not significantly changed from prior. Cardiac size is within normal limits with median sternotomy hardware, unchanged. Surgical clips project over the left chest wall. No new focal airspace opacity, pleural effusion, or pneumothorax. | No acute cardiopulmonary abnormality. Right sided pulmonary nodules are nonspecific. These were previously evaluated with CT and PET/CT, please see separate reports. CT would provide far better characterization if clinically warranted. As the patient has a history of breast and thyroid cancer, malignancy remains a consideration. |
Generate impression based on medical findings. | Female, 64 years old.Reason: dyspnea History: dyspnea Limited by rotation. Cardiomegaly. No focal opacity to suggest pneumonia. No evidence of pneumothorax or significant pleural effusion. | Cardiomegaly. No focal opacity to suggest pneumonia. No evidence of pneumothorax or significant pleural effusion. |
Generate impression based on medical findings. | Personal history of NF1. Evaluate left flank plexiform neurofibroma and compare it to previous, also intra pelvic tumors. BONE MARROW: No fractures. Bone marrow signal is within normal limits.SOFT TISSUES: Again seen is a heterogeneously enhancing soft tissue mass in the left lower back centered just above the iliac crest (series 1301, image 41) unchanged in size measuring approximately 6.2 x 11.0 x 4.5 cm (AP x TV x CC) previously measured 6.5 x 11.1 x 4.5 cm. The mass remains somewhat heterogeneous and demonstrates increased T2 signal and decreased T1 signal compared to the adjacent fat. The deep margin of the lesion is indistinct and blends with the underlying fat. The lesion appears separate from the adjacent deep paraspinal and gluteal muscles; the intervening fat planes appear intact. Additional numerous round targetoid T2 hyperintense lesions are present throughout the soft tissues of the abdomen, pelvis and bilateral lower extremities compatible with neurofibromas. An example lesion in the anterior musculature of the right thigh (series 1301, image 13) measures approximately 1.4 x 1.8 cm, (previously 1.3 x 1.8 cm).JOINTS: No significant abnormality noted.ADDITIONAL | 1.No change in size of soft tissue mass centered in the left lower back immediately superior to the left iliac crest measuring 6.2 x 11.0 x 4.5 cm 2.Additional smaller neurofibromas scattered throughout the soft tissues of the abdomen, pelvis and bilateral lower extremities appear similar. |
Generate impression based on medical findings. | Reason: S/P thoracentesis History: Undergoing therapeutic thoracentesis for pleural effusion Normal heart size and moderate mediastinal widening compatible with lymphadenopathy.Moderately large bilateral pleural effusions, greater on the right, decreased on the left side since the previous radiograph.Underlying pulmonary opacity compatible with metastatic disease and atelectasis. | Decreased left pleural effusion and no pneumothorax. |
Generate impression based on medical findings. | Male, 56 years old.Reason: eval for effusion History: SOB No significant cardiopulmonary abnormality.Healed right rib fractures. | No significant abnormality. |
Generate impression based on medical findings. | Chest pain Small left pneumothorax measuring under 1 cm with mild splinting and/or scoliosis concave to the left. Borderline cardiomegaly | Small left pneumothorax |
Generate impression based on medical findings. | Unspecified cerebral artery occlusion with cerebral infarction The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. This is stable compared to the prior exam.There is redemonstration of small foci of signal hyperintensity on T2 and FLAIR MRI in the cerebellar hemispheres as well as the brainstem which were also present on the prior exam and remain unchangedThe lateral ventricles are fairly large. The biventricular diameter currently measures 44 mm and previously measured the same.Several punctate foci of a signal loss and susceptibility imaging are present along the left temporal lobe subcortical white matter a couple of which were present on the prior examNo abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate an opacity in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. | 1.The exam is stable compared to the July 2014 exam.2.Punctate periventricular and subcortical white matter as well as cerebellar and brainstem lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Old lacunar infarcts are present in the cerebellar hemispheres4.There are several microhemorrhages present in the left temporal lobe subcortical white matter which are nonspecific |
Generate impression based on medical findings. | Female, 70 years old.Reason: Central Line Placement History: NA Median sternotomy with a small left pleural effusion, basilar atelectasis and cardiomegaly with coronary stents.Right jugular catheter, tip in SVC.ET tube tip approximately 5 cm above the carina.An NG tube terminates in the stomach. | Pleural effusions and basilar atelectasis with cardiomegaly. Right jugular catheter, tip in SVC. |
