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Generate impression based on findings. | Male; 47 years old. Reason: r/o abdominal bleed History: anemia No free fluid is seen within the abdomen. | No free fluid. |
Generate impression based on findings. | Female; 67 years old. Reason: cirrhosis eval for HCC History: cirrhosis LIVER: The liver measures 5.5 cm in length. The liver parenchyma nodular and echogenic with a coarse echotexture. No suspicious lesion is identified. There is a small amount of ascites. The portal vein is patent and demonstrates a normal direction of flow with a peak velocity of 30 cm/sec.BILIARY TRACT: The gallbladder is not distended. There is no cholelithiasis, gallbladder wall thickening or pericholecystic fluid. The common bile duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 20.2 cm in length.RIGHT KIDNEY: The right kidney measures 9.5 cm in length. The renal cortex demonstrates normal echogenicity. There is no hydronephrosis. OTHER: Left kidney measures 12.5 cm in length. There is no hydronephrosis. | 1.Cirrhotic liver morphology without focal hepatic lesion. Small amount of ascites.2.Splenomegaly. |
Generate impression based on findings. | Painless jaundice with a large liver LIVER: No obvious discrete liver mass. Liver length 18.5 cm.GALLBLADDER, BILIARY TRACT: Severe bilobar intrahepatic ductal dilatation associated with severe extrahepatic ductal dilatation. Debris versus tumor within the extrahepatic duct noted. Associated with large porta hepatis mass measuring approximately 4.6 x 3 x 3 cm.PANCREAS: Atrophy of pancreatic body. The pancreas head is not well visualized due to overlying gas.RIGHT KIDNEY: Echogenic parenchyma with multiple cysts. No stone, worrisome mass, stone, or hydronephrosis. Right kidney 9.6 cm in length.OTHER: No ascites. Spleen 7.7 cm in length. | Severe bilobar intrahepatic as well as extrapelvic biliary dilatation secondary to obstruction by large porta hepatis mass. Differential diagnosis includes malignancy either of pancreatic or biliary origin. Would recommend correlation with dedicated cross-sectional imaging.Echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction.Dr. Woodruff notified of findings 2/13/2015; 11:30 am. |
Generate impression based on findings. | Male; 52 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No suspicious mass in the right thyroid bed.LEFT LOBE: Redemonstrated 3 x 3 x 6 mm hyperechoic focus in the left thyroid bed (previously 4 x 3 x 5 cm), unchanged. A new 4 x 3 x 5 mm hypoechoic lesion with flow on color Doppler is seen in the left thyroid bed.ISTHMUS: No suspicious mass in the isthmus bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 6 lymph node measures 3 x 3 x 4 mm. A normal fatty hilum is not identified and there is increased vascularity.Two new abnormal left level 4 lymph nodes are identified. They measure 6 x 3 x 7 and 5 x 3 x 4 cm they demonstrate increased vascularity and have lost their normal fatty hilum. OTHER: No significant abnormality noted. | Abnormal lymph nodes and a new lesion in the left thyroid bed suspicious for recurrence. The thyroid bed lesions are small and may not be amenable to biopsy. The lymph nodes are amenable to biopsy.Findings discussed with Dr. Cohen at 11:43 on 2/13/2015. |
Generate impression based on findings. | Male; 59 years old. Reason: nephrology rec History: AKI RIGHT KIDNEY: The right kidney measures 11.6 cm in length. The cortex demonstrates normal echogenicity. There is no hydronephrosis, shadowing renal stone, or concerning mass identified.LEFT KIDNEY: The left kidney measures 12.8 cm in length. The cortex demonstrates normal echogenicity. There is no hydronephrosis, shadowing renal stone, containing mass identified.URINARY BLADDER: The bladder is decompressed by Foley catheter.OTHER: No significant abnormalities noted. | 1.No hydronephrosis. Normal ultrasound of the kidneys. |
Generate impression based on findings. | Female; 63 years old. Reason: Rising creatinine, decreased urine output, hematuria 3 days ago History: Rising creatinine recent stem cell transplant on chemo. RIGHT KIDNEY: Right kidney measures 9.6 cm in length. Renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, suspicious mass.LEFT KIDNEY: The left kidney measures 12.4 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone or suspicious mass.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on findings. | Female; 46 years old. Reason: R/O Amyloidosis History: Proteinuria Ultrasound guidance and technical assistance were provided for a native right kidney biopsy. Three passes were performed. The procedure was successfully completed. | Successful ultrasound guided biopsy of the native right kidney. |
Generate impression based on findings. | 64-year-old Male. Proteinuria. Ultrasound guidance and technical assistance was provided for a right kidney biopsy. The procedure was successfully completed. Two cores were obtained. | Successful ultrasound guided biopsy of the right kidney. |
Generate impression based on findings. | Female; 57 years old. Reason: r/o fatty liver disease History: elevated GGT LIVER: The liver measures 22.1 cm in length. This diffuse coarse and echogenic with geographic areas of focal sparing. No suspicious lesions are identified.The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 20 cm/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common bile duct measures 5 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas is unremarkable. The body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: The spleen measures 10.2 cm in length.RIGHT KIDNEY: The right kidney measures 11.1 cm in length. There is no hydronephrosis, shadowing renal stone, or suspicious lesion identified. OTHER: The left kidney measures 10.2 cm in length. There is no hydronephrosis, shadowing renal stone or suspicious lesion identified. | Hepatomegaly and diffuse hepatic steatosis. |
Generate impression based on findings. | Male; 64 years old. Reason: hematuria History: hematuria RIGHT KIDNEY: The right kidney measures 12.2 cm in length. There are two simples cysts in the midpole, the largest measures a 2.7 x 3.0 x 3.1 cm. No hydronephrosis, shadowing renal stone, or suspicious lesion is identified.LEFT KIDNEY: The left kidney measures 11.9 cm in length. There is a 0.7 x 0.6 x 0.7 cm simple cyst. No hydronephrosis, shadowing renal stone or suspicious lesion is identified.BLADDER: The bladder is partially distended and incompletely evaluated.OTHER: The prostate measures 5.8 x 4.5 x 5.6 cm. | 1.Bilateral simple renal cysts.2.Enlarged prostate. |
Generate impression based on findings. | Male 23 years old Reason: evaluate for tenderness to scalp, History: pain x over 1 yer Survey ultrasound scanning areas of tenderness on the scalp, in particularly on the right side with comparison to the left side was performed, showing no focal abnormalities. | Normal exam. No focal lesions found. |
Generate impression based on findings. | Declining renal function, evaluate for urinary obstruction. RIGHT KIDNEY: Kidney measures 13.0 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. Midpole exophytic simple cyst measuring 2.5 x 2.6 x 2.5 cm. LEFT KIDNEY: Kidney measures 13.1m in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No hydronephrosis or nephrolithiasis. 2.Right renal simple cyst. |
Generate impression based on findings. | Male; 31 years old. Reason: 31 y/o M with unexplained nausea, vomiting, RUQ u/s requested to rule out gallstones or other etiology History: as above LIVER: The liver has a smooth contour, the parenchyma is normal in echogenicity. It measures 17.7 cm in length. The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 20 cm/sec.BILIARY TRACT: The gallbladder is unremarkable with no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common bile duct measures 2 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The visualized head of the pancreas is unremarkable. The body and tail of the pancreas obscured by overlying bowel gas.SPLEEN: The spleen measures 13.2 cm in length.RIGHT KIDNEY: Right kidney measures 10.6 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis. OTHER: The left kidney measures 10.8 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis. | No cholelithiasis or other ultrasound finding to explain the patient's symptoms. |
Generate impression based on findings. | Ms. MacQueen is a 28-year-old female presenting with a physician palpated lump in the left inferior breast. Per patient, she herself does not palpate any discrete mass. She denies any history of trauma, fever or chills Upon physical exam at the physician palpated area of concern, no discrete mass is appreciated. There is subtle nodularity to the breast parenchyma at this area.A targeted left breast ultrasound was performed for the palpable area of concern. In the left inferior breast 6 o'clock location, approximately 1 cm from the nipple, no suspicious cystic or solid mass is identified. | No sonographic evidence for malignancy. Patient should follow up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female; 48 years old. Reason: goiter History: cough, goiter RIGHT LOBE MEASUREMENTS: 4.7 x 1.8 x 1.5 cmLEFT LOBE MEASUREMENTS: 5.6 x 1.8 x 1.3 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Multiple cystic nodules are seen within the right thyroid lobe. A cyst within the superior pole of the right lobe is spongiform and demonstrates comet tail artifact. This measures 1.1 x 0.6 x 0.8 cm.LEFT LOBE: Multiple cystic nodules are seen within the left thyroid lobe. Within the lower pole is a 0.9 x 0.5 x 0.8 cm cystic nodule.ISTHMUS: At the junction of the isthmus and the left thyroid lobe is a 1.8 x 1.1 x 0.6 cm complex, predominantly cystic lesion mural nodularity and a focus of calcification along the rim. An additional nodule at the junction of the isthmus and the right thyroid lobe has ultrasound characteristics of a colloid nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious lymph nodes identified.OTHER: No significant abnormality noted. | Multinodular goiter. No dominant nodule. |
Generate impression based on findings. | Male; 53 years old. Reason: assess mid back, thoracic fluid collection History: Recently drained mid back, thoracic fluid collection There is a subcutaneous 5.5 x 3.2 x 2.4 cm complex fluid collection in the soft tissues of the back. This extends nearly to the skin surface | 5.5 x 2.2 x 2.4 cm subcutaneous abscess extending nearly to the skin surface. |
