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Generate impression based on medical findings. | Male, 67 years old.Reason: new trach History: new trach Open sternotomy, with one lap sponge still in place as well as a new apparently Ray-Tec sponge superiorly at the level of the thoracic inlet following tracheostomy tube placement.Unchanged pulmonary opacities consistent with edema and pleural effusions.New right chest tube.Tracheostomy tube tip within 2 cm above the carina.Right jugular Swan-Ganz catheter tip in left pulmonary artery.IABP catheter distal tip 7 cm below the top of the aortic arch.New right subclavian catheter tip in SVC. | Unchanged pulmonary opacities and pleural effusions. Sternotomy wound with packing sponges. New tracheostomy tube placement. |
Generate impression based on medical findings. | Male, 52 years old.Reason: s/p thoracentesis History: as above Lines and tubes are unchanged. Decrease in left pleural effusion. No pneumothorax. Patchy bibasilar opacities again noted. Unchanged heart size. | Slight decrease in left pleural effusion without evidence of pneumothorax. |
Generate impression based on medical findings. | Female, 68 years old.Evaluate lung fields for cause of hypoxemia. Interval extubation.Mediastinal drains, left chest tube and a right jugular Swan-Ganz catheter are unchanged in position.Increasing pleural fluid, atelectasis and consolidation at the left base. Minimal pleural fluid and atelectasis on the right without significant change.No visible pneumothorax. | Decreased lung aeration on the left due to worsening atelectasis, retrocardiac consolidation and a subpulmonic fluid collection. |
Generate impression based on medical findings. | 62 old male with history of peritoneal mesothelioma. Evaluate for disease status. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Scattered subcentimeter simple cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Of note, there is misregistration artifact on the postcontrast images.Bilateral T2 hyperintense, T1 hypointense, nonenhancing foci compatible with simple cyst. The largest cyst demonstrates thin septations at the right upper pole measuring 5.7 x 4.8 cm.Additionally, there are T1 hyperintense, T2 isointense nonenhancing foci compatible with hemorrhagic cysts. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Peritoneal deposits are decreased in size. Reference nodule adjacent to the left hepatic lobe measures 2.4 x 2.1 cm (series 7, image 14), previously measuring 3.3 x 2.2 cm.Nodule adjacent to the lesser curvature measures 2.4 x 1.6 cm (series 7, image 8), previously measuring 2.9 x 1.4 cm.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Improving peritoneal nodules.2.Bilateral renal simple and hemorrhagic cysts with the right upper pole cyst demonstrating thin septations. |
Generate impression based on medical findings. | Female, 52 years old.Reason: pna History: coughx2wks. No focal air space opacity.No pneumothorax, pulmonary edema, or significant pleural effusion.Scattered calcified granulomas.Unremarkable cardiomediastinal silhouette. | No specific evidence of infection. |
Generate impression based on medical findings. | 36-year-old female with obstruction. Evaluate for acute kidney injury. RIGHT KIDNEY: The right kidney measures 12.2 cm in length. The cortex is echogenic. There is minimal hydronephrosis. No shadowing calculi or hydronephrosis is present. A small echogenic focus measures 0.9 cm may represent a renal stone.LEFT KIDNEY: The left kidney measures 12.3 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present.URINARY BLADDER: Unremarkable.OTHER: A splenule is seen adjacent to the spleen. | Echogenic kidneys compatible with medical renal disease without evidence of hydronephrosis. |
Generate impression based on medical findings. | Female, 67 years old.Reason: Left staghorn nephrolithiasis s/p PCNL. Evaluate for pneumothorax or hydrothorax History: as above Cardiomediastinal silhouette is unremarkable.No focal airspace opacity, pleural effusion, or pneumothorax. | No acute cardiopulmonary abnormality, specifically no evidence of pneumothorax or hydrothorax. |
Generate impression based on medical findings. | Female, 84 years old.Reason: sepsis and line placement History: sepsis Endotracheal tube at the carina should be slightly withdrawn.Right central venous catheter at the cavoatrial junction. No pneumothorax. Pacemaker leads in appropriate position.Left basilar opacity may represent small effusion or atelectasis.Cardiac silhouette at upper limits normal. | Left basilar opacity may represent small effusion and/or atelectasis. |
Generate impression based on medical findings. | Reason: s/p thoracotomy History: intubated ET tube tip approximately 5 cm above the carina.ICD lead and LVAD, partially visualized.Large left pleural effusion, slightly increased with underlying atelectasis and consolidation.Mild atelectasis at the right base, unchanged. | Increasing left pleural effusion, possibly hemothorax. |
Generate impression based on medical findings. | Female, 66 years old. Abdominal pain, enteric tube placement. Enteric tube seen coiled at level of gastric fundus, tip extends into gastric body. Nonobstructive bowel gas pattern. No free air seen on decubitus imaging.Small to moderate right pleural effusion. Basilar atelectasis.Evaluation of shoulder joints suboptimal secondary to positioning. Spinal degenerative disease. | Enteric tube as above. Nonobstructive bowel gas pattern.Right pleural effusion, basilar atelectasis. |
Generate impression based on medical findings. | Female 60 years old Reason: kidney stone History: stone RIGHT KIDNEY: The right kidney measures 12.1 cm. An echogenic focus in the right renal collecting system measures 0.7 cm and demonstrates posterior shadowing compatible with a renal calculus. No evidence of hydronephrosis.LEFT KIDNEY: The left kidney measures 11.5 cm. No shadowing calculi or hydronephrosis is present. BLADDER: No significant abnormalities are noted.OTHER: No significant abnormalities noted. | Nonobstructing right renal calculus, however CT is more sensitive for identifying small renal calculi. No evidence of hydronephrosis bilaterally. |
Generate impression based on medical findings. | Male, 29 years old.Reason: r/o disease process History: dyspnea and sob Prominence of the left hilum warrants further evaluation with a CT. Otherwise, no other abnormalities identified. Heart size is normal. | Rounded opacity in the left hilum not well visualized on the lateral view may represent lymphadenopathy. CT thorax is recommended. |
Generate impression based on medical findings. | 70-year-old male with history of recent URI and shortness of breath. The cardiomediastinal silhouette is unremarkable. No focal air space opacities pleural effusions, or pneumothorax. There is residual barium within the stomach. | No specific evidence of infection. |
Generate impression based on medical findings. | Status post liver transplant; increased bilirubin; evaluate vessels. LIMITED ABDOMENLIVER: Status post liver transplant. Subcapsular hypoechoic collection posterior to the right lobe of liver unchanged.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.OTHER: Trace ascites again noted and unchanged | Patent hepatic vasculature with normal directional flow. |
Generate impression based on medical findings. | Male, 63 years old.Assess Swan. Dyspnea. Left jugular Swan-Ganz catheter catheter tip at the right main pulmonary artery. Sternotomy hardware appears in alignment.Right subclavian IABP with marker projecting about 4 cm below the top of the aortic arch.Small lung volumes. Pleural fluid, edema and atelectasis about the same. | Left jugular Swan-Ganz catheter has been slightly retracted with tip now at the distal right main pulmonary artery level. |