Generate impression based on medical findings. | Female, 52 years old.Fever 48 hours postop Unchanged cardiomegaly and mediastinal widening. Improving atelectasis. No new focal opacities. | Dependent opacities are most suggestive of atelectasis, likely from aspirated or retained secretions in the postoperative setting. Mediastinal widening is unchanged, incompletely evaluated by plain technique. |
Generate impression based on medical findings. | Cervical, thoracic, and lumbar radiculopathy on EMG as well as fasciculations, possible ALS. There is a small area of nonexpansile T2 hyperintensity in the dorsal columns and left grey matter of the spinal cord at the C2 level. There is no associated abnormal enhancement. The rest of the spinal cord appears to be unremarkable. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable, aside from a small hemangioma in a mid thoracic vertebral body. There is a disc extrusion at L3-4 that results in moderate to severe spinal canal stenosis. There is also facet hypertrophy and ligamentum flavum thickening at this level, which results in mild to moderate bilateral neural foraminal narrowing. There is a disc protrusion at L4-5 that results in mild spinal canal narrowing. There is also facet hypertrophy and ligamentum flavum thickening at this level, which results in mild bilateral neural foraminal narrowing. There is no significant spinal canal or neural foraminal narrowing at the other lumbar levels or in the cervical and thoracic spine. The paravertebral soft tissues are unremarkable, aside from dependent edema in the posterior lumbar subcutaneous tissues. There is a small left renal cyst. There may be cholelithiasis. | 1. Nonspecific lesion involving the dorsal columns and left grey matter of the spinal cord at the C2 level. Differential considerations include prior ischemia, trauma, or infection, for example.2. A disc extrusion at L3-4 that results in moderate to severe spinal canal stenosis.3. A disc protrusion at L4-5 that results in mild spinal canal narrowing. 4. Possible cholelithiasis. |
Generate impression based on medical findings. | Female, 33 years old.Reason: pna History: pna Possible right basilar opacity versus artifact.Heart size normal.Left subclavian catheter, tip in SVC. | Possible right basilar opacity which could indicate early infection. Otherwise, unremarkable. |
Generate impression based on medical findings. | Male, 77 years old.Reason: preop TECAB History: cough Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Quadrant surgical clips. | No significant abnormality. |
Generate impression based on medical findings. | 77 year old female status post fall. There is no evidence of intracranial hemorrhage, mass or edema. Diffuse areas of periventricular white matter hypodensity consistent with microangiopathic changes. If there is clinical concern for stroke an MRI may be considered.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | Diffuse microangiopathic changes. If there is clinical concern for stroke an MRI may be considered. |
Generate impression based on medical findings. | Female, 70 years old.Reason: cough and bronchial breath sounds at left base History: cough Cardiomediastinal silhouette is normal.No pleural effusion or pneumothorax. No focal pulmonary opacity.Surgical clips in the left axilla. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Elbow pain, history of lateral epicondyle release LIGAMENTS: No significant abnormality noted.TENDONS: No significant abnormality noted.ARTICULAR SURFACES AND BONE: There is mild irregularity and increased signal of the lateral epicondyle which may be degenerative in nature. A small amount of fluid is noted between the epicondyle and radial head although there is no fluid signal tracking laterally.SURROUNDING STRUCTURES: No significant abnormality noted.ADDITIONAL | Mild irregularity of the lateral epicondyle which may be degenerative or possibly postsurgical in nature. |
Generate impression based on medical findings. | Female, 79 years old.Reason: Concern for fluid o/l History: Tachypnea Remember with mild basilar edema and atelectasis with small pleural effusions, unchanged and suggestive of CHF. | Stable CHF with pulmonary opacities and pleural effusions. |
Generate impression based on medical findings. | 77-year-old male with metastatic prostate cancer and history of lung cancer. CHEST:LUNGS AND PLEURA: Postsurgical changes with volume loss from prior right lower lobectomy noted.No new infiltrates, nodules, masses or effusions seen. Elevation of the right hemidiaphragm persists.MEDIASTINUM AND HILA: Calcifications from prior granulomatous disease again noted. No enlarged lymph nodes identified. No other abnormalities.CHEST WALL: Again noted are diffuse sclerotic skeletal metastases there sclerotic in nature. Previous lesions identified have increased in size and there are scattered newer foci.ABDOMEN:LIVER, BILIARY TRACT: Diffuse low-attenuation liver is present indicative of diffuse fatty infiltration. This obscures metastatic