Generate impression based on findings. | Male; 33 years old. Reason: eval for obstruction, reason for AKI History: AKI RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: Continued decrease in size of the complex fluid collection along the posterior portion of the transplanted kidney. This currently measures 1.8 x 1.9 x 0.8 cm (previously 2.3 x 1.4 x 1.3 cm).KIDNEY: The transplanted kidney measures 12.7 cm in length. The cortex is echogenic. There is no shadowing renal stone.COLLECTING SYSTEM/URETER: Persistent mild dilatation of the transplant collecting system appearing similar to the prior study.URINARY BLADDER: The bladder wall appears thickened however the bladder is not fully distended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels.The iliac artery and anastomoses are patent. The renal arteries are patent with velocities of 0.4-0.9 m/sec (resistive indices 0.63-0.80). The segmental arteries are patent with velocities of 0.3-0.5 m/sec (resistive indices 0.61-0.66).The arcuate arteries are patent with velocities of 0.2-0.4 m/sec (resistive index 0.62-0.68).The iliac vein and renal vein are patent. OTHER: No significant abnormality noted | 1.Mild hydronephrosis not significantly changed compared to the prior ultrasound.2.Patent transplant renal vasculature.3.Continued decrease in size of perinephric hematoma. |
Generate impression based on findings. | Female; 40 years old. Reason: immobile mass in the left thoracolumbar area History: See Attached Outside Orders. In the midline soft tissues of the mid back is a 8.4 x 9.6 x 3.1 cm fusiform, well circumscribed, solid lesion that is isoechoic to the surrounding fat. There is trace flow on color Doppler. | Solid soft tissue mass in the mid back could represent lipoma however other etiologies are not excluded. |
Generate impression based on findings. | Male; 69 years old. Reason: evaluate for pancreatitis, also evaluate gallbladder for stones/gallstone pancreatitis History: elevated lipase, elevated WBC LIVER: The liver contour is smooth. The parenchyma is coarse and echogenic. The liver measures 18.3 cm in length.The main portal vein is patent and demonstrates a normal direction of flow with a peak velocity 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis. The gallbladder wall is normal thickness and there is no pericholecystic fluid. The common bile duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are normal in appearance. The pancreatic tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 5.6 cm in length.RIGHT KIDNEY: Right kidney measures 12.4 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis. OTHER: The left kidney measures 12.1 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis.Bilateral pleural effusions. | 1.Normal gallbladder, no cholelithiasis.2.No evidence of pancreatitis.3.Hepatomegaly and hepatic steatosis.4.Bilateral pleural effusions |
Generate impression based on findings. | Right upper quadrant pain with nausea and vomiting LIVER: Mildly coarse echotexture again noted. Liver length 19.3 cm. No mass.GALLBLADDER, BILIARY TRACT: Gallbladder sludge and stones without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.1 cm in lengthOTHER: Left kidney 13 cm in length. Spleen 13.6 cm in length. | Gallbladder sludge and stones without acute inflammation or ductal dilatation. Hepatomegaly with coarse echotexture suggestive for fatty infiltration again noted. No ascites. |
Generate impression based on findings. | Lower abdominal pain and tenderness with progression of chronic renal disease RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Increased parenchyma echogenicity again noted. Multiple cysts stable.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels Interval improvement in systolic wave form upstroke now without evidence for delay. No change in diastolic dampening with increased resistive indices again noted. Resistive index of the renal arteries range from 0.8 to 0.9.OTHER: No significant abnormality noted | No change in echogenic renal parenchyma. No evidence for worrisome mass, perinephric collection, or obstruction.Interval improvement in systolic wave form upstroke now without evidence for delay. No change in diastolic dampening consistent with increased parenchymal resistance pattern. |
Generate impression based on findings. | Male 64 years old Reason: Evaluate for hydronephrosis History: Elevated creatinine RIGHT KIDNEY: Echogenic kidney. Right kidney measures 11 cm. no focal lesions or hydronephrosis except for subcentimeter simple cysts.LEFT KIDNEY: Echogenic kidney. Left kidney measures 11 .2 cm. Again noted is upper pole complex cystic lesion measuring 6 x 4.4 cm. This is not significantly changed in size and appearance compared to previous study. No hydronephrosis.URINARY BLADDER: Mild bladder wall thickening.OTHER: Cholelithiasis. | Left upper pole complex cystic lesion. CT or MRI with renal mass protocol is recommended for further evaluation. |
Generate impression based on findings. | Ms. Kelly is a 24 year old female presenting with a physician detected area of "breast thickening" in the right breast. She denies any discrete mass, trauma, or fever/chills. Family history of breast cancer in mother, diagnosed at the age of 56. Upon physical exam at the palpable area of concern, no discrete mass is appreciated.A targeted right breast ultrasound was performed for the palpable area of concern. In the right breast 12 o'clock location, approximately 2 cm from the nipple, no suspicious cystic or solid mass is identified. | No sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Thyroid nodule. Assess interval change. RIGHT LOBE MEASUREMENTS: 5.1 X 1.7 x 1.5 cm, unchanged.LEFT LOBE MEASUREMENTS: 4.5 x 1.6 x 1.2 cm, unchanged.ISTHMUS MEASUREMENTS: 0.2 cm, unchangedRIGHT LOBE: Normal echotexture and size. A predominantly solid isoechoic nodule with a hypoechoic halo is again seen in the inferior pole and is unchanged in appearance and size, measuring 0.6 x 0.5 x 0.4 cm. LEFT LOBE: Normal echotexture and size. No significant abnormality noted.ISTHMUS: Normal echotexture and size. No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are present bilaterally. Right level 4 lymph node measures 0.6 x 0.4 x 0.4 cm. OTHER: No significant abnormality noted. | 1.Normal thyroid size2.Right inferior pole isoechoic thyroid nodule measuring 0.6 cm, unchanged. |
Generate impression based on findings. | Ms. Jadotte is a 55-year-old female presenting with bilateral breast tenderness and self palpated lumps. She has a personal history of bilateral cyst aspiration. Right breast: Upon physical exam at the patient's area of concern in the right breast, no discrete mass is appreciated. A right breast ultrasound is performed for the patient's area of concern. In the right breast 8 o'clock location, approximately 3 cm from the nipple, a normal 4-mm lymph node is identified. There is no suspicious cystic or solid mass seen.Left breast: Upon physical exam of the patient's area of concern in the left breast, no discrete mass is appreciated. A left breast ultrasound is performed for the patient's area of concern. In the left breast 3 o'clock location, approximately 3 cm from the nipple, a 4 mm simple breast cyst is identified. There is no suspicious cystic or solid mass seen. | Benign intramammary lymph node in the right breast. Simple breast cyst in the left breast. No sonographic evidence for malignancy. Patient should follow-up with her primary care physician for bilateral breast tenderness as clinically warranted. As long as the patient's physical examination remains normal, bilateral screening mammogram is next due in Sept 2015. All results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | History of sickle cell disease with, with elevated liver function tests and alkaline phosphatase. LIMITED ABDOMEN | 1.Small sized spleen compatible with sickle cell patient.2.Mildly enlarged liver with normal echotexture. |
Generate impression based on findings. | Ms. Smith is a 16 year old female presenting with a physician detected mass in the right breast. The patient herself does not palpate any abnormality. Upon physical exam at the palpable area of concern, a soft, mobile nontender mass is appreciated in the right lower, inner breast.A targeted right breast ultrasound was performed for the palpable area of concern. In the right breast 5 o'clock location, approximately 2 cm from the nipple, there is a 3.0 x 1.1 x 2.0 cm lobulated hypoechoic solid mass. There is moderate amount of associated vascularity. | Sonographic findings compatible with a fibroadenoma. Due to the size and palpability of this lesion, a surgical consultation is recommended at this time. All results and recommendations were relayed to the patient and her mother at time of dictation.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Female; 52 years old. Reason: evaluate for cirrhosis History: chronic HCV LIVER: The liver measures 14.5 cm in length. The liver surface is smooth and the liver parenchyma demonstrates a normal echotexture. No suspicious mass is identified. There is no ascites.The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 20 cm/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas appear normal. The pancreatic tail is obscured by overlying bowel gas.SPLEEN: 8.3 cm in length.RIGHT KIDNEY: Right kidney measures 10.8 cm in length. The renal parenchyma demonstrates normal echogenicity. There is no suspicious mass, hydronephrosis or shadowing stone. OTHER: The left kidney measures 9.8 cm in length. The renal parenchyma demonstrates normal echogenicity. There is no suspicious mass, hydronephrosis or shadowing stone. | No evidence of cirrhosis. No suspicious liver mass is identified. |
Generate impression based on findings. | Female; 30 years old. Reason: please evaluate for kidney stones or hydronephrosis History: flank and ureter pain in pregnant patient. RIGHT KIDNEY: The right kidney measures 12.1 cm in length. The renal parenchyma is normal in echogenicity. There is minimal caliectasis and hydronephrosis. Within the right kidney is a 6 x 4 x 2 mm nonobstructing renal stone. No suspicious renal mass is identified. LEFT KIDNEY: The left kidney measures 12.6 cm in length. The renal parenchyma is normal in echogenicity. There is minimal caliectasis and hydronephrosis. No shadowing renal stone or suspicious renal mass is identified.OTHER: The bladder is partially distended and incompletely evaluated. | 1.Nonobstructing right renal stone.2.Minimal caliectasis and hydronephrosis bilaterally. |