Generate impression based on medical findings. | Reason: hx of bladder cancer s/p cystectomy, evaluate for metastatic disease History: see above Unremarkable cardiac and mediastinal silhouette. Small calcified pulmonary nodules consistent with previous granulomatous infection.Port catheter with its tip in the SVC.No sign of metastatic disease. | No sign of metastatic disease. |
Generate impression based on medical findings. | Reason: hemoptysis last week, evaluate for etiology History: cough Unremarkable cardiac and mediastinal silhouette. Catheter tip in the SVC.Large lung volumes suggestive of COPD, with mild chronic interstitial opacities, but interval resolution of pulmonary edema.No apparent source of hemoptysis. | COPD with no acute findings. |
Generate impression based on medical findings. | Female, 34 years old.Reason: r/o acute chest History: chest pain No focal consolidation, effusion, or pneumothorax. Stably enlarged heart and enlarged pulmonary artery.Vascular stents and position of right internal jugular chest port catheter unchanged. | No acute abnormalities. No radiographic findings of acute chest. |
Generate impression based on medical findings. | Male, 4 months old. Klippel-Trenaunay malformation left leg. There is extensive circumferential thickening and edema of the superficial soft tissues of the left lower extremity, extending from level of the hip to the ankle. Multiple lobulated fluid collections are noted, compatible with vascular malformations, particularly in the left gluteal region, with extension across the midline to the contralateral buttock and gluteal musculature as well as extension into the left pelvis. The deep veins of the left lower extremity appear hypoplastic, including inability to visualize a normal popliteal vein. Multiple dilated vascular structures are noted within the lateral soft tissues (series 1001, images 21, 29, 40; series 1101, image 4) likely corresponding to persistent embryonic veins. Patchy areas of soft tissue enhancement correlating with vascular malformations, without significant abnormal enhancement about any of the larger collections to indicate superimposed infection.The osseous structures and muscles are symmetric compared to the contralateral lower extremity. | Extensive subcutaneous soft tissue thickening/edema and multiple fluid collections, compatible with a known history of Klippel-Trenaunay syndrome and multiple vascular malformations. Hypoplastic deep veins and dilated superficial vascular structures throughout the lower extremity, likely corresponding to persistent embryonic veins. |
Generate impression based on medical findings. | 15-year-old male with right neck lymphangioma Several prominent submandibular cervical lymph nodes are noted with normal morphology. In the right submandibular region inferior to the parotid gland is a small, 1.8-cm simple fluid collection without vascularity or soft tissue component corresponding to the region of abnormality seen on prior CT. | Small residual fluid collection at the site of questioned lymphangioma. |
Generate impression based on medical findings. | Male, 53 years old.Reason: Evaluate for pneumonia triggering seizure History: Seizure No significant cardiopulmonary abnormality.No specific evidence of infection or edema. | No significant abnormality. |
Generate impression based on medical findings. | Male 69 years old; Reason: Patient with right neck paraganglioma. Please assess and compare for growth. History: right neck paraganglioma Calcific arteriosclerotic disease affects the right carotid artery system. There is a soft tissue mass centered between the internal/external carotid arteries measuring 1.1 x 0.8 x 1.2 cm previously, 1.1 x 0.9 x 1.4 cm and is not significantly changed.Calcific arteriosclerotic disease affects the left carotid artery system. | 1.Right carotid body tumor not significantly changed. |
Generate impression based on medical findings. | Reason: any signs of acute change? Pulmonary edema? History: tachypnea Venous catheter and Dobbhoff tube unchanged.Opacity at the left base suggestive of pleural effusion and underlying atelectasis/consolidation.No specific evidence of pulmonary edema or other acute change. | Left pleural effusion and atelectasis with no acute change. |
Generate impression based on medical findings. | 53-year-old female, with anterior mediastinal lymphadenopathy and right lower lobe nodule on outside CT, with complaints of chest pain and night sweats. LUNGS AND PLEURA: 3-mm nodule in the left upper lobe (image 57/98) is non-specific. No pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. Prominence of fatty infiltrated soft tissue in the anterior mediastinum. Appearance is compatible with residual thymus. Small, not significantly enlarged lymph nodes in the prevascular space.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Multiple hypodense lesions in the liver with peripheral nodular enhancement likely represent hemangiomas. | Fatty infiltrated soft tissue in the anterior mediastinum. Appearance is most compatible with residual thymus. If patient remains symptomatic, follow-up in 6 to 12 months is recommended. |
Generate impression based on medical findings. | Metastatic cervical cancer on systemic therapy, evaluate for persistent disease, history of bilateral hydronephrosis status post ureteral stent placement ABDOMEN:LUNG BASES: Bilateral breast prostheses.LIVER, BILIARY TRACT: Gallbladder sludge.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable asymmetrically atrophic right kidney. Moderate left-sided and mild right sided hydronephroureter, increased from earlier study. Left-sided nephroureteral stent and right sided nephroureteral stent, left-sided stent located at level of ureteropelvic junction. Ureteral wall thickening seen bilaterally.RETROPERITONEUM, LYMPH NODES: No pathologically enlarged adenopathy. BOWEL, MESENTERY: Mild to moderate circumferential rectal wall thickening. PELVIS:UTERUS, ADNEXA: Status post hysterectomy. No enhancing soft tissue signal seen at level of postoperative bed. Stable lobulated right adnexal T2 hyperintense lesion encasing the right ureter. Structure essentially unchanged accounting for differences in technique, structure measures approximately 2.6 x 2.4 cm, image 39 series 1301, may represent a lymphocele related to prior nodal dissection.BLADDER: Bilateral nephroureteral stents seen extending into underdistended bladder. BONES, SOFT TISSUES: Scattered foci of susceptibility artifact in pelvis and ventral abdomen, likely postprocedural in etiology. | 1. Mild to moderate rectal wall thickening, may be posttreatment related but correlation with patient's clinical history recommended to exclude proctitis.2. Moderate left-sided and mild right sided hydronephroureter, increased from earlier study. Bilateral ureteral stents present, ureteral wall thickening seen bilaterally.3. Stable lobulated right adnexal T2 hyperintense lesion encasing the right ureter. Structure essentially unchanged accounting for differences in technique, structure measures approximately 2.6 x 2.4 cm, may represent a lymphocele related to prior nodal dissection. |