lesions on CT and if concern over metastases to liver exists, ultrasound or MRI would be recommended. No such lesions are identified. Patient is status post cholecystectomy. No intrahepatic or extrahepatic bile duct dilatation is seen.SPLEEN: No significant abnormality notedPANCREAS: Resection of the pancreatic head mass noted on 2005 CT is present. The pancreatic duct has returned to near normal diameter compared to the marked dilatation previously. No evidence of recurrent tumor is seen in surgical bed. No other abnormalities are noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged retroperitoneal lymph node posterior to the aorta seen inferiorly at the abdominal/pelvic junction (series 4, image 127) measuring 1.7 x 1.2 cm. This was not present on the December, 2005 examination.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostatectomy. No evidence of tumor recurrence in surgical bed.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse sclerotic metastases seen throughout the bony skeleton. These were not present on 2005 CT examination. New since 2005 examination right inguinal hernia containing small bowel and mesenteric fat/vessels without apparent complication.OTHER: No significant abnormality noted | 1. Prior right lower lobe lung resection. Diffuse thoracic skeletal metastases with slight increase number and size of sclerotic lesions noted previously. 2. Diffuse fatty infiltration of the liver. This obscures the ability to detect liver metastases as described above. 3. New lymphadenopathy in retroperitoneum of the abdomen measured above. 4. Resection of prior noted pancreatic neuroendocrine tumor without evidence of recurrence. 5. Diffuse sclerotic metastases in the abdomen and pelvis. 6. New right inguinal hernia with small bowel without complication evident. |
Generate impression based on medical findings. | Female, 64 years old.Reason: Pt. is a 64 yo F admitted for SBO. with s/p placement of central line for TPN. Please confirm tip of the catheter. History: abdominal pain, nausea Focal atelectasis or scarring left lower lung zone.Left PICC, tip at right atrial level. | Left PICC, tip at right atrial level. |
Generate impression based on medical findings. | Female, 42 years old.Reason: Evaluation for cardiopulmonary abnormalities History: Kidney Donor Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. | No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | There are scattered foci of T2 hyperintensity within the subcortical and periventricular white matter, primarily subcortical in location. Many of these were present on the 2006 study, with a few that are new. None demonstrate mass effect, restricted diffusion, susceptibility abnormality, or enhancement. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is unremarkable. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. | Mild chronic small vessel ischemic disease. |
Generate impression based on medical findings. | Port placementVIEW: Chest AP Left chest port tip in the SVC. Cardiothymic silhouette normal. Multiple metastatic pulmonary nodules are present not significantly changed. No pleural effusion or pneumothorax. | Left chest port tip in the SVC. |
Generate impression based on medical findings. | 59-year-old female with right hip pain, soft tissue injury. ACETABULAR LABRUM: There is a probable small tear of the anterior/superior labrum.ARTICULAR CARTILAGE AND BONE: Mild osteoarthritis affects the right hip joint, including joint space narrowing and subchondral cyst formation.SOFT TISSUES: There is complete avulsion of the right semimembranosus tendon from the ischial tuberosity, with associated retraction and thickening. A large fluid collection extends along the medial aspect of the retracted semimembranosus tendon, from the level of the ischial tuberosity, inferiorly, and out of the field-of-view, likely representing a large hematoma. There is significant fatty atrophy of the bilateral gluteus muscles, as well as the right vastus lateralis.ADDITIONAL | 1.Avulsion and retraction of the right semimembranosus tendon.2.Large associated hematoma, which extends out of field-of-view.3.Mild osteoarthritis of the right hip joint.4.Probable small tear of the anterior/superior labrum. |
Generate impression based on medical findings. | Male; 52 years. Reason: F/U on cholangiocarcinoma CHEST:LUNGS AND PLEURA: Pulmonary nodule in left base (series 4 image 70), unchanged compared to 5/7/11MEDIASTINUM AND HILA: Subcarinal lymphadenopathy measuring 1.3 cm, unchanged. Other borderline enlarged mediastinal lymph nodes are not significantly changed.