Generate impression based on findings. | Male; 69 years old. Reason: hematuria History: hematuria history of prostate cancer RIGHT KIDNEY: The right kidney measures 9.2 cm in length. The renal cortex is normal in echogenicity. No shadowing stone, hydronephrosis or worrisome renal mass is identified. LEFT KIDNEY: The left kidney measures 9.5 cm in length. The renal cortex is normal in echogenicity. There is a 1.5 x 1.3 x 1.8 cm simple renal cyst. No shadowing stone, hydronephrosis or worrisome renal mass is identified. URINARY BLADDER: Bladder is nondistended. | 1.Left simple renal cyst. 2.No nephrolithiasis or hydronephrosis. |
Generate impression based on findings. | Male; 48 years old. Reason: 48M PMHx lymphoma as a child w/ radiation S/P AVR/MVR for AS/MS, with transaminitis and elevated bilirubin. Eval for biliary etiologies, possible fatty liver or hepatic congestion? History: none LIVER: The liver measures 16.8 cm in length. The liver surface is smooth and the parenchyma is normal in echotexture. There is no worrisome mass and no ascites. The main portal vein is patent and demonstrates a normal direction of flow with a paucity of 20 cm/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance without wall thickening or cholelithiasis. The common duct measures 2 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are normal in appearance. The tail of the pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 10 cm in length.RIGHT KIDNEY: The right kidney measures 12.0 cm in length. The renal cortex is normal in echogenicity. There is no renal stone, hydronephrosis or worrisome renal mass.LEFT KIDNEY: The left kidney measures 11.3 cm in length. The renal cortex is normal in echogenicity. There is no renal stone, hydronephrosis or worrisome renal massOTHER: No significant abnormalities noted. | Normal ultrasound of the right upper quadrant. No cholelithiasis or evidence of hepatic steatosis. |
Generate impression based on findings. | Male; 52 years old. Reason: Septic with chronically infected kidneys. L perc nephrostomy pulled, R tube still in place. Eval L kidney for hydronephrosis, fluid collection, or signs of infection. History: above RIGHT KIDNEY: The right kidney measures 10.4 cm in length. The renal cortex is echogenic. Within the mid right kidney is a 2.6 x 2.8 x 2.7 cm minimally complex cyst. No shadowing renal stone, hydronephrosis, or worrisome renal mass is identified.LEFT KIDNEY: The left kidney measures 15 cm in length. Renal cortex is echogenic. There is minimal hydronephrosis. Evaluation is somewhat limited but no perinephric fluid collection is seen. No shadowing renal stone or worrisome renal mass is identified.OTHER: Moderate to severe ascites. | 1.Echogenic kidneys consistent with medical renal disease.2.Minimal left hydronephrosis.3.Moderate to severe ascites. |
Generate impression based on findings. | Female; 73 years old. Reason: RUQ ultrasound to evaluate for gallstones in pt with elevated lipase and epigastric pain History: epigastric pain LIVER: The liver measures 17.2 cm in length. The liver contour is smooth, the parenchyma demonstrates coarse echotexture. No worrisome masses identified.The portal vein is patent and demonstrates a normal direction of flow with a peak velocity of 0.33 m/sec.BILIARY TRACT: The gallbladder is normal in appearance without shadowing stones. There is no gallbladder wall thickening or pericholecystic fluid. There is mild intrahepatic biliary ductal dilatation. The common bile duct measures 3 mm, normal.PANCREAS: The pancreas is unremarkable. The body and tail are obscured by overlying bowel gas. There is no ultrasound evidence of pancreatitis.SPLEEN: The spleen measures 1.7 cm in length.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. The renal cortex is echogenic. There is no renal stone or hydronephrosis. No worrisome renal mass is identified. Within the superior pole of the right kidney and a 1.1 x 1.1 x 1.1 centimeter simple renal cyst.OTHER: The left kidney measures 11.7 cm in length. The renal cortex is echogenic. There is no renal stone or hydronephrosis. No worrisome renal mass is identified. | 1.No ultrasound evidence of pancreatitis. 2.Mild intrahepatic biliary ductal dilatation. No cholelithiasis, evidence of acute cholecystitis, or extrahepatic biliary ductal dilatation.3.Echogenic kidneys consistent with medical renal disease. |
Generate impression based on findings. | Female; 63 years old. Reason: Sharp rise in LFTs, s/p stem cell transplant, concern for occlusive process History: Increase in LFTs LIVER: The liver measures 15.3 cm in length. The liver contour is smooth. The parenchyma is increased in echogenicity and coarse in echotexture. Within the left lobe of the liver is a 3.2 x 2.2 x 2.8 cm complex cyst which is not significant changed. No worrisome mass is identified.The main portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.46 m/sec.BILIARY TRACT: Status post cholecystectomy. The common duct measures 8 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas appear unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 12.6 cm in length.RIGHT KIDNEY: The right kidney measures in 12.3 length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass. OTHER: The left kidney measures 11.6 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass. | 1.Echogenic and coarse liver parenchyma consistent with chronic liver disease and/or hepatic steatosis. 2.Stable hepatic cyst. |
Generate impression based on findings. | Thyromegaly on exam with dysphasia RIGHT LOBE MEASUREMENTS: 6.6 x 2.4 x 1.6 cmLEFT LOBE MEASUREMENTS: 7.3 x 2.7 x 1.9 cmISTHMUS MEASUREMENTS: Sir .1 cmRIGHT LOBE: Normal parenchymal echogenicity. Midpole hypoechoic subcentimeter nodule measuring 0.3 x 0.4 x 0.2 cmLEFT LOBE: Normal parenchymal echogenicity. Multiple solid and spongiform nodules. A representative midpole nodule measures 0.9 x 1 x 0.6 cm.ISTHMUS: Normal parenchymal echogenicity.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal side thyroid gland without evidence for enlargement or parenchymal heterogeneity. Multiple left thyroid nodules as described. |
Generate impression based on findings. | Ms. Jacobsen is a 42-year-old female with right breast mastectomy in February 2014 for IDC/DCIS along with a prophylactic left breast mastectomy. She was treated with chemotherapy. She now presents with two palpable areas along the postsurgical scars in the right upper outer breast./right lower axillary region. Upon physical exam at the patient's palpable areas of concern, subtle nodularity is identified at the margin of the implant along the postsurgical scars.A targeted right breast ultrasound was performed for the palpable areas of concern. - in the right lower axillary region, no suspicious cystic or solid mass is identified. The edge of the implant is present at this location.- in the right upper outer breast, no suspicious cystic or solid masses identified. Again, the edge of the implant is present at this location. | No sonographic evidence for malignancy. Patient is scheduled to see Dr. Jaskowiak after this appointment. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Polycythemia vera with elevation in liver enzymes LIMITED ABDOMENLIVER: Mildly echogenic and coarse liver echotexture without mass. The liver length 16.9 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen 15.2 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11 cm in lengthOTHER: Left kidney 11.9 cm in length. No ascites | Mildly coarse and echogenic liver parenchyma suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. No ascites. Mild splenomegaly.Patent hepatic vessels with normal directional flow. |
Generate impression based on findings. | Ms. McWright is a 35-year-old female presenting with a tender palpable abnormality in the left axillary region for the past one week. Upon physical exam of the left axillary region, a subcentimeter pimple-like lesion is identified. There is minimal associated erythema and skin thickening.A targeted left axillary ultrasound was performed for the patient’s area of concern. In the left axillary region, there is a superficial hypoechoic mass measuring 2.0 x 2.7 cm. This mass is located within the dermal layer and is associated with moderate to marked vascularity. Findings are compatible with an inflamed epidermal inclusion cyst, with minimal associated skin thickening. No suspicious cystic or solid mass is identified. | Inflamed epidermal inclusion cyst with no sonographic evidence for malignancy. Patient can try hot compresses for relief of symptoms.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male; 57 years old. Reason: of liver, hep c, screen for hcc History: same LIVER: The liver measures 16.9 cm in length. The liver contour is smooth, the parenchyma is coarse in echotexture and increased in echogenicity. No worrisome mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: Again seen is adenomyomatosis the gallbladder fundus. The gallbladder wall is normal thickness. The common duct measures 5 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.9 cm in length.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, renal stone, or worrisome mass identified. OTHER: The left kidney measures 10.1 cm in length. Again seen within the inferior pole of the left kidney is a 8.4 x 5.9 x 6.0 cm simple cysts (previously 7.4 x 6.6 x 6.2 cm). | Coarse echogenic liver compatible with hepatic steatosis. No worrisome mass is identified. |
Generate impression based on findings. | Female; 65 years old. Reason: r/o bleeding/trauma to abdominal organs History: s/p LVAD, pulsating abdomen No free fluid is seen within the abdomen and pelvis. The liver is echogenic. The right renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. The left kidney is not visualized. | No free fluid within the abdomen and pelvis. |