Generate impression based on medical findings. | Reason: s/p removal of chest tube, evaluate pleural space History: n/a Interval removal of a right chest tube.Residual moderate pleural effusion and underlying pulmonary opacity but no significant pneumothorax.Skinfolds over the left upper lung but no pneumothorax.Air collections project over the right upper quadrant of the abdomen, possibly in left pleural space or chest wall.No new findings. | Interval chest tube removal with no pneumothorax or other acute change. |
Generate impression based on medical findings. | Female, 48 years old, presenting with cough and hypoxia. Evaluate pneumothorax and pneumonia. Stable right apical opacity. Right-sided effusion stable. Thickening of the right minor fissure consistent with effusion.Lines and tubes appear unchanged. | Stable right apical opacity. Right-sided effusion stable. |
Generate impression based on medical findings. | 63 year old female. Eval NGT placement; resistance to TF. Enteric tube tip terminates in the distribution of the gastric body. Pelvis excluded from field-of-view. Evaluation of the abdomen is slightly limited by overlying drains. Please refer to recent chest radiograph for findings related to the chest. | Enteric tube tip terminates in the distribution of the gastric body. |
Generate impression based on medical findings. | Female, 67 years old.Reason: S/P LVAD. Eval for infection History: Leukocytosis Support devices are otherwise unchanged. Patchy bibasilar opacities and pleural effusions again noted. Unchanged mild cardiomegaly. No pneumothorax. | Stable basilar opacity. Support devices stable. No interval change. |
Generate impression based on medical findings. | 49-year-old female with history of thrombosis of a right mid lateral quadrant superficial vein, now with recurrent symptoms. Right-sided abdominal pain. Grayscale and color ultrasound of the right upper quadrant subcutaneous soft tissues in the area of the patient's complaint demonstrates no significant abnormalities. No abnormal blood vessels are identified. There are no fluid collections or inflammatory changes in this location. | No evidence of thrombosed superficial vessel or other findings to account for the patient's symptoms. |
Generate impression based on medical findings. | 57-year-old female with history of piriform sinus cancer status post CRT. Evaluate for disease. CHEST:LUNGS AND PLEURA: Postsurgical changes from left upper lobectomy, similar to multiple prior studies. Scattered micronodules, unchanged. No suspicious nodules, masses, or pleural effusion.Mild centrilobular emphysema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Moderate coronary calcifications.CHEST WALL: Right chest port catheter with catheter tip in proximal SVC. UPPER ABDOMEN: Left renal cyst. | No evidence of metastatic disease. |
Generate impression based on medical findings. | Clinical question:? Bleed or mass effect. Signs and symptoms: Seizure Nonenhanced CT of brain:The images through the anterior aspect of the temporal lobes demonstrate a subtle area of low attenuation in the left anterior temporal lobe. This is within the white matter and mid no distinct involvement of cortex. There is also extensive beam hardening artifact secondary to bone. Recommend follow-up exam with an MRI for better evaluation. The finding could represent edema from an inflammatory process (viral encephalitis), masse, venous thrombosis or other causes. I cannot be entirely certain if this finding is not an artifact or represent a focal area of encephalomalacia of unknown etiology. Considering provided clinical history of seizure further MR is recommended.The density and morphology of brain is otherwise entirely within normal limits. The cortical sulci, ventricular system and all CSF cisterns as well as gray -- white matter differentiation is preserved. The density of intracranial venous sinuses show no definitive abnormality.Calvarium, limited real paranasal sinuses, orbits and mastoid air cells are unremarkable. | 1.Subtle suspected area of edema in the white matter of the left anterior temporal lobe as detailed above. Follow-up wirth and MRI is recommended if patient's symptoms persist. Please see above comments as for etiology.2.this examination is otherwise unremarkable. |
Generate impression based on medical findings. | Male, 57 years old.Reason: eval for infection History: recent intubation, pw malaise, recent valve replacement Focal atelectasis left lower lobe possibly from aspirated secretions or mucous plugging.No reliable evidence of infection or edema.Minimal left pleural effusion or pleural scarring.Status post median sternotomy for CABG, heart size normal. | Focal atelectasis left lower lobe and possible small left pleural effusion. No reliable evidence of infection. |
Generate impression based on medical findings. | Female, 58 years old.Reason: Change in diffuse consolidation? History: DAH Right central venous catheter tip in the SVC. Left upper quadrant surgical clips noted. The patient has been extubated and the enteric tube has been removed.The cardiac silhouette is stable.Bilateral airspace opacities appear decreased from prior examinations. Bilateral pleural effusions appear stable. | Improving bilateral airspace opacities with pleural effusions. |
Generate impression based on medical findings. | Base of tongue cyst seen on outside MRI. Evaluate for possible vallecular cyst or thyroglossal duct cyst. There is a lobulated structure measuring approximately 18 x 10 mm (CC x TR) at the base of the tongue extending to the anterior margin of the hyoid bone with prominent T2 hyperintense and slight T1 hyperintense signal. It is slightly eccentric to the left of midline. There is no associated fat signal. There is no evidence of abnormal enhancement or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. | 18 mm lobulated structure extending from the base of the tongue towards the anterior margin of the hyoid bone, favoring a thyroglossal duct cyst based on location. However, other considerations such as lymphatic malformation remain within the differential. |
Generate impression based on medical findings. | Female, 91 years old.Reason: is there an infiltrate History: cough, sob. ?history copd Large lung volumes consistent with COPD, with left-sided linear scarring.Heart size normal. | COPD, but no acute abnormality. |
Generate impression based on medical findings. | 48-year-old female with shortness of breath. Evaluate for fluid overload. Mild cardiomegaly. Cardiomediastinal contours within normal limits.Septal lines and thickened minor fissure compatible with mild pulmonary edema.No acute focal consolidation. No pneumothorax or pleural effusion.Status post right mastectomy and right axillary lymphadenectomy. | Mild pulmonary edema. |
Generate impression based on medical findings. | 28 year old with history of left ventricular systolic dysfunction and hypertension presenting for evaluation of cardiac function and scar. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 52%, the LV end diastolic volume index is 86 ml/m2 (normal range: 74+/-15), the LVEDV is 193 ml (normal range 142+/-34), the LV end systolic volume index is 42 ml/m2 (normal range 25+/-9), the LVESV is 93 ml (normal range 47+/-19), the LV mass index is 59 g/m2 (normal range 85+/-15), and the LV mass is 132 g (normal range 164+/-36). The left ventricular dysfunction is global. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 82 ml/m2 (normal range 82+/-16), the RVEDV is 184 ml (normal range 142+/-31), the RV end systolic volume index is 40 ml/m2 (normal range 31+/-9), and the RVESV is 90 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.OtherIn some views, there appears to be a small patent ductus arteriosus but it is not well visualized. Of note, no PDA flow is noted on his echocardiograms. Correlation with physical exam suggested.Extracardiac FindingsThis study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered. | 1. Mildly reduced left ventricular systolic dysfunction (LVEF 52%) without evidence of scar, infarct or inflammation. The LV dysfunction is global. 2. Normal right ventricular size and function (RVEF 51%)3. There is mild mitral and tricuspid regurgitation. 4. In some views, there appears to be a small patent ductus arteriosus but it is not well visualized. Of note, no PDA flow is noted on his echocardiograms. Correlation with physical exam suggested. |