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Pneumobilia with right and left hepatic lobe internal metallic biliary stents extending into the duodenum. Soft tissue attenuation in the porta hepatis/gallbladder fossa is similar to prior.SPLEEN: Splenomegaly, measuring 17 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple enlarged and borderline enlarged retroperitoneal lymph nodes with retroperitoneal stranding are not significantly changed. Left para-aortic lymph node (series 3 image 128) measures 1.3 x 1.7 cm, unchanged. Partially calcified portacaval lymph node (series 3 image 26) measures 3 x 1.6 centimeters, unchanged.BOWEL, MESENTERY: Multiple borderline enlarged mesenteric lymph nodes.There may be a focal circumferential wall thickening of the cecum (series 3 image 153), raising the possibility of a primary mass as this would be atypical for metastases.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small free fluid.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Stable soft tissue attenuation in the porta hepatis/gallbladder fossa with periportal and retroperitoneal lymphadenopathy, consistent with known cholangiocarcinoma.2. Apparent focal circumferential wall thickening of the cecum, may represent primary neoplasm as this is atypical for metastases. Recommend correlating with colonoscopy. |
Generate impression based on medical findings. | Reason: ptx History: none No sign of pneumothorax.Interval extubation.NG tube tip in the stomach with sidehole in the esophagus.Increased lower zone nonspecific opacity which may be related to aspirated secretions and atelectasis. | 1. No pneumothorax.2. Proximal location of NG tube. |
Generate impression based on medical findings. | Male, 52 years old.Reason: s/p redo OLT History: s/p redo OLT Small lung volumes with basilar opacities and pleural effusions, unchanged, suggestive of aspiration.Tracheostomy tube tip approximately 3 cm above the carina.An NG tube terminates in the stomach.A Dobbhoff tube extends below the lower margin of the image.Right jugular Swan-Ganz catheter, tip in the right interlobar pulmonary artery.Right jugular catheter, tip in SVC. | Swan-Ganz catheter advanced. Stable pleural effusions and basilar opacities. |
Generate impression based on medical findings. | Male, 65 years old.Reason: sepsis workup History: sepsis workup New right hilar nodule which may be cavitary. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. | Right hilar nodule which may be cavitary. Chest CT is recommended for further evaluation. |
Generate impression based on medical findings. | Recent screening mammogram performed on 8/16/2016 was within normal limits. Patient presents with right breast itching and pain. Personal history of bilateral breast reduction in 2012. Family history of breast cancer in a maternal aunt and a maternal cousin. A targeted right ultrasound was performed for the patient’s area of concern. On physical examination, no discrete palpable mass noted in the right breast 3:00 position. No evidence of skin redness noted. Ultrasound demonstrates normal glandular tissue. There is no solid or cystic mass identified. | No sonographic evidence for malignancy corresponding to patient's area of pain in the right breast 3:00 position. Annual screening mammogram is recommended.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on medical findings. | Female, 49 years old.Reason: evaluate s/p bronchial thermoplasty History: s/p bronchial thermoplasty The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax. | No acute cardiopulmonary abnormalities.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Finger injury Note that the examination is limited by motion artifact.LIGAMENTS: No significant abnormality noted.TENDONS: There is rupture of the FDP tendon overlying the fifth digit with retraction to the level of the proximal third of the proximal phalanx. The distal fibers of the tendon overlie the mid diaphysis of the middle phalanx. There is soft tissue edema within the volar portion of the digit. There is an associated hyperextension deformity of the finger as a result.BONES: The underlying marrow signal of the fifth digit is normal without evidence of fracture.ADDITIONAL | Rupture of the FDP tendon overlying the fifth digit with associated hyperextension deformity. Evaluation of the associated nerve fibers is limited given inherent limitations of MRI and by motion artifact. |
Generate impression based on medical findings. | Redemonstrated are 2 brain enhancing lesions, presumed metastases, one involving the right parietal lobe and the other in the left cerebellar hemisphere, unchanged in appearance (changes in the appearance of contrast enhancement are likely technical in nature). There are no other new metastases. Associated vasogenic edema and mass effect are stable. Fiducials are in place. Midline shift and ventricular sizes are stable. The paranasal sinuses and mastoid air cells are essentially clear. Expected vascular flow voids are demonstrated. | Redemonstrated are 2 brain enhancing lesions, presumed metastases, one involving the right parietal lobe and the other in the left cerebellar hemisphere. Fiducials are in place. |