Generate impression based on findings. | Male; 65 years old. Reason: elevated LFT History: as above LIVER: The liver measured 13.1 cm in length. The liver contour is smooth, the parenchyma is coarse in echotexture and diffusely increased in echogenicity. No worrisome mass is identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: There is no cholelithiasis or gallbladder wall thickening. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.0 cm in length.RIGHT KIDNEY: Right kidney measures 10.0 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. No worrisome renal mass is identified. OTHER: The left kidney measures 11.1 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. No worrisome renal mass is identified. | Echogenic liver compatible with hepatic steatosis. |
Generate impression based on findings. | Male; 42 years old. Reason: change in mass in thyroid bed History: thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No evidence of recurrence.LEFT LOBE: Status post thyroidectomy. There is a heterogeneous focus in the left thyroid bed that measures 7 x 5 x 12 mm (previously 6 x 4 x 17 mm).ISTHMUS: Status post thyroidectomy. No evidence of recurrence.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 3 cervical lymph node seen on the prior study currently measures 8 x 6 x 13 mm (previously 9 x 5 x 15 mm), has a fatty hilum and benign appearance.OTHER: No significant abnormality noted. | Heterogeneous focus in the left thyroid bed is stable in appearance and slightly decreased in size. This again favors a benign etiology however attention to this area on future studies is recommended. |
Generate impression based on findings. | Female; 18 years old. Reason: eval transplant kidney and native kidney, r/o pyelo (fat stranding, etc) History: fever, s/p renal transplant RENAL TRANSPLANT LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: The transplanted kidney measures 17.8 cm in length. There is no shadowing renal stone or worrisome renal mass.COLLECTING SYSTEM/URETER: There is minimal hydronephrosis.URINARY BLADDER: The bladder is not distended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels The renal transplant inflow and outflow vessels are patent.OTHER: The native kidneys are atrophic and echogenic. The right native kidney measures 6.4 cm in length. The left native kidney measures 9.0 cm in length. No fluid collections surrounding the native kidneys. | 1.Atrophic, echogenic native kidneys.2.Minimal hydronephrosis of the transplanted kidney. Patent renal transplant vasculature. 3.No evidence of pyelonephritis. |
Generate impression based on findings. | Male; 59 years old. Reason: GB or liver or biliary tract abn History: ruq pain LIVER: The liver measures 13 cm in length. Cirrhotic liver morphology with nodular contour and coarsened echotexture. No worrisome hepatic lesions are identified.The main portal vein is patent with hepatic pedal flow and a peak velocity of 0.15 m/sec.There is mild ascites.BILIARY TRACT: The gallbladder is nondistended. The gallbladder wall measures 3 mm in thickness, normal. There is no cholecystic fluid. The patient was not tender when scanning over the gallbladder. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized to overlying bowel gas.SPLEEN: The spleen measures 12 cm in length.RIGHT KIDNEY: The right kidney measures 9.5 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing stone. No worrisome mass is identified. OTHER: The left kidney measures 9.8 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing stone. No worrisome mass is identified. | 1.No cholelithiasis, biliary dilatation, or evidence of acute cholecystitis.2.Cirrhotic liver morphology with mild ascites. |
Generate impression based on findings. | Male; 61 years old. Reason: macroadenoma of pituitary; low TSH History: macroadenoma of pituitary RIGHT LOBE MEASUREMENTS: 7.2 x 3.0 x 3.1 cmLEFT LOBE MEASUREMENTS: 7.4 x 1.2 x 2.4 cmISTHMUS MEASUREMENTS: 0.9 cmRIGHT LOBE: Right lobe is enlarged, extending below the level of clavicle. The intrathoracic portion is not well visualized. Multiple nodules are seen in the inferior right thyroid lobe. A mid thyroid nodule measures 1.5 x 1.2 x 1.2 cm it is predominantly isoechoic with small hypoechoic areas. This nodule extends intra-thoracically, the intrathoracic portion is not well visualized.LEFT LOBE: The left lobe is enlarged, extending below the level of the clavicle. Intrathoracic portion is not well visualized. No discrete nodule is seen.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No worrisome lymphadenopathy.OTHER: No significant abnormality noted. | Enlarged thyroid with multiple right lobe nodules. |
Generate impression based on findings. | Male; 69 years old. Reason: RUQ discomfort History: HBV LIVER: The liver measures 15.0 cm in length. The liver contour is smooth. The parenchyma is coarse and diffusely increased in echogenicity. No worrisome mass is identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.15 m/sec. BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis or gallbladder wall thickening. The common duct measures 2 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas is unremarkable. The body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 11.0 cm in length.RIGHT KIDNEY: Status post right nephrectomy. OTHER: The left kidney measures 10.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. Previously seen hyperechoic, non-shadowing lesion in the interpolar region of the left kidney currently measures 6 x 5 x 5 mm, stable since November 2013. | 1.Coarse liver echotexture. No focal mass is identified.2.Stable size and appearance of hyperechoic left renal lesion. |
Generate impression based on findings. | Female; 23 years old. Reason: 23yoF T1DM with Cr 3.0, unclear if AKI on CKD or baseline CKD, p/w flank pain History: as above RIGHT KIDNEY: The right kidney measures 9.1 cm. The renal cortex is echogenic. There is no hydronephrosis, shadowing renal stone, or worrisome mass.LEFT KIDNEY: The left kidney measures 9.1 cm. The renal cortex is echogenic. There is a hydronephrosis, shadowing renal stone, or worrisome mass.URINARY BLADDER: The bladder is nondistended.OTHER: No significant abnormalities noted. | Echogenic kidneys compatible with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Female; 74 years old. Reason: kidney stone? History: flank pain, pyuria, microscopic hematuria RIGHT KIDNEY: The right kidney measures 9.9 cm in length. The renal cortex is echogenic. There is no hydronephrosis, shadowing renal stone, or worrisome mass.LEFT KIDNEY: The left kidney measures 10.3 cm in length. The renal cortex is echogenic. There is no hydronephrosis, shadowing renal stone, or worrisome mass.URINARY BLADDER: The bladder is not distended.OTHER: No significant abnormalities noted. | 1.Echogenic kidneys compatible with medical renal disease.2.No shadowing renal stone or hydronephrosis. |
Generate impression based on findings. | Female; 49 years old. Reason: Large Thyroid mass that extends from the right lobe to the left. History: Large Thyroid mass that extends from the right lobe to the left. RIGHT LOBE MEASUREMENTS: 7.5 x 2.2 x 2.5 cmLEFT LOBE MEASUREMENTS: 7.5 x 2.1 x 1.8 cm ISTHMUS MEASUREMENTS: 3.5 cmRIGHT LOBE: The right lobe is completely replaced by nodules. No dominant nodule is identified. LEFT LOBE: Left lobe is completely replaced by solid nodules with minimal flow on color Doppler. No dominant nodule is identified.ISTHMUS: The Isthmus is completely replaced by solid nodules with minimal flow on color Doppler. No dominant nodule is identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No worrisome lymphadenopathy.OTHER: No significant abnormality noted. | Multinodular goiter. |
Generate impression based on findings. | Female; 55 years old. Reason: evaluate for abdominal wall abscess History: abdominal wall erythema In the subcutaneous tissues superior to the liver along the midline of the abdomen is a complex, loculated fluid collection. This collection measures 3.4 x 1.1 x 2.3 cm and demonstrates no vascularity on color Doppler. | 3.4 x 1.1 x 2.3 cm loculated subcutaneous fluid collection . A benign etiology such as a seroma or resolving hematoma is favored. Abscess is considered less likely. |
Generate impression based on findings. | Male; 44 years old. Reason: Ultrasound of Soft Module Mass over L5-S (Sacrum). Two bumps in lower back for three months. Fluctuating in Size - ? Cyst. In the subcutaneous tissues of the left lower back is a calcified lesion measuring 1.1 cm in craniocaudal dimension. Due to the heavy calcification this lesion cannot be further characterized by ultrasound. Similarly, in the subcutaneous tissues of the right lower back a calcified lesion measures 2.1 cm craniocaudal dimension and cannot be further characterized due to heavy calcification.In the midline of the lower back/sacrum is a subcutaneous solid nodule with no vascularity on color Doppler. This measures 2.7 x 1.9 x 0.7 cm. | 1.Calcified lesions in the subcutaneous tissues superior to the left and right buttocks cannot be further characterized by ultrasound.2.Midline subcutaneous lesion may represent a lipoma however this lesion is considered indeterminate on ultrasound. If clinically indicated, MRI may be considered for further evaluation. |
Generate impression based on findings. | Male; 29 years old. Reason: mild LFT abnormalities, evaluate for hepatic abnormalities History: LFT abnormalities LIVER: The liver measures 12.5 cm in length. Liver surface is smooth. The liver parenchyma is increased in echogenicity with a coarsened echotexture. No worrisome mass is identified. There is no ascites.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.3 cm in length.RIGHT KIDNEY: The right kidney measures 10.2 cm in length. The renal cortex is normal in echogenicity. There is no shadowing renal stone or hydronephrosis. No worrisome mass is identified. OTHER: The left kidney measures 9.2 cm in length. The renal cortex is normal in echogenicity. There is no shadowing renal stone or hydronephrosis. No worrisome mass is identified | Coarse, echogenic liver compatible with hepatic steatosis. |