Generate impression based on medical findings. | Reason: Evaluate for picc line placement History: pancreatitis Normal heart and mediastinum.Catheter tip in the SVC.Increased opacity in or overlying left hilum which may represent a mass or focal consolidation. A CT scan is recommended for further evaluation.(A text page was sent to Dr.Escue at the time of reporting).Severe bullous emphysema. | Severe emphysema with possible left hilar mass for which a CT scan is recommended. |
Generate impression based on medical findings. | Age: 57 yearsGender: MaleReason for Study: Reason: 57M intubated in MICU, pulled back ETT after AM CXR, ?ETT placement History: 57M intubated in MICU, pulled back ETT after AM CXR, ?ETT placement ET tube with its tip now in the proximal right mainstem bronchus.Left-sided chest tube unchanged with increasing lateral pneumothorax.Left mainstem bronchial stent stable.Left IJ venous catheter and NG tube unchanged.Diffuse pulmonary opacity similar to the prior exam. | ET tube tip in the proximal right mainstem bronchus. Increasing left-sided pneumothorax. |
Generate impression based on medical findings. | Reason: pna? vomiting, recent pneumonia History: vomiting Patchy airspace opacity in right and left lower lobes, consistent with aspiration and/or infection.Unremarkable cardiac and mediastinal silhouette. | Bilateral lower lobe airspace opacities compatible with aspiration and infection. |
Generate impression based on medical findings. | 12-year-old male patient with headaches, vomiting, left-sided weakness. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. 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. | No evidence of intracranial hemorrhage, mass, or acute infarct. |
Generate impression based on medical findings. | Male, 32 years old.Reason: cardiopulm abnormalities? History: chest pain No significant cardiopulmonary abnormality. | No significant abnormality. |
Generate impression based on medical findings. | Male, 38 years old.Shortness of breath The cardiomediastinal silhouette is within normal limits. No focal airspace opacity, significant pleural effusion, or pneumothorax. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Visual loss. Rule out optic neuritis. There is no definite T2 hyperintensity or enhancement involving the bilateral optic nerves. There is questionable subtle increased T2 hyperintensity involving the posterior aspect of the intraorbital nerves, left relatively greater than right. No abnormal enhancement. Remainder of the bilateral orbital structures are unremarkable.The included parts of the brain are unremarkable as well. The sella turcica is expanded and near completely CSF filled with only thin rim of pituitary tissue along the floor of the sella. A 3 mm apparent triangular-shaped cystlike lesion at the junction between the infundibulum and the compressed pituitary may represent a benign entity such as a tiny pars intermedia cyst or Rathke's cleft cyst. There is deviation of the pituitary infundibulum to the right though without discrete intrasellar mass, otherwise. There is mild, scattered mucosal thickening in the paranasal sinuses. | 1.There is no definite MRI evidence of optic neuritis. There is questionable subtle T2 hyperintensity involving the posterior intraorbital optic nerves, left relatively greater than right, which is of uncertain significance and possibly artifactual.2.Partially empty sella with rightward deviation of the infundibulum. This finding can be normal variant or associated with pseudotumor cerebri in the appropriate clinical setting. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Heart liver transplant, check for left lower lobe consolidation Interval removal of right PICC line. Abandoned left ICD lead unchanged in position.Right lung base continues to demonstrate a single chest tube, however the second right basilar and mediastinal catheters have otherwise been removed since prior study. Both lungs appear well expanded with minimal scarring and/or atelectasis greater on the left. The cardiac and mediastinal contours are within limits | Remaining right chest tube unchanged |
Generate impression based on medical findings. | Reason: evaluate for meniscal tear, ligament tear, etc. Had a fall about 6 weeks ago with subsequent persistent swelling History: right knee pain MENISCI: There is complex, multidirectional tearing of the medial meniscus involving the body and posterior horn, with a prominently oblique component, which contacts the superior and inferior articular surfaces, and has progressed from the prior study in 2013. Additionally, there is a complex, multidirectional tear of the lateral meniscus with lateral extrusion and redundancy of the fragmented meniscus into the posterior intercondylar notch. There is a posterior lateral parameniscal cyst. Overall, the tearing is likely degenerative, and has progressed from the prior study.ARTICULAR CARTILAGE AND BONE: Again seen is severe tricompartmental osteoarthritis including near total chondral loss in the weightbearing aspects of the joint, particularly in the lateral tibiofemoral compartment, slightly progressed from the prior study in 2013. There is diffuse grade 3 chondral loss in the patellofemoral compartment. There are exuberant tricompartmental osteophytes.LIGAMENTS: The cruciate and collateral ligaments are intact. The posterior corner structures appear to be intact. EXTENSOR MECHANISM: The extensor mechanism is intact.ADDITIONAL | 1.Complex, multidirectional degenerative type tearing/maceration of the medial and lateral menisci, which has progressed from the prior study in 2013.2.Tricompartmental osteoarthritis with exuberant osteophyte formation and multifocal complete chondral loss.3.Moderate joint effusion. |
Generate impression based on medical findings. | Female, 48 years old, with pulsatile tinnitus and white matter lesion. Assess for change in white matter lesion. Again seen is an area of ill-defined T2 hyperintensity spreading from the left periatrial white matter superiorly into the left postcentral gyrus. The overall size and extent of this lesion have not significantly changed. The lesion is somewhat more distinct on the current examination, possibly due to imaging at 3 Tesla. As before, this lesion induces no mass effect and there is no associated pathologic enhancement. Single voxel spectroscopy of this lesion demonstrates a nonspecific elevation of choline relative to the contralateral normal side. The NAA level is unaffected. No unexpected metabolite resonances are seen.A punctate focus of T2 hyperintensity is seen within the right orbital gyrus, unchanged and nonspecific. No new areas of parenchymal signal abnormality are seen. No pathologic parenchymal enhancement is detected. Redemonstrated is a 5 mm lobular focus of enhancement within the left cerebellopontine angle cistern adjacent to the petrosal vein which is unchanged.No restricted diffusion is seen. No abnormal extra-axial fluid or evidence of intracranial hemorrhage is seen. The ventricular system is normal in size and morphology. Patchy, moderately severe paranasal sinus mucosal thickening is seen, similar to prior. | 1.No significant interval change is seen in the overall size of a nonenhancing ill-defined T2 hyperintense lesion in the left parietal lobe. Single voxel spectroscopy of this lesion shows a nonspecific degree of choline elevation with preserved NAA. Differential diagnosis would continue to include both non-neoplastic and neoplastic etiologies including sequela of prior inflammation or demyelination, dysplastic tissue, or low-grade neoplasm.2.Stable lobular enhancing structure within the left cerebellopontine angle cistern which may represent a focally dilated vascular structure, probably venous. |