Generate impression based on medical findings. | Female, 72 years old.Reason: Patient with hx aspergilloma History: shortness of breath Borderline cardiomegaly. Extensive pulmonary fibrosis and bronchiectasis, right greater than left, not significantly changed from the prior exam.Unchanged right greater than left apical consolidation. No new pulmonary opacities identified.No pleural effusion or pneumothorax. | Extensive chronic abnormalities in both lungs with focal apical opacities, right greater than left, not significantly changed since the prior exam. |
Generate impression based on medical findings. | Age: 35 yearsGender: FemaleReason for Study: Reason: Consolidation History: Cough and chest pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions. | No acute cardiopulmonary abnormalities are identified. No specific evidence of infection or edema. |
Generate impression based on medical findings. | Female, 86 years old.Reason: eval for SOB History: see above history of chronic systolic congestive heart failure Left-sided ICD unchanged in position. Stable cardiomegaly. Mild basilar opacities likely due to a combination of edema and atelectasis. Trace pleural fluid. | Mild basilar opacities likely due to a combination of edema and atelectasis. Trace pleural fluid. |
Generate impression based on medical findings. | Age: 59 yearsGender: FemaleReason for Study: Reason: assess for cause of SOB History: shortness of breath The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions. | No acute cardiopulmonary abnormalities are identified. |
Generate impression based on medical findings. | Reason: assess for infection - ams History: assess for infection - ams Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease. | No significant abnormalities. |
Generate impression based on medical findings. | Male, 70 years old.Reason: SOB History: above Increasing basilar opacities suggestive of aspirated secretions and possible edema.Mild cardiomegaly status post median sternotomy for CABG. | Gradually increasing basilar opacities suggestive of subsegmental atelectasis and possible edema. |
Generate impression based on medical findings. | Reason: eval for infiltrate or effusion History: chest pain Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease. | No significant abnormalities. |
Generate impression based on medical findings. | Male, 39 years old.Reason: cardiogenic shock History: as above Persistent decreased patchy opacity in the right lung base compatible with resolving right middle lobe pneumonia. Lungs otherwise remain clear. Moderate nonspecific cardiomegaly.Stable position of central venous catheter.No pneumothorax. No effusion. | Persistent right lung opacity. No change in cardiomegaly. |
Generate impression based on medical findings. | Female, 78 years old.Reason: eval lung fields History: sp AVR, MVR Patient has been extubated. Left basilar chest tube has been slightly repositioned. Other lines and tubes, not substantially different. Lower lung volumes. Apparent increase in diffuse pulmonary opacities, likely related to lower lung volumes. Small left pleural effusion. No significant pneumothorax. Unchanged heart size. | Patient has been extubated. Left basilar chest tube has been slightly repositioned.Apparent increase in diffuse pulmonary opacities, likely related to lower lung volumes. Small left pleural effusion. |
Generate impression based on medical findings. | Male, 59 years old.Reason: pleural effusion History: pleural effusion Bilateral pleural effusions are unchanged. Other findings also stable. | Bilateral pleural effusions are unchanged. |
Generate impression based on medical findings. | Reason: s/p intubation, check tube position History: sob ET tube tip approximately 5 cm above the carina. No significant pulmonary abnormalities. | ET tube in acceptable position. |
Generate impression based on medical findings. | Reason: 60 y/o with RA, + quantiferon gold, evaluate History: quantiferon gold Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease. | No significant abnormalities. |
Generate impression based on medical findings. | Arachnoid cyst, Chiari malformation, and neck and back pain. Brain: There is inferior extension of the cerebellar tonsils, left greater than right, by approximately 15 mm with a peg-like configuration with crowding of tissue at the foramen magnum that results in impeded CSF flow across the posterior foramen magnum and a relatively small posterior fossa. There is a 7 mm wide extra-axial CSF space medial to the left temporal lobe. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal in size and configuration, including a subcentimeter right lateral ventricular xanthogranuloma. There is no midline shift. The major cerebral flow voids are intact. There is mild posterior plagiocephaly. The orbits, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Spine: There is thoracic syringohydromyelia centered at the T7 vertebral body level that measures up to 7 mm in width. There is mild retroflexion of the dens with minimally attenuated adjacent CSF flow. The conus medullaris is positioned at the L1 vertebral body level. The vertebral column alignment is otherwise within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. | 1. Findings compatible with Chiari malformation with inferior extension of the cerebellar tonsils, left greater than right, by approximately 15 mm and a thoracic syrinx that measures up to 7 mm in width.2. Mildly retroflexed dens.3. Small medial temporal region arachnoid cyst. |