Generate impression based on findings. | Female; 27 years old. Reason: gallstones, gallbladder wall dilation History: transaminitis, elevated bili LIVER: The liver measures 15.3 cm in length. The contour is smooth and the parenchyma demonstrates a coarsened echotexture.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec. No worrisome hepatic lesion is identified.BILIARY TRACT: Small layering stones are seen within the gallbladder. No gallbladder wall thickening or pericholecystic fluid. No sonographic Murphy sign elicited. The common bile duct is normal and measures 5 mm in diameter. There is no intrahepatic delayed ductal dilatation. No biliary ductal stone is identified.PANCREAS: Head of the pancreas is unremarkable. The body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 9.9 cm in length.RIGHT KIDNEY: The right kidney measures 11.6 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, renal stone, or worrisome mass identified.OTHER: The left kidney measures 10.8 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, renal stone, or worrisome mass identified. | 1.Small layering gallstones without sonographic evidence of cholecystitis.2.Coarsened echotexture of hepatic parenchyma. |
Generate impression based on findings. | Female; 43 years old. Reason: elevated transaminases; +HepBsag LIVER: The liver measures 13.7 cm in length. The surface is smooth. The parenchyma is increased in echogenicity with a coarsened echotexture. The main portal vein is patent and demonstrates pedal flow with peak velocity of 0.2 m/sec. No worrisome masses identified. There is no ascites.BILIARY TRACT: The gallbladder is normal in appearance. There is no shadowing stone or gallbladder wall thickening. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 8.7 cm in length.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. The cortex is normal echogenicity. There is no shadowing stone, hydronephrosis, or worrisome mass identified. OTHER: The left kidney measures 10.3 cm in length and is partially visualized. | 1.Echogenic and coarse liver parenchyma suggestive of chronic liver disease/fatty infiltration. 2.No worrisome hepatic lesion. |
Generate impression based on findings. | Female; 67 years old. Reason: elevated LFT's; liver ultrasound History: Lymphoma and elevated LFT's LIVER: The liver measures 18.7 cm in length. The liver contour is smooth. The parenchyma is diffusely increased in echogenicity and demonstrates a coarsened echotexture. The right lobe of liver, adjacent to the gallbladder fossa is a geographic area of increased echogenicity likely represents focal fatty infiltration or fibrosis. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.16 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is normal in appearance. The body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 12.6 cm in length.RIGHT KIDNEY: The right kidney measures 10.5 cm in length. The cortex is normal in echogenicity. There is minimal hydronephrosis. No shadowing stone or worrisome renal mass is identified. LEFT KIDNEY: The left kidney measures 10.9 cm in length. The cortex is normal in echogenicity. There is mild hydronephrosis. A ureteral stent is seen within the collecting system. No shadowing renal stone or worrisome mass is identified.OTHER: A ureteral stent is seen within the nondistended bladder. | 1.Mild hepatomegaly.2.Increased echogenicity and coarse echotexture compatible with hepatic dysfunction/fatty infiltration.3.Bilateral hydronephrosis. |
Generate impression based on findings. | Male; 67 years old. Reason: Does this patient have hepatosplenomegaly and ascites? History: 67 year old man with insulin dependent diabetes mellitus and recent 20 pound weight loss. History of hepatitis about 30 years ago. Evaluate liver and spleen. LIVER: The liver measures 13.0 cm in length. The liver contour is smooth. The liver parenchyma is coarse and echogenic. Within the left lobe of the liver, adjacent to the gallbladder fossa is an ill-defined hypoechoic area with increased vascularity on color Doppler. There is no ascites.The main portal vein is patent with a peak velocity of 0.31 m/sec.BILIARY TRACT: A large, non-mobile mass (4.8 x 1.9 cm) with internal vascularity occupies much of the gallbladder lumen. This mass is inseparable from the hypoechoic hepatic lesion described above. The common duct measures 5 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 13.4 cm in length and contains a 2.4 x 2.1 x 2.4 cm hypodense lesion.RIGHT KIDNEY: The right kidney measures local 11.2 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 11.3 cm in length. The cortex is normal in echogenicity. At least two simple cysts are seen within the kidney. The cyst in the upper pole measures 2.7 x 1.7 x 2.1 cm, the lower pole cyst measures 1.8 x 1.6 x 1.9 cm. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | 1.Large, nonmobile, vascular mass occupying much of the gallbladder lumen inseparable from hypoechoic adjacent liver lesion. These findings are concerning for gallbladder carcinoma with possible hepatic invasion. Follow up with cross-sectional imaging is recommended.2.Mild splenomegaly with indeterminate 2.4 cm hypodense splenic lesion. 3.Coarse, echogenic liver compatible with hepatic steatosis.These findings were discussed by telephone with Dr. Rogers on 2/18/2015 at 12:00 pmI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male; 68 years old. Reason: evaluate liver for portal venous flow and biliary tree patentcy History: transaminitis LIVER: The liver measures 18.3 cm in length. The liver contour is smooth. The parenchyma is increased in echogenicity with coarse echotexture. Within the left lobe of the liver is a 2.5 x 2.5 x 1.9 cm simple cyst. No worrisome masses identified. There is no ascites.The main portal vein is patent with a peak velocity of 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. The common duct measures 5 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 9.5 cm in length.RIGHT KIDNEY: The right kidney measures 13.2 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass. OTHER: The left kidney measures 13.4 cm in length. The cortex is normal in echogenicity. No hydronephrosis, shadowing stone, or worrisome mass.Small right pleural effusion. | 1.Mild hepatomegaly. Course and echogenic liver compatible with parenchymal dysfunction.2.Patent main portal vein. No biliary ductal dilatation.3.Simple liver cyst. |
Generate impression based on findings. | 54 year-old woman with right breast cancer on chemotherapy. A targeted right ultrasound was performed for the multiple, palpable masses in the right breast and right axilla. At the two o'clock position 4 cm from the nipple, there is a 15 x 13 x 11 mm hypoechoic mass with irregular margins and increased vascularity, previously 15 x 14 x 11 mm.At the 10 o'clock position 5 cm from the nipple there is a 24 x 20 x 9 mm hypoechoic mass with irregular margins and mildly increased vascularity, previously 24 x 18 x 9 mm.An enlarged right axillary lymph node with increased cortical flow is seen and measures 18 x 13 x 6 mm, previously 23 mm in largest dimension. | 1. Unchanged appearance and size of the right breast masses at the 2 o'clock and 10 o'clock position.2. Minimal decrease in size of right axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy without worrisome mass. Stable postoperative echogenic focus within the right thyroidectomy bed measuring 1.3 x 0.4 x 0.4 cm.LEFT LOBE: Status post thyroidectomy without worrisome massISTHMUS: Status post thyroidectomy without worrisome massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination post thyroidectomy without worrisome mass or regional adenopathy. |
Generate impression based on findings. | Male; 61 years old. Reason: History of hepatitis C. Please evaluate for hepatocellular CA. History: As above LIVER: The liver measures 16.5 cm in length. The liver contour is smooth. The parenchyma is diffusely increased in echogenicity with a coarsened echotexture. No worrisome mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.23 m/sec.BILIARY TRACT: The gallbladder is nondistended. Multiple shadowing stones are seen within the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 12.2 cm in length.RIGHT KIDNEY: The right kidney measures 11.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 10.8 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | 1.Coarse and echogenic liver compatible with parenchymal dysfunction. No worrisome hepatic lesion.2.Cholelithiasis without ultrasound evidence of cholecystitis. |
Generate impression based on findings. | Male; 61 years old. Reason: Evaluate known right thyroid nodule History: right thyroid nodule RIGHT LOBE MEASUREMENTS: 5.1 x 1.8 x 1.5 cmLEFT LOBE MEASUREMENTS: 3.8 by 1.6 x 1.3 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: A dominant 2.1 x 2.0 x 1.7 cm solid, hypoechoic right mid thyroid lobe nodule with no calcifications or vascularity on color Doppler.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No worrisome lymphadenopathy.OTHER: No significant abnormality noted. | Dominant 2.1-cm solid right thyroid nodule is amenable to percutaneous ultrasound-guided biopsy. |
Generate impression based on findings. | Female; 43 years old. Reason: large gallstone on bedside US, eval for acute cholecystitis History: RUQ abdominal pain LIVER: The liver measures 18.2 cm in length. Liver contour is smooth. The parenchyma demonstrates a coarsened echotexture. No worrisome hepatic mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.27 m/sec.BILIARY TRACT: Gallbladder is not distended. There is a 2 x 3 cm shadowing stone within the body of the gallbladder. The gallbladder wall is thickened measuring 6 mm. There is no pericholecystic fluid. Sonographic Murphy's sign was not elicited. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 7.9 cm in length.RIGHT KIDNEY: Right kidney measures 10.5 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 10.1 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | Cholelithiasis without acute inflammation or ductal dilatation. Coarsened echogenic liver parenchyma suggestive for fatty infiltration/parenchymal dysfunction without mass. No ascites.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male; 52 years old. Reason: please evaluate for malignancy or worsening portal HTN (ascites) History: 52 yo M with Hereditary hemochromatosis associated cirrhosis LIVER: The liver measures 20.0 cm in length. The liver is nodular in contour, the parenchyma is echogenic and very coarsened in echotexture. Within this limitation, no focal lesion is identified.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.27 m/sec.BILIARY TRACT: Status post cholecystectomy. The common duct measures 8 mm in diameter. There is no intrahepatic biliary duct dilatation.PANCREAS: The the body of the pancreas are unremarkable. The pancreatic tail is not well-visualized due to overlying bowel gas.SPLEEN: The spleen measures 15.4 cm in length.KIDNEYS: Right kidney measures 13.2 cm in length. The left kidney measures 13.7 cm in length. A 2.5 x 1.5 x 2.2 cm simple cyst is seen in the upper pole of left kidney. There is no hydronephrosis, shadowing renal stone, or worrisome renal mass identified in either kidney. OTHER: A 3.5 x 3.8 x 5.3 cm lymph node is again seen in the region of the pancreatic head. | 1.Cirrhotic liver morphology. Within this limitation no focal lesion is identified.2.5.3-cm lymph node again seen near the pancreatic head, stable. |