Generate impression based on medical findings. | Female, 52 years old.Reason: eval for pulm edema History: chf exacerbation The lungs and pleural spaces remain clear. Heart size is upper limits of normal with mild left ventricular chamber dilatation. No pneumothorax or evidence of edema. | No pulmonary edema. Left ventricular enlargement. |
Generate impression based on medical findings. | Female, 73 years old.Reason: pleural effusion History: sob Interval increase in size of large right pleural effusion with associated compressive atelectasis of the right lower lobe. There is mild mediastinal shift to the left. Mild left basilar subsegmental atelectasis. Cardiac mediastinal silhouette is unchanged in size. Calcifications of the aortic arch. No new focal pulmonary opacity. | Interval increase in size of a large right pleural effusion with associated compressive atelectasis of the right lower lobe and mild leftward mediastinal shift. |
Generate impression based on medical findings. | Male, 42 years old. Reason: eval for infiltrate or edema History: SOB Mild cardiomegaly with pulmonary vascular redistribution, unchanged.Moderate axial interstitial edema with thickening of the fissures.No large pleural effusion or pneumothorax. | Moderate CHF. |
Generate impression based on medical findings. | Male 3 years old Reason: respiratory failure History: monitor PNAVIEW: Chest AP (one view) 11/6/2015 at 0509 hours. ET tube, feeding tube, NG tube and right upper extremity central line are again noted. Interval removal of left-sided chest tube.Cardiac silhouette size is top normal. Persistent bibasilar opacities and small bilateral pleural effusions right greater than left. | No change in multifocal opacities and bilateral pleural effusions after left-sided chest tube removal. |
Generate impression based on medical findings. | Male, 71 years old.Reason: eval ETT placement History: intubated for respiratory distress Diffuse pulmonary edema pattern again noted. Mild cardiomegaly. Small right pleural effusion. No pneumothorax. Endotracheal tube terminates approximately 8 cm from the carina. NG tube terminates within the body of the stomach. | Diffuse pulmonary edema again noted. Endotracheal tube terminates 8 cm from the carina. |
Generate impression based on medical findings. | Fever and chills. Shortness of breath Two nonspecific focal poorly defined groundglass opacities in the mid left and right lower lungs. Although possibly superimposed structures and artifactual, serial imaging is needed to confirm given patient history and possibility of early multifocal pneumonia.Mildly decreased lung volumes.Cardiac and mediastinal contours are within limits | Questionable multifocal bilateral groundglass opacities concerning for possible infection given patient history. Serial imaging is needed to confirmDr Acket contacted. |
Generate impression based on medical findings. | Female 43 years old Reason: HCC screening History: hep B LIVER: Liver measures 9.4 cm in length. The parenchyma is normal in echotexture. No focal hepatic lesion is seen. No ascites. Main portal vein is patent with flow toward the liver on color Doppler imaging.BILIARY TRACT: Multiple shadowing gallstones are identified and unchanged from prior exam. Additional nonshadowing subcentimeter foci which are not freely mobile are again demonstrated on this exam and may reflect additional stones or polyps. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 8.2 cm. The left kidney measures 8.4 cm. No hydronephrosis or shadowing renal calculus bilaterally.SPLEEN: The spleen measures 8.3 cm in length. OTHER: No significant abnormality noted. | 1.No focal hepatic lesion. 2.Cholelithiasis without evidence of cholecystitis. Additional subcentimeter nonshadowing foci are not freely mobile and may reflect additional stones or polyps. Both findings are stable compared to prior |
Generate impression based on medical findings. | Female, 69 years old.Reason: lightheaded, SOB History: same Large lung volumes consistent with COPD.Heart size normal.No specific evidence of infection or edema. | COPD, but no acute abnormality. |
Generate impression based on medical findings. | Female, 50 years old.Reason: SOB History: SOB Interval removal of left PICC. Sternotomy hardware intact. Aortic valve replacement. Bibasilar atelectasis. Interval improvement of right pleural effusion. No focal pulmonary opacities. Cardiomediastinal silhouette is unchanged. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | 62 year old female with history of Hodgkin lymphoma CHEST:LUNGS AND PLEURA: Fibrotic changes in the lung apices are unchanged.MEDIASTINUM AND HILA: Small anterior mediastinal node is stable measuring 9 mm in diameter image number 29, series number 3. Other small mediastinal nodes are also stable.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large left renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.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. | No significant change from previous study. |
Generate impression based on medical findings. | Female, 33 years old.History: Chest pain, status post stent two days ago. Unremarkable cardiomediastinal mediastinal silhouette, cardiothoracic ratio appears slightly smaller compared to previous study.Coronary stent.No focal pulmonary or pleural disease. No pleural effusions or pneumothorax. | No acute cardiopulmonary process. |
Generate impression based on medical findings. | Age: 52 yearsGender: FemaleReason for Study: Reason: swan-ganz; dyspnea History: see above Right IJ Swan-Ganz unchanged with its tip in the right pulmonary artery.IABP marker in the proximal descending aorta .Left-sided ICD unchanged.Stable marked cardiac enlargement.Lungs are clear. | Sports device is unchanged. Stable cardiopulmonary appearance with cardiomegaly without specific evidence of pulmonary edema. |
Generate impression based on medical findings. | 29-year-old female with history of Crohn's disease and severe left hip pain. Please rule out synovitis. ACETABULAR LABRUM: There is a degenerative lateral labral tear.ARTICULAR CARTILAGE AND BONE: Linear signal abnormality within the acetabulum likely represents acetabular stress fracture stretching superolaterally to inferomedially. SOFT TISSUES: No significant abnormality noted. Ligamentum teres and transverse ligament are intact. Iliopsoas tendon is intact with normal signal and morphology. Adductor, gluteal, and hamstring insertions are unremarkable. There is no muscular fatty atrophy.ADDITIONAL | 1. Findings compatible with stress fracture of the superior acetabulum and synovitis of the left hip.2. Degenerative changes including labral tear and osteophyte formation resulting in cam type deformity of the femoral head.3. Marrow edema of the femoral head and neck may be compatible with reactive changes from synovitis, stress injury, or avascular necrosis. |