Generate impression based on medical findings. | 75-year-old female with swelling in the upper chest. Heterogenous structure below the left clavicle/upper chest. Evaluate for possible abscess versus solid structure. In the left chest wall soft tissues, there is a complex fluid collection measuring 7.6 x 3.1 x 5.2 cm. This fluid structure is located 2.5 cm deep to the skin surface. | Complex fluid collection in the left anterior chest wall measuring 7.6 x 3.1 x 5.2 cm. The differential includes seroma, hematoma, or abscess. Findings were reported to Dr. Ganjoo on 12/12/2016 at 4:15 PM. |
Generate impression based on medical findings. | Male, 72 years old.Reason: lung transplant History: followup Mild scarring at the left lung base again noted. No new focal lung consolidation. No pleural effusion or pneumothorax. No acute bony abnormality. | No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | Tongue vascular malformation: evaluate extent as well as type. MRI: There is a T2 hyperintense, enhancing lesion in the anterior oral tongue, which measures up to 25 mm. There is also an infiltrative T2 hyperintense, enhancing lesion in the right submandibular space that measures up to 45 mm, as well as a subcentimeter nodular component within the submandibular gland itself. There appear to be septations, flow voids, and perhaps phleboliths within the lesions. An area of high T2 signal in the left supraclavicular fossa may represent an additional lesion or a cluster or lymph nodes, although assessment is limited due to artifacts in this region on some sequences. Otherwise, there is no evidence of significant cervical lymphadenopathy. The thyroid is unremarkable. The osseous structures are unremarkable. The airways are intact. The imaged intracranial structures are unremarkable. MRA: The major venous and arteries structures are intact, without evidence of enlarged feeding arteries or draining veins associated with the tongue and submandibular space lesions. There is no significant steno-occlusive disease in the cervical arteries. | Lesions in the oral tongue and right submandibular space likely represents a low flow vascular malformation, such as a venous malformations. An area of high T2 signal in the left supraclavicular fossa may represent an additional vascular malformation or a cluster or lymph nodes, although assessment is limited due to artifacts in this region on some sequences. |
Generate impression based on medical findings. | Male, 53 years old.Swan placement, eval for pneumonia. Right jugular Swan-Ganz catheter tip projects over the proximal right upper lobe artery.Caudal aspect of the Swan-Ganz catheter as it passes through the right atrium may prolapse into the suprahepatic IVC.No pneumothorax.Persistent atelectasis at the bases. Patchy groundglass opacity left lower lobe suspicious for aspirated secretions. Left ovoid lesion may be in the fissure chest wall. | Caudal aspect of the Swan-Ganz catheter in the right atrium may be slightly prolapsing into the suprahepatic IVC. Probable aspiration of secretions but no specific signs of pneumonia. |
Generate impression based on medical findings. | Male, 72 years old.Reason: dyspnea History: SOB Severe cardiomegaly with a tortuous aorta.No specific evidence of infection or edema.Left subclavian pacemaker, leads unchanged in position.Right jugular catheter, tip in SVC. | Severe cardiomegaly, but no acute abnormality. |
Generate impression based on medical findings. | Reason: eval pulmonary edema History: pulmonary edema Unremarkable cardiac and mediastinal silhouette. Perihilar and lower zone bronchial thickening but no specific evidence of edema or pneumonia.Nodular opacity at the right apex, partly attributable to costal cartilage and scarring, but there may be an underlying pulmonary nodule and erect PA and lateral radiographs are recommended for further evaluation. | 1. No sign of pulmonary edema or pneumonia.2. Possible nodule at the right apex for which erect PA and lateral chest radiographs are recommended. |
Generate impression based on medical findings. | Male, 66 years old.Reason: Evaluate pneumothorax History: SOB. s/p right lung biopsy c/b ptx s/p right pleural drain placement. Valve clamped at 115p Interval increase in right pneumothorax. Pigtail catheter unchanged. Other findings stable. | Interval increase in right pneumothorax. |
Generate impression based on medical findings. | 22 year old female febrile, s/p shunt revision FM to gallbladder. Right VP shunt coursing through the right hemithorax with tip projecting over the right upper abdominal quadrant. Small thin catheter again noted overlying the lower neck and upper chest unchanged, likely a spinal canal catheter.New retrocardiac opacity which could represent aspiration, infection or atelectasis. Small left pleural effusion. No pneumothorax. Stable cardiomediastinal silhouette. | New retrocardiac opacity which could represent infection, aspiration or atelectasis. Small left pleural effusion. |