Generate impression based on findings. | Female; 81 years old. Reason: hx of renal mass, please evaluate History: see above RIGHT KIDNEY: The right kidney measures 9.9 cm in length. Moderate hydronephrosis appears slightly worse when compared to the prior ultrasound. No shadowing renal stone or worrisome renal mass is identified.LEFT KIDNEY: The left kidney measures 8.1 cm in length. The renal cortex is increased in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome renal mass is identified. There is a 3.1-cm simple cysts in the upper pole renal sinus.URINARY BLADDER: The bladder is nondistended.OTHER: No significant abnormalities noted. | 1.Moderate right hydronephrosis slightly worse when compared to the prior ultrasound.2.3.1 cm simple cyst in the right upper pole renal sinus.3.Echogenic kidneys compatible with medical renal disease. |
Generate impression based on findings. | Hepatitis B carrier LIVER: Heterogeneous coarse liver architecture again noted without mass. Liver length 13.3 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 11.1 cm in length.OTHER: Left kidney 10.8 cm in length. Spleen is 9.1 cm in length. No ascites. | Stable heterogeneous coarse liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Epigastric pain LIVER: Normal parenchymal echogenicity without mass. Liver length 13.1 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.2 cm in lengthOTHER: Left kidney 9.8 cm in length. Spleen 9.6 cm in length. No ascites. | Negative right upper quadrant ultrasound. No hepatobiliary abnormality. |
Generate impression based on findings. | Female; 66 years old. Reason: rule out gallstones, cholelithiasis History: RUQ pain, post-prandial - history of well controlled Crohn's disease LIVER: The liver measures 13.7 cm in length. The liver contour is smooth, the parenchyma is diffusely increased in echogenicity with a coarsened echotexture.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal-appearing without cholelithiasis or gall bladder wall thickening. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail of pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 8.2 cm in length.KIDNEYS: The right kidney measures 11.8 cm in length. The left kidney measures 10.6 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis, shadowing renal stone, or worrisome renal mass identified. OTHER: No significant abnormalities noted. | 1.Normal appearing gallbladder, no cholelithiasis.2.Hepatic steatosis. |
Generate impression based on findings. | 64 year old woman with multiple breast cysts, screening mammogram. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A round mass in the left upper outer breast at middle depth appears slightly increased in size. Otherwise, small benign-appearing masses are seen bilaterally, unchanged in size from prior examinations and likely cysts. ULTRASOUND | Cyst in the left breast but no mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female; 45 years old. Reason: history of stage IC3 ovarian cancer, now thyroid nodule seen on recent CT scan History: none RIGHT LOBE MEASUREMENTS: 5.5 x 1.8 x 1.4 cmLEFT LOBE MEASUREMENTS: 4.4 x 1.9 x 1.2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: Arising from the left aspect of the isthmus is a 4.1 x 3.9 x 2.0 cm nodule. This is predominantly solid with small cystic areas during it is somewhat spongiform appearance. Punctate hyperechoic foci appear to have ring down artifact.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.5 x 0.7 x 0.3 cm right level 3 lymph node has a fatty hilum and benign appearance.OTHER: No significant abnormality noted. | Predominately solid 4.1 cm isthmus nodule is amenable to biopsy. |
Generate impression based on findings. | Male; 21 years old. Reason: evaluate for loculated fluid collection associated with pilonidal cyst/abscess History: ongoing induration, foul smelling drainage s/p incision on 01/31/2014 In the region of the patient's incision there is a sinus tract extending to skin surface. It is approximately 6 mm in depth and extends approximately 1 cm craniocaudal. There is no drainable fluid collection and no increased vascularity in this region. | A sinus tract is seen at the site of the patient's incision. No drainable fluid collection was identified. |
Generate impression based on findings. | Female; 84 years old. Reason: concern for abscess History: indurated wound Diffuse subcutaneous edema of the lower back in the area of induration. No fluid collection is identified. | Diffuse subcutaneous edema without drainable abscess. |
Generate impression based on findings. | Male; 63 years old. Reason: evaluate for ascites History: ascites Cirrhotic liver morphology. The bladder is decompressed by a Foley catheter.There is mild ascites in the abdomen and pelvis. | Mild ascites. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid mass identified. A few simple cysts are seen in both breasts. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Female; 59 years old. Reason: Please eval ruq for signs of abscess and liver abnormalities in a pt with gb cancer History: gallbaldder ca, fevers LIVER: The liver measures 16.3 cm in length. The liver is echogenic with a coarsened echotexture. Multifocal, confluent hypoechoic masses are seen in both lobes of the liver and occupy the majority of the right lobe. There is mild ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.56 m/sec.BILIARY TRACT: Status post cholecystectomy. Mild bilobar intrahepatic biliary ductal dilatation. A stent is seen within the common duct which measures 6 mm in diameter.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.9 cm in length.RIGHT KIDNEY: The right kidney measures 9.4 cm in length. The cortex normal in echogenicity There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 11.1 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | 1.Bilobar multifocal confluent liver lesions are favored to represent neoplasm/malignancy. There is no definitive evidence of abscess. Correlation with cross-sectional imaging is recommended for further evaluation.2.Mild bilobar intrahepatic biliary ductal dilatation.3.Mild ascites. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of right breast and right axilla (2/5/15), images from ultrasound guided biopsy (2/9/15) performed at DuPage Medical Group. ULTRASOUND IMAGES OF RIGHT BREAST AND RIGHT AXILLA (2/5/15):Irregularly shaped, microlobulated mass, measuring 23 x 19 x 22 mm, with increased blood fow is visualized at 10 o'clock in the right breast. This mass is highly suggestive for malignancy. An abnormal lymph node with asymmetric cortical thickening is present in the right axilla. One normal appearing lymph node is also present in the right axilla.IMAGES FROM ULTRASOUND GUIDED BIOPSY (2/9/15):A needle biopsy was performed for the right breast mass at 10 o'clock position with an appropriate needle placement. The annotation on the image states that a "buckle clip" is placed within the mass.Per outside pathology report, the biopsy result was malignant, invasive carcinoma grade 3. | Biopsy proven right breast carcinoma, with an abnormal right axillary lymph node. If mammogram has not been performed, it should be performed.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Abnormal LFTs; history breast carcinoma LIVER: Numerous bilobar mass lesions throughout the liver. Liver length 16.7 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without obvious acute inflammation. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.3 cm in lengthOTHER: Left kidney 8.9 cm in length. Spleen 7.8 cm in length. Moderate ascites. Pleural effusions. | Numerous bilobar hepatic mass lesions consistent with extensive hepatic metastases. Cholelithiasis without acute inflammation or ductal dilatation. Moderate ascites. |
Generate impression based on findings. | Female; 31 years old. Reason: eval left neck salivary gland History: left neck tenderness 4 x 4 mm colloid cyst in the right thyroid gland.The patient indicated the area of tenderness on the left neck posterior to the ear. Images obtained in this location reveal no abnormal lymph nodes or fluid collection. The imaged portions of the left submandibular gland are unremarkable. | No ultrasound finding to explain the patient's left neck tenderness. |
Generate impression based on findings. | Female; 57 years old. Reason: RUQ pathology History: sepsis, unknown source of infection, ?gb or biliary source LIVER: The liver measures 21.5 cm in length. The liver surface is smooth. The parenchyma has normal echogenicity. No worrisome mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.22 m/sec.BILIARY TRACT: Layering sludge is seen within the gallbladder. No discrete gallstone is identified. The gallbladder wall measures 5 mm. There is pericholecystic fluid. The common duct measures 3 mm in diameter.There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well-visualized due to overlying bowel gas.SPLEEN: The spleen measures 11.1 cm in length.KIDNEYS: The right kidney measures 12.0 cm in length. The left kidney measures 11.6 cm in length. The renal cortices are echogenic bilaterally. There is no hydronephrosis, shadowing renal stone, or worrisome renal mass identified.OTHER: The bladder is compressed by a Foley catheter.In the midline of the pelvis, superior to the bladder is a well-circumscribed, solid, echogenic mass. | 1.Gallbladder wall thickening and pericholecystic fluid concerning for acute cholecystitis. Sludge is seen layering within the gallbladder but no discrete stone is identified. No biliary ductal dilatation.2.Echogenic kidneys compatible with medical renal disease.3.Hepatomegaly.4.Well-circumscribed midline pelvic mass is favored to represent a pedunculated uterine fibroid; cross sectional imaging would be helpful for further characterization.These findings were discussed by telephone with Dr. Gao on 2/18/2015 at 15:50. |