Generate impression based on medical findings. | 78-year-old female with shortness of breath and abdominal pain ABDOMEN:LUNG BASES: Chest report is dictated separately. Please see the chest port for chest findings.LIVER, BILIARY TRACT: Interval progression of hepatic metastatic disease. Reference lesion near the dome now as conglomerated with several other surrounding lesions and ill-defined borders. Measures 2.7 x 2.1 cm image number 15, series number level. There is increase in the size and number of the hepatic metastases.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral adrenal glands cannot be well identified due to surrounding extensive metastatic disease. 2.1 x 1.3 cm right adrenal nodule suspicious for metastatic disease.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy which is increased in size and number compared to previous study. Reference left para-aortic adenopathy measures 2.6 x 1.5 cm image number 68, series number 11.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: New lytic lesion in L4 vertebral body suspicious for metastatic disease.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right acetabular lytic lesion destroying the bone consistent with metastatic disease. New from previous study.OTHER: Small amount of fluid in the pelvis. | Interval progression of disease with increase in the size and number of hepatic and retroperitoneal metastatic disease and new bone metastases. |
Generate impression based on medical findings. | Chest pain No cardiopulmonary abnormality | Normal |
Generate impression based on medical findings. | Screening for TB. Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease. | No significant abnormalities. |
Generate impression based on medical findings. | Male, 69 years old.Reason: is there an infiltrate History: flu like symptoms, history pancreatic cancer, on chem. Right chest wall port catheter tip at the RA/SVC junction.No focal air space opacity.No pneumothorax, pulmonary edema, or significant pleural effusion.Unremarkable cardiomediastinal silhouette. | No specific evidence of infection. |
Generate impression based on medical findings. | Male 61 years old Reason: New AKI, r/o obstruction History: new aki RIGHT KIDNEY: The right kidney measures 12.7 cm in length and demonstrates increased parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen. Nonobstructing right renal stone.LEFT KIDNEY: The left kidney is difficult to see; however, no definite hydronephrosis evident.BLADDER: No significant abnormality noted.OTHER: No significant abnormalities noted. | 1.Increased parenchymal echogenicity of the right kidney consistent medical renal disease, but no hydronephrosis.2.Left kidney not well seen, but no hydronephrosis is evident.3.Nonobstructing right renal stone. |
Generate impression based on medical findings. | Female 61 years old Reason: pna vs cardiopulm process History: chest pain Low lung volumes. No focal consolidation, pleural effusion or pneumothorax. The heart and mediastinal contours are within normal limits for size. The bones and upper abdomen are unremarkable. Spinal catheters unchanged. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Tenderness to palpation and fluid drainage, evaluate for osteomyelitis. Postsurgical changes of bilateral below the knee amputations are present.The bone marrow signal of the visualized right distal femur and remaining proximal tibia/fibula is within normal limits without evidence of osteomyelitis. On the coronal views, the bone marrow signal of the visualized left distal femur and remaining proximal tibia/fibula is within normal limits without evidence of osteomyelitis.Mildly increased T2 signal within the medial soft tissues of the remaining left leg as seen on the coronal views is nonspecific but compatible with soft tissue edema. No discrete, loculated fluid collections are identified. | No osteomyelitis. Mild soft tissue edema within the remaining portion of the medial left leg, correlate clinically for cellulitis. |
Generate impression based on medical findings. | Clinical question: Concern for encephalitis. Signs and symptoms: AMS, unclear etiology. Nonenhanced brain MRI:Examination is severely compromised due to extensive motion artifact secondary to patient's status. Multip MRI sequences were repeated without significant improvement.Diffusion-weighted images are grossly unremarkable.Examination demonstrates patchy confluent foci of periventricular and minimally subcortical Flair/T2 hyperintensity in bilateral cerebral hemispheres which are nonspecific however considering patient's stated age of 74 likely representing chronic changes of microvascular ischemic disease. There is subtle enlargement (ex vacuo) of ventricular system without deviation of midline.No detectable signal abnormality of cerebral cortex, mildly prominent cortical sulci within normal for stated age and unremarkable CSF spaces. The signal void of major intracranial arterial branches are identified. No gross abnormality of calvarium, soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells. | 1.Severely limited exam due to extensive motion artifact.2.No convincing evidence of an acute intracranial process, edema, bleed, mass effect or midline shift.3.Findings of chronic small vessel ischemic strokes of moderate degree. |
Generate impression based on medical findings. | 50-year-old female with right chest wall pain. Evaluate for rib fracture. Cardiomediastinal silhouette is unremarkable.No focal lung opacity pleural effusion or pneumothorax.No evidence of displaced rib fracture.Postsurgical changes from right mastectomy unchanged. | No evidence of displaced rib fracture. No significant interval change. |
Generate impression based on medical findings. | Male, 57 years old.Reason: r/o infiltrate History: Right lung infiltrate Diffuse right lung opacities with opacity in the mid and lower aspect the left lung and probable small pleural effusions again noted. Unchanged cardiomegaly. Enteric tube extends inferiorly off the field-of-view. No pneumothorax. | Diffuse pulmonary opacities with relative sparing of the upper aspect the left lung, unchanged. Probably small pleural effusions. |
Generate impression based on medical findings. | Reason: Labrum Tear History: Pain ROTATOR CUFF: There is thickening and increased signal and undersurface fraying of the distal supraspinatus tendon without discrete tear. The supraspinatous muscle is within normal limits. The remainder of the musculature and tendons of the rotator cuff are unremarkable.SUPRASPINATUS OUTLET: No significant abnormality noted.GLENOHUMERAL JOINT AND GLENOID LABRUM: Gadolinium is seen extending into the superior labrum and tracking laterally consistent with a SLAP tear (series 5, image 11).There is a focal defect in the glenoid articular cartilage, (series 3, image 18).BICEPS TENDON: No significant abnormality noted. ADDITIONAL | 1.SLAP tear, as above.2.Tendinosis and undersurface fraying of the distal supraspinatus tendon without discrete tear.3.Focal defect in the articular cartilage along the posterior glenoid. |
Generate impression based on medical findings. | 41-year-old female with questionable thyroid enlargement and questionable right-sided nodule. RIGHT LOBE MEASUREMENTS: 2.4 x 1.6 x 4.2 cmLEFT LOBE MEASUREMENTS: 2.1 x 1.3 x 4.2 cmISTHMUS MEASUREMENTS: 0.2 cm in AP dimension. RIGHT LOBE: Heterogeneous echotexture. No focal lesions. LEFT LOBE: Heterogeneous echotexture. A subcentimeter cyst is seen in the left lobe. No focal lesions. ISTHMUS: Normal in appearance.PARATHYROID GLANDS: No enlarged parathyroid gland identified.LYMPH NODES: No regional lymphadenopathy. OTHER: No significant abnormality noted. | Heterogeneous, moderately vascular thyroid gland without discrete nodule. |