Generate impression based on medical findings. | 67-year-old male with colon cancer and ground-glass opacities. CHEST:LUNGS AND PLEURA: Reference lesion behind right main stem bronchus is slightly increased in size. It currently measures 27 x 27 mm, previously 26 x 26 (image 39 series 3). Other lung nodules have significantly increased in size. Specifically two right lower lobe nodules. One currently measures 27 x 21 mm, previously 22 x 18 (image 47 series 4). Another currently measures 15 x 12 mm, previously 7 x 7 mm (image 43 series 4). Near resolution of bilateral ground-glass opacities. MEDIASTINUM AND HILA: Reference precarinal lymph node is unchanged and currently measures 19 x 14, previosuly19 x 14 mm (image 32 series 3). Coronary artery calcifications. CHEST WALL: Right sided port with catheter tip at aortocaval junction. Sternotomy wires are noted. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Calcification the pancreatic tail, unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal stone without evidence of hydronephrosis is unchanged.RETROPERITONEUM, LYMPH NODES: Reference aortocaval lymph node measures 22 x 17mm, previously, 22 x 19 mm.BOWEL, MESENTERY: Mild wall thickening of the small bowel segments in the pelvis likely secondary to radiation is unchanged. Small wide mouth ventral hernia containing nonobstructive bowel segments is unchanged.BONES, SOFT TISSUES: Degenerative changes are noted. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Reference left external iliac lymph node is unchanged measuring 14 x 8 mm previously 13 x 8 mm (image 179 series 3).BOWEL, MESENTERY: Rectal anastomoses again identified.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. While minimal change in the reference lung masses, there are substantial increase in size in several other lung nodules.2. No significant change in size of retroperitoneal lymph node size. 3. Interval improvement in ground-glass opacities. |
Generate impression based on medical findings. | Female 75 years old Reason: pna? History: COPD, cough Cardiomediastinal silhouette is within normal limits. Elevation of the left hemidiaphragm is again noted. Slight increase in reticular opacities at the lung bases, worse on the right. No pneumothorax or pleural effusion is identified. Redemonstration of aortic atherosclerosis and mild spinal curvature. | Slight increase in reticular opacities at the bases, worse on the right. This may represent chronic/recurrent aspiration or atelectasis. |
Generate impression based on medical findings. | Abdominal wall discomfort right lower quadrant Small right inguinal fascial defect associated with fat-containing small reducible hernia without bowel involvement | Small right inguinal fascial defect associated with fat-containing small reducible hernia without bowel involvement |
Generate impression based on medical findings. | 58-year-old male with diabetic foot ulcer, cellulitis and elevated inflammatory markers evaluate for left fifth toe osteomyelitis. There is ulceration of the soft tissues along the dorsolateral aspect of the fifth toe. There is a biphalangeal fifth toe with abnormal signal intensity and enhancement of the tuft of the distal phalanx, highly suggestive of osteomyelitis. There is mild edema on fluid sensitive sequences within the base of the distal phalanx with preserved fat signal intensity on T1-weighted images likely representing reactive osteitis. We see no additional foci of osteomyelitis. There is swelling of the soft tissues of the little toe. There is soft tissue edema along the dorsum of the foot. There is increased signal intensity within the plantar musculature of the foot which may reflect mild inflammation and atrophy, but is commonly seen in diabetic patients. We see no rim-enhancing fluid collection to indicate abscess formation. | Findings highly suggestive of osteomyelitis of the tuft of the distal phalanx of the fifth toe. These findings are related to Dr. Natelborg, Christina at 5149, via text page at 6:00 PM on 11/3/2015. |
Generate impression based on medical findings. | Intermittent vascular lesion on the left dorsum of tongue. Neck: There is no evidence of mass lesions or significant cervical lymphadenopathy. In particular, no tongue lesion is discernible. The thyroid and major salivary glands are unremarkable. The osseous structures are grossly intact. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. | 1. The reported tongue lesion is not discernible. 2. No evidence of acute intracranial hemorrhage, mass, or acute infarct. |
Generate impression based on medical findings. | 94 years old Female. Reason: ET and NG placement History: Eval ET and NG location. There is no evidence for infiltrate in both lung, or pneumothorax. Cardiac silhouette is stable. Small left pleural effusion is stable. | Stable left small pleural effusion. |