Generate impression based on findings. | Patient with AML status post chemo with elevated bilirubin LIVER: Echogenic and coarse liver echotexture again noted without mass. Liver length 18.8 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 14 cm in lengthOTHER: Left kidney 13.4 cm in length. Spleen 14.4 cm in length. No ascites | Coarse and echogenic liver echotexture again noted consistent with fatty infiltration/parenchymal dysfunction without mass or duct dilatation. Mild hepatomegaly. No ascites. |
Generate impression based on findings. | Female; 67 years old. Reason: usg of liver, cirrhosis, screen for hcc, also f/u GB polyps LIVER: Liver is normal in size measuring 15.1 cm in length. Parenchyma diffusely echogenic with a coarse echotexture. A 1.1 x 1.2 x 1.1 cm simple cyst is seen in the right lobe of the liver, unchanged. No worrisome focal hepatic lesion evident. There is no ascites. The main portal vein is patent with normal hepatopetal flow and a peak velocity of 0.1 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance with a 5 x 4 x 1 mm gallbladder polyp, without significant change. No evidence of cholelithiasis, gallbladder wall thickening or pericholecystic fluid. The common bile duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 12.0 cm in length. The renal cortex is echogenic. No evidence of hydronephrosis or hydroureter. No shadowing caliculi evident.LEFT KIDNEY: The left kidney measures 11.2 cm in length. The renal cortex is echogenic. No evidence of hydronephrosis or hydroureter. No shadowing caliculi evident.SPLEEN: The spleen measures 8.9 cm in length. | 1.Cirrhotic liver, no worrisome hepatic mass.2.Gallbladder polyp.3.Echogenic kidneys suggestive of medical renal disease. |
Generate impression based on findings. | Male; 64 years old. Reason: new AKI on CKD, recent clots, portable exam History: AKI RIGHT KIDNEY: The right kidney measures 9.5 cm in length. The renal parenchyma is echogenic. Again seen is a simple appearing cyst in the upper pole of the kidney which measures 2.7 x 2.4 x 2.7 cm on the current study. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 9.6 in length. The renal parenchyma is echogenic. There is no hydronephrosis or shadowing renal stone.URINARY BLADDER: The bladder is not distended. | 1.Echogenic kidneys consistent with medical renal disease.2.Simple appearing renal cyst. |
Generate impression based on findings. | 24-year-old with right breast mass. The patient is unable to describe the area of concern. However, a clinic note shows the area of concern to be in the right upper outer quadrant. A targeted right ultrasound was performed for the clinical area of concern. There is no solid or cystic mass identified. Dense parenchymal tissue is seen, and this could account for a clinically palpable area of concern. | No sonographic evidence for malignancy. Dense parenchymal tissue in the right upper outer quadrant. Clinical correlation with this finding is recommended. The patient will be in touch with Dr. Dade to ensure these benign findings are concordant with her physical exam. If there is any question of discordance, further evaluation could include referral to a breast surgeon.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Male; 61 years old. Reason: HCV please assess for cirrhosis and assess for mass LIVER: The liver is enlarged measuring 18.2 cm in length. The liver surface is smooth, the parenchyma is heterogeneous with a coarse echotexture. No focal hepatic lesion is identified. The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.35 m/sec.BILIARY TRACT: There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Gallbladder polyposis measuring up to 4 x 3 x 4 mm. The common bile duct measures 7 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.6 cm in length.RIGHT KIDNEY: The right kidney measures 9.5 cm in length. The renal parenchyma is echogenic. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: The left kidney measures 10.4 cm in length. The renal parenchyma is echogenic. There is no hydronephrosis or shadowing renal stone. | 1.Hepatomegaly. Heterogeneous, coarse liver suggestive of hepatic steatosis/parenchymal dysfunction.2.No focal hepatic lesion.3.Gallbladder polyposis.4.Echogenic kidneys suggestive of medical renal disease. |
Generate impression based on findings. | Female; 36 years old. Reason: Outside Request: abdominal pain x 1 day LIVER: The liver measures 12.5 cm in length. The liver surface is smooth. The parenchyma is normal in echogenicity and architecture. No focal hepatic mass is identified. The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no gallbladder wall thickening or pericholecystic fluid. The common bile duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: Head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 8.5 cm in length.RIGHT KIDNEY: The right kidney measures 9.7 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: The left kidney measures 8.9 cm in length. The renal mass normal echogenicity. There is no hydronephrosis or shadowing renal stone. | Normal ultrasound of the right upper quadrant. |
Generate impression based on findings. | Female; 56 years old. Reason: History of multinodular goiter with tenderness to left palpable nodularity. RIGHT LOBE MEASUREMENTS: 5.1 x 1.7 x 1.4 cmLEFT LOBE MEASUREMENTS: 5.5 x 1.8 x 1.2 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: The right lobe is heterogeneous. In the lower pole is a mildly hypoechoic, heterogeneous solid nodule which measures 1.6 x 1.0 x 0.9 cm (previously 1.5 x 1.0 x 1.0 cm).LEFT LOBE: Multiple heterogeneous nodules are seen in the left lobe. A dominant nodule in the midpole heterogeneous with solid components and internal vascularity measures 1.6 x 1.2 x 0.7 cm (previously 1.6 x 1.1 x 0.8 cm). This is stable in appearance compared to the prior ultrasound.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.8 x 0.9 x 0.6 cm right level 2 and 1.7 x 0.9 x 0.8 cm left level 2 lymph nodes have a normal ultrasound appearance with a fatty hilum. | 1.Multinodular thyroid not significantly changed compared to the prior study.2.Bilateral prominent level 2 lymph nodes with a normal ultrasound appearance are likely reactive in etiology. |
Generate impression based on findings. | History of hepatitis B, screen for hepatocellular carcinoma. LIVER: The liver measures 13.0 cm in length. There is mildly coarse echotexture of the liver parenchyma. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is a comet artifact arising from the gallbladder wall consistent with adenomyomatosis. There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.3 cm in length. RIGHT KIDNEY: Kidney measures 9.9 cm in length. The parenchyma is slightly echogenic. No hydronephrosis. Stable echogenic focus in the upper pole measuring 0.7 x 0.6 x 0.4 cm. LEFT KIDNEY: Kidney measures 10.1 cm in length. The parenchyma is slightly echogenic. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Mildly coarse echotexture of the liver. No focal masses or ascites is present.2.Mildly echogenic renal parenchyma bilaterally consistent with medical renal disease.3.Adenomyomatosis/cholesterolosis of the gallbladder. |
Generate impression based on findings. | Female; 67 years old. Reason: hep c screen for hcc History: same LIVER: The liver measures 18.8 cm in length. The liver contour is smooth, the parenchyma is mildly increased in echogenicity. No hepatic mass is identified. The main portal vein is patent and demonstrates hepatopetal flow with peak velocity of 0.39 m/sec.BILIARY TRACT: The gallbladder is contracted. There is no pericholecystic fluid, sonographic Murphy's sign was not elicited. The proximal common bile duct is prominent measuring 9 mm, increased from 7 mm seen on April 2010 ultrasound study. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.1 cm in length.RIGHT KIDNEY: Right kidney measures 10.3 cm in length. The cortex is increased in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 9.5 cm in length. The cortex is increased in echogenicity. A hypoechoic structure in the superior pole measures 1.1 x 1.3 x 1.1 cm and contains internal echoes and is heterogeneous. This was not definitely seen on the prior sonographic studies. There is no hydronephrosis or shadowing renal stone. | 1.Hepatomegaly. Mildly echogenic liver suggestive of parenchymal dysfunction. 2.No hepatic mass.3.Bilateral echogenic kidneys compatible with medical renal disease.4.Prominent proximal common bile duct, correlation with patient's clinical history and laboratory values recommended, if there is clinical concern for choledocholithiasis, MRCP or ERCP is recommended.5.1.3 cm hypoechoic left renal structure is indeterminate. Contrast enhanced CT or MRI is recommended for further evaluation. |
Generate impression based on findings. | Female; 47 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer, 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No residual thyroid tissue. No suspicious lesion.LEFT LOBE: No residual thyroid tissue. No suspicious lesion.ISTHMUS: No residual thyroid tissue. No suspicious lesion.LYMPH NODES: Two prominent level 4 lymph nodes on the left are seen. The largest measures 1.2 x 0.6 x 0.5 cm and has a fatty hilum. A left level 6 lymph node near the clavicle measures 0.7 x 0.3 x 1.1 cm and has a fatty hilum. | 1.No evidence of recurrence in the thyroid bed. 2.A few prominent bilateral lymph nodes have a normal appearing fatty hila and are likely benign reactive nodes. |