Generate impression based on medical findings. | Sickle cell pain rule out infection or acute chest. Stents projecting over the left brachiocephalic vein appear similar. IVC filter unchanged in position and may be suprarenal. Cardiomegaly, unchanged. Basilar scarring, left greater than right. No pleural fluid or focal airspace opacity. Degenerative changes spine. Humeral head chronic infarcts. | No specific evidence of acute chest. Unchanged cardiomegaly. |
Generate impression based on medical findings. | Male, 57 years old.Reason: Sob History: e Cardiac silhouette is normal in size.Low lung volumes with no focal consolidation, sizable effusion or pneumothorax. Minimal left retrocardiac bandlike atelectasis. | Low lung volumes with minimal left retrocardiac bandlike atelectasis. |
Generate impression based on medical findings. | Female, 56 years old.Cough, evaluate for pneumonia. No pulmonary opacities suggest infection.Left upper extremity PICC, terminating in the left axillary/subclavian junction.Minimal atelectasis. | No signs of pneumonia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Female, 59 years old.Reason: cardiopulm eval History: SAH No focal lung consolidation. Mild left basilar subsegmental atelectasis or scar. Moderate cardiomegaly again noted. No pleural effusion or pneumothorax. | No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | 71-year-old male with history of tachypnea and shortness of breath. Feeding tube tip outside the field of view. Right upper extremity PICC tip in the SVC.Unchanged cardiomegaly with bibasilar opacities and small bilateral pleural effusions are perhaps slightly increased when compared to prior. No pneumothorax.Multiple right-sided rib fractures again noted. Bilateral shoulder arthroplasties are incompletely imaged. | Nonspecific bibasilar opacities and small bilateral pleural effusions increased compared to the prior study. |
Generate impression based on medical findings. | 69-year-old female undergoing renal biopsy. Ultrasound guidance was provided for a renal biopsy performed by nephrology service. | Ultrasound guidance was provided for renal biopsy performed by nephrology service. 3 passes were attempted. |
Generate impression based on medical findings. | Pulmonary AVMs due to due to hereditary hemorrhagic telangiectasis. Coiling in the past. Measurement of AVMs and feeding vessels. New AVMs? LUNGS AND PLEURA: Multiple stable micronodules are again identified throughout the lungs, which may represent telangiectasias or AVMs. The largest AVM in the posterior basal segment of the right lower lobe has slightly increased in size, now measuring 9 x 8 x 11 mm (image#170 series #8 and image #28 series #80688), previously measuring 10 x 6 x 8 mm in 3/08. Size of the feeding artery and the draining vein increased; the feeding artery measures 3.4 mm (previously 2.5mm) and the draining vein measures 3.0 mm (previously 1.8 mm). Embolic coils are again identified in the anterior basal and posterior basal segments of the right lower lobe. MEDIASTINUM AND HILA: Unchanged tracheal diverticulum (series #9, image #9). Small unchanged mediastinal lymph nodes. Normal heart size.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | 1. The largest AVM in the right lower lobe has minimally increased in size, with increase in size of the feeding artery and the draining vein.2. Other unchanged multifocal scattered pulmonary micronodules. No new nodules. |
Generate impression based on medical findings. | Female, 40 years old, with vertigo. No evidence of restricted diffusion is seen. Scattered punctate T2 hyperintense foci are seen predominantly within the juxtacortical white matter of the cerebral hemispheres, a nonspecific finding. A 3 mm focus of susceptibility within the right insula is seen likely representing chronic microhemorrhage.No pathologic parenchymal or extra-axial enhancement is seen. No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricles are normal in size and morphology.On dedicated MRA imaging, normal flow related signal is seen within the anterior and posterior circulation. No evidence of any significant vascular stenosis or occlusion is seen. No aneurysm or vascular malformation is detected within the limitations of technique. | 1.No acute intracranial abnormality.2.No significant vascular abnormality.3.Scattered small foci of white matter T2 hyperintensity are seen, a nonspecific finding which may reflect sequelae of prior inflammation, demyelination, a vasculitic process or migraine headache. |
Generate impression based on medical findings. | Age: 44 yearsGender: FemaleReason for Study: Reason: eval for PNA History: tachycardia, fever Decreased lung volumes with stable cardiomediastinal silhouette.Port-A-Cath is noted in the SVC.No new pulmonary opacities identified.Bilateral shoulder arthroplasties. | No specific evidence of acute infection. |
Generate impression based on medical findings. | Female, 56 years old.Reason: r/o lung mass History: chest pain Left fourth rib metastasis with a large soft tissue component identified.Basilar atelectasis is seen.Heart size normal.Lower thoracic and lumbar metastases are not well seen, but are present on the prior abdomen CT. | Left fourth rib metastasis with a large soft tissue component. Basilar subsegmental atelectasis. Other metastases not identified although CT would be more sensitive. |
Generate impression based on medical findings. | 80-year-old male with shortness of breath. Unchanged cardiomediastinal silhouette. Symmetric basilar predominant interstitial opacities, septal lines, and pleural effusions are compatible with pulmonary edema. No specific evidence of acute infection. Left chest wall ICD again noted with properly positioned leads. | Pulmonary edema/CHF. |
Generate impression based on medical findings. | Female, 72 years old.Reason: pna History: ams Small lung volumes.Mild cardiomegaly.No specific evidence of infection or edema. | Mild cardiomegaly, otherwise unremarkable. |
Generate impression based on medical findings. | Age: 69 yearsGender: MaleReason for Study: Reason: ETT placement, worsening of pleural effusions History: sob ET tube and NG tube unchanged.Stable cardiomediastinal silhouette with prominence of the central pulmonary arteries.Improved aeration of the left basilar atelectasis noted on the prior exam.Small pleural effusions unchanged. | Significant interval improvement in left basilar atelectasis. |
Generate impression based on medical findings. | Female, 58 years old.ETT. Right mainstem bronchus intubation. This has been corrected on a subsequent film.Cardiomegaly, pulmonary nodules and masses, and an edema-like interstitial abnormality are not significantly changed. | Right mainstem bronchus intubation. |
Generate impression based on medical findings. | 63-year-old male with history of head and neck cancer. Evaluate disease status one month post chemo/RT. CHEST:LUNGS AND PLEURA: New subcentimeter micronodule in the left upper lobe (series 5, image 32). While metastasis is considered less likely, appropriate follow-up is recommended. Calcified right upper lobe micro-nodule also noted (best seen on high resolution scan, series 4, image 111), likely benign.No suspicious masses or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.CHEST WALL: Stable sclerosis of left seventh rib. Patient's known left thyroid mass partially visualized (series 3, image1). Please refer to report for dedicated CT soft tissue neck performed on the same date for further characterization.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal nodule.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted. | New left upper lobe micronodule as described above. While metastasis is considered less likely, continued 3 month follow-up is recommended to confirm benignity. Other findings as above. |
Generate impression based on medical findings. | Male, 65 years old.Reason: neutropenic fever History: neutropenic fever Lungs are clear. Heart size within normal limits. Right jugular line tip over the SVC without pneumothorax. | No significant cardiopulmonary abnormality. Right central line with tip over the SVC and no pneumothorax. |
Generate impression based on medical findings. | Female, 52 years old.Productive cough Stable heart size.Patchy airspace opacities, increasing at the right base. No large pleural effusions.Feeding tube in the stomach. Left IJ catheter at the confluence of the brachiocephalic veins. | Patchy airspace opacities increasing at the right base most compatible with infection. |
Generate impression based on medical findings. | Female, 47 years old.Reason: ETT eval History: intubated, cardiogenic shock Stable life support devices including IABP projecting over the aortic arch.Stable cardiomediastinal silhouette.Persistent bibasilar atelectasis and small pleural effusions. No pneumothorax. | No significant interval changes with persistent bibasilar atelectasis and small pleural effusions. |
Generate impression based on medical findings. | Mitral valve replacement Swan-Ganz remains at the pulmonary outflow, just projecting to the right main pulmonary artery. Prosthetic valve, mediastinal chest tubes are all otherwise unchanged yet the ETT and NG have been removedMarked cardiomegaly, decreased lung findings of basilar atelectasis are similar. | ETT and NGT removed |
Generate impression based on medical findings. | Age: 27 yearsGender: FemaleReason for Study: Reason: daily CXR for ARDS and ECMO History: see above ET tube with its tip 1 cm above the carina.NG tube with its tip beyond the margin of the image.ECMO catheter unchanged.Cardiac enlargement with diffuse pulmonary airspace opacities similar to the prior exam. | Support devices unchanged. Stable cardiopulmonary appearance of ARDS/diffuse alveolar damage. |
Generate impression based on medical findings. | Male, 40 years old.Reason: pulmonary edema, pneumonia History: hypoxia Left greater than right pulmonary opacities again noted, not substantially different. Marked cardiomegaly again noted. Left greater than right pleural effusions are likely. Unchanged central venous catheter. | Left greater than right pulmonary opacities again noted, not substantially different |
Generate impression based on medical findings. | Female, 65 years old.Reason: follow up right pleural effusion, catheter in place History: none Right pleural effusion and right Pleurx catheter unchanged.Innumerable pulmonary metastases are stable.Right jugular catheter, tip in SVC.Cholecystectomy clips noted. | Unchanged right pleural effusion and a Pleurx catheter. |
Generate impression based on medical findings. | Female, 74 years old.Pleural effusions. Bilateral crackles. Dual lead ICD is unchanged.Interval extubation.Marked cardiomegaly, unchanged.Bilateral small pleural effusions and moderate pulmonary edema appears similar to prior. | CHF with moderate edema, unchanged. |
Generate impression based on medical findings. | Chest pain Mild cardiomegaly without additional cardiopulmonary abnormality. Cholecystectomy clips | Persistent mild cardiomegaly without superimposed acute new abnormality |
Generate impression based on medical findings. | MRI: There are small areas of acute infarction involving the right insular cortex, and right parietal cortex. There is subarachnoid hemorrhage in the right sylvian fissure, and scattered along the right temporal and occipital lobe sulci as well hemorrhage in the right occipital horn, not as well appreciated on CT. There is moderate diffuse volume loss and scattered T2 signal abnormalities in the periventricular and subcortical white matter most consistent with chronic microvascular ischemic changes. There is a small old right cerebellar hemispheric infarct. There are old pontine infarcts as well with significant encephalomalacia.MRA: There is a short segment of focal severe luminal irregularity and narrowing in the cavernous right internal carotid artery which is favored to represent atherosclerotic disease, much less likely aneurysmal dilatation (series 301 image 61). Only one major branch of the right MCA bifurcation is seen with the other expected large branch or branches presumed to be occluded. A paucity of right MCA vessels is seen more distally. There is luminal irregularity of the right M1 branch without high-grade stenosis. The anterior cerebral arteries are patent. There is no flow related enhancement at the expected location of the distal vertebral arteries. There is a prominent right posterior communicating artery and perhaps a hypoplastic left posterior communicating artery. There is flow related enhancement in both posterior cerebral arteries, right greater than left which may be in part due to decreased caliber of the left posterior cerebral artery as compared to the right. There is probable retrograde filling of the basilar artery tip. The basilar artery is markedly attenuated more proximally. | 1.Small areas of acute infarction involving the right insular cortex and right parietal cortex. Occlusion of one or more of the branches off the right MCA bifurcation is suspected with paucity of distal right MCA branch vessels as compared to the left. Given the mismatch between the large vessel occlusion and few small infarcts, question is raised as to the chronicity of the vessel occlusion.2.Subarachnoid hemorrhage in the right sylvian fissure, right temporal and occipital sulci as well as intraventricular hemorrhage layering in the right occipital horn.3.Short segment high-grade focal stenosis of the distal right cavernous carotid artery with aneurysmal dilatation much less likely.4.Chronic microvascular ischemic changes and old cerebellar and pontine infarcts.5.Occlusion of bilateral vertebral arteries, proximal to mid basilar artery with retrograde filling of the basilar tip predominantly via a patent and large right posterior communicating artery. Again chronicity of these findings is uncertain particularly given the history of a chronic pontine infarct. |
Generate impression based on medical findings. | Male, 79 years old.Reason: esophageal cancer History: s/p minimally invasive esophagectomy Marked improvement in left pleural effusion and near complete resolution of prior left lower lobe atelectasis. Minimal right pleural effusion likely.Apical scarring stable.No new findings. | Near resolution of left basilar opacity and left pleural effusion with no new findings. |
Generate impression based on medical findings. | Female, 84 years old.Reason: assess for pneumonia, fluid overload History: as above Worsening basilar opacities and pleural effusions suggestive of edema with basilar atelectasis on the left.At least mild cardiomegaly is noted. | Worsening opacities suggestive of CHF with pulmonary edema and pleural effusions, although left lower lobe pneumonia or aspiration is in the differential diagnosis. |