Generate impression based on findings. | Ms. Wassenhove is an 87 year old female with a personal history of left breast cancer on neoadjuvant therapy. She needs ultrasound evaluation to evaluate imaging response. On physical exam, there is a 1.5-cm palpable mass at the two o'clock position of the left breast. A targeted left breast ultrasound was performed for the palpable area of concern. In the left breast 2 o'clock location, approximately 5 cm from the nipple, a 1.4 x 1.2 x 1.4 cm irregularly shaped hypoechoic mass is identified with hyperechoic halo. This mass previously measured 1.5 x 1.3 x 1.8 cm in 12/2014. | Little interval change in size of known left breast cancer.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male; 60 years old. Reason: 60 y/o M with PMH of SVT with likely lipoma on upper back, please ultrasound and evaluate On the right upper back at the site of the palpable abnormality is a 6.2 x 1.6 x 4.5 cm intramuscular, ovoid structure which is isoechoic to the adjacent muscle with thin internal striations that are parallel to the long axis of the structure itself. Portions of the border of this lesion are not easily discernible from the adjacent muscle. There is no internal vascularity seen on color Doppler. | 6.2 x 1.6 x 4.5 cm intramuscular structure is most compatible with a lipoma. Other benign etiologies such as normal variant of the musculature are also considered. |
Generate impression based on findings. | Ms. Goodman is a 20-year-old female presenting with bilateral palpable breast masses for the past 6 years. According to the electronic medical record, patient has had multiple prior ultrasounds, a biopsy revealing fibroadenoma in 2013 and recommendations to see a breast surgeon. This history was gathered after the exam was done, as at the time of examination today the patient did not provide any of this history. Upon physical exam of the right breast, at least 3 palpable masses are identified, the largest of which is in the right lower inner breast.Targeted right breast ultrasound is performed for the patient's areas of concerns.- 5 o'clock location: 3.1 x 1.6 x 2.2 cm, compared to 3.3 x 1.8 x 2.6 cm.- 9 o'clock location: 1.6 x 1 .0 x 1.7 cm, compared to 1.8 x 1.1 x 1.8 cm- 10 o'clock location: 1.0 by 0.4 x 1.2 cmUpon physical exam of left breast, at least for palpable masses are identified, the largest of which is in the left lower inner breast.Targeted left breast ultrasound is performed for the patient's area of concerns.- 7 o'clock location: 3.2 x 1.2 x 3.6 cm, compared to 3.7 x 2.0 x 3.5 cm.- 3 o'clock location: 1.1 x 0.7 x 1.2 cm- 12 o'clock location: 0.9 x 0.8 cm, compared to 0.9 x 1.2 cm.- 12 o'clock location: 1.1 x 0.6 cm | Multiple bilateral hypoechoic masses, likely representing fibroadenomata. Surgical consultation is recommended for this patient. All results and recommendations were thoroughly discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Female; 41 years old. Reason: evaluate for hydronephrosis History: recent kidney stone diagnosis The exam is somewhat limited due to patient body habitus.RIGHT KIDNEY: The right kidney measures 13.0 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone identified.LEFT KIDNEY: The left kidney measures 13.7 cm in length. There is normal echogenicity. There is a hydronephrosis or shadowing renal stone identified.URINARY BLADDER: The bladder is nondistended. | No hydronephrosis or shadowing renal stone. |
Generate impression based on findings. | 44 year old woman with history of calcifications seen on screening mammogram 1/23/15. Also complains of a palpable mass in right superolateral axilla. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Regional, round calcifications are seen in the left superolateral breast. These are highly likely benign based on distribution and morphology. ULTRASOUND | 1. Regional round calcifications in the left superolateral breast are highly likely benign. Followup with unilateral diagnostic mammogram is recommended in 6 months. Recommendation was discussed with and provided to the patient in writing.2. Sebaceous cyst of the right axilla.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Female; 44 years old. Reason: abdominal pain associated with food, negative EGD History: abdominal pain LIVER: The liver measures 14.4 cm in length. The liver surface is smooth, the parenchyma is mildly increased in echogenicity but normal in echotexture. Within the right lobe of liver is a 1.3 x 1.2 x 1.3 cm hyperechoic focus with no flow on color Doppler.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, wall thickening or pericholecystic fluid. The common duct measures 0.1 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.4 cm in length.KIDNEYS: The right kidney measures 10.6 cm in length, the left measures 10.7 cm in length. There is no hydronephrosis or shadowing renal stone bilaterally. | 1.No cholelithiasis or evidence of cholecystitis.2.1.3 cm echogenic focus in the right lobe of the liver. Benign etiologies such as focal fat or hemangioma are favored. |
Generate impression based on findings. | Male; 61 years old. Reason: 61 y/o M with elevated ALT, RUQ u/s requested to rule out fatty liver disease LIVER: The liver measures 15.2 cm in length. The liver contour is smooth. The parenchyma is markedly increased in echogenicity with a coarsened echotexture. There is a geographic area of sparing adjacent to gallbladder fossa. These findings limit sensitivity for identification of focal hepatic masses.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.2 m/sec.BILIARY TRACT: A small amount of debris is seen layering within the dependent portions of the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 0.3 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9 .0 cm in length.KIDNEYS: The right kidney measures 11.1 cm in length, the left kidney measures 11.4 cm in length. There is no hydronephrosis or shadowing renal stone bilaterally. | Echogenic and coarse liver parenchyma compatible with hepatic steatosis. |
Generate impression based on findings. | Female; 78 years old. Reason: 78 yo f w/ elevated lfts, concern for fatty liver vs. biliary disease History: elevated lfts LIVER: The liver is enlarged and measures 19.3 cm in length. The liver contour is smooth, the parenchyma is normal in echogenicity. No worrisome mass is identified.BILIARY TRACT: Punctate shadowing stones are seen within the gallbladder. There is no gall bladder wall thickening or pericholecystic fluid. There is mild intrahepatic biliary ductal dilatation. The common hepatic duct measures 4 mm in diameter, the common bile duct measures 10 mm in diameter. No shadowing stones are seen within the duct.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.3 cm in length.KIDNEYS: The right kidney measures 10.9 centimeters in length and contains a 6 x 7 x 5 mm simple cyst. The left kidney measures 11.5 cm in length. Bilaterally there is no hydronephrosis or shadowing renal stone, the renal cortex is normal in echogenicity. OTHER: No significant abnormalities noted. | 1.Hepatomegaly.2.Mild intra-and extrahepatic biliary ductal dilatation. No stones are seen within the ducts. This finding may be age-related rather than secondary to an obstructive process. |
Generate impression based on findings. | 28 year old woman with history of mastalgia in the lateral right breast. A targeted right breast ultrasound was performed for the patient’s area of concern. No solid or cystic mass was identified. | No sonographic evidence for malignancy. Clinical follow up for her pain is recommended. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female; 63 years old. Reason: of biliary tree, mid-epigastric and right upper quadrant pain, evaluate biliary tree LIVER: The liver measures 15.9 cm in length. The liver contour is smooth, the parenchyma demonstrates a coarsened echogenicity. There is no focal hepatic lesion identified. The main portal vein is patent with hepatopetal flow and a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, gallbladder wall thickening or pericholecystic fluid. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gasSPLEEN: The spleen measures 7.2 cm in length.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. Left kidney measures 10.8 cm in length. The cortex is increased in echogenicity. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: Left kidney measures 10.8 cm in length. The cortex is increased in echogenicity. There is no hydronephrosis or shadowing renal stone. Two cysts are seen within the lower pole of the kidney. The largest measures 2.4 x 1.9 x 2.0 cm (previously measured 3.5 x 2.1 x 2.5 cm) and is minimally complex. The second cyst is simple in appearance and measures 1.3 x 1.2 x 1.1 cm.OTHER: No significant abnormalities noted. | 1.Coarsened liver echotexture without focal hepatic lesion.2.No cholelithiasis or biliary ductal dilatation.3.Echogenic kidneys bilaterally compatible with medical renal disease.4.Minimally complex left lower pole kidney cyst measures smaller on the current study which may be to technical differences and the lobulated configuration of the lesion. |
Generate impression based on findings. | Female 25 years old; Reason: 25 y.o. female with hyperparathyroidism. Ultrasound shows left thyroid nodule measuring 1.5x0.7x0.8cm. RIGHT LOBE MEASUREMENTS: 4.1 x 1.1 x 1.2 cmLEFT LOBE MEASUREMENTS: 4.1 x 1.2 x 1.3 cmISTHMUS MEASUREMENT: 0.1 cmRIGHT LOBE: Normal appearing thyroid gland with no dominant nodule.LEFT LOBE: Normal appearing thyroid gland with no dominant nodule.ISTHMUS: No significant abnormality noted.LYMPH NODES: 0.9 x 0.7 x 0.2 cm left level 5 lymph node with a fatty hilum, favoring benignity.OTHER: Posterior to the superior pole of the left lobe of the thyroid is a 1.3 x 1.0 x 0.6 cm hypoechoic structure with increased vascularity relative to the adjacent thyroid. This correlates with the structure seen on the outside study where it measured 1.5 x 0.7 x 0.8 cm. | 1.Hypoechoic structure with increased vascularity relative to the adjacent thyroid appears extrathyroidal in location. The characteristics of this lesion support the diagnosis of a parathyroid adenoma rather than a thyroid nodule. |
Generate impression based on findings. | Male 53 years old; Reason: r/o recurrence History: h/o thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomy ISTHMUS MEASUREMENT: Status post thyroidectomyRIGHT LOBE: No suspicious nodule in the thyroid bedLEFT LOBE: No suspicious nodule in the thyroid bedISTHMUS: No suspicious nodular in the thyroid bedLYMPH NODES: 1.0 x 0.7 x 0.4 cm right level 2 lymph node with a fatty hilum .OTHER: No significant abnormality noted. | 1.Status post thyroidectomy. No evidence of disease recurrence.2.Prominent right level 2 lymph node has a benign appearance and is likely reactive in etiology. |